Silvicultural Practices in Forests of the Southern United States: Insect and Disease Considerations

Treesearch

T. Evan Nebeker; Theodor D. Leininger; James S. Meadows

1999-01-01

The relationship between silvicultural practices, e.g. thinning, and pest organisms (insects and diseases) has been investigated extensively in pine species but to a lesser degree in hardwoods. Of critical interest is the potential negative impact to the residual stand resulting from insect damage and diseases that develop as a consequence of silvicultural practices....

Decision Points and Considerations for Identifying Rural Districts That Have Closed Student Achievement Gaps. REL 2016-130

ERIC Educational Resources Information Center

Culbertson, Michael J.; Billig, Shelley H.

2016-01-01

Rural districts have long faced challenges in closing achievement gaps between subgroups of students. This brief report describes key decision points and considerations for decision-makers interested in identifying rural districts that have closed academic achievement gaps. Examining practices in these districts may suggest activities associated…

Dangers of neglecting non-financial conflicts of interest in health and medicine.

PubMed

Wiersma, Miriam; Kerridge, Ian; Lipworth, Wendy

2018-05-01

Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Emerging Patterns in Transferring Assessment Practices from F2f to Online Environments

ERIC Educational Resources Information Center

Beebe, Ronald; Vonderwell, Selma; Boboc, Marius

2010-01-01

This study explores the transfer of assessment practices from f2f to online environments by college instructors, with a particular interest in the factors influencing assessment in online learning settings. Assessment is a critical aspect of the learning environment, and considerable research has suggested various methods of formative and…

Atmospheric waves and their utilization in soaring flight

NASA Technical Reports Server (NTRS)

Baldit, M Albert

1923-01-01

In soaring flight, ascending air currents are utilized and the interesting question is raised whether there are such currents which extend to any considerable distance and which can be utilized practically.

Proposing a Center on Aging and Well-Being: Research, Education, and Practice Considerations

ERIC Educational Resources Information Center

Lindenbach, Jeannette M.; Jessup-Falcioni, Heather

2016-01-01

This environmental scan aimed to discover research interests and educational needs of faculty, graduate, and undergraduate students to inspire research, education, and practice in the development of a center on aging and well-being for older adults. The scan consisted of a search of university faculty and researchers regarding research on aging; a…

Examining the Beliefs and Practices of Four Effective Australian Primary Science Teachers

NASA Astrophysics Data System (ADS)

Fitzgerald, Angela; Dawson, Vaille; Hackling, Mark

2013-06-01

With trends across many countries still indicating the decline of student interest in school science and diminishing numbers of students studying science beyond the compulsory years, it seems that the field remains in crisis. To address these unfortunate trends, there needs to be a greater emphasis on science education research that highlights the good news stories. For example, what are science teachers actually doing in their classrooms to increase student interest and understanding in science? This article focuses on the science teaching beliefs and practices of four Western Australian primary school teachers. The teachers were nominated by a professional colleague as effective practitioners. The study involved gathering information from classroom observations and teacher interviews to provide background information to assist in developing understandings of these teachers and their science teaching. This article reports on the initial findings drawn from Deanne A, Kate B, Lisa C and Rebecca D. Their practices were organised into the following six categories: classroom environment; conceptual knowledge and procedural skills; teaching strategies and approaches; student-specific considerations; teacher-specific considerations; and context-specific considerations. In examining the components contributing to these categories, it was evident that the teachers' beliefs, as well as the contextual factors inherent in each classroom environment, influenced how and why they teach science in the ways they do.

What clicks actually mean: Exploring digital news user practices.

PubMed

Kormelink, Tim Groot; Meijer, Irene Costera

2018-05-01

This article problematizes the relationship between clicks and audience interests. Clicking patterns are often seen as evidence that news users are mostly interested in junk news, leading to concerns about the state of journalism and the implications for society. Asking and observing how 56 users actually browse news and what clicking and not clicking mean to them, we identified 30 distinct considerations for (not) clicking and classified them into three categories: cognitive, affective and pragmatic. The results suggest, first, that interest is too crude a term to account for the variety of people's considerations for (not) clicking. Second, even if one aims for roughly estimating people's news interests, clicks are a flawed instrument because a lack of clicking does not measure people's lack of interest in news. Third, taking users' browsing patterns seriously could help bridge the gap between what people need as citizens and what they actually consume. Finally, we argue that all metrics should be critically assessed from a user perspective rather than taken at face value.

What clicks actually mean: Exploring digital news user practices

PubMed Central

Kormelink, Tim Groot; Meijer, Irene Costera

2017-01-01

This article problematizes the relationship between clicks and audience interests. Clicking patterns are often seen as evidence that news users are mostly interested in junk news, leading to concerns about the state of journalism and the implications for society. Asking and observing how 56 users actually browse news and what clicking and not clicking mean to them, we identified 30 distinct considerations for (not) clicking and classified them into three categories: cognitive, affective and pragmatic. The results suggest, first, that interest is too crude a term to account for the variety of people’s considerations for (not) clicking. Second, even if one aims for roughly estimating people’s news interests, clicks are a flawed instrument because a lack of clicking does not measure people’s lack of interest in news. Third, taking users’ browsing patterns seriously could help bridge the gap between what people need as citizens and what they actually consume. Finally, we argue that all metrics should be critically assessed from a user perspective rather than taken at face value. PMID:29782573

Osteomyelitis: A Context for Wound Management.

PubMed

Groll, Mary E; Woods, Timothy; Salcido, Richard

2018-06-01

To provide an overview of osteomyelitis. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, you should be able to:1. Distinguish the pathogenesis of osteomyelitis in children and adults.2. Identify practical considerations for diagnosis and evidence-based treatment of osteomyelitis. This educational activity reviews the pathogenesis of osteomyelitis and discusses practical considerations for diagnosis, treatment, and functional rehabilitation of pediatric and adult patients with osteomyelitic wounds. Antibiotic, surgical, and adjunctive treatments will be addressed. Emphasis is placed on consulting with infectious disease specialists and using evidence-based guidelines for antibiotic prescribing.

Connecting Research in Science Literacy and Classroom Practice: A Review of Science Teaching Journals in Australia, the UK and the United States, 1998-2008

ERIC Educational Resources Information Center

Hand, Brian; Yore, Larry D.; Jagger, Susan; Prain, Vaughan

2010-01-01

In the last 15 years (1994-2009), there has been considerable increased research interest in: (1) characterising the distinctive nature and constitutive elements of science literacy and (2) investigating classroom practices or necessary conditions that enable students to acquire this disciplinary capacity. This raises the question of the extent to…

High-Content Electrophysiological Analysis of Human Pluripotent Stem Cell-Derived Cardiomyocytes (hPSC-CMs).

PubMed

Kong, Chi-Wing; Geng, Lin; Li, Ronald A

2018-01-01

Considerable interest has been raised to develop human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) as a model for drug discovery and cardiotoxicity screening. High-content electrophysiological analysis of currents generated by transmembrane cell surface ion channels has been pursued to complement such emerging applications. Here we describe practical procedures and considerations for accomplishing successful assays of hPSC-CMs using an automated planar patch-clamp system.

77 FR 51898 - Registration of Intermediaries

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... Title VII of the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) regarding... of preferred stock. However, upon further reflection, the Commission is concerned that the Proposal...; (4) sound risk management practices; and (5) other public interest considerations. The Commission...

7 CFR 1780.70 - Owner's procurement regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... practices between firms; organizational conflicts of interest; and unnecessary experience and bonding... avoid the purchase of unnecessary or duplicate items. Consideration should be given to consolidation or separation of procurement items to obtain a more economical purchase. Where appropriate, an analysis shall be...

Conflict of interest: nurses at risk!

PubMed

Erlen, Judith A

2008-01-01

Conflict of interest as it relates to healthcare is gaining increasing attention. Pharmaceutical companies and manufacturers that produce medical devices are coming under greater scrutiny because of the influence that their marketing practices may have on the patient management decisions made by healthcare professionals. The result is that healthcare agency administrators are developing conflict of interest policies and procedures for their professional employees. The driving force behind many of these policies is the need to maintain the trust of the public by refraining from questionable professional conduct. This article presents 2 hypothetical cases to provide nurses with an understanding of the concept of conflict of interest and the ethical considerations this issue raises, and describes the subtle and not-so-subtle influences on professional practice decisions. Recommendations are offered to help nurses avoid conflict of interest and preserve their professional integrity. It is incumbent upon nurses to become cognizant of the types of situations that may present a conflict of interest for them and to take the necessary steps to avoid such professional impropriety.

Homosexual foot fetishism.

PubMed

Weinberg, M S; Williams, C J; Calhan, C

1994-12-01

262 respondents from an organization for homosexual foot fetishists provide information from a broader sample than clinical cases and allow examination of the effects of sexual preference on fetishism. Data show a wide range of feet/footwear objects to be arousing. Such interests were often associated with particular types of men, yet interests were subject to change over time. Fetishistic arousal rested on both sensual and symbolic aspects of the fetish. Symbolically, it was the theme of "masculinity" that made male feet/footwear arousing, showing parallels to "femininity" evoked by female feet/footwear for male heterosexual fetishists. For many of the respondents, fetishism did not seem to be a substitute for living persons. Respondents had intimate relationships and were able to incorporate their fetish interests into stable relationships and less intimate ones. Considerable involvement in sadomasochistic practices was also found as was involvement in the gay world. Finally, nothing about a fetishistic interest seemed to preclude the development of subcultural forms around the practice.

Racializing drug design: implications of pharmacogenomics for health disparities.

PubMed

Lee, Sandra Soo-Jin

2005-12-01

Current practices of using "race" in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an "infrastructure of racialization" created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry. The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice.

Principal Score Methods: Assumptions, Extensions, and Practical Considerations

ERIC Educational Resources Information Center

Feller, Avi; Mealli, Fabrizia; Miratrix, Luke

2017-01-01

Researchers addressing posttreatment complications in randomized trials often turn to principal stratification to define relevant assumptions and quantities of interest. One approach for the subsequent estimation of causal effects in this framework is to use methods based on the "principal score," the conditional probability of belonging…

77 FR 6867 - Practice Guide for Proposed Trial Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... maintaining a complete and understandable file history and the parties' interest in protecting truly sensitive... complete and understandable file history for public notices purposes. The rule encourages parties to redact... been obvious over the prior art, the Board may review objective evidence of secondary considerations. B...

Implementation of Children's Rights: What Is in "The Best Interests of the Child" in Relation to the Individual Education Plan (IEP) Process for Pupils with Autistic Spectrum Disorders (ASD)?

ERIC Educational Resources Information Center

Prunty, Anita

2011-01-01

The concept of children's rights evolved during the 1980s giving prominence to the role of children as active participants in the construction of their lives. The rhetoric of children's rights has emerged as an important consideration in all policy and practice relating to children. Implementation of children's rights in practice is necessary to…

Language Choice among Peers in Project-Based Learning: A Hong Kong Case Study of English Language Learners' Plurilingual Practices in Out-of-Class Computer-Mediated Communication

ERIC Educational Resources Information Center

Hafner, Christoph A.; Li, David C. S.; Miller, Lindsay

2015-01-01

Recently there has been considerable interest in the role of first language use in second/foreign language learning, especially where students share a common first language. However, most research has focused on in-class interaction between teachers and learners. Much less attention has been given to students' out-of-class practices, for example,…

Organ Donation After Circulatory Death: Ethical Issues and International Practices.

PubMed

Jericho, Barbara G

2018-05-21

Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs. Although there may be diversity among DCD programs in Europe, Australia, Israel, China, the United States, and Canada, addressing ethical considerations in these DCD programs is essential to respect donors and recipients during the altruistic and generous act of organ donation.

Teachers' Perceptions of Teaching Mathematics at the Senior Secondary Level in Fiji

ERIC Educational Resources Information Center

Dayal, Hem Chand

2013-01-01

In recent times, there has been considerable interest shown in the affective domain of mathematics education with research findings pointing out that affective variables have profound impact on classroom practices of mathematics teachers. In other words, teachers' conceptions of mathematics and mathematics teaching are greatly influenced by…

Peri-viable birth: legal considerations.

PubMed

Sayeed, Sadath A

2014-02-01

Peri-viable birth raises an array of complex moral and legal concerns. This article discusses the problem with defining viability, touches on its relationship to abortion jurisprudence, and analyzes a few interesting normative implications of current medical practice at the time of peri-viable birth. Copyright © 2014 Elsevier Inc. All rights reserved.

Study of the Sustainability of an Integrated Ecosystem with Energy Considerations

EPA Science Inventory

In recent years, there has been a growing interest in the study of sustainability. This is primarily due to the realization that continuous sustenance of the current ecosystem is possible only if we carefully understand the implications of the policies that are being practiced. I...

Testing during Study Insulates against the Buildup of Proactive Interference

ERIC Educational Resources Information Center

Szpunar, Karl K.; McDermott, Kathleen B.; Roediger, Henry L., III

2008-01-01

Recent interest in the benefits of retrieval practice on long-term retention--the testing effect--has spawned a considerable amount of research toward understanding the underlying nature of this ubiquitous memory phenomenon. Taking a test may benefit retention through both direct means (engaging appropriate retrieval processes) and indirect means…

Student Teachers, Socialisation, School Placement and Schizophrenia: The Case of Curriculum Change

ERIC Educational Resources Information Center

Gleeson, J.; O'Flaherty, J.; Galvin, T.; Hennessy, J.

2015-01-01

The dissonance between the socialisation experiences of student teachers during their own schooling and practicums and university-based teacher education programmes is indicative of the broader theory/practice dichotomy in education. While this dichotomy is of considerable interest to all teacher educators, studies of students' pre- and…

Measuring School Readiness: Conceptual and Practical Considerations

ERIC Educational Resources Information Center

Snow, Kyle L.

2006-01-01

Recent interest and investment in early childhood education as a means of promoting children's school readiness has prompted the need for clear definitions of school readiness. Traditionally school readiness has been viewed within a maturationist frame, based on a chronological set-point, which led to the emergence of readiness testing. Following…

29 CFR 452.1 - Introductory statement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provisions of the Act with “a practical guide * * * as to how the office representing the public interest in... DISCLOSURE ACT OF 1959 General Considerations § 452.1 Introductory statement. (a) This part discusses the... which will guide him in performing his duties unless and until he is directed otherwise by authoritative...

78 FR 12933 - Proceedings Before the Commodity Futures Trading Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

... proceedings. These new amendments also provide that Judgment Officers may conduct sua sponte discovery in... discovery; (4) sound risk management practices; and (5) other public interest considerations. The amendments... representative capacity, it was done with full power and authority to do so; (C) To the best of his knowledge...

Evolution and Impartiality*

PubMed Central

Kahane, Guy

2014-01-01

Lazari-Radek and Singer argue that evolutionary considerations can resolve Sidgwick’s dualism of practical reason, because such considerations debunk moral views that give weight to self-interested or partial considerations, but cannot threaten the principle Universal Benevolence. I argue that even if we grant these claims, this appeal to evolution is ultimately self-defeating. Lazari-Radek and Singer face a dilemma. Either their evolutionary argument against partial morality succeeds, but then we need to also give up our conviction that suffering is bad; or there is a way to defend this conviction, but then their argument against partiality fails. Utilitarians, I suggest, should resist the temptation to appeal to evolutionary debunking arguments. PMID:24711673

Racializing Drug Design: Implications of Pharmacogenomics for Health Disparities

PubMed Central

Lee, Sandra Soo-Jin

2005-01-01

Current practices of using “race” in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an “infrastructure of racialization” created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry. The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice. PMID:16257939

Choosing academia versus private practice: factors affecting oral maxillofacial surgery residents' career choices.

PubMed

Lanzon, Jesse; Edwards, Sean P; Inglehart, Marita R

2012-07-01

This study explored how residents who intend to enter private practice versus academic careers differ in their background and educational characteristics, engagement in different professional activities, professional values, and satisfaction. Survey data were collected from 257 residents in oral and maxillofacial surgery programs in the United States. The responses of the respondents who planned a career in private practice (65%) and who considered academia (35%) were compared with χ(2) and independent-sample t tests. Residents who considered academia were more likely to be women (29% vs 8%; P < .001), from non-European American backgrounds (37% vs 20%; P = .006), were less likely to be married (43% vs 71%; P < .001), and were less likely to have children (17% vs 40%; P < .001) than residents who planned to become private practitioners. A larger percentage of residents with interest in private practice reported having debts of $301,000 to $400,000 compared with the percentage of residents interested in academia. No differences were found in the way they financed their education or in their financial considerations. However, the 2 groups differed in the importance they placed on different characteristics of their professional lives and in their job-related satisfaction. Residents interested in academia responded less positively to the statement that they are extremely satisfied with their career compared with residents interested in private practice. Future clinicians placed a higher value on having manageable hours and more time performing outpatient procedures than future educators. These findings showed, first, that the characteristics at the beginning of residency programs that are likely to indicate an increased interest in academic careers are being a woman, from a non-European American background, and having an interest in research. Second, once residents are admitted, different types of surgeries and different types of professional activities tend to appeal to residents who want to practice in private practice settings versus work in academia. Third, residents interested in academia have a relatively lower level of satisfaction compared with residents interested in practicing outside of academia. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Specialty Practice and Cost Considerations in the Management of Uveitis Associated With Juvenile Idiopathic Arthritis.

PubMed

Palestine, Alan G; Singh, Jasleen K; Kolfenbach, Jason R; Ozzello, Daniel J

2016-07-01

To evaluate whether cost, prior insurance authorization concerns, and subspecialty practice influence therapeutic decisions in the treatment of uveitis associated with juvenile idiopathic arthritis. A total of 2,965 pediatric ophthalmologists, uveitis specialists, retina specialists, and rheumatologists across the United States were surveyed via e-mail regarding their choice in long-term therapy for a hypothetical patient with uveitis associated with juvenile idiopathic arthritis. Outcomes of interest were differences in therapy choice based on cost/prior authorization and specialty practice. There were significant differences in the use of methotrexate and biologics among specialists, both with and without consideration for cost and prior authorization. Physicians in four different specialties who treat uveitis associated with juvenile idiopathic arthritis agree on methotrexate as a first-line treatment choice and a biologic immunosuppressive medication as a second choice, but there are significant differences between the specialties in their use of these medications. Cost and insurance considerations did not affect therapy selection. [J Pediatr Ophthalmol Strabismus. 2016;53(4):246-251.]. Copyright 2016, SLACK Incorporated.

Education, practical training and professional development for public health practitioners: a scoping review of the literature and insights for sustainable food system capacity-building.

PubMed

Wegener, Jessica; Fong, Debbie; Rocha, Cecilia

2018-06-01

Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to support SFS-oriented education, practical training (PT) and continuing professional development (CPD) among trainees and public health practitioners (PHP). A secondary objective was to compile the evidence into practical considerations for educators, supervising practitioners and professional associations. A scoping review of the literature published between 2007 and 2017 was conducted in May 2017 using four databases: CINAHL, MEDLINE, Scopus and HSSA, along with bibliography hand-searching and expert consultation. Articles were screened for relevance and specificity by independent raters. Nineteen articles were included for analysis. Two-thirds of the articles related to dietitians and public health nutritionists. Emerging practices included curriculum-based considerations, incorporation of 'sustainability' within professional competencies and self-reflection related to SFS. Descriptions of SFS-related education, PT and CPD practices appeared largely in the literature from developed countries. Articles converged on the need for ecosystems, food systems and sustainability considerations within and across practice to support current and future practitioners. There is growing interest in SFS but guidance to support educators and preceptors is lacking. Updates to dietary guidelines to reflect issues of sustainability are a timely prompt to examine the education, training and development needs of trainees and PHP. Practical examples of emerging practices can empower PHP to promote SFS in all areas of practice. More research is needed to address identified gaps in the literature and to improve SFS-specific education, PT and CPD.

Medical students' attitudes and wishes towards extending an educational general practice app to be suitable for practice: A cross-sectional survey from Leipzig, Germany.

PubMed

Sandholzer, Maximilian; Deutsch, Tobias; Frese, Thomas; Winter, Alfred

2016-06-01

In medical education and practice, smartphone apps are increasingly becoming popular. In general practice, apps could play an important future role in supporting medical education and practice. To explore medical students' perceptions regarding the potential of a general practice app for training and subsequent work as a physician. Cross-sectional survey among Leipzig fourth-year medical students who were provided with an app prototype for a mandatory general practice course. Response rate was 99.3% (n = 305/307); 59.0% were female and mean age was 24.5 years. Students certified that the app had a higher potential than textbooks in both education (57.4% vs. 18.0%) and practice (47.1% vs. 22.8%). Students' most desired possible app extensions when anticipating its use for subsequent work as a physician were looking up information for diagnostics, therapy and prediction (85.1%), access to electronic patient files (48.1%), communication and networking (44.3%), organization of medical training (42.9%) and online monitoring of patients (38.1%). Students experienced with medical smartphone apps were more interested in app extensions. Consideration to use the app to support the opening of their own practice was significantly associated with higher interest in accessing electronic patient files, networking with colleagues and telemedicine. Fourth year medical students from Leipzig see a high potential in smartphone apps for education and practice and are interested in further using the technology after undergraduate education.

Employer-Supported Child Care: Investing in Human Resources.

ERIC Educational Resources Information Center

Burud, Sandra L.; And Others

This book for employers interested in establishing child care programs is organized into five major topic areas. Part One provides an overview of employer-supported child care. Part Two discusses the processes of identifying and estimating benefits of child care to companies, and tax considerations. Part Three presents practical guidelines and a…

The Impact of Western Progressive Educational Ideas in Japan: 1868-1940

ERIC Educational Resources Information Center

Yamasaki, Yoko

2010-01-01

Little is known about the impact of Western educational ideals in Japan during the Meiji (1868-1912), Taisho (1912-1926) and Showa (post-1926) eras, although, in reality, there was considerable interest among Japanese educators in Western thought and practice and there were numerous attempts to disseminate these ideas widely. This article…

Migrant Workers and the Changing Psychological Contract

ERIC Educational Resources Information Center

Morgan, Arthur; Finniear, Jocelyn

2009-01-01

Purpose: The influx of migrant workers in the UK has widespread interest. This group's experience of the British work place has evoked considerable debate ranging from the potential to be exploited through unscrupulous practices to allegations about taking away jobs from British workers. The purpose of this paper is to extend knowledge about the…

A Comparison of Rubrics for Identifying Empirically Supported Practices with Single-Case Research

ERIC Educational Resources Information Center

Maggin, Daniel M.; Briesch, Amy M.; Chafouleas, Sandra M.; Ferguson, Tyler D.; Clark, Courtney

2014-01-01

The use of single-case research methods for validating academic and behavioral interventions has gained considerable attention in recent years. As such, there has been a proliferation of methods for evaluating whether, and to what extent, primary research reports provide evidence of intervention effectiveness. Despite the recent interest in…

The Construction of Social Class in Social Work Education: A Study of Introductory Textbooks

ERIC Educational Resources Information Center

Strier, Roni; Feldman, Guy; Shdaimah, Corey

2012-01-01

Social work introductory textbooks reflect myriad practical interests, pedagogical concerns, and theoretical considerations. However, they also present students with accepted views, dominant perspectives, and main discourses of knowledge. In light of this centrality, the present article examines the representation of the concept of "social class"…

A Framework for Applying History and Philosophy of Science to Science Education.

ERIC Educational Resources Information Center

Duschl, Richard A.

Interest in the application of the history and philosophy of science to science education raises important questions about the effect such considerations will have on educational practice. In this paper, the application emphasizes concepts related to theory testing and theory development specifically and to the growth of knowledge generally. This…

"I Have No English Friends": Some Observations on the Practice of Action Learning with International Business Students

ERIC Educational Resources Information Center

Brook, Cheryl; Milner, Christopher

2014-01-01

This account reports on some experiences of facilitating action learning with international business students. Interest in international student learning and the international student experience is significant and increasing with a considerable range of literature on the subject. Some of this literature is concerned with the perceived…

Context, Communication and Commiseration: Psychological and Practical Considerations in Change Management

ERIC Educational Resources Information Center

Clarke, Hugh

2013-01-01

In this paper, the author draws upon his interest, as a psychotherapist, in working with change at a psychological and individual level, and on his experience of the radical changes currently taking place in higher education, specifically the University where he manages several services, including a Counselling Service. Through leading and…

Respiratory dysfunction in patients with chronic neck pain: What is the current evidence?

PubMed

Dimitriadis, Zacharias; Kapreli, Eleni; Strimpakos, Nikolaos; Oldham, Jacqueline

2016-10-01

Respiratory function of patients with neck pain has not been given much consideration in usual clinical practice. The problem has however been highlighted occasionally by renown clinical scientists and recently there is a growing interest in the investigation of respiratory function in this clinical population. The aim of this review is to critically present the emerging evidence and discuss the similarities and differences observed. Although the evidence for some respiratory parameters is conflicting, it seems to be generally agreed that others such as maximal voluntary ventilation, strength of respiratory muscles, chest mechanics and partial pressure of arterial carbon dioxide are affected in patients with chronic neck pain. The effect size of the respiratory dysfunction regarding these respiratory parameters can be approximately described as moderate. These findings not only suggest a more thoughtful drug prescription, but they may lead to consideration of incorporation of respiratory assessment and treatment into routine physiotherapy practice. Indeed preliminary studies exploring the incorporation of such a treatment into usual practice have provided very promising results not only in relation to respiratory function, but also for other parameters of clinical interest. There remains however imminent need for randomized controlled trials to confirm the evidence base for such an approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

PubMed

Dove, Edward S; Kelly, Susan E; Lucivero, Federica; Machirori, Mavis; Dheensa, Sandi; Prainsack, Barbara

2017-09-01

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of 'relational autonomy' in particular have argued that people's identities, needs, interests - and indeed autonomy - are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person's care and responsibility for connected others.

Recommendations for Planning and Managing International Short-term Pharmacy Service Trips

PubMed Central

Alsharif, Naser Z.; Rovers, John; Connor, Sharon; White, Nicole D.; Hogue, Michael D.

2017-01-01

International pharmacy service trips by schools and colleges of pharmacy allow students to provide health care to medically underserved areas. A literature review (2000-2016) in databases and Internet searches with specific keywords or terms was performed to assess current practices to establish and maintain successful pharmacy service trips. Educational documents such as syllabi were obtained from pharmacy programs and examined. A preliminary draft was developed and authors worked on sections of interest and expertise. Considerations and current recommendations are provided for the key aspects of the home institution and the host country requirements for pharmacy service trips based on findings from a literature search and the authors’ collective, extensive experience. Evaluation of the trip and ethical considerations are also discussed. This article serves as a resource for schools and colleges of pharmacy that are interested in the development of new pharmacy service trips and provides key considerations for continuous quality improvement of current or future activities. PMID:28381883

Recommendations for Planning and Managing International Short-term Pharmacy Service Trips.

PubMed

Johnson, Kalin L; Alsharif, Naser Z; Rovers, John; Connor, Sharon; White, Nicole D; Hogue, Michael D

2017-03-25

International pharmacy service trips by schools and colleges of pharmacy allow students to provide health care to medically underserved areas. A literature review (2000-2016) in databases and Internet searches with specific keywords or terms was performed to assess current practices to establish and maintain successful pharmacy service trips. Educational documents such as syllabi were obtained from pharmacy programs and examined. A preliminary draft was developed and authors worked on sections of interest and expertise. Considerations and current recommendations are provided for the key aspects of the home institution and the host country requirements for pharmacy service trips based on findings from a literature search and the authors' collective, extensive experience. Evaluation of the trip and ethical considerations are also discussed. This article serves as a resource for schools and colleges of pharmacy that are interested in the development of new pharmacy service trips and provides key considerations for continuous quality improvement of current or future activities.

Web-based tailored lifestyle programs: exploration of the target group's interests and implications for practice.

PubMed

Verheijden, Marieke W; Jans, Marielle P; Hildebrandt, Vincent H

2008-01-01

An important challenge in Web-based health promotion is to increase the reach of the target audience by taking the target groups' desires into consideration. Data from 505 members of a Dutch Internet panel (representative for Dutch Internet users) were used to asses the target group's interests and needs. 28% participated in Web-based tailored lifestyle programs, 57% expressed an interest in such programs, and 15% expressed no interest. Interest in Web-based programs was predominantly caused by a general interest in lifestyle and online tests. Participation in Web-based tailored lifestyle programs should not take more than 17 minutes per occasion. 84% were interested in follow-up testing after the initial participation. Responders were particularly interested in physical activity and nutrition. Hardly anyone was willing to pay for participation. The results from this study support the use of Web-based tailored lifestyle programs in behavior change efforts.

Designers as Teachers and Learners: Transferring Workplace Design Practice into Educational Settings

ERIC Educational Resources Information Center

Mawson, B.

2007-01-01

The nature of the design process and how to develop this skill in novice designers has been of considerable interest to technology educators. The relationship between workplace and school-based design is one area in which a need for further research has been identified by Hill and Anning (2001, "International Journal of Technology and Design…

Generic Attributes as Espoused Theory: The Importance of Context

ERIC Educational Resources Information Center

Jones, Anna

2009-01-01

There has been considerable interest in generic attributes in higher education for over a decade and yet while generic skills or attributes are an important aspect of policy, there is often a lack of consistency between beliefs about the importance of these skills and attributes and the degree to which exist in teaching practice. There has been an…

Open Ends and Means: Inquiry as a Link between Formal Music Concepts and Informal Music Learning

ERIC Educational Resources Information Center

Schmidt-Jones, Catherine Anne

2017-01-01

There is currently considerable interest in strengthening the connections between formal music education and informal, self-motivated music practices. Participants in this study were adults who were self-motivated to learn formal music concepts, but had encountered barriers to doing so independently. The study offered them individual online…

Bibliographic Management Software: A Focus Group Study of the Preferences and Practices of Undergraduate Students

ERIC Educational Resources Information Center

Salem, Jamie; Fehrmann, Paul

2013-01-01

With the growing population of undergraduate students on our campus and an increased focus on their success, librarians at a large midwestern university were interested in the citation management styles of this university cohort. Our university library spends considerable resources each year to maintain and promote access to the robust…

Assessing tree and stand biomass: a review with examples and critical comparisons

Treesearch

Bernard R. Parresol

1999-01-01

There is considerable interest today in estimating the biomass of trees and forests for both practical forestry issues and scientific purposes. New techniques and procedures are brought together along with the more traditional approaches to estimating woody biomass. General model forms and weighted analysis are reviewed, along with statistics for evaluating and...

The Influence of Classroom Disciplinary Climate of Schools on Reading Achievement: A Cross-Country Comparative Study

ERIC Educational Resources Information Center

Ning, Bo; Van Damme, Jan; Van Den Noortgate, Wim; Yang, Xiangdong; Gielen, Sarah

2015-01-01

Despite considerable interest in research and practice in the effect of classroom disciplinary climate of schools on academic achievement, little is known about the generalizability of this effect over countries. Using hierarchical linear analyses, the present study reveals that a better classroom disciplinary climate in a school is significantly…

Developing an Occupational Drug Abuse Program: Considerations and Approaches. Services Research Monograph Series.

ERIC Educational Resources Information Center

Stephen, Mae; Prentice, Robert

This monograph, developed as a guide for companies interested in establishing drug abuse programs, begins with a brief summary of studies assessing the extent and costs of employee drug use. The next section addresses some practical and conceptual issues about establishing a drug abuse program. Suggestions for implementing a drug abuse program are…

Consideration of Culture and Context in School-Wide Positive Behavior Support: A Review of Current Literature

ERIC Educational Resources Information Center

Fallon, Lindsay M.; O'Keeffe, Breda V.; Sugai, George

2012-01-01

A review of the literature related to culture and student behavior reveals a number of interesting observations that are not surprising. First, culture is a difficult construct to define and has been defined variably over the years. Second, schools are becoming increasingly diverse, and evidence-based behavior management practices have been…

Data-Driven Learning: Taking the Computer out of the Equation

ERIC Educational Resources Information Center

Boulton, Alex

2010-01-01

Despite considerable research interest, data-driven learning (DDL) has not become part of mainstream teaching practice. It may be that technical aspects are too daunting for teachers and students, but there seems to be no reason why DDL in its early stages should not eliminate the computer from the equation by using prepared materials on…

Vocational interests of adolescents: relationships between self-esteem and locus of control.

PubMed

Mullis, A K; Mullis, R L

1997-12-01

The purpose of this study was to examine relationships among scores on vocational interests, self-esteem, and locus of control for high school students. Grade and sex differences were also examined. 1364 high school students ranging in age from 14 to 19 years of age were administered the Coopersmith Self-esteem Inventory, Nowicki-Strickland Locus of Control Scale for Children, and the Strong-Campbell Interest Inventory. High school students with higher scores on self-esteem and showing an orientation toward internal locus of control expressed more interests in a variety of vocational themes than adolescents with lower scores on self-esteem and scores for external locus of control. Sex and grade differences in vocational interests of adolescents were also noted. The findings were discussed in light of theoretical and practical considerations.

Materials for VPHGs: practical considerations in the case of astronomical instrumentation

NASA Astrophysics Data System (ADS)

Bianco, Andrea; Pariani, Giorgio; Zanutta, Alessio; Bertarelli, Chiara

2012-09-01

Volume Phase Holographic Gratings are interesting dispersing elements for astronomical instrumentation. An important point, in the realization of the grating, is the choice of the holographic material. Dichromated Gelatines (DCGs) are the best candidate, but they show some drawback especially regarding their water sensitivity and the complex developing process required to enhance their performances. New holographic materials are becoming interesting, such as photopolymers and photochromic materials. An exhaustive review of these classes of materials will be reported and their performances compared to those of DCGs, focusing mainly to the astronomical instrumentation field.

Incorporating equity considerations in transport infrastructure evaluation: Current practice and a proposed methodology.

PubMed

Thomopoulos, N; Grant-Muller, S; Tight, M R

2009-11-01

Interest has re-emerged on the issue of how to incorporate equity considerations in the appraisal of transport projects and large road infrastructure projects in particular. This paper offers a way forward in addressing some of the theoretical and practical concerns that have presented difficulties to date in incorporating equity concerns in the appraisal of such projects. Initially an overview of current practice within transport regarding the appraisal of equity considerations in Europe is offered based on an extensive literature review. Acknowledging the value of a framework approach, research towards introducing a theoretical framework is then presented. The proposed framework is based on the well established MCA Analytic Hierarchy Process and is also contrasted with the use of a CBA based approach. The framework outlined here offers an additional support tool to decision makers who will be able to differentiate choices based on their views on specific equity principles and equity types. It also holds the potential to become a valuable tool for evaluators as a result of the option to assess predefined equity perspectives of decision makers against both the project objectives and the estimated project impacts. This framework may also be of further value to evaluators outside transport.

Operation Sun Beam, Shots Little Feller I, II and Johnie Boy. Project officers report. Project 6. 6. Electromagnetic measurements

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

Henderson, W.D.; Livingston, P.M.; Rutter, R.L.

Of considerable interest from both a physical and practical viewpoint is the coupling of electromagnetic energy from a nuclear explosion into various electrical systems in the vicinity of the burst. A series of electromagnetic measurements were made on Shots Little Feller I, Little Feller II, and Johnie Boy. It is clear from the records that radiation shielding must be given closer consideration in future tests. Due to equipment failure and radiation inactivation, only the Johnie Boy dynamic current measurement and the passive peak current indicators on all three events are interpretable.

Maximum-performance fiber-optic irradiation with nonimaging designs.

PubMed

Fang, Y; Feuermann, D; Gordon, J M

1997-10-01

A range of practical nonimaging designs for optical fiber applications is presented. Rays emerging from a fiber over a restricted angular range (small numerical aperture) are needed to illuminate a small near-field detector at maximum radiative efficiency. These designs range from pure reflector (all-mirror), to pure dielectric (refractive and based on total internal reflection) to lens-mirror combinations. Sample designs are shown for a specific infrared fiber-optic irradiation problem of practical interest. Optical performance is checked with computer three-dimensional ray tracing. Compared with conventional imaging solutions, nonimaging units offer considerable practical advantages in compactness and ease of alignment as well as noticeably superior radiative efficiency.

The Worth of a Sparrow: A Decision Case in University Research and Public Relations.

ERIC Educational Resources Information Center

Crookston, R. Kent; And Others

1993-01-01

The University of Minnesota trapped and killed birds to reduce bird damage to research grain plots. When the Animal Rights Coalition demanded the practice be stopped, the situation became a public controversy. Presents an abridged form of this case as a focus for consideration of research methods, interest group agenda, and the universities' role…

Dual Credit: Secondary to Post-Secondary Transitions--Dual Credit Policy and Practice in BC and Elsewhere

ERIC Educational Resources Information Center

FitzGibbon, John

2015-01-01

There has been considerable interest in British Columbia in improving secondary to post-secondary transitions, and the provincial government and secondary and post-secondary institutions have adopted a number of strategies intended to aid in successful student transition from one system to the other. This paper looks specifically at the policy and…

What is restoring bottomland hardwood forests? A study from the Lower Mississippi Alluvial Valley

Treesearch

Callie Jo Schweitzer

1998-01-01

The interest in changing the use of the Lower Mississippi Alluvial Valley (LMAV) floodplain has been gathering momentum. Recent changes in Federal farm programs, heightened awareness of the value of forested wetlands and increasingly productive farming practices have allowed for consideration of land use changes. Marginal agricultural land in the LMAV, cleared at the...

Stakeholders, Networks and Links in Early Childhood Policy: Network Analysis and the "Transition to School: Position Statement"

ERIC Educational Resources Information Center

Wallis, Jake; Dockett, Sue

2015-01-01

The importance of a positive start to school has been highlighted in a range of national and international research. This has stimulated considerable ongoing research attention, as well as initiatives across policy and practice, all with the aim of promoting a positive transition to school for all children. Despite the common interests across…

Practical Considerations in Donation After Circulatory Determination of Death in Switzerland.

PubMed

Dalle Ave, Anne L; Shaw, David M; Elger, Bernice

2017-09-01

Faced with similar issues of organ scarcity to its neighbors, Switzerland has developed donation after circulatory determination of death (DCDD) as a way to expand the organ pool since 1985. Here, we analyze the history, practical considerations, and ethical issues relating to the Swiss donation after circulatory death programs. In Switzerland, determination of death for DCDD requires a stand-off period of 10 minutes. This time between cardiac arrest and the declaration of death is mandated in the guidelines of the Swiss Academy of Medical Sciences. As in other DCDD programs, safeguards are put to avoid physicians denying lifesaving treatment to savable patients because of being influenced by receivers' interest. An additional recommendation could be made: Recipients should be transparently informed of the worse graft outcomes with DCDD programs and given the possibility to refuse such organs.

The effect of non traditional teaching methods in entrepreneurship education on students entrepreneurial interest and business startups: A data article.

PubMed

Olokundun, Maxwell; Moses, Chinonye Love; Iyiola, Oluwole; Ibidunni, Stephen; Ogbari, Mercy; Peter, Fred; Borishade, Taiye

2018-08-01

Traditional methods of teaching entrepreneurship in universities involves more theoretical approaches which are less effective in motivating considerations for an entrepreneurship career. This owes to the fact that such techniques essentially make students develop a dormant attitude rather than active participation. Expert views suggest that experiential entrepreneurship teaching methods in universities which involve practical activities and active participation can be considered salient to students' development of entrepreneurial interest an business startup potentials. This present study presents data on the extent to which experiential teaching methods in entrepreneurship adopted by Nigerian universities stimulate students' entrepreneurial interest and business startups. Data have been gathered following a descriptive cross-sectional quantitative survey conducted among university students ( N = 600) of four selected institutions in Nigeria offering a degree programme in entrepreneurship. Hierarchical Multiple Regression Analysis was used in confirming the hypothesis proposed in the study using the Statistical Package for Social Sciences (SPSS) version 22.The findings from the analysis showed that the adoption of experiential practical activities considered as best practices in entrepreneurship teaching in Nigerian universities can stimulate students' interest and drive for engaging in business start-up activities even as undergraduates. The field data set is made extensively available to allow for critical investigation.

Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

PubMed Central

Kelly, Susan E; Lucivero, Federica; Machirori, Mavis; Dheensa, Sandi; Prainsack, Barbara

2017-01-01

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person’s care and responsibility for connected others. PMID:28989327

Mixed Methods in Biomedical and Health Services Research

PubMed Central

Curry, Leslie A.; Krumholz, Harlan M.; O’Cathain, Alicia; Plano Clark, Vicki L.; Cherlin, Emily; Bradley, Elizabeth H.

2013-01-01

Mixed methods studies, in which qualitative and quantitative methods are combined in a single program of inquiry, can be valuable in biomedical and health services research, where the complementary strengths of each approach can yield greater insight into complex phenomena than either approach alone. Although interest in mixed methods is growing among science funders and investigators, written guidance on how to conduct and assess rigorous mixed methods studies is not readily accessible to the general readership of peer-reviewed biomedical and health services journals. Furthermore, existing guidelines for publishing mixed methods studies are not well known or applied by researchers and journal editors. Accordingly, this paper is intended to serve as a concise, practical resource for readers interested in core principles and practices of mixed methods research. We briefly describe mixed methods approaches and present illustrations from published biomedical and health services literature, including in cardiovascular care, summarize standards for the design and reporting of these studies, and highlight four central considerations for investigators interested in using these methods. PMID:23322807

Imagining Moral Bioenhancement Practices: Drawing Inspiration from Moral Education, Public Health Ethics, and Forensic Psychiatry.

PubMed

Specker, Jona; Schermer, Maartje H N

2017-07-01

In this article, we consider contexts or domains in which (future) moral bioenhancement interventions possibly or most likely will be implemented. By looking closely at similar or related existing practices and their relevant ethical frameworks, we hope to identify ethical considerations that are relevant for evaluating potential moral bioenhancement interventions. We examine, first, debates on the proper scope of moral education; second, proposals for identifying early risk factors for antisocial behaviour; and third, the difficult balancing of individual freedom and third party concerns in (forensic) psychiatry. In imagining moral bioenhancement in practice, we observe that unlike other forms of enhancement, moral enhancement fundamentally asks how the interests and preferences of the individual and the interests of others should be weighed (in view of public safety and managing public risk). Highly diverse domains such as education, mental health, and the judicial domain might be involved, and moral bioenhancement might challenge existing institutional settings. Given these highly varied contexts and domains, it appears unlikely that there will be a distinct set of practices that will be referred to as "moral bioenhancement."

Value Orientations of Student Physical Education Teachers Learning to Teach on School-Based Initial Teacher Education Courses in England

ERIC Educational Resources Information Center

Capel, Susan

2016-01-01

There has been considerable interest in the socialisation of (student) physical education (PE) teachers, the beliefs and values developed as a result of this socialisation and the impact of these on teachers' learning, behaviours and practices and the curriculum. Many studies looking at the beliefs and values of PE teachers have used the values…

Laminar and Turbulent Gaseous Diffusion Flames. Appendix C

NASA Technical Reports Server (NTRS)

Faeth, G. M.; Urban, D. L. (Technical Monitor); Yuan, Z.-G. (Technical Monitor)

2001-01-01

Recent measurements and predictions of the properties of homogeneous (gaseous) laminar and turbulent non-premixed (diffusion) flames are discussed, emphasizing results from both ground- and space-based studies at microgravity conditions. Initial considerations show that effects of buoyancy not only complicate the interpretation of observations of diffusion flames but at times mislead when such results are applied to the non-buoyant diffusion flame conditions of greatest practical interest. This behavior motivates consideration of experiments where effects of buoyancy are minimized; therefore, methods of controlling the intrusion of buoyancy during observations of non-premixed flames are described, considering approaches suitable for both normal laboratory conditions as well as classical microgravity techniques. Studies of laminar flames at low-gravity and microgravity conditions are emphasized in view of the computational tractability of such flames for developing methods of predicting flame structure as well as the relevance of such flames to more practical turbulent flames by exploiting laminar flamelet concepts.

Developing longitudinal qualitative designs: lessons learned and recommendations for health services research.

PubMed

Calman, Lynn; Brunton, Lisa; Molassiotis, Alex

2013-02-06

Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.

Maximizing ecological and evolutionary insight in bisulfite sequencing data sets

PubMed Central

Lea, Amanda J.; Vilgalys, Tauras P.; Durst, Paul A.P.; Tung, Jenny

2017-01-01

Preface Genome-scale bisulfite sequencing approaches have opened the door to ecological and evolutionary studies of DNA methylation in many organisms. These approaches can be powerful. However, they introduce new methodological and statistical considerations, some of which are particularly relevant to non-model systems. Here, we highlight how these considerations influence a study’s power to link methylation variation with a predictor variable of interest. Relative to current practice, we argue that sample sizes will need to increase to provide robust insights. We also provide recommendations for overcoming common challenges and an R Shiny app to aid in study design. PMID:29046582

The ethics of general practice and advertising.

PubMed

Colman, R D

1989-06-01

UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational.

Selected methods for quantification of community exposure to aircraft noise

NASA Technical Reports Server (NTRS)

Edge, P. M., Jr.; Cawthorn, J. M.

1976-01-01

A review of the state-of-the-art for the quantification of community exposure to aircraft noise is presented. Physical aspects, people response considerations, and practicalities of useful application of scales of measure are included. Historical background up through the current technology is briefly presented. The developments of both single-event and multiple-event scales are covered. Selective choice is made of scales currently in the forefront of interest and recommended methodology is presented for use in computer programing to translate aircraft noise data into predictions of community noise exposure. Brief consideration is given to future programing developments and to supportive research needs.

Expected consequences of convenience euthanasia perceived by veterinarians in Quebec.

PubMed

Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

2017-07-01

In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal's interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian's goal was to respect the animal's interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia.

Expected consequences of convenience euthanasia perceived by veterinarians in Quebec

PubMed Central

Rathwell-Deault, Dominick; Godard, Béatrice; Frank, Diane; Doizé, Béatrice

2017-01-01

In companion animal practice, convenience euthanasia (euthanasia of a physically and psychologically healthy animal) is recognized as one of the most difficult situations. There is little published on veterinary perceptions of the consequences of convenience euthanasia. A qualitative study on the subject based on interviews with 14 veterinarians was undertaken. The animal’s interests in the dilemma of convenience euthanasia was taken into consideration, strictly from the point of view of the physical suffering and stress related to the procedure. The veterinarian’s goal was to respect the animal’s interests by controlling physical pain. Most often, veterinarians made their own interests and those of the owners a priority when considering the consequences of their decision to perform or refuse convenience euthanasia. PMID:28698691

[Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

PubMed

Branik, Emil

2003-09-01

In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

Evidence-based medicine was bound to fail: a report to Alvan Feinstein.

PubMed

Fava, Giovanni A

2017-04-01

John Ioannidis has provided a lucid account, in the form of a report to David Sackett, of how evidence-based medicine (EBM) was hijacked to serve vested interests: major randomized controlled trials are largely done by and for the benefit of the industry; meta-analyses and guidelines are flooded with conflicts of interest; national and federal research funds are unable to address basic clinical questions. Nonetheless, EBM would remain a worthwhile goal. In this paper, in the form of a report to Alvan Feinstein, it is argued that current developments were largely predictable. EBM certainly gave an important contribution to questioning unsubstantiated therapeutic claims. Time has come, however, to become aware of its considerable limitations, including overall reductionism and insufficient consideration of problems related to financial conflicts of interest. EBM does not represent the scientific approach to medicine: it is only a restrictive interpretation of the scientific approach to clinical practice. EBM drives the prescribing clinician to an overestimated consideration of potential benefits, paying little attention to the likelihood of responsiveness and to potential vulnerabilities in relations to the adverse effects of treatment. It is time to substitute the fashionable popularity of a strategy developed outside of clinical medicine with models and research based on the insights of clinical judgment and patient-doctor interaction, as Feinstein had outlined. Copyright © 2017 Elsevier Inc. All rights reserved.

Big whorls carry little whorls

NASA Technical Reports Server (NTRS)

Hunt, J. C. R.; Buell, J. C.; Wray, A. A.

1987-01-01

The aim of the research was to explore the space-time structure of homogeneous turbulence by computing and then interpreting the two-point spectra and correlations of the velocity and pressure fields. Many of these statistics are of considerable practical importance. In particular, it is of interest to compare the different time and length integral scales and microscales for Eulerian and Lagrangian qualities, and to compare the space and time spectra.

Economic considerations in the care of patients with head and neck malignancies.

PubMed

Pfister, D G; Ruchlin, H S; Elkin, E B

1997-05-01

In an era of cost-consciousness and managed care, quality concerns practice variability attributed to nonmedical factors, and growing attention to outcomes research, there is increasing interest in the economics of malignant disease. This review explores economic issues pertinent to the management of patients with head and neck malignancies. Using economic principles to evaluate medical practice does not uniformly mean that less money should be spent; rather, the intention is to optimize efficiency in the use of limited resources. Accordingly costs are best evaluated in the context of other outcomes of interest. The available economic literature for head and neck tumors is limited; it is often compromised by the use of facility charges as a proxy for true costs and the adoption of a truncated economic perspective. Given the potential health policy implications of such studies, their methodologies and results warrant careful scrutiny. Many opportunities exist for further research.

Financial conflicts of interest in plastic surgery: background, potential for bias, disclosure, and transparency.

PubMed

Luce, Edward A

2015-04-01

Relationships between physicians and industry, whether it be pharmaceutical companies, medical device manufacturers, or purveyors of medical technology, contain both an element of potential for good and a potential for harm. Certainly, the potential for good is realized when the collaboration results in improved plastic surgery patient care due to product and technology development. If the collaboration contains a financial component, the potential for harm exists in the form of a financial conflict of interest on the part of the physician. Recently, considerable discussion has been directed toward the pervasiveness of financial conflict of interest in all three arenas of the profession of medicine: education, research, and clinical practice, although an overlap exists among all three with respect to the issue of conflict of interest. This article will focus on conflict of interest in plastic surgery education, both continuing medical education for practitioners and graduate medical education for plastic surgery residents, as well as conflict of interest in research, such as conflicts related to publications in our literature.

Spacecraft Hybrid Control At NASA: A Look Back, Current Initiatives, and Some Future Considerations

NASA Technical Reports Server (NTRS)

Dennehy, Neil

2014-01-01

There is a heightened interest within NASA for the design, development, and flight implementation of mixed actuator hybrid attitude control systems for science spacecraft that have less than three functional reaction wheel actuators. This interest is driven by a number of recent reaction wheels failures on aging, but still scientifically productive, NASA spacecraft. This paper describes the highlights of the first NASA Cross-Center Hybrid Control Workshop that was held in Greenbelt, Maryland in April of 2013 under the sponsorship of the NASA Engineering and Safety Center (NESC). A brief historical summary of NASA's past experiences with spacecraft mixed actuator hybrid attitude control approaches, some of which were implemented on-orbit, will be provided. This paper will also convey some of the lessons learned and best practices captured at that workshop. Some relevant recent and current hybrid control activities will be described with an emphasis on work in support of a repurposed Kepler spacecraft. Specific technical areas for future considerations regarding spacecraft hybrid control will also be identified.

The doctor as businessman: the changing politics of a cultural icon.

PubMed

Stone, D A

1997-04-01

From just after the Civil War, when medicine began to professionalize, until the late 1970s, doctors and policy makers believed that clinical judgment should not be influenced by the financial interests of doctors. Physicians were highly entrepreneurial, and organized medicine fought to preserve their entrepreneurial interests, but the moral norm that justified their autonomy from state regulation was a strict separation of clinical judgment and pecuniary interests. Under managed care, the old norm is reversed. A good doctor takes financial considerations into account in making clinical decisions. Theoretically, doctors should consider measures of cost to society, but in practice, the payment systems of managed care plans induce doctors to consider the impact of each clinical decision on their own income. Because doctors share the risks of insuring patients with managed care plans, they have the same incentives as insurers to avoid patients who are expensively sick. The new cultural image of doctors as entrepreneurs masks their considerable loss of clinical autonomy under managed care. It also serves to persuade doctors to accept managed care arrangements and to persuade insurance consumers and patients to accept reduced benefits from employers and the government.

Problem of the slotted wing : a communication from the Aerodynamic Institute of the Aachen Technical High School

NASA Technical Reports Server (NTRS)

Klemperer, W

1922-01-01

It is to be expected that the advantageous properties, hitherto discovered in many slotted wing sections, depend very largely on the contour of the slot and the structural details of the wing. It is therefore of interest, aside from measurements on wings of constant cross-section along the span, to measure also wing models in which the structural details have already been given practical consideration.

New 'PropCo' chief sets out goals.

PubMed

Baillie, Jonathan

2013-02-01

Plans now well into implementation, to transfer ownership, this April, of the assets and buildings formerly owned by Primary Care Trusts on their abolition to a new limited company, NHS Property Services, have naturally aroused considerable interest across the healthcare estates community. At last October's Healthcare Estates 2012 conference, Simon Holden, who was appointed Chief Executive of the new Government-owned company in August 2012, explained 'how the organisation will work in practice'.

ESHRE's good practice guide for cross-border reproductive care for centers and practitioners.

PubMed

Shenfield, F; Pennings, G; De Mouzon, J; Ferraretti, A P; Goossens, V

2011-07-01

This paper outlines ESHRE's guidance for centers and physicians providing fertility treatment to foreign patients. This guide aims to ensure high-quality and safe assisted reproduction treatment, taking into account the patients, their future child and the interests of third-party collaborators such as gametes donors and surrogates. This is achieved by including considerations of equity, safety, efficiency, effectiveness (including evidence-based care), timeliness and patient centeredness.

The ethics of general practice and advertising.

PubMed Central

Colman, R D

1989-01-01

UK general practitioners (GPs) are self-employed entrepreneurs running small businesses with commercial considerations. In this situation there is no clear distinction between information, self-promotion and advertising. In response to the growing public demand for more information about medical services, the medical profession should voluntarily accept the notion of soft self-promotion in the form of 'notices' or 'announcements' placed in newspapers. Newspapers are the most effective way of giving easy access to information. The resistance to newspapers may be more concerned with preserving certain medical traditions than consideration of the public interest. The General Medical Council's (GMC's) arguments against soft self-promotion are seen as misguided paternalism, inconsistent and irrational. PMID:2746609

Exploring clinical wisdom in nursing education.

PubMed

McKie, Andrew; Baguley, Fiona; Guthrie, Caitrian; Jackson, Carol; Kirkpatrick, Pamela; Laing, Adele; O'Brien, Stephen; Taylor, Ruth; Wimpenny, Peter

2012-03-01

The recent interest in wisdom in professional health care practice is explored in this article. Key features of wisdom are identified via consideration of certain classical, ancient and modern sources. Common themes are discussed in terms of their contribution to 'clinical wisdom' itself and this is reviewed against the nature of contemporary nursing education. The distinctive features of wisdom (recognition of contextual factors, the place of the person and timeliness) may enable their significance for practice to be promoted in more coherent ways in nursing education. Wisdom as practical knowledge (phronesis) is offered as a complementary perspective within the educational preparation and practice of students of nursing. Certain limitations within contemporary UK nursing education are identified that may inhibit development of clinical wisdom. These are: the modularization of programmes in higher education institutions, the division of pastoral and academic support and the relationship between theory and practice.

Expanding scope of practice: inter-professional collaboration or conflict?

PubMed

Gardner, Deborah

2010-01-01

With the implementation of the Patient Protection and Affordable Care Act, interdisciplinary fights are becoming more public with more to come. Currently, the most visible fight is over scope of practice (SOP) expansion, state laws that govern advanced practice nursing and vary idiosyncratically by state. Until there is an expansion of SOP, APNs in many states will not be able to provide services to the fullest extent of their training and knowledge, skills, and experience and patients will continue to go without care. For physicians, the values and identity associated with the history of the medical profession being dominant transcend the policy details and budgetary considerations that might be viewed as "interests. For nursing, the values for trust and professional recognition associated with providing high-quality care to all is central to the profession's identity and transcend the interest-based conflict. A mediator can challenge thought leaders from both professions to acknowledge their core values, to facilitate discussions in which each side accepts those aspects of the other's values that it can agree with, and then build on those shared beliefs.

A typology of intellectual property management for public health innovation and access: design considerations for policymakers.

PubMed

Taubman, Antony

2010-01-19

This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation - though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of 'exclusive rights', as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a sense of practical options available and the factors that might guide their application, but without advocating any particular approach.

A Typology of Intellectual Property Management for Public Health Innovation and Access: Design Considerations for Policymakers§

PubMed Central

Taubman, Antony

2010-01-01

This paper seeks to set the practical discipline of public interest intellectual property (IP) management in public health into its broader policy context. The most immediate and direct impact of IP systems on public welfare results not from international standards nor from national legislation – though these norms are fundamentally important - but rather from the accumulated impact of numerous practical choices whether or not to seek IP protection; where and where not; and how any exclusive rights are deployed, by whom, and to what end. IP management is the essentially practical exercise of limited exclusive rights over protected subject matter, the judicious use of those rights to leverage outcomes that advance an institution's or a firm's objectives. Exclusive rights are used to construct and define knowledge-based relationships, to leverage access to technology and other necessary resources, and to enhance market-based incentives. IP management choices range across a broad spectrum, spanning public domain strategies, open or exclusive licensing, and strong exclusivity. The idea of ‘exclusive rights’, as a specific legal mechanism, can run counter to expectations of greater openness and accessibility, but actual outcomes will depend very much on how these mechanisms are used in practice. For public interest or public sector institutions concerned with health research and development, particularly the development of new medicines, IP management choices can be just as critical as they are for private firms, although a predominant institutional concentration on advancing direct public interest objectives may lead to significantly different approaches in weighing and exercising practical choices for IP management: even so, a private sector approach should not be conflated with exclusivity as an end in itself, nor need public interest IP management eschew all leverage over IP. This paper offers a tentative framework for a richer typology of those choices, to give a sense of practical options available and the factors that might guide their application, but without advocating any particular approach. PMID:20517487

Women's accounts of help-seeking in early rheumatoid arthritis from symptom onset to diagnosis.

PubMed

Townsend, Anne; Backman, Catherine L; Adam, Paul; Li, Linda C

2014-12-01

As interest in gender and health grows, the notion that women are more likely than men to consult doctors is increasingly undermined as more complex understandings of help seeking and gender emerge. While men's reluctance to seek help is associated with practices of masculinities, there has been less consideration of women's help-seeking practices. Rheumatoid arthritis (RA) is a chronic disease that predominantly affects women and requires prompt treatment but considerable patient-based delays persist along the care pathway. This paper examines women's accounts of help seeking in early RA from symptom onset to diagnosis. We conducted in-depth interviews with 37 women with RA <12 months in Canada. Analysis was based on a constant comparison, thematic approach informed by narrative analysis. The women's accounts featured masculine practices associated with men's help-seeking. The women presented such behaviours as relational, e.g. rooted in family socialisation and a determination to maintain roles and 'normal' life. Our findings raise questions about how far notions of gender operate to differentiate men and women's help seeking and may indicate more similarities than differences. Recognising this has implications for policy and practice initiatives for both men and women. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Women’s accounts of help-seeking in early rheumatoid arthritis from symptom onset to diagnosis

PubMed Central

Townsend, Anne; Backman, Catherine L; Adam, Paul; Li, Linda C

2018-01-01

Background As interest in gender and health grows, the notion that women are more likely than men to consult doctors is increasingly undermined as more complex understandings of help seeking and gender emerge. While men’s reluctance to seek help is associated with practices of masculinities, there has been less consideration of women’s help-seeking practices. Rheumatoid arthritis (RA) is a chronic disease that predominantly affects women and requires prompt treatment but considerable patient-based delays persist along the care pathway. This paper examines women’s accounts of help seeking in early RA from symptom onset to diagnosis. Methods We conducted in-depth interviews with 37 women with RA <12 months in Canada. Analysis was based on a constant comparison, thematic approach informed by narrative analysis. Results The women’s accounts featured masculine practices associated with men’s help-seeking. The women presented such behaviours as relational, e.g. rooted in family socialisation and a determination to maintain roles and ‘normal’ life. Discussion Our findings raise questions about how far notions of gender operate to differentiate men and women’s help seeking and may indicate more similarities than differences. Recognising this has implications for policy and practice initiatives for both men and women. PMID:24567194

Cosmetic head and face surgery--ethnic considerations.

PubMed

Pierce, H E

1980-05-01

In recent years there has developed an "image awareness" among various racial and ethnic groups throughout the world. Perhaps because people live longer, a greater sense of self-esteem based on the way one looks has developed. The communications media are highly promotional of interest in one's self. People want to feel good and look good, even if it requires blepharoplasty, face-lift, rhinoplasty, dermabrasion, or other types of cosmetic surgery. It is interesting that persons born in one place, and for business or personal reasons transposed to another part of the world, soon desire to remold their physical and cultural images in accordance with the practices and customs of their new milieux. This paper addresses these problems.

Learning Management Systems: Practical Considerations for the Selection and Implementation of an E-learning Platform for the Navy

DTIC Science & Technology

2007-01-28

is interested in B2B and B2C e-commerce, enterprise resource planning, e-procurement, supply-chain management, data mining, and knowledge discovery... social networking tools, collaborative spaces, knowledge management, “connecting-enabling” protocols like RSS, and other tools. The intent of the ILE...delivered to them, what learning pedagogy is appropriate for them, the optimal level of social interaction for learning, and available resources

Applications and limitations of radiomics

NASA Astrophysics Data System (ADS)

Yip, Stephen S. F.; Aerts, Hugo J. W. L.

2016-07-01

Radiomics is an emerging field in quantitative imaging that uses advanced imaging features to objectively and quantitatively describe tumour phenotypes. Radiomic features have recently drawn considerable interest due to its potential predictive power for treatment outcomes and cancer genetics, which may have important applications in personalized medicine. In this technical review, we describe applications and challenges of the radiomic field. We will review radiomic application areas and technical issues, as well as proper practices for the designs of radiomic studies.

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders.

PubMed

Galletly, Cherrie; Castle, David; Dark, Frances; Humberstone, Verity; Jablensky, Assen; Killackey, Eóin; Kulkarni, Jayashri; McGorry, Patrick; Nielssen, Olav; Tran, Nga

2016-05-01

This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Mixing methodology, nursing theory and research design for a practice model of district nursing advocacy.

PubMed

Reed, Frances M; Fitzgerald, Les; Rae, Melanie

2016-01-01

To highlight philosophical and theoretical considerations for planning a mixed methods research design that can inform a practice model to guide rural district nursing end of life care. Conceptual models of nursing in the community are general and lack guidance for rural district nursing care. A combination of pragmatism and nurse agency theory can provide a framework for ethical considerations in mixed methods research in the private world of rural district end of life care. Reflection on experience gathered in a two-stage qualitative research phase, involving rural district nurses who use advocacy successfully, can inform a quantitative phase for testing and complementing the data. Ongoing data analysis and integration result in generalisable inferences to achieve the research objective. Mixed methods research that creatively combines philosophical and theoretical elements to guide design in the particular ethical situation of community end of life care can be used to explore an emerging field of interest and test the findings for evidence to guide quality nursing practice. Combining philosophy and nursing theory to guide mixed methods research design increases the opportunity for sound research outcomes that can inform a nursing model of care.

Between protest, revenge and material interests: a phenomenological analysis of looting in the Somali war.

PubMed

Bakonyi, Jutta

2010-04-01

This paper examines practices of looting in the Somali war. Rather than being inspired primarily by economic objectives, lootings are complex and ambiguous social activities, which are embedded in daily practices and the political rhetoric of the war. In Somalia, looting activities have been driven by a broad range of motives, including military-strategic considerations and/or desire to revenge past atrocities and (perceived) injustices, as well as economic interests. Furthermore, the organisational structure, the performance of actions and the main targets of looters have differed widely. Based on an empirical analysis of different waves and phases of looting in the context of war and state decay in Somalia, the paper identifies five types of looting. Beyond a state-centred conceptualisation of order, the study reveals that looting is not an expression of political chaos, but rather is patterned by and rooted in local moral universes, which have been fundamentally transformed during the course of the violent conflicts in the country since the end of the 1970s.

Ethical considerations when counseling patients about stem cell tourism.

PubMed

Tsou, Amy

2015-02-01

Worldwide, many clinics market stem-cell based interventions often touted as effective for many diseases including spinal cord injury, multiple sclerosis (MS), and other neurodegenerative diseases. These clinics and their expensive, unproven treatments continue to fuel the practice of stem cell tourism. Given concerns about patient exploitation and safety, how should the physician engage a patient who wants to pursue such treatments? This article presents the case of a patient with neuromyelitis optica interested in pursuing expensive stem cell injections abroad. This article describes stem cell tourism along with some of the ethical issues physicians should consider, while also providing practical resources that physicians may employ to educate and engage patients in making an informed decision.

Surrogate decision making: reconciling ethical theory and clinical practice.

PubMed

Berger, Jeffrey T; DeRenzo, Evan G; Schwartz, Jack

2008-07-01

The care of adult patients without decision-making abilities is a routine part of medical practice. Decisions for these patients are typically made by surrogates according to a process governed by a hierarchy of 3 distinct decision-making standards: patients' known wishes, substituted judgments, and best interests. Although this framework offers some guidance, it does not readily incorporate many important considerations of patients and families and does not account for the ways in which many patients and surrogates prefer to make decisions. In this article, the authors review the research on surrogate decision making, compare it with normative standards, and offer ways in which the 2 can be reconciled for the patient's benefit.

Conflicts of interest in biomedical publications: considerations for authors, peer reviewers, and editors.

PubMed

Gasparyan, Armen Yuri; Ayvazyan, Lilit; Akazhanov, Nurbek A; Kitas, George D

2013-12-01

This article overviews evidence on common instances of conflict of interest (COI) in research publications from general and specialized fields of biomedicine. Financial COIs are viewed as the most powerful source of bias, which may even distort citation outcomes of sponsored publications. The urge to boost journal citation indicators by stakeholders of science communication is viewed as a new secondary interest, which may compromize the interaction between authors, peer reviewers and editors. Comprehensive policies on disclosure of financial and non-financial COIs in scholarly journals are presented as proxies of their indexing in evidence-based databases, and examples of successful medical journals are discussed in detail. Reports on clinical trials, systematic reviews, meta-analyses and clinical practice guidelines may be unduly influenced by author-pharmaceutical industry relations, but these publications do not always contain explicit disclosures to allow the readers to judge the reliability of the published conclusions and practice-changing recommendations. The article emphasizes the importance of adhering to the guidance on COI from learned associations such as the International Committee of Medical Journal Editors (ICMJE). It also considers joint efforts of authors, peer reviewers and editors as a foundation for appropriately defining and disclosing potential COIs.

Conflicts of interest in biomedical publications: considerations for authors, peer reviewers, and editors

PubMed Central

Gasparyan, Armen Yuri; Ayvazyan, Lilit; Akazhanov, Nurbek A.; Kitas, George D.

2013-01-01

This article overviews evidence on common instances of conflict of interest (COI) in research publications from general and specialized fields of biomedicine. Financial COIs are viewed as the most powerful source of bias, which may even distort citation outcomes of sponsored publications. The urge to boost journal citation indicators by stakeholders of science communication is viewed as a new secondary interest, which may compromize the interaction between authors, peer reviewers, and editors. Comprehensive policies on disclosure of financial and non-financial COIs in scholarly journals are presented as proxies of their indexing in evidence-based databases, and examples of successful medical journals are discussed in detail. Reports on clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines may be unduly influenced by author-pharmaceutical industry relations, but these publications do not always contain explicit disclosures to allow the readers to judge the reliability of the published conclusions and practice-changing recommendations. The article emphasizes the importance of adhering to the guidance on COI from learned associations such as the International Committee of Medical Journal Editors (ICMJE). It also considers joint efforts of authors, peer reviewers, and editors as a foundation for appropriately defining and disclosing potential COIs. PMID:24382859

An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model.

PubMed

Grant, Bettyanne; Colello, Sandra; Riehle, Martha; Dende, Denise

2010-04-01

To discuss the new Magnet Model as it relates to the successful implementation of a practice change. There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses' work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality.

Evaluation of Consideration and Incorporation of Green and Sustainable Remediation (GSR) Practices in Army Environmental Remediation. Volume 2. Pilot Project GSR Evaluation Reports

DTIC Science & Technology

2012-08-27

Project Team. This option involves the use of on-site wind turbines to provide all of the approximately 73,800 MWh of the electricity estimated to...and improves the GSR parameter for percentage of energy from renewable resources. Footprint for constructing the wind turbines is not considered...the potential for wind turbines at the site, and an FS is currently being conducted. The National Guard may also be interested in sustainable

The credibility crisis in research: Can economics tools help?

PubMed Central

Gall, Thomas; Ioannidis, John P. A.; Maniadis, Zacharias

2017-01-01

The issue of nonreplicable evidence has attracted considerable attention across biomedical and other sciences. This concern is accompanied by an increasing interest in reforming research incentives and practices. How to optimally perform these reforms is a scientific problem in itself, and economics has several scientific methods that can help evaluate research reforms. Here, we review these methods and show their potential. Prominent among them are mathematical modeling and laboratory experiments that constitute affordable ways to approximate the effects of policies with wide-ranging implications. PMID:28445470

THE BIOTERRORISM THREAT: TECHNOLOGICAL AND POLITICAL CONSIDERATIONS

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

J. F. PILAT

2000-03-01

Bioterrorism--along with biowarfare, from which it may not always be distinguishable in practice--will be a feature of the strategic landscape in the 21st century and is high on the US national security agenda. Bioterrorism poses a potential threat to the US population, agriculture, interests, friends and allies, and military forces (asymmetric threats). Yet these possibilities have not been widely pursued or realized by terrorists. The perceived threat is far worse than anything experienced to date, and is largely technologically driven.

The credibility crisis in research: Can economics tools help?

PubMed

Gall, Thomas; Ioannidis, John P A; Maniadis, Zacharias

2017-04-01

The issue of nonreplicable evidence has attracted considerable attention across biomedical and other sciences. This concern is accompanied by an increasing interest in reforming research incentives and practices. How to optimally perform these reforms is a scientific problem in itself, and economics has several scientific methods that can help evaluate research reforms. Here, we review these methods and show their potential. Prominent among them are mathematical modeling and laboratory experiments that constitute affordable ways to approximate the effects of policies with wide-ranging implications.

Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group.

PubMed

Faulkner, Eric; Annemans, Lieven; Garrison, Lou; Helfand, Mark; Holtorf, Anke-Peggy; Hornberger, John; Hughes, Dyfrig; Li, Tracy; Malone, Daniel; Payne, Katherine; Siebert, Uwe; Towse, Adrian; Veenstra, David; Watkins, John

2012-12-01

Personalized medicine technologies can improve individual health by delivering the right dose of the right drug to the right patient at the right time but create challenges in deciding which technologies offer sufficient value to justify widespread diffusion. Personalized medicine technologies, however, do not neatly fit into existing health technology assessment and reimbursement processes. In this article, the Personalized Medicine Special Interest Group of the International Society for Pharmacoeconomics and Outcomes Research evaluated key development and reimbursement considerations from the payer and manufacturer perspectives. Five key areas in which health economics and outcomes research best practices could be developed to improve value assessment, reimbursement, and patient access decisions for personalized medicine have been identified. These areas are as follows: 1 research prioritization and early value assessment, 2 best practices for clinical evidence development, 3 best practices for health economic assessment, 4 addressing health technology assessment challenges, and 5 new incentive and reimbursement approaches for personalized medicine. Key gaps in health economics and outcomes research best practices, decision standards, and value assessment processes are also discussed, along with next steps for evolving health economics and outcomes research practices in personalized medicine. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

PubMed

Keefe, Francis J; Main, Chris J; George, Steven Z

2018-05-01

There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

Towards Patient-Centered Conflicts of Interest Policy

PubMed Central

Young, Peter D.; Xie, Dawei; Schmidt, Harald

2018-01-01

Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians’ medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians’ reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS) launched the Open Payments Program (OPP) to publicly disclose and bring transparency to the relationships between industry and physicians in the United States. We set out to explore user awareness of the database and the ease of accessibility to disclosed information, however, as we show, both awareness and actual use are very low. Two practical policies can greatly enhance its intended function and help alleviate ethical tension. The first is to provide data for individual physicians not merely in absolute terms, but in meaningful context, that is, in relation to the zip code, city, and state averages. The second increases access to the OPP dataset by adding hyperlinks from physicians’ professional websites directly to their Open Payments disclosure pages. These changes considerably improve transparency and the utility of available data, and can furthermore enhance professionalism and accountability by encouraging physicians to reflect more actively on their own practices. PMID:29524935

Security Standards and Best Practice Considerations for Quantum Key Distribution (QKD)

DTIC Science & Technology

2012-03-01

SECURITY STANDARDS AND BEST PRACTICE CONSIDERATIONS FOR QUANTUM KEY DISTRIBUTION (QKD) THESIS...protection in the United States. AFIT/GSE/ENV/12-M05 SECURITY STANDARDS AND BEST PRACTICE CONSIDERATIONS FOR QUANTUM KEY DISTRIBUTION (QKD...FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. AFIT/GSE/ENV/12-M05 SECURITY STANDARDS AND BEST PRACTICE CONSIDERATIONS FOR QUANTUM KEY

Implementing the patient-centered medical home model for chronic disease care in small medical practices: practice group characteristics and physician understanding.

PubMed

Baxter, Louisa; Nash, David B

2013-01-01

Strengthening primary care may improve health outcomes and restrain spending. The patient-centered medical home (PCMH) model is endorsed as a tool to achieve this. Early evaluations in large group practices demonstrate improvements in some health outcomes. Evidence is lacking from small medical practices that deliver the majority of primary health care. This was a national survey of 200 physicians that explored perceptions of PCMH. There was considerable interest in adoption of the model; however, providing PCMH care was seen as an extension of traditional roles that requires additional reimbursement. No differentiation was made among a variety of payment models to do this. All joint principle components of the model were identified as important: extending access and information technology were the most contentious. There was consensus that PCMH might improve the quality of primary care; however, tension between wider societal benefits and rising costs for individual practices was a challenge to implementation.

Exploring the workforce implications of a decade of medical school expansion: variations in medical school growth and changes in student characteristics and career plans.

PubMed

Shipman, Scott A; Jones, Karen C; Erikson, Clese E; Sandberg, Shana F

2013-12-01

To explore whether medical school enrollment growth may help address workforce priorities, including diversity, primary care, care for underserved populations, and academic faculty. The authors compared U.S. MD-granting medical schools, applicants, and matriculants immediately before expansion (1999-2001) and 10 years later (2009-2011). Using data from the American Medical Association Physician Masterfile and the Association of American Medical Colleges, they examined medical schools' past production of physicians and changes in matriculant characteristics and practice intentions. Among the 124 schools existing in 1999-2001, growth varied substantially. Additionally, 11 new schools enrolled students by 2009-2011. Aggregate enrollment increased by 16.6%. Increases in applicants led to a lower likelihood of matriculation for all but those with rural backgrounds, racial/ethnic minorities, applicants >24 years old, and those with Medical College Admission Test scores > 33. The existing schools that expanded most had a history of producing the highest percentages of physicians practicing in primary care and in underserved and rural areas; those that expanded least had produced the greatest percentage of faculty. Compared with existing schools, new schools enrolled higher percentages of racial/ethnic minorities and of students with limited parental education or lower income. Matriculants' interest in primary care careers showed no decline; interest in practicing with underserved populations increased, while interest in rural practice declined. Despite expansion, the characteristics of matriculating medical students changed little, except at new schools. Further expansion may benefit from targeted consideration of workforce needs.

Vocational rehabilitation: facilitating evidence based practice through participatory action research.

PubMed

Maciver, Donald; Prior, Susan; Forsyth, Kirsty; Walsh, Mike; Meiklejohn, Allison; Irvine, Linda; Pentland, Duncan

2013-04-01

Improving vocational rehabilitation in line with the current evidence base is an area of considerable interest. Aims To describe the strategies used by a multidisciplinary team in the initial stages of a participatory action research (PAR) approach to improving a vocational rehabilitation service. A literature review and PAR process were completed. One hundred and fifteen participants engaged in multifaceted data collection and analysis, building consensus around key principles for a new vocational rehabilitation service. A synthesis of our literature review and PAR process was developed into a set of principles for practice which we plan to implement across the service. We have developed methodologies in interdisciplinary collaborations spanning statutory and non-statutory services. We have developed a set of principles for practice and detailed plans for implementation are being drawn up to inform provision in the future.

Evaluating interest in an influenza A(H5N1) vaccine among laboratory workers who work with highly-pathogenic avian influenza viruses in the United States.

PubMed

Russell, Kate E; Bresee, J S; Katz, J M; Olsen, S J

2018-01-04

Highly pathogenic avian influenza A (HPAI) viruses found in poultry and wild birds occasionally infect humans and can cause serious disease. In 2014, the Advisory Committee on Immunization Practices (ACIP) reviewed data from one licensed ASO3-adjuvanted influenza A(H5N1) vaccine for consideration of use during inter-pandemic periods among persons with occupational exposure. To guide vaccine policy decisions, we conducted a survey of laboratory workers to assess demand for HPAI vaccination. We designed an anonymous web survey (EpiInfo 7.0) to collect information on demographics, type of work and time spent with HPAI viruses, and interest in HPAI vaccination. Eligible participants were identified from 42 entities registered with United States Department of Agriculture's Agricultural Select Agent program in 2016 and emailed electronic surveys. Personnel with Biosafety Level 3 enhanced (BSL-3E) laboratory access were surveyed. Descriptive analysis was performed. Overall, 131 responses were received from 33 principal investigators, 26 research scientists, 24 technicians, 15 postdoctoral fellows, 6 students, and 27 others. The estimated response rate was 15% among the laboratory personnel of responding principal investigators. One hundred respondents reported working in a BSL-3E area where HPAI experiments occurred with a mean time of 5.1-11.7 h per week. Overall, 49% were interested in receiving an A(H5N1) vaccine. By role, interest was highest among students (80%) and among those who spent >50% of their time in a BSL-3E area (64%). Most (61%) of those who said they might be or were not interested in vaccine believed it would not provide additional protection to current safety practices. Half of responding laboratory workers was interested in receiving an influenza A(H5N1) vaccine. HPAI vaccination of laboratory workers at risk of occupational exposure could be used along with existing safety practices to protect this population. Published by Elsevier Ltd.

The Perfect Womb: Promoting Equality of (Fetal) Opportunity.

PubMed

Kendal, Evie

2017-06-01

This paper aims to address how artificial gestation might affect equality of opportunity for the unborn and any resultant generation of "ectogenetic" babies. It will first explore the current legal obstacles preventing the development of ectogenesis, before looking at the benefits of allowing this technology to control fetal growth and development. This will open up a discussion of the treatment/enhancement divide regarding the use of reproductive technologies, a topic featured in various bioethical debates on the subject. Using current maternity practices in Western society as a comparator, this paper will conclude that neither naturally nor artificially gestated fetuses have interests that can conflict with those of potential parents who might want to use this technology to control fetal development. Such control may include selective implantation of embryos of a desired gender, deliberate choice of genetic traits, or maintenance of an ideal incubation environment to avoid fetal damage. Objections on the basis of disability as well as concerns regarding eugenics will be addressed. The paper will conclude that none of these objections are compelling grounds to prevent the development and use of ectogenesis technologies for the purpose of achieving specific reproductive goals, particularly when compared to current practices in pre-implantation genetic diagnosis and selective abortion on the grounds of undesired traits. As such, when deciding whether to support ectogenesis research, the enduring interests of parents must be the primary consideration, with societal concerns regarding potential misuse the only valid secondary consideration.

[Anthropology and "crisis in medicine": The pathologist M. Kuczynski-Godard (1890-1967) and the indigenous peoples of Central Asia and Peru].

PubMed

Knipper, Michael

2009-01-01

This article examines the work of the German-Peruvian physician Max Kuczynski/Máxime Kuczynski-Godard (Berlin 1890-Lima 1967) in rural areas of Central Asia (1924-26) and Peru (1938-48). The main focus of the text is on the scientific approach behind the specific interest of this pathologist in disease and health issues among native populations. Kuczynski's theoretical considerations are analyzed in the context of the wide controversies within the German medical community around a "crisis in medicine" when he was professor at Berlin University during the interwar years. Accordingly, his determination to leave the laboratory and to shift research and healthcare practice closer to rural populations proves to be the expression of profound epistemological and ethical considerations.

Validation of cell-based fluorescence assays: practice guidelines from the ICSH and ICCS - part IV - postanalytic considerations.

PubMed

Barnett, David; Louzao, Raaul; Gambell, Peter; De, Jitakshi; Oldaker, Teri; Hanson, Curtis A

2013-01-01

Flow cytometry and other technologies of cell-based fluorescence assays are as a matter of good laboratory practice required to validate all assays, which when in clinical practice may pass through regulatory review processes using criteria often defined with a soluble analyte in plasma or serum samples in mind. Recently the U.S. Food and Drug Administration (FDA) has entered into a public dialogue in the U.S. regarding their regulatory interest in laboratory developed tests (LDTs) or so-called home brew assays performed in clinical laboratories. The absence of well-defined guidelines for validation of cell-based assays using fluorescence detection has thus become a subject of concern for the International Council for Standardization of Haematology (ICSH) and International Clinical Cytometry Society (ICCS). Accordingly, a group of over 40 international experts in the areas of test development, test validation, and clinical practice of a variety of assay types using flow cytometry and/or morphologic image analysis were invited to develop a set of practical guidelines useful to in vitro diagnostic (IVD) innovators, clinical laboratories, regulatory scientists, and laboratory inspectors. The focus of the group was restricted to fluorescence reporter reagents, although some common principles are shared by immunohistochemistry or immunocytochemistry techniques and noted where appropriate. The work product of this two year effort is the content of this special issue of this journal, which is published as 5 separate articles, this being Validation of Cell-based Fluorescence Assays: Practice Guidelines from the ICSH and ICCS - Part IV - Postanalytic considerations. © 2013 International Clinical Cytometry Society.

EEG-Neurofeedback as a Tool to Modulate Cognition and Behavior: A Review Tutorial

PubMed Central

Enriquez-Geppert, Stefanie; Huster, René J.; Herrmann, Christoph S.

2017-01-01

Neurofeedback is attracting renewed interest as a method to self-regulate one’s own brain activity to directly alter the underlying neural mechanisms of cognition and behavior. It not only promises new avenues as a method for cognitive enhancement in healthy subjects, but also as a therapeutic tool. In the current article, we present a review tutorial discussing key aspects relevant to the development of electroencephalography (EEG) neurofeedback studies. In addition, the putative mechanisms underlying neurofeedback learning are considered. We highlight both aspects relevant for the practical application of neurofeedback as well as rather theoretical considerations related to the development of new generation protocols. Important characteristics regarding the set-up of a neurofeedback protocol are outlined in a step-by-step way. All these practical and theoretical considerations are illustrated based on a protocol and results of a frontal-midline theta up-regulation training for the improvement of executive functions. Not least, assessment criteria for the validation of neurofeedback studies as well as general guidelines for the evaluation of training efficacy are discussed. PMID:28275344

A critical appraisal of clinical practice guidelines for the treatment of lower-limb osteoarthritis

PubMed Central

Pencharz, James N; Grigoriadis, Elizabeth; Jansz, Gwenderlyn F; Bombardier, Claire

2002-01-01

Clinical practice guidelines are important tools to assist clinical decision-making. Recently, several guidelines addressing the management of osteoarthritis (OA) have been published. Clinicians treating patients with OA must ensure that these guidelines are developed with consistency and methodological rigour. We undertook a qualitative summary and critical appraisal of six medical treatment guidelines for the management of lower-limb OA published in the medical literature within the past 5 years. A review of these six guidelines revealed that each possesses strengths and weakness. While most described the scope and intended patient populations, the guidelines varied considerably in the rigour of their development, coverage of implementation issues, and disclosure of conflicts of interest. PMID:11879536

Sustainable business models: systematic approach toward successful ambulatory care pharmacy practice.

PubMed

Sachdev, Gloria

2014-08-15

This article discusses considerations for making ambulatory care pharmacist services at least cost neutral and, ideally, generate a margin that allows for service expansion. The four pillars of business sustainability are leadership, staffing, information technology, and compensation. A key facet of leadership in ambulatory care pharmacy practice is creating and expressing a clear vision for pharmacists' services. Staffing considerations include establishing training needs, maximizing efficiencies, and minimizing costs. Information technology is essential for efficiency in patient care delivery and outcomes assessment. The three domains of compensation are cost savings, pay for performance, and revenue generation. The following eight steps for designing and implementing an ambulatory care pharmacist service are discussed: (1) prepare a needs assessment, (2) analyze existing strengths, weaknesses, opportunities, and threats, (3) analyze service gaps and feasibility, (4) consider financial opportunities, (5) consider stakeholders' interests, (6) develop a business plan, (7) implement the service, and (8) measure outcomes. Potential future changes in national healthcare policy (such as pharmacist provider status and expanded pay for performance) could enhance the opportunities for sustainable ambulatory care pharmacy practice. The key challenges facing ambulatory care pharmacists are developing sustainable business models, determining which services yield a positive return on investment, and demanding payment for value-added services. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Circle of healing: traditional storytelling, part two.

PubMed

Porter, Walter

2003-01-01

For decades, Bible stories have been a source of both conflict and healing. In earlier days, Christian missionaries often went to considerable lengths to question the accuracy of traditional northern Native stories, especially those with supernatural dimensions, and to discredit traditional Native spiritual leaders, such as medicine men and women, angakoks, and shamans. The missionaries’ efforts often undercut Native culture and sometimes contributed to the intergenerational trauma that creates widespread hurt and pain in northern Native communities today. At the same time, a significant number of northern Native people derive considerable solace and support from their Christian beliefs and church affiliations, and many Christian religious organizations active in the North today no longer oppose traditional Native stories, practices, and values. Many northern Native people recognize that there is great value in both Native stories and the stories found in the Bible, but some still feel a tension in trying to reconcile acceptance of both. In his presentation, Walter Porter provided an interesting perspective on this issue, and his approach has considerable potential for healing.

31 CFR Appendix C to Part 356 - Investment Considerations

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Investment Considerations C Appendix C..., App. C Appendix C to Part 356—Investment Considerations I. Inflation-Protected Securities A. Principal and Interest Variability An investment in securities with principal or interest determined by...

Guideline funding and conflicts of interest: article 4 in Integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.

PubMed

Boyd, Elizabeth A; Akl, Elie A; Baumann, Michael; Curtis, J Randall; Field, Marilyn J; Jaeschke, Roman; Osborne, Molly; Schünemann, Holger J

2012-12-01

Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that healthcare recommendations are informed by the best available research evidence. This is the fourth of a series of 14 articles prepared to advise guideline developers in respiratory and other disease. It focuses on commercial funding of guidelines and managing conflict of interest effectively in the context of guidelines. In this review, we addressed the following topics and questions. (1) How are clinical practice guidelines funded? (2) What are the risks associated with commercial sponsorship of guidelines? (3) What relationships should guideline committee members be required to disclose? (4) What is the most efficient way to obtain complete and accurate disclosures? (5) How should disclosures be publicly shared? (6) When do relationships require management? (7) How should individual conflicts of interest be managed? (8) How could conflict of interest policies be enforced? The literature review included a search of PubMed and other databases for existing systematic reviews and relevant methodological research. Our conclusions are based on available evidence, consideration of what guideline developers are doing, and workshop discussions. Professional societies often depend on industry funding to support clinical practice guideline development. In addition, members of guideline committees frequently have financial relationships with commercial entities, are invested in their intellectual work, or have conflicts related to clinical revenue streams. No systematic reviews or other rigorous evidence regarding best practices for funding models, disclosure mechanisms, management strategies, or enforcement presently exist, but the panel drew several conclusions that could improve transparency and process.

[Sexuality of our seniors: happy end or new beginning?].

PubMed

Degauquier, C; Absil, A S; Meuris, S; Psalti, I; Jurysta, F

2012-01-01

Comparing surveys from successive periods demonstrates that elderly people now enjoy a better and more varied sexual life than previous generations. The proportion of older people who remain sexually active has significantly increased, and the practices of masturbation or oral sex have spread considerably. The generation effect has an incidence upon sexual behaviour: older people's repertoire of sexual practices differs from that of younger people, in the sense that it focuses less on sexual intercourse and oral sex. Women and men, beyond the common trends towards sexuality characterised by a more open repertoire of sexual practices, differ in terms of sexual interest and subjective sexual wellbeing. The cessation of sexual activity by individuals who had previously been sexually active is often the result of a cascade of reactions, such as the occurrence of a sexual dysfunction in one or both partners, anticipation of failure, increased anxiety, lack of adaptation of sexuality and/or avoidance behaviour.

The business of refractive laser assisted cataract surgery (ReLACS).

PubMed

Berdahl, John P; Jensen, Matthew P

2014-01-01

Refractive Laser Assisted Cataract Surgery (ReLACS) combines the femtosecond laser with other noncovered tests and services in an attempt to reduce spectacle dependence in combination with cataract surgery. Significant interest is present among ophthalmologists who are considering adopting this technology, however significant capital outlays and continuing expenses can make the decision to adopt ReLACS foreboding. We review the financial considerations of ReLACS and review the trends seen in early adopters of this technology. Recent findings have shown that ReLACS is a growing segment of cataract surgery. Most practices who have implemented the technology have broken even and have a positive outlook on the financial return of implementing the ReLACS program. The average break-even analysis point for practices is around 230 cases a year. ReLACS is growing and appears to be a financial viable approach for many practices.

The Impact Hazard in the Context of Other Natural Hazards and Predictive Science

NASA Astrophysics Data System (ADS)

Chapman, C. R.

1998-09-01

The hazard due to impact of asteroids and comets has been recognized as analogous, in some ways, to other infrequent but consequential natural hazards (e.g. floods and earthquakes). Yet, until recently, astronomers and space agencies have felt no need to do what their colleagues and analogous agencies must do in order the assess, quantify, and communicate predictions to those with a practical interest in the predictions (e.g. public officials who must assess the threats, prepare for mitigation, etc.). Recent heightened public interest in the impact hazard, combined with increasing numbers of "near misses" (certain to increase as Spaceguard is implemented) requires that astronomers accept the responsibility to place their predictions and assessments in terms that may be appropriately considered. I will report on preliminary results of a multi-year GSA/NCAR study of "Prediction in the Earth Sciences: Use and Misuse in Policy Making" in which I have represented the impact hazard, while others have treated earthquakes, floods, weather, global climate change, nuclear waste disposal, acid rain, etc. The impact hazard presents an end-member example of a natural hazard, helping those dealing with more prosaic issues to learn from an extreme. On the other hand, I bring to the astronomical community some lessons long adopted in other cases: the need to understand the policy purposes of impact predictions, the need to assess potential societal impacts, the requirements to very carefully assess prediction uncertainties, considerations of potential public uses of the predictions, awareness of ethical considerations (e.g. conflicts of interest) that affect predictions and acceptance of predictions, awareness of appropriate means for publicly communicating predictions, and considerations of the international context (especially for a hazard that knows no national boundaries).

Blood stem cells and non-hematological clinical practice: pragmatics before therapeutics.

PubMed

Parker, Graham C

2007-02-01

There is considerable interest in biological sources for replacement, repair, as well as vascularization of tissue. The remarkable properties of blood stem cells encourage interest in their therapeutic potential. But what are these properties, and how do they influence their clinical potential and the advisability of stem cell use as a therapeutic resource? Rational assessment of the significance of in vitro and animal in vivo data should precede the rush from the bench to the bedside. Basic stem cell research is rife with examples where the truth of the subsequently demonstrated mechanism is stranger than the initial interpretation proved fiction. This review will assess tissue contribution by different blood related stem cells, differing possible mechanisms underlying observed repair phenomena, and consider the potency and pitfalls of stem cell therapeutics.

Patients who challenge.

PubMed

Ward, Michael; Savulescu, Julian

2006-12-01

Individuals have different values. They seek to express their individuality even when receiving medical care. It is a part of modern medical practice and respect for patient autonomy to show respect for different values. We give an account of what it means to respect different values and challenging patients in medical practice. Challenging choices are often choices which are perceived by many to be either irrational or against a person's interests, such as engaging in harmful or excessively risky activities. When the medical profession is involved in such choices, the basic medical principle of acting in a person's best interests is challenged. Often doctors refuse to respect controversial choices on paternalistic grounds. We should all respect and facilitate the controversial choices of competent individuals, subject to resource limitations, our own and others well-being and autonomy, and the public interest. But more importantly, sometimes such choices make for a better, more autonomous life. Sometimes, such choices reflect considerations of global well-being or altruism, or idiosyncratic attitudes to risk. Sometimes, they reflect unusual values. However, in some other cases, controversial choices are irrational and are not expressions of our autonomy. Doctors should assist patients to make rational if individual choices. The patient also bears the responsibility for bringing his beliefs to the attention of the clinician.

Extending Data Worth Analyses to Select Multiple Observations Targeting Multiple Forecasts.

PubMed

Vilhelmsen, Troels N; Ferré, Ty P A

2018-05-01

Hydrological models are often set up to provide specific forecasts of interest. Owing to the inherent uncertainty in data used to derive model structure and used to constrain parameter variations, the model forecasts will be uncertain. Additional data collection is often performed to minimize this forecast uncertainty. Given our common financial restrictions, it is critical that we identify data with maximal information content with respect to forecast of interest. In practice, this often devolves to qualitative decisions based on expert opinion. However, there is no assurance that this will lead to optimal design, especially for complex hydrogeological problems. Specifically, these complexities include considerations of multiple forecasts, shared information among potential observations, information content of existing data, and the assumptions and simplifications underlying model construction. In the present study, we extend previous data worth analyses to include: simultaneous selection of multiple new measurements and consideration of multiple forecasts of interest. We show how the suggested approach can be used to optimize data collection. This can be used in a manner that suggests specific measurement sets or that produces probability maps indicating areas likely to be informative for specific forecasts. Moreover, we provide examples documenting that sequential measurement election approaches often lead to suboptimal designs and that estimates of data covariance should be included when selecting future measurement sets. © 2017, National Ground Water Association.

A qualitative study of student perspectives and experiences in an information technology education program

NASA Astrophysics Data System (ADS)

Choi, Heekyung

2009-12-01

The purpose of this study is to learn about students' perspectives of an undergraduate level information technology (IT) education program. The IT program is a recent effort to create a new educational opportunity for computing in college, with recognition that the recent IT developments have had a greater influence on various aspects of people's lives than ever. Students' perspectives are a necessary piece of information to develop this innovative IT education program into a sound educational opportunity. Data were gathered through qualitative in-depth interviews conducted with 28 undergraduate students, most of whom have taken one or more IT classes before. The interview data were analyzed using the grounded theory approach. The analysis found that college students perceived that they were very competent in dealing with IT primarily due to their continued exposure to computers since youth. However, this perceived competency was not very stable. Students felt that they did not have sufficient IT competency when technical skills of dealing with IT came to attention. They also felt so when comparing their IT competency with that of their peers, examining it in a class context, and confronting a transition from education to the real world. In spite of their preference for and confidence in self-guided learning, students wanted to receive a formal instruction in IT when they needed to learn something difficult, something that they were not very interested in, and something important for their future lives. They also expressed a desire to gain a comprehensive understanding of computers without needing to learn fundamental computing principles. Students' various interests in IT education were dispersed around learning practical technical skills and understanding social implications of IT. Many participants' focus was a mix of the two factors, which was often expressed as an area that dealt with "how humans and computers interact." This blended interest suggested a potential defining characteristic for IT education. Students' motivations for pursuing IT education ranged from their passion to some practical considerations. The majority of students expressed mixed motivations, often more strongly inclined to practicality. This finding implied that students' practical considerations as well as their pure interests were an important factor to consider in administering an IT program. Participants found that the primary value of the IT program was that it incorporated technological and social topics which had not been well connected previously. Yet, balancing the technical and non-technical components in the curriculum also proved to be the most controversial aspect. Students perceived that the weaknesses of the IT program were also associated with its interdisciplinary nature. Students also viewed that the topics in the IT program were more closely related to many real world problems than the curricula of typical college education programs. Finally, the analysis revealed that students determined the value of the IT minor program in relation to their majors and career interests. Students took the IT minor to supplement their majors, in terras of their interests in developing their careers beyond formal education. Overall, this investigation showed that students perceived this broad-based education program for IT as an intermediate field that filled a significant niche in college education caused by the recent technological innovations: between technical and social, between school and everyday life, and between formal education and the "real world." The results have practical implications for the development of IT programs in college and for future research directions.

International perspectives on education, training, and practice in clinical neuropsychology: comparison across 14 countries around the world.

PubMed

Grote, Christopher L; Novitski, Julia I

2016-11-01

To review and summarize data provided by special issue authors regarding the education, training, and practice of neuropsychologists from 14 surveyed countries. A table was constructed to present an overview of variables of interest. There is considerable diversity among surveyed countries regarding the education and training required to enter practice as a clinical neuropsychologist. Clinical neuropsychologists are typically well compensated, at least in comparison to what constitutes an average salary in each country. Despite substantial variations in education and training pathways, and availability of neuropsychologists from country to country, two common areas for future development are suggested. First, identification, development, and measurement of core competencies for neuropsychological education and practice are needed that can serve as a unifying element for the world's clinical neuropsychologists. Second, greater emphasis on recognizing and addressing the need for assessment and treatment of diverse populations is needed if the world's citizens can hope to benefit from the expertise of practitioners in our field.

Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

PubMed

Johnston, Lee M; Finegood, Diane T

2015-03-18

Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

Queen Christina's moral claim on the living: justification of a tenacious moral intuition.

PubMed

Masterton, Malin; Helgesson, Gert; Höglund, Anna T; Hansson, Mats G

2007-09-01

In the long-running debate on the interest of the dead, Joan C. Callahan argues against such interests and although Søren Holm for practical reasons is prepared to consider posthumous interests, he does not see any moral basis to support such interests. He argues that the whole question is irresolvable, yet finds privacy interests where Tutankhamen is concerned. Callahan argues that there can be reasons to hold on to the fiction that there are posthumous interests, namely if it is comforting for the living and instrumental for society. Thus, despite arguing against the position that the dead have any interests or for any moral basis for such interests, these "interests" are still taken into consideration in the end. This shows the unsatisfactory basis of their positions and indicates the tenacity of the moral intuition that the dead can have moral claims on the living. One example of a posthumous interest is the interest in one's good name. Here we argue that it is an interest of moral significance. This implies that if individuals restrict use of their sample when they are still alive, those restrictions apply after their death. Further, it implies that one should be concerned with the reputation of historic persons. Research that defeats these interests calls for justification. We have suggested two lines of thinking along which such a discussion could go: investigating the truth-value of the good name and the relevance of bringing it into possible disrepute.

45 CFR 611.13 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... donation of Federal property and interests in property, (3) the detail of Federal personnel, (4) the sale... or any interest in such property without consideration or at a nominal consideration, or at a... interest to be served by such sale or lease to the recipient, and (5) any Federal agreement, arrangement...

Wildlife governance in the 21st century—Will sustainable use endure?

USGS Publications Warehouse

Decker, Daniel J.; Organ, John F.; Forstchen, Ann; Jacobson, Cynthia A.; Siemer, William F.; Smith, Christian A.; Lederle, Patrick E.; Schiavone, Michael V.

2017-01-01

In light of the trajectory of wildlife governance in the United States, the future of sustainable use of wildlife is a topic of substantial interest in the wildlife conservation community. We examine sustainable-use principles with respect to “good governance” considerations and public trust administration principles to assess how sustainable use might fare in the 21st century. We conclude that sustainable-use principles are compatible with recently articulated wildlife governance principles and could serve to mitigate broad values and norm shifts in American society that affect social acceptability of particular uses. Wildlife governance principles emphasize inclusive discourse among diverse wildlife interests, which could minimize isolated exchanges among cliques of like-minded people pursuing their ambitions without seeking opportunity for sharing or understanding diverse views. Aligning governance practices with wildlife governance principles can help avoid such isolation. In summary, sustainable use of wildlife is likely to endure as long as society 1) believes the long-term sustainability of wildlife is not jeopardized, and 2) accepts practices associated with such use as legitimate. These are 2 criteria needing constant attention.

Null but not void: considerations for hypothesis testing.

PubMed

Shaw, Pamela A; Proschan, Michael A

2013-01-30

Standard statistical theory teaches us that once the null and alternative hypotheses have been defined for a parameter, the choice of the statistical test is clear. Standard theory does not teach us how to choose the null or alternative hypothesis appropriate to the scientific question of interest. Neither does it tell us that in some cases, depending on which alternatives are realistic, we may want to define our null hypothesis differently. Problems in statistical practice are frequently not as pristinely summarized as the classic theory in our textbooks. In this article, we present examples in statistical hypothesis testing in which seemingly simple choices are in fact rich with nuance that, when given full consideration, make the choice of the right hypothesis test much less straightforward. Published 2012. This article is a US Government work and is in the public domain in the USA.

Amateur Telescope Making

NASA Astrophysics Data System (ADS)

Tonkin, Stephen

Many amateur astronomers make their own instruments, either because of financial considerations or because they are just interested. Amateur Telescope Making offers a variety of designs for telescopes, mounts and drives which are suitable for the home-constructor. The designs range from simple to advanced, but all are within the range of a moderately well-equipped home workshop. The book not only tells the reader what he can construct, but also what it is sensible to construct given what time is available commercially. Thus each chapter begins with reasons for undertaking the project, then looks at theoretical consideration before finishing with practical instructions and advice. An indication is given as to the skills required for the various projects. Appendices list reputable sources of (mail order) materials and components. The telescopes and mounts range from "shoestring" (very cheap) instruments to specialist devices that are unavailable commercially.

Discovery of practical production processes for arylsulfur pentafluorides and their higher homologues, bis- and tris(sulfur pentafluorides): Beginning of a new era of “super-trifluoromethyl” arene chemistry and its industry

PubMed Central

Garrick, Lloyd M; Saito, Norimichi

2012-01-01

Summary Various arylsulfur pentafluorides, ArSF5, have long been desired in both academic and industrial areas, and ArSF5 compounds have attracted considerable interest in many areas such as medicines, agrochemicals, and other new materials, since the highly stable SF5 group is considered a “super-trifluoromethyl group” due to its significantly higher electronegativity and lipophilicity. This article describes the first practical method for the production of various arylsulfur pentafluorides and their higher homologues, bis- and tris(sulfur pentafluorides), from the corresponding diaryl disulfides or aryl thiols. The method consists of two steps: (Step 1) treatment of a diaryl disulfide or an aryl thiol with chlorine in the presence of an alkali metal fluoride, and (step 2) treatment of the resulting arylsulfur chlorotetrafluoride with a fluoride source, such as ZnF2, HF, and Sb(III/V) fluorides. The intermediate arylsulfur chlorotetrafluorides were isolated by distillation or recrystallization and characterized. The aspects of these new reactions are revealed and reaction mechanisms are discussed. As the method offers considerable improvement over previous methods in cost, yield, practicality, applicability, and large-scale production, the new processes described here can be employed as the first practical methods for the economical production of various arylsulfur pentafluorides and their higher homologues, which could then open up a new era of “super-trifluoromethyl” arene chemistry and its applications in many areas. PMID:22509218

26 CFR 1.368-1T - Purpose and scope of exception of reorganization exchanges (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

.... In determining whether a proprietary interest in the target corporation is preserved, the consideration to be exchanged for the proprietary interests in the target corporation pursuant to a contract to... interest in the target corporation is preserved. If the contract does not provide for fixed consideration...

26 CFR 1.368-1T - Purpose and scope of exception of reorganization exchanges (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

.... In determining whether a proprietary interest in the target corporation is preserved, the consideration to be exchanged for the proprietary interests in the target corporation pursuant to a contract to... interest in the target corporation is preserved. If the contract does not provide for fixed consideration...

Continuing education at the cutting edge: promoting transformative knowledge translation.

PubMed

McWilliam, Carol L

2007-01-01

As the evidence-based practice movement gains momentum, continuing education practitioners increasingly confront the challenge of developing and conducting opportunities for achieving research uptake. Recent thinking invites new approaches to continuing education for health professionals, with due consideration of what knowledge merits uptake by practitioners, who should play what role in the knowledge transfer process, and what educational approach should be used. This article presents an innovative theory-based strategy that encompasses this new perspective. Through a facilitated experience of perspective transformation, clinicians are engaged in an on-the-job process of developing a deeply felt interest in research findings relevant to everyday practice, as well as ownership of that knowledge and its application. The strategy becomes a sustainable, integrated part of clinical practice, fitting naturally within its dynamic, unique environment, context, and climate and overcoming the barrier of time. Clinician experience of a top-down push toward prescribed practice change is avoided. With an expanded role encompassing facilitation of active learning partnerships for practice change, the continuing educator fosters a learning organization culture across the institution. The resultant role changes and leadership and accountability issues are elaborated.

"Alcohol and nicotine"--Concept and evaluation of an interdisciplinary elective course with OSPE in preclinical medical education.

PubMed

Bergelt, Corinna; Lauke, Heidrun; Petersen-Ewert, Corinna; Jücker, Manfred; Bauer, Christiane K

2014-01-01

In the last decade, increasing interest has been paid to interdisciplinary and practical courses in the medical education in Germany. This report describes the implementation and outcome of a preclinical interdisciplinary elective course with a team-teaching concept developed by lecturers in medical psychology, anatomy, physiology and biochemistry. The practical orientation of the course led to the implementation of a final interdisciplinary OSPE to ensure fair consideration of the different disciplines involved in grading. Individual OSPE results correlate well with the fact that different skills are required in medical psychology compared to those required in anatomy, physiology and biochemistry. Student course evaluation and lecturers` experience indicate the success of this elective course. Its concept can be well adapted to other interdisciplinary courses.

Committee on Veterinary Medicine at the Society for Medical Education: Skills Labs in Veterinary Medicine - a brief overview.

PubMed

Dilly, Marc; Gruber, Christian

2016-01-01

Since 2012, skills labs have been set up to teach practical skills at veterinary training facilities in the German-speaking world. In addition to didactic considerations, ethical points of view in terms of animal protection form the basis of the increasing significance of skills labs in veterinary medicine. Not least because of the quality standards in veterinary medicine training which apply across Europe, the link between veterinary medicine training facilities is particularly significant when it comes to the setting up and development of skills labs. The Committee on Veterinary Medicine is therefore not only interested in exchange and cooperation within veterinary medicine, but also sees an opportunity for mutual gain in the link with the Society for Medical Education Committee "Practical Skills".

Ethical considerations in dental laser research, education, and practice

NASA Astrophysics Data System (ADS)

Goldstein, Alan T.; Coluzzi, Donald J.; Sulewski, John G.; White, Joel M.

1995-05-01

This presentation addresses the interplay between commerce and conscience. The relationship between industry and academia must be free of both true and apparent conflict of interest. Obviously, the matter is of great importance, since as scientists and clinicians, our integrity is our most valuable asset. This is no less true for the manufacturers of dental laser technology. Ethics, then, is a bottom-line issue for all concerned. Often, in spite of good intentions, there has been no clear-cut policy on this issue. Occasionally, when there has been policy, there has been no mechanism for implementation. Universities have conflict-of-interest requirements, while industry and others in the profession do not. In the academic sphere, we are obligated to be open, thorough, honest and scrupulous in our research and educational activities. Recently, the Board of Directors of the Academy of Laser Dentistry unanimously passed a resolution clarifying their position on conflict-of-interest issues. We offer it to SPIE so that ultimately, we may face our profession and business colleagues squarely, and with full and faithful disclosure. Issues of conflict of interest, principal investigators, financial interests, and recommendations for full disclosure are presented.

Breaking up is hard to do: lessons learned from a pharma-free practice transformation.

PubMed

Evans, David; Hartung, Daniel M; Beasley, Denise; Fagnan, Lyle J

2013-01-01

Academic medical centers are examining relationships with the pharmaceutical industry and making changes to limit interactions. Most doctors, however, practice outside of academic institutions and see pharmaceutical detailers and accept drug samples and gifts. Little guidance for practicing physicians exists about transforming practices to become pharma-free. Consideration must be given to the impact on practice culture, staff views, and patient needs. A small private practice, setting out to transform into a pharma-free clinic, used a practice transformation process that examined the industry presence in the clinic, educated the doctors on potential conflicts of interest, and improved practice flow. Staff were given the opportunity to share concerns, and their issues were acknowledged. Educational interventions were developed to help providers keep current. Finally, efforts were made to educate patients about the policy. The clinic recorded the degree to which it was detailed. Loss of gifts, keeping current with new drugs, and managing without samples were noted concerns. Policy change champions developed strategies to address concerns. A shift in practice culture to a pharma-free clinic is achievable and maintainable over time. Barriers to success can be identified and overcome with attention given to careful gathering of information, staff input, and stakeholder education.

Climate Change and Morality: Students' perspectives on the individual and society

NASA Astrophysics Data System (ADS)

Sternäng, Li; Lundholm, Cecilia

2011-05-01

There is a growing interest in addressing moral aspects in the research and education of socio-scientific issues. This paper investigates students' interpretations of climate change from a moral perspective. The students were 14 years old, studying at Green Schools in the Beijing area, China. The study was based on semi-structured group interviews and the data were analysed from an intentional perspective, which means that both cognitive and situational aspects were taken into consideration in the analysis. Previous research has revealed a close relation between morality and socio-scientific issues and also advocated the need for addressing ethical aspects in science education. However, empirical studies exploring the question of what students' moral reasoning might look like at the individual level have not yet generated enough attention. In this study this is the core focus of interest. The findings show that the students conceptualise the solutions to mitigating climate change in relation to two different stances. That is, they contextualise the problems and solutions by addressing the individual, where the individual is either 'myself' or 'someone else'. The different notions of the individual become crucial as the students' views and considerations for the environment, as well as society, change according to the different contexts. From a moral point of view, the students seem quite unaware of their varying consideration for others, the environment and society. The paper ends with a discussion of implications for practice and research.

A field ornithologist’s guide to genomics: Practical considerations for ecology and conservation

USGS Publications Warehouse

Oyler-McCance, Sara J.; Oh, Kevin; Langin, Kathryn; Aldridge, Cameron L.

2016-01-01

Vast improvements in sequencing technology have made it practical to simultaneously sequence millions of nucleotides distributed across the genome, opening the door for genomic studies in virtually any species. Ornithological research stands to benefit in three substantial ways. First, genomic methods enhance our ability to parse and simultaneously analyze both neutral and non-neutral genomic regions, thus providing insight into adaptive evolution and divergence. Second, the sheer quantity of sequence data generated by current sequencing platforms allows increased precision and resolution in analyses. Third, high-throughput sequencing can benefit applications that focus on a small number of loci that are otherwise prohibitively expensive, time-consuming, and technically difficult using traditional sequencing methods. These advances have improved our ability to understand evolutionary processes like speciation and local adaptation, but they also offer many practical applications in the fields of population ecology, migration tracking, conservation planning, diet analyses, and disease ecology. This review provides a guide for field ornithologists interested in incorporating genomic approaches into their research program, with an emphasis on techniques related to ecology and conservation. We present a general overview of contemporary genomic approaches and methods, as well as important considerations when selecting a genomic technique. We also discuss research questions that are likely to benefit from utilizing high-throughput sequencing instruments, highlighting select examples from recent avian studies.

Understanding adolescent student perceptions of science education

NASA Astrophysics Data System (ADS)

Ebert, Ellen Kress

This study used the Relevance of Science Education (ROSE) survey (Sjoberg & Schreiner, 2004) to examine topics of interest and perspectives of secondary science students in a large school district in the southwestern U.S. A situated learning perspective was used to frame the project. The research questions of this study focused on (a) perceptions students have about themselves and their science classroom and how these beliefs may influence their participation in the community of practice of science; (b) consideration of how a future science classroom where the curriculum is framed by the Next Generation Science Standards might foster students' beliefs and perceptions about science education and their legitimate peripheral participation in the community of practice of science; and (c) reflecting on their school science interests and perspectives, what can be inferred about students' identities as future scientists or STEM field professionals? Data were collected from 515 second year science students during a 4-week period in May of 2012 using a Web-based survey. Data were disaggregated by gender and ethnicity and analyzed descriptively and by statistical comparison between groups. Findings for Research Question 1 indicated that boys and girls showed statistically significant differences in scientific topics of interest. There were no statistical differences between ethnic groups although. For Research Question 2, it was determined that participants reported an increase in their interest when they deemed the context of the content to be personally relevant. Results for Research Question 3 showed that participants do not see themselves as youthful scientists or as becoming scientists. While participants value the importance of science in their lives and think all students should take science, they do not aspire to careers in science. Based on this study, a need for potential future work has been identified in three areas: (a) exploration of the perspectives and interests of non-mainstream students and urban students whose representation in this study was limited; (b) investigation of topics where students expressed low interests topics; and (c) development and design of authentic communities of practice in the science classroom.

Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.

PubMed

Redwood, Sabi; Brangan, Emer; Leach, Verity; Horwood, Jeremy; Donovan, Jenny L

2016-06-22

Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities. Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets. One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery. The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and healthcare delivery at a time of considerable organisational turmoil and financial constraints. The concept gained momentum and will likely be of interest to those involved in setting up similar arrangements, and researchers in the social and implementation sciences with an interest in their evaluation.

Practical virtue ethics: healthcare whistleblowing and portable digital technology.

PubMed

Bolsin, S; Faunce, T; Oakley, J

2005-10-01

Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development.

The acceptance of in silico models for REACH: Requirements, barriers, and perspectives

PubMed Central

2011-01-01

In silico models have prompted considerable interest and debate because of their potential value in predicting the properties of chemical substances for regulatory purposes. The European REACH legislation promotes innovation and encourages the use of alternative methods, but in practice the use of in silico models is still very limited. There are many stakeholders influencing the regulatory trajectory of quantitative structure-activity relationships (QSAR) models, including regulators, industry, model developers and consultants. Here we outline some of the issues and challenges involved in the acceptance of these methods for regulatory purposes. PMID:21982269

Electronic properties of bilayer graphenes strongly coupled to interlayer stacking and an external field

DOE PAGES

Park, Changwon; Ryou, Junga; Hong, Suklyun; ...

2015-07-02

Bilayer graphene (BLG) with a tunable band gap appears interesting as an alternative to graphene for practical applications; thus, its transport properties are being actively pursued. Using density functional theory and perturbation analysis, we investigated, under an external electric field, the electronic properties of BLG in various stackings relevant to recently observed complex structures. We established the first phase diagram summarizing the stacking-dependent gap openings of BLG for a given field. Lastly, we further identified high-density midgap states, localized on grain boundaries, even under a strong field, which can considerably reduce the overall transport gap.

Cryogenic Vacuum Insulation for Vessels and Piping

NASA Technical Reports Server (NTRS)

Kogan, A.; Fesmire, J.; Johnson, W.; Minnick, J.

2010-01-01

Cryogenic vacuum insulation systems, with proper materials selection and execution, can offer the highest levels of thermal performance. Three areas of consideration are vital to achieve the optimum result: materials, representative test conditions, and engineering approach for the particular application. Deficiency in one of these three areas can prevent optimum performance and lead to severe inefficiency. Materials of interest include micro-fiberglass, multilayer insulation, and composite arrangements. Cylindrical liquid nitrogen boil-off calorimetry methods were used. The need for standard thermal conductivity data is addressed through baseline testing. Engineering analysis and design factors such as layer thickness, density, and practicality are also considered.

Updating the OMERACT filter: discrimination and feasibility.

PubMed

Wells, George; Beaton, Dorcas E; Tugwell, Peter; Boers, Maarten; Kirwan, John R; Bingham, Clifton O; Boonen, Annelies; Brooks, Peter; Conaghan, Philip G; D'Agostino, Maria-Antonietta; Dougados, Maxime; Furst, Daniel E; Gossec, Laure; Guillemin, Francis; Helliwell, Philip; Hewlett, Sarah; Kvien, Tore K; Landewé, Robert B; March, Lyn; Mease, Philip J; Ostergaard, Mikkel; Simon, Lee; Singh, Jasvinder A; Strand, Vibeke; van der Heijde, Désirée M

2014-05-01

The "Discrimination" part of the OMERACT Filter asks whether a measure discriminates between situations that are of interest. "Feasibility" in the OMERACT Filter encompasses the practical considerations of using an instrument, including its ease of use, time to complete, monetary costs, and interpretability of the question(s) included in the instrument. Both the Discrimination and Reliability parts of the filter have been helpful but were agreed on primarily by consensus of OMERACT participants rather than through explicit evidence-based guidelines. In Filter 2.0 we wanted to improve this definition and provide specific guidance and advice to participants.

Integration and Test of Shuttle Small Payloads

NASA Technical Reports Server (NTRS)

Wright, Michael R.

2003-01-01

Recommended approaches for space shuttle small payload integration and test (I&T) are presented. The paper is intended for consideration by developers of shuttle small payloads, including I&T managers, project managers, and system engineers. Examples and lessons learned are presented based on the extensive history of NASA's Hitchhiker project. All aspects of I&T are presented, including: (1) I&T team responsibilities, coordination, and communication; (2) Flight hardware handling practices; (3) Documentation and configuration management; (4) I&T considerations for payload development; (5) I&T at the development facility; (6) Prelaunch operations, transfer, orbiter integration and interface testing; (7) Postflight operations. This paper is of special interest to those payload projects that have small budgets and few resources: that is, the truly faster, cheaper, better projects. All shuttle small payload developers are strongly encouraged to apply these guidelines during I&T planning and ground operations to take full advantage of today's limited resources and to help ensure mission success.

The physician as a manager.

PubMed

McDonagh, T J

1982-02-01

The practice of occupational medicine has undergone considerable change over the last decade. Increased awareness of potential health hazards associated with the workplace and its products and wastes, the interest of society and workers in these subjects, and related governmental regulation have resulted in expanded occupational health programs within industry. The occupational physician has become a key company resource in the optimal management of the business impacts of health-related issues. Health-related matters often have noteworthy business implications, and the occupational physician needs to spend considerable time as a manager in the planning, resourcing, implementation, evaluation, and stewardship of programs. Thus he is experiencing greater demands and often is inadequately prepared for this nonclinical, nonscientific role. Therefore, the preparation of occupational physicians to assume such managerial responsibilities needs to receive high priority. The physician must be willing to accept this challenge both to ensure the program's success and to retain a leadership position in occupational health programs.

Tutorial: Parallel Computing of Simulation Models for Risk Analysis.

PubMed

Reilly, Allison C; Staid, Andrea; Gao, Michael; Guikema, Seth D

2016-10-01

Simulation models are widely used in risk analysis to study the effects of uncertainties on outcomes of interest in complex problems. Often, these models are computationally complex and time consuming to run. This latter point may be at odds with time-sensitive evaluations or may limit the number of parameters that are considered. In this article, we give an introductory tutorial focused on parallelizing simulation code to better leverage modern computing hardware, enabling risk analysts to better utilize simulation-based methods for quantifying uncertainty in practice. This article is aimed primarily at risk analysts who use simulation methods but do not yet utilize parallelization to decrease the computational burden of these models. The discussion is focused on conceptual aspects of embarrassingly parallel computer code and software considerations. Two complementary examples are shown using the languages MATLAB and R. A brief discussion of hardware considerations is located in the Appendix. © 2016 Society for Risk Analysis.

Senior academic physicians and retirement considerations.

PubMed

Moss, Arthur J; Greenberg, Henry; Dwyer, Edward M; Klein, Helmut; Ryan, Daniel; Francis, Charles; Marcus, Frank; Eberly, Shirley; Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Gillespie, John; Goldstein, Robert; Haigney, Mark; Krone, Ronald; Lichstein, Edgar; Locati, Emanuela; Oakes, David; Thomsen, Poul Erik Bloch; Zareba, Wojciech

2013-01-01

An increasing number of academic senior physicians are approaching their potential retirement in good health with accumulated clinical and research experience that can be a valuable asset to an academic institution. Considering the need to let the next generation ascend to leadership roles, when and how should a medical career be brought to a close? We explore the roles for academic medical faculty as they move into their senior years and approach various retirement options. The individual and institutional considerations require a frank dialogue among the interested parties to optimize the benefits while minimizing the risks for both. In the United States there is no fixed age for retirement as there is in Europe, but European physicians are initiating changes. What is certain is that careful planning, innovative thinking, and the incorporation of new patterns of medical practice are all part of this complex transition and timing of senior academic physicians into retirement. Copyright © 2013 Elsevier Inc. All rights reserved.

The relevance of globalization to nursing: a concept analysis.

PubMed

Grootjans, J; Newman, S

2013-03-01

This paper emerged alongside the development of learning materials for a new unit of study on global health and nursing. The proposed unit was for inclusion in a graduate entry master of nursing course leading to registration. It became evident that there has been growing attention within the nursing literature to the demands of an increasingly globalized world and the subsequent challenges confronting nursing as a profession. At the same time, the literature is inconsistent and contains mixed messages with regard to how nurses and nursing might respond to these challenges. This paper aims to (i) present the findings of a narrative analysis of the current nursing discourse on globalization, and (ii) to identify directional cohesiveness for the nursing profession in the seemingly disparate literature. Concept analysis following extensive literature review. Several nursing authors argue that nurses globally are increasingly sharing concerns expressed by nurses at a local level. Concerns such as the future sustainability of the profession and more specifically practice concerns such as the continuing failure of nurses to adequately deal with social justice issues requires careful consideration by every nurse. While strategies recommended for dealing with these concerns lack a cohesive thread, some interesting themes and innovative recommendations have emerged. For example, the need for nurses to consider replacing environmental considerations with ecological considerations and that nurses consider preventative nursing practice beyond the immediate needs of clients and from a more global perspective. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

The use of biomarkers in the military: from theory to practice.

PubMed

Yehuda, Rachel; Neylan, Thomas C; Flory, Janine D; McFarlane, Alexander C

2013-09-01

This paper provides a summary of relevant issues covered in the conference, "The Use of Biomarkers in the Military: Theory to Practice" held at the New York Academy of Science on September 14, 2012. The conference covered the state of the science in identification of PTSD biomarkers, including, the definition of different classes of biomarkers pertaining to PTSD. The aim of the satellite conference was to bring together researchers who have been supported by the Department of Defense, Veterans Administration, National Institutes of Health, and other agencies around the world, who are interested in the identification of biomarkers for PTSD risk, diagnosis, symptom severity and treatment response, for a discussion of salient issues regarding biomarker development for PTSD, as well as special considerations for the use of biomarkers in the military. Copyright © 2013. Published by Elsevier Ltd.

Widening the debate about conflict of interest: addressing relationships between journalists and the pharmaceutical industry.

PubMed

Lipworth, Wendy; Kerridge, Ian; Sweet, Melissa; Jordens, Christopher; Bonfiglioli, Catriona; Forsyth, Rowena

2012-08-01

The phone-hacking scandal that led to the closure of the News of the World newspaper in Britain has prompted international debate about media practices and regulation. It is timely to broaden the discussion about journalistic ethics and conduct to include consideration of the impact of media practices upon the population's health. Many commercial organisations cultivate relationships with journalists and news organisations with the aim of influencing the content of health-related news and information communicated through the media. Given the significant influence of the media on the health of individuals and populations, we should be alert to the potential impact of industry-journalist relationships on health care, health policy and public health. The approach taken by the medical profession to its interactions with the pharmaceutical industry provides a useful model for management of industry influence.

The role of socio-technical principles in leveraging meaningful benefits from IT investments.

PubMed

Doherty, Neil F

2014-03-01

In recent years there has been a great deal of academic and practitioner interest in the role of 'benefits realisation management' [BRM] approaches, as a means of proactively leveraging value from IT investments. This growing body of work owes a very considerable, but as yet unacknowledged, debt to the work of Ken Eason, and other early socio-technical theorists. Consequently, the aim of this paper is to demonstrate, using the literature, how many of the principles, practices and techniques of BRM have evolved either directly or indirectly from socio-technical approaches to systems design. In so doing, this article makes a further important contribution to the literature by explicitly identifying the underlying principles and key practices of benefits realisation management. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Best practices for controlled ovarian stimulation in IVF

PubMed Central

Jungheim, Emily S.; Meyer, Melissa; Broughton, Darcy E.

2015-01-01

As applications for IVF have expanded over the years, so too have approaches to controlled ovarian stimulation (COS) for IVF. With this expansion and improved knowledge of basic reproductive biology, there is increasing interest in how COS practice influences IVF outcomes, and whether or not specific treatment scenarios call for personalized approaches to COS. For the majority of women undergoing COS and their treating physicians, the goal is to achieve a healthy live birth through IVF in a fresh cycle. Opinions on how COS strategy best leads to this common goal varies among centers as many clinicians base COS strategy not on evidence obtained through prospective randomized trials, but rather through observational studies and experience. Overall, when it comes to COS most clinicians recognize the approach should not be “one size fits all”, but rather a patient-centered approach that takes the existing evidence into consideration. The pages that follow outline the existing evidence for best practices in COS for IVF highlighting how these practices may be incorporated into a patient-centered approach. PMID:25734345

Technical challenges in designing post-marketing eCRFs to address clinical safety and pharmacovigilance needs.

PubMed

Lu, Zhengwu

2010-01-01

To identify key challenges and propose technical considerations in designing electronic case report form (eCRF) for post-marketing studies, the author undertakes a comprehensive literature review of peer reviewed and grey literature to assess the key aspects, processes, standards, recommendations, and best practices in designing eCRFs based on industry experience in designing and supporting electronic data capture (EDC) studies. Literature search using strings on MEDLINE and PUBMED returned few papers directly related to CRF design. Health informatics and general practice journals were searched and results reviewed. Many conference, government commission, health professional and special interests group websites provide relevant information from practical experience - summarization of this information is presented. Further, we presented a list of concrete technical considerations in dealing with EDC technology/system limitations based on literature assessment and industry implementation experience. It is recognized that cross-functional teams be involved in eCRF design process and decision making. To summarize the keys in designing eCRFs to address post-market study safety and pharmacovigilance needs, the first is to identify required data elements from the study protocol supporting data analyses and reporting requirements. Secondly, accepted best practices, CDASH & CDISC guidelines, and company internal or therapeutic unit standard should be considered and applied. Coding (MedDRA & WHODD) mapping should be managed and implemented as well when possible. Finally, we need to be on top of the EDC technologies, challenge the technologies, drive EDC improvement via working with vendors, and utilize the technologies to drive clinical effectiveness. Copyright (c) 2009 Elsevier Inc. All rights reserved.

Quality assurance and quality improvement in U.S. clinical molecular genetic laboratories.

PubMed

Chen, Bin; Richards, C Sue; Wilson, Jean Amos; Lyon, Elaine

2011-04-01

A robust quality-assurance program is essential for laboratories that perform molecular genetic testing to maintain high-quality testing and be able to address challenges associated with performance or delivery of testing services as the use of molecular genetic tests continues to expand in clinical and public health practice. This unit discusses quality-assurance and quality-improvement considerations that are critical for molecular genetic testing performed for heritable diseases and conditions. Specific discussion is provided on applying regulatory standards and best practices in establishing/verifying test performance, ensuring quality of the total testing process, monitoring and maintaining personnel competency, and continuing quality improvement. The unit provides a practical reference for laboratory professionals to use in recognizing and addressing essential quality-assurance issues in human molecular genetic testing. It should also provide useful information for genetics researchers, trainees, and fellows in human genetics training programs, as well as others who are interested in quality assurance and quality improvement for molecular genetic testing. 2011 by John Wiley & Sons, Inc.

From bad pharma to good pharma: aligning market forces with good and trustworthy practices through accreditation, certification, and rating.

PubMed

Miller, Jennifer E

2013-01-01

This article explores whether the bioethical performance and trustworthiness of pharmaceutical companies can be improved by harnessing market forces through the use of accreditation, certification, or rating. Other industries have used such systems to define best practices, set standards, and assess and signal the quality of services, processes, and products. These systems have also informed decisions in other industries about where to invest, what to buy, where to work, and when to regulate. Similarly, accreditation, certification, and rating programs can help drug companies address stakeholder concerns in four areas: clinical trial design and management, dissemination of clinical trial results, marketing practices, and the accessibility of medicines. To illuminate processes - such as conflicts of interests and revolving-door policies - that can jeopardize the integrity of accreditation, certification, and ratings systems, the article concludes with a consideration of recent failures of credit-rating agencies and a review of the regulatory capture literature. © 2013 American Society of Law, Medicine & Ethics, Inc.

Illusion or delusion--Lean management in the health sector.

PubMed

McIntosh, Bryan; Sheppy, Bruce; Cohen, Ivan

2014-01-01

There has been considerable interest in the implementation of practices imported from manufacturing into healthcare as a solution to rising healthcare spending and disappointing patient safety indicators. One approach that has attracted particular interest is Lean management and the purpose of this paper is to engage with this topic. Secondary research. Despite widespread enthusiasm about the potential of Lean management processes, evidence about its contribution to higher organisational performance remains inconsistent. This paper engages with the major Lean concepts of operations management and human resource management, including just-in-time, total quality management, total productive maintenance and does not engage in-depth with concepts related to employee empowerment, and training This paper contributes to the organisational management literature in healthcare by showing that although Lean management seems to have the potential to improve organisational performance it is far from a panacea against under performing hospitals. It informs policy making by suggesting that a progressive managerial philosophy has a stronger impact on healthcare performance than the adoption of practices from any particular managerial approach. This paper provides a critical evaluation of the impact of Lean practices in informing healthcare policy. The paper contributes to the organisational management literature in healthcare by showing that even though Lean management in healthcare appears to have the potential to improve organisational performance; there remain problems with its application.

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

PubMed Central

2010-01-01

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future. PMID:20529367

Psychiatrists' relationships with industry: the principal-agent problem.

PubMed

Appelbaum, Paul S; Gold, Azgad

2010-01-01

Psychiatrists' relationships with the pharmaceutical and device industries have been a growing focus of attention, with questions raised about the impact of those relationships on prescribing practices, diagnostic criteria, practice guidelines, continuing education, conduct and reporting of research, and patients' and public trust. Indeed, these concerns exist for the medical profession as a whole, with various remedial measures proposed. We suggest that such relationships can be understood as giving rise to a "principal-agent problem," which occurs when an agent (here, a physician) is engaged to advance the interests of another party, the principal (typically a patient), but also faces incentives to promote other interests. Studies suggest that at least some relationships--which include attending industry-sponsored presentations, meeting with marketing representatives, and accepting samples--can alter psychiatrists' and other physicians' behavior in ways that can compromise patients' interests, and that industry-funded research may create bias in the medical literature. These effects are difficult to detect in specific cases, however, because of asymmetries of information and may not be apparent even to physicians themselves. Principal-agent analysis suggests that the possible responses to such problems, including appeals to ethical principles, monitoring behavior, and managing risk-inducing situations, should include consideration of aligning agents' incentives with principals' interests. This type of analysis underscores the similarity of the issues raised by physicians' relationships with industry to problems that arise more generally in society, thus reducing physicians' potential affective responses to these issues and efforts to address them. Finally, such analysis directs attention to the benefits and costs of each alternative, thereby encouraging reliance on evidence as a basis for policy.

Assessing the trend in sustainable remediation: A questionnaire survey of remediation professionals in various countries.

PubMed

Hou, Deyi; Guthrie, Peter; Rigby, Mark

2016-12-15

Over the past decade, sustainable remediation has grown from an emerging concept into a widely accepted new institutional norm. Scholar literature increased exponentially from nearly none in late 1990s to over 400 publications per year in 2014. The present study used a questionnaire survey conducted in 2012 and 2014 to assess the global trend in the awareness and practice of sustainable remediation. A total of 373 responses were received from survey participants located in 22 countries. The survey found that the US and the UK similarly had the highest level of awareness and adoption rate of sustainable remediation. Asia and other developing countries had much lower awareness levels and/or adoption rates. For all regions, the adoption rates were significantly lower than awareness levels, indicating a large gap between awareness and practice. One specific example is regarding minimizing greenhouse gas emission, which is a focal point in sustainable remediation literature, but with very low adoption rate according to this survey. This study also found that the adoption rates of a few sustainable remediation considerations, such as "minimizing local scale secondary impact", "minimizing national to global scale secondary impact", and "bringing prosperity to disadvantaged community", had decreased between 2012 and 2014. On the other hand, the survey also suggests the remediation community has rendered more expertise, training, and resources in sustainable remediation between 2012 and 2014. The mixed results suggest that in order to enhance sustainable remediation adoption, it is imperative to employ continued effort to enhance the understanding of sustainable remediation by practitioners and to link self-interest and public interest with sustainable remediation considerations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Toward Real-Time Infoveillance of Twitter Health Messages.

PubMed

Colditz, Jason B; Chu, Kar-Hai; Emery, Sherry L; Larkin, Chandler R; James, A Everette; Welling, Joel; Primack, Brian A

2018-06-21

There is growing interest in conducting public health research using data from social media. In particular, Twitter "infoveillance" has demonstrated utility across health contexts. However, rigorous and reproducible methodologies for using Twitter data in public health are not yet well articulated, particularly those related to content analysis, which is a highly popular approach. In 2014, we gathered an interdisciplinary team of health science researchers, computer scientists, and methodologists to begin implementing an open-source framework for real-time infoveillance of Twitter health messages (RITHM). Through this process, we documented common challenges and novel solutions to inform future work in real-time Twitter data collection and subsequent human coding. The RITHM framework allows researchers and practitioners to use well-planned and reproducible processes in retrieving, storing, filtering, subsampling, and formatting data for health topics of interest. Further considerations for human coding of Twitter data include coder selection and training, data representation, codebook development and refinement, and monitoring coding accuracy and productivity. We illustrate methodological considerations through practical examples from formative work related to hookah tobacco smoking, and we reference essential methods literature related to understanding and using Twitter data. (Am J Public Health. Published online ahead of print June 21, 2018: e1-e6. doi:10.2105/AJPH.2018.304497).

[The dream, anno 2007].

PubMed

Hebbrecht, M

2007-01-01

The dream has always been of interest to psychiatrists. It can assist with the diagnosis and treatment of psychiatric disorders. To find out whether the dream is regarded as meaningful in modern psychiatry and to discover how dreams can be used by psychiatrists in clinical practice. Initially, psychoanalytic monographs on the subject of dreams were read thoroughly. This is followed by a literature search in PubMed and PEPWeb on the basis of the search terms 'dream', 'dreams' and 'dreaming'. results There has been considerable interest in dreams in the psychiatric literature published in the last few decades. Neuroscientific data seem to confirm Freud's wish-fulfilling theory. The dream plays a role in the consolidation of memory. It seems reasonable that psychopathological diagnosis should take the content of dreams into account. Not only is the dream a fascinating subject for research, it is also useful in the diagnosis and treatment of a number of psychiatric disorders.

Does international family nursing need a professional organization?

PubMed

Curry, Donna Miles

2007-11-01

An International Family Nursing Conference has been held on a periodic basis since the 1980s. It started with several nursing professionals with a common interest: wanting to meet to share research and practice ideas. The organization of these conferences has been completely voluntary and sponsored by some very benevolent individuals and an institution of higher education. The fact that any of these conferences came off is attributed to considerable personal financial support and an untold number of volunteer hours. A group met in 2005 at the 7th International Family Nursing Conference in Victoria, British Columbia, Canada, to discuss whether there was any interest in forming a professional organization for family nursing. This article explores the cost/ benefits of such an endeavor. Input from other small newly created professional nursing organizations is shared. Conclusions provide summative questions related to development of a formal international professional nursing organization that family nurses must address.

Pathology Image-Sharing on Social Media: Recommendations for Protecting Privacy While Motivating Education.

PubMed

Crane, Genevieve M; Gardner, Jerad M

2016-08-01

There is a rising interest in the use of social media by pathologists. However, the use of pathology images on social media has been debated, particularly gross examination, autopsy, and dermatologic condition photographs. The immediacy of the interactions, increased interest from patients and patient groups, and fewer barriers to public discussion raise additional considerations to ensure patient privacy is protected. Yet these very features all add to the power of social media for educating other physicians and the nonmedical public about disease and for creating better understanding of the important role of pathologists in patient care. The professional and societal benefits are overwhelmingly positive, and we believe the potential for harm is minimal provided common sense and routine patient privacy principles are utilized. We lay out ethical and practical guidelines for pathologists who use social media professionally. © 2016 American Medical Association. All Rights Reserved.

Ethical problems in the relationship between health and work.

PubMed

Berlinguer, G; Falzi, G; Figa-Talamanca, I

1996-01-01

Throughout history, the relationship between employers and workers has been subject to the equilibrium of power, to legislative norms, to ethical considerations, and more recently to scientific knowledge. The authors examine the ethical conflicts that arise from the application of scientific knowledge to preventive health policies in the workplace. In particular, they discuss the ethical conflicts in the application of screening practices, in the setting of "allowable limits" of harmful work exposures, and in the right of workers to be informed about work hazards. Ethical problems are also created by conflicting interests in the protection of the environment, the health of the general public, and the health of the working population, and by conflicting interests among workers, and even within the individual worker, as in the case of "fetal protection" policies. The authors emphasize the positive use of scientific information and respect for human dignity in resolving these conflicts.

Genetic Testing and Parkinson Disease: Assessment of Patient Knowledge, Attitudes, and Interest

PubMed Central

Wood, Elisabeth McCarty; Xie, Sharon X.; Siderowf, Andrew; Van Deerlin, Vivianna M.

2012-01-01

The most common genetic contributor to late-onset Parkinson disease (PD) is the LRRK2 gene. In order to effectively integrate LRRK2 genetic testing into clinical practice, a strategy tailored to the PD population must be developed. We assessed 168 individuals with PD for baseline knowledge of genetics, perceived risk, and interest and opinions regarding genetic counseling and testing. Most participants felt that they were familiar with general genetics terms but overall knowledge levels were low, with an average score of 55%. The majority of participants thought it was likely they inherited a PD gene (72%), believed genetic testing for PD would be useful (86%), and were interested in genetic testing (59%) and genetic counseling (56%). However, only a few participants had heard of any genetic tests for PD (29%) or LRRK2 (10%). There appears to be a significant level of interest in genetics and genetic testing within the PD population, but a considerable deficit in genetics knowledge and an over-estimation of risk. Genetic education and counseling tools to address these needs were developed to provide patients with the ability to make informed and knowledgeable genetic testing decisions. PMID:21476119

Engaging patients in primary care practice transformation: theory, evidence and practice.

PubMed

Sharma, Anjana E; Grumbach, Kevin

2017-06-01

Patient engagement is a fundamental strategy for achieving patient centred care and is receiving increasing attention in primary care reform efforts such as the patient-centred medical home and related care models. Much of the prior published theory and evidence supporting patient engagement has focused on improving engagement in individual care. Much less is understood about engaging patients as partners in practice improvement at the primary care clinic or practice level. We review the historical and policy context for the growing interest in the USA and UK in patient engagement at the primary care practice level, highlight findings from systematic reviews of the research evidence on practice-level patient engagement and discuss practical considerations for implementing patient engagement. We conclude that while there are persuasive ethical and social justice reasons for empowering patient involvement in practice improvement at the clinic level, research conducted to date in primary care provides suggestive but not yet resounding evidence in support of the instrumental triple aim benefit of practice-level patient engagement. We propose a research agenda to better understand the process and outcomes of practice-level patient engagement and its potential advantages to both the practice and the patients and communities served. Better evidence as well as resources to support and incentivize effective and feasible engagement methods are needed to catalyse greater diffusion of practice-level patient engagement in primary care practices. © The Author 2016. Published by Oxford University Press.

Increasing medical student interest in general practice in New Zealand: where to from here?

PubMed

Poole, Phillippa; Bourke, David; Shulruf, Boaz

2010-05-28

To meet increasing health demands, increasing the proportion of local graduates entering general practice is imperative. Students entering or exiting The University of Auckland's medical programme from 2006 to 2008 were invited to complete a tracking project survey. Levels of interest in general practice were determined along with characteristics associated with a greater or lesser interest in this career. 712 students replied--a response rate of 80%. At entry, 40% of students had a strong interest in a career in general practice, and at exit, 29% (P =0.003). A quarter at each time point had no interest. The proportion of domestic students born outside NZ or Australia was 160/376 (42.5%). There were significantly higher levels of interest in general practice among females, students born in NZ, and those from outside Auckland--especially rural origin. Flexibility in career was more important to students with a strong interest in general practice than those with no interest. Auckland medical students have levels of interest in general practice comparable with international data. Increasing this interest further may require admission of a greater proportion of students from those groups with higher interest levels, greater emphasis on the positive aspects of general practice, and on GPs as equals to other specialists.

76 FR 78591 - Corporate Reorganizations; Guidance on the Measurement of Continuity of Interest

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-19

... determining whether the target shareholders are fully subject to market appreciation and depreciation, certain... circumstances under which the consideration to be exchanged for the proprietary interests in the target... binding contract provides for fixed consideration, the target corporation shareholders can generally be...

The role (or not) of economic evaluation at the micro level: can Bourdieu's theory provide a way forward for clinical decision-making?

PubMed

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2010-06-01

Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making. Copyright 2010 Elsevier Ltd. All rights reserved.

Novel Biomarkers for Predicting Cardiovascular Disease in Patients With Diabetes.

PubMed

Retnakaran, Ravi

2018-05-01

It is generally acknowledged that patients with diabetes comprise a high-risk population for the development of cardiovascular disease. However, it is perhaps less well recognized that there actually exists considerable heterogeneity in vascular risk within this patient population, with a sizable subset of individuals seemingly at low risk for major cardiovascular events despite the presence of diabetes. Because traditional clinical risk calculators have shown wide variability in their performance in the setting of diabetes, there exists a need for additional risk predictors in this patient population. In this context, there has been considerable interest in the potential utility of circulating biomarkers as clinical tools that might facilitate risk stratification and thereby guide therapeutic and preventative decision-making. Coupled with the current era of dedicated cardiovascular outcome trials in type 2 diabetes, this interest has spawned a growing literature of recent studies that evaluated potential biomarkers. To date, these studies have identified N-terminal pro-B-type natriuretic peptide, high-sensitivity cardiac troponins, and growth differentiation factor-15 as cardiovascular biomarkers of particular potential in patients with diabetes. Furthermore, recognizing the potential benefit of collective consideration of different biomarkers reflecting distinct pathophysiologic processes that might contribute to the development of cardiovascular disease, there is emerging emphasis on the evaluation of combinations of biomarkers for optimal risk prediction. Although not currently ready for clinical practice, this rapidly-growing topic of biomarker research might ultimately facilitate the goal of individualized risk stratification and thereby enable truly personalized management of diabetes. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys.

PubMed

Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

2012-04-01

To report doctors' rejection of specialties as long-term careers and reasons for rejection. Postal questionnaires. United Kingdom. Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.

Theoretical and methodological issues with testing the SCCT and RIASEC models: Comment on Lent, Sheu, and Brown (2010) and Lubinski (2010).

PubMed

Armstrong, Patrick Ian; Vogel, David L

2010-04-01

The current article replies to comments made by Lent, Sheu, and Brown (2010) and Lubinski (2010) regarding the study "Interpreting the Interest-Efficacy Association From a RIASEC Perspective" (Armstrong & Vogel, 2009). The comments made by Lent et al. and Lubinski highlight a number of important theoretical and methodological issues, including the process of defining and differentiating between constructs, the assumptions underlying Holland's (1959, 1997) RIASEC (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional types) model and interrelations among constructs specified in social cognitive career theory (SCCT), the importance of incremental validity for evaluating constructs, and methodological considerations when quantifying interest-efficacy correlations and for comparing models using multivariate statistical methods. On the basis of these comments and previous research on the SCCT and Holland models, we highlight the importance of considering multiple theoretical perspectives in vocational research and practice. Alternative structural models are outlined for examining the role of interests, self-efficacy, learning experiences, outcome expectations, personality, and cognitive abilities in the career choice and development process. PsycINFO Database Record (c) 2010 APA, all rights reserved.

Automatic retinal interest evaluation system (ARIES).

PubMed

Yin, Fengshou; Wong, Damon Wing Kee; Yow, Ai Ping; Lee, Beng Hai; Quan, Ying; Zhang, Zhuo; Gopalakrishnan, Kavitha; Li, Ruoying; Liu, Jiang

2014-01-01

In recent years, there has been increasing interest in the use of automatic computer-based systems for the detection of eye diseases such as glaucoma, age-related macular degeneration and diabetic retinopathy. However, in practice, retinal image quality is a big concern as automatic systems without consideration of degraded image quality will likely generate unreliable results. In this paper, an automatic retinal image quality assessment system (ARIES) is introduced to assess both image quality of the whole image and focal regions of interest. ARIES achieves 99.54% accuracy in distinguishing fundus images from other types of images through a retinal image identification step in a dataset of 35342 images. The system employs high level image quality measures (HIQM) to perform image quality assessment, and achieves areas under curve (AUCs) of 0.958 and 0.987 for whole image and optic disk region respectively in a testing dataset of 370 images. ARIES acts as a form of automatic quality control which ensures good quality images are used for processing, and can also be used to alert operators of poor quality images at the time of acquisition.

Securing Wireless Communications of the Internet of Things from the Physical Layer, An Overview

NASA Astrophysics Data System (ADS)

Zhang, Junqing; Duong, Trung; Woods, Roger; Marshall, Alan

2017-08-01

The security of the Internet of Things (IoT) is receiving considerable interest as the low power constraints and complexity features of many IoT devices are limiting the use of conventional cryptographic techniques. This article provides an overview of recent research efforts on alternative approaches for securing IoT wireless communications at the physical layer, specifically the key topics of key generation and physical layer encryption. These schemes can be implemented and are lightweight, and thus offer practical solutions for providing effective IoT wireless security. Future research to make IoT-based physical layer security more robust and pervasive is also covered.

From stem cell to red blood cells in vitro: "the 12 labors of Hercules".

PubMed

Douay, Luc

2010-06-01

This article describes the research in progress that will permit the large-scale production of human red blood cells from hematopoietic stem cells. It also discusses the current state of this research, suggests the obstacles to be overcome to pass from the laboratory model to clinical practice, and analyzes the possible indications in the medium and long term. The potential interest of pluripotent stem cells as an unlimited source of red blood cells is considered. If it succeeds, this new approach could mark a considerable advance in the field of transfusion. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Career choices of medical students: a national survey of 1780 students.

PubMed

Lefevre, Jérémie H; Roupret, Morgan; Kerneis, Solen; Karila, Laurent

2010-06-01

OBJECTIVES Many factors influence the career specialty decisions made by medical students. The aim of this study was to broaden consideration of the determinants of specialty choice in a large population of medical students in their sixth year of study. METHODS A total of 2588 students distributed across all of the 39 medical schools in France participated in a National Practice Examination in December 2008, after which an electronic questionnaire was administered. Study criteria were: population characteristics; demographics, and motivation for and drawbacks to medical specialty choice. RESULTS A total of 1780 students (1111 women, 62%) responded to the questionnaire (69% response rate). The mean age of respondents was 23.8 years (22-35 years). Of these, 1555 students (87%) stated their preferred medical specialty. Surgical and medical specialties were the two specialties selected most frequently by students (n = 729, 47%). General practice was chosen by 20%. Gender influenced the choice of specialty: 88% of future paediatricians, 82% of gynaecologists and 77% of general practitioners (GPs) were women (p < 0.05). Main motivating factors included interesting diseases, opportunities for private practice and patient contact. Main drawbacks limiting the choice of other specialties were poor quality of life, an exclusively hospital-based career and loss of patient contact. Gender was the criterion most associated with significant differences in factors of motivation for or discouragement from a career. Patient contact and opportunities for private practice were significantly highlighted by future GPs compared with students opting for the medical or surgical specialties (p < 0.0001). CONCLUSIONS Students' career choices regarding specialties or general practice result from the interplay among several factors. Career interest in general practice is particularly low. Initiatives to address the factors affecting student career choices regarding less favoured specialties and to deal with the growing feminisation of the profession, which will lead to irreversible changes in clinical practice, are required.

Knowledge, Attitude, and Practice of Yoga in Medical Students: Assessment of Anthropometry and Lifestyle Factors.

PubMed

Hegde, Shreelaxmi V; Rao, Swathi K; Menezes, Ritesh G; Kotian, Shashidhar M; Shetty, Sowmya

2018-03-29

Medical students often experience significant stress during their undergraduate training. Evidence has shown short-term yoga to be effective in decreasing stress in students. This study aimed to assess knowledge about, attitude toward, and practice of (KAP) yoga among medical students. A secondary objective was to analyze their dietary habits and physical activity. Participants consisted of 224 medical students aged 18-23 years in pre- and paraclinical groups. A closed-ended KAP questionnaire was used to collect data. Anthropometric measurements were taken. Results showed that paraclinical students (70.5%) favorably perceived the health benefits of yoga. Nearly three-fourths of study subjects had previously practiced yoga; greater numbers intended to practice yoga in the future. About 95.5% of the preclinical students who had done yoga had discontinued the practice. Perceived barriers to the practice of yoga were lack of time, insufficient facilities, lack of company, and lack of interest. Consideration of the undergraduates' lifestyle revealed that 50.4% of preclinical students did not exercise, and they routinely consumed more junk food with fewer servings of fresh fruits/salads. Preclinical students exhibited higher BMI and waist circumference compared to paraclinical students. Findings suggest that knowledge of and attitude regarding yoga were good among medical undergraduates.

Lines of Practice: A Practice-Centered Theory of Interest Relationships

ERIC Educational Resources Information Center

Azevedo, Flavio S.

2011-01-01

Based on a three-year-long ethnography of the hobby of model rocketry, I present a practice-centered theory of interest relationships--that is, the pattern of long-term, self-motivated engagement in open-ended practices that has been theorized under the concept of "individual interests". In contrast to extant theories of individual interests, in…

Medical confidentiality versus disclosure: Ethical and legal dilemmas.

PubMed

Agyapong, V I O; Kirrane, R; Bangaru, R

2009-02-01

A case is described of a fifty year old single man who made disclosures about criminal sexual practices during a psychiatric assessment. In common practice with other professional men, a doctor is under a duty not to disclose, without the consent of his patient, information which he has gained in his professional capacity other than in exceptional circumstances. We discuss the ethical and legal considerations surrounding issues of medical confidentiality and the dilemma that sometimes face clinicians, when they feel obliged, in the public interest, to disclose information they have gained in confidence. Breach of confidences can have deleterious consequences; particularly for the doctor-patient relationship, but failure to disclose in some situations could have serious implications for the well-being of the wider society. Doctors should be aware of the basic principles of confidentiality and the ethical and legal framework around which they are built.

Governance and community benefit: are nonprofit hospitals good candidates for Sarbanes-Oxley type reforms?

PubMed

Alexander, Jeffrey A; Young, Gary J; Weiner, Bryan J; Hearld, Larry R

2008-04-01

Recent investigations into the activities of nonprofit hospitals have pointed to weak or lax governance on the part of some of these organizations. As a result of these events, various federal and state initiatives are now either under way or under discussion to strengthen the governance of hospitals and other nonprofit corporations through mandatory board structures and practices. However, despite policy makers' growing interest in these types of governance reforms, there is in fact little empirical evidence to support their contribution to the effectiveness of hospital boards. The purpose of this article is to report the results of a study examining the relationship between the structure and practices of nonprofit hospital boards relative to the hospital's provision of community benefits. Our results point to modest relationships between these sets of variables, suggesting considerable limitations to what federal and state policy makers can accomplish through legislative initiatives to improve the governance of nonprofit hospitals.

The Baby Friendly Hospital Initiative and the ten steps for successful breastfeeding. a critical review of the literature.

PubMed

Gomez-Pomar, Enrique; Blubaugh, Robert

2018-02-07

There is no doubt regarding the multiple benefits of breastfeeding for infants and society in general. Therefore, the World Health Organization (WHO) in a conjoint effort with United Nations International Children's Emergency Fund (UNICEF) developed the "Ten Steps to Successful Breastfeeding" in 1992, which became the backbone of the Baby Friendly Hospital Initiative (BFHI). Following this development, many hospitals and countries intensified their position towards creating a "breastfeeding oriented" practice. Over the past two decades, the interest increased in the BFHI and the Ten Steps. However, alongside the implementation of the initiative, extensive research continues to evaluate the benefits and dangers of the suggested practices. Hence, it is our intention to make a critical evaluation of the current BFHI and the Ten Steps recommendations in consideration of the importance of providing an evidence-based breastfeeding supported environment for our mothers and infants.

Modeling individual effects in the Cormack-Jolly-Seber Model: A state-space formulation

USGS Publications Warehouse

Royle, J. Andrew

2008-01-01

In population and evolutionary biology, there exists considerable interest in individual heterogeneity in parameters of demographic models for open populations. However, flexible and practical solutions to the development of such models have proven to be elusive. In this article, I provide a state-space formulation of open population capture-recapture models with individual effects. The state-space formulation provides a generic and flexible framework for modeling and inference in models with individual effects, and it yields a practical means of estimation in these complex problems via contemporary methods of Markov chain Monte Carlo. A straightforward implementation can be achieved in the software package WinBUGS. I provide an analysis of a simple model with constant parameter detection and survival probability parameters. A second example is based on data from a 7-year study of European dippers, in which a model with year and individual effects is fitted.

Protein stability: a crystallographer’s perspective

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

Deller, Marc C., E-mail: mdeller@stanford.edu; Kong, Leopold; Rupp, Bernhard

An understanding of protein stability is essential for optimizing the expression, purification and crystallization of proteins. In this review, discussion will focus on factors affecting protein stability on a somewhat practical level, particularly from the view of a protein crystallographer. Protein stability is a topic of major interest for the biotechnology, pharmaceutical and food industries, in addition to being a daily consideration for academic researchers studying proteins. An understanding of protein stability is essential for optimizing the expression, purification, formulation, storage and structural studies of proteins. In this review, discussion will focus on factors affecting protein stability, on a somewhatmore » practical level, particularly from the view of a protein crystallographer. The differences between protein conformational stability and protein compositional stability will be discussed, along with a brief introduction to key methods useful for analyzing protein stability. Finally, tactics for addressing protein-stability issues during protein expression, purification and crystallization will be discussed.« less

The future of optometric practice? The results of a survey of optometrists and optometry students.

PubMed

Silverman, Morton W; Woodruff, Chris; Hardigan, Patrick C

2004-10-01

There is an apparent increase in the number of private optometry practices that are closing due to a lack of interested buyers. We examined some of the factors that influence the market for optometry practices in a survey of practicing optometrists and third- and fourth-year optometry students. Optometrists in six states, and students at four schools and colleges of optometry, completed a mailed or faxed survey regarding attitudes toward optometric practice, including fair/reasonable compensation for a new optometrist, the value of optometric practices, and preferred mode of practice on graduation. Doctors and students differed significantly in the amount of money they reported as fair/reasonable compensation for a recently graduated optometrist joining a practice. Comparing students to doctors in specific categories of compensation, students chose a higher fair/reasonable compensation compared to doctors. Students were more likely than doctors to choose >$70,000 as fair/reasonable compensation, while doctors were more likely than students to choose $40,000 to $69,000. Doctors tended to overvalue their practices for the purpose of selling the practice when using percentage of gross income as a valuation method. Students' choices for mode of practice changed dramatically from their ideal when taking their current financial situation into consideration. Students were more likely to choose corporate practice as their preferred practice mode when considering their current financial situation than when not restricted. There are many factors that affect the value and marketability of an optometric practice. In order to sell a practice, the owner must consider the effects of the needs and desires of recently graduated optometrists.

Effectiveness of capacity building interventions relevant to public health practice: a systematic review.

PubMed

DeCorby-Watson, Kara; Mensah, Gloria; Bergeron, Kim; Abdi, Samiya; Rempel, Benjamin; Manson, Heather

2018-06-01

This systematic review assessed the effectiveness of capacity building interventions relevant to public health practice. The aim is to inform and improve capacity building interventions. Four strategies were used: 1) electronic database searching; 2) reference lists of included papers; 3) key informant consultation; and 4) grey literature searching. Inclusion (e.g., published in English) and exclusion criteria (e.g., non-English language papers published earlier than 2005) are outlined with included papers focusing on capacity building, learning plans, or professional development plans within public health and related settings, such as non-governmental organizations, government, or community-based organizations relating to public health or healthcare. Outcomes of interest included changes in knowledge, skill or confidence (self-efficacy), changes in practice (application or intent), and perceived support or supportive environments, with outcomes reported at the individual, organizational or systems level(s). Quality assessment of all included papers was completed. Fourteen papers were included in this review. These papers reported on six intervention types: 1) internet-based instruction, 2) training and workshops, 3) technical assistance, 4) education using self-directed learning, 5) communities of practice, and 6) multi-strategy interventions. The available literature showed improvements in one or more capacity-building outcomes of interest, mainly in terms of individual-level outcomes. The available literature was moderate in quality and showed a range of methodological issues. There is evidence to inform capacity building programming and how interventions can be selected to optimize impact. Organizations should carefully consider methods for analysis of capacity building interventions offered; specifically, through which mechanisms, to whom, and for which purpose. Capacity-building interventions can enhance knowledge, skill, self-efficacy (including confidence), changes in practice or policies, behaviour change, application, and system-level capacity. However in applying available evidence, organizations should consider the outcomes of highest priority, selecting intervention(s) effective for the outcome(s) of interest. Examples are given for selecting intervention(s) to match priorities and context, knowing effectiveness evidence is only one consideration in decision making. Future evaluations should: extend beyond the individual level, assess outcomes at organizational and systems levels, include objective measures of effect, assess baseline conditions, and evaluate features most critical to the success of interventions.

Exploring policy makers' perspectives on a clinical controversy: airway surgery for adult obstructive sleep apnoea.

PubMed

Elshaug, A G; Hiller, J E; Moss, J R

2009-10-01

Worldwide, there is increasing focus on measures to reduce ineffective healthcare practices. Upper airway surgeries for the treatment of adult obstructive sleep apnoea (OSA) represent a case-study in this area, given recent publications that draw into question their efficacy. Policy stakeholders were canvassed to assess their perspectives on this. Senior health policy stakeholders from Australia were criterion and snowball sampled (to identify opinion leaders). Participants were presented with preparatory material and took part in individual semistructured interviews. These focused on eliciting responses to recently published evidence and a relevant Cochrane review. Questions were posed relating to clinical effectiveness and associated policy implications. Interviews were taped and transcribed for thematic analysis. Participant comments were de-identified. Ten stakeholders were interviewed before saturation was reached. Thematic analysis highlighted participant concern with the diversity of procedures on offer, coupled with limited effectiveness (suggesting potential clinical uncertainty) and considerations therefore of resource allocation (potential opportunity cost). Stakeholders seem aware of the methodological complexities, the ethical issues raised and the role of patients in considerations regarding appropriateness. Finally, policy stakeholders acknowledge that these procedures appear appropriate only for a minority, with consensus that policy level restrictions to government funding for these procedures may be warranted. This report highlights that this clinical controversy is of interest and relevance from a policy perspective with lessons and potential implications for clinical practice. It further highlights the need for clinical consensus on definitions of surgical "success" in treating this condition, as this forms an important pretext to policy considerations.

Adaptive trial designs: a review of barriers and opportunities

PubMed Central

2012-01-01

Adaptive designs allow planned modifications based on data accumulating within a study. The promise of greater flexibility and efficiency stimulates increasing interest in adaptive designs from clinical, academic, and regulatory parties. When adaptive designs are used properly, efficiencies can include a smaller sample size, a more efficient treatment development process, and an increased chance of correctly answering the clinical question of interest. However, improper adaptations can lead to biased studies. A broad definition of adaptive designs allows for countless variations, which creates confusion as to the statistical validity and practical feasibility of many designs. Determining properties of a particular adaptive design requires careful consideration of the scientific context and statistical assumptions. We first review several adaptive designs that garner the most current interest. We focus on the design principles and research issues that lead to particular designs being appealing or unappealing in particular applications. We separately discuss exploratory and confirmatory stage designs in order to account for the differences in regulatory concerns. We include adaptive seamless designs, which combine stages in a unified approach. We also highlight a number of applied areas, such as comparative effectiveness research, that would benefit from the use of adaptive designs. Finally, we describe a number of current barriers and provide initial suggestions for overcoming them in order to promote wider use of appropriate adaptive designs. Given the breadth of the coverage all mathematical and most implementation details are omitted for the sake of brevity. However, the interested reader will find that we provide current references to focused reviews and original theoretical sources which lead to details of the current state of the art in theory and practice. PMID:22917111

Blood transfusion at the time of the First World War--practice and promise at the birth of transfusion medicine.

PubMed

Boulton, F; Roberts, D J

2014-12-01

The centenary of the start of the First World War has stirred considerable interest in the political, social, military and human factors of the time and how they interacted to produce and sustain the material and human destruction in the 4 years of the war and beyond. Medical practice may appear distant and static and perhaps seems to have been somewhat ineffectual in the face of so much trauma and in the light of the enormous advances in medicine and surgery over the last century. However, this is an illusion of time and of course medical, surgical and psychiatric knowledge and procedures were developing rapidly at the time and the war years accelerated implementation of many important advances. Transfusion practice lay at the heart of resuscitation, and although direct transfusion from donor to recipient was still used, Geoffrey Keynes from Britain, Oswald Robertson from America and his namesake Lawrence Bruce Robertson from Canada, developed methods for indirect transfusion from donor to recipient by storing blood in bottles and also blood-banking that laid the foundation of modern transfusion medicine. This review explores the historical setting behind the development of blood transfusion up to the start of the First World War and on how they progressed during the war and afterwards. A fresh look may renew interest in how a novel medical speciality responded to the needs of war and of post-war society. © 2015 British Blood Transfusion Society.

[Current issues in legal cases of compensation for healthcare malpractice].

PubMed

Heiner, Tamás; Barzó, Tímea

2014-09-21

The number of medical malpractice lawsuits filed each year in Hungary has considerably increased since 1990. The judicial decisions and practices on determining and awarding wrongful damages recoverable for medical malpractices in the Hungarian civil law have been developing for decades. In the meantime, a new Hungarian Civil Code (Act V of 2013) has entered into force, which among others, necessitates the revaluation of assessment of damages recoverable for medical malpractices. There are two main areas where fundamental changes have been introduced, which may significantly affect the outcome of medical malpractice lawsuits in the future. In the early stage of medical malpractices it was unclear whether the courts had to consider either the contractual relationship between patients and healthcare providers (contractual liability) or general codal articles on damages arising from non-contractual liability/torts (delictual liability) in their judgement delivered in the cases. Both the theoretical and practical experience of the last ten years shows that healthcare services agreements are concluded between healthcare providers and patients with the aim and intention to provide appropriate professional healthcare services to patients, which meet patients' interests and wishes. The medical service is violated if it fails to meet patients' interests and wishes as well as the objectives of the agreement. Since the new legislation implies a stricter liability for damages in the case of breach of contract and stricter rules for exempting the party in breach from compensation obligations, the opportunities to exempt healthcare providers from these obligations have become limited compared to previous regulations. This modification, which was aimed at further integrating the established judicial practices into legislation, stipulates the application of the rules for liability for damages resulting from medical malpractice in non-contractual situations. This paper analyses dogmatic and practical problems related to this topic. Another important area of current analysis is the institution of injury fees, which replaced the reimbursement of non-pecuniary damages. The mere fact of infringement allows setting injury fees. Taking into consideration the current resources in staff and equipment available in healthcare, this regulation may promote claims for injury fees impartial. Consequently, courts will have to apply other criteria when judgment in 'trivial cases', which might not require legal assessment, is delivered.

Integration and Test for Small Shuttle Payloads

NASA Technical Reports Server (NTRS)

Wright, Michael R.; Day, John H. (Technical Monitor)

2001-01-01

Recommended approaches for shuttle small payload integration and test (I&T) are presented. The paper is intended for consideration by developers of small shuttle payloads, including I&T managers, project managers, and system engineers. Examples and lessons learned are presented based on the extensive history of the NASA's Hitchhiker project. All aspects of I&T are presented, including: (1) I&T team responsibilities, coordination, and communication; (2) Flight hardware handling practices; (3) Documentation and configuration management; (4) I&T considerations for payload development; (5) I&T at the development facility; (6) Prelaunch operations, transfer, orbiter integration, and interface testing; and (7) Postflight operations. This paper is of special interest to those payload projects which have small budgets and few resources: That is, the truly 'faster, cheaper, better' projects. All shuttle small payload developers are strongly encouraged to apply these guidelines during I&T planning and ground operations to take full advantage of today's limited resources and to help ensure mission success.

Ethical considerations of teaching spirituality in the academy.

PubMed

Becker, Annette L

2009-11-01

Despite evidence in college students indicating a hunger for spiritual insight and spirituality's application in health care, there continues to be guardedness within the academy towards inclusion of curricula that address spirituality. The purpose of this article is to examine the ethical considerations of teaching spirituality in the academy by describing current trends, issues relevant to nursing education and practice, legitimate concerns of the academy, and the importance of an ethical instructional response when teaching about spirituality. Data supporting the interest and desire by students to explore meaning and purpose in the context of spirituality will be presented. Challenges and barriers inherent in teaching this topic will be described, including the affective response, the lack of a universally accepted definition of spirituality, and spirituality's relationship to religion. Pedagogical strategies consistent with an ethical instructional response will be discussed as the key to eliciting trust within the academy. A model of teaching spirituality and health will be offered to illustrate these possibilities.

High-speed architecture for the decoding of trellis-coded modulation

NASA Technical Reports Server (NTRS)

Osborne, William P.

1992-01-01

Since 1971, when the Viterbi Algorithm was introduced as the optimal method of decoding convolutional codes, improvements in circuit technology, especially VLSI, have steadily increased its speed and practicality. Trellis-Coded Modulation (TCM) combines convolutional coding with higher level modulation (non-binary source alphabet) to provide forward error correction and spectral efficiency. For binary codes, the current stare-of-the-art is a 64-state Viterbi decoder on a single CMOS chip, operating at a data rate of 25 Mbps. Recently, there has been an interest in increasing the speed of the Viterbi Algorithm by improving the decoder architecture, or by reducing the algorithm itself. Designs employing new architectural techniques are now in existence, however these techniques are currently applied to simpler binary codes, not to TCM. The purpose of this report is to discuss TCM architectural considerations in general, and to present the design, at the logic gate level, or a specific TCM decoder which applies these considerations to achieve high-speed decoding.

Policy considerations for improving influenza vaccination rates among pregnant women.

PubMed

Mollard, Elizabeth K; Guenzel, Nicholas; Brown, Peggy A; Keeler, Heidi J; Cramer, Mary E

2014-01-01

Influenza exposure during pregnancy can cause severe health problems for both the mother and her offspring, including an increased risk of mortality. Influenza vaccination during all trimesters of pregnancy is safe and effective, and recommended by professional organizations such as the American College of Obstetrics and Gynecology. Despite these recommendations, the U.S. vaccination rates remain low in this high-risk population. A policy analysis based on the five-part method identified by Teitelbaum and Wilensky () addresses factors to consider in identifying the best voluntary policy options to improve the vaccination rates. The authors provide discussion of the background, landscape, and stakeholder interests and the pros and cons of two voluntary policy options to increase vaccination. The policy options include: (a) financial incentives for providers and (b) an education emphasis for providers and staff. The authors conclude that based on considerations of cost, provider preference, and practicality of implementation, a continuing educational intervention is the preferred policy venue to increase vaccination rates. © 2014 Wiley Periodicals, Inc.

Toward a Safety Risk-Based Classification of Unmanned Aircraft

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2016-01-01

There is a trend of growing interest and demand for greater access of unmanned aircraft (UA) to the National Airspace System (NAS) as the ongoing development of UA technology has created the potential for significant economic benefits. However, the lack of a comprehensive and efficient UA regulatory framework has constrained the number and kinds of UA operations that can be performed. This report presents initial results of a study aimed at defining a safety-risk-based UA classification as a plausible basis for a regulatory framework for UA operating in the NAS. Much of the study up to this point has been at a conceptual high level. The report includes a survey of contextual topics, analysis of safety risk considerations, and initial recommendations for a risk-based approach to safe UA operations in the NAS. The next phase of the study will develop and leverage deeper clarity and insight into practical engineering and regulatory considerations for ensuring that UA operations have an acceptable level of safety.

The Medawar Lecture 2004 The truth about science

PubMed Central

Lipton, Peter

2005-01-01

The attitudes of scientists towards the philosophy of science is mixed and includes considerable indifference and some hostility. This may be due in part to unrealistic expectation and to misunderstanding. Philosophy is unlikely directly to improve scientific practices, but scientists may find the attempt to explain how science works and what it achieves of considerable interest nevertheless. The present state of the philosophy of science is illustrated by recent work on the ‘truth hypothesis’, according to which, science is generating increasingly accurate representations of a mind-independent and largely unobservable world. According to Karl Popper, although truth is the aim of science, it is impossible to justify the truth hypothesis. According to Thomas Kuhn, the truth hypothesis is false, because scientists can only describe a world that is partially constituted by their own theories and hence not mind-independent. The failure of past scientific theories has been used to argue against the truth hypothesis; the success of the best current theories has been used to argue for it. Neither argument is sound. PMID:16147521

[Nutrition or industry. Experiences with nutritional considerations in the agricultural policy].

PubMed

Botten, G

1991-06-30

The need to export health considerations to various sector policies is regarded as important in health promotion. Health is generally a highly appreciated benefit; thus many sectors seek to use health as an argument for their policy. This article describes the relation between nutrition and agricultural policy in Norway. In areas where nutrition and agriculture had mutual interests, health considerations were easily exported. However, when interests diverged the issue became more complicated. Much effort was focused upon achieving correct use of nutritional arguments. Before negotiating and weighing respective viewpoints it is essential to clarify each sector's standpoint and interest. Conflicts and negotiations are linked to strategies which seek explicitly to integrate health premisses into sectors outside the health services itself.

ELSI practices in genomic research in East Asia: implications for research collaboration and public participation

PubMed Central

2014-01-01

Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the ‘ELSI 2.0’ initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries. PMID:24944586

[Marketing in veterinary practice; a theoretical framework].

PubMed

Schuurmans, A J; Smidts, A

1990-03-15

An increase in the number of veterinarians, while at the same time the number of animals has remained constant, has resulted in growing competition. By extending the range of products and by enlarging the veterinarians' scope of activities this competition can be decreased. A marketing-orientation will be helpful in this respect. This article indicates in which way marketing concepts can be used in a veterinary practice. The services of the veterinarian will be looked at by means of the Abell approach. This focuses on the functions performed by the services and examines, per function performed, for whom this might be interesting and which alternatives there might be. Next the concept of market segmentation is filled in for a veterinary practice by means of a hypothetical example. The marketing mix (product, place, price, promotion and personnel) is given considerable attention. The last element of marketing in a veterinary practice that is discussed here is the marketing information system. In a next article the question will be answered how marketing-directed the Dutch veterinarian works nowadays. To find this out research has been done; 166 vets were interviewed by telephone for approximately 40 minutes each.

Clinician Telephone Training to Reduce Family Tobacco Use: Analysis of Transcribed Recordings

PubMed Central

Walters, Bethany Hipple; Ossip, Deborah J.; Drehmer, Jeremy E.; Nabi-Burza, Emara; Whitmore, Regina; Gorzkowski, Julie; Winickoff, Jonathan P.

2018-01-01

Background Family tobacco use and exposure are significant threats to the health of children and their families. However, few pediatric clinicians address family tobacco use and exposure in a routine and effective manner. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention was developed to tackle this gap between clinical need and clinical practice. Objective To review the main considerations and questions that clinicians and office staff expressed during telephone training to participate in CEASE. Methods This study was conducted in pediatric practices in 5 US states. Practices were recruited by the American Academy of Pediatrics (10 intervention, 10 control). Ten training calls were recorded and transcribed. The data was then coded inductively based on themes found in the transcripts. Results The data revealed that clinicians and staff were concerned about prescribing, dosing, and insurance coverage of nicotine replacement therapy; motivation for and methods to help families become tobacco-free; and the impact of the intervention on practice operations. Conclusion While the majority of clinicians and office staff were interested and enthusiastic about helping families become tobacco-free, they expressed concerns that could threaten implementation of family tobacco control strategies. PMID:29497272

A reliability-based maintenance technicians' workloads optimisation model with stochastic consideration

NASA Astrophysics Data System (ADS)

Ighravwe, D. E.; Oke, S. A.; Adebiyi, K. A.

2016-06-01

The growing interest in technicians' workloads research is probably associated with the recent surge in competition. This was prompted by unprecedented technological development that triggers changes in customer tastes and preferences for industrial goods. In a quest for business improvement, this worldwide intense competition in industries has stimulated theories and practical frameworks that seek to optimise performance in workplaces. In line with this drive, the present paper proposes an optimisation model which considers technicians' reliability that complements factory information obtained. The information used emerged from technicians' productivity and earned-values using the concept of multi-objective modelling approach. Since technicians are expected to carry out routine and stochastic maintenance work, we consider these workloads as constraints. The influence of training, fatigue and experiential knowledge of technicians on workload management was considered. These workloads were combined with maintenance policy in optimising reliability, productivity and earned-values using the goal programming approach. Practical datasets were utilised in studying the applicability of the proposed model in practice. It was observed that our model was able to generate information that practicing maintenance engineers can apply in making more informed decisions on technicians' management.

Transmission loss of double panels filled with porogranular materials.

PubMed

Chazot, Jean-Daniel; Guyader, Jean-Louis

2009-12-01

Sound transmission through hollow structures found its interest in several industrial domains such as building acoustics, automotive industry, and aeronautics. However, in practice, hollow structures are often filled with porous materials to improve acoustic properties without adding an excessive mass. Recently a lot of interest arises for granular materials of low density that can be an alternative to standard absorbing materials. This paper aims to predict vibro-acoustic behavior of double panels filled with porogranular materials by using the patch-mobility method recently published. Biot's theory is a basic tool for the description of porous material but is quite difficult to use in practice, mostly because of the solid phase characterization. The original simplified Biot's model (fluid-fluid model) for porogranular material permitting a considerable reduction in data necessary for calculation has been recently published. The aim of the present paper is to propose a model to predict sound transmission through a double panel filled with a porogranular material. The method is an extension of a previous paper to take into account the porogranular material through fluid-fluid Biot's model. After a global overview of the method, the case of a double panel filled with expanded polystyrene beads is studied and a comparison with measurements is realized.

Practical Considerations Informing Teachers' Technology Integration Decisions: The Case of Tablet PCs

ERIC Educational Resources Information Center

Pareja Roblin, Natalie; Tondeur, Jo; Voogt, Joke; Bruggeman, Bram; Mathieu, Griet; van Braak, Johan

2018-01-01

The unique characteristics of tablet PCs promise important benefits for education. Yet, little is known about the rationale underlying teachers' decisions concerning their educational uses within the constraints of daily classroom practice. The current multiple case study investigated the practical considerations informing nine secondary school…

Toxic red tides and harmful algal blooms: A practical challenge in coastal oceanography

NASA Astrophysics Data System (ADS)

Anderson, Donald M.

1995-07-01

The debate over the relative value of practical or applied versus fundamental research has heated up considerably in recent years, and oceanography has not been spared this re-evaluation of science funding policy. Some federal agencies with marine interests have always focused their resources on practical problems, but those with a traditional commitment to basic research such as the National Science Foundation have increasingly had to fight to maintain their freedom to fund quality science without regard to practical or commercial applications. Within this context, it is instructive to highlight the extent to which certain scientific programs can satisfy both sides of this policy dilemma—i.e. address important societal issues through advances in fundamental or basic research. One clear oceanographic example of such a program involves the phenomena called "red tides" or "harmful algal blooms". This paper describes the nature and extent of the problems caused by these outbreaks, emphasizing the alarming expansion in their incidence and their impacts in recent years, both in the U.S. and worldwide. The objective is to highlight fundamental physical, biological, and chemical oceanographic question that must be addressed if we are to achieve the practical goal of scientifically based management of fisheries resources, public health, and ecosystem health in regions threatened by toxic and harmful algae.

Best Practices for Siting Solar Photovoltaics on Municipal Solid Waste Landfills. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

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

Kiatreungwattana, K.; Mosey, G.; Jones-Johnson, S.

2013-04-01

The Environmental Protection Agency and the National Renewable Energy Laboratory developed this best practices document to address common technical challenges for siting solar photovoltaics (PV) on municipal solid waste (MSW) landfills. The purpose of this document is to promote the use of MSW landfills for solar energy systems. Closed landfills and portions of active landfills with closed cells represent thousands of acres of property that may be suitable for siting solar photovoltaics (PV). These closed landfills may be suitable for near-term construction, making these sites strong candidate to take advantage of the 30% Federal Business Energy Investment Tax Credit. Itmore » was prepared in response to the increasing interest in siting renewable energy on landfills from solar developers; landfill owners; and federal, state, and local governments. It contains examples of solar PV projects on landfills and technical considerations and best practices that were gathered from examining the implementation of several of these projects.« less

Opportunities and methodological challenges in EEG and MEG resting state functional brain network research.

PubMed

van Diessen, E; Numan, T; van Dellen, E; van der Kooi, A W; Boersma, M; Hofman, D; van Lutterveld, R; van Dijk, B W; van Straaten, E C W; Hillebrand, A; Stam, C J

2015-08-01

Electroencephalogram (EEG) and magnetoencephalogram (MEG) recordings during resting state are increasingly used to study functional connectivity and network topology. Moreover, the number of different analysis approaches is expanding along with the rising interest in this research area. The comparison between studies can therefore be challenging and discussion is needed to underscore methodological opportunities and pitfalls in functional connectivity and network studies. In this overview we discuss methodological considerations throughout the analysis pipeline of recording and analyzing resting state EEG and MEG data, with a focus on functional connectivity and network analysis. We summarize current common practices with their advantages and disadvantages; provide practical tips, and suggestions for future research. Finally, we discuss how methodological choices in resting state research can affect the construction of functional networks. When taking advantage of current best practices and avoid the most obvious pitfalls, functional connectivity and network studies can be improved and enable a more accurate interpretation and comparison between studies. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

The development, evolution, and status of Holland's theory of vocational personalities: Reflections and future directions for counseling psychology.

PubMed

Nauta, Margaret M

2010-01-01

This article celebrates the 50th anniversary of the introduction of John L. Holland's (1959) theory of vocational personalities and work environments by describing the theory's development and evolution, its instrumentation, and its current status. Hallmarks of Holland's theory are its empirical testability and its user-friendliness. By constructing measures for operationalizing the theory's constructs, Holland and his colleagues helped ensure that the theory could be implemented in practice on a widespread basis. Empirical data offer considerable support for the existence of Holland's RIASEC types and their ordering among persons and environments. Although Holland's congruence hypotheses have received empirical support, congruence appears to have modest predictive power. Mixed support exists for Holland's hypotheses involving the secondary constructs of differentiation, consistency, and vocational identity. Evidence of the continued impact of Holland's theory on the field of counseling psychology, particularly in the area of interest assessment, can be seen from its frequent implementation in practice and its use by scholars. Ideas for future research and practice using Holland's theory are suggested.

Flow/Soot-Formation Interactions in Nonbuoyant Laminar Diffusion Flames

NASA Technical Reports Server (NTRS)

Dai, Z.; Faeth, G. M.

1999-01-01

Nonpremixed (diffusion) flames are attractive for practical applications because they avoid the stability, autoignition, flashback, etc. problems of premixed flames. Unfortunately, soot formation in practical hydrocarbon-fueled diffusion flames reduces their attractiveness due to widely-recognized public health and combustor durability problems of soot emissions. For example, more deaths are attributed to the emission of soot (15,000-60,000 deaths annually in the U.S. alone) than any other combustion-generated pollutant. In addition, continuum radiation from soot-containing flames is the principle heat load to combustor components and is mainly responsible for engine durability problems of aircraft and gas turbine engines. As a result, there is considerable interest in controlling both soot concentrations within flames and soot emissions from flames. Thus, the objective of the present investigation is to study ways to control soot formation in diffusion flames by manipulating the mixing process between the fuel and oxidant streams. In order to prevent the intrusion of gravity from masking flow properties that reduce soot formation in practical flames (where effects of gravity are small), methods developed during past work will be exploited to minimize effects of buoyant motion.

Medicine, 1450-1620, and the history of science.

PubMed

Siraisi, Nancy G

2012-09-01

History of science and history of medicine are today largely organized as distinct disciplines, though ones widely recognized as interrelated. Attempts to evaluate the extent and nature of their relation have reached varying conclusions, depending in part on the historical period under consideration. This essay examines some characteristics of European medicine from the fifteenth to the early seventeenth century and considers their relevance for the history of science. Attention is given to the range of interests and activities of individuals trained in or practicing medicine, to the impact of changes in natural philosophy, to the role of observation, description, and accumulation of information, and to the exchange of knowledge among the medical community.

Protein stability: a crystallographer’s perspective

PubMed Central

Deller, Marc C.; Kong, Leopold; Rupp, Bernhard

2016-01-01

Protein stability is a topic of major interest for the biotechnology, pharmaceutical and food industries, in addition to being a daily consideration for academic researchers studying proteins. An understanding of protein stability is essential for optimizing the expression, purification, formulation, storage and structural studies of proteins. In this review, discussion will focus on factors affecting protein stability, on a somewhat practical level, particularly from the view of a protein crystallographer. The differences between protein conformational stability and protein compositional stability will be discussed, along with a brief introduction to key methods useful for analyzing protein stability. Finally, tactics for addressing protein-stability issues during protein expression, purification and crystallization will be discussed. PMID:26841758

The Current State and Path Forward For Enterprise Image Viewing: HIMSS-SIIM Collaborative White Paper.

PubMed

Roth, Christopher J; Lannum, Louis M; Dennison, Donald K; Towbin, Alexander J

2016-10-01

Clinical specialties have widely varied needs for diagnostic image interpretation, and clinical image and video image consumption. Enterprise viewers are being deployed as part of electronic health record implementations to present the broad spectrum of clinical imaging and multimedia content created in routine medical practice today. This white paper will describe the enterprise viewer use cases, drivers of recent growth, technical considerations, functionality differences between enterprise and specialty viewers, and likely future states. This white paper is aimed at CMIOs and CIOs interested in optimizing the image-enablement of their electronic health record or those who may be struggling with the many clinical image viewers their enterprises may employ today.

Civil society? What deliberative democrats can tell advocates about how to build public commitment to the health promotion agenda.

PubMed

Evoy, Brian E; McDonald, Michael; Frankish, C James

2008-01-01

Closing the health inequity gap can be seen as an issue of justice, however what concretely best serves the interest of justice is in dispute. It is argued that standard policy-making mechanisms are inadequate to address this issue, and therefore more and better public dialogue is required. Drawing on deliberative democratic theory and practice, three public organizing considerations are offered: organizing within the state sphere, organizing within the public sphere, and using cross strategies. It is recommended that public resources be provided to involve the public in deliberations about population health promotion issues related to the wicked problem of health inequities.

Mechanics of ultrasound elastography

PubMed Central

Li, Guo-Yang

2017-01-01

Ultrasound elastography enables in vivo measurement of the mechanical properties of living soft tissues in a non-destructive and non-invasive manner and has attracted considerable interest for clinical use in recent years. Continuum mechanics plays an essential role in understanding and improving ultrasound-based elastography methods and is the main focus of this review. In particular, the mechanics theories involved in both static and dynamic elastography methods are surveyed. They may help understand the challenges in and opportunities for the practical applications of various ultrasound elastography methods to characterize the linear elastic, viscoelastic, anisotropic elastic and hyperelastic properties of both bulk and thin-walled soft materials, especially the in vivo characterization of biological soft tissues. PMID:28413350

Theoretical and practical considerations for the development of online international collaborative learning for dental hygiene students.

PubMed

Gussy, M G; Knevel, R J M; Sigurdson, V; Karlberg, G

2006-08-01

Globalization and concurrent development in computer and communication technology has increased interest in collaborative online teaching and learning for students in higher education institutions. Many institutions and teachers have introduced computer-supported programmes in areas including dental hygiene. The potential for the use of this technology is exciting; however, its introduction should be careful and considered. We suggest that educators wanting to introduce computer-supported programmes make explicit their pedagogical principles and then select technologies that support and exploit these principles. This paper describes this process as it was applied to the development of an international web-based collaborative learning programme for dental hygiene students.

Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys

PubMed Central

Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

2012-01-01

Objectives To report doctors' rejection of specialties as long-term careers and reasons for rejection. Design Postal questionnaires. Setting United Kingdom. Participants Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Main outcome measures Current specialty choice; any choice that had been seriously considered but not pursued (termed ‘rejected’ choices) with reasons for rejection. Results 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of ‘job content’ was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. Conclusions There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes. PMID:22532656

Chemically frozen multicomponent boundary layer theory of salt and/or ash deposition rates from combustion gases

NASA Technical Reports Server (NTRS)

Rosner, D. E.; Chen, B.-K.; Fryburg, G. C.; Kohl, F. J.

1979-01-01

There is increased interest in, and concern about, deposition and corrosion phenomena in combustion systems containing inorganic condensible vapors and particles (salts, ash). To meet the need for a computationally tractable deposition rate theory general enough to embrace multielement/component situations of current and future gas turbine and magnetogasdynamic interest, a multicomponent chemically 'frozen' boundary layer (CFBL) deposition theory is presented and its applicability to the special case of Na2SO4 deposition from seeded laboratory burner combustion products is demonstrated. The coupled effects of Fick (concentration) diffusion and Soret (thermal) diffusion are included, along with explicit corrections for effects of variable properties and free stream turbulence. The present formulation is sufficiently general to include the transport of particles provided they are small enough to be formally treated as heavy molecules. Quantitative criteria developed to delineate the domain of validity of CFBL-rate theory suggest considerable practical promise for the present framework, which is characterized by relatively modest demands for new input information and computer time.

Planners to the rescue: spatial planning facilitating the development of offshore wind energy.

PubMed

Jay, Stephen

2010-04-01

The development of offshore wind energy has started to take place surprisingly quickly, especially in North European waters. This has taken the wind energy industry out of the territory of planning systems that usually govern the siting of wind farms on land, and into the world of departmental, sectoral regulation of marine activities. Although this has favoured the expansion of offshore wind energy in some respects, evidence suggests that the practice and principles of spatial planning can make an important contribution to the proper consideration of proposals for offshore wind arrays. This is especially so when a strategic planning process is put in place for marine areas, in which offshore wind is treated as part of the overall configuration of marine interests, so that adjustments can be made in the interests of wind energy. The current process of marine planning in the Netherlands is described as an illustration of this. (c) 2009 Elsevier Ltd. All rights reserved.

Defining minors' abortion rights.

PubMed

Rhodes, A M

1988-01-01

The right to abortion is confirmed in the Roe versus Wade case, by the US Supreme Court. It is a fundamental right of privacy but not an absolute right, and must consider state interests. During the first trimester of pregnancy abortion is a decision of the woman and her doctor. During the second trimester of pregnancy the state may control the abortion practice to protect the mothers health, and in the last trimester, it may prohibit abortion, except in cases where the mother's life or health are in danger. The states enacted laws, including one that required parents to give written consent for a unmarried minor's abortion. This law was struck down by the US Court, but laws on notification were upheld as long as there was alternative procedures where the minor's interests are upheld. Many of these law have been challenged successfully, where the minor was judged mature and where it served her best interests. The state must enact laws on parental notification that take into consideration basic rights of the minor woman. Health professionals and workers should be aware of these laws and should encourage the minor to let parents in on the decision making process where possible.

Study motives, career choices and interest in paediatric dentistry among final year dental students in Nigeria

PubMed Central

2014-01-01

Background Students’ motives for studying Dentistry have been a subject of interest for years because of the potential for understanding the psychological makeup and subsequent job satisfaction for the dentist. It is also useful in identifying expectations of the profession. This study therefore tried to identify study motives and career preferences of dental students especially with respect to the practice of paediatric dentistry. Methods This was a cross-sectional study using a self-administered questionnaire. The final year students in six dental schools in Nigeria were required to fill the questionnaire. Students were asked to rank their motives and career preferences on a Likert like scale with points ranging from 0–5 where 0 represented a factor that had no influence on their decision and 5 represented a very influential factor. The underlying dimensions for study motives, career preference, impression about and motive for interest in the practice of paediatric dentistry were identified using factor analysis. Results One hundred and seventy nine of 223 students (80.3%) participated in this study. Motives for the practice of dentistry included characteristics of the profession, altruism and intellectual challenges, existence of artistic theme in dentistry and parent’s recommendation. Overall, 67.1% of respondents indicated interest in postgraduate studies and 50.8% were interested in paediatric dentistry practice. The main motives for showing interest in the practice of paediatric dentistry were ‘personal interest, professional interest and interest of significant others in children’, and ‘family influence’. Significantly more males than females were interested in the practice of paediatric dentistry though the motives for interest in the practice of paediatric dentistry did not differ significantly by sex or age. Conclusion The non-significant sex difference in the motives for interest in the practice of paediatric dentistry is a possible reflection of changes in strong cultural themes in the motives for career choices in Nigeria. PMID:24989055

Community pharmacists' interest in and attitude to pharmacy practice research in Ethiopia: A cross-sectional study.

PubMed

Bhagavathula, Akshaya Srikanth; Gebreyohannes, Eyob Alemayehu; Gebresillassie, Begashaw Melaku; Erku, Daniel Asfaw; Negesse, Chernet Tafere; Belay, Yared Belete

2017-01-01

Pharmacy practice-research became an important component in the pharmacy practice. However, limited studies were conducted in sub-Saharan Africa to understand the pharmacists' interest and attitude towards pharmacy practice-research. We aimed to assess the community pharmacists' interest and attitude towards pharmacy practice-research in Ethiopia. A cross-sectional survey was conducted among community pharmacists in eight major cities in Ethiopia. A validated 25-item self-administered questionnaire covering interest and attitude related to pharmacy practice-research was distributed. Responses were analysed using descriptive and inferential statistics. A total of 389 community pharmacists responded to the survey (response rate- 88.4%). Most of community pharmacists showed a high level of interest and positive attitude in being involved in all aspects of pharmacy practice-research. The median summary score for interest and attitude were 38 (IQR 20-40) (range possible 10-50) and 30 (IQR 18-39), respectively. Sixty-seven percent of the respondents thought about being involved in research, felt research is important for their career (57.6%), confident to conduct the research (56.2%), and agreed that research is a part of pharmacy practice (48.5%). However, only forty-six percent agreed that they underwent research training. A multivariate analysis showed that females were more interested in pharmacy practice research than males [AOR: 1.50, 95% CI: 0.99-2.27; p<0.05]. Community pharmacists showed high interest towards several areas of research competencies and demonstrated positive attitude towards pharmacy practice-research. Our findings suggest that providing research training to community pharmacists may contribute in undertaking research activities and build the research capacity in Ethiopia.

Community pharmacists’ interest in and attitude to pharmacy practice research in Ethiopia: A cross-sectional study

PubMed Central

Negesse, Chernet Tafere; Belay, Yared Belete

2017-01-01

Pharmacy practice-research became an important component in the pharmacy practice. However, limited studies were conducted in sub-Saharan Africa to understand the pharmacists’ interest and attitude towards pharmacy practice-research. We aimed to assess the community pharmacists’ interest and attitude towards pharmacy practice-research in Ethiopia. A cross-sectional survey was conducted among community pharmacists in eight major cities in Ethiopia. A validated 25-item self-administered questionnaire covering interest and attitude related to pharmacy practice-research was distributed. Responses were analysed using descriptive and inferential statistics. A total of 389 community pharmacists responded to the survey (response rate- 88.4%). Most of community pharmacists showed a high level of interest and positive attitude in being involved in all aspects of pharmacy practice-research. The median summary score for interest and attitude were 38 (IQR 20–40) (range possible 10–50) and 30 (IQR 18–39), respectively. Sixty-seven percent of the respondents thought about being involved in research, felt research is important for their career (57.6%), confident to conduct the research (56.2%), and agreed that research is a part of pharmacy practice (48.5%). However, only forty-six percent agreed that they underwent research training. A multivariate analysis showed that females were more interested in pharmacy practice research than males [AOR: 1.50, 95% CI: 0.99–2.27; p<0.05]. Community pharmacists showed high interest towards several areas of research competencies and demonstrated positive attitude towards pharmacy practice-research. Our findings suggest that providing research training to community pharmacists may contribute in undertaking research activities and build the research capacity in Ethiopia. PMID:28617834

Interest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program.

PubMed

Shrestha, Roman; Karki, Pramila; Copenhaver, Michael

2017-09-01

The adoption of mobile technologies for health (mHealth) in healthcare has grown considerably in recent years, but systematic assessment of interest in the use of mHealth in HIV prevention efforts among people who use drugs (PWUD) is lacking. We therefore examined interest in use of mHealth technology in HIV prevention and associated individual-level factors among high-risk PWUD enrolled in methadone maintenance program. A total of 400 HIV-negative PWUD, who reported drug- and/or sex-related risk behaviors completed a standardized assessment using audio computer assisted self-interview (ACASI). Results revealed significant interest in using mHealth-based approaches for specific purposes, including: to receive medication reminders (72.3%), to receive information about HIV risk reduction (65.8%), and to assess HIV risk behaviors (76.5%). Multivariate analysis showed that interest in receiving medication reminders was associated with currently taking medication and being neurocognitively impaired, whereas interest in receiving HIV-risk reduction information was associated with being non-white, married, and perceiving the person was at high-risk for contracting HIV. Similarly, participants' interested in using mHealth for HIV risk behavior assessment was associated with having recently visited a healthcare provider and exhibiting depressive symptoms. Overall, this study demonstrated that high-risk PWUD are interested in using mHealth-based tools as a key part of an HIV prevention approach within a common type of drug treatment settings. Thus, formative research on preferences for design and functionality of mHealth-based HIV prevention tools are now needed, followed by practical development, implementation, and evaluation of these new intervention strategies.

A curricular frame for physics education: Development, comparison with students' interests, and impact on students' achievement and self-concept

NASA Astrophysics Data System (ADS)

Häussler, Peter; Hoffmann, Lore

2000-11-01

This article presents three interlinked studies aimed at: (1) developing a curricular frame for physics education; (2) assessing the students' interest in the contents, contexts, and activities that are suggested by that curricular frame; and (3) developing a curriculum that is in line with that frame and measuring its cognitive and emotional effects on students. The curricular frame was developed by adopting the Delphi technique and drawing on the expertise of 73 persons selected according to specified selection criteria. Interest data of some 8000 students and information of the presently taught physics curriculum were sampled longitudinally as well as cross-sectionally in various German Länder (states) by questionnaire. The third study comprised 23 experimental and 7 control classes. As a result of the comparison between the features of the curricular frame, the interest structure of students, and the current physics curriculum, there is a remarkable congruency between students' interest in physics and the kind of physics education identified in the Delphi study as being relevant. However, there is a considerable discrepancy between students' interest and the kind of physics instruction practiced in the physics classroom. Regression analysis revealed that students' interest in physics as a school subject is hardly related to their interest in physics, but mainly to the students' self-esteem of being good achievers. The data strongly suggest physics be taught so that students have a chance to develop a positive physics-related self-concept and to link physics with situations they encounter outside the classroom. A curriculum based on these principles proved superior compared to a traditional curriculum.

Costs of vitamin D testing and prescribing among children in primary care.

PubMed

Basatemur, Emre; Hunter, Rachael; Horsfall, Laura; Sutcliffe, Alastair; Rait, Greta

2017-10-01

Vitamin D has attracted considerable interest in recent years, with a marked increase in diagnosis of vitamin D deficiency seen among children in clinical practice in the UK. The economic implications of this change in diagnostic behaviour have not been explored. We performed a cohort study to examine longitudinal trends in healthcare expenditure arising from vitamin D testing and prescribing for children in primary care in England, using the electronic healthcare records of 722,525 children aged 0-17 years held in The Health Improvement Network database. Combined costs of vitamin D tests and prescriptions increased from £1647 per 100,000 person-years in 2008 (95% CI, £934 to £3007) to £28,913 per 100,000 person-years in 2014 (95% CI, £26,361 to £31,739). The total cost of vitamin D prescriptions and tests for children in primary care at the national level in England in 2014 was estimated to be £4.31 million (95% CI, £2.96-£6.48 million). There has been a marked increase in healthcare expenditure on vitamin D tests and prescriptions for children in primary care over the past decade. Future research should explore the drivers for this change in diagnostic behaviour and the reasons prompting investigation of vitamin D status in clinical practice. What is Known: • Vitamin D deficiency has attracted considerable interest in recent years, with a marked increase in diagnosis seen in children. • The economic implications of this change in diagnostic behaviour have not been explored. What is New: • There has been a large increase in healthcare expenditure on vitamin D tests and prescriptions for children in primary care in England over the past decade (> 15 fold between 2008 and 2013). • Screening of vitamin D status in children without specific risk factors or clinical features of deficiency may represent avoidable healthcare expenditure.

31 CFR 8.40 - Conflicting interests.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Conflicting interests. 8.40 Section 8... ALCOHOL, TOBACCO AND FIREARMS Duties and Restrictions Relating to Practice § 8.40 Conflicting interests... interests in practice before the Bureau, except by express consent of all directly interested parties after...

31 CFR 8.40 - Conflicting interests.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Conflicting interests. 8.40 Section 8... ALCOHOL, TOBACCO AND FIREARMS Duties and Restrictions Relating to Practice § 8.40 Conflicting interests... interests in practice before the Bureau, except by express consent of all directly interested parties after...

31 CFR 8.40 - Conflicting interests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Conflicting interests. 8.40 Section 8... ALCOHOL, TOBACCO AND FIREARMS Duties and Restrictions Relating to Practice § 8.40 Conflicting interests... interests in practice before the Bureau, except by express consent of all directly interested parties after...

31 CFR 8.40 - Conflicting interests.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Conflicting interests. 8.40 Section 8... ALCOHOL, TOBACCO AND FIREARMS Duties and Restrictions Relating to Practice § 8.40 Conflicting interests... interests in practice before the Bureau, except by express consent of all directly interested parties after...

The roles of family, culture, and social cognitive variables in the career interests and goals of Asian American college students.

PubMed

Hui, Kayi; Lent, Robert W

2018-01-01

Although family and cultural factors have been assumed to play important roles in the career development of Asian Americans, theory-driven research on this topic remains limited. We examined culturally relevant factors that may contribute to Asian Americans' consideration of fields in which they are overrepresented (e.g., science, technology, engineering) and underrepresented (e.g., education, social science). Drawing from social cognitive career theory, a culture-specific, social cognitive model of career interests and choice was tested in Holland's (1997) Investigative (I) and Social (S) themes. A sample of 802 Asian American undergraduates completed measures of family support, self-efficacy, outcome expectations, interest, and career choice consideration in relation to both Holland themes. Two indicators of acculturation/enculturation (adherence to Asian values and generation status in the United States) were also obtained. The model accounted for a substantial amount of variance in Asian American college students' career consideration in both themes. Family support and acculturation played varying roles, depending on the Holland theme. For example, family support was linked to career choice consideration both directly (in the S theme) and indirectly, via other predictors (in both themes). Contrary to expectations, the acculturation variables did not moderate the relation of family support or interest to career consideration in either theme. We discuss the implications of these findings for efforts to understand and facilitate the career development of Asian American college students. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Diagnostic change and the increased prevalence of autism

PubMed Central

King, Marissa; Bearman, Peter

2009-01-01

Background Increased autism prevalence rates have generated considerable concern. However, the contribution of changes in diagnostic practices to increased prevalence rates has not been thoroughly examined. Debates over the role of diagnostic substitution also continue. California has been an important test case in these controversies. The objective of this study was to determine the extent to which the increased prevalence of autism in California has been driven by changes in diagnostic practices, diagnostic substitution and diagnostic accretion. Methods Retrospective case record examination of 7003 patients born before 1987 with autism who were enrolled with the California Department of Developmental Services between 1992 and 2005 was carried out. Of principal interest were 631 patients with a sole diagnosis of mental retardation (MR) who subsequently acquired a diagnosis of autism. The outcome of interest was the probability of acquiring a diagnosis of autism as a result of changes in diagnostic practices was calculated. The probability of diagnostic change is then used to model the proportion of the autism caseload arising from changing diagnostic practices. Results The odds of a patient acquiring an autism diagnosis were elevated in periods in which the practices for diagnosing autism changed. The odds of change in years in which diagnostic practices changed were 1.68 [95% confidence interval (CI) 1.11–2.54], 1.55 (95% CI 1.03–2.34), 1.58 (95% CI 1.05–2.39), 1.82 (95% CI 1.23–2.7) and 1.61 (95% CI 1.09–2.39). Using the probability of change between 1992 and 2005 to generalize to the population with autism, it is estimated that 26.4% (95% CI 16.25–36.48) of the increased autism caseload in California is uniquely associated with diagnostic change through a single pathway—individuals previously diagnosed with MR. Conclusion Changes in practices for diagnosing autism have had a substantial effect on autism caseloads, accounting for one-quarter of the observed increase in prevalence in California between 1992 and 2005. PMID:19737791

No evidence that polygynous marriage is a harmful cultural practice in northern Tanzania

PubMed Central

Lawson, David W.; James, Susan; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G. M.; Borgerhoff Mulder, Monique

2015-01-01

Polygyny is cross-culturally common and a topic of considerable academic and policy interest, often deemed a harmful cultural practice serving the interests of men contrary to those of women and children. Supporting this view, large-scale studies of national African demographic surveys consistently demonstrate that poor child health outcomes are concentrated in polygynous households. Negative population-level associations between polygyny and well-being have also been reported, consistent with the hypothesis that modern transitions to socially imposed monogamy are driven by cultural group selection. We challenge the consensus view that polygyny is harmful, drawing on multilevel data from 56 ethnically diverse Tanzanian villages. We first demonstrate the vulnerability of aggregated data to confounding between ecological and individual determinants of health; while across villages polygyny is associated with poor child health and low food security, such relationships are absent or reversed within villages, particularly when children and fathers are coresident. We then provide data indicating that the costs of sharing a husband are offset by greater wealth (land and livestock) of polygynous households. These results are consistent with models of polygyny based on female choice. Finally, we show that village-level negative associations between polygyny prevalence, food security, and child health are fully accounted for by underlying differences in ecological vulnerability (rainfall) and socioeconomic marginalization (access to education). We highlight the need for improved, culturally sensitive measurement tools and appropriate scales of analysis in studies of polygyny and other purportedly harmful practices and discuss the relevance of our results to theoretical accounts of marriage and contemporary population policy. PMID:26504213

Approaching confidentiality at a familial level in genomic medicine: a focus group study with healthcare professionals

PubMed Central

Dheensa, Sandi; Fenwick, Angela; Lucassen, Anneke

2017-01-01

Objectives Clinical genetics guidelines from 2011 conceptualise genetic information as confidential to families, not individuals. The normative consequence of this is that the family's interest is the primary consideration and genetic information is shared unless there are good reasons not to do so. We investigated healthcare professionals' (HCPs') views about, and reasoning around, individual and familial approaches to confidentiality and how such views influenced their practice. Method 16 focus groups with 80 HCPs working in/with clinical genetics services were analysed, drawing on grounded theory. Results Participants raised seven problems with, and arguments against, going beyond the individual approach to confidentiality. These problems fell into two overlapping categories: ‘relationships’ and ‘structures’. Most participants had never considered ways to—or thought it was impossible to—treat familial genetic information and personal information differently. They worried that putting the familial approach into practice could disrupt family dynamics and erode patient trust in the health service. They also thought they had insufficient resources to share information and feared that sharing might change the standard of care and make them more vulnerable to liability. Conclusions A familial approach to confidentiality has not been accepted or adopted as a standard, but wider research suggests that some of the problems HCPs perceived are surmountable and sharing in the interest of the family can be achieved. However, further research is needed to explore how personal and familial genetic information can be separated in practice. Our findings are relevant to HCPs across health services who are starting to use genome tests as part of their routine investigations. PMID:28159847

INCORPORATING WETLANDS IN WATER QUALITY TRADING: ECONOMIC CONSIDERATIONS (Journal Article)

EPA Science Inventory

Incorporating the use of wetlands as a technology to enhance water quality trading programs requires consideration of ecological, legal, and economic issues. We explore the case of encouraging the use of wetlands with a focus on the economic considerations. Interestingly, it is...

Articles on Practical Cybernetics. Computer-Developed Computers; Heuristics and Modern Sciences; Linguistics and Practice; Cybernetics and Moral-Ethical Considerations; and Men and Machines at the Chessboard.

ERIC Educational Resources Information Center

Berg, A. I.; And Others

Five articles which were selected from a Russian language book on cybernetics and then translated are presented here. They deal with the topics of: computer-developed computers, heuristics and modern sciences, linguistics and practice, cybernetics and moral-ethical considerations, and computer chess programs. (Author/JY)

A Bayesian network meta-analysis for binary outcome: how to do it.

PubMed

Greco, Teresa; Landoni, Giovanni; Biondi-Zoccai, Giuseppe; D'Ascenzo, Fabrizio; Zangrillo, Alberto

2016-10-01

This study presents an overview of conceptual and practical issues of a network meta-analysis (NMA), particularly focusing on its application to randomised controlled trials with a binary outcome of interest. We start from general considerations on NMA to specifically appraise how to collect study data, structure the analytical network and specify the requirements for different models and parameter interpretations, with the ultimate goal of providing physicians and clinician-investigators a practical tool to understand pros and cons of NMA. Specifically, we outline the key steps, from the literature search to sensitivity analysis, necessary to perform a valid NMA of binomial data, exploiting Markov Chain Monte Carlo approaches. We also apply this analytical approach to a case study on the beneficial effects of volatile agents compared to total intravenous anaesthetics for surgery to further clarify the statistical details of the models, diagnostics and computations. Finally, datasets and models for the freeware WinBUGS package are presented for the anaesthetic agent example. © The Author(s) 2013.

Effect of thermal processing and canning on cadmium and lead levels in California market squid: the role of metallothioneins.

PubMed

Galitsopoulou, A; Georgantelis, D; Kontominas, M G

2013-01-01

The effects of two common seafood preparation practices (roasting and industrial canning) on the heavy metal content--cadmium (Cd) and lead (Pb)--of various tissues of California market squid were studied. Emphasis was placed on the role of metallothioneins (MT) in Cd and Pb behaviour during processing. Cd and Pb analysis was conducted by a Zeeman GTA-AAS atomic absorption spectrometry system; MT analysis was performed by a mercury saturation assay. Results showed that Cd levels in the mantle and whole squid were considerably affected by both processing practices, reaching a 240% increase in mantle and a 40% increase in whole squid. Interestingly, Cd behaviour was associated with MT changes during squid processing. On the other hand, Pb content was not affected from either processing or associated with MT content in the raw or processed squid. Therefore, processing operations may affect Cd and Pb content differently due to the specific metal bioaccumulation and chemical features of each heavy metal type.

Q-Sample Construction: A Critical Step for a Q-Methodological Study.

PubMed

Paige, Jane B; Morin, Karen H

2016-01-01

Q-sample construction is a critical step in Q-methodological studies. Prior to conducting Q-studies, researchers start with a population of opinion statements (concourse) on a particular topic of interest from which a sample is drawn. These sampled statements are known as the Q-sample. Although literature exists on methodological processes to conduct Q-methodological studies, limited guidance exists on the practical steps to reduce the population of statements to a Q-sample. A case exemplar illustrates the steps to construct a Q-sample in preparation for a study that explored perspectives nurse educators and nursing students hold about simulation design. Experts in simulation and Q-methodology evaluated the Q-sample for readability, clarity, and for representativeness of opinions contained within the concourse. The Q-sample was piloted and feedback resulted in statement refinement. Researchers especially those undertaking Q-method studies for the first time may benefit from the practical considerations to construct a Q-sample offered in this article. © The Author(s) 2014.

Superresolution microscopy for microbiology

PubMed Central

Coltharp, Carla; Xiao, Jie

2014-01-01

Summary This review provides a practical introduction to superresolution microscopy from the perspective of microbiological research. Because of the small sizes of bacterial cells, superresolution methods are particularly powerful and suitable for revealing details of cellular structures that are not resolvable under conventional fluorescence light microscopy. Here we describe the methodological concepts behind three major categories of super-resolution light microscopy: photoactivated localization microscopy (PALM) and stochastic optical reconstruction microscopy (STORM), structured illumination microscopy (SIM) and stimulated emission-depletion (STED) microscopy. We then present recent applications of each of these techniques to microbial systems, which have revealed novel conformations of cellular structures and described new properties of in vivo protein function and interactions. Finally, we discuss the unique issues related to implementing each of these superresolution techniques with bacterial specimens and suggest avenues for future development. The goal of this review is to provide the necessary technical background for interested microbiologists to choose the appropriate super-resolution method for their biological systems, and to introduce the practical considerations required for designing and analysing superresolution imaging experiments. PMID:22947061

The concept of antifragility and its implications for the practice of risk analysis.

PubMed

Aven, Terje

2015-03-01

Nassim Taleb's antifragile concept has been shown considerable interest in the media and on the Internet recently. For Taleb, the antifragile concept is a blueprint for living in a black swan world (where surprising extreme events may occur), the key being to love variation and uncertainty to some degree, and thus also errors. The antonym of "fragile" is not robustness or resilience, but "please mishandle" or "please handle carelessly," using an example from Taleb when referring to sending a package full of glasses by post. In this article, we perform a detailed analysis of this concept, having a special focus on how the antifragile concept relates to common ideas and principles of risk management. The article argues that Taleb's antifragile concept adds an important contribution to the current practice of risk analysis by its focus on the dynamic aspects of risk and performance, and the necessity of some variation, uncertainties, and risk to achieve improvements and high performance at later stages. © 2014 Society for Risk Analysis.

A practical field guide to conducting nursing research in low- and middle-income countries.

PubMed

LeBaron, Virginia T; Iribarren, Sarah J; Perri, Seneca; Beck, Susan L

2015-01-01

The purpose of this report is to offer practical guidance to nurse investigators interested in international research in low- and middle-income countries (LMICs). Lessons learned and strategies for planning and implementing an international research project are addressed. Four nurse researchers who conducted studies in diverse international settings (Argentina, India, South Africa, and Tanzania) describe their collective experiences regarding study planning and implementation; data collection using a variety of methods; and cultural, contextual and ethical considerations. Nurses who undertake international health research projects, particularly in LMICs, can face unique challenges and opportunities. Recommendations for success include advance planning, remaining flexible, having a backup plan, cultivating an attitude of curiosity and cultural humility, establishing collaborative and respectful partnerships, and budgeting adequate time. Nurse scientists often receive little training and support to conduct international research. Guidance to undertake research projects in LMICs can build capacity for nurses to make significant contributions to global health. Copyright © 2015 Elsevier Inc. All rights reserved.

Unscientific beliefs about scientific topics in nutrition.

PubMed

Brown, Andrew W; Ioannidis, John P A; Cope, Mark B; Bier, Dennis M; Allison, David B

2014-09-01

Humans interact with food daily. Such repeated exposure creates a widespread, superficial familiarity with nutrition. Personal familiarity with nutrition from individual and cultural perspectives may give rise to beliefs about food not grounded in scientific evidence. In this summary of the session entitled “Unscientific Beliefs about Scientific Topics in Nutrition,” we discuss accumulated work illustrating and quantifying potentially misleading practices in the conduct and, more so, reporting of nutrition science along with proposed approaches to amelioration. We begin by defining “unscientific beliefs” and from where such beliefs may come, followed by discussing how large bodies of nutritional epidemiologic observations not only create highly improbable patterns of association but implausible magnitudes of implied effect. Poor reporting practices, biases, and methodologic issues that have distorted scientific understandings of nutrition are presented, followed by potential influences of conflicts of interest that extend beyond financial considerations. We conclude with recommendations for improving the conduct, reporting, and communication of nutrition-related research to ground discussions in evidence rather than solely on beliefs.

Integrating art and science: A case study of middle school reform

NASA Astrophysics Data System (ADS)

Smar, Benedict J.

2000-10-01

Schools are under tremendous pressure to change and improve. Among the many strategies advocated to improve learning is that of curriculum integration. For arts advocates, that translates into an interest in integrating the arts into the curriculum. While the arts have never been at the forefront of America's educational priorities, recent rhetoric, policy, and research suggested they are more a part of mainstream educational reform policy at this time. However, while current policy and the literature support a strong role for the arts in education, practice may be more influenced by the variety of complex, powerful issues faced by schools as organizations engaged in navigating the turbulent waters of change. The juxtaposition of these factors, along with limited empirical data about the practical considerations of arts integration in the context of change, created a need to know more about the practicalities of integrating the arts into the curriculum. The purpose of this study was to examine the practical considerations which surround integrating art and science at the middle school level. A case study design was employed which used qualitative methods to gather data including interviews, informal conversations, direct observations, and the examination of artifacts. Data were analyzed using a theoretically grounded, Capacity Analysis Model developed through review of the literature. The findings indicated that integrating the arts into the curriculum must be considered in light of the broader context of educational change. The school's capacity to deal with change is central to the integrative process. Building capacity on individual, cultural, structural, and environmental levels facilitated an emergent link between art and science. The process was interactive and complex. The continuous interaction and synthesis of the four capacities manifested itself as the school's integrative capacity. It was concluded that building the capacity to address change, engaging in meaningful dialogue, collaborating in curriculum planning, developing common teaching practices and definitions, integrating the people, sharing ownership of curriculum, and active participation of the art teacher in the process are critical elements when considering the practical side of integrating the arts into the curriculum.

Practical Considerations in Pediatric Surgery

PubMed Central

Louis, Matthew R.; Meaike, Jesse D.; Chamata, Edward; Hollier, Larry H.

2016-01-01

The care of pediatric patients requires special considerations that are often not addressed in the literature. Relatively straightforward tasks such as clinical evaluation, antibiotic use, splinting, wound closure, and care of simple burns become complicated in the pediatric population for several reasons. The authors seek to demystify some of these topics using the senior author's years of clinical experience treating pediatric patients by giving practical advice and general considerations when treating children. PMID:27895539

32 CFR 195.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... term Federal financial assistance includes: (1) Grants and loans of Federal funds, (2) The grant or... or any interest in such property without consideration or at a nominal consideration, or at a consideration which is reduced for the purpose of assisting the recipient, or in recognition of the public...

Parental Perceptions and Practices toward Childhood Asthma

PubMed Central

Nofal, Abdullah; Heena, Humariya

2016-01-01

Introduction. Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective. To investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods. Using a self-administered questionnaire, a two-stage cross-sectional survey of parents of children aged between 3 and 15 years, was conducted from schools located in Riyadh province in central Saudi Arabia. Results. During the study interval, 2000 parents were asked to participate in the study; 1450 parents responded, of whom 600 (41.4%) reported that their children had asthma, dyspnea, or chest allergy (recurrent wheezing or coughing), while 478 (32.9%) of the parents reported that their children were diagnosed earlier with asthma by a physician. Therefore, the final statistical analyses were performed with 600 participants. Furthermore, 321 (53.5%) respondents believed that asthma is solely a hereditary disease. Interestingly, 361 (60.3%) were concerned about side effects of inhaled corticosteroids and 192 (32%) about the development of dependency on asthma medications. Almost 76% of parents had previously visited a pediatric emergency department during an asthma attack. Conclusions. Parents had misperceptions regarding asthma and exhibited ineffective practices in its management. Therefore, improving asthma care and compliance requires added parental education. PMID:27843948

47 CFR 24.831 - Mutually exclusive applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... will be entitled to comparative consideration with one or more conflicting applications only if the Commission determines that such comparative consideration will serve the public interest. (d)-(j) [Reserved] ...

47 CFR 24.831 - Mutually exclusive applications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... will be entitled to comparative consideration with one or more conflicting applications only if the Commission determines that such comparative consideration will serve the public interest. (d)-(j) [Reserved] ...

47 CFR 24.831 - Mutually exclusive applications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... will be entitled to comparative consideration with one or more conflicting applications only if the Commission determines that such comparative consideration will serve the public interest. (d)-(j) [Reserved] ...

47 CFR 24.831 - Mutually exclusive applications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... will be entitled to comparative consideration with one or more conflicting applications only if the Commission determines that such comparative consideration will serve the public interest. (d)-(j) [Reserved] ...

47 CFR 24.831 - Mutually exclusive applications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... will be entitled to comparative consideration with one or more conflicting applications only if the Commission determines that such comparative consideration will serve the public interest. (d)-(j) [Reserved] ...

16 CFR 1012.1 - General policy considerations; scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Policy, sets forth requirements for advance public notice, public attendance, and recordkeeping for... 16 Commercial Practices 2 2010-01-01 2010-01-01 false General policy considerations; scope. 1012.1 Section 1012.1 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL MEETINGS POLICY-MEETINGS...

Public health nutrition practice in Canada: a situational assessment.

PubMed

Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

2008-08-01

Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

Moral courage in nursing: A concept analysis.

PubMed

Numminen, Olivia; Repo, Hanna; Leino-Kilpi, Helena

2017-12-01

Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one's moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. This article is an analysis of the concept of moral courage in nursing. Rodgers' evolutionary method of concept analysis provided the framework to conduct the analysis. The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher's Index. The following key words were used: "moral" OR "ethical" AND "courage" OR "strength" AND "nurs*" with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.

Norwegian medical students' attitudes towards the pharmaceutical industry.

PubMed

Lea, Dordi; Spigset, Olav; Slørdal, Lars

2010-07-01

Whereas there is a considerable body of information on the interaction between physicians and the pharmaceutical industry, little is known about the pharmaceutical industry-medical student relationship. We have assessed the extent of contact between Norwegian medical students and the pharmaceutical industry as well as the attitudes of these students towards the pharmaceutical industry. A self-assessment questionnaire was distributed to fifth- and sixth-year students attending the four medical schools in Norway and to Norwegian medical students attending selected universities abroad. A total of 65.8% of all eligible students returned a completed questionnaire. Of these, 73.9% had been exposed to various levels of contact with the pharmaceutical industry, but only 17.5% reported having a generally positive attitude towards the industry. The level of exposure did not correlate in students' attitudes; rather, it correlated positively to a feeling of competence in terms of being able to handle such interactions. A majority of students responded that while they would decline accepting monetary gifts, they would welcome receiving reimbursements for meeting expenses, meals and educational material. Students favoured a practice of full disclosure of potential industry-related conflicts of interest among the university teaching staff. There were considerable differences in the students' attitudes between universities, suggesting that medical students are prone to influence from university lecturers. Norwegian medical students are opinionated, critical and curious with respect to pharmaceutical industry relations. This interest can be explored and probably also modified by educational initiatives.

Biomarkers in bladder cancer: present status and perspectives.

PubMed

Kim, Wun-Jae; Park, Soongang; Kim, Yong-June

2007-03-27

Bladder cancers are a mixture of heterogeneous cell populations, and numerous factors are likely to be involved in dictating their recurrence, progression and the patient's survival. For any candidate prognostic marker to have considerable clinical relevance, it must add some predictive capacity beyond that offered by conventional clinical and pathologic parameters. Here, the current situation in bladder cancer research with respect to identification of suitable prognostic markers is reviewed. A number of individual molecular markers that might predict bladder cancer recurrence and progression have been identified but many are not sufficiently sensitive or specific for the whole spectrum of bladder cancer diseases seen in routine clinical practice. These limitations have led to interest in other molecular parameters that could enable more accurate prognosis for bladder cancer patients. Of particular interest is the epigenetic silencing of tumor suppressor genes. Since the methylation of these genes can correlate with a poor prognosis, the methylation profile may represent a new bio-marker that indicates the risk of transitional cell carcinoma development. In addition, bladder cancer research is likely to be revolutionized by high-throughput molecular technologies, which allow rapid and global gene expression analysis of thousands of tumor samples. Initial studies employing these technologies have considerably expanded our ability to classify bladder cancers with respect to their survivability. Future microarray analyses are likely to reveal particular gene expression signatures that predict the likelihood of bladder cancer progression and recurrence, as well as patient's survival and responsiveness to different anti-cancer therapies, with great specificity and sensitivity.

Prediction of unsteady airfoil flows at large angles of incidence

NASA Technical Reports Server (NTRS)

Cebeci, Tuncer; Jang, H. M.; Chen, H. H.

1992-01-01

The effect of the unsteady motion of an airfoil on its stall behavior is of considerable interest to many practical applications including the blades of helicopter rotors and of axial compressors and turbines. Experiments with oscillating airfoils, for example, have shown that the flow can remain attached for angles of attack greater than those which would cause stall to occur in a stationary system. This result appears to stem from the formation of a vortex close to the surface of the airfoil which continues to provide lift. It is also evident that the onset of dynamic stall depends strongly on the airfoil section, and as a result, great care is required in the development of a calculation method which will accurately predict this behavior.

When Is Posting about Patients on Social Media Unethical "Medutainment"?

PubMed

Bennett, Katelyn G; Vercler, Christian J

2018-04-01

Social media is characterized by online spaces for rapid communication, advertising, professional development, and advocacy, and these platforms have revolutionized the way we interact with people and our culture. In plastic surgery, platforms like Facebook, Snapchat, and Instagram are especially attractive for practice promotion and instantaneous connection with potential patients. However, considerable risks and ethical dilemmas lie in wait for the plastic surgeon who attempts to use patient photographs and videos for advertising. It is critical for plastic surgeons who use patient images for this purpose to facilitate fully informed consent, consider both context of use and the patient-physician power differential, and put patients' interests ahead of their own. © 2018 American Medical Association. All Rights Reserved.

Internet pharmacy: issues of access, quality, costs, and regulation.

PubMed

Crawford, Stephanie Y

2003-02-01

Internet pharmacy has been the focus of heightened interest over the past 3 years since the first major Web site was introduced in the United States. This paper addresses issues pertaining to Internet pharmacies that sell prescriptions and other products to consumers at the retail level. The Internet pharmacy industry has shifted rapidly in the short time span. This paper begins with a summary of historical considerations and the shifting organization of Internet pharmacy. The advantages and disadvantages of online pharmacy practice are listed. Issues of access, quality, and cost are described. The challenges in regulation at the state and federal levels are presented. Advice to consumers is offered regarding the use of Internet pharmacy sites for purchasing prescription drug products.

Human research ethics committees: examining their roles and practices.

PubMed

Guillemin, Marilys; Gillam, Lynn; Rosenthal, Doreen; Bolitho, Annie

2012-07-01

Considerable time and resources are invested in the ethics review process. We present qualitative data on how human research ethics committee members and health researchers perceive the role and function of the committee. The findings are based on interviews with 34 Australian ethics committee members and 54 health researchers. Although all participants agreed that the primary role of the ethics committee was to protect participants, there was disagreement regarding the additional roles undertaken by committees. Of particular concern were the perceptions from some ethics committee members and researchers that ethics committees were working to protect the institution's interests, as well as being overprotective toward research participants. This has the potential to lead to poor relations and mistrust between ethics committees and researchers.

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

Baone, Chaitanya; Acharya, Naresh; Wiegman, Herman

As microgrid installations are steadily growing in the United States and around the world, widespread adoption of commercial microgrids would rely upon the economic benefit to the owners and operators. With the introduction of new market mechanisms and growing penetration of non-traditional generation assets, there is an increasing need and interest in allowing distributed assets to participate in traditional grid services such as frequency regulation. This paper considers the problem of determining the optimal balance of energy and ancillary services for individual microgrid generation assets to participate in such markets. An optimization framework that maximizes the predicted performance of themore » microgrid over a day-ahead time horizon while accounting for individual asset constraints is proposed. Simulation results on a realistic test system with practical considerations are presented.« less

Transformational leadership in nursing practice.

PubMed

Doody, Owen; Doody, Catriona M

Traditionally, nurses have been over-managed and led inadequately, yet today they face unprecedented challenges and opportunities. Organisations constantly face changes that require an increasingly adaptive and flexible leadership. This type of adaptive leadership is referred to as 'transformational'; under it, environments of shared responsibilities that influence new ways of knowing are created. Transformational leadership motivates followers by appealing to higher ideas and moral values, where the leader has a deep set of internal values and ideas. This leads to followers acting to sustain the greater good, rather than their own interests, and supportive environments where responsibility is shared. This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration.

Opt-Out Parental Consent in Online Surveys: Ethical Considerations.

PubMed

Harris, Jane; Porcellato, Lorna

2018-07-01

This article aims to foster discussion and debate around seeking parental consent from young people recruited online. The growth of social media, particularly for young people, has led to increased interest in young people's online activities as both a research topic and recruitment setting. In a health-related study, which sought to recruit young people aged 13 to 18 years old from YouTuber fan communities to an online survey, the question arose of how parental consent could be sought from young people below 16 when no link existed between researcher and parents/guardians. A practical strategy is proposed which combines novel communication methods for participant information, opt-out online consent and age verification to address this issue. Strengths and limitations of these approaches are discussed.

Enhanced supercapacitor performances using C-doped porous TiO2 electrodes

NASA Astrophysics Data System (ADS)

Chen, Juanrong; Qiu, Fengxian; Zhang, Ying; Liang, Jianzheng; Zhu, Huijun; Cao, Shunsheng

2015-11-01

Considerable efforts have been paid to develop electrochemical capacitors with energy storage capability in order to meet the demands of multifunctional electronics. Here we report a facile method to fabricate C-doped porous anatase TiO2. This technique involves the preparation of monodisperse cationic polystyrene nanoparticles (CPN), following sequential deposition of tetrabutylorthotitanate (TBT), and directly carbonizing of CPN. Interestingly, during the process of carbonizing CPN, a phase transition of TiO2 will be happened and whist C-doped porous anatase TiO2 is in situ formed. When this porous C-doped TiO2 is used as electrode material to prepare electrochemical capacitor, it manifests a higher capacitance than the commercial P25, effectively broadening it potential for many practical applications.

Asian and Pacific Islander cultural values: considerations for health care decision making.

PubMed

McLaughlin, L A; Braun, K L

1998-05-01

As the United States becomes more ethnically diverse, health care practitioners must learn about the perspectives and values of a variety of cultural groups. Of interest is how these cultural values intersect with those of the dominant culture, especially in the health care arena. This article explores the values that influence decision making among Asian and Pacific Islander cultures, with specific illustrations from six of these cultures. The literature, along with our observations as health professionals and researchers working in Hawaii, suggest potential areas of conflict between the more collectivist values of Asian and Pacific Islander cultures and the more individualist orientation of the U.S. health care system. Implications for practice and research are presented.

Field site selection

NASA Technical Reports Server (NTRS)

Schwarz, D. E.; Ellefsen, R. E.

1981-01-01

Several general guidelines should be kept in mind when considering the selection of field sites for teaching remote sensing fundamentals. Proximity and vantage point are two very practical considerations. Only through viewing a broad enough area to place the site in context can one make efficient use of a site. The effects of inclement weather when selecting sites should be considered. If field work is to be an effective tool to illustrate remote sensing principles, the following criteria are critical: (1) the site must represent the range of class interest; (2) the site must have a theme or add something no other site offers; (3) there should be intrasite variation within the theme; (4) ground resolution and spectral signature distinction should be illustrated; and (5) the sites should not be ordered sequentially.

Biotransformation of lignocellulosic materials into value-added products-A review.

PubMed

Bilal, Muhammad; Asgher, Muhammad; Iqbal, Hafiz M N; Hu, Hongbo; Zhang, Xuehong

2017-05-01

In the past decade, with the key biotechnological advancements, lignocellulosic materials have gained a particular importance. In serious consideration of global economic, environmental and energy issues, research scientists have been re-directing their interests in (re)-valorizing naturally occurring lignocellulosic-based materials. In this context, lignin-modifying enzymes (LMEs) have gained considerable attention in numerous industrial and biotechnological processes. However, their lower catalytic efficiencies and operational stabilities limit their practical and multipurpose applications in various sectors. Therefore, to expand the range of natural industrial biocatalysts e.g. LMEs, significant progress related to the enzyme biotechnology has appeared. Owing to the abundant lignocellulose availability along with LMEs in combination with the scientific advances in the biotechnological era, solid-phase biocatalysts can be economically tailored on a large scale. This review article outlines first briefly on the lignocellulose materials as a potential source for biotransformation into value-added products including composites, fine chemicals, nutraceutical, delignification, and enzymes. Comprehensive information is also given on the purification and characterization of LMEs to present their potential for the industrial and biotechnological sector. Copyright © 2017 Elsevier B.V. All rights reserved.

Multi-susceptibile Single-Phased Ceramics with Both Considerable Magnetic and Dielectric Properties by Selectively Doping

PubMed Central

Liu, Chuyang; Zhang, Yujing; Jia, Jingguo; Sui, Qiang; Ma, Ning; Du, Piyi

2015-01-01

Multiferroic ceramics with extraordinary susceptibilities coexisting are vitally important for the multi-functionality and integration of electronic devices. However, multiferroic composites, as the most potential candidates, will introduce inevitable interface deficiencies and thus dielectric loss from dissimilar phases. In this study, single-phased ferrite ceramics with considerable magnetic and dielectric performances appearing simultaneously were fabricated by doping target ions in higher valence than that of Fe3+, such as Ti4+, Nb5+ and Zr4+, into BaFe12O19. In terms of charge balance, Fe3+/Fe2+ pair dipoles are produced through the substitution of Fe3+ by high-valenced ions. The electron hopping between Fe3+ and Fe2+ ions results in colossal permittivity. Whilst the single-phased ceramics doped by target ions exhibit low dielectric loss naturally due to the diminishment of interfacial polarization and still maintain typical magnetic properties. This study provides a convenient method to attain practicable materials with both outstanding magnetic and dielectric properties, which may be of interest to integration and multi-functionality of electronic devices. PMID:25835175

Multi-susceptibile single-phased ceramics with both considerable magnetic and dielectric properties by selectively doping.

PubMed

Liu, Chuyang; Zhang, Yujing; Jia, Jingguo; Sui, Qiang; Ma, Ning; Du, Piyi

2015-04-02

Multiferroic ceramics with extraordinary susceptibilities coexisting are vitally important for the multi-functionality and integration of electronic devices. However, multiferroic composites, as the most potential candidates, will introduce inevitable interface deficiencies and thus dielectric loss from dissimilar phases. In this study, single-phased ferrite ceramics with considerable magnetic and dielectric performances appearing simultaneously were fabricated by doping target ions in higher valence than that of Fe(3+), such as Ti(4+), Nb(5+) and Zr(4+), into BaFe12O19. In terms of charge balance, Fe(3+)/Fe(2+) pair dipoles are produced through the substitution of Fe(3+) by high-valenced ions. The electron hopping between Fe(3+) and Fe(2+) ions results in colossal permittivity. Whilst the single-phased ceramics doped by target ions exhibit low dielectric loss naturally due to the diminishment of interfacial polarization and still maintain typical magnetic properties. This study provides a convenient method to attain practicable materials with both outstanding magnetic and dielectric properties, which may be of interest to integration and multi-functionality of electronic devices.

Multi-susceptibile Single-Phased Ceramics with Both Considerable Magnetic and Dielectric Properties by Selectively Doping

NASA Astrophysics Data System (ADS)

Liu, Chuyang; Zhang, Yujing; Jia, Jingguo; Sui, Qiang; Ma, Ning; Du, Piyi

2015-04-01

Multiferroic ceramics with extraordinary susceptibilities coexisting are vitally important for the multi-functionality and integration of electronic devices. However, multiferroic composites, as the most potential candidates, will introduce inevitable interface deficiencies and thus dielectric loss from dissimilar phases. In this study, single-phased ferrite ceramics with considerable magnetic and dielectric performances appearing simultaneously were fabricated by doping target ions in higher valence than that of Fe3+, such as Ti4+, Nb5+ and Zr4+, into BaFe12O19. In terms of charge balance, Fe3+/Fe2+ pair dipoles are produced through the substitution of Fe3+ by high-valenced ions. The electron hopping between Fe3+ and Fe2+ ions results in colossal permittivity. Whilst the single-phased ceramics doped by target ions exhibit low dielectric loss naturally due to the diminishment of interfacial polarization and still maintain typical magnetic properties. This study provides a convenient method to attain practicable materials with both outstanding magnetic and dielectric properties, which may be of interest to integration and multi-functionality of electronic devices.

A Review of Issues Related to Data Acquisition and Analysis in EEG/MEG Studies.

PubMed

Puce, Aina; Hämäläinen, Matti S

2017-05-31

Electroencephalography (EEG) and magnetoencephalography (MEG) are non-invasive electrophysiological methods, which record electric potentials and magnetic fields due to electric currents in synchronously-active neurons. With MEG being more sensitive to neural activity from tangential currents and EEG being able to detect both radial and tangential sources, the two methods are complementary. Over the years, neurophysiological studies have changed considerably: high-density recordings are becoming de rigueur; there is interest in both spontaneous and evoked activity; and sophisticated artifact detection and removal methods are available. Improved head models for source estimation have also increased the precision of the current estimates, particularly for EEG and combined EEG/MEG. Because of their complementarity, more investigators are beginning to perform simultaneous EEG/MEG studies to gain more complete information about neural activity. Given the increase in methodological complexity in EEG/MEG, it is important to gather data that are of high quality and that are as artifact free as possible. Here, we discuss some issues in data acquisition and analysis of EEG and MEG data. Practical considerations for different types of EEG and MEG studies are also discussed.

Considerations for the development of shale gas in the United Kingdom.

PubMed

Hays, Jake; Finkel, Madelon L; Depledge, Michael; Law, Adam; Shonkoff, Seth B C

2015-04-15

The United States shale gas boom has precipitated global interest in the development of unconventional oil and gas resources. Recently, government ministers in the United Kingdom started granting licenses that will enable companies to begin initial exploration for shale gas. Meanwhile, concern is increasing among the scientific community about the potential impacts of shale gas and other types of unconventional natural gas development (UGD) on human health and the environment. Although significant data gaps remain, there has been a surge in the number of articles appearing in the scientific literature, nearly three-quarters of which has been published since the beginning of 2013. Important lessons can be drawn from the UGD experience in the United States. Here we explore these considerations and argue that shale gas development policies in the UK and elsewhere should be informed by empirical evidence generated on environmental, public health, and social risks. Additionally, policy decisions should take into account the measured effectiveness of harm reduction strategies as opposed to hypothetical scenarios and purported best practices that lack empirical support. Copyright © 2015 Elsevier B.V. All rights reserved.

Could a revision of the current guidelines for cancer drug use improve the quality of cancer treatment?

PubMed

Lippert, Theodor H; Ruoff, Hans-Jörg; Volm, Manfred

2014-01-01

Clinical practice guidelines are indispensable for such a variable disease as malignant solid tumors, with the complex possibilities of drug treatment. The current guidelines may be criticized on several points, however. First, there is a lack of information on the outcome of treatment, such as the expected success and failure rates. Treating not only drug responders but also nonresponders, that is, patients with drug resistance, must result in failures. There is no mention of the possibility of excluding the drug nonresponders, identifiable by special laboratory tests and no consideration is given to the different side effects of the recommended drug regimens. Nor are there any instructions concerning tumor cases for which anticancer drug treatment is futile. In such cases, early palliative care may lead to significant improvements in both life quality and life expectancy. Not least, there is no transparency concerning the preparation of the guidelines: persons cannot be identified who could give a statement of conflicts of interest, and responsibility is assumed only by anonymous medical associations. A revision of the current guidelines could considerably improve cancer treatment.

47 CFR 1.1319 - Consideration of the environmental impact statements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Consideration of the environmental impact... § 1.1319 Consideration of the environmental impact statements. (a) If the action is subject to a... environmental and non-environmental public interest factors. (2) Upon review of an initial decision, the...

16 CFR 1061.12 - Commission consideration on merits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Commission consideration on merits. 1061.12 Section 1061.12 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL APPLICATIONS FOR EXEMPTION... available and relevant information on the proposal. (c) The Commission's evaluation will focus on: (1...

STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 1 - GENERAL CONSIDERATIONS

EPA Science Inventory

This document is Volume 1 of a three volume series that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This first volume provides general considerations associated with the selection and design of BMPs.
Volume I provi...

Students who are deaf and hard of hearing and use sign language: considerations and strategies for developing spoken language and literacy skills.

PubMed

Nussbaum, Debra; Waddy-Smith, Bettie; Doyle, Jane

2012-11-01

There is a core body of knowledge, experience, and skills integral to facilitating auditory, speech, and spoken language development when working with the general population of students who are deaf and hard of hearing. There are additional issues, strategies, and challenges inherent in speech habilitation/rehabilitation practices essential to the population of deaf and hard of hearing students who also use sign language. This article will highlight philosophical and practical considerations related to practices used to facilitate spoken language development and associated literacy skills for children and adolescents who sign. It will discuss considerations for planning and implementing practices that acknowledge and utilize a student's abilities in sign language, and address how to link these skills to developing and using spoken language. Included will be considerations for children from early childhood through high school with a broad range of auditory access, language, and communication characteristics. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Financial Capability in Early Social Work Practice: Lessons for Today.

PubMed

Stuart, Paul H

2016-10-01

During the profession's first decades, social workers tried to improve their clients’ financial capability (FC). This article describes the methods used by early social workers who attempted to enhance the FC of their clients, based on contemporary descriptions of their practice. Social workers initially emphasized thrift, later adding more sophisticated consideration of the cost of foods, rent, and other necessities. Social work efforts were furthered by home economists, who served as specialists in nutrition, clothing, interior design, and other topics related to homemaking. Early home economists included specialists in nutrition and family budgeting; these specialists worked with social services agencies to provide a financial basis for family budgets and assisted clients with family budgeting. Some agencies engaged home economists as consultants and as direct providers of instruction on home budgets for clients. By the 1930s, however, social work interest in family budget problems focused on the psychological meaning of low income to the client, rather than in measures to increase client FC. Consequently, social workers’ active engagement with family budget issues—engagement that characterized earlier decades—faded. These early efforts can inform contemporary practice as social workers are once again concerned about improving their clients’ FC.

Replication initiatives will not salvage the trustworthiness of psychology.

PubMed

Coyne, James C

2016-05-31

Replication initiatives in psychology continue to gather considerable attention from far outside the field, as well as controversy from within. Some accomplishments of these initiatives are noted, but this article focuses on why they do not provide a general solution for what ails psychology. There are inherent limitations to mass replications ever being conducted in many areas of psychology, both in terms of their practicality and their prospects for improving the science. Unnecessary compromises were built into the ground rules for design and publication of the Open Science Collaboration: Psychology that undermine its effectiveness. Some ground rules could actually be flipped into guidance for how not to conduct replications. Greater adherence to best publication practices, transparency in the design and publishing of research, strengthening of independent post-publication peer review and firmer enforcement of rules about data sharing and declarations of conflict of interest would make many replications unnecessary. Yet, it has been difficult to move beyond simple endorsement of these measures to consistent implementation. Given the strong institutional support for questionable publication practices, progress will depend on effective individual and collective use of social media to expose lapses and demand reform. Some recent incidents highlight the necessity of this.

Practical considerations for a second-order directional hearing aid microphone system

NASA Astrophysics Data System (ADS)

Thompson, Stephen C.

2003-04-01

First-order directional microphone systems for hearing aids have been available for several years. Such a system uses two microphones and has a theoretical maximum free-field directivity index (DI) of 6.0 dB. A second-order microphone system using three microphones could provide a theoretical increase in free-field DI to 9.5 dB. These theoretical maximum DI values assume that the microphones have exactly matched sensitivities at all frequencies of interest. In practice, the individual microphones in the hearing aid always have slightly different sensitivities. For the small microphone separation necessary to fit in a hearing aid, these sensitivity matching errors degrade the directivity from the theoretical values, especially at low frequencies. This paper shows that, for first-order systems the directivity degradation due to sensitivity errors is relatively small. However, for second-order systems with practical microphone sensitivity matching specifications, the directivity degradation below 1 kHz is not tolerable. A hybrid order directive system is proposed that uses first-order processing at low frequencies and second-order directive processing at higher frequencies. This hybrid system is suggested as an alternative that could provide improved directivity index in the frequency regions that are important to speech intelligibility.

Mineral waters, electricity, and hemlock: devising therapeutics for children in eighteenth-century institutions.

PubMed

Mathisen, Ashley

2013-01-01

The development of paediatric medicine as a formal field of medical specialisation is usually traced to the mid-nineteenth century at the earliest. While it is true that formal specialisation in children's medicine was not, on the whole, typical for eighteenth-century medical practitioners, many displayed a deep and lasting interest in the diseases of children, and were consequently eager to develop therapeutic practices which could be targeted at infants and children. This led to a variety of attempts at innovation, many of which benefitted from the co-operation of, and opportunities afforded by, institutions. By examining the efforts of several medical practitioners at the London Foundling Hospital and at the Dispensary for the Infant Poor, this article explores how eighteenth-century medical practitioners used their affiliations with institutions to address the problems of devising or adapting therapeutic practices and treatments for children. In tailoring medical practice to suit children and, more specifically, in using institutions to do so, medical practitioners were demonstrating that child patients required special consideration, that children's diseases could be managed medically and with the benefit of new approaches and methods, and that children's health, as a whole, was the province of medical practitioners.

Harmonizing and consolidating the measurement of patient-reported information at health care institutions: a position statement of the Mayo Clinic

PubMed Central

Eton, David T; Beebe, Timothy J; Hagen, Philip T; Halyard, Michele Y; Montori, Victor M; Naessens, James M; Sloan, Jeff A; Thompson, Carrie A; Wood, Douglas L

2014-01-01

Patient-reported outcomes (PROs) capture how patients perceive their health and their health care; their use in clinical research is longstanding. Today, however, PROs increasingly are being used to inform the care of individual patients, and document the performance of health care entities. We recently wrote and internally distributed an institutional position statement titled “Harmonizing and Consolidating the Measurement of Patient-Reported Outcomes at Mayo Clinic: A Position Statement for the Center for the Science of Health Care Delivery”. The statement is meant to educate clinicians, clinical teams, and institutional administrators about the merits of using PROs in a systematic manner for clinical care and quality measurement throughout the institution. The present article summarizes the most important messages from the statement, describing PROs and their use, identifying practical considerations for implementing them in routine practice, elucidating potential barriers to their use, and formulating strategies to overcome these barriers. The lessons learned from our experience – including pitfalls, challenges, and successes – may inform other health care institutions that are interested in systematically using PROs in health care delivery science and practice. PMID:24550683

Becoming a scientist: The role of undergraduate research in students' cognitive, personal, and professional development

NASA Astrophysics Data System (ADS)

Hunter, Anne-Barrie; Laursen, Sandra L.; Seymour, Elaine

2007-01-01

In this ethnographic study of summer undergraduate research (UR) experiences at four liberal arts colleges, where faculty and students work collaboratively on a project of mutual interest in an apprenticeship of authentic science research work, analysis of the accounts of faculty and student participants yields comparative insights into the structural elements of this form of UR program and its benefits for students. Comparison of the perspectives of faculty and their students revealed considerable agreement on the nature, range, and extent of students' UR gains. Specific student gains relating to the process of becoming a scientist were described and illustrated by both groups. Faculty framed these gains as part of professional socialization into the sciences. In contrast, students emphasized their personal and intellectual development, with little awareness of their socialization into professional practice. Viewing study findings through the lens of social constructivist learning theories demonstrates that the characteristics of these UR programs, how faculty practice UR in these colleges, and students' outcomes - including cognitive and personal growth and the development of a professional identity - strongly exemplify many facets of these theories, particularly, student-centered and situated learning as part of cognitive apprenticeship in a community of practice.

Going Global: Toward Competency-Based Best Practices for Global Health in Dental Education.

PubMed

Seymour, Brittany; Shick, Elizabeth; Chaffee, Benjamin W; Benzian, Habib

2017-06-01

The Global Oral Health Interest Group of the Consortium of Universities for Global Health (GOHIG-CUGH) published recommended competencies to support development of competency-based global health education in dental schools. However, there has been no comprehensive, systematically derived, or broadly accepted framework for creating and delivering competency-based global health education to dental students. This article describes the results of a collaborative workshop held at the 2016 American Dental Education Association (ADEA) Annual Session & Exhibition designed to build on the GOHIG-CUGH competencies and start to develop systematic approaches for their practical application. Workshop organizers developed a preliminary theoretical framework for guiding the development of global health in dental education, grounded in published research. Collectively, workshop participants developed detailed outcomes for the theoretical framework with a focus on three educational practices: didactic, experiential, and research learning and how each can meet the competencies. Participants discussed learning objectives, keys to implementation, ethical considerations, challenges, and examples of success. Outcomes demonstrated that no educational practice on its own meets all 33 recommended competencies for dental students; however, the three educational practices combined may potentially cover all 33. Participants emphasized the significance of sustainable approaches to student learning for both students and communities, with identified partners in the communities to collaborate on the development, implementation, evaluation, and long-term maintenance of any student global health activity. These findings may represent early steps toward professional consensus and best practices for global health in dental education in the United States.

Researching Lesbian, Gay, and Bisexual Youth: Conceptual, Practical, and Ethical Considerations

ERIC Educational Resources Information Center

D'Augelli, Anthony R.; Grossman, Arnold H.

2006-01-01

Developmental and educational researchers have overlooked the development of sexual orientation among adolescents and youth, even as they study sexual development and identity development during adolescence. This paper examines some conceptual, practical, and ethical considerations involved in conducting research on lesbian, gay, and bisexual…

Overservicing in dental practice--ethical perspectives.

PubMed

Hartshorne, Johan; Hasegawa, Thomas K

2003-10-01

Overservicing or the acceptance of unnecessary, inappropriate, excessive or fraudulent treatment is regarded as sanctioned lying, cheating or stealing and thus constitutes unethical conduct and a breach of the integrity of the profession. During the past year the media have repeatedly reported that the private sector is bloated with overservicing: one of the most important factors contributing to the increasing inflation of health care costs. Overservicing is an ethical problem presenting with a conflict situation among the interests of the patient, the provider and the funder. For example, since dentists are in a position to gain financially from their professional recommendations, they are at risk of having a conflict of interest: by overservicing they collect more fees. Low medical aid tariffs, delayed payment of benefits, oversupply of dentists, decreasing business and the spiralling costs of dental materials and equipment are the primary causes of high practice overheads and low cash-flow levels. Dentists may seek alternatives such as overservicing or unnecessary treatment to generate income and to improve their cash flow and/or profit. The main motives for overservicing are economic survival and financial gain. Some dentists may overtreat unintentionally due to out-dated treatment philosophies or where criteria for diagnosis and effective care are not clear, leading to variation in treatment decisions. Some overservicing may be due to patient-initiated demand. Dentists are largely unregulated as to the appropriateness or necessity of treatment decisions because of their professional status. Society trusts that their professionals will put the benefit of those they serve above their own self-interests. The aim of this review is to provide dentists with some guidance to the process of ethical decision making, the ethical principles involved, moral rules, and guidelines for professional standard of care. Business considerations whether profit, financial gain or economic survival should never justify overservicing by the dentist. If the patients' best interests are always considered, the profession of dentistry can ethically exist within a business structure.

DNA Isolation of Microbial Contaminants in Aviation Turbine Fuel via Traditional Polymerase Chain Reaction (PCR) and Direct PCR. Preliminary Results

DTIC Science & Technology

2005-11-01

fuel gauge malfunctions, fuel line and filter plugging, and corrosion. As a result, there is considerable interest in identifying microbial growth ...corrosion. As a result, there is considerable interest in identifying microbial growth and finding strategies to mitigate it. Previous research to... Rhodotorula sp. Yes Yes Trichosporium sp. Yes Trichoderma sp. (viride + others) Yes Yes 4 Table 2. Culturability Determined as a Percentage of

Energetics of drug-DNA interactions.

PubMed

Chaires, J B

1997-01-01

Understanding the thermodynamics of drug binding to DNA is of both practical and fundamental interest. The practical interest lies in the contribution that thermodynamics can make to the rational design process for the development of new DNA targeted drugs. Thermodynamics offer key insights into the molecular forces that drive complex formation that cannot be obtained by structural or computational studies alone. The fundamental interest in these interactions lies in what they can reveal about the general problems of parsing and predicting ligand binding free energies. For these problems, drug-DNA interactions offer several distinct advantages, among them being that the structures of many drug-DNA complexes are known at high resolution and that such structures reveal that in many cases the drug acts as a rigid body, with little conformational change upon binding. Complete thermodynamic profiles (delta G, delta H, delta S, delta Cp) for numerous drug-DNA interactions have been obtained, with the help of high-sensitivity microcalorimetry. The purpose of this article is to offer a perspective on the interpretation of these thermodynamics parameters, and in particular how they might be correlated with known structural features. Obligatory conformational changes in the DNA to accommodate intercalators and the loss of translational and rotational freedom upon complex formation both present unfavorable free energy barriers for binding. Such barriers must be overcome by favorable free energy contributions from the hydrophobic transfer of ligand from solution into the binding site, polyelectrolyte contributions from coupled ion release, and molecular interactions (hydrogen and ionic bonds, van der Waals interactions) that form within the binding site. Theoretical and semiempirical tools that allow estimates of these contributions to be made will be discussed, and their use in dissecting experimental data illustrated. This process, even at the current level of approximation, can shed considerable light on the drug-DNA binding process.

32 CFR 644.541 - Award of contract.

Code of Federal Regulations, 2011 CFR

2011-07-01

... auctioneers, are in a position to give other advice and assistance, and may authorize auction sales on behalf... auctioneers. Consideration should be given to auction sales when there is likely to be considerable interest...

Minors and Contested Medical-Surgical Treatment.

PubMed

Snelling, Jeanne

2016-01-01

Use of the best-interests test as the legal standard to justify medical treatment (or its cessation) in respect to legally incompetent adults or minors has come under sustained critique over the years. "Best interests" has variously been alleged to be indeterminate as well as susceptible to majoritarian ideology and inherent bias. It has also been alleged to be inferior to rights-based approaches. Against the background of several particularly hard cases involving minors discussed by Gillett in a prior article in this journal, this article considers some of these critiques. It concludes that these critical accounts make significant contributions to enabling a more procedurally and substantively robust consideration of what might be in a child's best interests. However, it is argued that none of these accounts alone provide a superior framework that would justify jettisoning the concept of best interests. Further, it is suggested that best interests still has an important role in achieving patient-centered decisionmaking in this context. It concludes by suggesting a taxonomy of considerations when determining best interests.

49 CFR Appendix F to Part 222 - Diagnostic Team Considerations

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Diagnostic Team Considerations F Appendix F to.... 222, App. F Appendix F to Part 222—Diagnostic Team Considerations For purposes of this part, a diagnostic team is a group of knowledgeable representatives of parties of interest in a highway-rail grade...

49 CFR Appendix F to Part 222 - Diagnostic Team Considerations

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Diagnostic Team Considerations F Appendix F to.... 222, App. F Appendix F to Part 222—Diagnostic Team Considerations For purposes of this part, a diagnostic team is a group of knowledgeable representatives of parties of interest in a highway-rail grade...

49 CFR Appendix F to Part 222 - Diagnostic Team Considerations

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Diagnostic Team Considerations F Appendix F to.... 222, App. F Appendix F to Part 222—Diagnostic Team Considerations For purposes of this part, a diagnostic team is a group of knowledgeable representatives of parties of interest in a highway-rail grade...

49 CFR Appendix F to Part 222 - Diagnostic Team Considerations

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Diagnostic Team Considerations F Appendix F to.... 222, App. F Appendix F to Part 222—Diagnostic Team Considerations For purposes of this part, a diagnostic team is a group of knowledgeable representatives of parties of interest in a highway-rail grade...

49 CFR Appendix F to Part 222 - Diagnostic Team Considerations

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Diagnostic Team Considerations F Appendix F to.... 222, App. F Appendix F to Part 222—Diagnostic Team Considerations For purposes of this part, a diagnostic team is a group of knowledgeable representatives of parties of interest in a highway-rail grade...

Tiered Systems of Support: Practical Considerations for School Districts. Issue Focus

ERIC Educational Resources Information Center

MDRC, 2017

2017-01-01

Students learn or progress at their own paces. How can schools make sure that they get the help they need--and only the help they need? Many are turning to multi-tiered systems of support. This brief provides some practical considerations for schools contemplating tiered approaches.

17 CFR 201.411 - Commission consideration of initial decisions by hearing officers.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Commission consideration of initial decisions by hearing officers. 201.411 Section 201.411 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice Appeal to the Commission and...

Palliative sedation versus euthanasia: an ethical assessment.

PubMed

ten Have, Henk; Welie, Jos V M

2014-01-01

The aim of this article was to review the ethical debate concerning palliative sedation. Although recent guidelines articulate the differences between palliative sedation and euthanasia, the ethical controversies remain. The dominant view is that euthanasia and palliative sedation are morally distinct practices. However, ambiguous moral experiences and considerable practice variation call this view into question. When heterogeneous sedative practices are all labeled as palliative sedation, there is the risk that palliative sedation is expanded to include practices that are actually intended to bring about the patients' death. This troublesome expansion is fostered by an expansive use of the concept of intention such that this decisive ethical concept is no longer restricted to signify the aim in guiding the action. In this article, it is argued that intention should be used in a restricted way. The significance of intention is related to other ethical parameters to demarcate the practice of palliative sedation: terminality, refractory symptoms, proportionality, and separation from other end-of-life decisions. These additional parameters, although not without ethical and practical problems, together formulate a framework to ethically distinguish a more narrowly defined practice of palliative sedation from practices that are tantamount to euthanasia. Finally, the article raises the question as to what impact palliative sedation might have on the practice of palliative care itself. The increasing interest in palliative sedation may reemphasize characteristics of health care that initially encouraged the emergence of palliative care in the first place: the focus on therapy rather than care, the physical dimension rather than the whole person, the individual rather than the community, and the primacy of intervention rather than receptiveness and presence. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Most Relevant Neuropathic Pain Treatment and Chronic Low Back Pain Management Guidelines: A Change Pain Latin America Advisory Panel Consensus.

PubMed

Amescua-Garcia, Cesar; Colimon, Frantz; Guerrero, Carlos; Jreige Iskandar, Aziza; Berenguel Cook, Maria; Bonilla, Patricia; Campos Kraychete, Durval; Delgado Barrera, William; Alberto Flores Cantisani, Jose; Hernandez-Castro, John Jairo; Lara-Solares, Argelia; Perez Hernandez, Concepcion; Rico, Maria Antonieta; Del Rocio Guillen Nunez, Maria; Sempertegui Gallegos, Manuel; Garcia, Joao Batista Santos

2018-03-01

Chronic pain conditions profoundly affect the daily living of a significant number of people and are a major economic and social burden, particularly in developing countries. The Change Pain Latin America (CPLA) advisory panel aimed to identify the most appropriate guidelines for the treatment of neuropathic pain (NP) and chronic low back pain (CLBP) for use across Latin America. Published systematic reviews or practice guidelines were identified by a systematic search of PubMed, the Guidelines Clearinghouse, and Google. Articles were screened by an independent reviewer, and potential candidate guidelines were selected for more in-depth review. A shortlist of suitable guidelines was selected and critically evaluated by the CPLA advisory panel. Searches identified 674 and 604 guideline articles for NP and CLBP, respectively. Of these, 14 guidelines were shortlisted for consensus consideration, with the following final selections made: "Recommendations for the pharmacological management of neuropathic pain from the Neuropathic Pain Special Interest Group in 2015-pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis."Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society" (2007). The selected guidelines were endorsed by all members of the CPLA advisory board as the best fit for use across Latin America. In addition, regional considerations were discussed and recorded. We have included this expert local insight and advice to enhance the implementation of each guideline across all Latin American countries.

12 CFR 263.8 - Conflicts of interest.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Conflicts of interest. 263.8 Section 263.8... RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.8 Conflicts of interest. (a) Conflict of interest in representation. No person shall appear as counsel for another person in an...

12 CFR 308.8 - Conflicts of interest.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Conflicts of interest. 308.8 Section 308.8... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.8 Conflicts of interest. (a) Conflict... judge may take corrective measures at any stage of a proceeding to cure a conflict of interest in...

Projecting adverse event incidence rates using empirical Bayes methodology.

PubMed

Ma, Guoguang Julie; Ganju, Jitendra; Huang, Jing

2016-08-01

Although there is considerable interest in adverse events observed in clinical trials, projecting adverse event incidence rates in an extended period can be of interest when the trial duration is limited compared to clinical practice. A naïve method for making projections might involve modeling the observed rates into the future for each adverse event. However, such an approach overlooks the information that can be borrowed across all the adverse event data. We propose a method that weights each projection using a shrinkage factor; the adverse event-specific shrinkage is a probability, based on empirical Bayes methodology, estimated from all the adverse event data, reflecting evidence in support of the null or non-null hypotheses. Also proposed is a technique to estimate the proportion of true nulls, called the common area under the density curves, which is a critical step in arriving at the shrinkage factor. The performance of the method is evaluated by projecting from interim data and then comparing the projected results with observed results. The method is illustrated on two data sets. © The Author(s) 2013.

Liability versus innovation: the legal case for regenerative medicine.

PubMed

Keren-Paz, Tsachi; El Haj, Alicia J

2014-10-01

Medical innovation occupies a position somewhere between standard practice and clinical research, but innovation is primarily intended to benefit an individual patient where standard treatment fails. Medical innovations in the area of regenerative medicine have the potential to completely transform medical practice, but rely upon some major revision to the nature of treatments beyond drug-based therapies. There is considerable investment in scientific and clinical research, but further attention could be paid to legal barriers to medical innovation imposed by the threat of medical malpractice. We survey in this article the legal framework for making determinations of medical malpractice in general, and highlight the issues specific to innovative treatments. In essence, liability could be imposed for failing to adequately inform the patient about the innovative nature of the suggested therapy or based on the fact that the risks outweighed the benefits. As for the latter, we examine whether liability is likely to be based merely on deviating from existing practice or on an examination on the merits of the treatments' risks and benefits. The facts that some risks are unforeseeable and some benefits are external to the patient complicate negligence determinations. The first fact relates to the problem of judging adverse events in hindsight; the second, to the obligation to make decisions based on the patient's best interest and avoid conflict of interests. In addition, we evaluate the relationship between the obligations to secure the patient's informed consent and to avoid clinical negligence. We identify the need for further research to examine the significance of the putative anti-innovation bias that current liability regimen has, and to examine whether a move to strict liability might avoid such bias, while being fair to patients who contribute for the advancement of medical knowledge by participating in innovative therapies.

Assessment of Cognitive Communications Interest Areas for NASA Needs and Benefits

NASA Technical Reports Server (NTRS)

Knoblock, Eric J.; Madanayake, Arjuna

2017-01-01

This effort provides a survey and assessment of various cognitive communications interest areas, including node-to-node link optimization, intelligent routing/networking, and learning algorithms, and is conducted primarily from the perspective of NASA space communications needs and benefits. Areas of consideration include optimization methods, learning algorithms, and candidate implementations/technologies. Assessments of current research efforts are provided with mention of areas for further investment. Other considerations, such as antenna technologies and cognitive radio platforms, are briefly provided as well.

Sign Life-Cycle Policies and Practices : Transportation Research Synthesis

DOT National Transportation Integrated Search

2017-10-01

MnDOT Metro District Traffic Engineering is interested in the practices that other state departments of transportation (DOTs) use to determine traffic sign life expectancy and replacement. Of particular interest is the state of the practice regarding...

26 CFR 25.2511-1 - Transfers in general.

Code of Federal Regulations, 2011 CFR

2011-04-01

... for insufficient consideration. However, in the case of a transfer creating an interest in property... creating an interest in the person disclaiming made before January 1, 1977, where the law governing the... this section is applicable for transfers creating an interest to be disclaimed made on or after...

Best practices for implementing, testing and using a cloud-based communication system in a disaster situation.

PubMed

Makowski, Dale

2016-01-01

This paper sets out the basics for approaching the selection and implementation of a cloud-based communication system to support a business continuity programme, including: • consideration for how a cloud-based communication system can enhance a business continuity programme; • descriptions of some of the more popular features of a cloud-based communication system; • options to evaluate when selecting a cloud-based communication system; • considerations for how to design a system to be most effective for an organisation; • best practices for how to conduct the initial load of data to a cloud-based communication system; • best practices for how to conduct an initial validation of the data loaded to a cloud-based communication system; • considerations for how to keep contact information in the cloud-based communication system current and accurate; • best practices for conducting ongoing system testing; • considerations for how to conduct user training; • review of other potential uses of a cloud-based communication system; and • review of other tools and features many cloud-based communication systems may offer.

Cause for concern: the absence of consideration of public and ethical interest in British public policy

PubMed Central

Pattison, S; Evans, H M

2006-01-01

In the UK, many fundamentally important policy decisions that are likely to affect the relationship between citizens and care services are now made at the sublegislative level and without adequate ethical consideration and scrutiny. This is well exemplified in the proposed guidance on the disclosure of information on children. A recent consultation paper by the UK government on the subject proposes an approach that seeks a simple technical solution to a complex problem, emphasising control and surveillance. This reflects pressure to be seen to act. The document fails with regard to ethical reflection appropriate to the complexity of the issue, an appreciation of complex relationships of trust, and a proper sense of the richness and complexity of the public interest. Such policies would, if implemented, fundamentally change the relationships between citizens and their carers, and among carers and the law and the state. This and similar proposals require far more ethical scrutiny and consideration of the public interest in the widest sense. PMID:17145911

An Interdisciplinary Approach to Sports Concussion Evaluation and Management: The Role of a Neuropsychologist.

PubMed

Ott, Summer D; Bailey, Christopher M; Broshek, Donna K

2018-05-01

Sports neuropsychology is a rapidly emerging field that affords neuropsychologists, the opportunity to work with a diverse group of individuals in terms of age, gender, sports, ethnicity, and language and sports has a way of bringing diverse communities together. Although working with athletes can be associated with unique challenges, neuropsychological assessment with this population and being part of an interdisciplinary sports medicine team is both exciting and rewarding and can merge a passion for sports with professional interests. This paper is intended to highlight the contribution of neuropsychology to the evaluation and management of sport-related concussion as well as describe the neuropsychologist's role as an integral member of interdisciplinary sports medicine teams. Clinical model, special considerations, assessment strategy, and administrative aspects of practice are discussed.

Using timed event sequential data in nursing research.

PubMed

Pecanac, Kristen E; Doherty-King, Barbara; Yoon, Ju Young; Brown, Roger; Schiefelbein, Tony

2015-01-01

Measuring behavior is important in nursing research, and innovative technologies are needed to capture the "real-life" complexity of behaviors and events. The purpose of this article is to describe the use of timed event sequential data in nursing research and to demonstrate the use of this data in a research study. Timed event sequencing allows the researcher to capture the frequency, duration, and sequence of behaviors as they occur in an observation period and to link the behaviors to contextual details. Timed event sequential data can easily be collected with handheld computers, loaded with a software program designed for capturing observations in real time. Timed event sequential data add considerable strength to analysis of any nursing behavior of interest, which can enhance understanding and lead to improvement in nursing practice.

Clinical use of indium-111 labeled blood products

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

Loken, M.K.; Clay, M.E.; Carpenter, R.T.

1985-12-01

Following the introduction of In-111 oxine as a label for blood cells by McAffee and Thakur in 1976, these procedures have become increasingly important in the practice of nuclear medicine. Of particular interest are studies involving the use of labeled leukocytes for the detection of focal infection. The clinical utility of labeled platelets is less well developed, although the use of platelets to detect the formation of thrombi in blood vessels and on vascular grafts and prostheses is gaining prominence. This report summarizes the techniques presently employed at the University of Minnesota for the labeling of blood products, and theirmore » clinical use. Consideration also is given to the desired expertise and cost factors involved in the labeling of leukocytes and platelets.43 references.« less

Flexible, Stretchable Sensors for Wearable Health Monitoring: Sensing Mechanisms, Materials, Fabrication Strategies and Features

PubMed Central

Liu, Yan; Wang, Hai; Zhao, Wei; Qin, Hongbo; Xie, Yongqiang

2018-01-01

Wearable health monitoring systems have gained considerable interest in recent years owing to their tremendous promise for personal portable health watching and remote medical practices. The sensors with excellent flexibility and stretchability are crucial components that can provide health monitoring systems with the capability of continuously tracking physiological signals of human body without conspicuous uncomfortableness and invasiveness. The signals acquired by these sensors, such as body motion, heart rate, breath, skin temperature and metabolism parameter, are closely associated with personal health conditions. This review attempts to summarize the recent progress in flexible and stretchable sensors, concerning the detected health indicators, sensing mechanisms, functional materials, fabrication strategies, basic and desired features. The potential challenges and future perspectives of wearable health monitoring system are also briefly discussed. PMID:29470408

A review of the effects of vitamins and other dietary supplements on seizure activity.

PubMed

Lee, Susan W; Chung, Steve S

2010-07-01

The role of pharmacological and surgical management of epilepsy continues to expand, but these treatments are often associated with significant side effects and morbidity. As a result, many patients with epilepsy and their physicians alike have gained interest in the role of vitamins and other dietary supplements for seizure management. In this review, we examine the potential anticonvulsant and proconvulsant effects of commonly used dietary supplements, as well as their potential effects on cognition or behavior. Our review was conducted through a literature search focusing on clinical trials involving patients with epilepsy and their seizure response to dietary supplementation. We summarize findings from previous clinical studies and comment on practical considerations regarding dietary supplementation for patients with epilepsy. Copyright 2010 Elsevier Inc. All rights reserved.

Marine biology, intertidal ecology, and a new place for biology.

PubMed

Benson, Keith R

2015-01-01

At the present time, there is considerable interest for the physical setting of science, that is, its actual 'place' of practice. Among historians of biology, place has been considered to be a crucial component for the study of ecology. Other historians have noted the 'built' environments (laboratories) for the study of biology along the seashore, even referring to these places in terms more applicable to vacation sites. In this paper, I examine the place of intertidal ecology investigations, both in terms of the physical space and the built space. Part of the examination will investigate the aesthetic aspect of the Pacific Coast, part will evaluate the unique character of the intertidal zone, and part will consider the construction of natural laboratories and built laboratories as characteristic places for biology.

Flexible, Stretchable Sensors for Wearable Health Monitoring: Sensing Mechanisms, Materials, Fabrication Strategies and Features.

PubMed

Liu, Yan; Wang, Hai; Zhao, Wei; Zhang, Min; Qin, Hongbo; Xie, Yongqiang

2018-02-22

Wearable health monitoring systems have gained considerable interest in recent years owing to their tremendous promise for personal portable health watching and remote medical practices. The sensors with excellent flexibility and stretchability are crucial components that can provide health monitoring systems with the capability of continuously tracking physiological signals of human body without conspicuous uncomfortableness and invasiveness. The signals acquired by these sensors, such as body motion, heart rate, breath, skin temperature and metabolism parameter, are closely associated with personal health conditions. This review attempts to summarize the recent progress in flexible and stretchable sensors, concerning the detected health indicators, sensing mechanisms, functional materials, fabrication strategies, basic and desired features. The potential challenges and future perspectives of wearable health monitoring system are also briefly discussed.

The Study of the Relationship between Probabilistic Design and Axiomatic Design Methodology. Volume 3

NASA Technical Reports Server (NTRS)

Onwubiko, Chin-Yere; Onyebueke, Landon

1996-01-01

Structural failure is rarely a "sudden death" type of event, such sudden failures may occur only under abnormal loadings like bomb or gas explosions and very strong earthquakes. In most cases, structures fail due to damage accumulated under normal loadings such as wind loads, dead and live loads. The consequence of cumulative damage will affect the reliability of surviving components and finally causes collapse of the system. The cumulative damage effects on system reliability under time-invariant loadings are of practical interest in structural design and therefore will be investigated in this study. The scope of this study is, however, restricted to the consideration of damage accumulation as the increase in the number of failed components due to the violation of their strength limits.

Rainbow Trapping in Hyperbolic Metamaterial Waveguide

PubMed Central

Hu, Haifeng; Ji, Dengxin; Zeng, Xie; Liu, Kai; Gan, Qiaoqiang

2013-01-01

The recent reported trapped “rainbow” storage of light using metamaterials and plasmonic graded surface gratings has generated considerable interest for on-chip slow light. The potential for controlling the velocity of broadband light in guided photonic structures opens up tremendous opportunities to manipulate light for optical modulation, switching, communication and light-matter interactions. However, previously reported designs for rainbow trapping are generally constrained by inherent difficulties resulting in the limited experimental realization of this intriguing effect. Here we propose a hyperbolic metamaterial structure to realize a highly efficient rainbow trapping effect, which, importantly, is not limited by those severe theoretical constraints required in previously reported insulator-negative-index-insulator, insulator-metal-insulator and metal-insulator-metal waveguide tapers, and therefore representing a significant promise to realize the rainbow trapping structure practically. PMID:23409240

Genetic transformation protocols using zygotic embryos as explants: an overview.

PubMed

Tahir, Muhammad; Waraich, Ejaz A; Stasolla, Claudio

2011-01-01

Genetic transformation of plants is an innovative research tool which has practical significance for the development of new and improved genotypes or cultivars. However, stable introduction of genes of interest into nuclear genomes depends on several factors such as the choice of target tissue, the method of DNA delivery in the target tissue, and the appropriate method to select the transformed plants. Mature or immature zygotic embryos have been a popular choice as explant or target tissue for genetic transformation in both angiosperms and gymnosperms. As a result, considerable protocols have emerged in the literature which have been optimized for various plant species in terms of transformation methods and selection procedures for transformed plants. This article summarizes the recent advances in plant transformation using zygotic embryos as explants.

Implementation of a mandatory checklist of protocols and objectives improves compliance with a wide range of evidence-based intensive care unit practices.

PubMed

Byrnes, Matthew C; Schuerer, Douglas J E; Schallom, Marilyn E; Sona, Carrie S; Mazuski, John E; Taylor, Beth E; McKenzie, Wendi; Thomas, James M; Emerson, Jeffrey S; Nemeth, Jennifer L; Bailey, Ruth A; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M

2009-10-01

To determine a) if a checklist covering a diverse group of intensive care unit protocols and objectives would improve clinician consideration of these domains and b) if improved consideration would change practice patterns. Pre- and post observational study. A 24-bed surgical/burn/trauma intensive care unit in a teaching hospital. A total of 1399 patients admitted between June 2006 and May 2007. The first component of the study evaluated whether mandating verbal review of a checklist covering 14 intensive care unit best practices altered verbal consideration of these domains. Evaluation was performed using real-time bedside audits on morning rounds. The second component evaluated whether the checklist altered implementation of these domains by changing practice patterns. Evaluation was performed by analyzing data from the Project IMPACT database after patients left the intensive care unit. Verbal consideration of evaluable domains improved from 90.9% (530/583) to 99.7% (669/671, p < .0001) after verbal review of the checklist was mandated. Bedside consideration improved on the use of deep venous thrombosis prophylaxis (p < .05), stress ulcer prophylaxis (p < .01), oral care for ventilated patients (p < 0.01), electrolyte repletion (p < .01), initiation of physical therapy (p < .05), and documentation of restraint orders (p < .0001). Mandatory verbal review of the checklist resulted in a greater than two-fold increase in transferring patients out of the intensive care unit on telemetry (16% vs. 35%, p < .0001) and initiation of physical therapy (28% vs. 42%, p < .0001) compared with baseline practice. A mandatory verbal review of a checklist covering a wide range of objectives and goals at each patient's bedside is an effective method to improve both consideration and implementation of intensive care unit best practices. A bedside checklist is a simple, cost-effective method to prevent errors of omission in basic domains of intensive care unit management that might otherwise be forgotten in the setting of more urgent care requirements.

Tolerance of ambiguity, perfectionism and resilience are associated with personality profiles of medical students oriented to rural practice.

PubMed

Eley, Diann S; Leung, Janni K; Campbell, Narelle; Cloninger, C Robert

2017-05-01

Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines - particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice. Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs. More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background. Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual's interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice - regardless of background.

Is psychological science a-cultural?

PubMed

Gone, Joseph P

2011-07-01

The history of psychological science, as it has intersected with ethnoracial, cultural, and other marginalized domains of group difference, is replete with disinterest, dismissal, or denigration of these diverse forms of psychological experience. This has led some to wonder whether psychological science is a-cultural, or even anti-cultural in orientation. Assessment of this provocative proposition first requires exploration of three composite questions: (1) What is culture?, (2) What is science?, and (3) What is psychological science? Based on brief consideration of these composite questions--which are remarkably complex in their own right--I argue that psychological science is not, has never been, and indeed cannot in principle be a-cultural. Instead, like all forms of knowing, psychological science emerges at particular historical moments to achieve particular goals that are motivated by particular interests. Throughout much of the history of psychological science, these goals and interests were tied to ideologically suspect agendas that contemporary psychologists are right to repudiate. The interesting question becomes whether psychology's knowledge practices can be disentangled from this earlier ideological contamination to furnish the discipline with viable methods. I propose that psychological science can in fact be so disentangled; nevertheless, the resulting methods are never adopted or deployed outside of culturally constituted interests, objectives, and motivations, thereby requiring ongoing critical engagement with the subtexts of disciplinary knowledge production. In fact, there seem to be important ways in which psychology's scientific aspirations hobble disciplinary inquiry into the human condition that has motivated multicultural psychologists to consider alternative paradigms of inquiry.

Measuring neuroplasticity associated with cerebral palsy rehabilitation: An MRI based power analysis.

PubMed

Reid, Lee B; Pagnozzi, Alex M; Fiori, Simona; Boyd, Roslyn N; Dowson, Nicholas; Rose, Stephen E

2017-05-01

Researchers in the field of child neurology are increasingly looking to supplement clinical trials of motor rehabilitation with neuroimaging in order to better understand the relationship between behavioural training, brain changes, and clinical improvements. Randomised controlled trials are typically accompanied by sample size calculations to detect clinical improvements but, despite the large cost of neuroimaging, not equivalent calculations for concurrently acquired imaging neuroimaging measures of changes in response to intervention. To aid in this regard, a power analysis was conducted for two measures of brain changes that may be indexed in a trial of rehabilitative therapy for cerebral palsy: cortical thickness of the impaired primary sensorimotor cortex, and fractional anisotropy of the impaired, delineated corticospinal tract. Power for measuring fractional anisotropy was assessed for both region-of-interest-seeded and fMRI-seeded diffusion tractography. Taking into account practical limitations, as well as data loss due to behavioural and image-processing issues, estimated required participant numbers were 101, 128 and 59 for cortical thickness, region-of-interest-based tractography, and fMRI-seeded tractography, respectively. These numbers are not adjusted for study attrition. Although these participant numbers may be out of reach of many trials, several options are available to improve statistical power, including careful preparation of participants for scanning using mock simulators, careful consideration of image processing options, and enrolment of as homogeneous a cohort as possible. This work suggests that smaller and moderate sized studies give genuine consideration to harmonising scanning protocols between groups to allow the pooling of data. Copyright © 2017 ISDN. All rights reserved.

77 FR 50628 - Review of Foreign Ownership Policies for Common Carrier and Aeronautical Radio Licensees

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... the licensee in a manner that best accommodates their financial considerations and business needs. 9... national security and law enforcement interests. 11. The First Report and Order defers consideration, to a...

32 CFR 989.4 - Initial considerations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.4 Initial considerations. Air Force personnel will: (a... CATEX from environmental impact analysis (appendix B). (c) Make environmental documents, comments, and... national security interests while at the same time considering important environmental factors. (g...

32 CFR 989.4 - Initial considerations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.4 Initial considerations. Air Force personnel will: (a... CATEX from environmental impact analysis (appendix B). (c) Make environmental documents, comments, and... national security interests while at the same time considering important environmental factors. (g...

32 CFR 989.4 - Initial considerations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.4 Initial considerations. Air Force personnel will: (a... CATEX from environmental impact analysis (appendix B). (c) Make environmental documents, comments, and... national security interests while at the same time considering important environmental factors. (g...

The CanPain SCI Clinical Practice Guidelines for Rehabilitation Management of Neuropathic Pain after Spinal Cord: screening and diagnosis recommendations.

PubMed

Mehta, S; Guy, S D; Bryce, T N; Craven, B C; Finnerup, N B; Hitzig, S L; Orenczuk, S; Siddall, P J; Widerström-Noga, E; Casalino, A; Côté, I; Harvey, D; Kras-Dupuis, A; Lau, B; Middleton, J W; Moulin, D E; O'Connell, C; Parrent, A G; Potter, P; Short, C; Teasell, R; Townson, A; Truchon, C; Wolfe, D; Bradbury, C L; Loh, E

2016-08-01

Clinical practice guidelines. To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI). The guidelines are relevant for inpatient and outpatient SCI rehabilitation settings in Canada. The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations. Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation. The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.

The policy debate over public investment in comparative effectiveness research.

PubMed

Rich, Eugene C

2009-06-01

Policy makers across the political spectrum, as well as many clinicians and physician professional associations, have proposed that better information on comparative clinical effectiveness should be a key element of any solution to the US health-care cost crisis. This superficial consensus hides intense disagreements over critical issues essential to any new public effort to promote more comparative effectiveness research (CER). This article reviews the background for these disputes, summarizes the different perspectives represented by policy makers and advocates, and offers a framework to aid both practicing and academic internists in understanding the key elements of the emerging debate. Regarding the fundamental question of "what is CER," disagreements rage over whether value or cost effectiveness should be a consideration, and how specific patient perspectives should be reflected in the development and the use of such research. The question of how to pay for CER invokes controversies over the role of the market in producing such information and the private (e.g., insurers and employers) versus public responsibility for its production. The financing debate further highlights the high stakes of comparative effectiveness research, and the risks of stakeholder interests subverting any public process. Accordingly there are a range of proposals for the federal government's role in prioritization, development, and dissemination of CER. The internal medicine community, with its long history of commitment to scientific medical practice and its leadership in evidence-based medicine, should have a strong interest and play an active role in this debate.

Conflicts of interest in medicine: taking diversity seriously.

PubMed

Williams, Jane; Mayes, Christopher; Komesaroff, Paul; Kerridge, Ian; Lipworth, Wendy

2017-07-01

Conflicts of interest (COI) are considered ubiquitous in many healthcare arrangements, 1 but there is disagreement on how COI should be defined, whether non-financial conflicts deserve attention and the relationship between COI and harm. We conducted a study of Australian healthcare professionals and students to gain a better understanding of the way that COI are understood in practice. In this paper, we outline an empirically derived taxonomy of the understanding of, and attitudes towards, COI. We carried out 25 semistructured interviews with clinicians working in several fields across Australia and held six focus group discussions with medical students in New South Wales. Interviewees and focus groups followed similar question routes investigating participants' understanding of COI and views of management. All data were compared and analysed using a matrix of pre-determined questions. There were, broadly, two views of COI: that COI were potentially harmful and morally compromising and another that saw COI as less serious and easily managed through existing structures. Definitions of COI varied widely and were both financial and non-financial. Causes of COI were, variously, systemic, individual and/or relational. Some participants associated COI with moral wrongdoing, and a variety of potential harms was identified. Views on how COI should be managed were similarly varied. We found considerable heterogeneity in how COI are understood in practice. This has implications for management systems that are currently in place, and we suggest a more sophisticated system for considering and mitigating COI. © 2017 Royal Australasian College of Physicians.

Benchmarking: applications to transfusion medicine.

PubMed

Apelseth, Torunn Oveland; Molnar, Laura; Arnold, Emmy; Heddle, Nancy M

2012-10-01

Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine-related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal. Copyright © 2012 Elsevier Inc. All rights reserved.

Surgeon-industry conflict of interest: survey of opinions regarding industry-sponsored educational events and surgeon teaching: clinical article.

PubMed

DiPaola, Christian P; Dea, Nicolas; Dvorak, Marcel F; Lee, Robert S; Hartig, Dennis; Fisher, Charles G

2014-03-01

Conflict of interest (COI) as it applies to medical education and training has become a source of considerable interest, debate, and regulation in the last decade. Companies often pay surgeons as faculty for educational events and often sponsor and give financial support to major professional society meetings. Professional medical societies, industry, and legislators have attempted to regulate potential COI without consideration for public opinion. The practice of evidence-based medicine requires the inclusion of patient opinion along with best available evidence and expert opinion. The primary goal of this study was to assess the opinion of the general population regarding surgeon-industry COI for education-related events. A Web-based survey was administered, with special emphasis on the surgeon's role in industry-sponsored education and support of professional societies. A survey was constructed to sample opinions on reimbursement, disclosure, and funding sources for educational events. There were 501 completed surveys available for analysis. More than 90% of respondents believed that industry funding for surgeons' tuition and travel for either industry-sponsored or professional society educational meetings would either not affect the quality of care delivered or would cause it to improve. Similar results were generated for opinions on surgeons being paid by industry to teach other surgeons. Moreover, the majority of respondents believed it was ethical or had no opinion if surgeons had such a relationship with industry. Respondents were also generally in favor of educational conferences for surgeons regardless of funding source. Disclosures of a surgeon-industry relationship, especially if it involves specific devices that may be used in their surgery, appears to be important to respondents. The vast majority of respondents in this study do not believe that the quality of their care will be diminished due to industry funding of educational events, for surgeon tuition, and/or travel expenses. The results of this study should help form the basis of policy and continued efforts at surgeon-industry COI management.

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force

PubMed Central

Powers, John H.; Patrick, Donald L.; Walton, Marc K.; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B.

2017-01-01

A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients’ health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient’s health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment—Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of ClinRO assessments used as end points in clinical trials. Applying good measurement practices to ClinRO assessment development and evaluation will lead to more efficient and accurate measurement of treatment effects. This is important beyond regulatory approval in that it provides evidence for the uptake of new interventions into clinical practice and provides justification to payers for reimbursement on the basis of the clearly demonstrated added value of the new intervention. PMID:28212963

Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force.

PubMed

Powers, John H; Patrick, Donald L; Walton, Marc K; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B

2017-01-01

A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment-Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of ClinRO assessments used as end points in clinical trials. Applying good measurement practices to ClinRO assessment development and evaluation will lead to more efficient and accurate measurement of treatment effects. This is important beyond regulatory approval in that it provides evidence for the uptake of new interventions into clinical practice and provides justification to payers for reimbursement on the basis of the clearly demonstrated added value of the new intervention. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Lifecourse factors and likelihood of rural practice and emigration: a survey of Ghanaian medical students.

PubMed

Kotha, Sudha Rani; Johnson, Jennifer C; Galea, Sandro; Agyei-Baffour, Peter; Nakua, Emmanuel; Asabir, Kwesi; Kwansah, Janet; Gyakobo, Mawuli; Dzodzomenyo, Mawuli; Kruk, Margaret E

2012-01-01

Health worker shortages and maldistribution have important implications for the capacity of health systems. Ghana has one of the highest physician emigration rates in the world, and over 75% of those who remain work in Ghana's two largest cities. The aim of this study was to investigate the contribution of experiential factors across Ghanaian medical students' lifespans on intent to practice in a rural area and intent to emigrate. All fourth year medical students in Ghana were surveyed on demographics, rural and international experience, and future career plans. Key outcomes of interest were students' stated likelihood of practicing in a deprived rural area or emigrating after graduation. Lifecourse predictors of interest were parental socioeconomic status, gender, relationship status, rural and international living experience, and school of study. Bivariate and multivariate logistic regression were used to estimate associations between predictors and outcomes of interest. Of 310 eligible students, 307 (99%) participated in the survey. Of these, 228 were Ghanaian and the focus of this analysis. It was found that 131 (57.5%) were willing to work in a deprived area in Ghana and 148 (64.9%) had considered emigrating after graduation. In the multivariate regression models, willingness to work in a deprived area was predicted by male gender (OR: 2.31, 95%CI: 1.23-4.35), having lived in a rural area but never lived abroad (OR: 2.77, 95%CI: 1.08-7.13), and low parental professional and educational status (OR: 2.33, 95%CI: 1.23-4.43). Consideration of emigration was predicted by having lived abroad but never in a rural area (OR: 3.39, 95%CI: 1.15-9.97). A sub-set of 80 individuals (35%) reported that they were willing to work in a deprived area in Ghana but also considering emigration. These subjects were more likely to be male. Students with parents of a lower socioeconomic class, those with rural experience, and those without international experience are more likely to stay in Ghana and are also more likely to work in a deprived area after graduation. Selective admissions policies based on lifecourse factors combined with exposure to rural practice in medical school may have a role in increasing the number of rural physicians.

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices

ERIC Educational Resources Information Center

Pizzo, Lianna; Chilvers, Amanda

2016-01-01

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general…

Practical, Ethical, and Legal Considerations regarding Videocounseling in College and University Counseling Centers: A Response to Quarto's "Influencing College Students' Perceptions of Videocounseling"

ERIC Educational Resources Information Center

Menzano, Silvestro; Goodwin, Alan; Rockett, Geraldine; Morris, Kathy

2011-01-01

There are numerous factors and concerns to take into consideration when implementing new technology into a counseling center's practice. These factors--informed consent, confidentiality, record-keeping, licensure, technical issues, eligibility, emergencies, and staff perceptions--are legitimate and must be addressed and resolved before…

Well-Being and Happiness: Critical, Practical and Philosophical Considerations for Policies and Practices in Lifelong Learning

ERIC Educational Resources Information Center

Gouthro, Patricia A.

2010-01-01

This paper argues that while the Inquiry into the Future of Lifelong Learning that was commissioned by NIACE makes some helpful recommendations for broadening the scope of lifelong learning to include considerations around well-being and happiness, the reports do not provide a sufficiently critical or philosophical analysis of the challenges…

Secondary Students' Considerations of Variability in Measurement Activities Based on Authentic Practices

ERIC Educational Resources Information Center

Dierdorp, Adri; Bakker, Arthur; Ben-Zvi, Dani; Makar, Katie

2017-01-01

Measurement activities were designed in this study on the basis of authentic professional practices in which linear regression is used, to study considerations of variability by students in Grade 12 (aged 17-18). The question addressed in this article is: In what ways do secondary students consider variability within these measurement activities?…

How Can We Enhance Girls' Interest in Scientific Topics?

ERIC Educational Resources Information Center

Kerger, Sylvie; Martin, Romain; Brunner, Martin

2011-01-01

Background: Girls are considerably less interested in scientific subjects than boys. One reason may be that scientific subjects are considered to be genuinely masculine. Thus, being interested in science may threaten the self-perception of girls as well as the femininity of their self-image. Aims: If scientific topics that are considered to be…

Structural and Dynamic Aspects of Interest Development: Theoretical Considerations from an Ontogenetic Perspective.

ERIC Educational Resources Information Center

Krapp, Andreas

2002-01-01

Presents a collection of theoretical concepts and models that can be used to describe and explore structural and dynamic aspects of interest development from an ontogenic research perspective. Outlines basic ideas of an educational-psychological conceptualization of interest that is based on a dynamic theory of personality. (SLD)

Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study

PubMed Central

West, Robert; Rushforth, Bruno; Stokes, Tim; Glidewell, Liz; Carder, Paul; Faulkner, Simon; Foy, Robbie

2017-01-01

Background There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected ‘big data’ in the evaluation of healthcare. We developed a set of evidence-based ‘high impact’ quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). Methods Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89). The QIs covered aspects of care (including processes and intermediate clinical outcomes) in relation to diabetes, hypertension, atrial fibrillation, myocardial infarction, chronic kidney disease (CKD) and ‘risky’ prescribing combinations. Regression models explored the impact of practice and patient characteristics. Clustering within practice was accounted for by including a random intercept for practice. Results Median practice achievement of the QIs ranged from 43.2% (diabetes control) to 72.2% (blood pressure control in CKD). Considerable between-practice variation existed for all indicators: the difference between the highest and lowest performing practices was 26.3 percentage points for risky prescribing and 100 percentage points for anticoagulation in atrial fibrillation. Odds ratios associated with the random effects for practices emphasised this; there was a greater than ten-fold difference in the likelihood of achieving the hypertension indicator between the lowest and highest performing practices. Patient characteristics, in particular age, gender and comorbidity, were consistently but modestly associated with indicator achievement. Statistically significant practice characteristics were identified less frequently in adjusted models. Conclusions Despite various policy and improvement initiatives, there are enduring inappropriate variations in the delivery of evidence-based care. Much of this variation is not explained by routinely collected patient or practice variables, and is likely to be attributable to differences in clinical and organisational behaviour. PMID:28704407

Fluctuations in energy loss and their implications for dosimetry and radiobiology

NASA Technical Reports Server (NTRS)

Baily, N. A.; Steigerwalt, J. E.

1972-01-01

Serious consideration of the physics of energy deposition indicates that a fundamental change in the interpretation of absorbed dose is required at least for considerations of effects in biological systems. In addition, theoretical approaches to radiobiology and microdosimetry seem to require statistical considerations incorporating frequency distributions of the magnitude of the event sizes within the volume of interest.

Shaping the future medical workforce: take care with selection tools.

PubMed

Poole, Phillippa; Shulruf, Boaz

2013-12-01

Medical school selection is a first step in developing a general practice workforce. To determine the relationship between medical school selection scores and intention to pursue a career in general practice. A longitudinal cohort study of students selected in 2006 and 2007 for The University of Auckland medical programme, who completed an exit survey on career intentions. Students are ranked for selection into year 2 of a six-year programme by combining grade point average from prior university achievement (60%), interview (25%) and Undergraduate Medicine and Health Sciences Admission Test (UMAT) scores (15%). The main outcome measure was level of interest in general practice at exit. Logistic regression assessed whether any demographic variables or admission scores predicted a 'strong' interest in general practice. None of interview scores, grade point average, age, gender, or entry pathway predicted a 'strong' interest in general practice. Only UMAT scores differentiated between those with a 'strong' interest versus those with 'some' or 'no' interest, but in an inverse fashion. The best predictor of a 'strong' interest in general practice was a low UMAT score of between 45 and 55 on all three UMAT sections (OR 3.37, p=0.020). Yet, the academic scores at entry of students with these UMAT scores were not lower than those of their classmates. Setting inappropriately high cut-points for medical school selection may exclude applicants with a propensity for general practice. These findings support the use of a wider lens through which to view medical school selection tools.

Relevant Information and Informed Consent in Research: In Defense of the Subjective Standard of Disclosure.

PubMed

Dranseika, Vilius; Piasecki, Jan; Waligora, Marcin

2017-02-01

In this article, we seek to contribute to the debate on the requirement of disclosure in the context of informed consent for research. We defend the subjective standard of disclosure and describe ways to implement this standard in research practice. We claim that the researcher should make an effort to find out what kinds of information are likely to be relevant for those consenting to research. This invites researchers to take empirical survey information seriously, attempt to understand the cultural context, talk to patients to be better able to understand what can be potentially different concerns and interests prevalent in the target population. The subjective standard of disclosure should be seen as a moral ideal that perhaps can never be perfectly implemented but still can and should be used as a normative ideal guiding research practice. In the light of these discussions, we call for more empirical research on what considerations are likely to be perceived as relevant by potential research participants recruited from different socio-economic and cultural groups.

The undergraduate research fellows program: a unique model to promote engagement in research.

PubMed

Vessey, Judith A; DeMarco, Rosanna F

2008-01-01

Well-educated nurses with research expertise are needed to advance evidence-based nursing practice. A primary goal of undergraduate nursing curricula is to create meaningful participatory experiences to help students develop a research skill set that articulates with rapid career advancement of gifted, young graduates interested in nursing research and faculty careers. Three research enrichment models-undergraduate honors programs, research assistant work-for-hire programs, and research work/mentorship programs-to be in conjunction with standard research content are reviewed. The development and implementation of one research work/mentorship program, the Boston College undergraduate research fellows program (UGRF), is explicated. This process included surveying previous UGRFs followed by creating a retreat and seminars to address specific research skill sets. The research skill sets included (a) how to develop a research team, (b) accurate data retrieval, (c) ethical considerations, (d) the research process, (e) data management, (f) successful writing of abstracts, and (g) creating effective poster presentations. Outcomes include evidence of involvement in research productivity and valuing of evidenced-based practice through the UGRF mentorship process with faculty partners.

A practical guide for short-term pediatric surgery global volunteers.

PubMed

Meier, Donald E; Fitzgerald, Tamara N; Axt, Jason R

2016-08-01

The tremendous need for increasing the quantity and quality of global pediatric surgical care in underserved areas has been well documented. Concomitantly there has been a significant increase in interest by pediatric surgeons in helping to relieve this problem through surgical volunteerism. The intent of the article is to serve as a practical guide for pediatric surgeons contemplating or planning a short-term global volunteer endeavor. The article is based on the authors' personal experiences and on the published experiences of other volunteers. The following aspects of volunteerism are discussed: ethical considerations, where and how to go, what and whom to take with you, what to expect in your volunteer locale, and what to do and what to avoid in order to enhance the volunteer experience. The points discussed in this guide will hopefully make the volunteer activity one that results in greatly improved immediate and long term surgical care for children and improves the chances that the activity will be a meaningful, pleasant, and productive experience for both the volunteer and the host physician. Copyright © 2016 Elsevier Inc. All rights reserved.

A practical model for economic evaluation of tissue-engineered therapies.

PubMed

Tan, Tien-En; Peh, Gary S L; Finkelstein, Eric A; Mehta, Jodhbir S

2015-01-01

Tissue-engineered therapies are being developed across virtually all fields of medicine. Some of these therapies are already in clinical use, while others are still in clinical trials or the experimental phase. Most initial studies in the evaluation of new therapies focus on demonstration of clinical efficacy. However, cost considerations or economic viability are just as important. Many tissue-engineered therapies have failed to be impactful because of shortcomings in economic competitiveness, rather than clinical efficacy. Furthermore, such economic viability studies should be performed early in the process of development, before significant investment has been made. Cost-minimization analysis combined with sensitivity analysis is a useful model for the economic evaluation of new tissue-engineered therapies. The analysis can be performed early in the development process, and can provide valuable information to guide further investment and research. The utility of the model is illustrated with the practical real-world example of tissue-engineered constructs for corneal endothelial transplantation. The authors have declared no conflicts of interest for this article. © 2015 Wiley Periodicals, Inc.

Nursing electives: an innovative and creative learning opportunity.

PubMed

Peate, Ian

Nursing elective can provide the nurse (learner or registered nurse) with a host of new opportunities to experience and observe practice from a variety of different perspectives. The nursing elective should be planned well in advance and much time and thought should be given to preparing for this activity. There are a number of resources (human and material) available to help with the planning of the event and as such careful and thorough planning at an early stage can make the activity much more successful. The funding of the elective event needs to be thought about early on in the planning stage if this is likely to be an issue. Practical considerations, such as insurance cover, honorary contracts, travel and other documents must also be considered carefully. The elective opportunity has the potential to provide the individual with a unique experience, a chance to delve deeper in relation to a particular area of interest as well as potentially experiencing the provision of health care through an alternative lens. The success of the elective largely depends upon the amount of effort the individual puts into it.

44 CFR 331.4 - Special consideration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY PREPAREDNESS PRESERVATION OF THE MOBILIZATION BASE THROUGH THE PLACEMENT OF PROCUREMENT... sells a significant proportion of its production to the Government is generally depressed or has a... hearing of interested parties, will give consideration to appropriate measures applicable to the entire...

WhatisKT wiki: a case study of a platform for knowledge translation terms and definitions — descriptive analysis

PubMed Central

2013-01-01

Background More than a hundred terms, often with unclear definitions and varying emphases, are used by health research and practice communities across the world who are interested in getting the best possible evidence applied (e.g., knowledge translation, implementation science, diffusion of innovations, and technology transfer). This makes finding published evidence difficult and can result in reduced, misinterpreted, or challenging interactions among professionals. Open dialogue and interaction among various professionals is needed to achieve consolidation of vocabulary. We use case report methods to describe how we sought to build an online tool to present the range of terms and facilitate the dialogue process across groups and disciplines interested in harnessing research evidence for healthcare. Methods We used a wiki platform from Wikispaces to present the problem of terminology and make a case and opportunity for collaboration on usage. Wikis are web sites where communities of users can collaborate online to build content and discuss progress. We gathered terms related to getting research into practice, sought published definitions, and posted these on the wiki (WhatisKT http://whatiskt.wikispaces.com/). We built the wiki in mid-2008 and promoted it through various groups and publications. This report describes the content of the site, our promotion efforts, use of the site, and how the site was used for collaboration up to the end of 2011. Results The WhatisKT wiki site now includes more than 120 pages. Traffic to the site has increased substantially from an average of 200 monthly visits in 2008 to 1700 in 2011. Visitors from 143 countries viewed the wiki in 2011, compared with 12 countries in 2008. However, most use has been limited to short term accesses of about 40 seconds per visit, and discussion of consolidation and solidifying terminology is conspicuously absent. Conclusions Although considerable interest exists in the terms and definitions related to getting research into practice based on increasing numbers of accesses, use of the WhatisKT wiki site for anything beyond quick lookups was minimal. Additional efforts must be directed towards increasing the level of interaction among the members of the site to encourage collaboration on term use. PMID:23347357

[Disclosure of conflicts of interest in the Tijdschrift voor Psychiatrie].

PubMed

Bergoets, M; Pieters, G

2009-01-01

Between March 2000 and December 2008 authors disclosed conflicts of interest in 9% of articles in the Tijdschrift voor Psychiatrie. For the same period, in the articles dealing with pharmaceuticals, the percentage of articles containing disclosures of conflict of interest was considerably higher, namely 24%. The policy of the journal with regard to the disclosure of conflicts of interest has helped to promote transparency. Further efforts are needed to encourage authors to disclose conflicts of interest.

The environmental history in pediatric practice: a study of pediatricians' attitudes, beliefs, and practices.

PubMed Central

Kilpatrick, Nikki; Frumkin, Howard; Trowbridge, Jane; Escoffery, Cam; Geller, Robert; Rubin, Leslie; Teague, Gerald; Nodvin, Janice

2002-01-01

We conducted a mail survey of practicing pediatricians in Georgia to assess their knowledge, attitudes, and behaviors regarding recording patients' environmental histories. Of 477 eligible pediatricians, 266 (55.8%) responded. Fewer than one in five reported having received training in environmental history-taking. Pediatricians reported that they strongly believe in the importance of environmental exposures in children's health, and 53.5% of respondents reported experience with a patient who was seriously affected by an environmental exposure. Pediatricians agreed moderately strongly that environmental history-taking is useful in identifying potentially hazardous exposures and in helping prevent these exposures. Respondents reported low self-efficacy regarding environmental history-taking, discussing environmental exposures with parents, and finding diagnosis and treatment resources related to environmental exposures. The probability of self-reported history-taking varied with the specific exposure, with environmental tobacco smoke and pets most frequently queried and asbestos, mercury, formaldehyde, and radon rarely queried. The pediatricians' preferred information resources include the American Academy of Pediatrics, newsletters, and patient education materials. Pediatricians are highly interested in pediatric environmental health but report low self-efficacy in taking and following up on environmental histories. There is considerable opportunity for training in environmental history-taking and for increasing the frequency with which such histories are taken. PMID:12153766

Predicting the onset of psychosis in patients at clinical high risk: practical guide to probabilistic prognostic reasoning.

PubMed

Fusar-Poli, P; Schultze-Lutter, F

2016-02-01

Prediction of psychosis in patients at clinical high risk (CHR) has become a mainstream focus of clinical and research interest worldwide. When using CHR instruments for clinical purposes, the predicted outcome is but only a probability; and, consequently, any therapeutic action following the assessment is based on probabilistic prognostic reasoning. Yet, probabilistic reasoning makes considerable demands on the clinicians. We provide here a scholarly practical guide summarising the key concepts to support clinicians with probabilistic prognostic reasoning in the CHR state. We review risk or cumulative incidence of psychosis in, person-time rate of psychosis, Kaplan-Meier estimates of psychosis risk, measures of prognostic accuracy, sensitivity and specificity in receiver operator characteristic curves, positive and negative predictive values, Bayes' theorem, likelihood ratios, potentials and limits of real-life applications of prognostic probabilistic reasoning in the CHR state. Understanding basic measures used for prognostic probabilistic reasoning is a prerequisite for successfully implementing the early detection and prevention of psychosis in clinical practice. Future refinement of these measures for CHR patients may actually influence risk management, especially as regards initiating or withholding treatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Teaching evidence-based medical care: description and evaluation.

PubMed

Grad, R; Macaulay, A C; Warner, M

2001-09-01

This paper describes and evaluates several years of a seminar series designed to stimulate residents to seek evidence-based answers to their clinical questions and incorporate this evidence into practice. At the first session, 86 of 89 (97%) residents completed a baseline needs assessment questionnaire. Post-course self-assessment questionnaires measured change from the first to the final seminar session in six domains of interest and skill, as well as residents' preferred sources of information for clinical problem solving up to 2 years after the course. Before the seminars, 48% of residents reported that textbooks were their most important source of information for solving clinical problems. A total of 58 of 75 (77%) residents completed the first post-course questionnaire. Residents reported significant increases in skill at formulating clinical questions and searching for evidence-based answers, appraising reviews, and deciding when and how to incorporate new findings into practice. Use of secondary sources of information such as "Best Evidence," moved up in importance from before the course to after the course. First-year family practice residents who completed our seminar series have reported increased skill at blending consideration of a clinical problem with the use of secondary sources of information to access evidence to support their health care decisions.

A nationwide survey of patient centered medical home demonstration projects.

PubMed

Bitton, Asaf; Martin, Carina; Landon, Bruce E

2010-06-01

The patient centered medical home has received considerable attention as a potential way to improve primary care quality and limit cost growth. Little information exists that systematically compares PCMH pilot projects across the country. Cross-sectional key-informant interviews. Leaders from existing PCMH demonstration projects with external payment reform. We used a semi-structured interview tool with the following domains: project history, organization and participants, practice requirements and selection process, medical home recognition, payment structure, practice transformation, and evaluation design. A total of 26 demonstrations in 18 states were interviewed. Current demonstrations include over 14,000 physicians caring for nearly 5 million patients. A majority of demonstrations are single payer, and most utilize a three component payment model (traditional fee for service, per person per month fixed payments, and bonus performance payments). The median incremental revenue per physician per year was $22,834 (range $720 to $91,146). Two major practice transformation models were identified--consultative and implementation of the chronic care model. A majority of demonstrations did not have well-developed evaluation plans. Current PCMH demonstration projects with external payment reform include large numbers of patients and physicians as well as a wide spectrum of implementation models. Key questions exist around the adequacy of current payment mechanisms and evaluation plans as public and policy interest in the PCMH model grows.

How Does One "Open" Science? Questions of Value in Biological Research.

PubMed

Levin, Nadine; Leonelli, Sabina

2017-03-01

Open Science policies encourage researchers to disclose a wide range of outputs from their work, thus codifying openness as a specific set of research practices and guidelines that can be interpreted and applied consistently across disciplines and geographical settings. In this paper, we argue that this "one-size-fits-all" view of openness sidesteps key questions about the forms, implications, and goals of openness for research practice. We propose instead to interpret openness as a dynamic and highly situated mode of valuing the research process and its outputs, which encompasses economic as well as scientific, cultural, political, ethical, and social considerations. This interpretation creates a critical space for moving beyond the economic definitions of value embedded in the contemporary biosciences landscape and Open Science policies, and examining the diversity of interests and commitments that affect research practices in the life sciences. To illustrate these claims, we use three case studies that highlight the challenges surrounding decisions about how--and how best--to make things open. These cases, drawn from ethnographic engagement with Open Science debates and semistructured interviews carried out with UK-based biologists and bioinformaticians between 2013 and 2014, show how the enactment of openness reveals judgments about what constitutes a legitimate intellectual contribution, for whom, and with what implications.

How Does One “Open” Science? Questions of Value in Biological Research

PubMed Central

Levin, Nadine

2016-01-01

Open Science policies encourage researchers to disclose a wide range of outputs from their work, thus codifying openness as a specific set of research practices and guidelines that can be interpreted and applied consistently across disciplines and geographical settings. In this paper, we argue that this “one-size-fits-all” view of openness sidesteps key questions about the forms, implications, and goals of openness for research practice. We propose instead to interpret openness as a dynamic and highly situated mode of valuing the research process and its outputs, which encompasses economic as well as scientific, cultural, political, ethical, and social considerations. This interpretation creates a critical space for moving beyond the economic definitions of value embedded in the contemporary biosciences landscape and Open Science policies, and examining the diversity of interests and commitments that affect research practices in the life sciences. To illustrate these claims, we use three case studies that highlight the challenges surrounding decisions about how––and how best––to make things open. These cases, drawn from ethnographic engagement with Open Science debates and semistructured interviews carried out with UK-based biologists and bioinformaticians between 2013 and 2014, show how the enactment of openness reveals judgments about what constitutes a legitimate intellectual contribution, for whom, and with what implications. PMID:28232768

Understanding school climate, aggression, peer victimization, and bully perpetration: contemporary science, practice, and policy.

PubMed

Espelage, Dorothy L; Low, Sabina K; Jimerson, Shane R

2014-09-01

Existing scholarship suggests that classroom practices, teacher attitudes, and the broader school environment play a critical role in understanding the rates of student reports of aggression, bullying, and victimization as well as correlated behaviors. A more accurate understanding of the nature, origins, maintenance, and prevalence of bullying and other aggressive behavior requires consideration of the broader social ecology of the school community. However, studies to date have predominantly been cross-sectional in nature, or have failed to reflect the social-ecological framework in their measurement or analytic approach. Thus, there have been limited efforts to parse out the relative contribution of student, classroom, and organizational-level factors. This special topic section emphasizes a departure from a focus on student attitudes and behaviors, to a social-contextual approach that appreciates how much features of the school environment can mitigate or perpetuate aggression. This collection of articles reflects innovative and rigorous approaches to further our understanding of climate, and has implications for theory, measurement, prevention, and practice. These studies highlight the influence of school climate on mental health, academic achievement, and problem behavior, and will hopefully stimulate interest in and further scholarship on this important topic. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Risk management in clinical practice. Part 5. Ethical considerations for dental enhancement procedures.

PubMed

Ahmad, I

2010-09-11

After the demise of the Industrial Age, we currently live in an 'Information Age' fuelled mainly by the Internet, with an ever-increasing medically and dentally literate population. The media has played its role by reporting scientific advances, as well as securitising medical and dental practices. Reality television such as 'Extreme makeovers' has also raised public awareness of body enhancements, with a greater number of people seeking such procedures. To satiate this growing demand, the dental industry has flourished by introducing novel cosmetic products such as bleaching kits, tooth coloured filling materials and a variety of dental ceramics. In addition, one only has to browse through a dental journal to notice innumerable courses and lectures on techniques for providing cosmetic dentistry. The incessant public interest, combined with unrelenting marketing by companies is gradually shifting the balance of dental care from a healing to an enhancement profession. The purpose of this article is to endeavour to answer questions such as, What is aesthetic or cosmetic dentistry? Why do patients seek cosmetic dentistry? Are enhancement procedures a part of dental practice? What, if any, ethical guidelines and constraints apply to elective enhancement procedures? What is the role of the dentist in providing or encouraging this type of 'therapy'? What treatment modalities are available for aesthetic dental treatment?

In-situ neutron imaging of hydrogenous fuels in combustion generated porous carbons under dynamic and steady state pressure conditions

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

Ossler, Frederik; Santodonato, Louis J.; Bilheux, Hassina Z.

Here, we report results from experiments where we characterize the surface properties of soot particles interacting with high-pressure methane. We also found considerable differences in behavior of the soot material between static and dynamic pressure conditions that can be explained by multiscale correlations in the dynamics, from the micro to macro of the porous fractal-like carbon matrix. The measurements were possible utilizing cold neutron imaging of methane mixed with combustion generated carbon (soot) inside steel cells. The studies were performed under static and dynamic pressure conditions in the range 10-90 bar, and are of interest for applications of energy storagemore » of hydrogenous fuels. The very high cross sections for neutrons compared to hard X-ray photons, enabled us to find considerable amounts of native hydrogen in the soot and to see and quantify the presence of hydrogen atoms in the carbon soot matrix under different pressure conditions. Our work lays the base for more detailed in-situ investigations on the interaction of porous carbon materials with hydrogen in practical environments for hydrogen and methane storage.« less

A parallel strategy for implementing real-time expert systems using CLIPS

NASA Technical Reports Server (NTRS)

Ilyes, Laszlo A.; Villaseca, F. Eugenio; Delaat, John

1994-01-01

As evidenced by current literature, there appears to be a continued interest in the study of real-time expert systems. It is generally recognized that speed of execution is only one consideration when designing an effective real-time expert system. Some other features one must consider are the expert system's ability to perform temporal reasoning, handle interrupts, prioritize data, contend with data uncertainty, and perform context focusing as dictated by the incoming data to the expert system. This paper presents a strategy for implementing a real time expert system on the iPSC/860 hypercube parallel computer using CLIPS. The strategy takes into consideration not only the execution time of the software, but also those features which define a true real-time expert system. The methodology is then demonstrated using a practical implementation of an expert system which performs diagnostics on the Space Shuttle Main Engine (SSME). This particular implementation uses an eight node hypercube to process ten sensor measurements in order to simultaneously diagnose five different failure modes within the SSME. The main program is written in ANSI C and embeds CLIPS to better facilitate and debug the rule based expert system.

Essential methodological considerations when using grounded theory.

PubMed

Achora, Susan; Matua, Gerald Amandu

2016-07-01

To suggest important methodological considerations when using grounded theory. A research method widely used in nursing research is grounded theory, at the centre of which is theory construction. However, researchers still struggle with some of its methodological issues. Although grounded theory is widely used to study and explain issues in nursing practice, many researchers are still failing to adhere to its rigorous standards. Researchers should articulate the focus of their investigations - the substantive area of interest as well as the focal population. This should be followed by a succinct explanation of the strategies used to collect and analyse data, supported by clear coding processes. Finally, the resolution of the core issues, including the core category and related categories, should be explained to advance readers' understanding. Researchers should endeavour to understand the tenets of grounded theory. This enables 'neophytes' in particular to make methodological decisions that will improve their studies' rigour and fit with grounded theory. This paper complements the current dialogue on improving the understanding of grounded theory methodology in nursing research. The paper also suggests important procedural decisions researchers need to make to preserve their studies' scientific merit and fit with grounded theory.

Progress towards Sustainable Utilisation and Management of Food Wastes in the Global Economy.

PubMed

Ghosh, Purabi R; Fawcett, Derek; Sharma, Shashi B; Poinern, Gerrard Eddy Jai

2016-01-01

In recent years, the problem of food waste has attracted considerable interest from food producers, processors, retailers, and consumers alike. Food waste is considered not only a sustainability problem related to food security, but also an economic problem since it directly impacts the profitability of the whole food supply chain. In developed countries, consumers are one of the main contributors to food waste and ultimately pay for all wastes produced throughout the food supply chain. To secure food and reduce food waste, it is essential to have a comprehensive understanding of the various sources of food wastes throughout the food supply chain. The present review examines various reports currently in the literature and quantifies waste levels and examines the trends in wastage for various food sectors such as fruit and vegetable, fisheries, meat and poultry, grain, milk, and dairy. Factors contributing to food waste, effective cost/benefit food waste utilisation methods, sustainability and environment considerations, and public acceptance are identified as hurdles in preventing large-scale food waste processing. Thus, we highlight the need for further research to identify and report food waste so that government regulators and food supply chain stakeholders can actively develop effective waste utilisation practices.

In-situ neutron imaging of hydrogenous fuels in combustion generated porous carbons under dynamic and steady state pressure conditions

DOE PAGES

Ossler, Frederik; Santodonato, Louis J.; Bilheux, Hassina Z.

2017-02-12

Here, we report results from experiments where we characterize the surface properties of soot particles interacting with high-pressure methane. We also found considerable differences in behavior of the soot material between static and dynamic pressure conditions that can be explained by multiscale correlations in the dynamics, from the micro to macro of the porous fractal-like carbon matrix. The measurements were possible utilizing cold neutron imaging of methane mixed with combustion generated carbon (soot) inside steel cells. The studies were performed under static and dynamic pressure conditions in the range 10-90 bar, and are of interest for applications of energy storagemore » of hydrogenous fuels. The very high cross sections for neutrons compared to hard X-ray photons, enabled us to find considerable amounts of native hydrogen in the soot and to see and quantify the presence of hydrogen atoms in the carbon soot matrix under different pressure conditions. Our work lays the base for more detailed in-situ investigations on the interaction of porous carbon materials with hydrogen in practical environments for hydrogen and methane storage.« less

Choice of recall period for patient-reported outcome (PRO) measures: criteria for consideration.

PubMed

Norquist, Josephine M; Girman, Cynthia; Fehnel, Sheri; DeMuro-Mercon, Carla; Santanello, Nancy

2012-08-01

Understand the choice of recall period for PRO measures based on intended use, characteristics of the disease, treatment, and attributes of studies. Current practice and considerations were reviewed within several disease areas (overactive bladder, menopausal hot flashes, niacin-induced flushing, osteoarthritis pain, irritable bowel symptoms, benign prostatic hyperplasia, and alopecia). Rationales were identified for using different recall periods, including event-driven (immediate), daily, up to weekly, and longer than weekly. This work demonstrates that (1) recall depends on what the PRO measure captures, its intended use, and attributes of the disease and study; (2) within the same disease area, recall can vary depending on the concept or phenomenon of interest; (3) recall must consider patient burden and their ability to easily and accurately recall the information requested; and (4) recall must be consistent with the duration of the trial and the scheduled clinic visits. Shorter recall periods may underestimate symptom burden when symptoms have diurnal or day-to-day fluctuation and may place undue burden on patients. On the other hand, recall intervals that are too long may either over- or underestimate the health state. Therefore, appropriate criteria should be considered given attributes of the disease when selecting an adequate recall period.

Progress towards Sustainable Utilisation and Management of Food Wastes in the Global Economy

PubMed Central

Ghosh, Purabi R.; Fawcett, Derek; Sharma, Shashi B.

2016-01-01

In recent years, the problem of food waste has attracted considerable interest from food producers, processors, retailers, and consumers alike. Food waste is considered not only a sustainability problem related to food security, but also an economic problem since it directly impacts the profitability of the whole food supply chain. In developed countries, consumers are one of the main contributors to food waste and ultimately pay for all wastes produced throughout the food supply chain. To secure food and reduce food waste, it is essential to have a comprehensive understanding of the various sources of food wastes throughout the food supply chain. The present review examines various reports currently in the literature and quantifies waste levels and examines the trends in wastage for various food sectors such as fruit and vegetable, fisheries, meat and poultry, grain, milk, and dairy. Factors contributing to food waste, effective cost/benefit food waste utilisation methods, sustainability and environment considerations, and public acceptance are identified as hurdles in preventing large-scale food waste processing. Thus, we highlight the need for further research to identify and report food waste so that government regulators and food supply chain stakeholders can actively develop effective waste utilisation practices. PMID:27847805

A Review of Issues Related to Data Acquisition and Analysis in EEG/MEG Studies

PubMed Central

Puce, Aina; Hämäläinen, Matti S.

2017-01-01

Electroencephalography (EEG) and magnetoencephalography (MEG) are non-invasive electrophysiological methods, which record electric potentials and magnetic fields due to electric currents in synchronously-active neurons. With MEG being more sensitive to neural activity from tangential currents and EEG being able to detect both radial and tangential sources, the two methods are complementary. Over the years, neurophysiological studies have changed considerably: high-density recordings are becoming de rigueur; there is interest in both spontaneous and evoked activity; and sophisticated artifact detection and removal methods are available. Improved head models for source estimation have also increased the precision of the current estimates, particularly for EEG and combined EEG/MEG. Because of their complementarity, more investigators are beginning to perform simultaneous EEG/MEG studies to gain more complete information about neural activity. Given the increase in methodological complexity in EEG/MEG, it is important to gather data that are of high quality and that are as artifact free as possible. Here, we discuss some issues in data acquisition and analysis of EEG and MEG data. Practical considerations for different types of EEG and MEG studies are also discussed. PMID:28561761

[Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

PubMed

Chiaravalli, M; Guzzetti, Laura; Tavani, M

2007-01-01

The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

Methodological considerations for studying social processes.

PubMed

Patterson, Barbara; Morin, Karen

2012-01-01

To discuss the nature of and considerations in the study of social processes. Social processes include the elements of time, change and human interaction and many phenomena of interest to nurse researchers. Despite the significance of social processes for nursing practice and the labelling in many studies of phenomena as processes, there seems to be an inability to describe processes fully. The paper includes a presentation of two methodological approaches for illuminating the dynamics of social processes: participant observation and prospective time-series designs. Strengths and limitations of the two paradigmatically different approaches are offered. The method an investigator chooses should be considered selectively and appropriately according to the nature of the problem, what is known about the phenomena to be studied, and the investigator's world view and theoretical perspective. The conceptualisation of process can also influence the methodological choice. Capturing a social process in its entirety with either a qualitative or quantitative approach can be a difficult task. The focus of this paper is an initiation and expansion of the dialogue about which methods provide the best insight into social processes. This knowledge may offer opportunities for nurse researchers to design and implement interventions for individuals as they progress through life events.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-04-25

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

Strategic Integration: The Practical Politics of Integrated Research in Context

ERIC Educational Resources Information Center

van Kerkhoff, Lorrae

2005-01-01

Designing an integrative research program requires that research leaders negotiate a balance between the scientific interest of research and the practical interests of non-scientific partners. This paper examines the ways integrated research is formally categorised, and analyses the tangible expressions of the practical politics involved in…

Common Goals for the Science and Practice of Behavior Analysis: A Response to Critchfield

ERIC Educational Resources Information Center

Schneider, Susan M.

2012-01-01

In his scholarly and thoughtful article, "Interesting Times: Practice, Science, and Professional Associations in Behavior Analysis," Critchfield (2011) discussed the science-practice frictions to be expected in any professional organization that attempts to combine these interests. He suggested that the Association for Behavior Analysis…

Current Practices in Hosting Non-US Pharmacy Students at US Pharmacy Schools in Experiential Clerkships

PubMed Central

Al-Dahir, Sara; Alsharif, Naser Z.; Gleason, Shaun E.; Tofade, Toyin; Flores, Emily K.; Katz, Michael; Dornblaser, Emily K.

2017-01-01

Objective: To provide specific considerations for hosting non-U.S. pharmacy students at U.S.-based colleges/schools of pharmacy (C/SOP) for experiential clerkships and training. Findings: A literature review (2000-2016) in PubMed, Google Scholar and IPA databases was conducted using specific keywords. Recommendations and future directions for development of experiential rotations for non-U.S. students in U.S. experiential rotations are presented for both the home and host country. Summary articles and best practices across the disciplines, as well as expert opinion, were found across U.S. models for hosting non-U.S. students in advanced practice rotations in the medical disciplines. Consistent themes regarding legal agreements, acculturation, standardized calendars and social and safety considerations were considered for inclusion in the final document. Conclusion: Development of a successful experiential rotation/training for non-U.S. students requires consideration for well-developed objectives, qualified preceptors, multitude of legal and cultural considerations and recommendations for longevity and sustainability. PMID:29302084

Consideration of the 15 Factors in the Metropolitan Planning Process

DOT National Transportation Integrated Search

1995-01-01

This synthesis will be of immediate interest to land luse and transportation : planning officials, with special interest to state, regional, and local planners : and administrators who must repond to the requirements of the Intermodal Surface : Trans...

Evaluating the Relationship between Teacher Credential Students' Ability to Read and Their Interest in Reading

ERIC Educational Resources Information Center

Cockerham, Barbara Jean

2013-01-01

Teacher enthusiasm for reading has considerable influence on students' reading interest and reading ability. The purpose of this study was to better understand the relationship between reading ability and reading interest among adults who plan to become teachers. This study tested whether there is a relationship between reading ability as measured…

Eleven essential steps to purchasing or selling a medical practice.

PubMed

Barrett, William

2014-01-01

Based on our experience in representing more than 100 doctors and medical specialists in practice sales and acquisitions, we have identified 11 key considerations important to a deal. There are several issues to consider while going through the process of buying or selling a practice including the implementation of a "letter of intent" as a first step rather than drafting a contract, securing a lease, and verifying the property is not in violation of the local zoning requirements. There are also considerations with regard to the patients, which range from how will the accounts receivable at the time of the closing be handled to who is responsible for the handling of continued treatment in an ongoing case after a deal is finalized. This article details these considerations and more.

Assessment and d/Deaf and Hard of Hearing Multilingual Learners: Considerations and Promising Practices.

PubMed

Pizzo, Lianna; Chilvers, Amanda

2016-01-01

The authors address considerations and promising practices relating to assessment of d/Deaf and Hard of Hearing Multilingual Learners. DMLs' unique culture(s), language(s), and learning needs must be considered when assessments of this population are being planned, conducted, and interpreted. The authors address theory and research on (a) general considerations for the overarching assessment process, (b) specific assessment approaches used to assess DMLs, and (c) assessment of language proficiency for diverse language learners. In addition, basic recommendations for the assessment of DMLs are made, including increased availability of assessments in various languages, use of multiple sources of individual and family data, assessment of all languages, and incorporation of a strong assessment component (that includes nondiscrimination practices) into teacher preparation programs.

16 CFR 801.13 - Aggregation of voting securities, assets and non-corporate interests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... COVERAGE RULES § 801.13 Aggregation of voting securities, assets and non-corporate interests. (a) Voting... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Aggregation of voting securities, assets and non-corporate interests. 801.13 Section 801.13 Commercial Practices FEDERAL TRADE COMMISSION RULES...

16 CFR 801.13 - Aggregation of voting securities, assets and non-corporate interests.

Code of Federal Regulations, 2011 CFR

2011-01-01

... COVERAGE RULES § 801.13 Aggregation of voting securities, assets and non-corporate interests. (a) Voting... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Aggregation of voting securities, assets and non-corporate interests. 801.13 Section 801.13 Commercial Practices FEDERAL TRADE COMMISSION RULES...

16 CFR 801.13 - Aggregation of voting securities, assets and non-corporate interests.

Code of Federal Regulations, 2012 CFR

2012-01-01

... COVERAGE RULES § 801.13 Aggregation of voting securities, assets and non-corporate interests. (a) Voting... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Aggregation of voting securities, assets and non-corporate interests. 801.13 Section 801.13 Commercial Practices FEDERAL TRADE COMMISSION RULES...

16 CFR 801.13 - Aggregation of voting securities, assets and non-corporate interests.

Code of Federal Regulations, 2014 CFR

2014-01-01

... COVERAGE RULES § 801.13 Aggregation of voting securities, assets and non-corporate interests. (a) Voting... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Aggregation of voting securities, assets and non-corporate interests. 801.13 Section 801.13 Commercial Practices FEDERAL TRADE COMMISSION RULES...

16 CFR 801.13 - Aggregation of voting securities, assets and non-corporate interests.

Code of Federal Regulations, 2013 CFR

2013-01-01

... COVERAGE RULES § 801.13 Aggregation of voting securities, assets and non-corporate interests. (a) Voting... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Aggregation of voting securities, assets and non-corporate interests. 801.13 Section 801.13 Commercial Practices FEDERAL TRADE COMMISSION RULES...

Children's Literacy Interest and Its Relation to Parents' Literacy-Promoting Practices

ERIC Educational Resources Information Center

Hume, Laura E.; Lonigan, Christopher J.; McQueen, Jessica D.

2015-01-01

This study examined how children's literacy interests related to parent literacy-promoting practices across time. Using a sample of 909 preschool-age children and the newly developed Child Activities Preference Checklist, literacy interest appeared to be a complex construct, not easily captured by a single measure. In a subsample of 230 children…

Conflicts of interest in medical science: peer usage, peer review and 'CoI consultancy'.

PubMed

Charlton, Bruce G

2004-01-01

In recent years, the perception has grown that conflicts of interest are having a detrimental effect on medical science as it influences health policy and clinical practice, leading medical journals to enforce self-declaration of potential biases in the attempt to counteract or compensate for the problem. Conflict of interest (CoI) declarations have traditionally been considered inappropriate in pure science since its evaluation systems themselves constitute a mechanism for eliminating the effect of individual biases. Pure science is primarily evaluated by 'peer usage', in which scientific information is 'replicated' by being incorporated in the work of other scientists, and tested by further observation of the natural world. Over the long-term, the process works because significant biases impair the quality of science, and bad science tends to be neglected or refuted. However, scientific evaluation operates slowly over years and decades, and only a small proportion of published work is ever actually evaluated. But most of modern medical science no longer conforms to the model of pure science, and may instead be conceptualized as a system of 'applied' science having different aims and evaluation processes. The aim of applied medical science is to solve pre-specified problems, and to provide scientific information ready for implementation immediately following publication. The primary evaluation process of applied science is peer review, not peer usage. Peer review is much more rapid (with a timescale of weeks or months) and cheaper than peer usage and (consequently) has a much wider application: peer review is a prospective validation while peer usage is retrospective. Since applied science consists of incremental advances on existing knowledge achieved using established techniques, its results can usually be reliably evaluated by peer review. However, despite its considerable convenience, peer review has significant limitations related to its reliance on opinion. One major limitation of peer review has proved to be its inability to deal with conflicts of interest, especially in a 'big science' context when prestigious scientists may have similar biases, and conflicts of interest are widely shared among peer reviewers. When applied medical science has been later checked against the slower but more valid processes of peer usage, it seems that reliance on peer review may allow damaging distortions to become 'locked-in' to clinical practice and health policy for considerable periods. Scientific progress is generally underpinned by increasing specialization. Medical journals should specialize in the communication of scientific information, and they have neither the resources nor the motivation to investigate and measure conflicts of interest. Effectively dealing with the problem of conflicts of interest in applied medical science firstly requires a more explicit demarcation between the communications media of pure medical science and applied medical science. Greater specialization of these activities would then allow distinctive aims and evaluation systems to evolve with the expectation of improved performance in both pure and applied systems. In future, applied medical science should operate with an assumption of bias, with the onus of proof on applied medical scientists to facilitate the 'data transparency' necessary to validate their research. Journals of applied medical science will probably require more rigorous processes of peer review than at present, since their publications are intended to be ready for implementation. But since peer review does not adequately filter-out conflicts of interest in applied medical science, there is a need for the evolution of specialist post-publication institutional mechanisms. The suggested solution is to encourage the establishment of independent 'CoI consultancy' services, whose role would be to evaluate conflicts of interest and other biases in published applied medical science prior to their implementation. Such services would be paid-for by the groups who intend to implement applied medical research.

Communities of Practice: Professional Development Through Fostering Connections

NASA Astrophysics Data System (ADS)

Ali, N. A.; Raftery, C.; Shackleford, R.; Nelson, A.; Turney, D.

2015-11-01

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.

Quasi-experimental designs in practice-based research settings: design and implementation considerations.

PubMed

Handley, Margaret A; Schillinger, Dean; Shiboski, Stephen

2011-01-01

Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain elements of randomization such that they can be considered "controlled" trials. Methodological design elements and practical implementation considerations for two quasi-experimental design approaches that have considerable promise in PBR settings--the stepped-wedge design, and a variant of this design, a wait-list cross-over design, are presented along with a case study from a recent PBR intervention for patients with diabetes. PBR-relevant design features include: creation of a cohort over time that collects control data but allows all participants (clusters or patients) to receive the intervention; staggered introduction of clusters; multiple data collection points; and one-way cross-over into the intervention arm. Practical considerations include: randomization versus stratification, training run in phases; and extended time period for overall study completion. Several design features of practice based research studies can be adapted to local circumstances yet retain elements to improve methodological rigor. Studies that utilize these methods, such as the stepped-wedge design and the wait-list cross-over design, can increase the evidence base for controlled studies conducted within the complex environment of PBR.

Physician to investigator: clinical practice to clinical research--ethical, operational, and financial considerations.

PubMed

Pierre, Christine

2008-01-01

Physicians who participate in clinical research studies gain benefits for themselves, their practice, and their patients. Historically, private practice physicians have chosen to defer to their counterparts in academic medicine when it comes to contributing to scientific advancement through clinical studies. A growing number of private practice physicians are now taking a serious second look and deciding that there are unique benefits for both the practice and the patient. Physicians who decide to participate in clinical research should give serious consideration to the time and resources that are required to meet both federal regulations and industry standards. In addition, ethical and scientific principles for assuring the protection of human research subjects must be a paramount commitment.

Medicaid Consent to Sterilization forms: historical, practical, ethical, and advocacy considerations.

PubMed

Block-Abraham, Dana; Arora, Kavita S; Tate, Danielle; Gee, Rebekah E

2015-06-01

The US government developed a Medicaid Consent to Sterilization form in the mid-1970s to protect vulnerable populations from coerced sterilization. US health care practices have evolved significantly since that time. The form, however, has not changed, and may be preventing access to desired services for the same vulnerable populations it was originally created to protect. This paper discusses the relevant historical, practical use, ethical, and advocacy considerations of the Medicaid sterilization consent form and proposes changes to make the form more pertinent to today's medical environment.

An overview of Medicare reimbursement regulations for advanced practice nurses.

PubMed

Frakes, Michael A; Evans, Tracylain

2006-01-01

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

Special considerations--Induction of labor in low-resource settings.

PubMed

Smid, Marcela; Ahmed, Yusuf; Ivester, Thomas

2015-10-01

Induction of labor in resource-limited settings has the potential to significantly improve health outcomes for both mothers and infants. However, there are relatively little context-specific data to guide practice, and few specific guidelines. Also, there may be considerable issues regarding the facilities and organizational capacities necessary to support safe practices in many aspects of obstetrical practice, and for induction of labor in particular. Herein we describe the various opportunities as well as challenges presented by induction of labor in these settings. Copyright © 2015 Elsevier Inc. All rights reserved.

Manipulating semiconductor colloidal stability through doping.

PubMed

Fleharty, Mark E; van Swol, Frank; Petsev, Dimiter N

2014-10-10

The interface between a doped semiconductor material and electrolyte solution is of considerable fundamental interest, and is relevant to systems of practical importance. Both adjacent domains contain mobile charges, which respond to potential variations. This is exploited to design electronic and optoelectronic sensors, and other enabling semiconductor colloidal materials. We show that the charge mobility in both phases leads to a new type of interaction between semiconductor colloids suspended in aqueous electrolyte solutions. This interaction is due to the electrostatic response of the semiconductor interior to disturbances in the external field upon the approach of two particles. The electrostatic repulsion between two charged colloids is reduced from the one governed by the charged groups present at the particles surfaces. This type of interaction is unique to semiconductor particles and may have a substantial effect on the suspension dynamics and stability.

Guidelines for international collaborative research.

PubMed

Rosser, W W; Culpepper, L; Lam, C L; Parkerson, G; Poon, V; Weel, C V

1997-08-01

As the global village becomes a reality, there is an increasing need to conduct international collaborative studies in family practice. A workshop at the WONCA meeting in Hong Kong used international attendees to produce a set of guidelines for international research. At the workshop four completed international projects, each using a different strategy, were presented so that common themes might become apparent. The themes were then discussed and guidelines emerged from the process. Seven guidelines emerged for consideration before embarking on an international collaborative research project in family medicine. The guidelines deal with the characteristics of the research question and the importance of communication. The need for simple, brief methods of data collection, funding and pilot testing were identified. The question must be relevant to all participants to maintain interest and measurement tools must be validated to understand the impact of cultural differences in understanding.

What is the role of genetic testing in movement disorders practice?

PubMed

Schneider, Susanne A; Klein, Christine

2011-08-01

Genetic testing holds many promises in movement disorders, but also pitfalls that require careful consideration for meaningful results. These include the primary indication for testing in the first place, concerns regarding the implications of symptomatic, presymptomatic, and susceptibility testing, the mutation frequency in the gene of interest, the general lack of neuroprotective treatment options for neurodegenerative movement disorders, the prognosis of the condition diagnosed, and patient confidentiality concerns. Furthermore, new technical achievements and the available technical expertise, feasibility of specific gene testing, and its coverage through a health insurance carrier should be considered. Guidelines for testing have been established by some disease societies to advise clinicians and in parallel legal regulations are being adjusted at a national and international level. We review these and other critical points and recent developments regarding genetic testing in the field of movement disorders.

d/Deaf and Hard of Hearing Multilingual Learners: The Development of Communication and Language.

PubMed

Pizzo, Lianna

2016-01-01

The author examines the theory and research relevant to educating d/Deaf and Hard of Hearing Multilingual Learners (DMLs). There is minimal research on this population, yet a synthesis of related theory, research, and practice on spoken-language bilinguals can be used to add to the body of knowledge on these learners. Specifically, the author reports on three major areas: (a) population characteristics of DMLs, (b) theories relevant to understanding the language development of DMLs, and (c) considerations for programs in designing and implementing educational services for DMLs. In the interest of ensuring that children receive the foundation for linguistic success, aspects of linguistically responsive teaching (Lucas & Villegas, 2013) are addressed, with a focus on adopting an asset-based perspective on educating DMLs that honors all of a child's language, identity, and cultural memberships.

Productivity and health: best practices for better measures of productivity.

PubMed

Schwartz, Steven M; Riedel, John

2010-09-01

Interest in quantifying the relationship between health status and lost productivity has accelerated among employers, researchers, and benefits advisors. Our objective was to engage a dialogue to highlight important productivity measurement issues for consideration in an overall business strategy. Critical review of selected topical literature. Four functions of productivity measurement are described: 1) the purposes of a measurement initiative, 2) norms and benchmarking, 3) health and productivity cost estimators, and 4) reporting results. Each function is described in detail; challenges are noted; examples are provided. This article supports the Integrated Benefits Institute consensus statements on productivity, underscoring the need to develop a conceptual framework of productivity measurement that guides the maturation of instruments and sets forth recommendations for their application consistent with the descriptive, comparative, and evaluative functions that foster health, well-being, and work performance.

Lagged effects of family-supportive organization perceptions and supervision in relation to generalized work-related resources.

PubMed

Matthews, Russell A; Toumbeva, Tatiana H

2015-07-01

In the present study, grounded in organizational support and social exchange theory, the dynamic lagged interplay between family supportive supervision (FSS), family supportive organization perceptions (FSOP), perceived organizational support (POS), and leader-member exchange (LMX) was examined. Data were collected from 435 respondents over 3 time points with 6-week lags between assessments. Consistent with theory, FSS had a significant lagged effect on FSOP, whereas the reverse relationship was not supported. Interestingly, contrary to conservation of resources theory, we did not find significant lagged effects between POS and FSOP. Results further indicated that LMX and FSS were reciprocally related over time, suggesting the potential for a dynamic, mutually beneficial exchange relationship between subordinates and supervisors. Theoretical implications and considerations for research and practice are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Formation of Hierarchical Cu-Doped CoSe2 Microboxes via Sequential Ion Exchange for High-Performance Sodium-Ion Batteries.

PubMed

Fang, Yongjin; Yu, Xin-Yao; Lou, Xiong Wen David

2018-04-06

Electrode materials based on electrochemical conversion reactions have received considerable interest for high capacity anodes of sodium-ion batteries. However, their practical application is greatly hindered by the poor rate capability and rapid capacity fading. Tuning the structure at nanoscale and increasing the conductivity of these anode materials are two effective strategies to address these issues. Herein, a two-step ion-exchange method is developed to synthesize hierarchical Cu-doped CoSe 2 microboxes assembled by ultrathin nanosheets using Co-Co Prussian blue analogue microcubes as the starting material. Benefitting from the structural and compositional advantages, these Cu-doped CoSe 2 microboxes with improved conductivity exhibit enhanced sodium storage properties in terms of good rate capability and excellent cycling performance. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The practice of agent-based model visualization.

PubMed

Dorin, Alan; Geard, Nicholas

2014-01-01

We discuss approaches to agent-based model visualization. Agent-based modeling has its own requirements for visualization, some shared with other forms of simulation software, and some unique to this approach. In particular, agent-based models are typified by complexity, dynamism, nonequilibrium and transient behavior, heterogeneity, and a researcher's interest in both individual- and aggregate-level behavior. These are all traits requiring careful consideration in the design, experimentation, and communication of results. In the case of all but final communication for dissemination, researchers may not make their visualizations public. Hence, the knowledge of how to visualize during these earlier stages is unavailable to the research community in a readily accessible form. Here we explore means by which all phases of agent-based modeling can benefit from visualization, and we provide examples from the available literature and online sources to illustrate key stages and techniques.

Report of secondary flows, boundary layers, turbulence and wave team, report 1

NASA Technical Reports Server (NTRS)

Scoggins, J. R.; Fitzjarrald, D.; Doviak, R.; Cliff, W.

1980-01-01

General criteria for a flight test option are that: (1) there be a good opportunity for comparison with other measurement techniques; (2) the flow to be measured is of considerable scientific or practical interest; and (3) the airborne laser Doppler system is well suited to measure the required quantities. The requirement for comparison, i.e., ground truth, is particularly important because this is the first year of operation for the system. It is necessary to demonstrate that the system does actually measure the winds and compare the results with other methods to provide a check on the system error analysis. The uniqueness of the laser Doppler system precludes any direct comparison, but point measurements from tower mounted wind sensors and two dimensional fields obtained from radars with substantially different sampling volumes are quite useful.

Preservice Childhood Education Teachers' Perceptions of Instructional Practices for Developing Young Children's Interest in Reading

ERIC Educational Resources Information Center

Al-Barakat, Ali Ahmad; Bataineh, Ruba Fahmi

2011-01-01

Within the context of the increasing attention to reading in educational contexts around the globe, this study uses a semistructured interview to explore 93 Jordanian preservice teachers' perceptions of instructional practices for developing young children's interest in reading. The participants reported on 7 major teacher practices they perceive…

Fundamental care and knowledge interests: Implications for nursing science.

PubMed

Granero-Molina, José; Fernández-Sola, Cayetano; Mateo-Aguilar, Ester; Aranda-Torres, Cayetano; Román-López, Pablo; Hernández-Padilla, José Manuel

2018-06-01

To characterise the intratheoretical interests of knowledge in nursing science as an epistemological framework for fundamental care. For Jürgen Habermas, theory does not separate knowledge interests from life. All knowledge, understanding and human research is always interested. Habermas formulated the knowledge interests in empirical-analytical, historical-hermeneutic and critical social sciences; but said nothing about health sciences and nursing science. Discursive paper. The article is organised into five sections that develop our argument about the implications of the Habermasian intratheoretical interests in nursing science and fundamental care: the persistence of a technical interest, the predominance of a practical interest, the importance of an emancipatory interest, "being there" to understand individuals' experience and an "existential crisis" that uncovers the individual's subjectivity. The nursing discipline can take on practical and emancipatory interests (together with a technical interest) as its fundamental knowledge interests. Nurses' privileged position in the delivery of fundamental care gives them the opportunity to gain a deep understanding of the patient's experience and illness process through physical contact and empathic communication. In clinical, academic and research environments, nurses should highlight the importance of fundamental care, showcasing the value of practical and emancipatory knowledge. This process could help to improve nursing science's leadership, social visibility and idiosyncrasy. © 2017 John Wiley & Sons Ltd.

42 CFR 409.35 - Criteria for “practical matter”.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Criteria for “practical matter”. (a) General considerations. In making a “practical matter” determination...) Examples of circumstances that meet practical matter criteria—(1) Beneficiary's condition. Inpatient care would be required “as a practical matter” if transporting the beneficiary to and from the nearest...

42 CFR 409.35 - Criteria for “practical matter”.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Criteria for “practical matter”. (a) General considerations. In making a “practical matter” determination...) Examples of circumstances that meet practical matter criteria—(1) Beneficiary's condition. Inpatient care would be required “as a practical matter” if transporting the beneficiary to and from the nearest...

42 CFR 409.35 - Criteria for “practical matter”.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Criteria for “practical matter”. (a) General considerations. In making a “practical matter” determination...) Examples of circumstances that meet practical matter criteria—(1) Beneficiary's condition. Inpatient care would be required “as a practical matter” if transporting the beneficiary to and from the nearest...

42 CFR 409.35 - Criteria for “practical matter”.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Criteria for “practical matter”. (a) General considerations. In making a “practical matter” determination...) Examples of circumstances that meet practical matter criteria—(1) Beneficiary's condition. Inpatient care would be required “as a practical matter” if transporting the beneficiary to and from the nearest...

Collecting Information About a CAM Practitioner’s Practice: A Preliminary Report of a Self-Interview Methodology

PubMed Central

Elder, William G.; Purdy, Hunter; Bentley, Andrew

2009-01-01

To prepare allopathic providers to advise patients about complementary and alternative medicine (CAM) therapies, the University of Kentucky CAM curriculum integration project has identified and trained CAM practitioners to coteach, precept, and demonstrate their respective practices. This project is interested in integrating CAM practitioners as teachers into this university and has formed a multidisciplinary committee for advice. The committee has recognized the importance of increased understanding of CAM practices to enhance communication within itself and to decide to which CAM practices students should receive exposure. This article reports our attempt to create a CAM practice description, based on questions general to CAM practice and specific to a particular approach. Because there is limited existing systematic research on CAM practice characteristics, these questions may interest researchers conducting qualitative studies, especially those seeking an example of questions to ask CAM practitioners. We also believe this practice description will be of general interest. PMID:19890441

15 CFR 923.52 - Consideration of the national interest in facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Coordination, Public..., and managing the coastal zone, including the siting of facilities such as energy facilities which are... to or affect a state's coastal zone. (4) Describe the process for continued consideration of the...

15 CFR 923.52 - Consideration of the national interest in facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS Coordination, Public..., and managing the coastal zone, including the siting of facilities such as energy facilities which are... to or affect a state's coastal zone. (4) Describe the process for continued consideration of the...

Interfacial contributions in lignocellulosic firber-reinforced polyurethane composites

Treesearch

Timothy G. Rials; Michael P. Wolcott; John M. Nassar

2001-01-01

Whereas lignocellulosic fibers have received considerable attention as a reinforcing agent in thermoplastic composites, their applicability to reactive polymer systems remains of considerable interest. The hydroxyl-rich nature of natural lignocellulosic fibers suggests that they are particularly useful in thermsetting systems such as polyurethanes. To further this...

Prevention of school bullying: the important role of autonomy-supportive teaching and internalization of pro-social values.

PubMed

Roth, Guy; Kanat-Maymon, Yaniv; Bibi, Uri

2011-12-01

This study examined students' perceptions of autonomy-supportive teaching (AST) and its relations to internalization of pro-social values and bullying in class. We hypothesized that: (1) teachers' AST, which involves provision of rationale and taking the student's perspective, would relate positively to students' identified internalization of considerateness towards classmates, and would relate negatively to external regulation (considerateness to obtain rewards or avoid punishments); (2) students' identified regulation would relate negatively to self-reported bullying in class, whereas external regulation would relate positively to bullying; and (3) the relation between teachers' AST and student bullying would be mediated by students' identification with the value of considerateness towards others. The sample consisted of 725 junior high school students (50% females) in Grades 7 and 8 from 27 classes in four schools serving students from lower-middle to middle-class socioeconomic backgrounds.   The participants completed questionnaires assessing the variables of interest. Correlational analysis supported the hypotheses. Moreover, mediational analyses using hierarchical linear modelling (HLM) demonstrated that identified regulation mediates the negative relation between AST and self-reported bullying in class. The mediational hypothesis was supported at the between-class level and at the within-class level.   The findings suggest that school policy aimed at bullying reduction should go beyond external control that involves external rewards and sanctions and should help teachers acquire autonomy-supportive practices focusing on students' meaningful internalization. ©2010 The British Psychological Society.

Ethical and clinical practice considerations for genetic counselors related to direct-to-consumer marketing of genetic tests.

PubMed

Wade, Christopher H; Wilfond, Benjamin S

2006-11-15

Several companies utilize direct-to-consumer (DTC) advertising for genetic tests and some, but not all, bypass clinician involvement by offering DTC purchase of the tests. This article examines how DTC marketing strategies may affect genetic counselors, using available cardiovascular disease susceptibility tests as an illustration. The interpretation of these tests is complex and includes consideration of clinical validity and utility, and the further complications of gene-environment interactions and pleiotropy. Although it is unclear to what extent genetic counselors will encounter clients who have been exposed to DTC marketing strategies, these strategies may influence genetic counseling interactions if they produce directed interest in specific tests and unrealistic expectations for the tests' capacity to predict disease. Often, a client's concern about risk for cardiovascular diseases is best addressed by established clinical tests and a family history assessment. Ethical dilemmas may arise for genetic counselors who consider whether to accept clients who request test interpretation or to order DTC-advertised tests that require a clinician's authorization. Genetic counselors' obligations to care for clients extend to interpreting DTC tests, although this obligation may be fulfilled by referral or consultation with specialists. Genetic counselors do not have an obligation to order DTC-advertised tests that have minimal clinical validity and utility at a client's request. This can be a justified restriction on autonomy based on consideration of risks to the client, the costs, and the implications for society. Published 2006 Wiley-Liss, Inc.

The Psychological Benefits from Reconceptualizing Music-Making as Mindfulness Practice.

PubMed

Steinfeld, Matthew; Brewer, Judson

2015-06-01

While the music psychology and education literatures have devoted considerable attention to how musical instrumentalists practice their instruments, less formal scholarly attention has been given in consideration of what it means to maintain a musical "practice" over time and across context. In this paper, the practice of mindfulness meditation is used as heuristic, arguing for a view of mindfulness meditation as a formalized de-specialization of the infinite number of other activities with which people can achieve mindfulness. Sitting meditation, requiring of one to observe the contents of their mind unmediated, can serve as a useful model for the musician in understanding the phenomenology of the music-making process and the "flow" states that can result from an embodied musical practice. Finally, reconceptualizing music-making as a mindfulness practice is considered with psychological and pedagogical implications relevant for developing musicians.

Postoperative Stereotactic Body Radiation Therapy (SBRT) for Spine Metastases: A Critical Review to Guide Practice

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

Redmond, Kristin J., E-mail: kjanson3@jhmi.edu; Lo, Simon S.; Fisher, Charles

Postoperative stereotactic body radiation therapy (SBRT) for metastatic spinal tumors is increasingly being performed in clinical practice. Whereas the fundamentals of SBRT practice for intact spinal metastases are established, there are as yet no comprehensive practice guidelines for the postoperative indications. In particular, there are unique considerations for patient selection and treatment planning specific to postoperative spine SBRT that are critical for safe and effective management. The purpose of this critical review is to discuss the rationale for treatment, describe those factors affecting surgical decision making, introduce modern surgical trends, and summarize treatment outcomes for both conventional postoperative external beammore » radiation therapy and postoperative spine SBRT. Lastly, an in-depth practical discussion with respect to treatment planning and delivery considerations is provided to help guide optimal practice.« less

A Situated Practice of Ethics for Participatory Visual and Digital Methods in Public Health Research and Practice: A Focus on Digital Storytelling

PubMed Central

Hill, Amy L.; Flicker, Sarah

2014-01-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as “digital storytelling.” We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health. PMID:23948015

A situated practice of ethics for participatory visual and digital methods in public health research and practice: a focus on digital storytelling.

PubMed

Gubrium, Aline C; Hill, Amy L; Flicker, Sarah

2014-09-01

This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.

Why are men interested in cosmetic surgery procedures? Examining the role of different forms of peer influence, social comparison, internalization, and body dissatisfaction.

PubMed

Matera, Camilla; Nerini, Amanda; Stefanile, Cristina

2018-06-16

The present research examined the roles of different forms of peer influence, internalization, social comparison, and body dissatisfaction in men's interest in cosmetic surgery. Participants were 204 Italian men (M age  = 34.02, SD = 11.21). Regression analyses showed that appearance conversations with friends and peer attribution were associated with consideration of cosmetic surgery for social reasons, while teasing on muscularity (but not teasing on general body and shape) was linked to interest in cosmetic surgery for intrapersonal motives. Social comparison was significantly and positively associated with men's interest in cosmetic surgery, while internalization was not. Dissatisfaction with body fat was linked to men's consideration of cosmetic surgery for social motivations, while muscularity and height dissatisfaction did not emerge as significant correlates of cosmetic surgery attitudes. These findings highlight the importance of psychosocial factors, such as peer influence, body fat dissatisfaction, and social comparison in men's interest in cosmetic procedures. Copyright © 2018 Elsevier Ltd. All rights reserved.

The role of health system governance in strengthening the rural health insurance system in China.

PubMed

Yuan, Beibei; Jian, Weiyan; He, Li; Wang, Bingyu; Balabanova, Dina

2017-05-23

Systems of governance play a key role in the operation and performance of health systems. In the past six decades, China has made great advances in strengthening its health system, most notably in establishing a health insurance system that enables residents of rural areas to achieve access to essential services. Although there have been several studies of rural health insurance schemes, these have focused on coverage and service utilization, while much less attention has been given to the role of governance in designing and implementing these schemes. Information from publications and policy documents relevant to the development of two rural health insurance policies in China was obtained, analysed, and synthesise. 92 documents on CMS (Cooperative Medical Scheme) or NCMS (New Rural Cooperative Medical Scheme) from four databases searched were included. Data extraction and synthesis of the information were guided by a framework that drew on that developed by the WHO to describe health system governance and leadership. We identified a series of governance practices that were supportive of progress, including the prioritisation by the central government of health system development and certain health policies within overall national development; strong government commitment combined with a hierarchal administrative system; clear policy goals coupled with the ability for local government to adopt policy measures that take account of local conditions; and the accumulation and use of the evidence generated from local practices. However these good practices were not seen in all governance domains. For example, poor collaboration between different government departments was shown to be a considerable challenge that undermined the operation of the insurance schemes. China's success in achieving scale up of CMS and NCMS has attracted considerable interest in many low and middle income countries (LMICs), especially with regard to the schemes' designs, coverage, and funding mechanisms. However, this study demonstrates that health systems governance may be critical to enable the development and operation of such schemes. Given that many LMICs are expanding health financing system to cover populations in rural areas or the informal sectors, we argue that strengthening specific practices in each governance domain could inform the adaptation of these schemes to other settings.

Evaluation of stone-matrix asphalt mixtures containing recycled asphalt shingles(RAS).

DOT National Transportation Integrated Search

2017-05-01

In recent years, there has been increased interest in the use of reclaimed material in asphalt : mixtures. The use of recycled asphalt shingles (RAS) has been of interest because of the high asphalt : content, although this asphalt is considerably st...

Appraising the methodological quality of the clinical practice guideline for diabetes mellitus using the AGREE II instrument: a methodological evaluation.

PubMed

Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

2017-02-01

To evaluate the methodological quality of the Palestinian Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological evaluation. A cross-cultural adaptation framework was followed to translate and develop a standardised Translated Arabic Version of the AGREE II. Palestinian Primary Healthcare Centres. Sixteen appraisers independently evaluated the Clinical Practice Guideline for Diabetes Mellitus using the Translated Arabic Version of the AGREE II. Methodological quality of diabetic guideline. The Translated Arabic Version of the AGREE II showed an acceptable reliability and validity. Internal consistency ranged between 0.67 and 0.88 (Cronbach's α). Intra-class coefficient among appraisers ranged between 0.56 and 0.88. The quality of this guideline is low. Both domains 'Scope and Purpose' and 'Clarity of Presentation' had the highest quality scores (66.7% and 61.5%, respectively), whereas the scores for 'Applicability', 'Stakeholder Involvement', 'Rigour of Development' and 'Editorial Independence' were the lowest (27%, 35%, 36.5%, and 40%, respectively). The findings suggest that the quality of this Clinical Practice Guideline is disappointingly low. To improve the quality of current and future guidelines, the AGREE II instrument is extremely recommended to be incorporated as a gold standard for developing, evaluating or updating the Palestinian Clinical Practice Guidelines. Future guidelines can be improved by setting specific strategies to overcome implementation barriers with respect to economic considerations, engaging of all relevant end-users and patients, ensuring a rigorous methodology for searching, selecting and synthesising the evidences and recommendations, and addressing potential conflict of interests within the development group.

Effective admissions practices to achieve greater student diversity in dental schools.

PubMed

Price, Shelia S; Grant-Mills, Donna

2010-10-01

In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.

Practical considerations in Bayesian fusion of point sensors

NASA Astrophysics Data System (ADS)

Johnson, Kevin; Minor, Christian

2012-06-01

Sensor data fusion is and has been a topic of considerable research, but rigorous and quantitative understanding of the benefits of fusing specific types of sensor data remains elusive. Often, sensor fusion is performed on an ad hoc basis with the assumption that overall detection capabilities will improve, only to discover later, after expensive and time consuming laboratory and/or field testing that little advantage was gained. The work presented here will discuss these issues with theoretical and practical considerations in the context of fusing chemical sensors with binary outputs. Results are given for the potential performance gains one could expect with such systems, as well as the practical difficulties involved in implementing an optimal Bayesian fusion strategy with realistic scenarios. Finally, a discussion of the biases that inaccurate statistical estimates introduce into the results and their consequences is presented.

String tightening as a self-organizing phenomenon.

PubMed

Banerjee, Bonny

2007-09-01

The phenomenon of self-organization has been of special interest to the neural network community throughout the last couple of decades. In this paper, we study a variant of the self-organizing map (SOM) that models the phenomenon of self-organization of the particles forming a string when the string is tightened from one or both of its ends. The proposed variant, called the string tightening self-organizing neural network (STON), can be used to solve certain practical problems, such as computation of shortest homotopic paths, smoothing paths to avoid sharp turns, computation of convex hull, etc. These problems are of considerable interest in computational geometry, robotics path-planning, artificial intelligence (AI) (diagrammatic reasoning), very large scale integration (VLSI) routing, and geographical information systems. Given a set of obstacles and a string with two fixed terminal points in a 2-D space, the STON model continuously tightens the given string until the unique shortest configuration in terms of the Euclidean metric is reached. The STON minimizes the total length of a string on convergence by dynamically creating and selecting feature vectors in a competitive manner. Proof of correctness of this anytime algorithm and experimental results obtained by its deployment have been presented in the paper.

Biological and psychological rhythms: an integrative approach to rhythm disturbances in autistic disorder.

PubMed

Botbol, Michel; Cabon, Philippe; Kermarrec, Solenn; Tordjman, Sylvie

2013-09-01

Biological rhythms are crucial phenomena that are perfect examples of the adaptation of organisms to their environment. A considerable amount of work has described different types of biological rhythms (from circadian to ultradian), individual differences in their patterns and the complexity of their regulation. In particular, the regulation and maturation of the sleep-wake cycle have been thoroughly studied. Its desynchronization, both endogenous and exogenous, is now well understood, as are its consequences for cognitive impairments and health problems. From a completely different perspective, psychoanalysts have shown a growing interest in the rhythms of psychic life. This interest extends beyond the original focus of psychoanalysis on dreams and the sleep-wake cycle, incorporating central theoretical and practical psychoanalytic issues related to the core functioning of the psychic life: the rhythmic structures of drive dynamics, intersubjective developmental processes and psychic containment functions. Psychopathological and biological approaches to the study of infantile autism reveal the importance of specific biological and psychological rhythmic disturbances in this disorder. Considering data and hypotheses from both perspectives, this paper proposes an integrative approach to the study of these rhythmic disturbances and offers an etiopathogenic hypothesis based on this integrative approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

Hearing the irrational: music and the development of the modern concept of number.

PubMed

Pesic, Peter

2010-09-01

Because the modern concept of number emerged within a quadrivium that included music alongside arithmetic, geometry, and astronomy, musical considerations affected mathematical developments. Michael Stifel embedded the then-paradoxical term "irrational numbers" (numerici irrationales) in a musical context (1544), though his philosophical aversion to the "cloud of infinity" surrounding such numbers finally outweighed his musical arguments in their favor. Girolamo Cardano gave the same status to irrational and rational quantities in his algebra (1545), for which his contemporaneous work on music suggested parallels and empirical examples. Nicola Vicentino's attempt to revive ancient "enharmonic" music (1555) required and hence defended the use of "irrational proportions" (proportiones inrationales) as if they were numbers. These developments emerged in richly interactive social and cultural milieus whose participants interwove musical and mathematical interests so closely that their intense controversies about ancient Greek music had repercussions for mathematics as well. The musical interests of Stifel, Cardano, and Vicentino influenced their respective treatments of "irrational numbers." Practical as well as theoretical music both invited and opened the way for the recognition of a radically new concept of number, even in the teeth of paradox.

Shrinkage Estimation of Varying Covariate Effects Based On Quantile Regression

PubMed Central

Peng, Limin; Xu, Jinfeng; Kutner, Nancy

2013-01-01

Varying covariate effects often manifest meaningful heterogeneity in covariate-response associations. In this paper, we adopt a quantile regression model that assumes linearity at a continuous range of quantile levels as a tool to explore such data dynamics. The consideration of potential non-constancy of covariate effects necessitates a new perspective for variable selection, which, under the assumed quantile regression model, is to retain variables that have effects on all quantiles of interest as well as those that influence only part of quantiles considered. Current work on l1-penalized quantile regression either does not concern varying covariate effects or may not produce consistent variable selection in the presence of covariates with partial effects, a practical scenario of interest. In this work, we propose a shrinkage approach by adopting a novel uniform adaptive LASSO penalty. The new approach enjoys easy implementation without requiring smoothing. Moreover, it can consistently identify the true model (uniformly across quantiles) and achieve the oracle estimation efficiency. We further extend the proposed shrinkage method to the case where responses are subject to random right censoring. Numerical studies confirm the theoretical results and support the utility of our proposals. PMID:25332515

Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers

PubMed Central

Young, Taryn; Garner, Paul

2017-01-01

Objectives To document low/middle-income country (LMIC) health researchers’ views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. Design We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. Participants We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Results Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred ‘occasionally’, and 24% ‘rarely’. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. Conclusions LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. PMID:29170291

Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers.

PubMed

Rohwer, Anke; Young, Taryn; Wager, Elizabeth; Garner, Paul

2017-11-22

To document low/middle-income country (LMIC) health researchers' views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred 'occasionally', and 24% 'rarely'. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The physician's virtues and legitimate self-interest in the patient-physician contract.

PubMed

McCullough, L B

1993-01-01

I will be the first to admit that we are now well into uncharted territory of the patient-physician contract. I also detect missing stretches of my dermal layer and you may spy some that I have yet to notice. In any case, I put to your serious consideration the proposal that part of the patient-physician contract must include respect for the legitimate interests of the physician by patients and third parties. The virtues of self-effacement and self-sacrifice and the concept of legitimate self-interest help us to understand in concrete, clinically applicable terms what such respect means in practice. That respect will, I think, be expressed with some variability, because there is no simple algorithm for negotiating conflicts between legitimate self-interest and the virtues of self-effacement and self-sacrifice. One important consequence of this moral variability is that the patient-physician contract and the virtues that sustain it will not yield to a single, finally authoritative account of how such conflicts should be negotiated. Instead, as we turn more attention to these matters, we will, I believe, discover that there is a range or continuum of ways in which the management of such ethical conflict can reliably be understood in the patient-physician contract. Rather than a single account of the ethical dimensions of the patient-physician contract, we should expect to develop a range of reliable accounts. A kind of rich and engaging moral pluralism should thus govern our understanding of the ethical dimensions of the patient-physician contract.(ABSTRACT TRUNCATED AT 250 WORDS)

The Best of Both Worlds: Building on the COPUS and RTOP Observation Protocols to Easily and Reliably Measure Various Levels of Reformed Instructional Practice

ERIC Educational Resources Information Center

Lund, Travis J.; Pilarz, Matthew; Velasco, Jonathan B.; Chakraverty, Devasmita; Rosploch, Kaitlyn; Undersander, Molly; Stains, Marilyne

2015-01-01

Researchers, university administrators, and faculty members are increasingly interested in measuring and describing instructional practices provided in science, technology, engineering, and mathematics (STEM) courses at the college level. Specifically, there is keen interest in comparing instructional practices between courses, monitoring changes…

Determinism and Underdetermination in Genetics: Implications for Students' Engagement in Argumentation and Epistemic Practices

ERIC Educational Resources Information Center

Jiménez-Aleixandre, María Pilar

2014-01-01

In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in "Teaching scientific inquiry: Recommendations for research and…

Nursing Models - Application to Practice Cutliffe John et al Nursing Models - Application to Practice 280pp Quay Books 9781856423793 1856423794 [Formula: see text].

PubMed

2010-09-22

The authors set themselves the interesting challenge of reviving the interest of academics and practitioners in nursing models. Such models were in vogue in the UK in the 1980s and 1990s, at a time dominated by the evidence-based practice movement.

Transferring cognitive tasks between brain imaging modalities: implications for task design and results interpretation in FMRI studies.

PubMed

Warbrick, Tracy; Reske, Martina; Shah, N Jon

2014-09-22

As cognitive neuroscience methods develop, established experimental tasks are used with emerging brain imaging modalities. Here transferring a paradigm (the visual oddball task) with a long history of behavioral and electroencephalography (EEG) experiments to a functional magnetic resonance imaging (fMRI) experiment is considered. The aims of this paper are to briefly describe fMRI and when its use is appropriate in cognitive neuroscience; illustrate how task design can influence the results of an fMRI experiment, particularly when that task is borrowed from another imaging modality; explain the practical aspects of performing an fMRI experiment. It is demonstrated that manipulating the task demands in the visual oddball task results in different patterns of blood oxygen level dependent (BOLD) activation. The nature of the fMRI BOLD measure means that many brain regions are found to be active in a particular task. Determining the functions of these areas of activation is very much dependent on task design and analysis. The complex nature of many fMRI tasks means that the details of the task and its requirements need careful consideration when interpreting data. The data show that this is particularly important in those tasks relying on a motor response as well as cognitive elements and that covert and overt responses should be considered where possible. Furthermore, the data show that transferring an EEG paradigm to an fMRI experiment needs careful consideration and it cannot be assumed that the same paradigm will work equally well across imaging modalities. It is therefore recommended that the design of an fMRI study is pilot tested behaviorally to establish the effects of interest and then pilot tested in the fMRI environment to ensure appropriate design, implementation and analysis for the effects of interest.

Wound care guidelines and formulary for community nurses.

PubMed

Baeyens, T A

2000-03-01

Community nursing is experiencing significant change as a result of developments such as improved technology, care in the community and earlier discharge of patients from hospital. Because of this, increasingly complex clinical care is required in the community, and it has been noted that community nurses are 'under considerable pressure' and show 'evidence of high stress and low morale'. Wound care is one area in which community nurses constantly battle to keep abreast of continual change. Growing product availability and diversity of use, changes in dressing techniques and the ever-increasing costs associated with wound care mean decision-making in wound care is often a complex task. In the Grampian region, a handbook of evidence-based practice guidelines with a product formulary was developed and distributed to all community nurses. The handbook was designed to ease the decision-making process by evaluating evidence-based practice and local preferences to recommend and guide nurses towards effective clinical practice and cost efficiency. All grades of district nurse in the region have been issued with their own copy of the handbook. It is presented in an A5 ring-binder format to make it easy to carry and to facilitate updating using loose-leaf inserts. The use of logos, extra information boxes and colour coding makes it easy for users to find specific areas of interest in the handbook. The success of the handbook has led to debate on the potential for development of a similar resource for use by practice nurses and in local community hospitals.

The rationale for simple approaches for sustainability assessment and management in contaminated land practice.

PubMed

Bardos, R Paul; Bone, Brian D; Boyle, Richard; Evans, Frank; Harries, Nicola D; Howard, Trevor; Smith, Jonathan W N

2016-09-01

The scale of land-contamination problems, and of the responses to them, makes achieving sustainability in contaminated land remediation an important objective. The Sustainable Remediation Forum in the UK (SuRF-UK) was established in 2007 to support more sustainable remediation practice in the UK. The current international interest in 'sustainable remediation' has achieved a fairly rapid consensus on concepts, descriptions and definitions for sustainable remediation, which are now being incorporated into an ISO standard. However the sustainability assessment methods being used remain diverse with a range of (mainly) semi-quantitative and quantitative approaches and tools developed, or in development. Sustainability assessment is site specific and subjective. It depends on the inclusion of a wide range of considerations across different stakeholder perspectives. Taking a tiered approach to sustainability assessment offers important advantages, starting from a qualitative assessment and moving through to semi-quantitative and quantitative assessments on an 'as required' basis only. It is also clear that there are a number of 'easy wins' that could improve performance against sustainability criteria right across the site management process. SuRF-UK has provided a checklist of 'sustainable management practices' that describes some of these. This paper provides the rationale for, and an outline of, and recently published SuRF-UK guidance on preparing for and framing sustainability assessments; carrying out qualitative sustainability assessment; and simple good management practices to improve sustainability across contaminated land management activities. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Cluster randomized trials utilizing primary care electronic health records: methodological issues in design, conduct, and analysis (eCRT Study).

PubMed

Gulliford, Martin C; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Charlton, Judith; Dregan, Alex

2014-06-11

There is growing interest in conducting clinical and cluster randomized trials through electronic health records. This paper reports on the methodological issues identified during the implementation of two cluster randomized trials using the electronic health records of the Clinical Practice Research Datalink (CPRD). Two trials were completed in primary care: one aimed to reduce inappropriate antibiotic prescribing for acute respiratory infection; the other aimed to increase physician adherence with secondary prevention interventions after first stroke. The paper draws on documentary records and trial datasets to report on the methodological experience with respect to research ethics and research governance approval, general practice recruitment and allocation, sample size calculation and power, intervention implementation, and trial analysis. We obtained research governance approvals from more than 150 primary care organizations in England, Wales, and Scotland. There were 104 CPRD general practices recruited to the antibiotic trial and 106 to the stroke trial, with the target number of practices being recruited within six months. Interventions were installed into practice information systems remotely over the internet. The mean number of participants per practice was 5,588 in the antibiotic trial and 110 in the stroke trial, with the coefficient of variation of practice sizes being 0.53 and 0.56 respectively. Outcome measures showed substantial correlations between the 12 months before, and after intervention, with coefficients ranging from 0.42 for diastolic blood pressure to 0.91 for proportion of consultations with antibiotics prescribed, defining practice and participant eligibility for analysis requires careful consideration. Cluster randomized trials may be performed efficiently in large samples from UK general practices using the electronic health records of a primary care database. The geographical dispersal of trial sites presents a difficulty for research governance approval and intervention implementation. Pretrial data analyses should inform trial design and analysis plans. Current Controlled Trials ISRCTN 47558792 and ISRCTN 35701810 (both registered on 17 March 2010).

Cluster randomized trials utilizing primary care electronic health records: methodological issues in design, conduct, and analysis (eCRT Study)

PubMed Central

2014-01-01

Background There is growing interest in conducting clinical and cluster randomized trials through electronic health records. This paper reports on the methodological issues identified during the implementation of two cluster randomized trials using the electronic health records of the Clinical Practice Research Datalink (CPRD). Methods Two trials were completed in primary care: one aimed to reduce inappropriate antibiotic prescribing for acute respiratory infection; the other aimed to increase physician adherence with secondary prevention interventions after first stroke. The paper draws on documentary records and trial datasets to report on the methodological experience with respect to research ethics and research governance approval, general practice recruitment and allocation, sample size calculation and power, intervention implementation, and trial analysis. Results We obtained research governance approvals from more than 150 primary care organizations in England, Wales, and Scotland. There were 104 CPRD general practices recruited to the antibiotic trial and 106 to the stroke trial, with the target number of practices being recruited within six months. Interventions were installed into practice information systems remotely over the internet. The mean number of participants per practice was 5,588 in the antibiotic trial and 110 in the stroke trial, with the coefficient of variation of practice sizes being 0.53 and 0.56 respectively. Outcome measures showed substantial correlations between the 12 months before, and after intervention, with coefficients ranging from 0.42 for diastolic blood pressure to 0.91 for proportion of consultations with antibiotics prescribed, defining practice and participant eligibility for analysis requires careful consideration. Conclusions Cluster randomized trials may be performed efficiently in large samples from UK general practices using the electronic health records of a primary care database. The geographical dispersal of trial sites presents a difficulty for research governance approval and intervention implementation. Pretrial data analyses should inform trial design and analysis plans. Trial registration Current Controlled Trials ISRCTN 47558792 and ISRCTN 35701810 (both registered on 17 March 2010). PMID:24919485

Distortions and Disconnections: Disrupted Brain Connectivity in Autism

ERIC Educational Resources Information Center

Wass, Sam

2011-01-01

The past few years have seen considerable interest in findings of abnormal brain connectivity in the autism spectrum disorders (ASD). We review recent work from neuroimaging and other sources, and argue that there is considerable convergent evidence suggesting that connectivity is disrupted in ASD. We point to evidence both of local…

Interfacial contributions in lignocellulosic fiber-reinforced polyurethane composites

Treesearch

Timothy G. Rials; Michael P. Wolcott; John M. Nassar

2001-01-01

Whereas lignocellulosic fibers have received considerable attention as a rein- forcing agent in thermoplastic composites, their applicability to reactive polymer systems remains of considerable interest. The hydroxyl-rich nature of natural lignocellulosic fibers suggests that they are particularly useful in thermosetting systems such as polyurethanes. To further this...

Statistical considerations in the analysis of data from replicated bioassays

USDA-ARS?s Scientific Manuscript database

Multiple-dose bioassay is generally the preferred method for characterizing virulence of insect pathogens. Linear regression of probit mortality on log dose enables estimation of LD50/LC50 and slope, the latter having substantial effect on LD90/95s (doses of considerable interest in pest management)...

Responding to and Supporting Students with Disabilities: Risk Management Considerations

ERIC Educational Resources Information Center

Lundquist, Anne; Shackelford, Allan

2011-01-01

Making the "right" risk management decisions involving students with significant psychological disabilities requires a clear and comprehensive understanding of the legal obligations and duties at issue. It also requires taking into consideration the best interests of these individual students. At the same time, decision makers must focus…

Preparing practicing dentists to engage in practice-based research

PubMed Central

DeRouen, Timothy A.; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

2013-01-01

Background The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices—a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). Methods The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: “What is the question?”; “What are the options?”; “How do you evaluate the evidence?”; and “How do you conduct a study?” Results The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Conclusions Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. Practice Implications As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend. PMID:18310739

"Talk, Talk and More Talk": Parental Perceptions of Young Children's Information Practices Related to Their Hobbies and Interests

ERIC Educational Resources Information Center

Barriage, Sarah

2016-01-01

Introduction: This article explores parental perceptions of young children's everyday life information practices related to their hobbies and interests. Method: Thirty-one parents of children between the ages of four and eight years old completed a survey about their children's hobbies and interests. Questions were related to the nature of the…

The Effectiveness of a Training Program Based on Practice of Careers in Vocational Interests Development

ERIC Educational Resources Information Center

Mahasneh, Omar. M.; Farajat, Amani. M.

2015-01-01

The present research was conducted to identify the effectiveness of a training program based on practice of careers in vocational interests development, to answer questions about the study and test its hypothesis the training program had been prepared and the adoption of a measure of vocational interests, as validity and reliability of each of…

Afterword: Considerations for Future Practice of Assessment and Accountability

ERIC Educational Resources Information Center

Bresciani, Marilee J.

2013-01-01

This afterword offers challenges and considerations as the assessment movement continues to develop. The author offers some simple considerations for readers to ponder as they advance their evidence-based decision making processes, and encourages others to use these methods within the context of recent neuroscientific evidence that learning and…

Planning a New School for Visually Handicapped Children in Nigeria.

ERIC Educational Resources Information Center

Shown, D. G.

The paper addresses considerations in planning a new school for visually impaired students in Nigeria. Site considerations touch upon safety, maximum educational achievement, adequate space for practicing mobility and future expansion, catchment area, and financial involvement. Curriculum considerations include use of a braille production machine,…

Neutrino Factory Plans at CERN

NASA Astrophysics Data System (ADS)

Riche, J. A.

2002-10-01

The considerable interest raised by the discovery of neutrino oscillations and recent progress in studies of muon colliders has triggered interest in considering a neutrino factory at CERN. This paper explains the reference scenario, indicates the other possible choices and mentions the R&D that are foreseen.

32 CFR 176.35 - HUD's review of the application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... other existing housing, social service, community economic, or other development plans adopted by the... to the expressed interest and requests of representatives of the homeless, whether the application... communities in the vicinity of the installation. (2) Impact of notices of interest. Takes into consideration...

What do computer scientists tweet? Analyzing the link-sharing practice on Twitter.

PubMed

Schmitt, Marco; Jäschke, Robert

2017-01-01

Twitter communication has permeated every sphere of society. To highlight and share small pieces of information with possibly vast audiences or small circles of the interested has some value in almost any aspect of social life. But what is the value exactly for a scientific field? We perform a comprehensive study of computer scientists using Twitter and their tweeting behavior concerning the sharing of web links. Discerning the domains, hosts and individual web pages being tweeted and the differences between computer scientists and a Twitter sample enables us to look in depth at the Twitter-based information sharing practices of a scientific community. Additionally, we aim at providing a deeper understanding of the role and impact of altmetrics in computer science and give a glance at the publications mentioned on Twitter that are most relevant for the computer science community. Our results show a link sharing culture that concentrates more heavily on public and professional quality information than the Twitter sample does. The results also show a broad variety in linked sources and especially in linked publications with some publications clearly related to community-specific interests of computer scientists, while others with a strong relation to attention mechanisms in social media. This refers to the observation that Twitter is a hybrid form of social media between an information service and a social network service. Overall the computer scientists' style of usage seems to be more on the information-oriented side and to some degree also on professional usage. Therefore, altmetrics are of considerable use in analyzing computer science.

The PCORI Engagement Rubric: Promising Practices for Partnering in Research

PubMed Central

Sheridan, Susan; Schrandt, Suzanne; Forsythe, Laura; Hilliard, Tandrea S.; Paez, Kathryn A.

2017-01-01

PURPOSE Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, and disseminating research is a promising way to improve clinical decision making and outcomes. Many researchers, patients, and other stakeholders, however, lack clarity about when and how to engage as partners within the clinical research process. To address the need for guidance on creating meaningful stakeholder partnerships in patient-centered clinical comparative effectiveness research, the Patient-Centered Outcomes Research Institute (PCORI) developed the PCORI Engagement Rubric (Rubric). METHODS PCORI developed the Rubric drawing from a synthesis of the literature, a qualitative study with patients, a targeted review of engagement plans from PCORI-funded project applications, and a moderated discussion and review with PCORI’s Advisory Panel on Patient Engagement. RESULTS The Rubric provides a framework for operationalizing engagement to incorporate patients and other stakeholders in all phases of research. It includes: principles of engagement; definitions of stakeholder types; key considerations for planning, conducting, and disseminating engaged research; potential engagement activities; and examples of promising practices from PCORI-funded projects. CONCLUSIONS PCORI designed the Rubric to illustrate opportunities for engagement to researchers interested in applying for PCORI funding and to patients and other stakeholders interested in greater involvement in research. By encouraging PCORI applicants, awardees, and others to apply the rubric, PCORI hopes to shift the research paradigm from one of conducting research on patients as subjects to a pursuit carried out in collaboration with patients and other stakeholders to better reflect the values, preferences, and outcomes that matter to the patient community. PMID:28289118

The PCORI Engagement Rubric: Promising Practices for Partnering in Research.

PubMed

Sheridan, Susan; Schrandt, Suzanne; Forsythe, Laura; Hilliard, Tandrea S; Paez, Kathryn A

2017-03-01

Engaging patients, caregivers, and other health care stakeholders as partners in planning, conducting, and disseminating research is a promising way to improve clinical decision making and outcomes. Many researchers, patients, and other stakeholders, however, lack clarity about when and how to engage as partners within the clinical research process. To address the need for guidance on creating meaningful stakeholder partnerships in patient-centered clinical comparative effectiveness research, the Patient-Centered Outcomes Research Institute (PCORI) developed the PCORI Engagement Rubric (Rubric). PCORI developed the Rubric drawing from a synthesis of the literature, a qualitative study with patients, a targeted review of engagement plans from PCORI-funded project applications, and a moderated discussion and review with PCORI's Advisory Panel on Patient Engagement. The Rubric provides a framework for operationalizing engagement to incorporate patients and other stakeholders in all phases of research. It includes: principles of engagement; definitions of stakeholder types; key considerations for planning, conducting, and disseminating engaged research; potential engagement activities; and examples of promising practices from PCORI-funded projects. PCORI designed the Rubric to illustrate opportunities for engagement to researchers interested in applying for PCORI funding and to patients and other stakeholders interested in greater involvement in research. By encouraging PCORI applicants, awardees, and others to apply the rubric, PCORI hopes to shift the research paradigm from one of conducting research on patients as subjects to a pursuit carried out in collaboration with patients and other stakeholders to better reflect the values, preferences, and outcomes that matter to the patient community. © 2017 Annals of Family Medicine, Inc.

What do computer scientists tweet? Analyzing the link-sharing practice on Twitter

PubMed Central

Schmitt, Marco

2017-01-01

Twitter communication has permeated every sphere of society. To highlight and share small pieces of information with possibly vast audiences or small circles of the interested has some value in almost any aspect of social life. But what is the value exactly for a scientific field? We perform a comprehensive study of computer scientists using Twitter and their tweeting behavior concerning the sharing of web links. Discerning the domains, hosts and individual web pages being tweeted and the differences between computer scientists and a Twitter sample enables us to look in depth at the Twitter-based information sharing practices of a scientific community. Additionally, we aim at providing a deeper understanding of the role and impact of altmetrics in computer science and give a glance at the publications mentioned on Twitter that are most relevant for the computer science community. Our results show a link sharing culture that concentrates more heavily on public and professional quality information than the Twitter sample does. The results also show a broad variety in linked sources and especially in linked publications with some publications clearly related to community-specific interests of computer scientists, while others with a strong relation to attention mechanisms in social media. This refers to the observation that Twitter is a hybrid form of social media between an information service and a social network service. Overall the computer scientists’ style of usage seems to be more on the information-oriented side and to some degree also on professional usage. Therefore, altmetrics are of considerable use in analyzing computer science. PMID:28636619

Thinking about Practical Work in Chemistry: Teachers' Considerations of Selected Practices for the Macroscopic Experience

ERIC Educational Resources Information Center

Lewthwaite, Brian

2014-01-01

This study explores teachers' thinking about practical work, especially in regards to the types of practical work they privilege in their teaching of chemistry to support students in their learning. It seeks to investigate the view that practical work, especially the type of practical work selected, is "unthinkingly" and…

Assessment: Examining Practice in Entrepreneurship Education

ERIC Educational Resources Information Center

Pittaway, Luke; Edwards, Corina

2012-01-01

Purpose: The purpose of this paper is to develop knowledge about the nature of student assessment practice in entrepreneurship education. Design/methodology/approach: This paper introduces general assessment practice issues and highlights key considerations. It explains prior research on assessment practice in entrepreneurship education and argues…

Systematic analysis of the quality of the scientific evidence and conflicts of interest in osteoarthritis of the hip and knee practice guidelines.

PubMed

Feuerstein, Joseph D; Pelsis, Jonathan R; Lloyd, Samuel; Cheifetz, Adam S; Stone, Kevin R

2016-02-01

To determine the validity of the hip and knee osteoarthritis guidelines. A systematic search of PubMed using a combination of Mesh and text terms with limitations to guidelines was performed to identify hip and knee osteoarthritis guidelines. The study was performed from April 17, 2014 to October 1, 2014. Guidelines were reviewed for graded levels of evidence, methods used to grade the evidence, and disclosures of conflicts of interest. Additionally, guidelines were also assessed for key quality measures using the AGREE II system for assessing the quality of guidelines. A total of 13 guidelines relevant to the diagnosis and/or treatment of hip/knee osteoarthritis was identified. The 180 recommendations reviewed were supported by 231 pieces of evidence. In total, 35% (n = 80; range: 0-26) were supported by level A evidence, 15% (n = 35; range: 0-10) were by level B, and 50% (n = 116; range: 0-62) were by level C. Median age of the guidelines was 4 years (±4.8; range: 0-16) with no comments on planned updates. In total, 31% of the guidelines included patients in the development process. Only one guideline incorporated cost consideration, and only 15% of the guidelines addressed the surgical management of osteoarthritis. Additionally, 46% of guidelines did not comment on conflicts of interest (COI). When present, there was an average 29.8 COI. Notably, 82% of the COI were monetary support/consulting. In total, 50% of the hip/knee osteoarthritis guideline recommendations are based on lower quality evidence. Nearly half the guidelines fail to disclose relevant COI and when disclosed, multiple potential COI are present. Future hip/knee osteoarthritis guideline development committees should strive to improve the transparency and quality of evidence used to formulate practice guidelines. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-04-25

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

Transition to Office-based Obstetric and Gynecologic Procedures: Safety, Technical, and Financial Considerations.

PubMed

Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E

2015-06-01

Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.

13 CFR 107.855 - Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”).

Code of Federal Regulations, 2012 CFR

2012-01-01

... § 107.855 Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”). “Cost of Money” means the interest and other consideration that you receive from a Small Business. Subject to lower ceilings prescribed by local law, the Cost of Money to the Small Business must not exceed...

13 CFR 107.855 - Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”).

Code of Federal Regulations, 2014 CFR

2014-01-01

... § 107.855 Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”). “Cost of Money” means the interest and other consideration that you receive from a Small Business. Subject to lower ceilings prescribed by local law, the Cost of Money to the Small Business must not exceed...

13 CFR 107.855 - Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”).

Code of Federal Regulations, 2013 CFR

2013-01-01

... § 107.855 Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”). “Cost of Money” means the interest and other consideration that you receive from a Small Business. Subject to lower ceilings prescribed by local law, the Cost of Money to the Small Business must not exceed...

13 CFR 107.855 - Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”).

Code of Federal Regulations, 2011 CFR

2011-01-01

... § 107.855 Interest rate ceiling and limitations on fees charged to Small Businesses (“Cost of Money”). “Cost of Money” means the interest and other consideration that you receive from a Small Business. Subject to lower ceilings prescribed by local law, the Cost of Money to the Small Business must not exceed...

23 CFR 777.11 - Other considerations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... habitat. (c) The acquisition of proprietary interests in replacement wetlands or natural habitats as a mitigation measure may be in fee simple, by easement, or by other appropriate legally recognized instrument... the purpose is no longer served, the lands and interests therein shall immediately revert to the State...

38 CFR 18.13 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... care, housing, social services, or parks and recreation; or (ii) The entire plant or other comparable...) grants of Federal funds, (2) the grant or donation of Federal property and interests in property, (3) the... or transient basis), Federal property or any interest in such property without consideration or at a...

75 FR 33384 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... 8228; TD 8410), Allocation and Apportionment of Interest Expense and Certain Other Expenses (Sec. Sec... to be assured of consideration. ADDRESSES: Direct all written comments to Gerald J. Shields, Internal...: Allocation and Apportionment of Interest Expense and Certain Other Expenses. OMB Number: 1545-1072...