Finley, Erin P; Noël, Polly H; Lee, Shuko; Haro, Elizabeth; Garcia, Hector; Rosen, Craig; Bernardy, Nancy; Pugh, Mary Jo; Pugh, Jacqueline A
Significant changes in national health policy, like the Veterans Choice Act, have created growing opportunities for veterans to receive care outside of the Veterans Administration (VA), yet little is known about the attitudes and practices in PTSD care of community providers, particularly their use of evidence-based psychotherapies (EBPs). The authors assessed psychotherapy practices of community providers serving veterans with PTSD in Texas. They surveyed Texas mental health providers regarding their patient population, practice setting, and posttraumatic stress disorder (PTSD)-related screening, assessment, and treatment practices. They identified providers from state licensing board rosters and included a stratified sample of social workers, marriage and family therapists, and professional counselors (500 each), all psychologists with available email addresses (n = 3,986), and 106 providers known to have completed state-sponsored training for 1 of the EBPs for PTSD, cognitive processing therapy. Four hundred sixty-three eligible respondents returned surveys (15% response rate). Providers reported treating a mean of 7.9 veterans with PTSD in the past year (range = 0-200; SD = 20.5), using a variety of therapeutic approaches for PTSD. Only 15.0% of providers reported regularly conducting psychotherapy for PTSD following a treatment manual, and fewer than half reported any use of EBPs for PTSD with patients. Although many veterans are receiving treatment for PTSD in the community, many community-based mental health providers in Texas do not consistently use recommended treatments for PTSD. These findings may suggest an important opportunity for VA to engage and partner with community providers to achieve high-quality care for veterans. (PsycINFO Database Record
Park, Alayna L; Moskowitz, Andrew L; Chorpita, Bruce F
The goal of this study is to explore providers' patterns of implementation by investigating how community mental health providers selected therapy practice modules from a flexible, modular evidence-based treatment working with youths with comorbid mental health problems. Data were obtained from 57 youths, 5-15 years old, presenting with anxiety, depressive, and/or conduct problems and their 27 providers during their participation in an effectiveness trial involving a modular evidence-based treatment. Although all youths evidenced clinically elevated symptomatology in at least two problem areas, providers targeted youths' comorbid problems with only about half of their study cases. Practice modules indicated for youths' comorbid problems were typically used less frequently and with less depth relative to practice modules indicated for youths' principal clinical problem and were often transdiagnostic in nature (i.e., designed to target more than one problem area). To determine whether providers' decisions to target youths' comorbid problems were systematic, multilevel, logistic regression analyses were conducted and revealed that youths' pretreatment characteristics and time in therapy influenced providers' patterns of module selection. Providers tend to use, but not exploit, the flexibility allowed by modular EBTs and to focus treatment on youths' principal presenting problem. In addition, providers appear to make these practice choices in a systematic and rational manner, and whether and which choices are associated with improved outcomes is an important area of future study.
Mooney, Kelly; Moreno, Candice; Chung, Paul J.; Elijah, Jacinta; Coker, Tumaini R.
Background Community health centers (CHCs) are a key element of the health care safety net for underserved children. They may be an ideal setting to create well-child care (WCC) clinical practice redesign to drastically improve WCC delivery. Objective To examine the perspectives of clinical and administrative staff at a large, multisite urban CHC on alternative ways to deliver WCC services for low-income children aged 0 to 3 years. Methods Eight semistructured interviews were conducted with 4 pediatric teams (each consisting of 1 pediatrician and 2 medical assistants) and 4 CHC executive/administrative staff (Medical Director, COO, CEO, and Nurse Supervisor). Discussions were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. Salient themes included WCC delivery challenges and endorsed WCC clinical practice redesign solutions. Results The 3 main WCC delivery challenges included long wait times due to insurance verification and intake paperwork, lack of time for parent education and sick visits due to WCC visit volume, and absence of a system to encourage physicians to use non–face-to-face communication with parents. To address WCC delivery challenges, CHC providers and administrators endorsed several options for clinical practice redesign in their setting. These included use of a health educator in a team-based model of care, a previsit tool for screening and surveillance, Web site health education, a structured system for non–face-to-face (eg, phone) parent communication, and group visits. Conclusion CHC-specific strategies for WCC clinical practice redesign endorsed by a large, multisite safety net clinic may lead to more efficient, effective, and family-centered WCC for low-income populations. PMID:24327599
DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn
Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…
Paynter, Jessica M.; Keen, Deb
This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use…
Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the
Mohan, Bishav; Aslam, Naved; Ralhan, Upma; Sharma, Sarit; Gupta, Naveen; Singh, Vivudh Pratap; Takkar, Shibba; Wander, G.S.
Introduction Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Appropriate blood pressure measurement techniques are the cornerstone of clinical acumen. Despite the clear guidelines on BP measurement technique, there seems to be large inter-observer variations. Aim & methods A prospective, observational study was done to assess the knowledge and to study the current practices of office BP measurement among the 400 medical and paramedical staff working in various hospitals of a northern district of India. A single observer under the supervision of investigators observed all the participants and a proforma was filled based on AHA guidelines. After observing BP measurement technique scoring was done (≤8 question correct = inaccurate practices, >9 questions correct = accurate practices). Similarly, the knowledge was assessed by giving a pretested questionnaire. Results 5.85 % of the medical staff had excellent knowledge and 80% of the doctors and 62% of the paramedical staff had good knowledge about BPM. Only 1.47% (3 doctors) and 0.5% (1 nurse) had accurate practices. There was no correlation between knowledge and practices. Conclusions We conclude that the right technique and knowledge of blood pressure measurement among community health providers is inadequate and warrants further interventions to improve. PMID:25173197
Prasad, V S; Duggal, M; Aggarwal, A K; Kumar, R
It is seen that outcome of animal bites is influenced by various factors including the treatment procedures practiced by health care providers (HCPs). A cross sectional study of health care providers was conducted during May 2000 in PHC Kurali and Naraingarh town of community development block Naraingarh in district Ambala, Haryana. A total of forty-four HCPs were interviewed at their health facility. They were asked about the qualification and number of years in practice. Health care providers were assessed for their knowledge regarding history taking, immediate management of animal bite, post bite anti-rabies treatment, follow up advice and availability of vaccines. Pre-exposure prophylaxis was known to 18.8% of HCPs. Fifty-nine per cent of HCPs were confident in managing dog bites and 93.1% knew about tissue culture vaccine. Vaccine cost was the commonest barrier (38.8%) in the management of animal bites. This study shows a gross difference between awareness and actual practice of management of animal bites.
Newman, Janet; Fazio, Vincent J; Caradoc-Davies, Tom T; Branson, Kim; Peat, Thomas S
To provide an experimental basis for a comprehensive molecular modeling evaluation study, 500 fragments from the Maybridge fragment library were soaked into crystals of bovine pancreatic trypsin and the structures determined by X-ray crystallography. The soaking experiments were performed in both single and pooled aliquots to determine if combination of fragments is an appropriate strategy. A further set of data was obtained from co-crystallizing the pooled fragments with the protein. X-ray diffraction data were collected on approximately 1000 crystals at the Australian Synchrotron, and these data were subsequently processed, and the preliminary analysis was performed with a custom software application (Jigsaw), which combines available software packages for structure solution and analysis.
Lim, Ahnate; Nakamura, Brad J; Higa-McMillan, Charmaine K; Shimabukuro, Scott; Slavin, Lesley
Enhancing the public health impact of evidence-based practices (EBPs) in usual care settings is a key priority of the National Institute of Mental Health. Longitudinal data from community mental health providers (N = 268) participating in a series of state-sponsored workshops in modular approaches to EBPs for youth are presented. EBP workshop attendance for youth anxiety resulted in increased knowledge for EBPs for anxiety (and not other conditions) and EBP workshop attendance for youth disruptive behaviors resulted in increased knowledge for EBPs for disruptive behaviors (and not other conditions). Providers' tendencies toward incorrectly classifying non-EBP therapies as evidence-based increased over time, suggesting that providers over-generalize the EBP label as a result of attending these types of workshops. Regarding EBP attitudes, most measures of attitudes improved when providers attended a workshop. Additionally, an overly inclusive view of what constitutes an EBP at intake was related to significant decreases in openness to trying EBPs over time, whereas more positive attitudes at intake was related to achieving a more refined view of what constitutes an EBP over the course of attending trainings. Study limitations and implications for implementation of EBPs in usual care settings are discussed.
Ball, Samuel; Bachrach, Ken; DeCarlo, Jacqueline; Farentinos, Chris; Keen, Melodie; McSherry, Terence; Polcin, Douglas; Snead, Ned; Sockriter, Richard; Wrigley, Paulen; Zammarelli, Lucy; Carroll, Kathleen
The successful dissemination of empirically supported addiction therapies to community providers requires an appreciation of the characteristics of those practitioners who might be willing participants in this process of technology transfer. Clinicians (N = 66) from 11 community treatment programs associated with six research-clinic partnerships of the National Drug Abuse Clinical Trials Network volunteered to be trained in Motivational Interviewing or Motivational Enhancement Therapy (MET/MI) and were assessed prior to training. The sample of clinicians was heterogeneous in education and credentials, had a high level of counseling experience, reported using a wide range of counseling techniques and orientations, but had limited prior exposure to MET/MI or to the use of treatment manuals of empirically supported therapies. In general, many of the clinicians reported beliefs and techniques that were consistent with their stated theoretical orientation and recovery status. Relatively few participants reported relying on one dominant orientation or set of techniques.
Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices
Background Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial. Methods 80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2. Results Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby’s first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and
Piatt, Jennifer A.; Jorgensen, Lisa J.
Individuals with disabilities currently represent the largest minority group in the United States, yet recreation undergraduate students often perceive this as a population they may or may not provide services to in their future careers. The activities presented in this paper, Inclusion Knowledge Audits (IKA), are developed to make the connection…
Communities of practice are emerging as an innovative approach to faculty development. While collaborative learning is becoming popular in the classroom, autonomy and individualism continue to dominate the culture of higher education for faculty. However, as we begin to recognize that old solutions to new problems are no longer effective, there is…
Rose, Deborah F.; Smith, Barbara J.
As public school personnel struggle to provide preschool-age children with disabilities with high quality, normalized or inclusive preschool experiences, there is an increased need for collaboration with community-based early childhood providers. This paper addresses the federal legal requirements for public school, Head Start, and community-based…
De Leon, Samantha; Connelly-Flores, Alison; Mostashari, Farzad; Shih, Sarah C
Electronic health records (EHRs) are expected to transform and improve the way medicine is practiced. However, providers perceive many barriers toward implementing new health information technology. Specifically, they are most concerned about the potentially negative impact on their practice finances and productivity. This study compares the productivity of 75 providers at a large urban primary care practice from January 2005 to February 2009, before and after implementing an EHR system, using longitudinal mixed model analyses. While decreases in productivity were observed at the time the EHR system was implemented, most providers quickly recovered, showing increases in productivity per month shortly after EHR implementation. Overall, providers had significant productivity increases of 1.7% per month per provider from pre- to post-EHR adoption. The majority of the productivity gains occurred after the practice instituted a pay-for-performance program, enabled by the data capture of the EHRs. Coupled with pay-for-performance, EHRs can spur rapid gains in provider productivity.
Huerta, Juan Carlos; Hansen, Michele J.
Good assessment is part of all good learning communities, and this article provides a useful set of best practices for learning community assessment planning: (1) articulating agreed-upon learning community program goals; (2) identifying the purpose of assessment (e.g., summative or formative); (3) employing qualitative and quantitative assessment…
Cox, Mary Ann
Described in this paper is a proposal concerning the responsibility of the California community colleges in providing remediation services and programs. The first part of the paper concerns the proposal itself. After a brief statement of the major issues under consideration, the conditions under which student success can be ensured in open access…
Reisman, Sorel, Ed.; Flores, John G., Ed.; Edge, Denzil, Ed.
This book provides information for researchers and practitioners on the current issues and best practices associated with electronic learning communities. Fourteen contributed chapters include: "Interactive Online Educational Experiences: E-volution of Graded Projects" (James Benjamin); "Hybrid Courses as Learning Communities"…
The idea that communities need to be inclusive is almost axiomatic. The process, whereby, community members engage in inclusive practices is far less understood. Similarly, UK universities are being encouraged to include the wider community and extent campus boundaries. Here, I suggest a particular theoretical lens which sheds light on engagement…
Allaire, Saralynn J.; Niu, Jingbo; Zhu, Yanyan; Brett, Belle
The purpose of this study was to evaluate the translation of positive research findings about a job retention intervention for persons with chronic illnesses to rehabilitation practice. A program to provide the intervention was developed and marketed in the community. Fifty-seven consumers with chronic illnesses received the intervention provided…
Nielsen, N Ole; Evans, Brian; King, Lonnie J
The need to devote more human resources to veterinary public practice to cope with escalating threats to biological security, public health, and economic prosperity, while also addressing societal value changes, has been widely recognized and supported. Most envisage increasing the numbers of veterinarians in government employment. Why not at least combine this initiative, wherever possible, with far greater involvement of rural practitioners to deliver contractual public-practice services and provide an enhanced community interface? This could make the difference between having a local practice in a community or none at all, as well as promising to be more cost effective. The concept of rural community practice (RCP) envisages combining traditional services provided in a "mixed-animal" veterinary practice with an expanded portfolio of public-practice and communication services that meet the emerging animal, public, and ecosystem health needs of the collective community, not just those of animal owners. These services could include those involving active sentinel surveillance programs for both domestic animal and wildlife diseases; on-farm food safety; bio-security; traceability and export certification and audit programs; disease investigation, including foreign animal diseases; surge capacity emergency response; managing for ecosystem health; and client and community education. An expanded practice team of animal-health professionals and technologists, led by veterinarians, would deliver these services. This RCP approach should have the potential to make rural practice more attractive from economic, lifestyle, and job-satisfaction perspectives; to enhance the visibility and recognition of the profession; and to respond to changing and new societal needs. It also promises to maintain a stable network of veterinary practices in rural communities. In addition, the recognition of veterinary medicine as a public good should provide for consideration of increased
Gregory, Paul A. M.; Austin, Zubin
Background: Intraprofessional conflict among pharmacists, regulated technicians and assistants may undermine attempts to advance patient care in community pharmacy. There is no available research examining this issue in light of the evolution of the profession and roles within the profession. Methods: A combination of interviews and focus groups involving pharmacists, technicians and assistants was undertaken. Each participant completed the Conflict Management Scale as a way of identifying conflict management style. Data were analyzed and coded using a constant-comparative, iterative method. Results: A total of 41 pharmacy team members participated in this research (14 pharmacists, 14 technicians and 13 assistants). Four key themes were identified that related to conflict within community pharmacy: role misunderstanding, threats to self-identity, differences in conflict management style and workplace demotivation. Interpretation: As exploratory research, this study highlighted the need for greater role clarity and additional conflict management skills training as supports for the pharmacy team. The impact of conflict in the workplace was described by participants as significant, adverse and multifactorial. Conclusions: To support practice change, there has been major evolution of roles and responsibilities of pharmacists, technicians and assistants. Conflict among pharmacy team members has the potential to adversely affect the quality of care provided to patients and is an issue for managers, owners, regulators and educators. PMID:28286591
Aseltine, Robert H; Reisine, Susan; Schilling, Elizabeth A; Kennedy, James
Background Despite their increasing share of the dental insurance market, little is known about dental practices' satisfaction with preferred provider organizations (PPOs). This analysis examined practice satisfaction with dental PPOs and the extent to which satisfaction was a function of communications from the plan, claims handling and compensation. Methods Data were collected through telephone surveys with dental practices affiliated with MetLife between January 2002 and December 2004. Each respondent was asked a series of questions related to their satisfaction with a systematically selected PPO with which they were affiliated. Six different PPO plans had sufficient observations to allow for comparative analysis (total n = 4582). Multiple imputation procedures were used to adjust for item non-response. Results While the average level of overall satisfaction with the target plan fell between "very satisfied" and "satisfied," regression models revealed substantial differences in overall satisfaction across the 6 PPOs (p < .05). Statistically significant differences between plans in overall satisfaction were largely explained by differences in the perceived adequacy of compensation. However, differences in overall satisfaction involving two of the PPOs were also driven by satisfaction with claims handling. Conclusion Results demonstrate the importance of compensation to dental practice satisfaction with PPOs. However, these results also highlight the critical role of service-related factors in differentiating plans and suggest that there are important non-monetary dimensions of PPO performance that can be used to recruit and retain practices. PMID:18005426
Maser, R E; Ellers, J M; DeCherney, G S
Surgical stress causes hyperglycemia with potential complications (e.g., impaired granulocytic function and delayed wound healing) particularly when glucose levels exceed 250 mg/dL. Standards of care for patients with diabetes undergoing surgery may vary by geographic locale, type of surgical procedure, and type of diabetes. We explored whether anesthesia providers monitor glucose levels in patients with diabetes. Records of 100 patients with diabetes who underwent surgery under general anesthesia (length of procedure: range, 1.9-11.8 hours) were reviewed. Demographic information, glucose levels, frequency of glucose monitoring, and treatment used for diabetes management preoperatively, intraoperatively, and postoperatively were recorded. There were 46 males and 54 females, aged 62 +/- 13 years (55% currently treated with insulin). Of the study cohort, 89% had preoperative, 23% had intraoperative, and 54% had postoperative glucose monitoring performed. As expected, postoperative glucose concentrations were significantly higher than preoperative glucose levels (mean difference, 99 mg/dL, P < .01). The mean postoperative glucose level was 262 +/- 89 mg/dL with 30 of the 54 monitored patients having a postoperative glucose level greater than 250 mg/dL. Individuals treated with insulin and those who underwent major surgery were more likely to have glucose levels monitored. These results suggest that better strategies for monitoring glucose levels during the surgical period are needed.
Brownhill, Suzanne; Chang, Esther; Bidewell, John; Johnson, Amanda
Community (district) nurses play a significant role in assisting and supporting bereaved informal carers (family members and friends) of recently decease clients of palliative care. Bereavement care demands a wide range of competencies including clinical decision-making. To date, little has been known about the decision-making role of community nurses in Australia. The aim of this study was to conduct in-depth examination of an existing data set generated from semi-structured interviews of 10 community nurses providing follow-up bereavement care home visits within an area health service of a metropolitan region of Sydney, Australia. A grounded theory approach to data analysis generated a model, which highlights an interaction between 'the relationship','the circumstances' (surrounding the bereavement),'the psychosocial variant', 'the mix of nurses', 'the workload', and 'the support' available for the bereaved and for community nurses, and elements of 'the visit' (central to bereavement care). The role of community nurses in bereavement care is complex, particularly where decision-making is discretionary and contingent on multiple variables that effect the course of the family's grief. The decision model has the potential to inform community nurses in their support of informal carers, to promote reflective practice and professional accountability, ensuring continuing competence in bereavement care.
Racher, Frances E
Defining the community as client or partner requires a different ethical approach, an approach focused on the aggregate, community, or societal level. A discussion of rule ethics, virtue ethics, and feminist ethics transports the community practitioner beyond traditional ethical principles to consider a more contemporary ethical foundation for public health and community practice. Inclusion, diversity, participation, empowerment, social justice, advocacy, and interdependence create an evolving ethical foundation to support community practice. Collaboration among health care professionals and members of the organizations, communities, and societies in which they practice will facilitate the further development of moral thought and ethical theory to underpin community practice.
Focus groups conducted in Saint Louis, Missouri, determined consumer and provider perceptions relevant to the roles and functions of community education programs. Needs identified included community unity, services that support families, and more participation in community schools. (JOW)
Chapman, Colin A; van Bavel, Bianca; Boodman, Carl; Ghai, Ria R; Gogarten, Jan F; Hartter, Joel; Mechak, Lauren E; Omeja, Patrick A; Poonawala, Sofia; Tuli, Dan; Goldberg, Tony L
Impoverished communities often turn to illegal extraction of resources from protected areas to alleviate economic pressures or to make monetary gains. Such practices can cause ecological damage and threaten animal populations. These communities also often face a high disease burden and typically do not have access to affordable health care. Here we argue that these two seemingly separate challenges may have a common solution. In particular, providing health care to communities adjacent to protected areas may be an efficient and effective way to reduce the disease burden while also improving local perceptions about protected areas, potentially reducing illegal extraction. We present a case study of a health centre on the edge of Kibale National Park, Uganda. The centre has provided care to c. 7,200 people since 2008 and its outreach programme extends to c. 4,500 schoolchildren each year. Contrasting the provision of health care to other means of improving community perceptions of protected areas suggests that health clinics have potential as a conservation tool in some situations and should be considered in future efforts to manage protected areas.
van Bavel, Bianca; Boodman, Carl; Ghai, Ria R.; Gogarten, Jan F.; Hartter, Joel; Mechak, Lauren E.; Omeja, Patrick A.; Poonawala, Sofia; Tuli, Dan; Goldberg, Tony L.
Impoverished communities often turn to illegal extraction of resources from protected areas to alleviate economic pressures or to make monetary gains. Such practices can cause ecological damage and threaten animal populations. These communities also often face a high disease burden and typically do not have access to affordable health care. Here we argue that these two seemingly separate challenges may have a common solution. In particular, providing health care to communities adjacent to protected areas may be an efficient and effective way to reduce the disease burden while also improving local perceptions about protected areas, potentially reducing illegal extraction. We present a case study of a health centre on the edge of Kibale National Park, Uganda. The centre has provided care to c. 7,200 people since 2008 and its outreach programme extends to c. 4,500 schoolchildren each year. Contrasting the provision of health care to other means of improving community perceptions of protected areas suggests that health clinics have potential as a conservation tool in some situations and should be considered in future efforts to manage protected areas. PMID:26456977
Linton, Jayme N.
This qualitative interpretive case study used Wenger's (1998) communities of practice (CoP) framework to analyze how the electronic learning community (eLC) process at an established state virtual high school operated like a community of practice. Components of the eLC process were analyzed according to elements of the CoP framework, which…
Verschelden, Griet; Van Eeghem, Elly; Steel, Riet; De Visscher, Sven; Dekeyrel, Carlos
This article addresses the position of community art practices and the role of practitioners in urban cracks. Community art practices raise possibilities for a reconceptualisation of the concept of community and an extension of the concept of art in public space. Urban cracks are conceptualised as spatial, temporal and relational manifestations of…
Kristoffersen, Ann-Elise; Simonsen, Eva
This article aims to discuss young deaf children's access to literacy within a sociocultural perspective. We introduce the concept of communities of practice as an aspect in early literacy development for young deaf children. Preschools are learning communities and thus constitute communities of practice. Our discussion on the use of communities…
Pollock, L L; Levine, M
As pharmacists increase their involvement in patients' drug therapy, the lack of opportunity for advanced clinical and administrative training becomes more critical, particularly for community pharmacists. To assist in the postgraduate development of community pharmacists, the faculty of pharmaceutical sciences at the University of British Columbia began a residency program in community pharmacy practice in June 1981. Modeled on the successful hospital pharmacy residencies, the program goals are to provide advanced clinical training in ambulatory patient care, and detailed and practical management training, and to develop pharmacists with skill in clinical teaching who will participate in the undergraduate programs of the faculty. The 12-month residency includes guided self-study and a series of practica in areas of therapeutics, management, drug information, clinical and teaching skill, professional service, and continuing education. These practica are served mainly in clinical practice settings such as community pharmacies, clinics, physicians' offices, and teaching hospitals. The residency has demonstrated its value and viability. Growing interest in such programs, and the success of this program in particular, should encourage the development of similar programs in Canada.
Kushner, Mitchell; Solorio, M. Rosa
OBJECTIVES: To examine the sexually transmitted infection (STI) and HIV testing practices of primary care providers (PCPs) practicing in predominantly Hispanic communities. METHODS: This is a cross-sectional study. PCPs were identified by matching ZIP codes of physician directories with ZIP codes of Los Angeles County areas that have a population that is > 50% Hispanic (N = 191). PCPs were mailed a survey that assessed their frequencies for asking patients about sexual history, offering STI and safe sex advice, total number of HIV tests ordered in the past six months and their perceived barriers to STI counseling. The survey response rate was 45% (N = 85). RESULTS: Although 73% of PCPs took sexual histories from patients regularly (daily-to-weekly), only 41% offered STI or safe sex advice regularly. PCPs who were white were less likely than those who were Hispanic/Asian/African American/other to take sexual histories from their patients regularly (OR 0.3, 95% CI 0.1-0.9). The total number of HIV tests ordered for patients by PCPs at their practice locations in the past six months were: none (6%), 1-10 tests (27%), 11-20 tests (24%) and > 20 tests (36%). Thirty-six percent of PCPs reported > or = 1 positive HIV test in the past six months. PCPs' perceived barriers to STI counseling included patient's young age (< 16 years), language and presence of patient's relative/partner in consultation room at time of visit. CONCLUSION: Our findings suggest a need for interventions with PCPs practicing in predominantly Hispanic communities to improve their STI and HIV practice patterns. PMID:17393950
Turoff, Murray; Hiltz, Starr Roxanne
Thirty four professionals who are part of a community of practice in the field of health related emergency response management provided information about the sources of information that they currently use the most, as well as their unmet information needs, and the kinds of information systems tools they would like to have. This professional community relies heavily on the Web, but they report severe information overload, in terms of not easily being able to find the kinds of information they want, amid the deluge of information that is there. In particular, they would find a system that uses social tagging and social recommender system features to be very useful for accessing relevant documents in the “gray literature.” We suggest that services such as these will be increasingly important for professional communities in general.
Welch, Marshall; Saltmarsh, John
This article provides an overview of current practice and essential infrastructure of campus community engagement centers in their efforts to establish and advance community engagement as part of the college experience. The authors identified key characteristics and the prevalence of activities of community engagement centers at engaged campuses…
Choi, Seul Ki; Seel, Jessica S; Steck, Susan E; Payne, Johnny; McCormick, Douglas; Schrock, Courtney S; Friedman, Daniela B
Prostate cancer (PrCA) screening is controversial, especially for African-American (AA) men who have higher PrCA incidence and mortality than other racial/ethnic groups. Patient-provider communication is important for the PrCA screening decision process. The study purpose was to better understand the current dialogue between primary care providers (PCPs-physicians and nurse practitioners) and AA men about PrCA prevention and screening. An online survey with 46 PCPs, education sessions (including pre/post surveys) with 56 AA men, and a forum with 5 panelists and 38 AA men for open dialogue were held to examine both provider and community perspectives on PrCA communication needs and practices. PCPs' perceptions of PrCA screening were varied and they used different PrCA screening guidelines in their practices. PCPs and AA men had different experiences with PrCA communication. PCPs reported that they have discussions about PrCA screening and prostate health with AA patients; few AA men reported these same experiences. About 38.0% of PCPs reported that they remain neutral about PSA testing during discussions; however, only 10.7% of AA men reported that their doctor remained neutral. Prostate health knowledge among AA men increased significantly following participation in the education sessions (p < 0.001). AA community members reported high satisfaction regarding the education session and forum. Different recommendations from PCPs may hinder AA men's decisions about PrCA screening. The forum used in this study could be a model for others to help improve patient-provider communication and increase engagement in dialogue about this common cancer.
Akkerman, Sanne; Petter, Christian; de Laat, Maarten
Purpose: The notion of communities of practice (CoP) has received great attention in educational and organisational practice and research. Although the concept originally refers to collaborative practices that emerge naturally, educational and HRD practitioners are increasingly searching for ways to create these practices intentionally in order to…
Brouwer, Patricia; Brekelmans, Mieke; Nieuwenhuis, Loek; Simons, Robert-Jan
Purpose: The first aim of this study is to explore to what extent communities of practice occur in the school workplace. The second aim is to explore the relation between communities of practice and diversity in composition of teacher teams. Design/methodology/approach: Quantitative as well as qualitative data were gathered from seven teacher…
Dewhurst, Frank W.; Navarro, Juan G. Cegarra
External communities of practice are groups formed by company clients and employees based on common interests, commitment, mutual trust and collaboration whose members regularly share knowledge and learning. This paper examines how external communities of practice contribute to the creation of relational capital through an empirical investigation…
Fleming, Jennifer L.; Sawyer, L. Brook; Campbell, Philippa H.
Early intervention providers submitted videotapes of home visits as part of requirements for a professional development course. Taped visits were classified into two practice groups: providers who demonstrated use of participation-based practices and those who did not (i.e., traditional practices). A sample of providers, selected from each of…
Marti, Eduardo J.; Kutnowski, Martin; Gray, Peter
For over 100 years, community colleges have been rightly seen as institutions designed to have an intimate relation to the community they serve. In order to know about the educational needs of the local communities, they were mandated to conduct frequent surveys and subsequently adapt the programs of study. Since its founding in 1959,…
Hughes, Frances A; Bamford, Anita
The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.
Ball, Jessica; Pence, Alan R.
Describes how Canada's University of Victoria worked with the Meadow Lake Tribal Council representing Aboriginal communities to develop the generative preschool curriculum model, an early childhood education (ECE) training program embracing community- and culturally-appropriate practice. Concludes that early indicators of program impact support…
Holdford, D; Kennedy, D T; Bernadella, P; Small, R E
Disease management (DM) is a comprehensive approach to preventing and treating disease that: (1) targets patients with specific diseases; (2) provides integrated services across organizational and professional boundaries; (3) utilizes services based on the best scientific evidence available; and (4) focuses on outcomes. DM differs from pharmaceutical care in that pharmaceutical care targets not only patients with specific diseases but also those with risk factors for drug-related problems, a history of nonadherence, and frequent changes in medication regimens. Steps to starting a DM program include: (1) identifying a target population based on the population's strategic importance to the goals and aims of the organization; (2) assessing the organization's available resources, both internal and external; (3) defining key indicators with which to assess the program for the purposes of internal quality control and of obtaining compensation from third-party payers; (4) implementing the program using the best scientific methods available; and (5) assessing the impact of the program. The development of a smoking cessation program at a nationwide retail pharmacy chain is used as an example of a DM program initiated in community pharmacy practice. Pharmacists are well positioned to take a major role in DM, because they are accessible to the community and because DM frequently involves drug therapy. DM is also widely used in managed care. It is important that community pharmacists be closely involved in the DM approach as it evolves.
Tomlin, Angela; Koch, Steven M; Raches, Christine; Minshawi, Noha F.; Swiezy, Naomi B.
The purpose of this study was to identify current practices in autism spectrum disorder (ASD) screening among early intervention and care providers in Indiana. Participants were asked about their ASD screening practices within the context of overall screening for developmental delays. Results indicated that providers conduct ASD screening less…
Eliscu, A T
How do you get beyond "Marketing 101" to make an impression that will distinguish your practice from all others? Author Andrea Eliscu believes that it is time for group practices to move beyond marketing basics and expand the definition to include community integration.
Wenger, Etienne C.; Snyder, William M.
Communities of practice are groups of people informally bound by shared expertise and passion for joint enterprise. In organizations that value knowledge, they can help drive strategy, solve problems quickly, transfer best practices, develop professional skills, and help recruit and retain talented employees. (SK)
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
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.
Burhansstipanov, Linda; Krebs, Linda U; Harjo, Lisa; Watanabe-Galloway, Shinobu; Pingatore, Noel; Isham, Debra; Duran, Florence Tinka; Denny, Loretta; Lindstrom, Denise; Crawford, Kim
Native Navigators and the Cancer Continuum (NNACC) was a community-based participatory research study among five American Indian organizations. The intervention required lay Native Patient Navigators (NPNs) to implement and evaluate community education workshops in their local settings. Community education was a new role for the NPNs and resulted in many lessons learned. NPNs met quarterly from 2008 through 2013 and shared lessons learned with one another and with the administrative team. In July 2012, the NPNs prioritized lessons learned throughout the study that were specific to implementing the education intervention. These were shared to help other navigators who may be including community education within their scope of work. The NPNs identified eight lessons learned that can be divided into three categories: NPN education and training, workshop content and presentation, and workshop logistics and problem-solving. A ninth overarching lesson for the entire NNACC study identified meeting community needs as an avenue for success. This project was successful due to the diligence of the NPNs in understanding their communities' needs and striving to meet them through education workshops. Nine lessons were identified by the NPNs who provided community education through the NNACC project. Most are relevant to all patient navigators, regardless of patient population, who are incorporating public education into navigation services. Due to their intervention and budget implications, many of these lessons also are relevant to those who are developing navigation research.
Sterrett, Susan E; Hawkins, Susan R; Hertweck, Mark L; Schreiber, Jodi
Development of interprofessional education programs that meet new Interprofessional Education Collaborative competencies is a challenge for faculty and administrators. This article describes a curricular design that places students in learning communities over a 2-year period with a plan for 5 learning sessions. Communities of practice is the theoretical framework of the curricular design, creating interprofessional clinicians capable of effective collaborative practice.
Kelly, Patricia J
Advanced practice nurses and nurse researchers with experience in clinical settings may encounter challenges in the initial development and implementation of community-based projects. Participatory action research methodology, a user-friendly framework for community-based research activities, provides a way for researchers and community members to work together to define a problem, take action, and evaluate their work. This article attempts to bridge the theory-implementation gap by describing background steps that researchers can use when conceptualizing and initiating a research project with community partners. Suggestions for initial steps and the planning and review cycles are presented, along with examples from the literature.
Ornstein, Hal; Baum, Neil
Steve Jobs is inarguably the greatest inventor and creative genius since Thomas Edison. He provided technology that enhances communication on a global level. Jobs also provided ideas and suggestions that could work in any medical practice regardless of the size of the practice, the location of the practice, or the employment model. His advice can be transferred from a high-tech business that employs thousands to a high-touch medical practice that has only a few employees. This article will list a few of Jobs leadership characteristics and how they might apply to physicians, their teams, and their practices. Wouldn't you like to be the Steve Jobs of healthcare? If so, read on!
Sherwood, Gwen; McNeill, Jeanette
Effective pain management continues to baffle clinicians in spite of numerous evidence-based guidelines and standards, focused clinical interventions and standardized assessments. Reflective practice is a mindful approach to practice that grounds clinicians in the moment with the individual patient to ask questions and then to listen to the patient's message about their pain experience. Reflective practice helps meld theoretical knowledge with lessons from experience to rethink mechanistic responses to patient pain. The subjective nature of pain means no two patients have the same experience, and, evidence based best practices are to be applied within the patient's preferences and context. The paper uses a case study to illustrate how to apply reflective practice to integrate the interprofessional quality and safety competencies to provide patient-centered pain management. Applying reflective questions throughout the care experience by all members of the healthcare team provides a mindful approach that focuses care on the individual patient.
This serial issue summarizes findings from a survey of 20 state mental retardation and developmental disabilities agencies and 93 community based providers on developing and financing community services. The survey queried respondents concerning: (1) which models or strategies for financing community services have been most effective; (2) what…
Moran, Kristen; Bodenhorn, Nancy
Perceptions and experiences of elementary school counselors' collaborative efforts with community mental health providers are examined through this exploratory phenomenological study. Ten participants engaged in two in-depth interviews. Collaboration was considered an effective way to increase services to students and their families. Six themes…
Davis, Tracy; Teaster, Pamela B.; Thornton, Alice; Watkins, John F.; Alexander, Linda; Zanjani, Faika
Purpose To explore primary care providers' HIV prevention practices for older adults. Primary care providers' perceptions and awareness were explored to understand factors that affect their provision of HIV prevention materials and HIV screening for older adults. Design and Method Data were collected through 24 semistructured interviews with primary care providers (i.e., physicians, physician assistants, and nurse practitioners) who see patients older than 50 years. Results Results reveal facilitators and barriers of HIV prevention for older adults among primary care providers and understanding of providers' HIV prevention practices and behaviors. Individual, patient, institutional, and societal factors influenced HIV prevention practices among participants, for example, provider training and work experience, lack of time, discomfort in discussing HIV/AIDS with older adults, stigma, and ageism were contributing factors. Furthermore, factors specific to primary and secondary HIV prevention were identified, for instance, the presence of sexually transmitted infections influenced providers' secondary prevention practices. Implications HIV disease, while preventable, is increasing among older adults. These findings inform future research and interventions aimed at increasing HIV prevention practices in primary care settings for patients older than 50. PMID:25736425
Barry, Charlotte D; Gordon, Shirley C; Lange, Bernadette
A community nursing practice (CNP) model is presented as the synthesis of a decade of experience of caring for persons and communities. Values form the basis of the model and provide the grounding for practice. Transcendent values of respect, caring, and wholeness are explicated in the actualizing values of primary health care: access, essentiality, empowerment, intersectoral collaboration, and community participation. Usefulness of the CNPM in providing a framework for community nursing practice at school-based community wellness centers in both the United States and Africa is described. Narratives of practice and research presented in the unique voice of three faculty members illuminate the model's values and paradigmatic view of person, nursing, community, and environment. These narratives provide insight into how the CNPM has served as a heuristic in the design of creative responses to calls for nursing in community nursing practice, education, and research.
Davies, Alison; Ramsay, Jill; Lindfield, Helen; Couperthwaite, John
The School of Health Sciences at the University of Birmingham provided opportunities for the development of student learning communities and online resources within the neurological module of the BSc Physiotherapy degree programme. These learning communities were designed to facilitate peer and independent learning in core aspects underpinning…
Joen Bettmann's depiction of practical life exercises as character-building reveals how caring, careful, and independent work leads to higher self-esteem, more concern for others, better understanding for academic learning, and a self-nurturing, respectful classroom community. Particular aspects of movement and silence exercises bring out what…
The “All about Blueberries” Community of Practice is adapting the best existing extension publications and developing new research-based extension recommendations related to blueberry 20 production and consumption. Our primary goal is to increase blueberry productivity and consumption of blueberries...
This article explores how Computer Sciences Corporation (CSC) manages knowledge retrieval by employees when they need to access documents written by colleagues in geographically distant units. CSC's establishment of virtual communities of practice facilitates the coordination of knowledge, and minimises contextual gaps between senders and…
This qualitative study examines current community college library practices in developmental education. Based on semistructured telephone interviews with 27 librarians across the United States, analysis of the results shows that there are librarians who proactively integrate basic library skills into developmental education and academic success…
Sergiovanni, Thomas J.
In an organizationally competent school, everyone has a role that defines his or her obligations and everyone is part of a reciprocal relationship that spells out mutual obligations. Reciprocal role relationships enable informal communities of practice to bubble up and institutionalized collaborative cultures to trickle down. When such informal…
Monaghan, Catherine H.; Columbaro, Norina L.
The application of Communities of Practice (CofP) can potentially serve as an effective learning strategy for higher education classrooms by contributing to student professional development while fostering a desire for life-long learning. The purpose of this qualitative study was to assess the effectiveness of this learning strategy and help…
Jones-Kavalier, Barbara; Flannigan, Suzanne L.
Based on research on hiring strategies used in community colleges nationwide, the authors use games as analogies to show how hiring practices are similar in many ways to games. They present a model for more entrepreneurial, innovative, and strategic approaches to hiring. Following a Foreword by George R. Boggs, this book contains seven chapters.…
Illinois Community College Board, 2007
The Illinois Community College Board has developed this Provider Manual as an easy reference to: (1) existing laws and regulations, both State and Federal; (2) best practices in the field of Adult Education; and to (3) act as a desk reference for both new and existing program administrators. The Manual describes: (1) the purpose of the Federal…
Openshaw, Kristi P.; Schultz, Jared C.; Millington, Michael J.
Rehabilitation counselor education is experiencing an explosion of knowledge, which is becoming increasingly difficult to organize and disseminate to students. Communities of practice, a form of social learning, provide a way to organize and disseminate information. Distance-based education programs are increasing within the field of…
Burns, Elizabeth A.; Howard, Jody K.; Kimmel, Sue C.
To properly prepare pre-service school librarians, school library educators in online courses must provide opportunities for collaborative engagement. This collaborative education should also recognize the pedagogical benefit of the organic formation of communities of practice that develop within areas outside of curriculum content. This…
Campano, Gerald; Ghiso, María Paula; Yee, Mary; Pantoja, Alicia
Community-based research can provide an avenue for understanding the complexities of students' and families' lives and working together for educational justice through what we refer to as coalitional literacy practices. In this article, we share a critical incident about a student's absence from school as an illustrative case of the grass-roots…
Stenzel, Anne K.; Feeney, Helen M.
This supplement to Volunteer Training and Development: A Manual for Community Groups, provides practical guidance in the selection, writing, and adaptation of effective case materials for specific educational objectives, and develops suitable cases for use by analyzing concrete situations and by offering illustrations of various types. An…
Stott, Amy L.; Brannon, S. Diane; Vasey, Joseph; Dansky, Kathryn H.; Kemper, Peter
High turnover and difficult recruitment of direct care workers are challenges for long-term care providers. This study reports the extent and variation of the use of management practices for direct care workers and their supervisors across four long-term care settings in the Better Jobs Better Care demonstration. Overall, there is limited use of…
National Centre for Vocational Education Research (NCVER), 2015
This good practice guide is intended to assist public and private registered training organisations (RTOs) planning to commence higher education (HE) delivery. The guide is based on research undertaken by Victor Callan and Kaye Bowman, who completed case studies with six providers currently delivering higher education qualifications in addition to…
Holland, John L.
After describing some current problems in vocational guidance and summarizing relevant knowledge and theory in the field, this paper presents some practical plans, materials, and ideas for providing more useful vocational assistance to people of all ages. The paper reviews such prominent vocational guidance approaches as vocational information and…
Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie
Introduction: A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods: Participants completed assessments of attitudes, confidence,…
You, Emily Chuanmei; Dunt, David; Doyle, Colleen
Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts.
The provision of quality mental health services in rural areas continues to be an ongoing challenge for nurses and the patients they serve. The use of computer mediated communication to construct collaborative learning environments similar to those suggested in Wenger's community of practice framework has the potential to mitigate a number of the difficulties faced by rural health care providers. The author presents a brief discussion of social learning theories, the communities of practice framework, and related concepts. Examples of current online communities of practice used as a means for knowledge construction in various professional disciplines are presented in building the case for the fit between online communities of practice and the needs of nurses in rural mental health. Nurses providing mental health care in rural areas have documented needs for interdisciplinary teamwork, access to a collaborative learning environment, and ongoing contact with expert resources. The construction of online communities of practice could potentially address a multitude of concerns identified by nurses practicing mental health care in rural areas.
Stott, Amy L; Brannon, S Diane; Vasey, Joseph; Dansky, Kathryn H; Kemper, Peter
High turnover and difficult recruitment of direct care workers are challenges for long-term care providers. This study reports the extent and variation of the use of management practices for direct care workers and their supervisors across four long-term care settings in the Better Jobs Better Care demonstration. Overall, there is limited use of direct care worker training, career advancement opportunities, and mentoring programs. Participation in care planning, communication about tasks, and direct care worker supervisor training and development practices vary significantly across long-term care settings. The paucity of training, career advancement opportunities, and mentoring programs suggests that government policies may be needed to encourage their use.
Osborn, Lawrence A; Stein, Catherine H
The present qualitative study examined community mental health providers' accounts of their therapeutic interactions with adults with serious mental illness in a recovery-oriented model of care. Ten long-time mental health care providers discussed their understanding of recovery principles, their use of directive practices, and factors that shape their work with consumers. Content analysis of mental health providers' accounts suggest that providers had no difficulty articulating basic principles of recovery-oriented care. Providers reported engaging in directive practices with consumers and described using traditional clinical factors such as level of functioning, degree of psychiatric symptoms, safety concerns, and legal status to assess consumers' ability for autonomous decision making. Providers generally did not express tension between their views of mental health recovery and their beliefs about utilizing directive approaches with consumers. Implications of present findings for research and practice are discussed.
Pyrko, Igor; Dörfler, Viktor; Eden, Colin
In this article, we develop the founding elements of the concept of Communities of Practice by elaborating on the learning processes happening at the heart of such communities. In particular, we provide a consistent perspective on the notions of knowledge, knowing and knowledge sharing that is compatible with the essence of this concept – that learning entails an investment of identity and a social formation of a person. We do so by drawing richly from the work of Michael Polanyi and his conception of personal knowledge, and thereby we clarify the scope of Communities of Practice and offer a number of new insights into how to make such social structures perform well in professional settings. The conceptual discussion is substantiated by findings of a qualitative empirical study in the UK National Health Service. As a result, the process of ‘thinking together’ is conceptualized as a key part of meaningful Communities of Practice where people mutually guide each other through their understandings of the same problems in their area of mutual interest, and this way indirectly share tacit knowledge. The collaborative learning process of ‘thinking together’, we argue, is what essentially brings Communities of Practice to life and not the other way round. PMID:28232754
Pyrko, Igor; Dörfler, Viktor; Eden, Colin
In this article, we develop the founding elements of the concept of Communities of Practice by elaborating on the learning processes happening at the heart of such communities. In particular, we provide a consistent perspective on the notions of knowledge, knowing and knowledge sharing that is compatible with the essence of this concept - that learning entails an investment of identity and a social formation of a person. We do so by drawing richly from the work of Michael Polanyi and his conception of personal knowledge, and thereby we clarify the scope of Communities of Practice and offer a number of new insights into how to make such social structures perform well in professional settings. The conceptual discussion is substantiated by findings of a qualitative empirical study in the UK National Health Service. As a result, the process of 'thinking together' is conceptualized as a key part of meaningful Communities of Practice where people mutually guide each other through their understandings of the same problems in their area of mutual interest, and this way indirectly share tacit knowledge. The collaborative learning process of 'thinking together', we argue, is what essentially brings Communities of Practice to life and not the other way round.
and determine which ones will be included in the overall lessons learned message to other units. A certain amount of self -censorship takes place...Communities of Practice will be examined. The self - organizing Community of Practice is found at one end of the spectrum and the sponsored Community of...Practice is located at the other. Successful Communities of Practice exist at both ends and many places in between. a) Self Organizing 32 Self
Boynes, Sean G; Moore, Paul A; Tan, Peter M; Zovko, Jayme
General descriptions or "snapshots" of sedation/general anesthesia practices during dental care are very limited in reviewed literature. The objective of this study was to determine commonalities in dental sedation/anesthesia practices, as well as to accumulate subjective information pertaining to sedation/anesthesia care within the dental profession. This questionnaire-based survey was completed by participating anesthesia providers in the United States. A standardized questionnaire was sent via facsimile, or was delivered by mail, to 1500 anesthesia providers from a randomized list using an online database. Data from the returned questionnaires were entered onto an Excel spreadsheet and were imported into a JMP Statistical Discovery Software program for analyses. Quantitative evaluations were confined to summation of variables, an estimation of means, and a valid percent for identified variables. A total of 717 questionnaires were entered for data analysis (N=717). Data from this study demonstrate the wide variation that exists in sedation/anesthesia care and those providing its administration during dental treatment in the United States. The demographics of this randomized population show anesthesia providers involved in all disciplines of the dental profession, as well as significant variation in the types of modalities used for sedation/anesthesia care. Data from this study reveal wide variation in sedation/anesthesia care during dental treatment. These distinctions include representation of sedation/anesthesia providers across all disciplines of the dental profession, as well as variations in the techniques used for sedation/anesthesia care.
Keppell, Michael, Ed.
"Instructional Design: Case Studies in Communities of Practice" documents real-world experiences of instructional designers and staff developers who work in communities of practice. "Instructional Design: Case Studies in Communities of Practice" explains the strategies and heuristics used by instructional designers when working…
Nancy M. Carlson
To explore the concept of community of practice, the research initially concentrates on a strategic business process in a research and applied engineering laboratory discovering essential communication tools and processes needed to cultivate a high functioning cross-disciplinary team engaged in proposal preparation. Qualitative research in the human ecology of the proposal process blends topic-oriented ethnography and grounded theory and includes an innovative addition to qualitative interviewing, called meta-inquiry. Meta-inquiry uses an initial interview protocol with a homogeneous pool of informants to enhance the researcher's sensitivity to the unique cultures involved in the proposal process before developing a formal interview protocol. In this study the preanalysis process uses data from editors, graphic artists, text processors, and production coordinators to assess, modify, enhance, and focus the formal interview protocol with scientists, engineers, and technical managers-the heterogeneous informants. Thus this human ecology-based interview protocol values homogeneous and heterogeneous informant data and acquires data from which concepts, categories, properties, and both substantive and formal theory emerges. The research discovers the five essential processes of owning, visioning, reviewing, producing, and contributing for strategic learning to occur in a proposal community of practice. The apprenticeship, developmental, and nurturing perspectives of adult learning provide the proposal community of practice with cohesion, interdependence, and caring, while core and boundary practices provide insight into the tacit and explicit dimensions of the proposal process. By making these dimensions explicit, the necessary competencies, absorptive capacity, and capabilities needed for strategic learning are discovered. Substantive theory emerges and provides insight into the ability of the proposal community of practice to evolve, flourish, and adapt to the
Galdzicki, Michal; Clancy, Kevin P; Oberortner, Ernst; Pocock, Matthew; Quinn, Jacqueline Y; Rodriguez, Cesar A; Roehner, Nicholas; Wilson, Mandy L; Adam, Laura; Anderson, J Christopher; Bartley, Bryan A; Beal, Jacob; Chandran, Deepak; Chen, Joanna; Densmore, Douglas; Endy, Drew; Grünberg, Raik; Hallinan, Jennifer; Hillson, Nathan J; Johnson, Jeffrey D; Kuchinsky, Allan; Lux, Matthew; Misirli, Goksel; Peccoud, Jean; Plahar, Hector A; Sirin, Evren; Stan, Guy-Bart; Villalobos, Alan; Wipat, Anil; Gennari, John H; Myers, Chris J; Sauro, Herbert M
The re-use of previously validated designs is critical to the evolution of synthetic biology from a research discipline to an engineering practice. Here we describe the Synthetic Biology Open Language (SBOL), a proposed data standard for exchanging designs within the synthetic biology community. SBOL represents synthetic biology designs in a community-driven, formalized format for exchange between software tools, research groups and commercial service providers. The SBOL Developers Group has implemented SBOL as an XML/RDF serialization and provides software libraries and specification documentation to help developers implement SBOL in their own software. We describe early successes, including a demonstration of the utility of SBOL for information exchange between several different software tools and repositories from both academic and industrial partners. As a community-driven standard, SBOL will be updated as synthetic biology evolves to provide specific capabilities for different aspects of the synthetic biology workflow.
Crawford, James Emil
The purpose of this dissertation was to develop a profile of writing centers in 12 community colleges governed by the Tennessee Board of Regents, including information on how the centers were established, funding and staffing sources, services provided, constituency demographic information, professional staff development, and the use of electronic…
Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan
Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098
Potemra, James; Maurer, John; Burns, Echelle
The Pacific Islands Ocean Observing System (PacIOOS; http://pacioos.org) is a data-serving group that relies on and promotes data interoperability. The PacIOOS "enterprise" is part of a large, US National effort aimed at providing information about the ocean environment to a wide range of users. These users range from casual beach-goers interested in the latest weather forecast or wave conditions to federal agencies responsible for public safety. In an effort to bridge the gap between the scientific community, who are responsible for making measurements and running forecast models, and the wide-ranging end-users, the data management group in PacIOOS has developed the infrastructure to host and distribute ocean-related data. The efficiency of this system has also allowed the group to build web-based tools to further help users. In this presentation we describe these efforts in more detail.
Brooks, Beth A; Davis, Sheila; Kulbok, Pamela; Frank-Lightfoot, Loraine; Sgarlata, Lisa; Poree, Shawanda
In light of the fragmentation of health care services and the need for health promotion and disease prevention, it is time to consider the important role community health workers (CHWs) could play as part of the health care team. Globally, CHWs tend to focus on a single patient condition, resulting in fragmented, uncoordinated health care services. Polyvalent (or multimodal) CHWs can provide a comprehensive, patient-centric range of care coordination services with other members of the health care team, ultimately improving patient outcomes and decreasing the cost of care. The potential benefits of the polyvalent CHW to the health care team are not widely understood in the United States. To fill this knowledge gap, a toolkit for nurse leaders in mainstream health care settings was created. The toolkit outlines the key elements essential to a successful CHW program and offers strategies for navigating the various challenges involved when integrating this new role into existing models of care.
Fries, Kathleen; Stewart, Julie G
The concept of community is multidimensional and may include geographical boundaries and/or the shared interests of its members. Community nursing practice involves nurses, patients, and families who collaborate to address health issues and to promote positive health initiatives. Informed by community health theorists, experiential learning activities provide the structure to promote partnering in community nursing practice to achieve outcomes that benefit those who serve and those who are served.
Park, Min Hae; Nguyen, Thang Huu; Dang, Anh Thi Ngoc; Ngo, Thoai Dinh
Objective To describe medical abortion (MA) practices among private providers in Vietnam. Methods The study subjects were women (n = 258) undergoing early MA through 12 private providers in Hanoi during February–June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200) of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow-up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion Follow-up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam. PMID:24082795
Palincsar, AnneMarie Sullivan; Magnusson, Shirley J.; Marano, Nancy; Ford, Danielle; Brown, Nancy
Describes an elementary-level professional-development project designed to build a community of practice focused on inquiry-based science teaching (Guided Inquiry supporting Multiple Literacies). Presents the basic tenets that guided the development of learning experiences for teachers and illustrates how the principles influenced the design of…
The article sets out the value of theorizing collective action from a social science perspective that engages with the messy actuality of practice. It argues that community health psychology relies on an abstract version of Paulo Freire's earlier writing, the Pedagogy of the Oppressed, which provides scholar-activists with a 'map' approach to collective action. The article revisits Freire's later work, the Pedagogy of Hope, and argues for the importance of developing a 'journey' approach to collective action. Theories of practice are discussed for their value in theorizing such journeys, and in bringing maps (intentions) and journeys (actuality) closer together.
Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika
Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes.
McMaster, Susan Marie
The purpose of this study is to apply best practices for succession planning to community colleges. Succession planning is relevant to management practices in community colleges because there is a surge in retirements in higher education from the "baby boomer" generation. Community colleges need to implement a succession plan to ensure…
This article argues that children in a particular virtual community are learning through their participation in the discursive and social practices of the community. Using Wenger's model of "communities of practice" the article illuminates examples of children's learning that were a direct result of collaboration towards a common goal.…
Krautscheid, Lorretta C
Communication errors are identified by the Joint Commission as the primary root cause of sentinel events across all categories. In addition, improving the effectiveness of communication among healthcare providers is listed as one of the Joint Commission's 2008 National Patient Safety Goals. Nursing programs are expected to graduate practice-ready nurses who demonstrate quality and safety in patient care, which includes interdisciplinary communication. Through objectively structured clinical assessment simulations, faculty evaluate each nursing student's ability to perform many aspects of care, including the ability to communicate effectively with physicians via telephone in an emergent situation. This quality improvement project reports the results of a three-year review of undergraduate student nurse performance (n = 285) related to effective clinical communication. Changes in teaching-learning strategies, implementation of a standardized communication tool, and clinical enhancements which resulted in improved student competency, will be presented.
New technologies seem to have expanded traditional face-to-face communities of practice across spatial and temporal boundaries into "online communities of practice." However, these virtual landscapes are significantly different from the context of face-to-face communities of practice that Lave and Wenger (1991) observed. This study…
Burgraff, Donna L.
This article describes the formation of an educational partnership developed in a rural, Appalachian, coal-mining community. Williamson Main Street, Inc., a downtown revitalization program, and Southern West Virginia Community and Technical College (Southern) combined their efforts to create the Tug Valley Economic Development Institute (TVEDI).…
Noble, Christy; Brazil, Victoria; Teasdale, Trudy; Forbes, Mark; Billett, Stephen
Prescribing in acute healthcare settings is a complex interprofessional process with a high incidence of medication errors. Opportunities exist to improve prescribing learning through collaborative practice. This qualitative interview-based study aimed to investigate the development of junior doctors' prescribing capacity and how pharmacists contribute interprofessionally to this development and the prescribing practices of a medical community. The setting for this study was a large teaching hospital in Australia where ethical approval was gained before commencing the study. A constructionist approach was adopted and the interviews were held with a purposive sample of 34 participants including junior doctors (n = 11), clinical supervisors (medical; n = 10), and pharmacists (n = 13). Informed by workplace learning theory, interview data were thematically analysed. Three key themes related to pharmacists' contributions to prescribing practices emerged: building prescribing capacities of junior doctors through guidance and instruction; sustaining safe prescribing practices of the community in response to junior doctor rotations; and transforming prescribing practices of the community through workplace learning facilitation and team integration. These findings emphasize the important contributions made by pharmacists to building junior doctors' prescribing capacities that also assist in transforming the practices of that community. These findings suggest that rather than developing more conventional education programs for prescribing, further consideration should be given to interprofessional collaboration in everyday activities and interactions as a means to promote both effective learning for individuals and advancing the enactment of effective prescribing practice.
Risling, Tracie; Ferguson, Linda
Although the community of practice (CoP) concept has been heavily utilized in business literature since its inception in the 1990s, it has not been significantly featured in nursing research. With student-centered approaches increasingly infusing nursing classrooms, including opportunities for collaborative learning and the development of student learning communities, it may be time to ask: Do we practice what we teach? Nursing academia faces challenges related to recruitment and retention, scholarly productivity and engagement of new faculty, and increasing demands for collaborative research. Challenges, some would argue, that could be addressed through CoPs; a sentiment reflected in the recent expansion of nursing CoP literature. What is the current state of the application of this concept in nursing academia and what barriers present in the promotion and development of CoPs in the academy? This article addresses these questions and provides guidance for those in search of community.
This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making.
WASHINGTON - As part of President Obama's Climate Action Plan, the U.S. Environmental Protection Agency (EPA) today released an online training module to help local government officials take actions to increase their communities' resiliency to a chan
Moore, Margaret E; Vaughan, K T L; Hayes, Barrie E
This paper addresses the following questions:What makes the community of practice concept an intriguing framework for developing library services for bioinformatics? What is the campus context and setting? What has been the Health Sciences Library's role in bioinformatics at the University of North Carolina (UNC) Chapel Hill? What are the Health Sciences Library's goals? What services are currently offered? How will these services be evaluated and developed? How can libraries demonstrate their value? Providing library services for an emerging community such as bioinformatics and computational biology presents special challenges for libraries including understanding needs, defining and communicating the library's role, building relationships within the community, preparing staff, and securing funding. Like many academic health sciences libraries, the University of North Carolina (UNC) at Chapel Hill Health Sciences Library is addressing these challenges in the context of its overall mission and goals.
Young, Jessica; Jaye, Chrystal; Egan, Tony; Williamson, Martyn; Askerud, Anna; Radue, Peter; Penese, Maree
Burgeoning numbers of patients with long-term conditions requiring complex care have placed pressures on healthcare systems around the world. In New Zealand, complex patients are increasingly being managed within the community. The Community of Clinical Practice concept identifies the network of carers around an individual patient whose central participants share a common purpose of increasing that patient's well-being. We conducted a focused ethnography of nine communities of clinical practice in one general practice setting using participant observation and interviews, and examined the patients' medical records. Data were analysed using a template organising style. Communities of clinical practice were interprofessional and included informal supports, services and non-professionals. These communities of clinical practice mediate practice, utilising informal networks to cut across boundaries, bureaucracy, mandated clinical pathways and professional jurisdictions to achieve optimum patient-centred care. Communities of clinical practice's repertoires are characterised by care and are driven by the moral imperative to care. They do 'whatever it takes', although there is a cost to this form of care. Well-functioning communities of clinical practice use patient's well-being as a guiding light and, by sharing a vision of care through trusting and respectful relationships, avoid fragmentation of care. The Community of Clinical Practice (CoCP) model is particularly useful in accounting for the 'messiness' of community-based care.
Sloggett, Kym; Kim, Nancy; Cameron, Debra
An increasing number of occupational therapists enter private practice. Six practicing occupational therapists were surveyed regarding the benefits of fieldwork to occupational therapy students. Findings indicate benefits to the profession, to the clinician, and to the facility. Potential barriers were time, costs, travel, and legalities.…
Elsom, Stephen; Happell, Brenda; Manias, Elizabeth
Significant changes to the delivery of mental health services have resulted in the expansion of the community mental health nursing role. This qualitative study was undertaken to explore the extent to which community mental health nurses are currently engaged in expanded forms of practice. Focus groups were undertaken with community mental health nurses (n = 27) from metropolitan and rural Victoria, Australia. Thematic analysis identified the following major themes: reported practice, consumers as beneficiaries of expanded practice, risk of harm and litigation, and barriers to expanded practice. The findings emphasize the need for significant changes in current legislation if expanded practice for nurses is to become a reality.
Althausen, Peter L
The development of a busy community-based trauma practice is a multifaceted endeavor that requires good clinical judgment, business acumen, interpersonal skills, and negotiation tactics. Private practice is a world in which perfect outcomes are expected and efficiency is paramount. Successful operative outcomes are dependent on solid clinical training, good preoperative planning, and communication with mentors when necessary. Private practitioners must display confidence, polite behavior, and promptness. Maintaining availability for consultation from emergency room physicians, private practice physicians, and local orthopaedic surgeons is a powerful marketing tool. Orthopaedic trauma surgery has been shown to be a profitable field for hospitals and private practitioners. However, physician success depends on a sound understanding of hospital finance, marketing skills, and knowledge of billing and coding. As the financial pressures of medical care increase, hospital negotiation will be paramount, and private practitioners must combine clinical and business skills to provide good patient care while maintaining independence and financial security.
Winecoff, Bonnie Watts
The purpose of this study was to describe implemented and planned Latino student success activities in North Carolina community colleges and to examine variations in these activities based on the degree of Latino settlement in the college service area. This study was designed to answer the following research questions: (1) What Latino student…
Workman, Jamie L.; Redington, Lyn
This is the first of a three-part series which will share information about how a mid-size, comprehensive university developed a learning community program, including a residential curriculum. Through intentional collaboration and partnerships, the team, comprised of faculty and staff throughout the university, developed a "multi-year plan…
Ross, Edna; Cox, Fannie M.
Hotel Louisville is owned and operated by Wayside Christian Mission and is staffed by screened and vetted Wayside resident clients. This unique situation, along with the University of Louisville (UofL) partnership, positions both as national exemplars for authentic community involvement with higher education. The purpose of this article is to…
Braga, Luis H.; Lorenzo, Armando J.
Cryptorchidism is one of the most common congenital anomalies of the male genitalia, occurring in 1% of boys by the age of one year. Even though the etiology of cryptorchidism is multifactorial, management has evolved with the clear recognition that hormonal treatment is not effective and surgery between 6–18 months of age leads to better testicular outcomes. Diagnostic laparoscopy is considered the standard approach for management of non-palpable testes, and can be combined with one or two-stage orchidopexy, with up to 80–90% success rates. This review discusses the natural history of retractile testicles, indications for hormonal treatment and orchidectomy, ultrasound’s role as a diagnostic tool, risks of infertility and testicular cancer, and surgical techniques for inguinal and intra-abdominal testes. PMID:28265313
Ali, N. A.; Raftery, C.; Shackleford, R.; Nelson, A.; Turney, D.
A community of practice is a group of people informally bound together by shared expertise and passion for a joint enterprise. Through facilitated discussion, we will share best practices and research about communities of practice, and explore how they evolve as they grow. The target audience for this Special Interest Group session is Education and Public Outreach professionals who are interested in using communities of practice as a way to support the professional development of their audiences. This session will be of interest to people who want to learn more about communities of practice as well as those who are currently coordinating similar efforts. Participants will have the opportunity to share their challenges and success, as well as gain new ideas for the planning, implementation, and expansion of efforts. This session will be facilitated by the coordinators of NASA's SMD Heliophysics EPO Forum online community of practice for middle and high school science teachers.
In 1991, the Family Planning Association (FPA) of the Malaysian state of Perak initiated a community-based development project in the remote Aborigine village of Kampung Tisong. The community consists of approximately 34 households who survive on an average income of about US $37. Malnutrition is pervasive, even minor ailments cause death, more serious afflictions are prevalent, and the closest government clinic is 20 kilometers away and seldom used by the Aborigines. 70% of the children have access to education, but parental illiteracy is a serious educational obstacle. The goals of the FPA program are to 1) promote maternal and child health and responsible parenthood, 2) provide health education, 3) encourage women to seek self-determination, and 4) encourage the development of self-reliance in the community as a whole. The first step was to survey the community's culture, beliefs, and health status with the help of the Aborigines Department and the village headman. After a series of preliminary meetings with other agencies, the FPA began to provide activities including health talks, health courses and demonstrations, medical examinations and check-ups, and first aid training. Environmental protection and sanitation measures were included in the educational activities, and following the traditional "mutual aid system," a small plot of land was cleared for vegetable production. Vegetable gardens and needlecraft will become income-producing activities for the women. Attempts to motivate the women to use family planning have been hindered by the fact that the health of 2 women deteriorated after they began using oral contraceptives. Positive changes are occurring slowly and steadily, however, and the FPA has been instrumental in having the settlement included in a program for the hardcore poor which will provide new housing and farming projects.
Wood, Brian R.; Unruh, Kenton T.; Martinez-Paz, Natalia; Annese, Mary; Ramers, Christian B.; Harrington, Robert D.; Dhanireddy, Shireesha; Kimmerly, Lisa; Scott, John D.; Spach, David H.
Background. To increase human immunodeficiency virus (HIV) care capacity in our region, we designed a distance mentorship and consultation program based on the Project ECHO (Extension for Community Healthcare Outcomes) model, which uses real-time interactive video to regularly connect community providers with a multidisciplinary team of academic specialists. This analysis will (1) describe key components of our program, (2) report types of clinical problems for which providers requested remote consultation over the first 3.5 years of the program, and (3) evaluate changes in participants′ self-assessed HIV care confidence and knowledge over the study period. Methods. We prospectively tracked types of clinical problems for which providers sought consultation. At baseline and regular intervals, providers completed self-efficacy assessments. We compared means using paired-samples t test and examined the statistical relationship between each survey item and level of participation using analysis of variance. Results. Providers most frequently sought consultation for changing antiretroviral therapy, evaluating acute symptomatology, and managing mental health issues. Forty-five clinicians completed a baseline and at least 1 repeat assessment. Results demonstrated significant increase (P < .05) in participants' self-reported confidence to provide a number of essential elements of HIV care. Significant increases were also reported in feeling part of an HIV community of practice and feeling professionally connected to academic faculty, which correlated with level of program engagement. Conclusions. Community HIV practitioners frequently sought support on clinical issues for which no strict guidelines exist. Telehealth innovation increased providers' self-efficacy and knowledge while decreasing professional isolation. The ECHO model creates a virtual network for peer-to-peer support and longitudinal mentorship, thus strengthening capacity of the HIV workforce. PMID
Harris, Bronwyn; Eyles, John; Goudge, Jane
In this article, we consider the conduct of post-apartheid health care in a policy context directed toward entrenching democracy, ensuring treatment-adherent patients, and creating a healthy populace actively responsible for their own health. We ask how tuberculosis treatment, antiretroviral therapy, and maternal services are delivered within South Africa's health system, an institutional site of colonial and apartheid injustice, and democratic reform. Using Foucauldian and post-Foucauldian notions of governmentality, we explore provider ways of doing to, for, and with patients in three health subdistricts. Although restorative provider engagements are expected in policy, older authoritarian and paternalistic norms persist in practice. These challenge and reshape, even 'undo' democratic assertions of citizenship, while producing compliant, self-responsible patients. Alongside the need to address pervasive structural barriers to health care, a restorative approach requires community participation, provider accountability, and a health system that does with providers as much as providers who do with patients.
Boehm, Amnon; Cohen, Ayala
It is important to develop commitment to community practice among social work students to encourage their engagement in this field as professionals later in life. This research examines factors that affect commitment to community practice among social work students. A structured questionnaire was administered to 277 social work students in one…
In this article, the role of theory in higher education research is problematised using a communities of practice framework. Drawing on a case study derived from the author's own published work and doctoral study, the article concludes that the differential uses of theory within communities of research practice can be fruitfully explored, in part,…
Duncan, S. Marie; Gordon, Doretta E.; Hu, Haihong
There is a growing interest among organizations in identifying and nurturing Communities of Practice. Delineating what is and what is not a Community of Practice (CoP) is not a clear-cut task. One specific area of difficulty is distinguishing between a team and a CoP. Because there are strong similarities between the two, it is often helpful to…
Couper, Graeme; Denny, Heather; Watkins, Annette
The importance of teaching second language learners the pragmatic norms of relevant communities of practice is widely recognised. Familiarisation with these norms is also an important aspect of socialisation for native speakers entering a new community of practice. This study focuses on pragmatic instruction of English as an additional language…
Madrigal, Ramon Anthony
Although the study of the Synoptic Problem has been the focus of scholarly attention for over two hundred years, the social learning theory known as Communities of Practice is a relatively recent phenomenon. This article describes a communities of practice approach to the study of the Synoptic Problem in an upper-division undergraduate course at a…
Spiwak, Rand S.
A study was conducted to identify those variables appearing to affect cash management practices in Florida community colleges, and recommend prescriptive measures concerning these practices. The study methodology included informal discussions with the chief fiscal officers of each Florida community college and appropriate state board staff,…
Wenger's portrait of Alinsu insurance claims processors as elaborated in "Communities of Practice: Learning, Meaning, and Identity" remains closely associated with the community of practice model. The enduring metaphor of Alinsu has limited the scope of Wenger's theory to relatively simplistic, closed, and reproductive systems. The model has both…
Imagined communities are not bound by space or time, they exist in opposition to other communities, and the members perceive themselves as existentially similar. Multiple case studies and interviews revealed that the seven Christian schools in this study functioned as imagined communities, and their literary practices served to establish,…
Esbeck, Tim, Comp.; Falcone, Lisa, Ed.
In developing this compendium of exemplary economic development practices among small and/or rural two-year colleges, the American Association of Community Colleges Commission on Small/Rural Community Colleges (CSMCC) sent out a call for program descriptions to all community colleges with less than 3,000 full-time employees or that were…
Jimenez-Silva, Margarita; Olson, Kate
Grounded in the construct of community of practice, the authors discuss the Teacher-Learner Community (TLC), where the goal is to support the development of pre-service teachers' understanding of culture, community, and background in learning. Insights and perceptions of pre-service teachers were gathered after implementing a TLC designed to…
Lewis, Laura A.; Koston, Zoe; Quartley, Marjorie; Adsit, Jason
A significant dilemma for the health and human service professions continues to be the question of how best to bridge the divide between academic research and practice. Communities of practice have traditionally been a vehicle for collaborative research and for information exchange (Moore, 2008). Through collaboration, communities of practice have…
Cornford, Charles S.; Carrington, Bruce
Doctors training to become general practitioners (GPs) enter new "communities of practice". For instance, they initially experience various types of isolation, need new skills and knowledge and find the organisation of general practice different to hospitals. "Communities of practice" concepts help explain some of their…
Strauser, David R.; Ciftci, Ayse; O'Sullivan, Deirdre
This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences…
Scherrens, Maurice W.
This book examines the institutional movement toward outsourcing support services, focusing on the development of outcome-oriented performance indicators and continuous self-assessment. Using 125 "lessons" based on support service theories, philosophies, and practices at George Mason University (Virginia), which collectively are termed…
Walumbe, Jackie; Swinglehurst, Deborah; Shaw, Sara
Objective To examine how those managing and providing community-based musculoskeletal (MSK) services have experienced recent policy allowing patients to choose any provider that meets certain quality standards from the National Health Service (NHS), private or voluntary sector. Design Intrinsic case study combining qualitative analysis of interviews and field notes. Setting An NHS Community Trust (the main providers of community health services in the NHS) in England, 2013–2014. Participants NHS Community Trust employees involved in delivering MSK services, including clinical staff and managerial staff in senior and mid-range positions. Findings Managers (n=4) and clinicians (n=4) working within MSK services understood and experienced the Any Qualified Provider (AQP) policy as involving: (1) a perceived trade-off between quality and cost in its implementation; (2) deskilling of MSK clinicians and erosion of professional values; and (3) a shift away from interprofessional collaboration and dialogue. These ways of making sense of AQP policy were associated with dissatisfaction with market-based health reforms. Conclusions AQP policy is poorly understood. Clinicians and managers perceive AQP as synonymous with competition and privatisation. From the perspective of clinicians providing MSK services, AQP, and related health policy reforms, tend, paradoxically, to drive down quality standards, supporting reconfiguration of services in which the complex, holistic nature of specialised MSK care may become marginalised by policy concerns about efficiency and cost. Our analysis indicates that the potential of AQP policy to increase quality of care is, at best, equivocal, and that any consideration of how AQP impacts on practice can only be understood by reference to a wider range of health policy reforms. PMID:26908521
Pearce, Kevin A; Jarrett, Traci D; Scutchfield, F Douglas; Talbert, Jeffery C; Bolt, W David; Barron, Mary A; Houlihan, Jessica M; Dignan, Mark B
Kentucky has among the highest rates of diabetes and obesity in the United States. The Kentucky Diabetes and Obesity Collaborative (KDOC) was designed to develop a novel research infrastructure that can be used by researchers focusing on obesity and diabetes among patients cared for by Federally Qualified Health Centers (FQHC) serving rural Kentucky. Focus groups were carried out to develop an understanding of the needs and interests of FQHC practitioners and staff regarding participation in KDOC. Focus groups were conducted with 6 FQHCs and included a total of 41 individuals including health care providers, administrative staff and clinical staff. The discussions ranged in time from 30 to 70 minutes and averaged 45 minutes. Analysis of the transcripts of the focus groups revealed 4 themes: 1) contextual factors, 2) infrastructure, 3) interpersonal relationships, and 4) clinical features. The participants also noted four requirements that should be met for a research project to be successful in rural primary care settings: 1) there must be a shared understanding of health priorities of rural communities between the researcher and the practices/providers; 2) the proposed research must be relevant to clinics and their communities; 3) research and recommendations for evidence-based interventions need to reflect the day-to-day challenges of rural primary care providers; and 4) there needs to be an understanding of community norms and resources. Although research-clinic partnerships were viewed favourably overall, challenges in data integration to support both research and clinical outcomes were identified.
Ronen, Ilana; Shemer-Elkiyam, Tal
The advantages of learning communities focused on analyzing social issues and educational repercussions in the field are presented in this study. The research examines the contribution of a learning community to enhancing student teachers' responsibility and their social involvement. The assumption was that participating in learning community…
Pigg, Kenneth E.
Attempts to synthesize a view of community leadership arising from community relationships with an interactional or field theory perspective. Suggests a change in focus from what leaders do to the quality of relationships between leaders and followers, requiring a different kind of leadership development. (SK)
Adepu, R; Nagavi, B. G.
The present study was conducted to assess the attitudes and behaviors of practicing community pharmacists towards patient counselling and use of patient information leaflets in the state of Karnataka. Convenient sampling method was adopted to collect the responses with the help of self-completion questionnaires. A total of 258 practicing community pharmacists in the age group of 22–60 y of both gender with practicing experience of 2-30 y participated in the study. Majority of respondents (80%) agreed that, patient counselling is their professional obligation. About 17% of the respondents mentioned that, they try to give basic information regarding drug usage to the patient. The reasons stated by the pharmacists to provide patient counselling were, professional satisfaction (43%), patients go with satisfaction (32%), observed increase in sales (8%), and also improved patient compliance (7.5%). The major barriers for offering patient counselling were mentioned as pharmacists' inadequate knowledge and confidence (78%), doctor dispensing (72%), no professional fee (56%), poor response from patients (82%), inadequate continuous professional development programs (75%). Many respondents agreed that, patient information leaflets certainly help in counselling but available information leaflets are company generated and prescriber focused. Many respondents found the present continuing professional development module was useful and are interested in weekend workshops to update their professional knowledge (83%). Restrictions on doctor dispensing, legalization of patient counselling, regular continuing professional development programs are the factors observed to motivate the pharmacists to offer patient counselling. PMID:20490295
Parboosingh, John T
Physicians interact with peers and mentors to frame issues, brainstorm, validate and share information, make decisions, and create management protocols, all of which contribute to learning in practice. It is likely that working together in this way creates the best environment for learning that enhances professional practice and professional judgment. So convincing are the arguments for this view that management practices already are changing to foster the integration of learning and practice. This article describes a program of research that is planned to assess the effectiveness of information and communication technologies that purport to support and enhance learning in practice.
Uma Ramani's characterization of practical life is philosophical and anthropological, suggesting that "human history is the story of the evolution of our practical life activities." Practical life is a collaborative activity that creates community and culture. One's adaptation to life through the daily work of ordering our environment…
Egan, Tony; Jaye, Chrystal
The social organization of clinical learning is under-theorized in the sociological literature on the social organization of health care. Professional scopes of practice and jurisdictions are formally defined by professional principles and standards and reflected in legislation; however, these are mediated through the day-to-day clinical activities of social groupings of clinical teams. The activities of health service providers typically occur within communities of clinical practice. These are also major sites for clinical curriculum delivery, where clinical students learn not only clinical skills but also how to be health professionals. In this article, we apply Wenger's model of social learning within organizations to curriculum delivery within a health service setting. Here, social participation is the basis of learning. We suggest that it offers a powerful framework for recognizing and explaining paradox and incongruence in clinical teaching and learning, and also for recognizing opportunities, and devising means, to add value to students' learning experiences.
Nicholson, S; Pauly, M V; Burns, L R; Baumritter, A; Asch, D A
Nonprofit hospitals are expected to provide benefits to their community in return for being exempt from most taxes. In this paper we develop a new method of identifying activities that should qualify as community benefits and of determining a benchmark for the amount of community benefits a nonprofit hospital should be expected to provide. We then compare estimates of nonprofits' current level of community benefits with our benchmark and show that actual provision appears to fall short. Either nonprofit hospitals as a group ought to provide more community benefits, or they are performing activities that cannot be measured. In either case, better measurement and accounting of community benefits would improve public policy.
Ellis, Irene; Chater, Keri
The purpose of this paper is to explore and describe the process of transition that nurses experience when moving from the acute sector to a specialist area of community nursing. Issues explored include the increased movement of nurses into the community sector, the experience of culture shock and changes in nursing roles. Transition issues including the need for effective management and infrastructure support, mentoring and preceptorship, skills acquisition and continuing education will be examined. Joint implementation of what is successful at both university and industry levels can improve the transition to community nursing.
Carney, Jolynn V.
The author examines the unique ability of mental health providers to offer humanistic services in a highly competitive atmosphere by using a wellness approach. J. E. Myers and T. J. Sweeney's (2005) 5 second-order factors are offered as a conceptual model. Therapeutic techniques and humanizing benefits for individuals, families, and communities…
Fields, J. M.
After examining reports from a large number of social surveys, two areas were identified where methodological improvements in the surveys would be especially useful for public policy. The two study areas are: the definition of noise indexes and the assessment of noise impact. Improvements in the designs of surveys are recommended which would increase the validity and reliability of the noise indexes. Changes in interview questions and sample designs are proposed which would enable surveys to provide measures of noise impact which are directly relevant for public policy.
Ungar, Michael; Manuel, Susan; Mealey, Stephanie; Thomas, Golda; Campbell, Carolyn
A study of 35 nonprofessional helpers, identified as community "guides," focused on the contribution each made to helping marginalized individuals and families become a part of their communities. The lessons learned through these lay helpers can inform a postmodern social work practice that promotes the use of indigenous practice principles…
Parker, Melissa; Patton, Kevin; Madden, Matthew; Sinclair, Christina
Despite the benefits associated with teacher development through participation in communities of practice, many questions about these groups remain unanswered. The purpose of this qualitative study was to examine a group of elementary physical education teachers as a community of practice whose objective was to develop and disseminate…
Nistor, Nicolae; Daxecker, Irene; Stanciu, Dorin; Diekamp, Oliver
Sense of community (SoC) in communities of practice (CoP) seems to play a similar role to that of group cohesion in small groups: Both sustain participants' knowledge sharing, which in turn substantiates the socio-cognitive structures that make up the CoP such as scholar identities, practical repertoires in research and teaching or relationships…
A community practice framework is presented as the synthesis of research findings from the analysis of a critical ethnonursing study of women in recovery from chemical dependence. Critical Social Theory is used to examine the paradoxical experiences of women from their lifeworld and system within the community. The framework focuses on the mutual moral caring actions of the community nurse and the women in the recovery. It is supported by the concepts of transcultural nursing ethics. The utility of the framework is to promote clarity of speech and parity of community membership for women in recovery from chemical dependence and their return to the community.
The purpose of this study, funded by Jobs for the Future through a grant to the Massachusetts Community Colleges Executive Office, was to: (1) provide an update on the status of developmental education within Massachusetts community colleges; (2) shed light on the alignment between research-based best practices to advance success among…
The community of practice includes agencies from across the federal government who convene to discuss ideas, activities, barriers, and ethics related to citizen science and crowdsourcing including scientific research, data management, and open innovation.
Lin, Ching-Ping; Black, Robert A.; LaPlante, Jay; Keppel, Gina A.; Tuzzio, Leah; Berg, Alfred O.; Whitener, Ron J.; Buchwald, Dedra S.; Baldwin, Laura-Mae; Fishman, Paul A.; Greene, Sarah M.; Gennari, John H.; Tarczy-Hornoch, Peter; Stephens, Kari A.
Health data sharing with and among practices is a method for engaging rural and underserved populations, often with strong histories of marginalization, in health research. The Institute of Translational Health Sciences, funded by a National Institutes of Health Clinical and Translational Science Award, is engaged in the LC Data QUEST project to build practice and community based research networks with the ability to share semantically aligned electronic health data. We visited ten practices and communities to assess the feasibility of and barriers to developing data sharing networks. We found that these sites had very different approaches and expectations for data sharing. In order to support practices and communities and foster the acceptance of data sharing in these settings, informaticists must take these diverse views into account. Based on these findings, we discuss system design implications and the need for flexibility in the development of community-based data sharing networks. PMID:21347138
Visone, Jeremy D.
This article shares a promising practice: collegial visits. During collegial visits, educators watch a colleague teach a lesson about a predetermined focus as a form of professional development. Educators, including the host teacher, debrief after the lesson. These visits are part of a cycle of learning that moves from theory to practice, and the…
Smalkoski, Kari; Axtell, Sara; Zimmer, Jeanne; Noor, Ibrahim
Generic outreach approaches are commonly used to target as many individuals as possible in a cultural community to achieve a greater response rate. However, this one-size-fits-all tactic is rarely effective. Community-engaged outreach practices have been successful with immigrant communities in Minnesota's Twin Cities. When practitioners,…
Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M
The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.
Suarez-Balcazar, Yolanda; Mirza, Mansha Parven; Hansen, Anne Marie Witchger
Today, more than ever, occupational therapists are engaged in close partnerships with community organizations and community settings such as service agencies, refugee and immigrant enclaves, and faith-based organizations, to name a few, for the purpose of engaging in scholarship of practice. However, we know little about the views of community partners regarding the development and sustainability of university-community partnerships. The purpose of this article is twofold: First, we will describe a pilot study in which we gathered qualitative data from community partners engaged in scholarship of practice with faculty and students, regarding their views about benefits of partnerships, challenges, and characteristics of sustainable partnerships. Second, based on this pilot study and extensive experience of the authors, we propose a revised version of a partnerships model available in the literature. We illustrate the model through examples of the authors' collective experiences developing and sustaining successful university-community partnerships.
Kladifko, Robert E.
School leaders must have knowledge and understanding of the various external and internal entities in their school community. Partnerships, with a focus on communication and interaction with diverse community leaders and professionals, are essential for school success. In this article, the author discusses successful practical experiences and…
Ferguson, Gibson Ronald
Through observation, questionnaires and, particularly, ethnographic interviews with parents, pupils, teachers and community organisers associated with a Yemeni complementary school, this paper develops a portrait of language repertoires, practices and preferences in a Yemeni diasporic community in a northern English city. Also investigated are the…
This article explores ways of learning experienced by university dance students participating in a community dance project. The students were unfamiliar with community-based practices and found themselves needing to remediate held attitudes about dance. How the students came to approach their learning within the dance-making process drew on…
Virtual community of practice (VCoP) teams are becoming a typical function in many knowledge-based organizations. VCoP teams can consist of team members located in various cities, states, and countries. The main characteristic of the VCoP is team members' sense of community that allows individuals to share knowledge. Knowledge sharing in a VCoP…
Goodyear, Leslie K.
New and novel uses of evaluation processes and findings are possible when a community of practice develops as evaluation stakeholders participate in multisite evaluations in multiple ways. Developing such communities takes advantage of what makes multisite evaluations special. This chapter uses the example of the Innovative Technology Experiences…
Sullivan, Catherine H
Refugees' cultural beliefs, communication barriers, and low health literacy may lead to health disparities within the Western health care system. This article describes a teaching-learning strategy emphasizing the community partnership between a baccalaureate school of nursing, an immigrant-refugee program, and a community literacy program in a rural state. Senior community health nursing students partnered with an immigrant-refugee program and a community literacy program to provide health promotion and prevention services to recently immigrated Hmong and Russian refugees. Priority health needs were identified and culturally appropriate health promotion and prevention education modules were designed and implemented by students. Students collaborated with community agencies and businesses to increase access to health resources for these vulnerable populations. Outcomes were the provision of cultural awareness experiences for nursing students and access to health care with increased knowledge of Western health care practices and beliefs for refugees.
Mangadu, Thenral; Kelly, Michael; Orezzoli, Max C E; Gallegos, Rebecca; Matharasi, Pracheta
Minority communities such as those on the US-Mexico border are placed at disproportionate high risk for child and adult obesity, diabetes and cardiovascular diseases. A built environment characterized by an arid desert climate, lack of access to healthy foods, barriers to increasing physical activity, cultural and community norms which deter healthy eating and sustainable food production, shape obesity-related health disparities in these communities. Three pilot community gardens (implemented by two local governmental organizations and one community-based organization) were funded through the local Healthy Eating Active Living (HEAL) initiative in El Paso, Texas, and Las Cruces and Anthony, New Mexico (US-MX border communities with high obesity rates) in order to encourage healthy lifestyles among families in the region. A mixed-methods evaluation (n = 223) examined the implementation process, immediate outcomes and best practices of implementing and sustaining community gardens in these minority binational communities. In addition to nutrition-related outcomes, the potential for psychosocial outcomes from participating in community and school garden projects were observed. The best practices in relation to (i) assessing community norms related to growing food, (ii) increasing access to land and water for community/school gardening and (iii) enhancing social support for gardening are discussed. The implications of these best practices for obesity prevention and implementing community gardens in a minority US-MX border community characterized by cultural, geographical and socioeconomic barriers are examined.
LaVetter, David; Kim, Hyun Duck
Over 45,000 U.S. community college athletes were transported to events during 2005-2006. Transporting college athletes has been an overlooked risk management issue facing administrators. Team travel accidents have caused death, injury, liability claims, property loss, and grief. National Junior College Athletic Association (NJCAA) member…
Freedman, Marjorie R; Alvarez, Karina P
Early childhood is a critical period for shaping and influencing feeding and lifestyle behaviors that have implications for future weight and health. With more women in the workforce, families have become reliant on child care. Thus, the child-feeding relationship has become a shared responsibility between the parent and child-care provider. Little is known about the impact of child-care providers on development of early childhood feeding behaviors and subsequent risk for obesity, especially in the Hispanic ethnic group. This research examined child-feeding attitudes, practices, and knowledge of multi-ethnic home-based and center-based child-care providers. Questionnaires were completed by a convenience sample of 72 providers, 50 of whom completed a pre- and post-test on child-feeding knowledge after receiving a 90-minute class based on Satter's division of responsibility feeding model during the spring of 2008. Results indicate many providers had practices consistent with this model. However, substantial differences were reported by Hispanic providers, who were statistically more likely to encourage children to finish meals before dessert, prepare foods they perceived as well-liked by children, coach children to eat foods perceived as appropriate, and not eat with children during meals. A substantial increase in knowledge from 73% correct at pretest to 82% at post-test was noted, with a substantial increase in knowledge on five of 13 questions. However, knowledge was not always congruent with behavior. This study points to differences among providers based on ethnicity, and strongly recommends recruiting Hispanic child-care providers to participate in educational programs and community efforts to prevent obesity.
Golden, Julie E.
Faculty development efforts for supporting online instructors represent a growing concern for higher education administrators. Providing online faculty with enriching experiences designed to improve practice, combat isolation, and share knowledge and resources is a challenge. This review examines the use of a community of practice (CoP) approach…
Dogan, Selcuk; Pringle, Rose; Mesa, Jennifer
The purpose of this article is to provide a review of empirical studies investigating the impact of professional learning communities (PLCs) on science teachers' practices and knowledge. Across 14 articles that satisfied the definition we embraced, most were devoted to the change in science teaching practices, disciplinary content knowledge (DCK)…
van Winkelen, Christine
Purpose: This paper aims to explore the use of developmental evaluation methods with community of practice programmes experiencing change or transition to better understand how to target support resources. Design/methodology/approach: The practical use of a number of developmental evaluation methods was explored in three organizations over a…
Kong, Ailing; Pearson, P. David
The authors gave the following talk at the 2004 NCTE Annual Convention in Indianapolis upon receiving the Alan C. Purves Award, presented to the RTE article from the previous volume year judged most likely to have an impact on classroom practice ("The Road to Participation: The Construction of a Literacy Practice in a Learning Community of…
Smith, Ann Marie; Hurst, Jeannine; Murakami, Elizabeth
The purpose of this study was to investigate the experiences of faculty as they engaged in professional development under a Teacher Preparation Initiative (TPI). This initiative engaged faculty in a community of practice that included activities such as aligning curricula, professional development, and examining teaching practices. This study was…
Rowlands, Kate; Avramenko, Alex
This paper introduces an innovative course design incorporating both communities of practice and reflective practice as a learning strategy for part-time learners in higher education. The new design has been applied to teaching HR practitioners in a UK-based business school. Findings indicate that the suggested way of organizing teaching and…
Marken, James A.; Dickinson, Gail K.
Implementing Communities of Practice (CoP) in online learning is well documented (Gray, 2004; Wenger & Snyder, 2000), and is of particular interest to the LIS profession (Yukawa, 2010). Most of the students in school library programs are practicing teachers seeking to add the library science endorsement to their existing license. They are…
Morris, Lynne Clemmons; Morris, Judson Henry, Jr.
Defines rurbanization (change process wherein small communities/rural areas build upon their social/cultural heritages in coping with impacts of rapid growth) and rurban practice. Itemizes skills needed for rurban human service work. Offers simulations to enhance rurban practice skills, incorporating sequential use of experiential learning tools…
Paynter, Jessica M.; Ferguson, Sarah; Fordyce, Kathryn; Joosten, Annette; Paku, Sofia; Stephens, Miranda; Trembath, David; Keen, Deb
A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and…
Ling, Tristan; Bereznicki, Luke; Westbury, Juanita; Chalmers, Leanne; Peterson, Gregory; Ollington, Robert
Objective. To provide a computer-based learning method for pharmacy practice that is as effective as paper-based scenarios, but more engaging and less labor-intensive. Design. We developed a flexible and customizable computer simulation of community pharmacy. Using it, the students would be able to work through scenarios which encapsulate the entirety of a patient presentation. We compared the traditional paper-based teaching method to our computer-based approach using equivalent scenarios. The paper-based group had 2 tutors while the computer group had none. Both groups were given a prescenario and postscenario clinical knowledge quiz and survey. Assessment. Students in the computer-based group had generally greater improvements in their clinical knowledge score, and third-year students using the computer-based method also showed more improvements in history taking and counseling competencies. Third-year students also found the simulation fun and engaging. Conclusion. Our simulation of community pharmacy provided an educational experience as effective as the paper-based alternative, despite the lack of a human tutor. PMID:26056406
Pivik, Jayne R; Goelman, Hillel
A process evaluation of a consortium of academic researchers and community-based service providers focused on the health and well-being of children and families provides empirical and practice-based evidence of those factors important for community-based participatory research (CBPR). This study draws on quantitative ratings of 33 factors associated with CBPR as well as open-ended questions addressing the benefits, facilitators, barriers, and recommendations for collaboration. Eight distinct but related studies are represented by 10 academic and 9 community researchers. Even though contextual considerations were identified between the academic and community partners, in large part because of their focus, organizational mandate and particular expertise, key factors for facilitating collaboration were found across groups. Both community and academic partners reported the following as very important for positive collaborations: trust and mutual respect; adequate time; shared commitment, decision making, and goals; a memorandum of understanding or partnership agreement; clear communication; involvement of community partners in the interpretation of the data and information dissemination; and regular meetings. The results are compared to current models of collaboration across different contexts and highlight factors important for CBPR with community service providers.
Hardy, Lisa J; Hughes, Amy; Hulen, Elizabeth; Figueroa, Alejandra; Evans, Coral; Begay, R Cruz
Community-engaged approaches to research and practice continue to show success in addressing health equity and making long-term change for partnership relationships and structures of power. The usefulness of these approaches is either diminished or bolstered by community trust, which can be challenging for partnerships to achieve. In this research note we present an example process for recruiting, interviewing, and hiring community researchers as a starting place for capacity building and for laying the foundation for data collection and analysis in health-related community projects. PMID:27833454
Chalmers, Lex; Keown, Paul
The Internet has had a transformative effect on many aspects of contemporary living. While there may be a tendency to overstate the impacts of this technology, workplaces and work practices in many societies have been greatly affected by almost instant access to massive amounts of information, delivered through broadening bandwidth. This paper…
Critical thinking is an important outcome of a college education. Assessment techniques that require students to demonstrate their understanding of course concepts are referred to as authentic assessment and promote the development of critical thinking. Little research exists on the types of assessment and grading practices utilized by community…
Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita
Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC)/non-circumcising communities (NCC); including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs) such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision. Results Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for ‘religious identity/privilege/sacrifice’ or ‘hygiene’; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting ‘foreign’ evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence. Conclusion HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance
van Zyl, Marjorie; Eygelaar, Johanna
Background Interventions by community care workers within the context of community-based integrated management of childhood illness (CIMCI) may have a positive effect on child health if the health workers have adequate knowledge about key family practices. Setting The study was conducted in rural areas of the West Coast district in the Western Cape, South Africa. Objectives The objective of this study was to determine the knowledge of community care workers about five of the 16 key family practices of CIMCI. Methods A descriptive survey collected a self-administered questionnaire from 257 community care workers out of a possible total of 270 (95.2% response rate). Descriptive and inferential statistical analysis was applied. Results Only 25 of the respondents (10%) obtained a score higher than 70% on the knowledge-based items of the questionnaire. Less than 25% of respondents answered questions in these key areas correctly (pneumonia [17%], tuberculosis [13%], HIV/AIDS [9%] immunisation [3%] and recommendations for a child with fever [21%]). Statistically significant correlations were found between the total score a respondent achieved and the highest level of education obtained (p < 0.01), the level of in-service training (p < 0.01), attendance of a CIMCI five-day training course (p < 0.01), and completing a subsequent refresher course (p < 0.01). Conclusion The knowledge of CCWs was inadequate to provide safe, quality CIMCI. CIMCI refresher courses should be offered annually to improve CCWs’ knowledge and the quality of care that they render. Regular update courses could contribute to building competence. PMID:26842523
Caplain, Roland; Yacoubou, Ismaïl; Adedemy, Didier; Sani, Alidou; Takam, Sandrine; Desplats, Dominique
Considerable effort has been made to provide rural African populations with basic health care, but the quality of this care remains unsatisfactory due to the absence of first-line GPs. This is a paradoxical situation in view of the large number of physicians trained in medical schools in French-speaking Africa and Madagascar. of the lack of GPs working in rural areas is a real concern, as many young doctors remain unemployed in cities. For more than 20 years, the NGO Santé Sud has proposed a Community General Medicine concept, which, combined with a support system, has allowed the installation of more than 200 community GPs in Mali and Madagascar. The advantage of this concept is that it provides family medicine and primary health care in the same practice. Since 2009, Santé Sud supports an installation project in rural areas of northern Benin, where community GPs work independently, as a complementary partner of the public sector. Since 2013, the installation process comprises a university degree created with the University of Parakou Faculty of Medicine. Based on this experience in Benin, the authors show that the presence of a first-line general practitioner is an original strategy that provides a major contribution to health promotion : reducing health inequalities between rural and urban populations, allowing women to receive medically assisted childbirth close to home, developing family planning activities, education and health care for chronic diseases, strengthening health coverage by participating in vaccination campaigns, etc. Due to their functions and proximity, community GPs represent an added value for health promotion.
Hoffart, Caroline; Kuster-Orban, Cindy; Spooner, Crystal; Neudorf, Kim
The Intraprofessional Practice Education (IPE) pilot project was designed to increase the number of high-quality practice education settings and to develop intraprofessional learning opportunities for nursing students from three different prelicensure programs. Students from the licensed practical nurse, registered nurse, and registered psychiatric nurse programs shared their practice education experience concurrently in a rural First Nations community. This project's framework, the Partnership Model for Community Health Nursing Education (PMCHNE), is described and includes an explanation of the planning and coordination that occurred prior to implementation of the pilot project. Various student practice education and cultural experiences are highlighted, and the results from the project's evaluation are discussed, including the utility of the PMCHNE and the benefits and challenges associated with implementing an IPE experience.
Townsend, Stephanie M; Campbell, Rebecca
Community-based rape prevention programs have received little attention in the research literature. In this study qualitative methods were used to describe such programs and to assess the degree of homogeneity in their practices. In-depth interviews were conducted with representatives of 10 community-based prevention programs in a single state. Findings suggest that two typologies exist: short programs and extended programs. Homogeneity across programs was common as most programs emphasized secondary and tertiary prevention and relied on short curricula that are implemented with mixed-gender groups of students. A comparison to practices found in the research literature indicate that they are mostly using the same practices and these practices have not been demonstrated to have sustained behavioral effects that would reduce the incidence of sexual violence. Implications for future practice are discussed.
Neogeography and Volunteered Geographic Information (VGI) are two terms that have emerged recently to describe the practice of geography by those not formally trained in it as a discipline and spatial data provided by individuals through social media and other Web-based tools. Both neogeography and VGI can be directly linked to the growth of various online mapping websites and applications that allow for the creation of electronic maps that are interactive, adaptable, and easily shared via the Internet and Web. As recent phenomena, the practice of neogeography and VGI is not well understood, nor are the links these new fields have to previously established knowledge on Geographic Information Systems and its associated practices. This thesis attempts to fill this knowledge gap through a participatory study of neogeographic practice. Using a participatory workshop format, I observed and documented representatives of community-based organizations in Syracuse, NY as they encountered online mapping tools for the first time. I followed up with two of those organizations in longer case studies to better understand how organizations with no obvious geographic focus come to see geography as a way of communicating complex ideas about space. This study revealed that while the technical complexity of the online mapping software continues to prove to be a hindrance to its use, there remains space for professional geographers to interact with laypeople who make maps. Furthermore, such engagement is necessary to begin to understand the issues involved with location-based information and privacy, access to data, and ability to use and communicate geographic concepts and knowledge.
Bang, Megan Elisabeth
There is a great need to raise the levels of science achievement for those groups of children who have traditionally underperformed. Prior cognitive research with Native people suggests that problems with achievement for Native students may be more complicated then simple problems with knowing or not knowing content knowledge. This dissertation hypothesizes that Native Americans engage in practices and have funds of knowledge that facilitate sophisticated reasoning in the domain of science. However, the knowledge and patterns of reasoning are not elicited, acceptable, or recognized in classroom science, or perhaps are in conflict with classroom science. Furthermore the divergence is not simply in the details of what is known; there is discord at the level of epistemology, in the fundamental ways in which Native people conceptualize knowledge of the natural world. This work proposes a new framework, Micro-practice epistemology, for understanding epistemology. I propose that epistemology should be understood as implicitly and explicitly imbedded in the worldviews, values, beliefs and practices of our everyday lives. Using both qualitative and quantitative methods this work investigates the everyday practices related to nature, the epistemological stances and biological knowledge embedded in those practices in a 3X3 model (age cohort: child, adult, elder X community). The three communities involved in this work include: Chicago urban Indian community, Menominee reservation community, and a rural working poor white community. I find significant differences in all three areas across communities. Native communities tend to participate in practices in which some aspect of nature is fore-grounded while non-Native participants tended to participate in practices in which nature is the back-grounded. These findings are extended to explore the ways in which worldviews and values are connected to practice and knowledge about the natural world. I find significant differences in
Kern, Robert S.; Liberman, Robert P.; Becker, Deborah R.; Drake, Robert E.; Sugar, Catherine A.; Green, Michael F.
The effects of errorless learning (EL) on work performance, tenure, and personal well-being were compared with conventional job training in a community mental health fellowship club offering 12-week time-limited work experience. Participants were 40 clinically stable schizophrenia and schizoaffective disorder outpatients randomly assigned to EL vs conventional instruction (CI) at a thrift-type clothing store. EL participants received training on how to perform their assigned job tasks based on principles of EL, such as error reduction and automation of task performance. CI participants received training common to other community-based entry-level jobs that included verbal instruction, a visual demonstration, independent practice, and corrective feedback. Participants were scheduled to work 2 hours per week for 12 weeks. For both groups, job training occurred during the first 2 weeks at the worksite. Work performance (assessed using the Work Behavior Inventory, WBI) and personal well-being (self-esteem, job satisfaction, and work stress) were assessed at weeks 2, 4, and 12. Job tenure was defined as the number of weeks on the job or total number of hours worked prior to quitting or study end. The EL group performed better than the CI group on the Work Quality Scale from the WBI, and the group differences were relatively consistent over time. Results from the survival analyses of job tenure revealed a non-significant trend favoring EL. There were no group differences on self-esteem, job satisfaction, or work stress. The findings provide modest support for the extensions of EL to community settings for enhancing work performance. PMID:18326529
Kern, Robert S; Liberman, Robert P; Becker, Deborah R; Drake, Robert E; Sugar, Catherine A; Green, Michael F
The effects of errorless learning (EL) on work performance, tenure, and personal well-being were compared with conventional job training in a community mental health fellowship club offering 12-week time-limited work experience. Participants were 40 clinically stable schizophrenia and schizoaffective disorder outpatients randomly assigned to EL vs conventional instruction (CI) at a thrift-type clothing store. EL participants received training on how to perform their assigned job tasks based on principles of EL, such as error reduction and automation of task performance. CI participants received training common to other community-based entry-level jobs that included verbal instruction, a visual demonstration, independent practice, and corrective feedback. Participants were scheduled to work 2 hours per week for 12 weeks. For both groups, job training occurred during the first 2 weeks at the worksite. Work performance (assessed using the Work Behavior Inventory, WBI) and personal well-being (self-esteem, job satisfaction, and work stress) were assessed at weeks 2, 4, and 12. Job tenure was defined as the number of weeks on the job or total number of hours worked prior to quitting or study end. The EL group performed better than the CI group on the Work Quality Scale from the WBI, and the group differences were relatively consistent over time. Results from the survival analyses of job tenure revealed a non-significant trend favoring EL. There were no group differences on self-esteem, job satisfaction, or work stress. The findings provide modest support for the extensions of EL to community settings for enhancing work performance.
Clark, J D; Williams, D E
This report suggests an educational format that has been used successfully in Michigan to introduce the Health Care Quality Improvement Initiative to the medical community. The activities related to pattern analysis and the Fourth Scope of Work will require a collaborative effort between the medical community and the peer review organization (PRO). To improve understanding by providers and practitioners of pattern analysis, the Fourth Scope of Work, and the new PRO requirements, a series of educational programs was designed. The first presentation in the educational series included information about the changes between the Third and Fourth Scope of Work as well as the new structure within the PRO responsible for the pattern analysis activities: the Center for Health Outcomes and Evaluation. Descriptions of the process to be followed in interactions between the Center and providers and practitioners also were included: For the second session, a hands-on exercise was created to introduce the concept of a pattern. The exercise included graphic representations of patterns and a worksheet format to encourage the user to find specific data points within tables and graphs, describe a pattern in hospital outcome data, and verify that the same outcome pattern appeared in subgroups of hospitals and physicians. The third component in the educational series was a demonstration of the interaction between the Center and a hospital participating in a cooperative improvement project. Hospital-specific and physician-specific data, with appropriate comparative data, were provided to an audience made up of hospital administrators, practicing physicians, and allied health personnel who then worked through the issues related to data validation, definition of a project, agreement on interventions, and remeasurement of the outcome under study.
Hsu, Chiehwen Ed; Mas, Francisco Soto; Jacobson, Holly E; Harris, Ann Marie; Hunt, Victoria I; Nkhoma, Ella T
Meeting the needs of public health emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to public health emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of public health emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies.
Broussard, A B; Delahoussaye, C P; Poirrier, G P
The practice role of nurse educators has emerged as a mechanism to unite practice, research, and education. The long-term outcome of such a synthesis should be an improvement in the quality of nursing care delivered to clients. Clinically focused nursing research designed by nurse educators who maintain a practice role or nurse clinicians who maintain a teaching role has the potential to unify and thus advance the profession. The authors discuss the historical background from which the practice role evolved, and efforts of recent nursing leaders to facilitate the incorporation of the nursing practice role by educators. Models for faculty practice are identified, and advantages of faculty practice are reviewed. The authors also describe barriers to the establishment of faculty practice, contemporary developments impacting faculty practice, and research needed to advance faculty practice. Nurse educators in many academic communities in the 1990s are discovering that not only must they produce scholarly work in addition to their teaching and service to the university and community, but that they may also be under growing pressure to be engaged in clinical practice. This pressure may be self-imposed or may be an expectation of their colleagues in nursing education or the administrators of their nursing programs. The focus of this research brief will be to describe the historical background from which this "new" role evolved, to discuss strategies or models developed to facilitate the faculty practice role, and to identify faculty practice issues that have emerged with the adoption of this role in academia. An additional focus will be to critically review faculty practice-related research performed since Chicadonz' (1987) review.
Genet, Russell M.
Communities of practice are natural, usually informal groups of people who work together. Experienced members teach new members the “ropes.” Social learning theorist Etienne Wenger’s book, Communities of Practice: Learning, Meaning, and Identity, defined the field. There are, in astronomy, many communities of practice. One set of communities uses relatively small telescopes to observe brighter objects such as eclipsing binaries, intrinsically variable stars, transiting exoplanets, tumbling asteroids, and the occultation of background stars by asteroids and the Moon. Advances in low cost but increasingly powerful instrumentation and automation have greatly increased the research capabilities of smaller telescopes. These often professional-amateur (pro-am) communities engage in research projects that require a large number of observers as exemplified by the American Association of Variable Star Observers. For high school and community college students with an interest in science, joining a student-centered, small telescope community of practice can be both educational and inspirational. An example is the now decade-long Astronomy Research Seminar offered by Cuesta College in San Luis Obispo, California. Each student team is required to plan a project, obtain observations (either locally or via a remote robotic telescope), analyze their data, write a paper, and submit it for external review and publication. Well over 100 students, composed primarily of high school juniors and seniors, have been coauthors of several dozen published papers. Being published researchers has boosted these students’ educational careers with admissions to choice schools, often with scholarships. This seminar was recently expanded to serve multiple high schools with a volunteer assistant instructor at each school. The students meet regularly with their assistant instructor and also meet online with other teams and the seminar’s overall community college instructor. The seminar
Hauser, Linda; Darrow, Rob
This paper presents a promising and powerful approach used to cultivate a doctoral community of inquiry and practice and harness the intelligence, commitment, and energy of all of its members in a blended learning environment. The discussion board online learning community approach was developed to transform a traditional face-to-face doctoral…
Sarirete, Akila; Chikh, Azeddine; Noble, Elizabeth
Purpose: The purpose of this paper is to define a community memory for a virtual communities of practice (CoP) based on organizational learning (OL) concept and ontologies. Design/methodology/approach: The paper focuses on applying the OL concept to virtual CoP and proposes a framework for building the CoP memory by identifying several layers of…
Laughter, Judson; Han, Keonghee Tao; King, Donna; Madhuri, Marga; Nayan, Rohany; Williams, Toni
The story presented here developed from a study group where we found space to explore and analyze ourselves and each other. In recounting our development from a Community of Interest to a Community of Practice (CoP), we first introduce a guiding theoretical framework building on a foundation of two concepts: "CoP" and…
Ho, Kendall; Jarvis-Selinger, Sandra; Norman, Cameron D; Li, Linda C; Olatunbosun, Tunde; Cressman, Céline; Nguyen, Anne
The timely incorporation of health research into the routine practice of individual health practitioners and interprofessional teams is a widely recognized and ongoing challenge. Health professional engagement and learning is an important cog in the wheel of knowledge translation; passive dissemination of evidence through journals and clinical practice guidelines is inadequate when used alone as an intervention to change the practices of the health professionals.An evolving body of research suggests that communities of practice can be effective in facilitating the uptake of best practices by individual health professionals and teams. Modern information technologies can extend the boundaries and reach of these communities, forming electronic communities of practice (eCoP) that can be used to promote intra- and interprofessional continuing professional development (CPD) and team-based, patient-centered care. However, examples of eCoPs and examination of their characteristics are lacking in the literature. In this paper, we discuss guidelines for developing eCoP. These guidelines will be helpful for others considering the use of the eCoP model in interprofessional learning and practice.
Afterschool Alliance, 2014
The 21st Century Community Learning Centers (21st CCLC) initiative is the only federal funding source dedicated exclusively to before-school, afterschool, and summer learning programs. Each state education agency receives funds based on its share of Title I funding for low-income students at high-poverty, low performing schools. Funds are also…
Pareja Roblin, Natalie N.; Ormel, Bart J. B.; McKenney, Susan E.; Voogt, Joke M.; Pieters, Jules M.
This study characterises the links between research and practice across 12 projects concerned with the collaborative design of lesson plans by teacher communities (TCs). Analyses focused on sources of knowledge used to inform lesson design, participants' roles and knowledge generated by the teacher community. Three patterns emerged pertaining…
Balint, Katherine A; George, Nancy M
The role of the Faith Community Nurse (FCN) is a multifaceted wholistic practice focused on individuals, families, and the faith and broader communities. The FCN is skilled in professional nursing and spiritual care, supporting health through attention to spiritual, physical, mental, and social health. FCNs can help meet the growing need for healthcare, especially for the uninsured, poor, and homeless. The contribution of FCNs on, primary prevention, health maintenance, and management of chronic disease deserves attention to help broaden understanding of the scope of FCN practice.
Background Reports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs). The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are “front-line” health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied. Methods Using Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15) open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies. Results The majority of pharmacists surveyed (276; 68%) recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist’s Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84%) recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31%) recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database. Conclusions The study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists’ practices around NHPs are consistent with
Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen
Background: In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. Methods: In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Results: Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. Discussion: There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Conclusion: Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx. PMID:26798376
Keenan, Thomas P.; Trotter, David Mitchell
Examines the changing role of community network associations or freenets in providing Internet access by examining the case of the Calgary Community Network Association (CCNA) in Alberta, Canada. Discusses the withdrawal of states from the telecommunications field, priorities of the Canadian government, and the role of the private sector.…
Cueva, Melany; Kuhnley, Regina; Lanier, Anne P.; Dignan, Mark
Community Health Aides and Community Health Practitioners (CHA/Ps), the primary providers of healthcare in rural Alaska, share the importance of story as a culturally respectful way for creating meaning and broadening understanding. Story is woven into the fabric of cancer education courses for CHA/Ps. Between May 2004 and April 2007, 13 week-long…
Achieving certification is a benefit to the nurses, to their patients, and to the organizations that support them. Developing an online learning community is a simple way for the institution to offer support to the nursing staff. Providing the resources for creation of online learning communities demonstrates the facility's commitment to communication, education, and professional development.
The review of the literature examines issues concerned with the use of psychotropic medication by people with severe disabilities living in community settings. Data on prevalence of drug usage are provided and include that 54.3% of residents of community residences receive some type of prescribed medication, most of which are classified as…
Office of Vocational and Adult Education, US Department of Education, 2009
A 50-state analysis of postsecondary correctional education policy conducted by the Institute for Higher Education Policy (IHEP) in 2005 found that 68 percent of all postsecondary correctional education is provided by community colleges. The IHEP findings were the basis for this review of partnerships between community colleges and prisons. This…
Bottoms, Sueann I.
Research suggests that long-term participation in professional development is critical in helping teachers meet the increasing demands of reform efforts and changing practice (Gallucci, 2003; Darling-Hammond, 1995; Little, 1993). Understanding the influence that participation in a community of teachers as a community of practice may have on teachers professional growth requires a deeper understanding of those aspects of teacher community that encourage or discourage participation. This research examines teachers perceptions as to why they participate in a community of practice. It also addresses what these perceptions suggest about the potential resources that participation in a community of practice provide in support of professional growth. This study utilizes community of practice as theoretical framework because it encourages thought about learning as participation rather than simply the acquisition of knowledge or skills (Wenger, 1999). This mid-level analysis focuses on the actions, artifacts, tools, stories, events, and discourse of the participants in a given context. It is a critical case study using a phenomenological perspective (Patton, 2005) to understand the essence of the experience of participation from the perspective of the participants themselves. Analysis of participants responses indicates that from their perspective, participation in a community of teachers as community of practice through a school-university partnership constitutes a resource for professional growth. Teachers in this study describe their participation in terms of leadership, disengagement, student-centeredness, pedagogy and pedagogical content knowledge, financial and material resources, professional development, collegial interactions and relationships, and shared personal practice. Analysis of participation is characterized by reason(s) for initial participation, for continuing or discontinuing participation, in terms of collegial interactions and relationships, and by
Printy, Susan M.
Improving the quality of teachers in schools is a keystone to educational improvement. New and veteran teachers alike need to enhance their content knowledge and pedagogical skills, but they must also examine, and often change, their underlying attitudes, beliefs, and values about the nature of knowledge and the abilities of students. Best accomplished collectively rather than individually, the interactions between teachers as they undertake the process of collaborative inquiry create "communities of practice." This dissertation investigates the importance of science and mathematics teachers' participation in communities of practice to their professional capabilities. The study tests the hypothesis that the social learning inherent in community of practice participation encourages teachers to learn from others with expertise, enhances teachers' sense of competence, and increases the likelihood that teachers' will use student-centered, problem-based instructional techniques aligned with national disciplinary standards. The researcher conceptualizes communities of practice along two dimensions that affect social learning: legitimate participation in activities and span of engagement with school members. Differences in teachers' subject area and the curricular track of their teaching assignment contribute to variation in teachers' participation in communities of practice along those dimensions. Using data from the National Educational Longitudinal Study, first and second follow-up, the study has two stages of multi-level analysis. The first stage examines factors that contribute to teachers' participation in communities of practice, including teachers' social and professional characteristics and school demographic and organizational characteristics. The second stage investigates the professional impact of such participation on the three outcome variables: teacher learning, teacher competence, and use of standards-based pedagogy. Hierarchical linear models provide
Špiranec, Sonja; Kos, Denis
Introduction: This paper provides a contribution to understandings of information literacy regarding context and transferability of information practices. Specifically, the paper analyses the subset of information practices in situations of student protests and addresses issues of transfer of information literacy practice from a highly formal…
Reveles, John Michael
This one-year ethnographic study of a third grade classroom examined the construction of elementary school science. The research focused on the co-development of scientific literacy and academic identity. Unlike much research in science education that views literacy as merely supportive of science; this dissertation research considers how students learned both disciplinary knowledge in science as well as about themselves as learners through language use. The study documented and analyzed how students came to engage with scientific knowledge and the impact this engagement had upon their academic identities over time. Ethnographic and discourse analytic methods were employed to investigate three research questions: (a) How were the students in a third grade classroom afforded opportunities to acquire scientific literate practices through the spoken/written discourse and science activities? (b) In what ways did students develop and maintain academic identities taken-up over time as they discursively appropriated scientific literate practices via classroom discourse? and (c) How did students collectively and individually inscribe their academic identities and scientific knowledge into classroom artifacts across the school year? Through multiple forms of analyses, I identified how students' communication and participation in science investigations provided opportunities for them to learn specific scientific literate practices. The findings of this empirical research indicate that students' communication and participation in science influenced the ways they perceived themselves as active participants within the classroom community. More specifically, students were observed to appropriate particular discourse practices introduced by the teacher to frame scientific disciplinary knowledge and investigations. Thus, emerging academic identities and developing literate practices were documented via analysis of discursive (spoken, written, and enacted) classroom interactions. A
Kinzie, Jillian; Schuh, John H.
The value of establishing a strong community in institutions of higher education has been in the forefront of the thinking of educators for a number of years. As colleges and universities have grown in complexity, establishing and sustaining strong campus communities has been described as challenging and difficult. John Gardner has provided a…
Weissman, Fred G.; And Others
A clerkship at the University of Southern California School of Pharmacy was developed to provide students with (1) experience in the identification, development,, implementation, and evaluation of patient care services in community pharmacies and (2) the skills required to successfully operate a community pharmacy on a day-to-day basis.…
Torrey, Michelle Kerber; Leginus, Mary Anne; Cecere, Susan
In this commentary the authors share their experiences on the design and implementation of community-centered early intervention programs in Prince George's County, MD. Their aim in designing community-centered programs was to provide infants and toddlers opportunities for learning, language, and motor development in natural environments with…
Balcaen, Philip L.; Hirtz, Janine R.
In this paper, we consider an approach to developing critically thoughtful e-Learning communities of practice--where participants are deliberate about the use of specific intellectual tools supporting critical thinking. We address Garrison & Anderson's (2003) argument that such critical thinking should play a central role within the ecology of…
Describes the LabNet project that has three interrelated goals: (1) encouraging the use of student projects to enhance science learning, (2) building a professional community of practice among high school science teachers, and (3) exploiting the potential of today's new technologies. (PR)
College readiness is a social construct requiring both student and adult preparedness. This paper used a case study methodology to explore how teaching in an early college program might promote adult college readiness in the instructors. A community of practice, enhanced by a co-teaching model, in two separate high school settings under one early…
Ball, Malcolm J.
Using the framework of communities of practice, data were collected from a labor union education program (152 survey responses, 3 life histories). Despite negative early schooling experiences, respondents saw union involvement as a rationale to participate in formal education. Union education was depicted as situated learning through participation…
Ottemiller, Dylan D.; Awais, Yasmine J.
With growing trends toward preventative, community-based health care, art therapists must expand their scope of practice beyond the medical model and individual psychodynamics in order to serve, include, and empower those in need. In this article the authors review literature that illustrates the unique qualities art therapists can contribute to…
Purpose: This paper aims to explore consultants' experiences of communities of practice (CoPs) in one of the world's largest information technology companies against organisational strategies. The research focus concerns experiences of formal top-down and underground CoPs. Design/methodology/approach: The paper is an exploratory case study.…
DeJarnette, Nancy K.; Sudeck, Maria
The purpose of this qualitative research study was to monitor pre-service teacher candidates' progression and implementation of the learning community philosophy along with classroom management strategies. The study took place during their final semester of clinical practice. Data were collected from self-reports, surveys, university supervisor…
Buckley, Sheryl; du Toit, Adeline
The change from an industrial economy to a knowledge economy forced many organizations to change their modus operandi if they were going to survive in a sustainable way. The introduction of communities of practice (CoPs) by Jean Lave and Etienne Wenger shed new light on knowledge sharing and dissemination of information. Sharing, interacting,…
Mills, Kathy A.; Chandra, Vinesh
With the advent of Web 2.0, the "social web," microblogging has emerged as a popular literacy practice through platforms such as Twitter. Yet the potential of microblogging in educational communities is currently underexplored. This case study of 150 preservice teachers shows how microblogging can positively influence reading and writing, with…
Rindstedt, Camilla; Aronsson, Karin
This study analyzes informal learning, drawing on video recordings of staff-child interaction in a pediatric unit. It is shown that even very young patients engage in intent community participation, carefully noting fine variations in examination and treatment practices. They orient to everyday routines in successively more complex ways, gradually…
Juriado, Rein; Gustafsson, Niklas
Purpose: The paper aims to discuss the emergence of communities of practice in a temporary event organisation involving public and private partners. Design/methodology/approach: The study employs qualitative methods in the form of 31 semi-structured interviews, a five-week period of participant observations and archive research in a Swedish…
Kelsey, Kathleen D.; Stafne, Eric T.
As Americans shift their work and leisure activities online, Extension seeks to remain viable by delivering programs through a website known as eXtension. eXtension is predicated on the voluntary labor of Extension specialists and educators who form Communities of Practice to create and deliver content through the website. Evaluation of eXtension…
LeTarte, Clyde E.; Schwinn, Carole J.
Describes the Total Quality Management (TQM) effort undertaken three years ago by Jackson Community College (JCC), in Michigan. Discusses the history of JCC, its early TQM efforts, the basic tenets of TQM, steps taken by JCC to integrate TQM practices into its evaluation methods, and benefits of TQM. (MAB)
Posey, Michael J.
The purpose of this mixed methods research study was to examine the environmental sustainability practices used at publicly supported community, junior, and technical college campuses in the eleven states accredited by the Southern Association of Colleges and Schools' Commission on Colleges. The Sustainability Assessment Questionnaire was emailed…
Although the concept of communities of practice (CoPs) has been applied to many fields, the application within the context of the senior citizens' interaction must be different from those in the vocational arena. In Toy Clinic Shops (TCSs) in Taiwan, senior volunteers together sharpen their skills of repairing toys for school children, which can…
Office of Community College Research and Leadership, 2010
As a pilot site selected to participate in Illinois' Shifting Gears (SG) initiative in 2007, Oakton Community College (OCC) partnered with Presbyterian Homes to develop a bridge course to prepare a cadre of their employed Certified Nurse Assistants (CNAs) to enter college-credit level prerequisite courses to a Practical Nursing program. Oakton…
Hill, Tracy A.
In recent years, enrollment and overall student performance in rural schools have declined. Research shows that principals are critical to the success of a school system and that implementing a virtual community of practice (CoP) at the principal level has solved some of the issues associated with rurality in some organizations. Such…
Kester, Joan Eleanor
This study examined how interagency collaboration occurs within one local transition community of practice using Wenger's (1998) social theory of learning. While postschool outcomes of youth with disabilities have improved moderately, there continue to be many barriers based upon changes in American society, including the diversity of the…
Searl, Julia; Harris, Perri
This compilation of about 200 abstracts features journal articles relevant to the community integration of people with developmental disabilities. Articles were selected based on their relevance to policy and practice. Research articles were included if they had a strong applied emphasis with clear implications for contemporary policy and…
Shacham, Miri; Od-Cohen, Yehudit
This paper grows from research which focuses on the learning characteristics of PhD students, incorporating communities of practice both during their studies and beyond completion of their PhD, and drawing on theories of adult learning and lifelong learning. It shows how professional discourse enhances academic discourse through student engagement…
The purpose of this proposed research study is to empirically explore the nature of virtual communities of practice (CoP) in a global organisation within the context of its International Corporate Volunteer (ICV) Program. This study investigates whether and how the use of virtual CoP evolves and becomes embedded within this organization. Following…
Muther, Richard S.; And Others
Information about the consultative practice of nephrology in a community environment was gathered and used to speculate about improvements that could be made in the training of nephrologists in academic medical centers, based on their knowledge of such training. (Author/MLW)
Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph
This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support…
Jones, Sandra C; Bennett, Sue; Iverson, Don; Robinson, Laura
Background Professional isolation is an important factor in low rural health workforce retention. Objective The aim of this study was to gain insights to inform the development of an implementation plan for a virtual community of practice (VCoP) for general practice (GP) training in regional Australia. The study also aimed to assess the applicability of the findings of an existing framework in developing this plan. This included ascertaining the main drivers of usage, or usefulness, of the VCoP for users and establishing the different priorities between user groups. Methods A survey study, based on the seven-step health VCoP framework, was conducted with general practice supervisors and registrars—133 usable responses; 40% estimated response rate. Data was analyzed using the t test and the chi-square test for comparisons between groups. Factor analysis and generalized linear regression modeling were used to ascertain factors which may independently predict intention to use the VCoP. Results In establishing a VCoP, facilitation was seen as important. Regarding stakeholders, the GP training provider was an important sponsor. Factor analysis showed a single goal of usefulness. Registrars had a higher intention to use the VCoP (P<.001) and to perceive it as useful (P<.001) than supervisors. Usefulness independently predicted intention to actively use the VCoP (P<.001). Regarding engagement of a broad church of users, registrars were more likely than supervisors to want allied health professional and specialist involvement (P<.001). A supportive environment was deemed important, but most important was the quality of the content. Participants wanted regular feedback about site activity. Regarding technology and community, training can be online, but trust is better built face-to-face. Supervisors were significantly more likely than registrars to perceive that registrars needed help with knowledge (P=.01) and implementation of knowledge (P<.001). Conclusions Important
Thomas, Renee Ahrens
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
Casey, M; Finch, C F; Mahoney, M; Townsend, M
Australian football and netball are the predominant sports played in rural Victoria, Australia. This exploratory study is the first to report the sport safety policies and practices adopted by junior Australian football and netball clubs in small rural communities. Eleven informants from four clubs completed a semi-structured interview and survey. Whilst the clubs performed a range of injury prevention activities, they did not have formal sports safety policies. Generally, netball informants reported fewer safety practices than football informants. Crucial factors influencing safety policies and practices were the reliance on volunteers and a lack of senior players. Barriers towards the adoption of safety policies and practices appeared to be related to rural population declines, a lack of qualified people and attitudes to injury in rural areas. Future research needs to identify how widespread this lack of sport safety policies and practices is across rural Australia and to identify strategies to overcome barriers to implementing them.
Skinner, Daniel; Gardner, William; Kelleher, Kelly J
Written from the perspective of hospitals, this article examines, in theory and in practice, challenges associated with hospitals' efforts to engage in neighborhood development more fully with the communities that neighbor them. Increasingly, these efforts include significant investments in housing, safety, and educational initiatives. These investments stretch the traditional expertise of medical practitioners and administrators and raise ethical and political questions about how best to engage and work with communities. After first describing the contexts within which hospital-community relationships arise, we examine ethical and political considerations likely to bear on the success of these projects. We conclude with recommendations to hospitals for operating within communities in a way that is consistent with hospitals' ethical commitments.
Carpenter-Song, Elizabeth; Torrey, William C
The US needs engaged and skilled psychiatrists to support the recovery of people with severe mental illnesses and we are currently facing a shortage. This paper examines what attracts providers to community psychiatry and what sustains them in their work. Focus groups and interviews were used to elicit the perspectives of prescribing clinicians in three community mental health clinics in the US. Community psychiatry has inherent challenges, including facing high-risk decisions, encountering intense affects, and occasionally witnessing bad outcomes. Psychiatrists are motivated and sustained in this work by (1) cultivating relationships with patients and colleagues, (2) focusing on the mission of promoting recovery, and (3) engaging with clinical practice as intellectually stimulating work. Administrators support the engagement and morale of psychiatrists by creating workflows that allow psychiatrists to meaningfully apply their expertise to support patients' recovery. These findings hold implications for recruiting and retaining a new generation of physicians.
Prochaska, John D; Mier, Nelda; Bolin, Jane N; Hora, Kerrie L; Clark, Heather R; Ory, Marcia G
Many recommended best practices exist for clinical and community diabetes management and prevention. However, in many cases, these recommendations are not being fully utilized. It is useful to gain a sense of currently utilized and needed practices when beginning a partnership building effort to ameliorate such practice problems. The purpose of this study was to assess current practices in clinical settings within the Brazos Valley in preparation for beginning a community-based participatory research project on improving diabetes prevention and management in this region. Fifty-seven physicians with admission privileges to a regional health system were faxed a survey related to current diabetes patient loads, knowledge and implementation of diabetes-related best practices, and related topics. Both qualitative and quantitative examination of the data was conducted. Fifteen percent of responding providers indicated they implemented diabetes prevention best practices, with significant differences between primary-care physicians and specialists. Respondents indicated a need for educational and counseling resources, as well as an increased health-care workforce in the region. The utilization of a faxed-based survey proved an effective means for assessing baseline data as well as serving as a catalyst for further discussion around coalition development. Results indicated a strong need for both clinical and community-based services regarding diabetes prevention and management, and provided information and insight to begin focused community dialogue around diabetes prevention and management needs across the region. Other sites seeking to begin similar projects may benefit from a similar process.
As a result of the standards and accountability reforms of the past two decades, heightened attention has been focused upon student learning in the K-12 classrooms, classroom teacher practice, and teacher preparation. This has led to the acknowledgement of limitations of traditional field practicum and that these learning experiences are not well understood (Bullough et al., 2003; Clift & Brady, 2005). Alternative models for student teaching, including those that foster social learning experiences, have been developed. However, research is necessary to understand the implications of these models for preservice teacher learning. Drawing on sociocultural theoretical frameworks and ethnographic perspectives (Gee and Green, 1998), this qualitative research study examined the learning experiences of a cohort of eight undergraduate preservice secondary science teachers who cotaught with eight cooperating teachers for their full practicum semester. In this model, interns planned and taught alongside multiple cooperating teachers and other interns. This study centers on the social and cultural learning that occurred within this networked model and the ways that the interns developed as high school science teachers within a coteaching community of practice (Wenger, 1998). This study utilized the following data sources: Intern and cooperating teachers interviews, field observations, meeting recordings, and program documentation. Analysis focused on community and interpersonal planes of development (Rogoff, 1995) in order understand of the nature of the learning experiences and the learning that was afforded through participant interactions. Several conclusions were made after the data were analyzed. On a daily basis, the interns participated in a wide range of cultural practices and in the activities of the community. The coteaching model challenged the idiosyncratic nature of traditional student teaching models by creating opportunities to learn across various classroom
Backman, Chantal; Bruce, Natalie; Marck, Patricia; Vanderloo, Saskia
The purpose of this quality improvement project was to determine the feasibility of using provider-led participatory visual methods to scrutinize 4 hospital units' infection prevention and control practices. Methods included provider-led photo walkabouts, photo elicitation sessions, and postimprovement photo walkabouts. Nurses readily engaged in using the methods to examine and improve their units' practices and reorganize their work environment.
Brooke, Joanne Mary; Mallion, Jaimee
The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses.
Harris, Bryn; Steensen, Becky; Klotz, Mary Beth; Skalski, Anastasia Kalamaros; Bieber, Barb
A growing strategy in the world of educational reform is the use of "communities of practice" (CoP) as a tool for promoting sustainable systems change. There are three basic characteristics of a CoP that distinguish it from other types of communities: (1) the domain; (2) the community; and (3) the practice. A community of practice model…
Metzger, M.; Brown, C.; Pérez-Soba, M.; Rounsevell, M.; Verweij, P.; Delbaere, B.; Cojocaru, G.; Saarikoski, H.; Harrison, P.; Zellmer, K.
The ecosystem services concept is seen by many as a useful paradigm to support decision-making at the complex interface between science, policy and practice. However, to be successful, it requires a strong willingness for collaboration and joint understanding. In support of this aspiration, OPPLA is being developed as a web portal to enable European communities to better manage ecosystems for human well-being and livelihoods. OPPLA will provide access to a variety of online resources such as tools, case studies, lessons learned, videos, manuals and training and educational materials. It will also provide expert forums and spaces for discussions between researchers, practitioners and decision makers. Hence a critical aspect of the success of OPPLA is the co-evolution of communities of practice. An example of a community of practice is the recently launched Ecosystem Services Community - Scotland (ESCom-Scotland; escomscotland.wordpress.com). ESCom-Scotland aims to support better management of Scotland's natural resources by helping to establish a community of practice between individuals and groups involved in the science, policy and practice behind sustainable ecosystem management. It aspires to encourage the sharing of ideas, increase collaboration and to initiate a support network for those engaging with the ecosystem services concept and it will use the OPPLA resources to support these activities. OPPLA is currently at the developmental stage and was instigated by two large European Commission funded research projects: OPERAs (www.operas-project.eu) and OpenNESS (www.openness-project.eu), with a combined budget of ca. €24m. These projects aim to improve understanding of how ecosystem services contribute to human well-being in different social-ecological systems. Research will establish whether, how and under what conditions the ecosystem services concept can move beyond the academic domain towards practical implementation in support of sustainable ecosystem
This study examined the learning, practice, and classroom communities of five beginning secondary science teachers for one school year. To varying degrees, the participants attempted to enact ambitious practice, a framework for instruction focused on providing students with opportunities to engage in rigorous and responsive science activity. The purpose of the study was twofold. First, this study investigated the resources beginning teachers recognized, generated, and used to shape and learn from practice. Second, this study examined the epistemic classroom community and science practice negotiated between the participants and their students. By analyzing teacher and student interactions in a classroom context, this study filled important gaps in the field's understanding of teacher learning and classroom communities as spaces for students to engage in authentic science practice. This study pursued answers to two groups of guiding questions: · What resources for instruction do beginning teachers recognize, generate, and use in their school contexts? How do beginning teachers' differing use of resources shape their particular trajectories of practice and professional learning? · How and why is science framed as a "public" or "private" practice? Over time, how and why does the public or private framing of science influence actors' (teachers, students) participation in the epistemic work in classroom spaces? How do teachers and students negotiate "what counts" as a science idea in classroom spaces? How is value assigned to science ideas and by whom? How do teachers and students work on science ideas over time given the kind of epistemic community they negotiate? Using a situative framework, this study traced both beginning teacher learning and the negotiation of their classrooms as epistemic communities over time. Analysis of discourse during classroom interactions, artifacts created by participants and students, and interviews with participants afforded insights
This paper addresses the importance of the concept of ideology in community work. The implications of a Marxist approach to ideology in community practice are analyzed in terms of the concepts of problematization (P. Freire, 1979) and consciousness-raising (J. Barreiro, 1976), illustrating the point with some examples. The traditional Marxist perspective is also examined in relation to the perspectives of social constructionism (I. Ibáñez, 1996), cultural studies (A. McRobbie, 1992), post-Marxism (E. Laclau & C. Mouffe, 1985), and feminism (D. Haraway, 1991). It is argued that the concepts of hegemony and habitus (P. Bourdieu, 1985) can be useful to community social psychology theory and practice. A "situated perspective"--in which it is possible to dialogue from different "subject positions," and articulate transformation and political action--is argued. The implications of this shifting in the concept of ideology by means of theoretical developments outside social communitypsychology can help to define the external (outside) agent's position in community practice.
Cantillon, P; D'Eath, M; De Grave, W; Dornan, T
There is widespread acceptance that clinical educators should be trained to teach, but faculty development for clinicians is undermined by poor attendance and inadequate learning transfer. As a result there has been growing interest in situating teacher development initiatives in clinical workplaces. The relationship between becoming a teacher and clinical workplace contexts is under theorised. In response, this qualitative research set out to explore how clinicians become teachers in relation to clinical communities and institutions. Using communities of practice (CoP) as a conceptual framework this research employed the sensitising concepts of regimes of competence and vertical (managerial) and horizontal (professional) planes of accountability to elucidate structural influences on teacher development. Fourteen hospital physicians completed developmental timelines and underwent semi-structured interviews, exploring their development as teachers. Despite having very different developmental pathways, participants' descriptions of their teacher identities and practice that were remarkably congruent. Two types of CoP occupied the horizontal plane of accountability i.e. clinical teams (Firms) and communities of junior doctors (Fraternities). Participants reproduced teacher identities and practice that were congruent with CoPs' regimes of competence in order to gain recognition and legitimacy. Participants also constructed their teacher identities in relation to institutions in the vertical plane of accountability (i.e. hospitals and medical schools). Institutions that valued teaching supported the development of teacher identities along institutionally defined lines. Where teaching was less valued, clinicians adapted their teacher identities and practices to suit institutional norms. Becoming a clinical educator entails continually negotiating one's identity and practice between two potentially conflicting planes of accountability. Clinical CoPs are largely
Irving, Paul W.; Sayre, Eleanor C.
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.
Ohmer, Mary L.; Korr, Wynne S.
Objective: Evidence-based practice is becoming increasingly important in social work and community practice. The authors reviewed existing research to assess the level of evidence available to guide community practice. Method: The authors conducted a review of the literature on community practice intervention research from 1985 to 2002 using…
Naude, Luzelle; Bezuidenhout, Hannemarie
The focus of this article is on the experiences of staff members involved in a student support programme. The experiential, social, and student-centred approaches incorporated in this programme provided not only students, but also academics with pathways to lifelong learning. Functioning in a community of practice (CoP) (with students and also…
Academic Senate for California Community Colleges, 2010
This paper discusses the importance of institutionalizing practices that promote equitable outcomes for all students within the vast California Community College (CCC) system. The CCC system, which annually provides educational opportunities for almost three million students, exists at the heart of the state economy and future labor pool. Because…
Fickes, Patricia D.
Community of practice provided the theoretical frame to study the Old Bedford Village crafts persons as they reproduced lifestyles of a Southern Alleghenies rural village from 200 to 300 years ago in early America. This study sought the "how" and "why" Old Bedford Village crafts persons engaged in learning processes as…
Miller, Anne Catherine; Karkazis, Katrina
Short Creek is a largely closed and isolated community on the border between Utah and Arizona, made up of the sister towns of Hildale, Utah, and Colorado City, Arizona. Beginning from childhood, the 6,000 or so members of the Fundamentalist Church of Jesus Christ of Latter-Day Saints (FLDS) are brought up in a lifestyle of plural marriage, meaning a marriage among one man and more than one woman, and are surrounded by their peers in "the covenant." A lifestyle of plural marriage is likely to affect the health of community members, but its effects have not been studied because of the community's isolation and distrust of outsiders. This paper addresses several questions that arise in contemplating the health of the Short Creek community: What are the health beliefs in this community, and what are their historical bases? Where do families seek medical care, and for what or at what threshold of illness or injury? What is the attitude of care providers serving this community, and how are the providers viewed by the community? More broadly, this paper examines the ways in which polygamy configures health. In order to meet this objective, this paper aims first to provide a brief account of this community's history and demographic profile, followed by a discussion of health care in this community and how it is affected by the practice of plural marriage, with the data comprised of qualitative interviews with health care providers to the community. The goals of this project are to gain a rich, historically nuanced understanding of the health of community members, and to identify directions for further academic and policy research. Our findings indicate that health in this community is shaped by limited resources, an attitude of health fatalism, and a profound insularity and corresponding isolation from the outside world.
Rose, Jayln; Glass, Nel
The article reports on selected findings of a research study concerning emotional wellbeing and professional nursing practice (Rose 2002). It highlights the relationship between community mental health nurses' and emotional wellbeing, and their capacity to provide satisfying professional nursing practice (Rose 2002). The notion of emotional wellbeing, factors that impacted upon the participants' emotional wellbeing, and the relationship of emotional wellbeing to professional practice were revealed in the study. These findings were based on a qualitative critical feminist research inquiry and specifically, interviews with five women community mental health nurses in Australia. Whilst complex, emotional wellbeing was found to be both implicitly and explicitly linked to the participants intertwined personal and professional experiences. Four key components were identified: the nebulous notion; the stress relationship; the mind, body, spirit connection; and, inner sense of balance. In terms of emotional wellbeing and professional practice, three themes were revealed. These were: being able to speak out (or not); being autonomous (or not) and being satisfied (or not). The authors argue that the emotional wellbeing of nurses working in community mental health settings is critical to satisfying professional practice. Furthermore nursing work involves emotional work which impacts on one's emotional wellbeing and emotional wellbeing is integrally linked to professional practice. It is recommended that health organisations must be pro-active in addressing the emotional needs of nurses to ensure the delivery of health care that is aligned to professional practice. This approach will ensure nurses will feel more recognised and validated in terms of their nursing practice.
Singleton, Judy L
In an effort to infuse gerontological content throughout a BSW curriculum, the College of Mount St. Joseph developed community partnerships with agencies that serve older adults. These partnerships led to specific "out-of-class" assignments in a macro social work practice class using a service-learning approach. The development and implementation of those assignments in the agency settings are described using Polvika's Conceptual Model for Community Interagency Collaboration. The successful outcomes are described in terms of the community partnership, services and benefits provided, and the degree of satisfaction by the agencies, students, and faculty with this pedagogical method.
Percoco, T A
The downsizing and closing of acute care facilities and the movement to community-based healthcare services are decreasing the need for RNs in acute care facilities. In the past, the associate-degree nurse (ADN) has filled the majority of positions in acute care. With the trend to provide health services in community setting, will the ADN be prepared for positions in community facilities? ADN educators must reevaluate how they are educating students for practice. The author reviews the 1995 recommendations from the Pew Health Professions Commission and relevant current directives from the National League for Nursing.
Young, C L; Hall, W T; Collins, J
Proposals for dealing with illegeal migration from Mexico to the United States generally do not recognize it as an international social problem. The proposals also present contradictory solutions. Amnesty, a humanitarian policy, is being suggested as well as increased restrictions and punishments, a policing policy. However, in the absence of a comprehensive national policy, community social and health care programs must provide services to illegal aliens. This article attempts to document some of the issues that illegal immigration presents for community agencies.
This fact sheet describes the U.S. Department of Energy's Community Renewable Energy Deployment (CommRE) program, which is a more than $20 million effort funded through the American Recovery and Reinvestment Act of 2009, to promote investment in clean energy solutions and provide real-life examples for other local governments, campuses, and small utilities to replicate. Five community-based renewable energy projects received funding from DOE through the CommRE and their progress is detailed.
Schmitz, John A; Vogt, Rebecca J; Rupp, Gary P; Brodersen, Bruce W; Abel, Jeramie M; Wohlers, Arden R; Marx, David B
Nebraska veterinary practitioners were surveyed to collect data about background characteristics and other factors related to veterinarians' decision to include or not include food animals in their practices and to practice in rural versus urban communities. Background characteristics that were significantly (p < or = 0.05) associated with choosing food-animal practice included growing up on a working farm or ranch; having parents who owned livestock; growing up in a town with a population of less than 10,000; majoring in animal science at university; being male; and having a primary interest, at the time of entering veterinary college, in food animal-exclusive or mixed-animal veterinary practice. The primary factor for choosing the community in which to practice was rural/urban lifestyle for rural veterinarians, while this factor was second for urban veterinarians. For all groups of veterinarians, the primary consideration in selecting their current practice was the species orientation of the practice. The primary reason for not choosing food-animal practice was better working conditions and lifestyle in companion-animal practice, followed by greater interest elsewhere.
Villarreal, Victor; Castro-Villarreal, Felicia
Schools have played an increasingly central role in providing mental health services to youth, but there are limitations to the services that are available through school-based mental health professionals. Thus, collaboration with non-school-based community mental health providers is oftentimes necessary. As collaboration can address limitations…
Vacc, Nicholas A.; Juhnke, Gerald A.; Nilsen, Keith A.
Compares the codes of ethics of 13 professional organizations for community mental health service providers. Results suggest that only two of the codes of ethics address many of the "Standards for Educational and Psychological Testing." Provides implications and recommendations for professional organizations. (Contains 20 references and…
The Performance Assessment Community of Practice (PA CoP) was developed in 2008 to improve consistency and quality in the preparation of performance assessments (PAs) and risk assessments across the Department of Energy (DOE) Complex. The term, PA, is used to represent all of these modeling applications in this report. The PA CoP goals are to foster the exchange of information among PA practitioners and to share lessons learned from PAs conducted for DOE, commercial disposal facilities, and international entities. Technical exchanges and workshops are a cornerstone of PA CoP activities. Previous technical exchanges have addressed Engineered Barriers (2009 - http://www.cresp.org/education/workshops/pacop/), the Advanced Simulation Capability for Environmental Management and the Cementitious Barriers Partnership (2010 - http://srnl.doe.gov/copexchange/links.htm). Each technical exchange also includes summary presentations regarding activities at DOE, the Nuclear Regulatory Commission (NRC) and other organizations (e.g., International Atomic Energy Agency (IAEA)) as well as a number of presentations from selected sites to provide insight and perspective from on-going modeling activities. Through the deployment of PA Assistance Teams, the PA CoP has also been engaged in the development of new PAs across the DOE Complex. As a way of improving consistency in the preparation of new PAs, the teams provide technical advice and share experiences, noteworthy practices, and lessons learned from previous Low-Level Waste Disposal Facility Federal Review Group (LFRG) reviews. Teams have provided support for PAs at Hanford, Idaho, Paducah and Portsmouth. The third annual PA CoP Technical Exchange was held on May 25-26, 2011 in Atlanta, GA. The PA CoP Steering Committee Meeting held its first meeting on May 24 prior to the Technical Exchange. Decision making using models and software quality assurance were the topical emphasis for the exchange. A new feature at the 2011 technical
Background. The opportunity to provide free surgical care for orofacial clefts has opened a new vista and is enhanced by well-informed communities who are aware of the free surgical services available to them. It is the responsibility of cleft care providers to adequately inform these communities via a combination of community mobilization and awareness creation. Methods. This was a nationwide, cross-sectional descriptive study of all orofacial cleft service providers in Nigeria using a structured, self-administered questionnaire. Results. A total of 4648 clefts have been repaired, 50.8% by the ten government-owned and 49.2% by the five nongovernment-owned organizations included in the study. The nongovernment-owned institutions seemed to be more aggressive about community mobilization and awareness creation than government-owned ones, and this was reflected in their patient turnout. Most of the organizations studied would prefer a separate, independent body to handle their awareness campaign. Conclusion. Community mobilization requires skill and dedication and may require formal training or dedicated budgets by government-owned and nongovernment-owned institutions alike. Organizations involved in cleft care provision must take community mobilization and awareness seriously if the largely unmet needs of orofacial cleft patients in Nigeria are to be tackled. PMID:27350971
Rodríguez-Burgos, Lilian Patricia; Rodríguez-Castro, Jennifer; Bojacá-Rodríguez, Sandra Milena; Izquierdo-Martínez, Dwrya Elena; Amórtegui-Lozano, Allain Alexander; Prieto-Castellanos, Miguel Angel
The purpose of this article is to analyze the psycho-cultural processes involved in knitting “mochilas” (traditional bags), a common craft in the Arhuaco indigenous community located in the Sierra Nevada de Santa Marta, Colombia. The article is structured in three parts, as follows: first, issues related to child development are discussed; then, the analysis method used to study the processes involved in the practice of knitting is presented and, finally, we reflect on the importance of recovering the sense and meaning of this everyday practice as a way to study child development. PMID:27298634
Background The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Methods Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Results Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. Conclusion This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings. PMID
Murphy, Nancy A; Carbone, Paul S
Children with disabilities and their families have multifaceted medical, developmental, educational, and habilitative needs that are best addressed through strong partnerships among parents, providers, and communities. However, traditional health care systems are designed to address acute rather than chronic conditions. Children with disabilities require high-quality medical homes that provide care coordination and transitional care, and their families require social and financial supports. Integrated community systems of care that promote participation of all children are needed. The purpose of this clinical report is to explore the challenges of developing effective community-based systems of care and to offer suggestions to pediatricians and policy-makers regarding the development of partnerships among children with disabilities, their families, and health care and other providers to maximize health and well-being of these children and their families.
Mossialos, Elias; Courtin, Emilie; Naci, Huseyin; Benrimoj, Shalom; Bouvy, Marcel; Farris, Karen; Noyce, Peter; Sketris, Ingrid
Community pharmacists are the third largest healthcare professional group in the world after physicians and nurses. Despite their considerable training, community pharmacists are the only health professionals who are not primarily rewarded for delivering health care and hence are under-utilized as public health professionals. An emerging consensus among academics, professional organizations, and policymakers is that community pharmacists, who work outside of hospital settings, should adopt an expanded role in order to contribute to the safe, effective, and efficient use of drugs-particularly when caring for people with multiple chronic conditions. Community pharmacists could help to improve health by reducing drug-related adverse events and promoting better medication adherence, which in turn may help in reducing unnecessary provider visits, hospitalizations, and readmissions while strengthening integrated primary care delivery across the health system. This paper reviews recent strategies to expand the role of community pharmacists in Australia, Canada, England, the Netherlands, Scotland, and the United States. The developments achieved or under way in these countries carry lessons for policymakers world-wide, where progress thus far in expanding the role of community pharmacists has been more limited. Future policies should focus on effectively integrating community pharmacists into primary care; developing a shared vision for different levels of pharmacist services; and devising new incentive mechanisms for improving quality and outcomes.
Salisbury, Christine L.; Cushing, Lisa S.
Despite calls for adoption and use of triadic early intervention practices, remarkably little research has prospectively compared this approach with traditional, provider-led service delivery. The aim of this study was to compare the actions of providers and caregivers within triadic and provider-led interactions with regard to the following: (1)…
Wilensky, Hiroko Nishi
The concept of communities of practice (CoP) was first introduced by Lave and Wenger in their short monograph, "Situated Learning: Legitimate Peripheral Participation." Since then, the concept has become immensely popular in a variety of disciplines. This dissertation traces the concept of CoP back to its inception and early transformation at the…
Burgess, Cathie; Cavanagh, Paddy
A lack of teacher awareness of the cultural and historical background of Aboriginal students has long been recognised as a major causative factor in the failure of Australian schools to fully engage Aboriginal students and deliver equitable educational outcomes for them. Using Wenger's communities of practice framework, this paper analyses the…
Gotto, George S.; Beauchamp, Donna; Simpson, Mary-Margaret
In this article, the authors describe Early Childhood Family Support Community of Practice (CoP), which was launched and facilitated by the Beach Center on Disability at the University of Kansas. A CoP is a group of people who share concerns or passions about a topic and who regularly interact based on their shared interests. The goal of Early…
Raz, Aviad E.
Purpose: The purpose of this paper is to describe and analyse the formation of CoPs (communities of practice) in three call centres of cellular communication operating companies in Israel. Design/methodology/approach: This study is based on a qualitative methodology including observations, interviews and textual analysis. Findings: In all three…
Legg, Julie E.; Casper, Kristin A.
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
Clement, T; Brown, J; Morrison, J; Nestel, D
General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.
Onwujekwe, Obinna; Mangham-Jefferies, Lindsay; Cundill, Bonnie; Alexander, Neal; Langham, Julia; Ibe, Ogochukwu; Uzochukwu, Benjamin; Wiseman, Virginia
The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT). Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs) with basic instruction (control); RDTs with provider training (provider arm); and RDTs with provider training plus a school-based community intervention (provider-school arm). The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93%) of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm) were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36): stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26) in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19) in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47). Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines. Trial Registration ClinicalTrials.gov NCT01350752 PMID:26309023
Background Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR “Allied Health”). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company
Scanlan, Martin; Kim, Minsong; Burns, Mary Bridget; Vuilleumier, Caroline
Purpose: Culturally and linguistically diverse students frequently do not receive equitable educational opportunities. Schools across public and private sectors that are striving to ameliorate this problem typically work in isolation, not collaboratively. This article examines how communities of practice emerge within a network of schools striving…
Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.
Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health
Fort, Jane G; McClellan, Linda
An important national health care effort is elimination of racial and ethnic disparities in six specific conditions: infant mortality, cancer screening and management, cardiovascular disease, diabetes, human immunodeficiency virus infection, and child and adult immunizations. To address this concern, several health entities in Nashville, Tennessee responded to a grant initiative from the Centers for Disease Control and Prevention to develop a Racial and Ethnic Approaches to Community Health (REACH) demonstration project. The resulting award is the Nashville REACH 2010 Project, charged to develop sustainable methods to reduce and, in time, eliminate racial and ethnic disparities in cardiovascular disease and diabetes in the North Nashville community, where mortality rates of these diseases are substantially higher than in other parts of the county. As one of its many interests, the project included potential health care providers to receive and disseminate messages about disease prevention and health education. The present paper describes the community-campus partnership between the Nashville REACH 2010 project and the post-baccalaureate program of Meharry Medical College, a partnership that enfolded Meharry's pre-professional health care students into the community-based participatory service research project to increase the awareness and sensitivity of future minority health care providers to issues in minority and poor, underserved populations and to increase potential providers' familiarity with the processes involved in community-based participatory research.
Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn
There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.
Part 2 of this three-part series of articles on becoming an aesthetic provider centers on the steps necessary to build an aesthetic practice. We will discuss the legal (e.g., licensure, scope of practice, malpractice, and documentation) and the business aspects (e.g., "your brand," staff development, networking, marketing, and revenue possibilities) of building a successful aesthetic practice. On the basis of years of experience, "pearls and pitfalls" will be discussed so novice, intermediate, and advanced aesthetic providers can minimize mistakes and maximize their success in this exciting and growing profession.
Smith, Dawn; Edwards, Nancy; Peterson, Wendy; Jaglarz, Maria; Laplante, Dorothy; Estable, Alma
This paper stems from findings of a literature review and consultation with key informants to explore nursing best practices in public health with rural and isolated Aboriginal communities. It summarizes background information on population distribution, the impact of colonization on Aboriginal health and the potential benefits for nurses and communities in adopting a partnership approach, rather than risking cultural imposition while applying best practices and knowledge derived from the dominant culture. The authors provide an alternative working definition for best practices in the context of public health nursing with Aboriginal communities based on findings from the literature review and key informant consultations. Findings include three principles for the development and assessment of nursing best practices with isolated Aboriginal communities: use of indigenous frameworks, capacity building and cultural safety. The discussion highlights examples that demonstrate the feasibility and strengths of these three principles across a selection of isolated, rural and national settings. Implications include a call for nursing leaders, managers and policy makers to take up this challenge and support wider dialogue and action to enable nursing practice that supports the efforts of Aboriginal people to improve health and social conditions.
Rausch, John Conrad; Perito, Emily Rothbaum; Hametz, Patricia
This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers' reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P < .05). Although most providers felt comfortable counseling patients and families about the prevention of overweight and obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers' approach to overweight and obese children.
Cheadle, Allen; Sullivan, Marianne; Krieger, James; Ciske, Sandra; Shaw, Molly; Schier, James K; Eisinger, Alison
Community-based organizations (CBOs), including grassroots, voluntary organizations, are an important part of any strategy for addressing social determinants of health. Because of the challenges faced by CBOs, "enabling systems" may be neededto help them survive and fulfill theirmissions, andresearchers have a variety of skills that allow them to play a role in such systems. The potential for researchers to play a role in supporting CBOs led the Seattle Urban Research Center (known as Seattle Partners) to establish a community research center (CRC) as one of its core projects. This article describes the operation of the Seattle Partners CRC and gives examples of how it has worked collaboratively with CBOs in providing technical assistance. The Discussion section draws from the CRC experience to examine the benefits and challenges of collaboration and the trade-off between capacity building and providing direct technical assistance in promoting long-term CBO viability.
Mompoint Gaillard, Pascale; Rajic, Višnja
Communities of practice as organisations of learning have developed different forms as: task-based, practice-based or knowledge based communities (Barab et al., 2004). The paper presents a case study of a successful community of practice developed under the umbrella of Council of Europe Pestalozzi programme for teacher development. The programme…
Granados, Nadia Regina
Through a Communities of Practice Network Analysis, this research illustrates the ways in which dual language graduates participate in multiple, varied, and overlapping communities of practice across time. Findings highlight that the dual language school as a shared community of practice represents a critical and formative part of participants'…
EPA and the U.S. Geological Survey (USGS) have initiated the “Village Blue” research project to provide real-time water quality monitoring data to the Baltimore community and increase public awareness about local water quality in Baltimore Harbor and the Chesapeake Ba...
Branson, Diane; Vigil, Debra C.; Bingham, Ann
The first few years of life represent a crucial period for optimal brain development for young children. Therefore, it is important to identify children at-risk for developmental delays, including autism spectrum disorders, at the earliest age possible. An argument for utilizing community childcare providers for universal developmental screening…
Wood, Amanda L.; Luiselli, James K.; Harchik, Alan E.
The present study evaluates a training program with paraprofessional service providers at a community-based habilitation setting. Four staff were taught to implement alternative and augmentative communication instruction with an adult who had autism and mental retardation through a combination of instruction, demonstration, behavior rehearsal, and…
Keller, Heather H.; Dwyer, John J. M.; Edwards, Vicki; Senson, Christine; Edward, H. Gayle
Food insecurity in older adults is influenced by financial constraints, functional disability, and isolation. Twenty-eight social- and community-service providers participated in four focus groups to report (a) perceptions and experiences with food insecurity in their older clients, (b) beliefs about their potential role(s) in promoting food…
Genet, Russell; Johnson, Jolyon; Boyce, Pat; Boyce, Grady; Buchheim, obert; Harshaw, Richard; Kenney, John; Collins, Dwight; Rowe, David; Brewer, Mark; Estrada, Reed; Estrada, Chris; Gillette, Sean; Ridgely, John; McNab, Christine; Freed, Rachel; Wallen, Vera
For over a decade, students from Cuesta College and number of high schools have engaged in astronomical research during one-term seminars. A community of practice - consisting of students, educators, and astronomers - has formed that is centered on supporting the students' astronomical research. The seminar has recently adopted distance education technology and automated telescopes in a hybrid form of on-line and inperson collaborations between students, educators, and astronomers. This hybridization is not only resulting in new areas of growth and opportunity, but has created a number of challenges. For example, as more schools joined this seminar, standardized teaching materials such as a textbook and self-paced, online learning units had to be developed. Automated telescopes devoted to expanding student research opportunities within this community of practice are being brought on line by Concordia University and the Boyce Research Initiatives and Educational Foundation. The Institute for Student Astronomical Research supports this growing community in many ways including maintaining a website and editing books of student papers published through the Collins Foundation Press.
Harris, G E
Although community-based research (CBR) is gaining popularity, especially within the field of HIV/AIDS research, there is a paucity of practical models or frameworks designed to guide researchers and community members. Within the present paper the author presents a ten-stage model of conducting CBR that emerged from two HIV/AIDS CBR studies that were conducted in Alberta, Canada. The main strengths and challenges to conducting HIV/AIDS CBR are also explored. Living a life with HIV has changed dramatically over the past few decades. There have been notable improvements in medical technology and treatment, resulting in increased quality and duration of life (Volberding, 1998; Wong-Staal, 1997) as well as improvements in psychosocial interventions leading to improved mental health services (Grinstead & Van Der Straten, 2000; Hoffman, 1996; Sarwer & Crawford, 1994; Schaffner, 1994). Perhaps most significant has been the astonishing community rallying and social support networks that have occurred among individuals living with HIV and AIDS (Roy & Cain, 2001). People living with HIV and AIDS have demonstrated their resilience and positive outlooks through developing a multitude of community connections and projects. These organizational groups have engaged in HIV peer counselling at community-based organizations, fund raising programs, board involvement in community agency organizations and HIV/AIDS national committees, as well as volunteer work in many settings. There has also been a recent focus on CBR, which includes having individuals living with HIV and AIDS, people vulnerable to HIV infection or other stakeholders in HIV/AIDS issues become partners in research projects with academic or trained researchers (Health Canada, 2002).
Urquhart, Robin; Cornelissen, Evelyn; Lal, Shalini; Colquhoun, Heather; Klein, Gail; Richmond, Sarah; Witteman, Holly O
A growing number of researchers and trainees identify knowledge translation (KT) as their field of study or practice. Yet, KT educational and professional development opportunities and established KT networks remain relatively uncommon, making it challenging for trainees to develop the necessary skills, networks, and collaborations to optimally work in this area. The Knowledge Translation Trainee Collaborative is a trainee-initiated and trainee-led community of practice established by junior knowledge translation researchers and practitioners to: examine the diversity of knowledge translation research and practice, build networks with other knowledge translation trainees, and advance the field through knowledge generation activities. In this article, we describe how the collaborative serves as an innovative community of practice for continuing education and professional development in knowledge translation and present a logic model that provides a framework for designing an evaluation of its impact as a community of practice. The expectation is that formal and informal networking will lead to knowledge sharing and knowledge generation opportunities that improve individual members' competencies (eg, combination of skills, abilities, and knowledge) in knowledge translation research and practice and contribute to the development and advancement of the knowledge translation field.
Mockshell, Jonathan; Ilukor, John; Birner, Regina
The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.
Akyol, Zehra; Garrison, D. Randy
Communications technologies have been continuously integrated into learning and training environments which has revealed the need for a clear understanding of the process. The Community of Inquiry (COI) Theoretical Framework has a philosophical foundation which provides planned guidelines and principles to development useful learning environments…
Bird, Nora J.; Pampaloni, Andrea M.
In this article the authors provide an overview of the concept of a digital branch library and the manner in which it can be used to enhance academic library community engagement. As the front door to the branch, the library's Website is key to going beyond service provision toward sustaining relationships with faculty, students, staff, and…
Lim, Maria; Chang, EunJung; Song, Borim
Art educators should be concerned with teaching their students to make critical connections between the classroom and the outside world. One effective way to make these critical connections is to provide students with the opportunity to engage in community-based art endeavors. In this article, three university art educators discuss engaging…
This paper, taken directly from the Accreditation Standards for University and College Counseling Centers published in the "Journal of Counseling and Development" (1994), delineates the standards that providers of psychological services in California community colleges must adhere to. Five pertinent areas are discussed: (1) the…
Parkin, Rebecca T
Communities and research participants increasingly feel that they have rights to be equal partners with researchers and to have access to the results of studies to which they have contributed. Concurrently, research sponsors have become aware of legal liabilities, societal repercussions, and credibility impacts of ignoring research communication responsibilities. However, issues related to research communications are rarely discussed at professional meetings or taught in academic programs. As a result, individual investigators may not be clear about their duties to communicate the results of their research. It is important to address this gap between expectations and abilities, because researchers' lack of communication fosters a climate of distrust in science and implies disinterest or disrespect for participants and communities. Ethical, legal, and professional frameworks and practices were reviewed to develop insights about principles, guidelines, and means that can be used to promote best practices. A review of general research guidance and specific requests for proposals revealed sponsors' communication priorities. While there are barriers to research communication, there is an increasing awareness among sponsors and investigators that effective and responsive communication is not a cheap or uniform add-on to a project or proposal. Communications must be tailored to the project considering all potential stakeholders, and resources need to be allocated specifically for communication activities within projects. Researchers, sponsors, professional societies and academia all have opportunities to improve principles, policies, frameworks, guidelines and strategies to foster "best practice" communication of research results.
Gale, J; Marshall-Lucette, S
Recovery-oriented practice, an approach aligned towards the service user perspective, has dominated the mental health care arena. Numerous studies have explored service users' accounts of the purpose, meaning and importance of 'recovery'; however, far less is known about healthcare staff confidence in its application to care delivery. A self-efficacy questionnaire and content analysis of nursing course documents were used to investigate a cohort of community mental health nurses' recovery-oriented practice and to determine the extent to which the current continuing professional development curriculum met their educational needs in this regard. Twenty-three community mental health nurses completed a self-efficacy questionnaire and 28 course documents were analysed. The findings revealed high levels of nurses' confidence in their understanding and ability to apply the recovery model and low levels of confidence were found in areas of social inclusion. The content analysis found only one course document that used the whole term 'recovery model'. The findings suggest a gap in the nurses' perceived ability and confidence in recovery-oriented practice with what is taught academically. Hence, nursing education needs to be more explicitly focused on the recovery model and its application to care delivery.
Beehler, Gregory P; Funderburk, Jennifer S; King, Paul R; Wade, Michael; Possemato, Kyle
Primary care-mental health integration (PC-MHI) is growing in popularity. To determine program success, it is essential to know if PC-MHI services are being delivered as intended. The investigation examines responses to the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) to explore PC-MHI provider practice patterns. Latent class analysis was used to identify clusters of PC-MHI providers based on their self-report of adherence on the PPAQ. Analysis revealed five provider clusters with varying levels of adherence to PC-MHI model components. Across clusters, adherence was typically lowest in relation to collaboration with other primary care staff. Clusters also differed significantly in regard to provider educational background and psychotherapy approach, level of clinic integration, and previous PC-MHI training. The PPAQ can be used to identify PC-MHI provider practice patterns that have relevance for future clinical effectiveness studies, development of provider training, and quality improvement initiatives.
Porter, Sallie; Qureshi, Rubab; Caldwell, Barbara Ann; Echevarria, Mercedes; Dubbs, William B.; Sullivan, Margaret W.
This study used a survey approach to investigate current developmental surveillance and developmental screening practices by pediatric primary care providers in a diverse New Jersey county. A total of 217 providers were contacted with a final sample size of 57 pediatric primary care respondents from 13 different municipalities. Most providers…
National Centre for Vocational Education Research (NCVER), 2016
The main purpose of this guide is to provide some ideas for employers of apprentices to provide an environment in which strong informal bases of support can succeed. Formal mentoring is an important aspect of apprenticeships; however, it is also informal mentoring--practices that are difficult to formally nurture--that plays a significant and…
Halila, Gerusa C.; Junior, Edson H.; Otuki, Michel F.; Correr, Cassyano J.
Background: In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC) medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. Objective: To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. Method: A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey® platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidence-based practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS® (version 22.0) for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05). Results: Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product’s efficacy (97%) and adverse effects (62.3%) were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. Conclusion: Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence could be used
Sison, Nathan; Yolken, Annajane; Poceta, Joanna; Mena, Leandro; Chan, Philip A; Barnes, Arti; Smith, Erin; Nunn, Amy
The Mississippi Delta region is one of the communities most heavily impacted by HIV/AIDS in the United States. To understand local provider attitudes and practices regarding HIV testing and care, we conducted 25 in-depth qualitative interviews with local primary care providers and infectious disease specialists. Interviews explored attitudes and practices regarding HIV testing and linkage to care. Most providers did not routinely offer HIV testing, noting financial barriers, financial disincentives to offer routine screening, misperceptions about local informed consent laws, perceived stigma among patients, and belief that HIV testing was the responsibility of the health department. Barriers to enhancing treatment and care included stigma, long distances, lack of transportation, and paucity of local infectious disease specialists. Opportunities for enhancing HIV testing and care included provider education programs regarding billing, local HIV testing guidelines, and informed consent, as well as telemedicine services for underserved counties. Although most health care providers in our study did not currently offer routine HIV testing, all were willing to provide more testing and care services if they were able to bill for routine testing. Increasing financial reimbursement and access to care, including through the Affordable Care Act, may provide an opportunity to enhance HIV/AIDS services in the Mississippi Delta.
Cretzmeyer, Margaret; Moeckli, Jane; Liu, William Ming
Since 2009, the U.S. Veterans Administration has made concentrated efforts to end homelessness among veterans. As part of these efforts, the Iowa City, Iowa, VA Health Care System in collaboration with local community providers deployed a supportive housing program aimed at homeless veterans. Called the Lodge program, it is intended to serve a Mid-Western mid-size city and its surrounding rural communities. This article presents qualitative findings from a mixed-method, two-year formative evaluation of the Lodge's implementation. Primary barriers to the effectiveness of the Lodge program were regulations hindering cooperation between service programs, followed by problems regarding information sharing and client substance abuse. Facilitators included personal communication and cooperation between individuals within and among service groups. The feasibility of implementing a Lodge program in a more rural community than Iowa City was also discussed.
Wallerstein, Nina; Duran, Bonnie
Community-based participatory research (CBPR) has emerged in the last decades as a transformative research paradigm that bridges the gap between science and practice through community engagement and social action to increase health equity. CBPR expands the potential for the translational sciences to develop, implement, and disseminate effective interventions across diverse communities through strategies to redress power imbalances; facilitate mutual benefit among community and academic partners; and promote reciprocal knowledge translation, incorporating community theories into the research. We identify the barriers and challenges within the intervention and implementation sciences, discuss how CBPR can address these challenges, provide an illustrative research example, and discuss next steps to advance the translational science of CBPR.
Leong, Christine; Sareen, Jitender; Enns, Murray W; Bolton, James; Alessi-Severini, Silvia
Community pharmacists frequently encounter patients suspected to be at risk of medication misuse, divergence and overdose; yet, little research exists in describing how pharmacists effectively identify and intervene during these encounters. This study aimed to understand the barriers and facilitators in community pharmacy practice using a focus group design to help inform policymakers in the development of effective and feasible strategies for limiting the means of medication misuse. Findings revealed three themes: (1) patient-level barriers (deciphering signs of misuse); (2) pharmacist-level barriers (type of practice experience); and (3) system-level barriers (prescriber, third-party payer). Insight into pharmacy practice provided a foundation for future study to explore strategies for improving care for at-risk patients.
French, Kim D; Desai, Neeraj R; Diamond, Edward; Kovitz, Kevin L
Interventional pulmonology (IP) is a field that uses minimally invasive techniques to diagnose, treat, and palliate advanced lung disease. Technology, formal training, and reimbursement for IP procedures have been slow to catch up with other interventional subspecialty areas. A byproduct of this pattern has been limited IP integration in private practice settings. We describe the key aspects and programmatic challenges of building an IP program in a community-based setting. A philosophical and financial buy-in by stakeholders and a regionalization of services, within and external to a larger practice, are crucial to success. Our experience demonstrates that a successful launch of an IP program increases overall visits as well as procedural volume without cannibalizing existing practice volume. We hope this might encourage others to provide this valuable service to their own communities.
White, Richard O.; Beech, Bettina M.; Miller, Stephania
IN BRIEF Disparities in diabetes care are prevalent in the United States. This article provides an overview of these disparities and discusses both potential causes and efforts to address them to date. The authors focus the discussion on aspects relevant to the patient-provider dyad and provide practical considerations for the primary care provider’s role in helping to diminish and eliminate disparities in diabetes care. PMID:21289869
Mosites, Emily; Carpenter, L Rand; McElroy, Kristina; Lancaster, Mary J; Ngo, Tue H; McQuiston, Jennifer; Wiedeman, Caleb; Dunn, John R
Tennessee has a high incidence of Rocky Mountain spotted fever (RMSF), the most severe tick-borne rickettsial illness in the United States. Some regions in Tennessee have reported increased illness severity and death. Healthcare providers in all regions of Tennessee were surveyed to assess knowledge, attitudes, and perceptions regarding RMSF. Providers were sent a questionnaire regarding knowledge of treatment, diagnosis, and public health reporting awareness. Responses were compared by region of practice within the state, specialty, and degree. A high proportion of respondents were unaware that doxycycline is the treatment of choice in children ≤ 8 years of age. Physicians practicing in emergency medicine, internal medicine, and family medicine; and nurse practitioners, physician assistants, and providers practicing for < 20 years demonstrated less knowledge regarding RMSF. The gaps in knowledge identified between specialties, designations, and years of experience can help target education regarding RMSF.
Boakye, Omenaa; Birney, Arden; Suter, Esther; Phillips, Leah Adeline; Suen, Victoria YM
Purpose This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. Methods We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers’ legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals’ scope of practice. Results Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. Conclusion These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice. PMID:27274267
McGowan, Jessie; Grad, Roland; Pluye, Pierre; Hannes, Karin; Deane, Katherine; Labrecque, Michel; Welch, Vivian; Tugwell, Peter
Background The movement towards evidence-based practice makes explicit the need for access to current best evidence to improve health. Advances in electronic technologies have made health information more available, but does availability affect the rate of use of evidence in practice? Objectives To assess the effectiveness of interventions intended to provide electronic retrieval (access to information) to health information by healthcare providers to improve practice and patient care. Search methods We obtained studies from computerized searches of multiple electronic bibliographic databases, supplemented by checking reference lists, and consultation with experts. Selection criteria Randomized controlled trials (RCTs) including cluster randomized trials (CRCTs), controlled clinical trials (CCT), and interrupted time series analyses (ITS) of any language publication status examining interventions of effectiveness of electronic retrieval of health information by healthcare providers. Data collection and analysis Duplicate relevancy screening of searches, data abstraction and risk of bias assessment was undertaken. Main results We found two studies that examined this question. Neither study found any changes in professional behavior following an intervention that facilitated electronic retrieval of health information. There was some evidence of improvements in knowledge about the electronic sources of information reported in one study. Neither study assessed changes in patient outcomes or the costs of provision of the electronic resource and the implementation of the recommended evidence-based practices. Authors’ conclusions Overall there was insufficient evidence to support or refute the use of electronic retrieval of healthcare information by healthcare providers to improve practice and patient care. PMID:19588361
Mercier, Rebecca J.; Buchbinder, Mara; Bryant, Amy; Britton, Laura
OBJECTIVE Abortion laws are proliferating in the United States, but little is known about their impact on abortion providers. In 2011, North Carolina instituted the Woman’s Right to Know (WRTK) Act, which mandates a 24-hour waiting period and counseling with state-prescribed information prior to abortion. We performed a qualitative study to explore the experiences of abortion providers practicing under this law. STUDY DESIGN We conducted semi-structured interviews with 31 abortion providers (17 physicians, 9 nurses, 1 physician assistant, 1 counselor, and 3 clinic administrators) in North Carolina. Interviews were audio-recorded and transcribed. Interview transcripts were analyzed using a grounded theory approach. We identified emergent themes, coded all transcripts, and developed a thematic framework. RESULTS Two major themes define provider experiences with the WRTK law: provider objections / challenges and provider adaptations. Most providers described the law in negative terms, though providers varied in the extent to which they were affected. Many providers described extensive alterations in clinic practices to balance compliance with minimization of burdens for patients. Providers indicated that biased language and inappropriate content in counseling can negatively impact the patient-physician relationship by interfering with trust and rapport. Most providers developed verbal strategies to mitigate the emotional impacts for patients. CONCLUSIONS Abortion providers in North Carolina perceive WRTK to have a negative impact on their clinical practice. Compliance is burdensome, and providers perceive potential harm to patients. The overall impact of WRTK is shaped by interaction between the requirements of the law and the adaptations providers make in order to comply with the law while continuing to provide comprehensive abortion care. PMID:25746295
Lukes, L.; LaDue, N.; Cheek, K.; Ryker, K.
As the National Research Council noted in its 2012 report on discipline-based education research (DBER) in undergraduate science and engineering, in order to advance DBER as a field of inquiry, "a robust infrastructure is required to recognize and support [DBER] within professional societies." One way to develop such an infrastructure around geoscience education research is to create a community of practice within the broader geoscience education community. In recent years, the members of the National Association of Geoscience Teachers (NAGT) have created two divisions to support the geoscience education needs of specific subpopulations of the geoscience community: the 2YC division, focusing on community college issues, and TED, focusing on teacher education. This year marks the first year of a new division within the National Association of Geoscience Teachers (NAGT) focused on geoscience education research. The Geoscience Education Research division (GER) is committed to the promotion of high quality, scholarly research in geoscience education that improves teaching and learning in K-12, higher education, and informal learning environments. High quality DBER in geoscience requires the ability to connect current theories of teaching and learning with deep content-specific conceptual understanding. A community of practice like NAGT GER, has the potential to improve the quality of scholarly efforts in geoscience education by providing a forum for improving the collective knowledge and expertise of the geoscience education research community. Current division initiatives and efforts will be highlighted and time for dialogue on future directions will be included.
Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J
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
Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H
Context Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. Methods We used key informant interviews, supplemented by document analysis. Findings The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. Conclusions In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. PMID:25199899
Burns, Mary Ann
Dewey (1933) provided the foundation for reflective practice in education with the notion that learning is not in the doing, but rather it is in the thinking about the doing that creates learning. Evidence is growing about the importance of reflection for improving teaching and learning practices to increase student achievement (York-Barr, et al.,…
Freedman, Darcy A; Blake, Christine E; Liese, Angela D
Access to nutritious foods is limited in disenfranchised communities in the United States. Policies are beginning to focus on improving nutritious food access in these contexts; yet, few theories are available to guide this work. We developed a conceptual model of nutritious food access based on the qualitative responses of food consumers in 2 different regions of the American South. Five domains (economic, service delivery, spatial-temporal, social, and personal) and related dimensions of nutritious food access were identified. The conceptual model provides practical guidance to researchers, policy makers, and practitioners working to improve nutritious food access in communities.
FREEDMAN, DARCY A.; BLAKE, CHRISTINE E.; LIESE, ANGELA D.
Access to nutritious foods is limited in disenfranchised communities in the United States. Policies are beginning to focus on improving nutritious food access in these contexts; yet, few theories are available to guide this work. We developed a conceptual model of nutritious food access based on the qualitative responses of food consumers in 2 different regions of the American South. Five domains (economic, service delivery, spatial–temporal, social, and personal) and related dimensions of nutritious food access were identified. The conceptual model provides practical guidance to researchers, policy makers, and practitioners working to improve nutritious food access in communities. PMID:24563605
Thananithisak, Chuanchom; Nimpitakpong, Piyarat; Chaiyakunapruk, Nathorn
Community pharmacists' involvement in tobacco control and their perceived role and barriers were assessed. In part I, a self-administered questionnaire was mailed to 164 community pharmacists who applied for community pharmacy accreditation from the Thai Pharmacy Council in 2003. In part II, an in-depth interview was conducted among 13 community pharmacists who participated in the 1-day smoking cessation services training. Main outcome measures were tobacco control-related activities, perceived tobacco control role, and perceived barriers. The questionnaire response rate was 51% (83/164 pharmacists), with half of the respondents (42/83, 51%) reporting active tobacco control activities. Of these pharmacists, seven (7/42, 17%) reported participating in public or policy advocacy by campaigning against smoking in the community. Thirty-four (34/42, 81%) and thirty-six (36/42, 86%) reported engaging in activities in their own pharmacies by providing educational materials and smoking cessation services, respectively. Even though the perceived roles in tobacco control of these pharmacists were high, they also reported several barriers, especially in five categories: lack of client demand, lack of educational materials, lack of smoking cessation products, lack of knowledge and skill, and lack of follow-up visits. On the other hand, lack of time and lack of reimbursement were not indicated as important barriers. Data from in-depth interviews confirmed these findings. This study revealed that Thai community pharmacists were engaged in various levels of tobacco control-related activities. Most of them perceived the significance of tobacco control activities. However, several barriers were also reported and need to be addressed further.
Joffe, Carole; Yanow, Susan
A hopeful note in the contemporary abortion environment in the United States is the expanding role of advanced practice clinicians--nurse practitioners, physician assistants and nurse-midwives--in first trimester abortion provision. A large percentage of primary health care in the U.S. is currently provided by these non-physicians but their involvement in abortion care is promising, especially in light of the shortage of physician providers. Two national symposia in 1990 and 1996 approved the expansion of early abortion care to non-physicians. As of January 2004, trained advanced practice clinicians were providing medical, and in some cases, early surgical abortion in 14 states. This has required not only medical training but also political organising to achieve the necessary legal and regulatory changes, state by state, by groups such as Clinicians for Choice and the Abortion Access Project, described here in examples in two states and the reflections of three advanced practice clinicians. Recent surveys in three states show a substantial interest among advanced practice clinicians in abortion training, leading to cautious optimism about the possibility of increased abortion access for women. Most encouraging, advanced practice clinicians, like their physician counterparts, show a level of passionate commitment to the work that is rare elsewhere in health care in the U.S. today.
It is common currency that science education in America isn't working well enough. We are failing to excite the curiosity of young minds in the great questions of the physical universe. LabNet—a prototype teacher-support project developed by TERC, and funded by the National Science Foundation, is dedicated to addressing this issue. The first three year phase of LabNet began in January 1989 and ended in mid-1992. During that time, some 562 high school teachers of physics in 37 states were involved. Three interconnected threads are woven through the fabric of LabNet. The first, and most vivid, is the use of projects to enhance students' science learning. LabNet's second thread is building a community of practice among LabNet teachers. The third thread woven into LabNet is promoting the use of new technologies in science teaching and learning. The most notable use of new technology in the LabNet project is telecommunications—computer-to-computer communication via telephone lines. A dedicated network has been created and made available to all participants. As the first national network designed for high school teachers of physical science, the LabNetwork is a dynamic medium for building and sustaining a community of practice for physics teachers separated by many thousands of miles. In recommendations directed at teachers, scientists, and particularly the National Science Foundation, steps are outlined that can be taken to strengthen the community and the teaching of science in both the secondary and elementary grades.
Li, Linda C; Grimshaw, Jeremy M; Nielsen, Camilla; Judd, Maria; Coyte, Peter C; Graham, Ian D
Background In the experience of health professionals, it appears that interacting with peers in the workplace fosters learning and information sharing. Informal groups and networks present good opportunities for information exchange. Communities of practice (CoPs), which have been described by Wenger and others as a type of informal learning organization, have received increasing attention in the health care sector; however, the lack of uniform operating definitions of CoPs has resulted in considerable variation in the structure and function of these groups, making it difficult to evaluate their effectiveness. Objective To critique the evolution of the CoP concept as based on the germinal work by Wenger and colleagues published between 1991 and 2002. Discussion CoP was originally developed to provide a template for examining the learning that happens among practitioners in a social environment, but over the years there have been important divergences in the focus of the concept. Lave and Wenger's earliest publication (1991) centred on the interactions between novices and experts, and the process by which newcomers create a professional identity. In the 1998 book, the focus had shifted to personal growth and the trajectory of individuals' participation within a group (i.e., peripheral versus core participation). The focus then changed again in 2002 when CoP was applied as a managerial tool for improving an organization's competitiveness. Summary The different interpretations of CoP make it challenging to apply the concept or to take full advantage of the benefits that CoP groups may offer. The tension between satisfying individuals' needs for personal growth and empowerment versus an organization's bottom line is perhaps the most contentious of the issues that make CoPs difficult to cultivate. Since CoP is still an evolving concept, we recommend focusing on optimizing specific characteristics of the concept, such as support for members interacting with each other
Hill, Jenny; D'Mello-Guyett, Lauren; Hoyt, Jenna; van Eijk, Anna M.; ter Kuile, Feiko O.; Webster, Jayne
by the availability, quality, scope, and methodological inconsistencies of the included studies. Conclusions A systematic assessment of the extent of substandard case management practices of malaria in pregnancy is required, as well as quality improvement interventions that reach all providers administering antimalarial drugs in the community. Pregnant women need access to information on which anti-malarial drugs are safe to use at different stages of pregnancy. Please see later in the article for the Editors' Summary PMID:25093720
De Coster, Greet; Banks-Leite, Cristina; Metzger, Jean Paul
Habitat loss often reduces the number of species as well as functional diversity. Dramatic effects to species composition have also been shown, but changes to functional composition have so far been poorly documented, partly owing to a lack of appropriate indices. We here develop three new community indices (i.e. functional integrity, community integrity of ecological groups and community specialization) to investigate how habitat loss affects the diversity and composition of functional traits and species. We used data from more than 5000 individuals of 137 bird species captured in 57 sites in the Brazilian Atlantic Forest, a highly endangered biodiversity hotspot.Results indicate that habitat loss leads to a decrease in functional integrity while measures of functional diversity remain unchanged or are even positively affected. Changes to functional integrity were caused by (i) a decrease in the provisioning of some functions, and an increase in others; (ii) strong within-guild species turnover; and (iii) a replacement of specialists by generalists. Hence, communities from more deforested sites seem to provide different but not fewer functions. We show the importance of investigating changes to both diversity and composition of functional traits and species, as the effects of habitat loss on ecosystem functioning may be more complex than previously thought. Crucially, when only functional diversity is assessed, important changes to ecological functions may remain undetected and negative effects of habitat loss underestimated, thereby imperiling the application of effective conservation actions.
De Coster, Greet; Banks-Leite, Cristina; Metzger, Jean Paul
Habitat loss often reduces the number of species as well as functional diversity. Dramatic effects to species composition have also been shown, but changes to functional composition have so far been poorly documented, partly owing to a lack of appropriate indices. We here develop three new community indices (i.e. functional integrity, community integrity of ecological groups and community specialization) to investigate how habitat loss affects the diversity and composition of functional traits and species. We used data from more than 5000 individuals of 137 bird species captured in 57 sites in the Brazilian Atlantic Forest, a highly endangered biodiversity hotspot. Results indicate that habitat loss leads to a decrease in functional integrity while measures of functional diversity remain unchanged or are even positively affected. Changes to functional integrity were caused by (i) a decrease in the provisioning of some functions, and an increase in others; (ii) strong within-guild species turnover; and (iii) a replacement of specialists by generalists. Hence, communities from more deforested sites seem to provide different but not fewer functions. We show the importance of investigating changes to both diversity and composition of functional traits and species, as the effects of habitat loss on ecosystem functioning may be more complex than previously thought. Crucially, when only functional diversity is assessed, important changes to ecological functions may remain undetected and negative effects of habitat loss underestimated, thereby imperiling the application of effective conservation actions. PMID:26136440
Piemonti, Adriana D.; Babbar-Sebens, Meghna; Jane Luzar, E.
This paper focuses on investigating (a) how landowner tenure and attitudes of farming communities affect the preference of individual conservation practices in agricultural watersheds, (b) how spatial distribution of landowner tenure affects the spatial optimization of conservation practices on a watershed scale, and (c) how the different attitudes and preferences of stakeholders can modify the effectiveness of alternatives obtained via classic optimization approaches that do not include the influence of existing social attitudes in a watershed during the search process. Results show that for Eagle Creek Watershed in central Indiana, USA, the most optimal alternatives (i.e., highest benefits for minimum economic costs) are for a scenario when the watershed consists of landowners who operate as farmers on their own land. When a different land-tenure scenario was used for the watershed (e.g., share renters and cash renters), the optimized alternatives had similar nitrate reduction benefits and sediment reduction benefits, but at higher economic costs. Our experiments also demonstrated that social attitudes can lead to alteration of optimized alternatives found via typical optimization approaches. For example, when certain practices were rejected by landowner operators whose attitudes toward practices were driven by economic profits, removal of these practices from the optimized alternatives led to a setback of nitrates reduction by 2-50%, peak flow reductions by 11-98 %, and sediments reduction by 20-77%. In conclusion, this study reveals the potential loss in optimality of optimized alternatives possible, when socioeconomic data on farmer preferences and land tenure are not incorporated within watershed optimization investigations.
Kelly, Carmel; Johnston, Jillian; Carey, Fiona
Summary Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.
Hall, Sandra; And Others
This manual provides guidelines for safe feeding practices for students with disabilities in Oregon schools. Stressed is the importance of distinguishing between feeding for the maintenance of health and feeding for the acquisition of skills. Individual sections cover: definitions of feeding programs; the school district responsibility; risks;…
Lanigan, Jane D.
Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…
Mazzotti, Valerie L.; Plotner, Anthony J.
Inadequate transition outcomes for youth with disabilities have produced a call for enhanced transition service delivery that includes implementation of evidence-based practices (EBPs). However, research indicates transition service providers still lack the knowledge and skills to effectively implement EBPs to ensure youth with disabilities…
Williams, Ian T.; And Others
Found that beginning the immunization schedule at the recommended age was crucial to appropriate vaccination later in life, and that health provider practices (such as failure to administer vaccinations simultaneously) were important predictors of underimmunization. Serious delays in vaccine administration were observed for poor children in all…
The USDA food and nutrient databases provide the basic infrastructure for food and nutrition research, nutrition monitoring, and dietary practice. They have had a long history that goes back to 1892, and are unique, as they are the only databases available in the public domain that perform these fu...
Yang, Chih-Hung; Hossain, Syeda Zakia; Sitharthan, Gomathi
Effective early childhood intervention (ECI) relies on collaboration among agencies, service providers, and families. Although previous literature has primarily focused on segments of collaboration within ECI service delivery, the actual process and how the adult stakeholders perceive and engage in collaborative practice have important…
Mahon, Suzanne M; Crecelius, Mary E
Providers of women's health services are often confronted with questions about cancer genetic testing. The provision of these services is complex. The process begins with accurate risk assessment and identification of individuals who might benefit from genetic testing services. There are practice, administrative, legal, and ethical considerations that should be considered when developing policies for the referral of at-risk individuals or before deciding to provide genetic services.
Ataman, Lauren M; Rodrigues, Jhenifer K; Marinho, Ricardo M; Caetano, João P J; Chehin, Maurício B; Alves da Motta, Eduardo L; Serafini, Paulo; Suzuki, Nao; Furui, Tatsuro; Takae, Seido; Sugishita, Yodo; Morishige, Ken-Ichiro; Almeida-Santos, Teresa; Melo, Cláudia; Buzaglo, Karen; Irwin, Kate; Wallace, W Hamish; Anderson, Richard A; Mitchell, Roderick T; Telfer, Evelyn E; Adiga, Satish K; Anazodo, Antoinette; Stern, Catharyn; Sullivan, Elizabeth; Jayasinghe, Yasmin; Orme, Lisa; Cohn, Richard; McLachlan, Rob; Deans, Rebecca; Agresta, Franca; Gerstl, Brigitte; Ledger, William L; Robker, Rebecca L; de Meneses E Silva, João M; Silva, Lígia H F Melo E; Lunardi, Franciele O; Lee, Jung R; Suh, Chang S; De Vos, Michael; Van Moer, Ellen; Stoop, Dominic; Vloeberghs, Veerle; Smitz, Johan; Tournaye, Herman; Wildt, Ludwig; Winkler-Crepaz, Katharina; Andersen, Claus Y; Smith, Brigid M; Smith, Kristin; Woodruff, Teresa K
Fertility preservation in the cancer setting, known as oncofertility, is a field that requires cross-disciplinary interaction between physicians, basic scientists, clinical researchers, ethicists, lawyers, educators, and religious leaders. Funded by the National Institutes of Health, the Oncofertility Consortium (OC) was formed to be a scientifically grounded, transparent, and altruistic resource, both intellectual and monetary, for building this new field of practice capable of addressing the unique needs of young patients with cancer. The OC has expanded its attention to include other nonmalignant conditions that can threaten fertility, and the work of the OC now extends around the globe, involving partners who together have created a community of shared effort, resources, and practices. The OC creates materials that are translated, disseminated, and amended by all participants in the field, and local programs of excellence have developed worldwide to accelerate the pace and improve the quality of oncofertility research and practice. Here we review the global oncofertility programs and the capacity building activities that strengthen these research and clinical programs, ultimately improving patient care.
Background Continuity is a fundamental tenet of primary care, and highly valued by patients; it may also improve patient outcomes and lower cost of health care. It is thus important to investigate factors that predict higher continuity. However, to date, little is known about the factors that contribute to continuity. The purpose of this study was to analyse practice, provider and patient predictors of continuity of care in a large sample of primary care practices in Ontario, Canada. Another goal was to assess whether there was a difference in the continuity of care provided by different models of primary care. Methods This study is part of the larger a cross-sectional study of 137 primary care practices, their providers and patients. Several performance measures were evaluated; this paper focuses on relational continuity. Four items from the Primary Care Assessment Tool were used to assess relational continuity from the patient’s perspective. Results Multilevel modeling revealed several patient factors that predicted continuity. Older patients and those with chronic disease reported higher continuity, while those who lived in rural areas, had higher education, poorer mental health status, no regular provider, and who were employed reported lower continuity. Providers with more years since graduation had higher patient-reported continuity. Several practice factors predicted lower continuity: number of MDs, nurses, opening on weekends, and having 24 hours a week or less on-call. Analyses that compared continuity across models showed that, in general, Health Service Organizations had better continuity than other models, even when adjusting for patient demographics. Conclusions Some patients with greater health needs experience greater continuity of care. However, the lower continuity reported by those with mental health issues and those who live in rural areas is concerning. Furthermore, our finding that smaller practices have higher continuity suggests that
Helb, Danica A; Tetteh, Kevin K A; Felgner, Philip L; Skinner, Jeff; Hubbard, Alan; Arinaitwe, Emmanuel; Mayanja-Kizza, Harriet; Ssewanyana, Isaac; Kamya, Moses R; Beeson, James G; Tappero, Jordan; Smith, David L; Crompton, Peter D; Rosenthal, Philip J; Dorsey, Grant; Drakeley, Christopher J; Greenhouse, Bryan
Tools to reliably measure Plasmodium falciparum (Pf) exposure in individuals and communities are needed to guide and evaluate malaria control interventions. Serologic assays can potentially produce precise exposure estimates at low cost; however, current approaches based on responses to a few characterized antigens are not designed to estimate exposure in individuals. Pf-specific antibody responses differ by antigen, suggesting that selection of antigens with defined kinetic profiles will improve estimates of Pf exposure. To identify novel serologic biomarkers of malaria exposure, we evaluated responses to 856 Pf antigens by protein microarray in 186 Ugandan children, for whom detailed Pf exposure data were available. Using data-adaptive statistical methods, we identified combinations of antibody responses that maximized information on an individual's recent exposure. Responses to three novel Pf antigens accurately classified whether an individual had been infected within the last 30, 90, or 365 d (cross-validated area under the curve = 0.86-0.93), whereas responses to six antigens accurately estimated an individual's malaria incidence in the prior year. Cross-validated incidence predictions for individuals in different communities provided accurate stratification of exposure between populations and suggest that precise estimates of community exposure can be obtained from sampling a small subset of that community. In addition, serologic incidence predictions from cross-sectional samples characterized heterogeneity within a community similarly to 1 y of continuous passive surveillance. Development of simple ELISA-based assays derived from the successful selection strategy outlined here offers the potential to generate rich epidemiologic surveillance data that will be widely accessible to malaria control programs.
Houser, P. R.
Earth is a unique, living planet due to the abundance and vigorous cycling and replenishing of water throughout the global environment. The water cycle operates on a continuum of time and space scales and exchanges large amounts of energy as water undergoes phase changes and is moved from one part of the Earth system to another. Water is essential to life and is central to society's welfare, progress, and sustainable economic growth. However, global water cycle variability which regulates flood, drought, and disease hazards is being continuously transformed by climate change, erosion, pollution, salinization, and agriculture and civil engineering practices. The most visible manifestation that could be expected from climate warming would be changes in the distribution of precipitation and evaporation, and the exacerbation of extreme hydrologic events, floods and droughts. Technological advances, climate modeling and forecasting improvements and the emergence of earth system science will enable development of solutions for these daunting global water problems, and much of the needed scientific information is already available. A plethora of institutional, policy, management and communication problems have been neglected, which has resulted in significant underutilization of existing scientific information for solving contemporary and anticipated water issues. Effective communication and outreach is the critical task to enable existing science to be used to its full potential, to develop comprehensive solution strategies and to set future research priorities. The missing link is a water-focused Community of Practice (CoP) who has knowledge of both the decision support needs and the cutting-edge research results, and therefore can formulate a broad array of solutions to water problems today and into the future. The concept of a community of practice refers to the process of social learning that occurs when people who have a common interest in some subject or problem
Atencio, Matthew; Koca, Canan
This paper analyses the construction of masculinities in Turkish physical education through Carrie Paechter's conceptualisation of gendered communities of practice. According to Paechter, educational communities of practice operate as sites of gendered activity. Membership within these communities contributes to the construction of a gendered…
Flogaitis, Evgenia; Nomikou, Christina; Naoum, Elli; Katsenou, Christina
The educational approach views the community of practice as a community of teachers and students who share common rules and values, information and experiences through dialogue and collaboration. Three doctoral theses are in progress at the University of Athens which study the possibilities of creating a community of practice in three different…
Ardichvili, Alexander; Page, Vaughn; Wentling, Tim
Reports the results of a qualitative study of success factors and barriers to the development of virtual knowledge-sharing communities of practice at Caterpillar Inc. Identified prerequisites for successful knowledge management through virtual communities of practice, as well as barriers to virtual community development, and discusses future…
Green, Amy E; Miller, Elizabeth A; Aarons, Gregory A
Public sector mental health care providers are at high risk for burnout and emotional exhaustion which negatively affect job performance and client satisfaction with services. Few studies have examined ways to reduce these associations, but transformational leadership may have a positive effect. We examine the relationships between transformational leadership, emotional exhaustion, and turnover intention in a sample of 388 community mental health providers. Emotional exhaustion was positively related to turnover intention, and transformational leadership was negatively related to both emotional exhaustion and turnover intention. Transformational leadership moderated the relationship between emotional exhaustion and turnover intention, indicating that having a transformational leader may buffer the effects of providers' emotional exhaustion on turnover intention. Investing in transformational leadership development for supervisors could reduce emotional exhaustion and turnover among public sector mental health providers.
Walaszek, Anne; Perdue, David G.; Rhodes, Kristine L.; Haverkamp, Donald; Forster, Jean
Introduction The epidemiology of colorectal cancer, including incidence, mortality, age of onset, stage of diagnosis, and screening, varies regionally among American Indians. The objective of the Improving Northern Plains American Indian Colorectal Cancer Screening study was to improve understanding of colorectal cancer screening among health care providers serving Northern Plains American Indians. Methods Data were collected, in person, from a sample of 145 health care providers at 27 health clinics across the Northern Plains from May 2011 through September 2012. Participants completed a 32-question, self-administered assessment designed to assess provider practices, screening perceptions, and knowledge. Results The proportion of providers who ordered or performed at least 1 colorectal cancer screening test for an asymptomatic, average-risk patient in the previous month was 95.9% (139 of 145). Of these 139 providers, 97.1% ordered colonoscopies, 12.9% ordered flexible sigmoidoscopies, 73.4% ordered 3-card, guaiac-based, fecal occult blood tests, and 21.6% ordered fecal immunochemical tests. Nearly two-thirds (64.7%) reported performing in-office guaiac-based fecal occult blood tests using digital rectal examination specimens. Providers who reported receiving a formal update on colorectal cancer screening during the previous 24 months were more likely to screen using digital rectal exam specimens than providers who had received a formal update on colorectal cancer screening more than 24 months prior (73.9% vs 56.9%, respectively, χ2 = 4.29, P = .04). Conclusion Despite recommendations cautioning against the use of digital rectal examination specimens for colorectal cancer screening, the practice is common among providers serving Northern Plains American Indian populations. Accurate up-to-date, ongoing education for patients, the community, and health care providers is needed. PMID:27978410
Sprague, Ann; Stewart, Paula; Niday, Patricia; Nimrod, Carl; Walker, Robin
OBJECTIVE: To evaluate how well physicians and other prenatal care providers educate women about early recognition of and appropriate response to the signs and symptoms of preterm labour (PTL). To assess use of antenatal steroids for babies born at less than 34 weeks' gestation. DESIGN: Before-after study using a population-based approach. SETTING: Health care providers' offices, hospitals, and prenatal classes in Ottawa, Ont. PARTICIPANTS: Prenatal care providers, women in hospital after giving birth, prenatal class participants. INTERVENTIONS: Prenatal care providers received information and educational materials on PTL and preterm birth (PTB). They passed this information on to pregnant women at their 18- to 20-week prenatal visits. Teachers of prenatal classes gave the same information in early-series classes. Clinical practice guidelines were developed, and hospital staff received education on appropriate response to PTL. MAIN OUTCOME MEASURES: Use of educational materials and steroid treatment. RESULTS: Statistically significant increases were seen in the numbers of care providers who had educational material about PTL and PTB, who reported giving the educational material to all women, and who reported discussing signs and symptoms of PTL and PTB with all women; women who reported that their care providers talked with them about PTL and PTB, and women delivering preterm (< 34 weeks) babies who received steroids. CONCLUSION: Providing knowledge and standardized educational materials to health care providers can help improve preventive practice for PTL and educate women about PTL. PMID:12046368
Ogunfiditimi, Folusho; Takis, Lisa; Paige, Virginia J; Wyman, Janet F; Marlow, Elissa
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.
Hernández, Alison; Hurtig, Anna-Karin; Dahlblom, Kjerstin; San Sebastián, Miguel
Background. The performance of midlevel health workers is a critical lever for strengthening health systems and redressing inequalities in underserved areas. Auxiliary nurses form the largest cadre of health workers in Guatemala. In rural settings, they provide essential services to vulnerable communities, and thus have great potential to address priority health needs. This paper examines auxiliary nurses' motivation and satisfaction, and the coping strategies they use to respond to challenges they confront in their practice. Methods. Semistructured interviews were conducted with 14 auxiliary nurses delivering health services in Alta Verapaz, Guatemala. Results. Community connectedness was central to motivation in this rural Guatemalan setting. Participants were from rural communities and conveyed a sense of connection to the people they were serving through shared culture and their own experiences of health needs. Satisfaction was derived through recognition from the community and a sense of valuing their work. Auxiliary nurses described challenges commonly faced in low-resource settings. Findings indicated they were actively confronting these challenges through their own initiative. Conclusions. Strategies to support the performance of midlevel health workers should focus on mechanisms to make training accessible to rural residents, support problem-solving in practice, and emphasize building relationships with communities served. PMID:23097715
Nicholas, Celeste R.
This article is the first to describe the discoursal construction of an adolescent community of practice (CoP) in a non-school setting. CoPs can provide optimal learning environments. The adolescent community centered around science journalism and positioned itself dichotomously in relationship to school literacy practices. The analysis focuses on recordings from a panel-style research interview from an early implementation of the Science Literacy Through Science Journalism (SciJourn) project. Researchers trained high school students participating in a youth development program to write science news articles. Students engaged in the authentic practices of professional science journalists, received feedback from a professional editor, and submitted articles for publication. I used a fine-grained critical discourse analysis of genre, discourse, and style to analyze student responses about differences between writing in SciJourn and in school. Students described themselves as agentic in SciJourn and passive in school, using an academic writing discourse of deficit to describe schooling experiences. They affiliated with and defined a SciJourn CoP, constructing positive journalistic identities therein. Educators are encouraged to develop similar CoPs. The discursive features presented may be used to monitor the development of communities of practice in a variety of settings.
Swanson, Amy R; Warren, Zachary E; Stone, Wendy L; Vehorn, Alison C; Dohrmann, Elizabeth; Humberd, Quentin
The increased prevalence of autism spectrum disorder and documented benefits of early intensive intervention have created a need for flexible systems for determining eligibility for autism-specific services. This study evaluated the effectiveness of a training program designed to enhance autism spectrum disorder identification and assessment within community pediatric settings across the state. Twenty-seven pediatric providers participated in regional trainings across a 3.5-year period. Trainings provided clinicians with strategies for conducting relatively brief within-practice interactive assessments following positive autism spectrum disorder screenings. Program evaluation was measured approximately 1.5 years following training through (a) clinician self-reports of practice change and (b) blind diagnostic verification of a subset of children assessed. Pediatric providers participating in the training reported significant changes in screening and consultation practices following training, with a reported 85% increase in diagnostic identification of children with autism spectrum disorder within their own practice setting. In addition, substantial agreement (86%-93%) was found between pediatrician diagnostic judgments and independent, comprehensive blinded diagnostic evaluations. Collaborative training methods that allow autism spectrum disorder identification within broader community pediatric settings may help translate enhanced screening initiatives into more effective and efficient diagnosis and treatment.
Calderwood, Patricia E.; Klaf, Suzanna
E. R. Smith, P. E. Calderwood, F. Dohm, and P. Gill Lopez's (2013) model of integrated mentoring within a community of practice framework draws attention to how mentoring as practice, identity, and process gives shape and character to a community of practice for higher education faculty and alerts us to several challenges such a framework makes…
Slatter, Wendy; France, Bev
This research investigated how secondary school technology teachers planned and implemented units that enabled students to access authentic technological practice through their contact with a community of practice (CoP). It was found that when teachers plan to access a community of practice for their students a complex dance-style relationship…
Woo, David James
As new technologies continue to shape society, there has been a greater need for communities of practice to facilitate changing teaching and learning practices through technology in schools. Legitimate peripheral participation through these communities of practice has become an essential means to spread and support this technology integration…
of Practice: Principles and Practices of the GIsML Community. Teaching and Teacher Education , 14, 5-19. Pasmore, W., & Sherwood, J. (1977...Associates, Inc. Pugach, M. (1999). The Professional Development of Teachers From A "Communities of Practice" Perspective. Teacher Education and
Hew, Khe Foon; Hara, Noriko
Despite the strong interests among practitioners, there is a knowledge gap with regard to online communities of practice. This study examines knowledge sharing among critical-care and advanced-practice nurses, who are engaged in a longstanding online community of practice. Data were collected about members' online knowledge contribution as well as…
Newswander, L. K.; Borrego, M.
This paper discusses the benefits of a community of practice (CoP) approach to graduate education in engineering and examines guidelines for implementation. Community of practice theory and applications to practice are presented. Journal clubs, groups of faculty and students who meet regularly to discuss literature, are identified as one specific…
De Micheli, Caterina; Galimberti, Carlo
This paper presents the development of an Immersive Virtual Technology (IVT) system serving a community of practice consisting of psychotherapists who use virtual environments for therapy and treatment of anxiety disorders. The psychosocial theoretical background includes the ethnomethodological approach, Situated Action Theory and the Intersubjectivity of the Utterance model. The dialogical importance promoted at each level of the analysis phases becomes the key to a deeper and more fluid understanding of the assumptions and meaning that guide the actions of and interactions between therapists and patients. The entire system design process is inspired by a dialogical perspective, which aims to effectively and non-rigidly integrate the design stages, analysis in context of use, ergonomic evaluation, creation of the virtual reality (VR) system, and final work on the clinical protocol in use.
Frehywot, Seble; Mullan, Fitzhugh; Vovides, Yianna; Korhumel, Kristine; Chale, Selamawit Bedada; Infanzon, Alexandra; Kiguli-Malwadde, Elsie; Omaswa, Francis
The Medical Education Partnership Initiative (MEPI) supports medical education capacity development, retention, and research in Sub-Saharan African institutions. Today, MEPI comprises more than 40 medical schools in Africa and 20 in the United States. Since 2011, the MEPI Coordinating Center, working with the MEPI schools and the U.S. government, has laid the groundwork and served as a catalyst for the creation and development of MEPI "communities of practice" (CoPs). These CoPs encompass seven components, some of which are virtual while others are tangible. They include technical working groups, principal investigator site visit exchanges, an annual symposium, a MEPI journal supplement, the MEPI Web site, newsletters, and webinars. Despite certain challenges and the question of sustainability, the presence within the MEPI network of an organization focused on promoting group consciousness and facilitating collaborative projects is an asset that is likely to continue to pay dividends for the foreseeable future.
Wang, Tiffany L.; Ames, Tyler D.; Le, Khoi M.; Wee, Corinne; Phieffer, Laura S.
Objective: The objective of this study was to determine whether advanced practice providers could learn to collect objective functional assessment data accurately and efficiently with commercially available devices that measure kinematics and kinetics (Nintendo Wii Balance Board [WBB] and Level Belt [LB]) to aid in the assessment of fall risk and outcomes after fragility fractures. Methods: Nine advanced practice providers participated in a 1-hour clinical assessment tools (CATs) training session on equipment use, providing standardized instructions, and practice of the testing procedures. Afterward, they participated in a skills demonstration evaluation and completed a postsession survey. Results: Participants successfully achieved a mean of 18.22 (standard deviation 1.56) of 20 performance measures. Of the incomplete or omitted tasks, the majority (10 of 16) occurred within the first of 3 CATs activities. Postsession survey results revealed that 9 of 9 participants reported that the 1 hour provided for training on the CATs was sufficient. All participants reported that after the training, they felt confident they could reliably carry out the tasks to test patients on both the WBB and the LB. The majority of participants reported that they believed that the WBB (7 of 9) and LB (8 out of 9) would be good assets to clinics in assessing patient functionality after fragility fractures. Conclusion: These results indicate that advanced practice providers can confidently learn and effectively test patients with the WBB and LB within 1 hour of training. In the future, adoption of CATs in the clinical setting may allow for objective, easy-to-use, portable, noninvasive, and relatively inexpensive measures to assess functional outcomes in patients with fragility fracture. PMID:26328225
Haggerty, Kevin P.; Shapiro, Valerie B.
This paper describes a public health orientation to drug and alcohol abuse prevention; reviews the state of the science underlying a risk and protective factor approach to alcohol and drug abuse prevention; describes Communities That Care, a community practice model that makes use of this evidence; and considers how this model reflects four important principles of social work practice. The intent of this article is to provide guidance to social workers who support the National Association of Social Work’s intention to make prevention practice central to the provision of alcohol and drug abuse services by social workers. PMID:23731424
McCreesh, Karen; Larkin, Louise; Lewis, Jeremy
The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development. PMID:26904293
McCreesh, Karen; Larkin, Louise; Lewis, Jeremy
The study aim was to elicit the motivators, barriers, and benefits of participation in a Community of Practice (CoP) for primary care physiotherapists. We used a qualitative approach using semistructured interviews. The participants were twelve physiotherapists partaking in a newly formed Shoulder CoP. A desire for peer support was the strongest motivator for joining, with improving clinical practice being less apparent. Barriers to participation included time and work pressures and poor research skills. The structure of the CoP, in terms of access to meetings and the provision of preparation work and deadlines for the journal clubs, was reported to be a facilitator. Multiple benefits ensued from participation. The role of teamwork was emphasised in relation to reducing isolation and achieving goals. The majority of participants reported positive clinical practice changes in terms of improved patient education, increased confidence, and availability of new resources. All participants reported some element of personal growth and development, in particular in their evidence-based practice skills. The results provide support for the use of CoPs as a means of continuing professional development for physiotherapists in the workplace, as significant benefits are gained in terms of evidence-based practice (EBP), patient care, and therapist personal development.
Project and team-based pedagogies are increasingly augmenting lecture-style science classrooms. Occasionally, university professors will invite students to tangentially partcipate in their research. Since 2006, Dr. Russ Genet has led an astronomy research seminar for community college and high school students that allows participants to work closely with a melange of professional and advanced amatuer researchers. The vast majority of topics have centered on measuring the position angles and searations of double stars which can be readily published in the Journal of Double Star Observations. In the intervening years, a collaborative community of practice (Wenger, 1998) formed with the students as lead researchers on their projects with the guidance of experienced astronomers and educators. The students who join the research seminar are often well prepared for further STEM education in college and career. Today, the research seminar involves multile schools in multiple states with a volunteer educator acting as an assistant instructor at each location. These assistant instructors interface with remote observatories, ensure progress is made, and recruit students. The key deliverables from each student team include a published research paper and a public presentation online or in-person. Citing a published paper on scholarship and college applications gives students' educational carreers a boost. Recently the Journal of Double Star Observations published its first special issue of exlusively student-centered research.
Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine
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.
McComas, David; Wilmot, Jonathan; Cudmore, Alan
In February 2015 the NASA Goddard Space Flight Center (GSFC) completed the open source release of the entire Core Flight Software (cFS) suite. After the open source release a multi-NASA center Configuration Control Board (CCB) was established that has managed multiple cFS product releases. The cFS was developed and is being maintained in compliance with the NASA Class B software development process requirements and the open source release includes all Class B artifacts. The cFS is currently running on three operational science spacecraft and is being used on multiple spacecraft and instrument development efforts. While the cFS itself is a viable flight software (FSW) solution, we have discovered that the cFS community is a continuous source of innovation and growth that provides products and tools that serve the entire FSW lifecycle and future mission needs. This paper summarizes the current state of the cFS community, the key FSW technologies being pursued, the development/verification tools and opportunities for the small satellite community to become engaged. The cFS is a proven high quality and cost-effective solution for small satellites with constrained budgets.
Chen, Fang-Pei; Wu, Hui-Ching; Huang, Chun-Jen
This study examined influences of causal attributions of schizophrenia and perceived and internalized mental illness stigma on perceived working alliance with, and informational support received from doctors practicing Western psychiatry in the Taiwanese social-cultural context. This cross-sectional quantitative study used a non-probability, purposive sampling technique to recruit 212 Taiwanese diagnosed with schizophrenia from Taiwanese Alliance of the Mentally Ill, 4 community mental health rehabilitation centres and 2 psychiatric hospitals between July 2012 and March 2013. Linear regression models were used for analysis. The results showed that environmental attributions were positively associated with both perceived working alliance and perceived informational support, while supernatural attributions were negatively associated with perceived working alliance and perceived informational support. Perceived stigma had a negative association with perceived working alliance. The discrimination domain of internalized stigma specifically had a positive association with perceived working alliance, while the withdraw domain had a negative association with perceived informational support. Findings inform the importance of culturally sensitive practices in developing an effective working relationship. Western psychiatric care providers need to explore consumers' casual attributions of mental illness and understand the impact of stigma so that providers may successfully engage consumers in care and provide tailored illness education and information.
Sloan, Kay; Pereira-Leon, Maura; Honeyford, Michelle
Established in 2006 by New Leaders for New Schools[TM], the Effective Practice Incentive Community (EPIC) initiative rewards high-need urban schools showing significant gains in student achievement. In exchange, schools agree to share the practices helping to drive those gains, which they do through an in-depth study of practice, aided by the EPIC…
Shapiro, Valerie B.; Oesterle, Sabrina; Abbott, Robert D.; Arthur, Michael W.; Hawkins, J. David
Social work has a long history of community practice, but community practice models have been understudied. An important first step in conducting such studies is the establishment of psychometrically sound measures that are relevant for evaluations of community practice. In this article, data are used from a community-randomized trial of Communities That Care, a coalition-based model of community practice shown to be effective at transforming communities and changing rates of problem behavior in youths. Coalition functioning is reported by coalition members in 12 communities across intervention implementation phases. A four-dimensional model of coalition functioning (goal-directedness, efficiency, opportunities for participation, and cohesion) was confirmed using factor analysis, and the dimensions were found to be invariant across time. One test of validity of these dimensions is conducted by correlating coalition members' ratings of coalition functioning with those of external observers. PMID:24778545
Welsh, Wayne N; Knudsen, Hannah K; Knight, Kevin; Ducharme, Lori; Pankow, Jennifer; Urbine, Terry; Lindsey, Adrienne; Abdel-Salam, Sami; Wood, Jennifer; Monico, Laura; Link, Nathan; Albizu-Garcia, Carmen; Friedmann, Peter D
Weak coordination between community correctional agencies and community-based treatment providers is a major barrier to diffusion of medication-assisted treatment (MAT)--the inclusion of medications (e.g., methadone and buprenorphine) in combination with traditional counseling and behavioral therapies to treat substance use disorders. In a multisite cluster randomized trial, experimental sites (j = 10) received a 3-h MAT training plus a 12-month linkage intervention; control sites (j = 10) received the 3-h training alone. Hierarchical linear models showed that the intervention resulted in significant improvements in perceptions of interagency coordination among treatment providers, but not probation/parole agents. Implications for policy and practice are discussed.
Keshavjee, K; Holbrook, AM; Lau, E; Esporlas-Jewer, I; Troyan, S
The COMPETE III Vascular Disease Tracker (C3VT) is a personalized, Web-based, clinical decision support tool that provides patients and physicians access to a patient’s 16 individual vascular risk markers, specific advice for each marker and links to best practices in vascular disease management. It utilizes the chronic care model1 so that physicians can better manage patients with chronic diseases. Over 1100 patients have been enrolled into the COMPETE III study to date.
Background Antenatal corticosteroids administered to women at risk of preterm birth is an intervention which has been proved to reduce the risk of respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality. There is a significant gap in the literature regarding the prevalence of the use of antenatal corticosteroids in Latin American countries and the attitudes and opinions of providers regarding this practice. The aim of this study was to assess the knowledge, attitudes and practices of health care providers regarding the use of antenatal corticosteroids in women at risk of preterm birth in Latin America. Methods This was a multicenter, prospective, descriptive study conducted in maternity hospitals in Ecuador, El Salvador, Mexico and Uruguay. Physicians and midwives who provide prenatal care or intrapartum care for women delivering in the selected hospitals were approached using a self-administered questionnaire. Descriptive statistics was used. Results The percentage of use of ACT in threatened preterm labour (TPL) reported by providers varies from 70% in Mexico to 97% in Ecuador. However, 60% to 20% of the providers mentioned that they would not use this medication in women at risk and would limit its use when there was a threatened preterm labour. In only one country recommended regimens of antenatal corticosteroids are followed by around 90% of providers whereas in the other three countries recommended regimens are followed by only 21%, 61%, 69% of providers. Around 40% of providers mentioned that they would administer a new dose of corticosteroids again, regardless the patient already receiving an entire regimen. Between 11% and 35% of providers, according to the countries, mentioned that they do not have adequate information on the correct use of this medication. Conclusions This study shows that the use of this intervention could be improved by increasing the knowledge of Latin American providers on its indications, benefits, and
accountability of MDA programs, in the April 2012 review; instead, we are providing in this report (1) the results of how the MDA program schedules compare...developed for several months at a time instead of for the life of the program. As a result, our findings on the specific program schedules are limited...practices, and some had major deficiencies. These results are significant because a reliable schedule is one key factor that indicates a program is
Knight, R E; Shoveller, J A; Carson, A M; Contreras-Whitney, J G
Although barriers related to lesbian, gay, bisexual, transgender and queer (LGBTQ) youth's experiences accessing sexual health services have been examined in detail, research into the experiences and perceptions of clinicians providing these services has been conspicuously absent. The aim of this article is to explore the perceptions and experiences of clinicians providing sexual health services for LGBTQ youth. Drawing on in-depth, semi-structured interviews, this study examines 24 clinicians' experiences providing sexual health services to LGBTQ youth in five communities in British Columbia, Canada. Our findings reveal how many clinicians provide services to LGBTQ youth with a lack of cultural competency-either implicitly (e.g., by describing heteronormative practices) or explicitly (e.g., by expressing frustration that they had not been sufficiently provided with appropriate training related to LGBTQ youth sexual health). Institutional norms and values were identified as the dominant barriers in the effective provision of LGBTQ-tailored services. Many clinicians find themselves unprepared to provide culturally competent sexual health services that have both the capacity to address individual-level issues (e.g. promoting condom use) while considering (and adapting services to) the broader socio-cultural and structural conditions that can render LGBTQ youth socially vulnerable.
Wolfe, Benjamin E.; Button, Julie E.; Santarelli, Marcela; Dutton, Rachel J.
SUMMARY Tractable microbial communities are needed to bridge the gap between observations of patterns of microbial diversity and mechanisms that can explain these patterns. We developed cheese rinds as model microbial communities by characterizing in situ patterns of diversity and by developing an in vitro system for community reconstruction. Sequencing of 137 different rind communities across 10 countries revealed 24 widely distributed and culturable genera of bacteria and fungi as dominant community members. Reproducible community types formed independent of geographic location of production. Intensive temporal sampling demonstrated that assembly of these communities is highly reproducible. Patterns of community composition and succession observed in situ can be recapitulated in a simple in vitro system. Widespread positive and negative interactions were identified between bacterial and fungal community members. Cheese rind microbial communities represent an experimentally tractable system for defining mechanisms that influence microbial community assembly and function. PMID:25036636
Wolfe, Benjamin E; Button, Julie E; Santarelli, Marcela; Dutton, Rachel J
Tractable microbial communities are needed to bridge the gap between observations of patterns of microbial diversity and mechanisms that can explain these patterns. We developed cheese rinds as model microbial communities by characterizing in situ patterns of diversity and by developing an in vitro system for community reconstruction. Sequencing of 137 different rind communities across 10 countries revealed 24 widely distributed and culturable genera of bacteria and fungi as dominant community members. Reproducible community types formed independent of geographic location of production. Intensive temporal sampling demonstrated that assembly of these communities is highly reproducible. Patterns of community composition and succession observed in situ can be recapitulated in a simple in vitro system. Widespread positive and negative interactions were identified between bacterial and fungal community members. Cheese rind microbial communities represent an experimentally tractable system for defining mechanisms that influence microbial community assembly and function.
Charles, Grant; Bainbridge, Lesley; Copeman-Stewart, Kathy; Kassam, Rosemin; Tiffin, Shelly
The Interprofessional Rural Program of British Columbia (IRPBC) was established in 2003 as a pilot program aimed at supporting the recruitment of health and human service professionals to rural communities in British Columbia, Canada. The program was designed to expose students in the health and human service professions to rural communities and to assess whether this exposure increased the likelihood of their return to work in nonurban settings once they completed their studies. The initial qualitative evaluation of IRPBC was conducted via individual interviews in the first year and written questionnaires in the second year. In general, IRPBC was perceived by the participants to have had a significant impact on the students and communities. The students who participated in it benefited not only from the chance to engage in rural practice but also from the opportunity to interact within an interprofessional context; and the communities participating in the program profited from enhanced health care and the possibility of attracting new practitioners from these students. Exposure to new ways of providing service and the impact that the introduction of teams of passionate students can have on both practitioners and small communities have greatly enriched the broader communities.
Naidoo, Sudeshni; Vernillo, Anthony T
The focus of healthcare ethics within the framework of ethical principles and philosophical foundations has always, in recent times, been the community, namely, the healthcare provider, the patient or, in research, the study participant. An initiative is thus described whereby a community of practice (CoP) model was developed around health ethics in health research, education and clinical care. The ethics curriculum was redesigned to include several components that are integrated and all embracing, namely, health research ethics, healthcare ethics, health personnel education in ethics and global and public health ethics. A CoP is a group who share a common interest and a desire to learn from and contribute to the community with their variety of experiences. The CoP is dynamic and organic, generating knowledge that can be translated into effective healthcare delivery and ethical research. It requires the collaboration and social presence of active participants such as community members, healthcare professionals and educators, ethicists and policy makers to benefit the community by developing approaches that adapt to and resonate with the community and its healthcare needs. Philosophical principles constitute the foundation or underpinning of this innovative curriculum. Recommendations are presented that will continue to guide the consolidation and sustainability of the CoP.
Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim
The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.
Schwartz, Brian S.; Parker, Cindy; Glass, Thomas A.; Hu, Howard
The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon- and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available “planetary health” metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations. PMID:17185267
Community college counseling is often not well understood in the "university-centric" higher education community. In fact, work at community college counseling centers typically involves an exaggerated version of the challenges found at university counseling centers. At a community college, there are usually vastly fewer resources from…
Background Multiple guidelines are often available to inform practice in complex interventions. Guidance implementation may be facilitated if it is tailored to particular clinical issues and contexts. It should also aim to specify all elements of interventions that may mediate and modify effectiveness, including both their content and delivery. We conducted a focused synthesis of recommendations from stroke practice guidelines to produce a structured and comprehensive account to facilitate the development of community-based exercise programmes after stroke. Methods Published stroke clinical practice guidelines were searched for recommendations relevant to the content and delivery of community-based exercise interventions after stroke. These were synthesised using a framework based on target intervention outcomes, personal and programme proximal objectives, and recommended strategies. Results Nineteen guidelines were included in the synthesis (STRIDES; STroke Rehabilitation Intervention-Development Evidence Synthesis). Eight target outcomes, 14 proximal objectives, and 94 recommended strategies were identified. The synthesis was structured to present best practice recommendations in a format that could be used by intervention programme developers. It addresses both programme content and context, including personal factors, service standards and delivery issues. Some recommendations relating to content, and many relating to delivery and other contextual issues, were based on low level evidence or expert opinion. Where opinion varied, the synthesis indicates the range of best practice options suggested in guidelines. Conclusions The synthesis may assist implementation of best practice by providing a structured intervention description that focuses on a particular clinical application, addresses practical issues involved in programme development and provision, and illustrates the range of best-practice options available to users where robust evidence is lacking. The
Watson, Tara Marie; Strike, Carol; Challacombe, Laurel; Demel, Geoff; Heywood, Diana; Zurba, Nadia
Through promotion of consistent, evidence-based policy and practice, best practice recommendations can improve service delivery. Nationally relevant best practice recommendations, including guidance for programmes that provide service to people who use drugs, are often created and disseminated by government departments or other national organisations. However, funding priorities do not always align with stakeholder- and community-identified needs for such recommendations, particularly in the case of harm reduction. We achieved success in developing and widely disseminating best practice documents for Canadian harm reduction programmes by bringing together a multi-stakeholder, cross-regional team of people with relevant and diverse experience and expertise. In this commentary, we summarise key elements of our experience to contribute to the literature more detailed and transparent dialogue about team processes that hold much promise for developing best practice resources. We describe our project's community-based principles and process of working together (e.g., regularly scheduled teleconferences to overcome geographic distance and facilitate engagement), and integrate post-project insights shared by our team members. Although we missed some opportunities for power-sharing with our community partners, overall team members expressed that the project offered them valuable opportunities to learn from each other. We aim to provide practical considerations for researchers, other stakeholders, and community members who are planning or already engaged in a process of developing best practice recommendations for programmes and interventions that address drug use.
Goodman, R M; Speers, M A; McLeroy, K; Fawcett, S; Kegler, M; Parker, E; Smith, S R; Sterling, T D; Wallerstein, N
Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities.
Samelson, Renee; Siddiqui, Maryam M.; Paglia, Michael J.; Strassberg, Emmie R.; Kelly, Elizabeth; Murtough, Katie L.; Schulkin, Jay
ACOG's research department recruited four medical centers to participate in a study on the attitudes and practices of medical providers and pregnant patients regarding influenza vaccination. Medical providers and patients were given voluntary surveys and medical record data was collected over two flu seasons, from 2013 to 2015. Discrepancies between self-reports of medical providers and patients and medical records were observed. Nearly 80% of patients self-reported accepting the influenza vaccine, but medical record data only reported 36% of patients accepting the vaccine. Similarly, all medical providers reported giving recommendations for the vaccine, but only 85% of patients reported receiving a recommendation. Age, education, a medical provider's recommendation, and educational materials were found to positively influence patient beliefs about the influenza vaccine. Accepting the vaccine was influenced by a patient's previous actions, beliefs, and a medical provider's recommendation. Patients who reported previously not accepting the vaccine and had negative feelings towards the vaccine but accepted it while pregnant reported concern for the health and safety of their baby. Future research should focus on groups that may be less likely to accept the vaccine and ways to dispel negative myths. Medical provider should continue to strongly recommend the vaccine and provide educational materials. PMID:27559272
Avey, Holly; Matheny, Kenneth B.; Robbins, Anna; Jacobson, Terry A.
In order to assess health care providers' training, perceptions, and practices regarding stress and health outcomes, a survey was administered to primary care providers in the outpatient medical clinics of a southeastern urban hospital serving a predominantly African-American indigent population. One-hundred-fifty-one of 210 providers (72%) responded. Forty-two percent of respondents reported receiving no instruction regarding stress and health outcomes during their medical/professional education. While 90% believed stress management was "very" or "somewhat" effective in improving health outcomes, 45% "rarely" or "never" discussed stress management with their patients. Respondents were twice as likely to believe that counseling patients about smoking, nutrition, or exercise was more important than counseling them about stress. Seventy-six percent lacked confidence in their ability to counsel patients about stress. The majority of respondents (57%) "rarely" or "never" practiced stress reduction techniques themselves. Belief in the importance of stress counseling, its effectiveness in improving health, and confidence in one's ability to teach relaxation techniques were all related to the probability that providers would counsel patients regarding stress. There is a need for curriculum reform that emphasizes new knowledge about stress and disease, new skills in stress reduction, and more positive beliefs about mind/body medicine and its integration into the existing health care structure. PMID:14527051
Ali, Mujtaba; Adams, Alexandra; Hossain, Md Anwar; Sutin, David; Han, Benjamin Hyun
There are an estimated 3.5 million Muslims in North America. During the holy month of Ramadan, healthy adult Muslims are to fast from predawn to after sunset. While there are exemptions for older and sick adults, many adults with diabetes fast during Ramadan. However, there are risks associated with fasting and specific management considerations for patients with diabetes. We evaluated provider practices and knowledge regarding the management of patients with diabetes who fast during Ramadan. A 15-question quality improvement survey based on a literature review and the American Diabetes Association guidelines was developed and offered to providers at the outpatient primary care and geriatric clinics at an inner-city hospital in New York City. Forty-five providers completed the survey. Most respondents did not ask their Muslim patients with diabetes if they were fasting during the previous Ramadan. Knowledge of fasting practices during Ramadan was variable, and most felt uncomfortable managing patients with diabetes during Ramadan. There is room for improvement in educating providers about specific cultural and medical issues regarding fasting for patients with diabetes during Ramadan.
Hahn, E J; Bryant, R; Peden, A; Robinson, K L; Williams, C A
To better prepare new graduates for entry-level positions in community settings, faculty of one college of nursing gathered information using focus groups of prospective employers. The groups were to identify the skills and qualities nurses need to practice in the community and ways to redesign nursing curricula to better prepare undergraduates for community-based practice. Data for this qualitative study were collected in five separate focus groups conducted with prospective employers (N = 18) from four major areas of Kentucky. By collaborating with prospective employers in the community, a partnership was established between nurse educators and community health leaders to improve the marketability of baccalaureate graduates. Assessment was the most frequently named skill essential to nursing practice in the community. Independence, critical thinking, collaboration, and confidence consistently emerged as important skills and qualities. Prospective employers were positive about developing partnerships to improve under-graduate nursing curricula. Recommendations for curricula to better prepare undergraduates for community-based practice are suggested.
... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What services may INA grantees provide to the community at large under section 166? 668.510 Section 668.510 Employees' Benefits EMPLOYMENT AND TRAINING... WORKFORCE INVESTMENT ACT Services to Communities § 668.510 What services may INA grantees provide to...
Traven, Ana; Jänicke, Amrei; Harrison, Paul; Swaminathan, Angavai; Seemann, Torsten; Beilharz, Traude H
Understanding multicellular fungal structures is important for designing better strategies against human fungal pathogens. For example, the ability to form multicellular biofilms is a key virulence property of the yeast Candida albicans. C. albicans biofilms form on indwelling medical devices and are drug resistant, causing serious infections in hospital settings. Multicellular fungal communities are heterogeneous, consisting of cells experiencing different environments. Heterogeneity is likely important for the phenotypic characteristics of communities, yet it is poorly understood. Here we used colonies of the yeast Saccharomyces cerevisiae as a model fungal multicellular structure. We fractionated the outside colony layers from the cells in the center by FACS, using a Cit1-GFP marker expressed exclusively on the outside. Transcriptomics analysis of the two subpopulations revealed that the outside colony layers are actively growing by fermentative metabolism, while the cells residing on the inside are in a resting state and experience changes to mitochondrial activity. Our data shows several parallels with C. albicans biofilms providing insight into the contributions of heterogeneity to biofilm phenotypes. Hallmarks of C. albicans biofilms - the expression of ribosome and translation functions and activation of glycolysis and ergosterol biosynthesis occur on the outside of colonies, while expression of genes associates with sulfur assimilation is observed in the colony center. Cell wall restructuring occurs in biofilms, and cell wall functions are enriched in both fractions: the outside cells display enrichment of cell wall biosynthesis enzymes and cell wall proteins, while the inside cells express cell wall degrading enzymes. Our study also suggests that noncoding transcription and posttranscriptional mRNA regulation play important roles during growth of yeast in colonies, setting the scene for investigating these pathways in the development of multicellular
Traven, Ana; Jänicke, Amrei; Harrison, Paul; Swaminathan, Angavai; Seemann, Torsten; Beilharz, Traude H.
Understanding multicellular fungal structures is important for designing better strategies against human fungal pathogens. For example, the ability to form multicellular biofilms is a key virulence property of the yeast Candida albicans. C. albicans biofilms form on indwelling medical devices and are drug resistant, causing serious infections in hospital settings. Multicellular fungal communities are heterogeneous, consisting of cells experiencing different environments. Heterogeneity is likely important for the phenotypic characteristics of communities, yet it is poorly understood. Here we used colonies of the yeast Saccharomyces cerevisiae as a model fungal multicellular structure. We fractionated the outside colony layers from the cells in the center by FACS, using a Cit1-GFP marker expressed exclusively on the outside. Transcriptomics analysis of the two subpopulations revealed that the outside colony layers are actively growing by fermentative metabolism, while the cells residing on the inside are in a resting state and experience changes to mitochondrial activity. Our data shows several parallels with C. albicans biofilms providing insight into the contributions of heterogeneity to biofilm phenotypes. Hallmarks of C. albicans biofilms – the expression of ribosome and translation functions and activation of glycolysis and ergosterol biosynthesis occur on the outside of colonies, while expression of genes associates with sulfur assimilation is observed in the colony center. Cell wall restructuring occurs in biofilms, and cell wall functions are enriched in both fractions: the outside cells display enrichment of cell wall biosynthesis enzymes and cell wall proteins, while the inside cells express cell wall degrading enzymes. Our study also suggests that noncoding transcription and posttranscriptional mRNA regulation play important roles during growth of yeast in colonies, setting the scene for investigating these pathways in the development of multicellular
Heightened levels of support provision are systematically observed in adults immediately following natural disasters, yet knowledge about adolescents' social support provision is less extensive. This longitudinal study of 262 adolescents assessed their help-providing behaviors during and after a flood. It was hypothesized that social support provided by adolescents would relate to subsequent perceptions of their relationships with others and perceptions of the self. Descriptive analyses demonstrated that the majority of respondents reported that they provided tangible, emotional, and informational support to others in need. A series of hierarchical multiple regression analyses indicated that higher levels of support provided following the flood were subsequently associated with higher levels of perceived social support, a stronger sense of community at school, and greater propensity to engage in proactive coping. These associations were statistically significant, controlling for the impact of exposure to disaster stressors, age, gender, and received social support. Theoretical considerations and practical implications related to processes of social support provisions in times of stress are discussed.
McDonald, Paul W; Viehbeck, Sarah
Models of research translation frequently emphasize independent roles for research producers and intended users. This article describes a novel approach for enhancing exchange between researchers and practitioners. The framework is based on Wenger's notion of Communities of Practice (CoP) where knowledge is regarded as a social enterprise at the center of member interactions. Research-based practices and policies emerge when research producers and users mutually engage one another about specific health promotion problems through negotiation and by creating and sharing technical standards and other resources. CoPs are more than loose networks or task-oriented teams. They aim to create both social and intellectual capital through mutual negotiation, reciprocity, trust, and cohesion. A Consortium of Quitline Operators across North America and a Canadian project to enhance research capacity for tobacco control research serve as examples of how the model has been successfully operationalized.
Young, Susan; Guo, Kristina L
The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.
Aarons, Gregory A.
Mental health provider attitudes toward adoption of innovation in general, and toward evidence-based practice (EBP) in particular, are important in considering how best to disseminate and implement EBPs. This article first explores the role of attitudes in acceptance of innovation and proposes a model of organizational and individual factors that may affect or be affected by attitudes toward adoption of EBP. Next, a recently developed measure of mental health provider attitudes toward adoption of EBP is presented along with a summary of preliminary reliability and validity findings. Attitudes toward adoption of EBP are then discussed in regard to provider individual differences and the context of mental health services. Finally, potential applications of attitude research to adoption of EBP are discussed. PMID:15694785
Villegas, P M
Health development is a priority objective in Malvar, a town of 27,800 people, as of 1996, in the province of Batangas. Malvar's population lives in 4633 households. The Japanese Organization for International Cooperation in Family Planning (JOICFP)-supported Sustainable Community-based Reproductive Health (RH)/Family Planning (FP) Project Emphasizing Quality of Care is very important to the people of Malvar. The project is managed by the Interagency Community Organizing Committee (ICOC) established in December 1993. The author describes the many ways in which the RH/FP project has contributed to Malvar's goal of providing universal access to various services, including family planning information and services and reproductive health services. The project has increased the acceptance of family planning and resulted in an increase in the contraceptive prevalence rate from 13.3% in 1993 to 61.0% in 1997. Over the same period, the infant mortality rate per 1000 live births has fallen from 39.4 to 14.1.
Gerald, Lynn B; Gerald, Joe K; McClure, Leslie A; Harrington, Kathy; Erwin, Sue; Bailey, William C
Background Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult. Therefore, we designed a study to evaluate the effect of hand sanitizer use in elementary schools on exacerbations among children with asthma. Purpose To describe the process of redesigning the trial in response to changes in the safety profile of the hand sanitizer as well as changes in hand hygiene practice in the schools. Methods The original trial was a randomized, longitudinal, subject-blinded, placebo-controlled, community-based crossover trial. The primary aim was to evaluate the incremental effectiveness of hand sanitizer use in addition to usual hand hygiene practices to decrease asthma exacerbations in elementary-age children. Three events occurred that required major modifications to the original study protocol: (1) safety concerns arose regarding the hand sanitizer’s active ingredient; (2) no substitute placebo hand sanitizer was available; and (3) community preferences changed regarding hand hygiene practices in the schools. Results The revised protocol is a randomized, longitudinal, community-based crossover trial. The primary aim is to evaluate the incremental effectiveness of a two-step hand hygiene process (hand hygiene education plus institutionally provided alcohol-based hand sanitizer) versus usual care to decrease asthma exacerbations. Enrollment was completed in May 2009 with 527 students from 30 schools. The intervention began in August 2009 and will continue through May 2011. Study results should be available at the end of 2011. Limitations The changed design does not allow us to
Barker, Judith C; Horton, Sarah B
Background Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. Methods Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age. Results Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations
Ploeg, Jenny; Denton, Margaret; Hutchison, Brian; McAiney, Carrie; Moore, Ainsley; Brazil, Kevin; Tindale, Joseph; Wu, Amina; Lam, Annie
The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons' access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to find relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to find that they relied on out-of-date resources and inefficient search strategies to find CSSs. Our findings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs.
Vu, Catherine M; Schwartz, Sara L; Austin, Michael J
BANANAS, Inc. is a nonprofit organization that has provided child care resource and referral services for over 35 years. BANANAS emerged as a grassroots effort initiated by a group of female volunteers who sought to build a network of women with children who needed childcare. As the organization developed, its leaders recognized and responded to additional needs, including resource and information sharing, workshops and classes, and political advocacy. Beginning as a collective, BANANAS has grown into a multifaceted service delivery and advocacy nonprofit operating with an annual budget of $12 million. This history of the agency reflects the development of a unique community-based effort, its challenges and rewards, and the multiple successes that this pioneering nonprofit has experienced.
Dossa, Almas; Capitman, John A
In this study, we explored provider perspectives on the benefits of and implementation challenges in using lay health mentor peers in a community-based replication of an efficacious 12-month older adult disability prevention program. In addition, we describe the association of the mentor program with site features and program completion. We conducted semi-structured telephone interviews with nurses, social workers, and site managers and obtained primary data on site features and secondary data on program completion. Major themes included the importance of the health mentor program and implementation challenges. Sites with mentor programs were more likely to have older adults complete the program compared with sites without mentor programs. Rural, small, and less diverse sites were more likely to have health mentor programs than urban, large, and more diverse sites. Implications include a need to fund more lay health mentor programs, obtain adequate staffing including minority staff for health mentor support, and implement strategies to improve program efficiency.
Macy, Rebecca J; Ogbonnaya, Ijeoma Nwabuzor; Martin, Sandra L
This practice note presents findings from a statewide survey of domestic violence and sexual assault agency directors (n = 80; 77% response rate), regarding their opinions about the outcome information that should be collected from victims during evaluations of five commonly provided services: legal advocacy, medical advocacy, group services, individual counseling, and shelter. The findings showed that four information types were repeatedly ranked among the most important to collect to understand whether services helped victims including victims' satisfaction with services, victims' progress toward meeting their goals, changes in the extent of violence and/or trauma that victims experienced, and changes in victims' knowledge.
Schueller, Stephen M; Washburn, Jason J; Price, Matthew
A growing number of Internet sites and mobile applications are being developed intended for use in clinical practice. However, during the development process (e.g., creating features and determining use cases), the needs and interests of providers are often overlooked. We explored providers' interests using a mixed-methods approach incorporating both qualitative and quantitative research methods. A first study used an interview approach to identify the challenges providers faced, tools they used, and any use of computers and apps specifically. Fifteen providers from both the United States and Canada completed the interview and recordings were transcribed and analyzed using a constructivist grounded theory approach. Four primary themes were identified including challenges, potential tools, access and usability. A second study used a brief survey completed by 132 providers at a large healthcare system to explore current use of and potential interest in Internet and mobile technologies. Although many providers (80.9%) reported recommending some form of technology to patients, this was mostly Internet websites that were predominantly informational/psychoeducational in nature. Overall, these studies combine to suggest a strong interest in websites and apps for use in clinical settings while highlighting potential areas (ease of use, patient security and privacy) that should be considered in the design and deployment of these tools.
While social work practice with people with dementia and their families has a long but largely hidden history, it is an emerging area of specialism. The increased incidence, prevalence and recognition of dementia suggest that this area of practice will expand and so learning from previous practice may offer helpful insights. This paper describes and reflects upon social work practice with 'dements' in the 1950s in England. It draws on a reading of a small book written by a psychiatric social worker, Miss M (Muriel) H Bree, outlining her role in providing after-care to patients with neuro-syphilis who had been discharged from hospital to live with their families between 1942 and 1952 through her consideration of 275 case records and seven illustrative case studies. As a historical document, Bree's account presents a rich description of the patients and their social circumstances in post-war Britain; an account of practice from a hospital based setting that reached into the community, and of the engagement of a social worker with her clients and their family members. Threads and continuities with contemporary social work practice with people with dementia are explored; particularly work with family carers, younger people with dementia, and the value placed upon continuity of care.
Weaver, Lisa D.; Pifer, Meghan J.; Colbeck, Carol L.
This article investigates how informal positions of power emerge within a community of practice and how positions of power influence communication and understanding about key issues. Findings from a study of one community of practice reveal Janusian leadership within the group and the effects of emergent, informal power roles on group goals,…
Zhao, Xiaoli; Bishop, M. J.
In order to seek more effective ways to design and support online communities of practice, we examined how Wikipedia, a large-scale online community of practice, is developed and emerges over time. We conducted a Delphi study to explore the social, organizational, and technical factors that Wikipedia experts believe have supported the evolution of…
Akkoç, Hatice; Balkanlioglu, Mehmet Ali; Yesildere-Imre, Sibel
This research aimed to analyse the induction experiences of preservice mathematics teachers during their school placements through the lens of communities of practice. The main research question was concerned with how preservice mathematics teachers perceive what constitutes the practice of a professional community of mathematics teachers. A…
Uncritically applying a community of practice model has become rather prevalent in higher education settings (Lea, 2005). This paper attempts to return to the spirit of Lave and Wenger's earlier (1991) work and to use a community of practice perspective as a heuristic to analyse participation patterns in a final year design studio in the…
The purpose of this reputation-based, multiple-site case study was to explore professional learning communities' impact on teacher classroom practice. The goal of this research was to describe the administrator and teachers' perceptions with respect to professional learning communities as it related to teacher practice in their school. Educators…
Verdon, Sarah; Wong, Sandie; McLeod, Sharynne
Collaboration with families and communities has been identified as one of six overarching principles to speech and language therapists' (SLTs') engagement in culturally competent practice (Verdon et al., 2015a). The aim of this study was to describe SLTs' collaboration with families and communities when engaging in practice to support the speech,…
Kaschak, Jennifer Cutsforth; Letwinsky, Karim Medico
This study investigates the unexpected emergence of a community of practice in a middle level mathematics and science methods course. The authors describe how preservice teacher participation in a collaborative, project-based service-learning experience resulted in the formation of a community of practice characterized by teamwork, meaningful…
Butin, Dan W.
This book offers a comprehensive rethinking of the theory and practice of service-learning in higher education. Democratic and community engagement are vital aspects of linking colleges and communities, and this book critically engages the best practices and powerful alternative models in the academy. Drawing on key theoretical insights and…
Pharo, Emma; Davison, Aidan; McGregor, Helen; Warr, Kristin; Brown, Paul
We report on the establishment of communities of practice at four Australian institutions and evaluate their effectiveness and durability as a means of building staff and institutional capacity for interdisciplinary teaching. A community of practice approach is a potentially valuable methodology for overcoming dynamics of fragmentation, isolation…
Enfield, Mark; Stasz, Bird
Reflection and Communities of Practice are common constructs in teacher education. Co-teaching is often seen as beneficial, yet teacher education students rarely have experiences being co-taught. Thus, reflection, communities of practice, and co-teaching, deserve careful consideration in designing teacher education learning experiences. Based on…
Hillman, Sara Katherine
Drawing on Lave and Wenger's (1991) and Wenger's (1998) "communities of practice" (CoP) framework, this study explores the shared repertoire of humor practices in the creation of community within the context of a culturally diverse and multilevel adult Arabic language classroom consisting of two native speakers, five heritage language learners…
Stephenson, Sandria S.
This paper reports the findings of an exploratory qualitative study using the implementation of Wenger's [(1998). "Communities of practice: Learning, meaning, and identity." Cambridge, MA: Cambridge University Press; Wenger, E. (2000). Communities of practice and social learning systems. "Organization," 7(2), 225-246] Theory of…
Eberle, Julia; Stegmann, Karsten; Fischer, Frank
Participating in communities of practice (CoPs) is an important way of learning. For newcomers in such communities, the learning process can be described as legitimate peripheral participation (LPP). Although a body of knowledge on LPP has been accumulated from qualitative case studies, mostly focusing on the use of practices, the concrete…
Edith Cowan Univ., Perth (Australia).
This document consists of an overview and five papers examining the findings of a comparative analysis of literacy practices in urban and rural Australian communities. The study included case studies of 23 families in 6 communities and documentation of the literacy practices within the 9 schools attended by the children of those families.…
O'Brien, Myles W; Shields, Christopher A; Oh, Paul I; Fowles, Jonathon R
The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.
Lopes, J. Bernardino; Branco, Julia; Jimenez-Aleixandre, Maria Pilar
According to the literature, there is a very important corpus of knowledge that allows for the investigation of some dimensions of `learning experience' provided to students, in relation to epistemic, pedagogical and meta-cognitive practices. However, in the literature, there is little investigation into the invariance (or not) of the characteristics of students' learning experience while being taught a scientific subject by the same teacher. This paper suggests that the relationship between the learning experience provided and the competences developed is not properly highlighted. This paper analyses the learning experience provided to students in epistemic, pedagogical and meta-cognitive terms. The students were taught the proprieties and applications of light by one teacher, in three classes, over 7 weeks. We analysed the data in each referred learning experience, using a pre-defined category system. The students' competences were evaluated by a competence test. The epistemic demand of each item and the students' performances were also analysed. Our findings point to the non invariance of learning experiences provided to students and the influence of some dimensions of learning experiences provided in the development of certain competences. These findings and their implications are contextualized and discussed.
Clark, Phillip G
Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.
Background Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts. Methods Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups. A Grounded Theory approach was used to analyze the data. Results A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight the challenges faced in practical implementation of community rehabilitation and point to possible strategies for its enhancement. PMID:24004881
Newcomer, Sarah N.; Puzio, Kelly
Drawing from an ethnographic study of how one school community negotiates English-only policy in Arizona, we investigated how a bilingual community of practice was established at one school. Integral to establishing this bilingual community was the mobilization of Spanish-speaking families in the school's daily life and operation. This…
Gordon, Adam J; Harding, John Daniel
Opioid misuse may be ignored by providers who are unwilling or not confident in engaging the complex nature of substance use disorders among their patient populations. Addiction is a complex disease and although providers often are comfortable in identifying, assessing, and treating the complex diseases of their patients, basic knowledge and skills of identification, assessment, and treatment expertise involving opioids for pain, addressing opioid misuse, and treatment of opioid use disorder are lacking. Initiatives to improve knowledge of opioid use, misuse, and opioid use disorder among health care providers are emerging. In this issue of the Substance Abuse journal, we examine the science and evidence base of educational interventions and public initiatives addressing opioid use and addiction. These initiatives include naloxone rescue awareness and programs, community-based training initiatives, and system or public health approaches to improve student, trainee, and clinician education/training revolving around opioid misuse and opioid use disorder. We call on stakeholders to fund more research to investigate and implement the proven means to educate undergraduate students, graduate trainees, and clinicians regarding pain and addiction. We also recognize the 2016 peer reviewers of our journal who have performed meritorious, volunteer service to advance the science of addiction.
Background The focus of India’s National Malaria Programme witnessed a paradigm shift recently from health facility to community-based approaches. The current thrust is on diagnosing and treating malaria by community health workers and prevention through free provision of long-lasting insecticidal nets. However, appropriate community awareness and practice are inevitable for the effectiveness of such efforts. In this context, the study assessed community perceptions and practice on malaria and similar febrile illnesses. This evidence base is intended to direct the roll-out of the new strategies and improve community acceptance and utilization of services. Methods A qualitative study involving 26 focus group discussions and 40 key informant interviews was conducted in two districts of Odisha State in India. The key points of discussion were centred on community perceptions and practice regarding malaria prevention and treatment. Thematic analysis of data was performed. Results The 272 respondents consisted of 50% females, three-quarter scheduled tribe community and 30% students. A half of them were literates. Malaria was reported to be the most common disease in their settings with multiple modes of transmission by the FGD participants. Adoption of prevention methods was seasonal with perceived mosquito density. The reported use of bed nets was low and the utilization was determined by seasonality, affordability, intoxication and alternate uses of nets. Although respondents were aware of malaria-related symptoms, care-seeking from traditional healers and unqualified providers was prevalent. The respondents expressed lack of trust in the community health workers due to frequent drug stock-outs. The major determinants of health care seeking were socio-cultural beliefs, age, gender, faith in the service provider, proximity, poverty, and perceived effectiveness of available services. Conclusion Apart from the socio-cultural and behavioural factors, the availability of
Background Computerized Provider Order Entry (CPOE) can improve patient safety, quality and efficiency, but hospitals face a host of barriers to adopting CPOE, ranging from resistance among physicians to the cost of the systems. In response to the incentives for meaningful use of health information technology and other market forces, hospitals in the United States are increasingly moving toward the adoption of CPOE. The purpose of this study was to characterize the experiences of hospitals that have successfully implemented CPOE. Methods We used a qualitative approach to observe clinical activities and capture the experiences of physicians, nurses, pharmacists and administrators at five community hospitals in Massachusetts (USA) that adopted CPOE in the past few years. We conducted formal, structured observations of care processes in diverse inpatient settings within each of the hospitals and completed in-depth, semi-structured interviews with clinicians and staff by telephone. After transcribing the audiorecorded interviews, we analyzed the content of the transcripts iteratively, guided by principles of the Immersion and Crystallization analytic approach. Our objective was to identify attitudes, behaviors and experiences that would constitute useful lessons for other hospitals embarking on CPOE implementation. Results Analysis of observations and interviews resulted in findings about the CPOE implementation process in five domains: governance, preparation, support, perceptions and consequences. Successful institutions implemented clear organizational decision-making mechanisms that involved clinicians (governance). They anticipated the need for education and training of a wide range of users (preparation). These hospitals deployed ample human resources for live, in-person training and support during implementation. Successful implementation hinged on the ability of clinical leaders to address and manage perceptions and the fear of change. Implementation proceeded
Clement, T.; Brown, J.; Morrison, J.; Nestel, D.
General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also…
Ingram, Julie; Maye, Damian; Kirwan, James; Curry, Nigel; Kubinakova, Katarina
Purpose: This article utilizes the Communities of Practice (CoP) framework to examine learning processes among a group of permaculture practitioners in England, specifically examining the balance between core practices and boundary processes. Design/methodology/approach: The empirical basis of the article derives from three participatory workshops…
Basak, Subal Chandra; Sathyanarayana, Dondeti
Today, community pharmacists play an important role in any country as they take responsibility for patient’s medicine related needs for access to healthcare. However, in India only the supply of medicines remains the core activity of the community pharmacist. Most community pharmacists in the country still hardly offer patient‐oriented service. The role of the pharmacists in the community, and with it their medicine management, may change in the wake of the rapid growth of domestic medicine output and national healthcare expenditure. This article seeks to discuss the genesis of Indian community pharmacy, the majority of which are privately owned, and sketches its education, training and future prospects. PMID:23093872
Galea, S; Factor, S H; Bonner, S; Foley, M; Freudenberg, N; Latka, M; Palermo, A G; Vlahov, D
The Urban Research Center at the Center for Urban Epidemiologic Studies brings together community members and researchers working in Harlem, New York. A Community Advisory Board (CAB) composed of community members, service providers, public health professionals, and researchers was formed to assist the Center's research and interventions and to guide community partnerships. Through a collaborative process, the CAB identified three public health problems-substance use, infectious diseases, and asthma-as action priorities. To deal with substance use, the Center created a Web-based resource guide for service providers and a "survival guide" for substance users, designed to improve access to community services. To deal with infectious diseases, the Center is collaborating with local community-based organizations on an intervention that trains injection drug users to serve as peer mentors to motivate behavior change among other injection drug users. To deal with asthma, the Center is collaborating with community child care providers on an educational intervention to increase asthma awareness among day care teaching staff, enhance communication between staff and families, and improve the self-management skills of children with asthma. The Center's experience has demonstrated that active communities and responsive researchers can establish partnerships that improve community health.
Faith community nurses (FCN) are in an ideal position to lead the faith community in creating structures and models to integrate research and evidence-based practices into faith-based ministries. In transforming an organization, the FCN considers ways to educate the community on the value of research. By embracing research as a method for informing practice, the FCN plays a vital role in evaluating faith-based interventions.
Dellinger, Ann M; West, Bethany A
Traffic crashes are the leading cause of death among teens. Health care providers have an opportunity to address what works to keep teens safe on the road during the patient visit. An online survey was conducted of 1088 health care providers who saw patients at or near driving age. The survey assessed which road safety topics were discussed and which types of educational products were used most often. Family and general practice physicians represented 44.3% of the sample, followed by pediatricians (22.5%), nurse practitioners (17.6%), and internists (15.5%). Nearly all respondents (92.9%) reported addressing one or more driving safety factors (seat belt use, nighttime driving, fatigue, teen passengers, alcohol/drug use, speeding/reckless driving, and cell phone use/texting) with adolescent patients and/or their parents. Seat belt use was reported more often (83.7%) than other topics. The use of parent-teen driving agreements, a known effective intervention, was reported by less than 10% of respondents. Since health care providers expressed interest in receiving written resource materials, distribution of parent-teen driving agreements to health care providers might encourage greater uptake and use of this effective intervention.
Dellinger, Ann M.; West, Bethany A.
Traffic crashes are the leading cause of death among teens. Health care providers have an opportunity to address what works to keep teens safe on the road during the patient visit. An online survey was conducted of 1088 health care providers who saw patients at or near driving age. The survey assessed which road safety topics were discussed and which types of educational products were used most often. Family and general practice physicians represented 44.3% of the sample, followed by pediatricians (22.5%), nurse practitioners (17.6%), and internists (15.5%). Nearly all respondents (92.9%) reported addressing one or more driving safety factors (seat belt use, nighttime driving, fatigue, teen passengers, alcohol/drug use, speeding/reckless driving, and cell phone use/texting) with adolescent patients and/or their parents. Seat belt use was reported more often (83.7%) than other topics. The use of parent–teen driving agreements, a known effective intervention, was reported by less than 10% of respondents. Since health care providers expressed interest in receiving written resource materials, distribution of parent–teen driving agreements to health care providers might encourage greater uptake and use of this effective intervention. PMID:26740816
In Northwest Cameroon, the emergence of literacy in the mother tongue is providing minority language communities with new alternatives for learning and communication. To some extent, these alternatives are shaped by existing literacy practices in English, as English is the language of formal education. However, new spaces are also emerging in…
An online community of practice (OCoP) is a group of people, who are brought together by a shared interest and with the aim of deepening their understanding of an area of knowledge through regular interactions facilitated by computer mediated communication (CMC) tools. An OCoP can potentially provides teachers with those elements of effective…
Mansell, Jim; Beadle-Brown, Julie; Whelton, Beckie; Beckett, Celia; Hutchinson, Aislinn
Background: An important question in community living is what factors influence the extent to which staff provide "active support". Methods: Engagement, care practices and a range of staff and organizational characteristics were studied in 72 residential homes serving 359 adults with intellectual disabilities. Managers in 36 settings were trained…
Drawing on an evaluation experience of a teacher education preparation project in a rural area of South Africa, this paper attempts to explore the possibility of using Communities of Practice (CoP) in teacher preparation. The paper concludes that the concept of CoP is powerful in providing spaces for self-reflection to pre-service teachers and…
Benko, Susanna L.; Guise, Megan; Earl, Casey E.; Gill, Witny
English teacher education programs often look for ways to help preservice teachers engage in critical reflection, participate in communities of practice, and write for authentic audiences in order to be able to teach in the 21st century. In this article, the authors describe how they used Twitter to provide opportunities for reflection and…
There is a growing recognition among secondary educators and administrators that students need to have a science education that provides connections between familiar classes like biology, chemistry, and physics. Because of this waxing interest in an integrative approach to the sciences, there is a broader push for school districts to offer classes geared towards the earth sciences, a field that incorporates knowledge and skills gleaned from the three core science subjects. Within the contexts of a regular secondary school day on a traditional schedule (45- to 50-minute long classes), it is challenging to engage students in rigorous field-based learning, critical for students to develop a deeper understanding of geosciences content, without requiring extra time outside of the regular schedule. We suggest instruction using common, manmade features like drainage retention ponds to model good field practices and provide students with the opportunity to calculate basic hydrologic budgets, take pH readings, and, if in an area with seasonal rainfall, make observations regarding soils by way of trenching, and near-surface processes, including mass wasting and the effects of vegetation on geomorphology. Gains in student understanding are discussed by analyzing the difference in test scores between exams provided to the students after they had received only in-class instruction, and after they had received field instruction in addition to the in-class lectures. In an advanced setting, students made measurements regarding ion contents and pollution that allowed the classes to practice lab skills while developing a data set that was analyzed after field work was completed. It is posited that similar fieldwork could be an effective approach at an introductory level in post-secondary institutions.
Day, Lukejohn W.; Nazareth, Michelle; Sewell, Justin L.; Williams, J. Lucas; Lieberman, David A.
Background Enteral access placement is performed among a variety of providers and specialties, yet there is a dearth of literature on trends and factors related to enteral access placement in the United States. Objective To examine trends in the incidence of enteral access procedures performed by gastroenterologists in the United States. Design Retrospective review of upper endoscopic procedures that involved percutaneous endoscopic gastrostomy (PEG) tube placement between 2000 and 2010 was performed. Setting Endoscopy sites participating in the Clinical Outcomes Research Initiative (CORI). Patients Patients undergoing an upper endoscopy. Intervention PEG tube placement. Main Outcome Measurements Number of PEG tubes placed. Results Overall PEG tube placement by a provider from 2000-2010 was 1.7% (number of PEG tubes performed/number of upper endoscopies performed) with the majority of them being performed by gastroenterologists. Very young and very old, non-white racial background (Hispanic OR 1.21; 95% CI, 1.13-1.28; blacks OR 2.24; 95% CI, 2.12-2.36) and males (OR 1.44; 95% CI, 1.39-1.50) were patient characteristics associated with greater PEG tube placement. In terms of practice setting, PEG tube placement occurred more frequently in a community/HMO environment and the East Coast. With respect to provider characteristics, male providers were less likely than females to perform a PEG tube (OR, 0.67; 95% CI, 0.64-0.71) and there was a trend that as providers were further out of medical school they were less likely to perform a PEG tube procedure. Interestingly, surgeons (OR 6.69; 95% CI, 6.18-7.24) and other providers (non-pediatric/non-general practitioner) (OR 3.22; 95% CI, 2.63-3.94) were more likely to perform PEG tubes than gastroenterologists. Limitations Participation in CORI is voluntary and may not capture data on non-GI providers. Conclusions Significant practice variation was noted in PEG tube placement in the United States with respect to patient and
Faye, S L
Introduced in the public health services in Senegal since 2007, Rapid Diagnostic Tests (RDTs) are a new technical opportunity for clinical diagnosis of malaria. We analyze how different categories of caregivers, who are the providers, assume appropriation of their professional practices. Similarly, we document, from the analysis of their application for care, attitudes of recipients towards RDTs. The results show a time lag between the uses of this tool and the recommendations. RDTs have a recognized epidemiological usefulness. However, their positive integration requires a change in behaviors that caregivers and recipients are not always willing to assume. Indeed, the architecture, working conditions and applications for care influence the modes of appropriation of this technical innovation.
Deneroff, Victoria Matzenauer
This is an ethnographic case study of one urban high school science teacher who was attempting to use inquiry-based teaching in her practice. Rather than focusing on pedagogy, the study examines the social networks and communities of practice in which Marie Gonzalez participated. I make the argument that science teaching is a Discourse (Gee, 1990), and that teaching inquiry science means constructing an identity as a participant in what I call the Discourse of Inquiry. I also use discourse analysis to tease out a Discourse of Traditional Science Teaching. I conclude that the Traditional and Inquiry Discourses mediate a teacher's ideas of what it means to teach, and that, while Inquiry teachers are "bilingual", that is, able to participate in both Discourses, Traditional teachers are deaf to the Discourse of Inquiry. Moreover, in my study there is convincing evidence that administrators charged with evaluation were also unfamiliar with the Discourse of Inquiry and were therefore unable to provide support for Marie's inquiry practice. In light of these findings, it is not at all surprising that Marie found it quite difficult to use inquiry-based pedagogy. In order for teachers to adopt discourse-based reforms such as inquiry, the Discourse must be available to teachers in their workplaces.
This dissertation examines student questions within three Communities of Practice (CoP), all urban middle school science environments. The study analyzed student questions from a sociocultural perspective and used ethnographic research techniques to detail how the CoP's shaped questions in the classroom. In the first study, two case study girls attempted to navigate questioning events that required them to negotiation participation. Their access to participation was blocked by participation frameworks that elevated some students as "gatekeepers" while suppressing the participation of others. The next two studies detail the introduction of written questioning opportunities, one into a public middle school classroom and the other into an informal classroom. In both studies, students responded to the interventions differently, most notable the adoption of the opportunity by female students who do not participate orally. Dissertation-wide findings indicate all students were able to ask questions, but varied in level of cognitive complexity, and the diagnostic interventions were able to identify students who were not known to be "target students", students who asked a high number of questions and were considered "interested in science". Some students' roles were as "gatekeepers" to participation of their peers. Two out of three teachers in the studies reported major shifts in their teaching practice due to the focus on questions and the methods used here have been found to be effective in producing educational research as well as supporting high-need classrooms in prior research. In conclusion, these studies indicate that social factors, including participation frameworks, gender dynamics, and the availability of alternative participation methods, play an important role in how students ask science-related questions. It is recommended that researchers continue to examine social factors that reduce student questions and modify their teaching strategies to facilitate
The purpose of this study was to compare how elected and appointed board trustees provide oversight for the community colleges they serve. The rationale for this study was that little examination of board governance processes at community colleges had occurred and, as a result, board members may lack the understanding necessary for effectively…
... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false How do Job Corps centers and service providers become involved in their local communities? 670.800 Section 670.800 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Community Connections...
... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false How do Job Corps centers and service providers become involved in their local communities? 670.800 Section 670.800 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Community Connections...
...) Strengthen the capacity of Native American-controlled institutions to provide education and work-based... institutions such as tribal colleges; (2) Increase the community's capacity to deliver supportive services... Year Plan in conjunction with, and in support of, strategic tribal planning and community...
Behar-Horenstein, Linda S; Garvan, Cyndi W; Moore, Thomas E; Catalanotto, Frank A
Valid and reliable instruments to measure and assess cultural competence for oral health care providers are scarce in the literature, and most published scales have been contested due to a lack of item analysis and internal estimates of reliability. The purposes of this study were, first, to develop a standardized instrument to measure dental students' knowledge of diversity, skills in culturally competent patient-centered communication, and use of culture-centered practices in patient care and, second, to provide preliminary validity support for this instrument. The initial instrument used in this study was a thirty-six-item Likert-scale survey entitled the Knowledge, Efficacy, and Practices Instrument for Oral Health Providers (KEPI-OHP). This instrument is an adaption of an initially thirty-three-item version of the Multicultural Awareness, Knowledge, and Skills Scale-Counselor Edition (MAKSS-CE), a scale that assesses factors related to social justice, cultural differences among clients, and cross-cultural client management. After the authors conducted cognitive and expert interviews, focus groups, pilot testing, and item analysis, their initial instrument was reduced to twenty-eight items. The KEPI-OHP was then distributed to 916 dental students (response rate=48.6 percent) across the United States to measure its reliability and assess its validity. Both exploratory and confirmatory factor analyses were conducted to test the scale's validity. The modification of the survey into a sensible instrument with a relatively clear factor structure using factor analysis resulted in twenty items. A scree test suggested three expressive factors, which were retained for rotation. Bentler's comparative fit and Bentler and Bonnett's non-normed indices were 0.95 and 0.92, respectively. A three-factor solution, including efficacy of assessment, knowledge of diversity, and culture-centered practice subscales, comprised of twenty-items was identified. The KEPI-OHP was found to
Banister, Elizabeth M.; Begoray, Deborah L.
Introduction There is a paucity of intervention programs for Aboriginal girls and many of those that exist are delivered in culturally inappropriate ways. Methods In this paper, we provide an overview of recent research that focused on delivering a sexual health mentorship program that enhanced the voices of Aboriginal youth and was culturally relevant and appropriate to indigenous youth. Results Our program served to enhance social connection and reinforced a sense of belonging and relational mutuality among group members. Conclusion The purpose of this article is to illustrate how a mentorship program that used a community of practice approach empowered Aboriginal youth to become successful border crossers and helped to align them with the wider community. PMID:18392205
Hayes, G. P.; Hearne, M. G.; Portner, D. E.; Borjas, C.; Moore, G.; Flamme, H.
The U.S. Geological Survey database of global subduction zone geometries (Slab1.0) combines a variety of geophysical data sets (earthquake hypocenters, moment tensors, active source seismic survey images of the shallow subduction zone, bathymetry, trench locations, and sediment thickness information) to image the shape of subducting slabs in three dimensions, at approximately 85% of the world's convergent margins. The database is used extensively for a variety of purposes, from earthquake source imaging, to magnetotelluric modeling. Gaps in Slab1.0 exist where input data are sparse and/or where slabs are geometrically complex (and difficult to image with an automated approach). Slab1.0 also does not include information on the uncertainty in the modeled geometrical parameters, or the input data used to image them, and provides no means to reproduce the models it described. Currently underway, Slab2 will update and replace Slab1.0 by: (1) extending modeled slab geometries to all global subduction zones; (2) incorporating regional data sets that may describe slab geometry in finer detail than do previously used teleseismic data; (3) providing information on the uncertainties in each modeled slab surface; (4) modifying our modeling approach to a fully-three dimensional data interpolation, rather than following the 2-D to 3-D steps of Slab1.0; (5) migrating the slab modeling code base to a more universally distributable language, Python; and (6) providing the code base and input data we use to create our models, such that the community can both reproduce the slab geometries, and add their own data sets to ours to further improve upon those models in the future. In this presentation we describe our vision for Slab2, and the first results of this modeling process.
Andrew, Nicola; Ferguson, Dorothy; Wilkie, George; Corcoran, Terry; Simpson, Liz
This paper analyses the current standing of nursing within the wider United Kingdom (UK) higher education (HE) environment and considers the development of academic identity within the sector, introducing a technology mediated approach to professional learning and development. A community of practice (CoP) is a way of learning based on collaboration among peers. Individuals come together virtually or physically, with a common purpose, defined by knowledge rather than task [Wenger, E., 1998. Communities of Practice: Learning, Meaning and Identity, sixth ed. Cambridge University Press, Cambridge]. In 2008, a small team of academics at Glasgow Caledonian University, School of Nursing, Midwifery and Community Health created and implemented iCoP, a project undertaken to pilot an international CoP, where novices and expert academics collaborated to debate and discuss the complex transition from clinician to academic. Although not intended as a conventional research project, the developmental journey and emerging online discussion provide an insight into the collective thoughts and opinions of a multi-national group of novice academics. The article also highlights the key challenges, problems and limitations of working in an international online arena with professionals who traditionally work and thrive in a face to face, real time environment.
Cheseldine, Sally; Brown, Marie; Wilkie, Fiona
Many Community Learning Disability Nurses (CLDNs) in Scotland who work with children will have had some child health input during their registered nurse education programme, but often not specific to the needs of children who might be referred to them now as result of population changes, community care policy and improved methods of diagnosis (PHIS, 2004). Community nurses have relatively poor skills in detecting and managing mental health problems and identify training as a means of addressing this (Fox et al., 2003). To address the practice development needs identified by CLDNs through their Personal Development Plans (PDPs), secondments were provided to a Child and Adolescent Mental Health Service (CAMHS) for children and young people with learning disabilities for 2 days a week for six months. This was taken up by five CLDNs over a period of 3 years. The goals they set in their secondments were evaluated using Goal Attainment Scaling (GAS). This paper aims to discuss the use of GAS within secondments, as a means of identifying learning needs and developing practice in the area of CAMH nursing. The background to the paper, work based learning, health needs of children with LD and GAS are highlighted. Recommendations for future development are made.
Morton Ninomiya, Melody E; Pollock, Nathaniel J
Historically, Indigenous health research in Canada has failed to engage Indigenous peoples and communities as primary stakeholders of research evidence. Increasingly, research ethics and methodologies are being positioned as tools for Indigenous self-determination. In response, mainstream institutions have developed new ethical principles for research involving Indigenous people. While these transformations are necessary steps towards re-orienting research practices, they are not prescriptive. In this paper, we make visible three dilemmas from a case study in which Indigenous health research frameworks provided limited guidance or were unclear about how to balance community priorities with Indigenous research principles. We also discuss the strategies used to resolve each of these dilemmas. We draw examples from a project that examined the lived experiences of children and youth living with FASD and their caregivers. This project was conducted in collaboration with Sheshatshiu Innu First Nation, an Indigenous community in Labrador, Canada. In doing so, we argue that knowing the key guiding principles in Indigenous health research is not always enough, and that the 'real-world' context of practices and relationships can lead to conflicts that are not easily resolved with adherence to these principles.
Betz, Marian E.; Sullivan, Ashley F.; Manton, Anne P.; Espinola, Janice A.; Miller, Ivan; Camargo, Carlos A.; Boudreaux, Edwin D.
Background We sought to examine the knowledge, attitudes and practices of emergency department (ED) providers concerning suicidal patient care and to identify characteristics associated with screening for suicidal ideation (SI). Methods 631 providers at eight EDs completed a voluntary, anonymous survey (79% response rate). Results The median participant age was 35 (interquartile range: 30-44) years and 57% were female. Half (48%) were nurses and half were attending (22%) or resident (30%) physicians. More expressed confidence in SI screening skills (81-91%) than in skills to assess risk severity (64-70%), counsel patients (46-56%) or create safety plans (23-40%), with some differences between providers. Few thought mental health provider staffing was almost always sufficient (6-20%) or that suicidal patient treatment was almost always a top ED priority (15-21%). More nurses (37%, 95%Confidence Interval [CI] 31-42%) than physicians (7%, 95%CI 4-10%) reported screening most or all patients for SI; this difference persisted after multivariable adjustment. In multivariable analysis, other factors associated with screening most or all patients for SI were self-confidence in skills, (OR 1.60, 95%CI 1.17-2.18), feeling that suicidal patient care was a top ED priority (OR 1.73, 95%CI 1.11-2.69) and 5+ post-graduate years of clinical experience (OR 2.06, 95%CI 1.03-4.13). Conclusions ED providers reported confidence in suicide screening skills but gaps in further assessment, counseling or referral skills. Efforts to promote better identification of suicidal patients should be accompanied by a commensurate effort to improve risk assessment and management skills, along with improved access to mental health specialists. PMID:23426881
Wachtel, Ruth E.; Dexter, Franklin
Background Residency programs accredited by the ACGME are required to teach core competencies, including systems-based practice (SBP). Projects are important for satisfying this competency, but the level of knowledge and problem-solving skills required presupposes a basic understanding of the field. The responsibilities of anesthesiologists include the coordination of patient flow in the surgical suite. Familiarity with this topic is crucial for many improvement projects. Intervention A course in operations research for surgical services was originally developed for hospital administration students. It satisfies 2 of the Institute of Medicine's core competencies for health professionals: evidence-based practice and work in interdisciplinary teams. The course lasts 3.5 days (eg, 2 weekends) and consists of 45 cognitive objectives taught using 7 published articles, 10 lectures, and 156 computer-assisted problem-solving exercises based on 17 case studies. We tested the hypothesis that the cognitive objectives of the curriculum provide the knowledge and problem-solving skills necessary to perform projects that satisfy the SBP competency. Standardized terminology was used to define each component of the SBP competency for the minimum level of knowledge needed. The 8 components of the competency were examined independently. Findings Most cognitive objectives contributed to at least 4 of the 8 core components of the SBP competency. Each component of SBP is addressed at the minimum requirement level of exemplify by at least 6 objectives. There is at least 1 cognitive objective at the level of summarize for each SBP component. Conclusions A curriculum in operating room management can provide the knowledge and problem-solving skills anesthesiologists need for participation in projects that satisfy the SBP competency. PMID:22132289
Buehler, Stephanie S.; Madison, Bereneice; Snyder, Susan R.; Derzon, James H.; Saubolle, Michael A.; Weissfeld, Alice S.; Weinstein, Melvin P.; Liebow, Edward B.; Wolk, Donna M.
infection; time factors; health care costs; length of stay; morbidity; mortality; antimicrobial therapy; rapid molecular techniques, polymerase chain reaction (PCR); in situ hybridization, fluorescence; treatment outcome; drug therapy; patient care team; pharmacy service, hospital; hospital information systems; Gram stain; pharmacy service; and spectrometry, mass, matrix-assisted laser desorption-ionization. Phenotypic as well as the following key words were searched: targeted therapy; rapid identification; rapid; Gram positive; Gram negative; reduce(ed); cost(s); pneumoslide; PBP2; tube coagulase; matrix-assisted laser desorption/ionization time of flight; MALDI TOF; blood culture; EMR; electronic reporting; call to provider; collaboration; pharmacy; laboratory; bacteria; yeast; ICU; and others. In addition to the electronic search being performed, a request for unpublished quality improvement data was made to the clinical laboratory community. Main results. Rapid molecular testing with direct communication significantly improves timeliness compared to standard testing. Rapid phenotypic techniques with direct communication likely improve the timeliness of targeted therapy. Studies show a significant and homogeneous reduction in mortality associated with rapid molecular testing combined with direct communication. Authors' conclusions. No recommendation is made for or against the use of the three assessed practices of this review due to insufficient evidence. The overall strength of evidence is suggestive; the data suggest that each of these three practices has the potential to improve the time required to initiate targeted therapy and possibly improve other patient outcomes, such as mortality. The meta-analysis results suggest that the implementation of any of the three practices may be more effective at increasing timeliness to targeted therapy than routine microbiology techniques for identification of the microorganisms causing BSIs. Based on the included studies, results
This report discusses the Redevelopment Ready Communities program in southeast Michigan, which encourages mature suburbs to bolster their competitiveness by making development more efficient and less complicated.
Marques dos Reis, Tiago; Guidoni, Camilo Molino; Girotto, Edmarlon; Guerra, Marisabelle Lima; de Oliveira Baldoni, André; Leira Pereira, Leonardo Régis
Objective. To summarize the effects of media methods used in continuing education (CE) programs on providing clinical community pharmacy services and the methods used to evaluate the effectiveness of these programs. Methods. A systematic review was performed using Medline, SciELO, and Scopus databases. The timeline of the search was 1990 to 2013. Searches were conducted in English, Portuguese, and Spanish. Results. Nineteen articles of 3990 were included. Fourteen studies used only one media method, and the live method (n=11) was the most frequent (alone or in combination). Only two studies found that the CE program was ineffective or partially effective; these studies used only the live method. Most studies used nonrobust, nonvalidated, and nonstandardized methods to measure effectiveness. The majority of studies focused on the effect of the CE program on modifying the knowledge and skills of the pharmacists. One study assessed the CE program’s benefits to patients or clients. Conclusion. No evidence was obtained regarding which media methods are the most effective. Robust and validated methods, as well as assessment standardization, are required to clearly determine whether a particular media method is effective. PMID:27402991
Timmins, Fiona; Neill, Freda; Murphy, Maryanne; Begley, Thelma; Sheaf, Greg
Spirituality is receiving unprecedented attention in the nursing literature. Both the volume and scope of literature on the topic is expanding, and it is clear that this topic is of interest to nurses. There is consensus that the spiritual required by clients receiving health ought to be an integrated effort across the health care team. Although undergraduate nurses receive some education on the topic, this is ad hoc and inconsistent across universities. Textbooks are clearly a key resource in this area however the extent to which they form a comprehensive guide for nursing students and nurses is unclear. This study provides a hitherto unperformed analysis of core nursing textbooks to ascertain spirituality related content. 543 books were examined and this provides a range of useful information about inclusions and omissions in this field. Findings revealed that spirituality is not strongly portrayed as a component of holistic care and specific direction for the provision of spiritual care is lacking. Fundamental textbooks used by nurses and nursing students ought to inform and guide integrated spiritual care and reflect a more holistic approach to nursing care. The religious and/or spiritual needs of an increasingly diverse community need to be taken seriously within scholarly texts so that this commitment to individual clients' needs can be mirrored in practice.
Nuehring, Elane M.; Raybin, Linda
Examined the feasibility of community-based care for mentally ill offenders and defendants by surveying criminal justice professionals (n=36), mental health and forensic professionals (n=38), and social service representatives (n=21). Findings indicated that mentally ill offenders and defendants were seen as manageable in the community but needing…
Phillips, Susan K.
Rural community colleges often face the problem of having to cancel classes due to low enrollment. To eliminate this problem one western community college developed several presentation modes for College Reading I (CR1) to combine low-enrollment classes. This study was a program evaluation on non-equivalent groups to determine which presentation…
Stein, Bradley D; Mendelsohn, Joshua; Gordon, Adam J; Dick, Andrew W; Burns, Rachel M; Sorbero, Mark; Shih, Regina A; Liccardo Pacula, Rosalie
Opioid analgesic and benzodiazepine use in individuals with opioid use disorders can increase the risk for medical consequences and relapse. Little is known about rates of use of these medications or prescribing patterns among communities of prescribers. The goal of this study was to examine rates of prescribing to Medicaid-enrollees in the calendar year after an opioid use disorder diagnosis, and to examine individual, county, and provider community factors associated with such prescribing. 2008 Medicaid claims data were used from 12 states to identify enrollees diagnosed with opioid use disorders, and 2009 claims data were used to identify rates of prescribing of each drug. Social network analysis was used to identify provider communities, and multivariate regression analyses was used to to identify patient, county, and provider community level factors associated with prescribing these drugs. The authors also examined variation in rates of prescribing across provider communities. Among Medicaid-enrollees identified with an opioid use disorder, 45% filled a prescription for an opioid analgesic, 37% filled a prescription for a benzodiazepine, and 21% filled a prescription for both in the year following their diagnosis. Females, older individuals, individuals with pain syndromes, and individuals residing in counties with higher rates of poverty were more likely to fill prescriptions. Prescribing rates varied substantially across provider communities, with rates in the highest quartile of prescribing communities over 2.5 times the rates in the lowest prescribing communities. Prescribing opioid analgesics and benzodiazepines to individuals diagnosed with opioid use disorders may increase risk of relapse and overdose. Interventions should be considered that target provider communities with the highest rates of prescribing and individuals at the highest risk.
Stein, Bradley D.; Mendelsohn, Joshua; Gordon, Adam J.; Dick, Andrew W.; Burns, Rachel M.; Sorbero, Mark; Shih, Regina A.; Pacula, Rosalie Liccardo
Background Opioid analgesic and benzodiazepine use in individuals with opioid use disorders (OUDs) can increase the risk for medical consequences and relapse. Little is known about rates of use of these medications or prescribing patterns among communities of prescribers. Aims To examine rates of prescribing to Medicaid-enrollees in the calendar year after an OUD diagnosis, and to examine individual, county, and provider community factors associated with such prescribing. Methods We used 2008 Medicaid claims data from 12 states to identify enrollees diagnosed with OUDs, and 2009 claims data to identify rates of prescribing of each drug. We used social network analysis to identify provider communities and multivariate regression analyses to identify patient, county, and provider community level factors associated with prescribing these drugs. We also examined variation in rates of prescribing across provider communities. Results Among Medicaid-enrollees identified with an OUD, 45% filled a prescription for an opioid analgesic, 37% for a benzodiazepine, and 21% for both in the year following their diagnosis. Females, older individuals, individuals with pain syndromes, and individuals residing in counties with higher rates of poverty were more likely to fill prescriptions. Prescribing rates varied substantially across provider communities, with rates in the highest quartile of prescribing communities over 2.5 times the rates in the lowest prescribing communities. Discussion Prescribing opioid analgesics and benzodiazepines to individuals diagnosed with OUDs may increase risk of relapse and overdose. Interventions should be considered that target provider communities with the highest rates of prescribing and individuals at highest risk. PMID:27449904
Kelly, Teresa; Simmons, Warren; Gregory, Esther
In Victoria, the Crimes (Mental Impairment and Unfitness to be Tried) Act (1997) reformed legal practice in relation to the detention, management and release of persons found by a court to be not guilty on the grounds of insanity or unfit to be tried. This Act provides a legal structure for such 'forensic patients' to move from secure inpatient facilities into the community. This new legislative landscape has generated challenges for all stakeholders and has provided the impetus for the development of a risk assessment and management model. The key components of the model are the risk profile, assessment and management plan. The discussion comprises theory, legislation, practice implications and limitations of the model. Practice implications concern the provision of objective tools, which identify risk and document strategic interventions to support clinical management. Some of the practice limitations include the model's applicability to risk assessment and management and its dependence on a mercurial multi-service interface in after-hours crisis situations. In addition to this, the paper articulates human limitations implicit in the therapeutic relationship that necessarily underpins the model. The paper concludes with an exploration of the importance of evaluative processes as well as the need for formal support and education for clinicians.
... HUMAN SERVICES Centers for Disease Control and Prevention Development of Best Practices for Community... developing best practices designed to support state and local health departments to meet public health... Federal public health authority, HHS/CDC intends to develop best practices in CHNA and...
Lovecchio, Catherine P; DiMattio, Mary Jane K; Hudacek, Sharon
The necessity to help baccalaureate nursing students transition to clinical practice in a health care environment governed by change has compelled nurse educators to investigate alternative clinical instruction models that nurture academic-practice partnerships and facilitate student clinical learning. This article describes an academic-practice partnership in a community hospital using the Clinical Liaison Nurse (CLN) model as a link between students and clinical faculty and reports results of a quasi-experimental study that compared perceptions of the clinical learning environment between students participating in the CLN model (experimental group) and those in a traditional, instructor-led clinical model (control group). Students assigned to the CLN model had statistically significantly higher individualization, satisfaction, and task orientation scores on the Clinical Learning Environment Inventory. The findings provide evidence that academic-practice partnerships can be successful in community hospital settings and enhance students' perceptions in the clinical learning environment.
Community-based participatory research (CBPR) has emerged in the last decades as a transformative research paradigm that bridges the gap between science and practice through community engagement and social action to increase health equity. CBPR expands the potential for the translational sciences to develop, implement, and disseminate effective interventions across diverse communities through strategies to redress power imbalances; facilitate mutual benefit among community and academic partners; and promote reciprocal knowledge translation, incorporating community theories into the research. We identify the barriers and challenges within the intervention and implementation sciences, discuss how CBPR can address these challenges, provide an illustrative research example, and discuss next steps to advance the translational science of CBPR. PMID:20147663
Dyer, J; Stringer, L C; Dougill, A J; Leventon, J; Nshimbi, M; Chama, F; Kafwifwi, A; Muledi, J I; Kaumbu, J-M K; Falcao, M; Muhorro, S; Munyemba, F; Kalaba, G M; Syampungani, S
The emphasis on participatory environmental management within international development has started to overcome critiques of traditional exclusionary environmental policy, aligning with shifts towards decentralisation and community empowerment. However, questions are raised regarding the extent to which participation in project design and implementation is meaningful and really engages communities in the process. Calls have been made for further local-level (project and community-scale) research to identify practices that can increase the likelihood of meaningful community engagement within externally initiated projects. This paper presents data from three community-based natural resource management (CBNRM) project case studies from southern Africa, which promote Joint Forest Management (JFM), tree planting for carbon and conservation agriculture. Data collection was carried out through semi-structured interviews with key stakeholders, community-level meetings, focus groups and interviews. We find that an important first step for a meaningful community engagement process is to define 'community' in an open and participatory manner. Two-way communication at all stages of the community engagement process is shown to be critical, and charismatic leadership based on mutual respect and clarity of roles and responsibilities is vital to improve the likelihood of participants developing understanding of project aims and philosophy. This can lead to successful project outcomes through community ownership of the project goals and empowerment in project implementation. Specific engagement methods are found to be less important than the contextual and environmental factors associated with each project, but consideration should be given to identifying appropriate methods to ensure community representation. Our findings extend current thinking on the evaluation of participation by making explicit links between the community engagement process and project outcomes, and by
Lewit, E M; Bentkover, J D; Bentkover, S H; Watkins, R N; Hughes, E F
Previous studies of the work loads and time utilization of general surgeons in two different practice settings suggested that paraprofessional surgical assistants (SAs) could reduce surgeon assisting time and perhaps increase productivity. In order to further assess the potential advantage of using SAs as surgical assistants, the present study examines assisting patterns in a prepaid group practice where SAs are used and in a community hospital where only physicians are available to assist. In the prepaid group practice, 87 per cent of general surgical procedures were performed with an assistant; in the c ommunity hospital, 67 per cent of general surgical procedures were performed with an assistant. General practitioners also were found to assist in the community hospital; family practice residents, medical students and "others" also assisted in prepaid group. In both settings, the propensity to use an assistant was positively correlated with operative complexity. On operations of greatest complexity, surgeons were most likely to act as first assistants. The use of SAs was not usually associated with operative sessions longer than when surgeons assisted, except on operations of high complexity. In the prepaid group, SAs also frequently assisted on orthopedic surgery, neurosurgery and obstetrics-gynecology, only occasionally on otolaryngology and plastic surgery, and never on ophthalmology. It appears that in organizations such as a prepaid group practice, where mechanisms for sharing resources exist and incentives are provided to minimize the total cost of surgery, the utilization of SAs might be associated with cost savings. At present, organizational and financial barriers exist to the introduction of paraprofessionals as surgical assistants. It is difficult to advocate the modification of these barriers to facilitate the training and large-scale introduction of this new group of paraprofessionals in the current surgical market where there may already be an
Much attention is given today to the importance of forging family, school, and community partnerships. Growing numbers of schools, many of them with afterschool programs, are dedicating resources to support and sustain relationships with families and community-based organizations. And, among government agencies and the philanthropic sector, there…
Hustedde, Ronald J.; Ganowicz, Jacek
Relates three classical theories (structural functionalism, conflict theory, symbolic interactionism) to fundamental concerns of community development (structure, power, and shared meaning). Links these theories to Giddens' structuration theory, which connects macro and micro structures and community influence on change through cultural norms.…
Arteaga, Blanca E.
Latino students represent the fastest-growing population in the state of California, the United States, and the California Community College (CCC) system. Unfortunately, compared to other ethnic groups, Latino community college students continue to lag academically. Given the importance of counseling services and the scarce research related to…
Schlack, Marilyn; And Others
The papers in this collection describe partnership programs and projects involving Kalamazoo Valley Community College (KVCC) in Michigan. The first paper, "The Arcadia Commons Partnership: The Community College and Economic Redevelopment," by Marilyn Schlack, describes the Arcadia Commons, a business-education park in downtown Kalamazoo,…
Skeadas, Gus J.
A study was conducted to determine how well Illinois' 38 community college districts satisfied the needs of board members, creditors, investors, and tax payers for financial information. A list of 38 financial reporting requirements was developed from the requirements of the Illinois Community College Board (ICCB) and guidelines from the Audits of…
Toomey, Traci L.; Fabian, Lindsey A.; Erickson, Darin J.; Wagenaar, Alexander C.; Fletcher, Linda; Lenk, Kathleen M.
The goal of this study was to assess the feasibility and effectiveness of two interventions aimed at reducing alcohol-related risks at community festivals--a training program for festival planners and a community organizing campaign. We randomly selected four festivals for each intervention and had 24 comparison festivals. Our assessment included…
Most educators probably know what it feels like to be part of an unproductive professional learning community--one where the topics range from last night's TV episodes to everyone's weekend plans before coming around to instructional issues. Other communities might just feel like another staff meeting with a list of announcements. But there are…
Katz, Arthur J., Ed.
Articles by social work educators on some of the critical issues in community mental health are presented. Examined are some conceptual and program developments related to coordination, continuity of care, and the use of teams in planning and service delivery for community mental health (Lawrence K. Berg). The issue of civil commitment to and…
Broadbent, Robyn; Papadopoulos, Theo
In 2008, the Helen Macpherson Smith (HMS) Trust commissioned Victoria University to conduct an evaluation of the Mentoring and Capacity Building Initiative's Regional Coordination Projects (RCPs). The RCPs are founded on a model of community education and collaboration that aims to enhance cross-sectoral and whole-of-community approaches to…
Flannigan, Suzanne; Jones, Barbara R.; Moore Jr., William
With the average age of faculty members exceeding 55, it is expected that "large numbers of community college faculty may retire at virtually the same time and in the near future" (Gahn & Twombly, 2001, p. 260). In the wake of their exodus, it is a reasonable assumption that community colleges will be faced with hiring many new full-…
Flannigan, Suzanne; Jones, Barbara; Moore, William
With the average age of faculty members exceeding 55, it is expected that "large numbers of community college faculty may retire at virtually the same time and in the near future" (Gahn & Twombly, 2001, p. 260). In the wake of their exodus, it is a reasonable assumption that community colleges will be faced with hiring many new full- and part-time…
Allen, Garth, Ed.; Martin, Ian, Ed.
This book, which was written for students of education and social policy and education practitioners in Great Britain, contains 13 papers concerning the interface between education, social welfare, and community within the British welfare state. The following papers are included: "Histories of Community Education: A Feminist Critique"…
Mullin, Christopher M.
Besides the shift in community college funding from the state to the student, a number of other innovations and trends have emerged with respect to community college finances. This chapter explores some of these developments, including performance-based funding, changes in student and institutional eligibility for financial aid, changes in local…
Ahuja, Jaspreet K C; Moshfegh, Alanna J; Holden, Joanne M; Harris, Ellen
The USDA food and nutrient databases provide the basic infrastructure for food and nutrition research, nutrition monitoring, policy, and dietary practice. They have had a long history that goes back to 1892 and are unique, as they are the only databases available in the public domain that perform these functions. There are 4 major food and nutrient databases released by the Beltsville Human Nutrition Research Center (BHNRC), part of the USDA's Agricultural Research Service. These include the USDA National Nutrient Database for Standard Reference, the Dietary Supplement Ingredient Database, the Food and Nutrient Database for Dietary Studies, and the USDA Food Patterns Equivalents Database. The users of the databases are diverse and include federal agencies, the food industry, health professionals, restaurants, software application developers, academia and research organizations, international organizations, and foreign governments, among others. Many of these users have partnered with BHNRC to leverage funds and/or scientific expertise to work toward common goals. The use of the databases has increased tremendously in the past few years, especially the breadth of uses. These new uses of the data are bound to increase with the increased availability of technology and public health emphasis on diet-related measures such as sodium and energy reduction. Hence, continued improvement of the databases is important, so that they can better address these challenges and provide reliable and accurate data.
Sanchez, Guillermo V; Roberts, Rebecca M; Albert, Alison P; Johnson, Darcia D; Hicks, Lauri A
Appropriate selection of antibiotic drugs is critical to optimize treatment of infections and limit the spread of antibiotic resistance. To better inform public health efforts to improve prescribing of antibiotic drugs, we conducted in-depth interviews with 36 primary care providers in the United States (physicians, nurse practitioners, and physician assistants) to explore knowledge, attitudes, and self-reported practices regarding antibiotic drug resistance and antibiotic drug selection for common infections. Participants were generally familiar with guideline recommendations for antibiotic drug selection for common infections, but did not always comply with them. Reasons for nonadherence included the belief that nonrecommended agents are more likely to cure an infection, concern for patient or parent satisfaction, and fear of infectious complications. Providers inconsistently defined broad- and narrow-spectrum antibiotic agents. There was widespread concern for antibiotic resistance; however, it was not commonly considered when selecting therapy. Strategies to encourage use of first-line agents are needed in addition to limiting unnecessary prescribing of antibiotic drugs.
Spivack, Jordan G; Swietlik, Maggie; Alessandrini, Evaline; Faith, Myles S
This study evaluated primary care providers' (PCPs, pediatricians, and nurse practitioners) knowledge, current practices, and perceived barriers to childhood obesity prevention and treatment, with an emphasis on first-year well-child care visits. A questionnaire was distributed to 192 PCPs in the primary care network at The Children's Hospital of Philadelphia (CHOP) addressing (i) knowledge of obesity and American Academy of Pediatrics (AAP) guidelines, (ii) anticipatory guidance practices at well visits regarding nutrition and exercise, and (iii) perceived barriers to childhood obesity treatment and prevention. Eighty pediatricians and seven nurse practitioners responded, and a minority correctly identified the definition (26%) and prevalence (9%) of childhood overweight and AAP guidelines for exercise (39%) and juice consumption (44%). Most PCPs (81%) spent 11-20 min per well visit during the first 2 years, and 79% discussed diet, nutrition, and exercise for > or =3 min. Although >95% of PCPs discussed juice, fruits and vegetables, sippy cups, and finger foods during the first year, over 35% never discussed fast food, TV, or candy, and 55% never discussed exercise. Few rated current resources as adequate to treat or prevent childhood obesity. Over 90% rated the following barriers for obesity prevention and treatment as important or very important: parent is not motivated, child is not motivated, parents are overweight, families often have fast food, watch too much TV, and do not get enough exercise. In conclusion, there is much room to improve PCPs' knowledge of obesity and AAP guidelines. Although PCPs rate fast-food consumption, TV viewing, and lack of exercise as important treatment barriers, many never discussed these topics during the first year.
Obreli-Neto, Paulo Roque; Pereira, Leonardo Régis Leira; Guidoni, Camilo Molino; Baldoni, André de Oliveira; Marusic, Srecko; de Lyra-Júnior, Divaldo Pereira; de Almeida, Kelsen Luis; Pazete, Ana Claudia Montolezi; do Nascimento, Janaina Dutra; Kos, Mitja; Girotto, Edmarlon; Cuman, Roberto Kenji Nakamura
Background Combined oral contraceptive (COC) use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs) are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use. Objective To evaluate the COC dispensing practices of CPs in a developing country. Method A cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs) (with counseled audio recording) visited community pharmacies with a prescription for Ciclo 21® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg). The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients’ medical and family history, and measuring of blood pressure) and provided counseling, as well as the quality of the screening and counseling, were evaluated. Results Of the 185 CPs contacted, 41 (22.2%) agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional), and all of the questions were closed-ended, viz., “do you smoke?” (n = 2) and “what is your age?” (n = 1). None of the CPs measured the patient’s blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs), and one CP provided counseling regarding both aspects. Conclusion The CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure. PMID:24324584
Kilbourne, Amy M; Irmiter, Cheryl; Capobianco, Jeff; Reynolds, Kathleen; Milner, Karen; Barry, Kristen; Blow, Frederic C
The historical fragmentation of physical and mental health services has impeded efforts to improve quality and outcomes of care for persons with mental disorders. However, there is little information on effective strategies that might reduce fragmentation and improve integrated services within non-academic, community-based healthcare settings. Twenty-three practices from across the U.S. participated in a learning community meeting designed to identify barriers to integrated care and strategies for reducing such barriers. Barriers were initially identified based on a quantitative survey of organizational factors. Focus groups were used to elaborate on barriers to integrated care and to identify strategies for reducing barriers that are feasible in community-based settings. Participants identified key barriers, including administrative (e.g., lack of common medical records for mental health and general medical conditions), financial (e.g., lack of reimbursement codes to bill for mental health and general medical care in the same setting), and clinical (e.g., lack of an integrated care protocol). Top strategies recommended by participants included templates (i.e., for memoranda of understanding) to allow providers to work across practice settings, increased medical record security to enable a common medical record between mental health and general medical care, working with state Medicaid agencies to establish integrated care reimbursement codes, and guidance in establishing workflows between different providers (i.e., avoid duplication of tasks). Strategies to overcome barriers to integrated care may require cooperation across different organizational levels, including administrators, providers, and health care payers in order for integrated care to be established and sustained over time.
Saxena, Vartika; Naithani, Manisha; Kumari, Ranjeeta; Singh, Richa; Das, Pranoti
Context: Neural tube defects (NTDs) are one of the most common congenital anomalies. NTDs are preventable if folic acid (FA) is supplemented before and during conception. Knowledge and supplementation of FA by pregnant women as well as it's timely provision by health providers is crucial in reducing the burden of NTDs in the community. Aim: To study the knowledge and supplementation of FA by pregnant women and it's prescription/provision by health providers. Settings and Design: A cross-sectional study was conducted in the block Doiwala, District Dehradun, Uttarakhand. Subjects and Methods: A total of 400 pregnant women and 121 government health providers (5 medical officers, 25 auxiliary nurse midwives [ANMs], and 91 accredited social health activists [ASHAs]) were interviewed on predesigned, pretested questionnaire by study/field investigator. Statistical Analysis Used: Proportion of different variables calculated and Chi-square test with Yates correction was applied. Results: Of 400, 73.50% of women had heard of FA. Overall, knowledge scores suggested intermediate to low level of knowledge about FA. Totally 94.25% of women had planned pregnancies; however, only 4.75% of women reported FA supplementation before conception. This indicates that if these women would have been properly counseled and prescribed FA, they might have taken it. About 60% of medical officers, 4% of ANMs, and 3.3% of ASHAs knew FA deficiency as one of the causes of NTD. None of the health providers reported to be prescribing/counseling FA to pregnant women. FA was out of supply on the block at the time of the study. Conclusions: Knowledge and supplementation practices related with FA are poor. PMID:27843847
Yasuhara, Tomohisa; Konishi, Motomi; Nishida, Takahiro; Kushihata, Taro; Sone, Tomomichi; Kurio, Wasako; Yamamoto, Yumi; Nishikawa, Tomoe; Yanada, Kazuo; Nakamura, Mitsutaka
Learning chemistry is cumulative: basic knowledge and chemical calculation skills are required to gain understanding of higher content. However, we often suffer from students' lack of learning skills to acquire these concepts. One of the reasons is the lack of adequate training in the knowledge and skills of chemistry, and one of the reasons for this lack is the lack of adequate evaluation of training procedures and content. Team-based learning (TBL) is a strong method for providing training in the knowledge and skills of chemistry and reaffirms the knowledge and skills of students of various levels. In our faculty, TBL exercises are provided for first-year students concurrently with lectures in physical chemistry and analytical chemistry. In this study, we researched the adoption of a peer evaluation process for this participatory learning model. Questionnaires taken after TBL exercises in the previous year showed a positive response to TBL. Further, a questionnaire taken after TBL exercises in the spring semester of the current year also yielded a positive response not only to TBL but also to peer evaluation. In addition, a significant correlation was observed between the improvement of students' grades in chemistry classes and the feeling the percentage (20%) of peer evaluation in overall evaluation low (logistic regression analysis, p=0.022). On the basis of the findings, we argue that TBL provides a generic, practical learning environment including an effective focus on learning strategy and evaluation of knowledge, skills, and attitudes, and studies on the educational effects of TBL and peer evaluation.
Manunta, Michele; De Luca, Claudio; Elefante, Stefano; Lanari, Riccardo; Pepe, Antonio; Zinno, Ivana; Casu, Francesco
The quantitative evaluation of ground deformation is traditionally based on in-situ surveying techniques that, through the intensive use of GPS stations, automatic total stations and levelling benchmarks, can measure up to sub-centimetre displacements. In the last decades, the extensive use of satellite remote sensing data, such as Synthetic Aperture Radar (SAR) images, has represented an important breakthrough in the context of non-invasive ground deformation analyses over large areas, thanks to their large spatial coverage and relatively short revisit time, as well as to their medium-high ground resolution. In such a context, the well-known Differential SAR Interferometry (DInSAR) technique allows us to map and measure deformation phenomena due to both natural and man-made causes with centimetre to millimetre accuracy. The Earth Science community has a wide interest in the use of DInSAR displacement maps both for crisis management and risk mitigation activities, and for surveillance, monitoring and analysis of geophysical phenomena. In areas characterized by high level of hazards the availability of routinely generated advanced DInSAR products would allow a fast analysis of their current status, providing a near real time monitoring. Similarly, an on-demand service would allow the customization of the products by selecting the area of interest, the SAR data to be processed, and other processing parameters to be set by the users to edit/correct/improve the final products. In this work we discuss the Satellite Data Thematic Core Service of EPOS and we present the EPOSAR service. In particular, the EPOSAR service, based on the well-known DInSAR approach referred to as Small Baseline Subset (SBAS), accomplishes a shared and synergic Earth Observation (EO) service aimed at designing, implementing and harmonizing efficient satellite data processing chains capable of ingesting the significantly increased data stream expected from the ESA Sentinel-1 satellites. EPOSAR
Raw, Anni; Mantecón, Ana Rosas
Background This paper draws on new research exploring community-based, participatory arts practice in Northern England and Mexico City to discuss contextual influences on artists’ practice, and whether a common practice model can be identified. The international comparison is used to interrogate whether such a practice model is transnational, displaying shared characteristics that transcend contextual differences. Methods The study used multi-site ethnography to investigate the participatory practice of more than 40 artists. Participant observation and extended individual and group dialogues provided data on practice in a diverse range of art forms and settings, analysed using open coding and grounded theory principles. Results Findings locate differences in practitioners’ motivations, and perceptions of the work’s function; however, key similarities emerge across both sites, in practitioners’ workshop methodologies and crucially in their creative strategies for catalysing change. A model is presented distilling the key elements of a common practice methodology, found across the study and across art forms. Conclusions The discussion notes where divergences echo nationalities of contributors, drawing inferences about the level of influence of national context in this work, and concludes with the implications of these findings for potential international collaboration, to face challenges within the community arts and health sector globally. PMID:25729411
Identifying attributes of successful invaders and traits of communities that increase susceptibility to invasion has progressed, but complex species-environment interactions limit generalizations about these relationships that might be useful to manage invasions. Using a native, ...
Ang, K T; Rohani, I; Look, C H
Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.
Scholarly publishing is no longer about simply producing and packaging articles and sending out to subscribers. To be successful, as well as being global and digital, Publishers and their journals need to be fully engaged with their stakeholders (authors, readers, funders, libraries etc), and constantly developing new products and services to support their needs in the ever-changing environment that we work in.Astronomy & Astrophysics (A&A) is a high quality, major international Journal that belongs to the astronomical communities of a consortium of European and South American countries supported by ESO who sponsor the journal. EDP Sciences is a non-profit publisher belonging to several learned societies and is appointed by ESO to publish the journal.Over the last decade, as well as publishing the results of worldwide astronomical and astrophysical research, A&A and EDP Sciences have worked in partnership to develop a wide range of services for the authors and readers of A&A:- A specialist language editing service: to provide a clear and excellent level of English ensuring full understanding of the high-quality science.- A flexible and progressive Open Access Policy including Gold and Green options and strong links with arXiv.- Enriched articles: authors are able to enhance their articles using a wide range of rich media such as 3D models, videos and animations.Multiple publishing formats: allowing readers to browse articles on multiple devices including eReaders and Kindles.- “Scientific Writing for Young Astronomers”: In 2008 EDP Sciences and A&A set up the Scientific Writing for Young Astronomers (SWYA) School with the objective to teach early PhD Students how write correct and efficient scientific papers for different mediums (journals, proceedings, thesis manuscripts, etc.).
Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian
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.
Sorvari, Sanna; Kutsch, Werner; Laj, Paolo; Asmi, Ari; Brus, Magdalena
European long-term environmental research infrastructures (often referred as ESFRI RIs) are the core facilities for providing services for scientists in their quest for understanding and predicting the complex Earth system and its functioning that requires long-term efforts to identify environmental changes (trends, thresholds and resilience, interactions and feedbacks). Many of the research infrastructures originally have been developed to respond to the needs of their specific research communities, however, it is clear that strong collaboration among research infrastructures is needed to serve the trans-boundary research requires exploring scientific questions at the intersection of different scientific fields, conducting joint research projects and developing concepts, devices, and methods that can be used to integrate knowledge. European Environmental research infrastructures have already been successfully worked together for many years and have established a cluster - ENVRI cluster - for their collaborative work. ENVRI cluster act as a collaborative platform where the RIs can jointly agree on the common solutions for their operations, draft strategies and policies and share best practices and knowledge. Supporting project for the ENVRI cluster, ENVRIplus project, brings together 21 European research infrastructures and infrastructure networks to work on joint technical solutions, data interoperability, access management, training, strategies and dissemination efforts. ENVRI cluster act as one stop shop for multidisciplinary RI users, other collaborative initiatives, projects and programmes and coordinates and implement jointly agreed RI strategies.
Devadasan, Narayanan; Criel, Bart; Van Damme, Wim; Ranson, Kent; Van der Stuyft, Patrick
Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE). We studied two Indian community health insurance (CHI) schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP) payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit packages with low maximum limits
García-Orenes, Fuensanta; Morugán-Coronado, Alicia; Zornoza, Raul; Scow, Kate
Agricultural practices have proven to be unsuitable in many cases, causing considerable reductions in soil quality. Land management practices can provide solutions to this problem and contribute to get a sustainable agriculture model. The main objective of this work was to assess the effect of different agricultural management practices on soil microbial community structure (evaluated as abundance of phospholipid fatty acids, PLFA). Five different treatments were selected, based on the most common practices used by farmers in the study area (eastern Spain): residual herbicides, tillage, tillage with oats and oats straw mulching; these agricultural practices were evaluated against an abandoned land after farming and an adjacent long term wild forest coverage. The results showed a substantial level of differentiation in the microbial community structure, in terms of management practices, which was highly associated with soil organic matter content. Addition of oats straw led to a microbial community structure closer to wild forest coverage soil, associated with increases in organic carbon, microbial biomass and fungal abundances. The microbial community composition of the abandoned agricultural soil was characterised by increases in both fungal abundances and the metabolic quotient (soil respiration per unit of microbial biomass), suggesting an increase in the stability of organic carbon. The ratio of bacteria:fungi was higher in wild forest coverage and land abandoned systems, as well as in the soil treated with oat straw. The most intensively managed soils showed higher abundances of bacteria and actinobacteria. Thus, the application of organic matter, such as oats straw, appears to be a sustainable management practice that enhances organic carbon, microbial biomass and activity and fungal abundances, thereby changing the microbial community structure to one more similar to those observed in soils under wild forest coverage. PMID:24260409
García-Orenes, Fuensanta; Morugán-Coronado, Alicia; Zornoza, Raul; Cerdà, Artemi; Scow, Kate
Agricultural practices have proven to be unsuitable in many cases, causing considerable reductions in soil quality. Land management practices can provide solutions to this problem and contribute to get a sustainable agriculture model. The main objective of this work was to assess the effect of different agricultural management practices on soil microbial community structure (evaluated as abundance of phospholipid fatty acids, PLFA). Five different treatments were selected, based on the most common practices used by farmers in the study area (eastern Spain): residual herbicides, tillage, tillage with oats and oats straw mulching; these agricultural practices were evaluated against an abandoned land after farming and an adjacent long term wild forest coverage. The results showed a substantial level of differentiation in the microbial community structure, in terms of management practices, which was highly associated with soil organic matter content. Addition of oats straw led to a microbial community structure closer to wild forest coverage soil, associated with increases in organic carbon, microbial biomass and fungal abundances. The microbial community composition of the abandoned agricultural soil was characterised by increases in both fungal abundances and the metabolic quotient (soil respiration per unit of microbial biomass), suggesting an increase in the stability of organic carbon. The ratio of bacteria:fungi was higher in wild forest coverage and land abandoned systems, as well as in the soil treated with oat straw. The most intensively managed soils showed higher abundances of bacteria and actinobacteria. Thus, the application of organic matter, such as oats straw, appears to be a sustainable management practice that enhances organic carbon, microbial biomass and activity and fungal abundances, thereby changing the microbial community structure to one more similar to those observed in soils under wild forest coverage.