Autism Spectrum Disorders: Neurobiology and Current Assessment Practices

ERIC Educational Resources Information Center

Allen, Ryan A.; Robins, Diana L.; Decker, Scott L.

2008-01-01

This study reviews recent research related to the neurobiology of Autism Spectrum Disorders (ASDs) an provides an empirical analysis of current assessment practices. Data were collected through a survey of 117 school psychologists. The Childhood Autism Rating Scale (CARS), Gilliam Autism Rating Scale (GARS), and Gilliam Asperger's Disorder Scale…

Current good manufacturing practice in manufacturing, packaging, labeling, or holding operations for dietary supplements. Final rule.

PubMed

2007-06-25

The Food and Drug Administration (FDA) is issuing a final rule regarding current good manufacturing practice (CGMP) for dietary supplements. The final rule establishes the minimum CGMPs necessary for activities related to manufacturing, packaging, labeling, or holding dietary supplements to ensure the quality of the dietary supplement. The final rule is one of many actions related to dietary supplements that we are taking to promote and protect the public health.

A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

ERIC Educational Resources Information Center

Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

2014-01-01

Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

The Social Work Ethics Audit: A Risk-Management Strategy.

ERIC Educational Resources Information Center

Reamer, Frederic G.

2000-01-01

Article integrates current knowledge on social work ethics and introduces the concept of a social work ethics audit to aid social workers in their efforts to identify pertinent ethical issues; review and assess the adequacy of their current ethics-related practices; modify their practices as needed; and monitor the implementation of these changes.…

Therapeutic touch: is there a scientific basis for the practice?

PubMed

Clark, P E; Clark, M J

1984-01-01

The research-related literature on the topic of therapeutic touch is critically reviewed. The purpose of the review is to explore the current scientific basis for the teaching and practice of therapeutic touch as a treatment modality. An examination of published research literature indicates that empirical support for the practice of therapeutic touch is, at best, weak. The results of well-designed, double-blind studies have been transient, of no significance, or are in need of independent replication. Current practice of therapeutic touch is empirically little more than practice of placebo. Considerations for further nursing research are also presented.

School Counselor Perceptions of Administrative Supervision Practices

ERIC Educational Resources Information Center

Eddings, Geoffrey Creighton

2012-01-01

This study examined the perceptions of school counselors regarding administrative supervision practices in K-12 public schools in South Carolina. Specifically, the goal was to gain insight into how school counselors view current building-level supervision practices in relation to Pajak's Twelve Dimensions of Supervisory Practice, as well as how…

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

PubMed

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

Assessing diabetes practices in clinical settings: precursor to building community partnerships around disease management.

PubMed

Prochaska, John D; Mier, Nelda; Bolin, Jane N; Hora, Kerrie L; Clark, Heather R; Ory, Marcia G

2009-12-01

Many recommended best practices exist for clinical and community diabetes management and prevention. However, in many cases, these recommendations are not being fully utilized. It is useful to gain a sense of currently utilized and needed practices when beginning a partnership building effort to ameliorate such practice problems. The purpose of this study was to assess current practices in clinical settings within the Brazos Valley in preparation for beginning a community-based participatory research project on improving diabetes prevention and management in this region. Fifty-seven physicians with admission privileges to a regional health system were faxed a survey related to current diabetes patient loads, knowledge and implementation of diabetes-related best practices, and related topics. Both qualitative and quantitative examination of the data was conducted. Fifteen percent of responding providers indicated they implemented diabetes prevention best practices, with significant differences between primary-care physicians and specialists. Respondents indicated a need for educational and counseling resources, as well as an increased health-care workforce in the region. The utilization of a faxed-based survey proved an effective means for assessing baseline data as well as serving as a catalyst for further discussion around coalition development. Results indicated a strong need for both clinical and community-based services regarding diabetes prevention and management, and provided information and insight to begin focused community dialogue around diabetes prevention and management needs across the region. Other sites seeking to begin similar projects may benefit from a similar process.

Intermediate Teachers' Perceptions of Reading Instruction Strategies and Professional Development Needs

ERIC Educational Resources Information Center

Joyner, Barbara

2017-01-01

In 1 urban Tennessee school, students in Grades 3 through 5 had not met adequate yearly progress in reading for the past 5 years. The purpose of this case study was to explore teachers' perceptions of current district-recommended teaching practice in reading. The research questions related to current instructional strategies, teaching practices,…

Forest Practice Rules and cumulative watershed impacts in California

Treesearch

L. M. Reid

1999-01-01

Response to the following questions, "As currently implemented, are existing California forest practice rules effective in preventing cumulative watershed impacts, including flooding?" and "What kind of measures might improve the effectiveness of forest practices rules for avoiding forestry-related cumulative watershed impacts

Review of musculoskeletal injuries and prevention in the endoscopy practitioner.

PubMed

Harvin, Glenn

2014-08-01

Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces.

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

ERIC Educational Resources Information Center

Cramm, Heidi; Egan, Mary

2015-01-01

Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…

On Being Critical: Uniting Theory and Practice through Emancipatory Action Research

ERIC Educational Resources Information Center

Ledwith, Margaret

2007-01-01

This paper engages with some of the specific issues that challenge critical practice. My argument is related to the Carr and Kemmis debate on "staying critical" and to ideas expressed in my current book, "Community Development: A Critical Approach." I refer to critical practice as any practice that has a transformative social justice intention,…

E-Learning Instructional Design Practice in American and Australian Institutions

ERIC Educational Resources Information Center

Sadeghi, Sayed Hadi

2017-01-01

This research study provides a comparative understanding of instructional design e-practice in an Australian and an American university. This comparative study identifies information relating to the current status of instructional design e-practice that will be of assistance to Australian universities to improve their existing online programs. The…

Pilot of a Learning Management System to Enhance Counselors' Relational Qualities through Mindfulness-Based Practices

ERIC Educational Resources Information Center

Ballinger, Julie Ann

2013-01-01

Mindfulness-based practices are associated with increased attentional qualities, improved self-focus styles, enhanced empathic understanding, and strengthened self-compassion, making these practices a viable addition to counselor training programs. However, current mindfulness training models are primarily designed for relief of psychological…

Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

PubMed

Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

2016-05-13

Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

From royal wet nurses to Facebook: The evolution of breastmilk sharing.

PubMed

Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M

2016-11-01

Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation.

From royal wet nurses to Facebook: The evolution of breastmilk sharing

PubMed Central

Baumgartel, Kelley L; Sneeringer, Larissa; Cohen, Susan M

2017-01-01

Wet-nursing was an essential practice that allowed for infant survival after many mothers died in childbirth. The story of wet-nursing is complicated by both religious pressures and cultural expectations of women. It is likely that these historical practices have shaped our current social, political and legislative environments regarding breastfeeding. The aim of this article is to provide a historical perspective on the practice of wet-nursing, with a focus on: 1) social views of wet nurses, 2) breastmilk evaluation and 3) the ideal wet nurse. Historical perspectives from Ancient Egypt, Ancient Greece and Rome, 19th and 20th century America and current practices are examined. An appreciation for the evolution of breastmilk sharing provides clinicians and lactation advocates with the historical origins which provided the template for current practice as it relates to donor milk, breastfeeding culture and relevant legislation. PMID:28936030

Review of Musculoskeletal Injuries and Prevention in the Endoscopy Practitioner

PubMed Central

2014-01-01

Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940

Public Health Campaigns to Change Industry Practices that Damage Health: An Analysis of 12 Case Studies

ERIC Educational Resources Information Center

Freudenberg, Nicholas; Picard Bradley, Sarah; Serrano, Monica

2009-01-01

Industry practices such as advertising, production of unsafe products, and efforts to defeat health legislation play a major role in current patterns of U.S. ill health. Changing these practices may be a promising strategy to promote health. The authors analyze 12 campaigns designed to modify the health-related practices of U.S. corporations in…

Tutors' Assessment Practices and Students' Situated Learning in Higher Education: Chalk and Cheese

ERIC Educational Resources Information Center

Orsmond, Paul; Merry, Stephen

2017-01-01

This article uses situated learning theory to consider current tutor assessment and feedback practices in relation to learning practices employed by students outside the overt curriculum. The case is made that an emphasis on constructive alignment and explicitly articulating assessment requirements within curricula may be misplaced. Outside of the…

Emerging Evidence for Instructional Practice: Repeated Viewings of Sign Language Models

ERIC Educational Resources Information Center

Beal-Alvarez, Jennifer S.; Huston, Sandra G.

2014-01-01

Current initiatives in education, such as No Child Left Behind and the National Common Core Standards movement, call for the use of evidence-based practices, or those instructional practices that are supported by documentation of their effectiveness related to student learning outcomes, including students with special needs. While hearing loss is…

Examining Science Teachers' Development of Interdisciplinary Science Inquiry Pedagogical Knowledge and Practices

ERIC Educational Resources Information Center

Chowdhary, Bhawna; Liu, Xiufeng; Yerrick, Randy; Smith, Erica; Grant, Brooke

2014-01-01

The current literature relates to how teachers develop knowledge and practice of science inquiry, but little has been reported on how teachers develop interdisciplinary science inquiry (ISI) knowledge and practice. This study examines the effect of university research experiences, ongoing professional development, and in-school support on…

Inclusion of Students with Disabilities: Preparation and Practices of Music Educators

ERIC Educational Resources Information Center

Hahn, Kathryn R.

2010-01-01

The purpose of this study was to examine the current professional preparation and practices of music educators in relation to teaching students with formally identified disabilities. Specifically, I created a survey to investigate the preparation of music educators to work with students with disabilities and their use of inclusionary practices in…

Subject cataloging practices in North American medical school libraries.

PubMed Central

Fredericksen, R B; Michael, H N

1976-01-01

A survey of North American medical school libraries was made to determine current trends in subject cataloging practices. First, responses from 114 of these libraries are recorded and analyzed in the following areas: subject heading authority lists employed; use of the divided versus the dictionary catalog; and the form in which local subject authority files are kept. Then, focusing on 78 libraries that use MeSH in combination with a divided catalog, a further analysis of responses is made concerning issues relating to subject cataloging practices: updating the subject catalog to conform to annual MeSH changes; use of guide cards in the catalog; use of MeSH subheadings; filing conventions; and related issues. An attempt is made to analyze the extent to which these libraries vary from NLM practices. Suggestions are offered for formulating subject cataloging practices for an individual library. Finally, while it is concluded that MeSH and the Current Catalog are useful tools, a more detailed explication of the use of MeSH and NLM cataloging practices would be beneficial. PMID:989741

Assessment of current cybersecurity practices in the public domain : cyber indications and warnings domain.

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

Hamlet, Jason R.; Keliiaa, Curtis M.

This report assesses current public domain cyber security practices with respect to cyber indications and warnings. It describes cybersecurity industry and government activities, including cybersecurity tools, methods, practices, and international and government-wide initiatives known to be impacting current practice. Of particular note are the U.S. Government's Trusted Internet Connection (TIC) and 'Einstein' programs, which are serving to consolidate the Government's internet access points and to provide some capability to monitor and mitigate cyber attacks. Next, this report catalogs activities undertaken by various industry and government entities. In addition, it assesses the benchmarks of HPC capability and other HPC attributes thatmore » may lend themselves to assist in the solution of this problem. This report draws few conclusions, as it is intended to assess current practice in preparation for future work, however, no explicit references to HPC usage for the purpose of analyzing cyber infrastructure in near-real-time were found in the current practice. This report and a related SAND2010-4766 National Cyber Defense High Performance Computing and Analysis: Concepts, Planning and Roadmap report are intended to provoke discussion throughout a broad audience about developing a cohesive HPC centric solution to wide-area cybersecurity problems.« less

Implementation of national comprehensive cancer network evidence-based guidelines to prevent and treat cancer-related infections.

PubMed

Wood, Sylvia K; Payne, Judith K

2012-06-01

Clinical practice guidelines are an important result of evidence-based research. However, current clinical practice remains out of step with the rapid pace of research advancements. Often, decades pass before research is translated into clinical practice. The National Comprehensive Cancer Network (NCCN) has created evidence-based clinical guidelines to promote effective clinical practice. Formerly, the NCCN established guidelines to reduce cancer-related infections only for neutropenic patients; however, they have expanded their guidelines beyond neutropenia to prevent and treat cancer-related infections. Implementing scientific evidence into clinical practice is challenging and complex, and healthcare professionals should understand barriers to implementing clinical practice guidelines to ensure successful translation into practice. This article provides a brief review of NCCN guidelines and describes common barriers encountered during implementation. In addition, a conceptual framework is offered to help identify and address potential concerns before and after adoption of guidelines.

Occupational therapy with people with depression: using nominal group technique to collate clinician opinion.

PubMed

Hitch, Danielle; Taylor, Michelle; Pepin, Genevieve

2015-05-01

This aim of this study was to obtain a consensus from clinicians regarding occupational therapy for people with depression, for the assessments and practices they use that are not currently supported by research evidence directly related to functional performance. The study also aimed to discover how many of these assessments and practices were currently supported by research evidence. Following a previously reported systematic review of assessments and practices used in occupational therapy for people with depression, a modified nominal group technique was used to discover which assessments and practices occupational therapists currently utilize. Three online surveys gathered initial data on therapeutic options (survey 1), which were then ranked (survey 2) and re-ranked (survey 3) to gain the final consensus. Twelve therapists completed the first survey, whilst 10 clinicians completed both the second and third surveys. Only 30% of the assessments and practices identified by the clinicians were supported by research evidence. A consensus was obtained on a total of 35 other assessments and interventions. These included both occupational-therapy-specific and generic assessments and interventions. Principle conclusion. Very few of the assessments and interventions identified were supported by research evidence directly related to functional performance. While a large number of options were generated, the majority of these were not occupational therapy specific.

Portland cement concrete pavement best practices summary report.

DOT National Transportation Integrated Search

2010-08-01

This report summarizes the work and findings from WA-RD 744. This work consisted of four separate efforts related to best practices for portland cement concrete (PCC) pavement design and construction: (1) a review of past and current PCC pavement, (2...

Cumulative Risk Assessment: Overview of Agency Guidance, Practice and Current Major Research Activities

EPA Science Inventory

Powerpoint presentation that includes the EPA's definition of CRA, relevant publications already in existence, the CRA Guidelines effort, science issues where research is still needed, program office practices related to CRA, and EPA research activities.

Contemporary Play Therapy: Theory, Research, and Practice

ERIC Educational Resources Information Center

Schaefer, Charles E., Ed.; Gerard Kaduson, Heidi, Ed.

2006-01-01

This highly practical book presents current developments in play therapy, including innovative applications for particular problems and populations. Contributors first discuss the latest ideas and techniques emerging from object-relations, experiential, dynamic, and narrative perspectives. Next, research evaluating the effectiveness of play…

Student Affairs and Alumni Relations

ERIC Educational Resources Information Center

Rissmeyer, Patricia A.

2010-01-01

Current realities and practices in higher education have resulted in greater collaboration among campus units. Limited resources have forced departments to share programs, activities, space, and personnel. Branding efforts have prompted consistency in communication and even in practice. Institutional strategic plans reflect increased collaboration…

Has the Art College Entry Portfolio Outlived Its Usefulness as a Method of Selecting Students in an Age of Relational, Collective and Collaborative Art Practice?

ERIC Educational Resources Information Center

O'Donoghue, Donal

2011-01-01

The purpose of this article is to invite focused discussion and critical debate about the instruments currently used to select students for art colleges in Europe and North America. At this time of significant expansion and diversification in practices of art making, we must ask if current selection instruments still work. What evidence is there…

The trials and tribulations of a practitioner-researcher: challenges and lessons learned through testing a feminist-cognitive-relational social work model of practice.

PubMed

Dombo, Eileen A; Bass, Ami P

2014-01-01

In practice with adult women who survived childhood sexual abuse, the field of social work currently lacks an evidence-based intervention. The current interventions, from the 1990s, come primarily from psychologists. The hypothesis that the Feminist-Cognitive-Relational Social Work Model and Intervention will be more effective in decreasing cognitive distortions, and increasing intimacy and relational health when compared to the standard agency intervention was tested in a quasi-experimental study. The challenges in carrying out the study in small, non-profit organizations are explored to highlight the difficulties in developing evidence-based interventions. Changes to implementation that resulted from the research findings are discussed.

Obesity Prevention Practices of Elementary School Nurses in Minnesota: Findings from Interviews with Licensed School Nurses

ERIC Educational Resources Information Center

Morrison-Sandberg, Leslie F.; Kubik, Martha Y.; Johnson, Karen E.

2011-01-01

Elementary schools are an optimal setting to provide obesity prevention interventions, yet little is known about the obesity prevention practices of elementary school nurses. The purpose of this study was to gain insight into current obesity-related school nursing practice in elementary schools in Minnesota, opinions regarding school nurse-led…

Entrepreneurship Education in Malaysia's Public Institutions of Higher Learning--A Review of the Current Practices

ERIC Educational Resources Information Center

Bin Yusoff, Mohd Nor Hakimin; Zainol, Fakhrul Anwar; Bin Ibrahim, Mohamed Dahlan

2015-01-01

The need for a practical and applicable model for entrepreneurial learning is becoming critical. In this study, we aimed to collect data related to entrepreneurship education practices by all institutes of higher learning (IHLs) in Malaysia as well as challenges faced, facilities, and supports offered by the universities. Given the important role…

Current trends in nursing theories.

PubMed

Im, Eun-Ok; Chang, Sun Ju

2012-06-01

To explore current trends in nursing theories through an integrated literature review. The literature related to nursing theories during the past 10 years was searched through multiple databases and reviewed to determine themes reflecting current trends in nursing theories. The trends can be categorized into six themes: (a) foci on specifics; (b) coexistence of various types of theories; (c) close links to research; (d) international collaborative works; (e) integration to practice; and (f) selective evolution. We need to make our continuous efforts to link research and practice to theories, to identify specifics of our theories, to develop diverse types of theories, and to conduct international collaborative works. Our paper gives implications for future theoretical development in diverse clinical areas of nursing research and practice. © 2012 Sigma Theta Tau International.

Hydrological Forecasting Practices in Brazil

NASA Astrophysics Data System (ADS)

Fan, Fernando; Paiva, Rodrigo; Collischonn, Walter; Ramos, Maria-Helena

2016-04-01

This work brings a review on current hydrological and flood forecasting practices in Brazil, including the main forecasts applications, the different kinds of techniques that are currently being employed and the institutions involved on forecasts generation. A brief overview of Brazil is provided, including aspects related to its geography, climate, hydrology and flood hazards. A general discussion about the Brazilian practices on hydrological short and medium range forecasting is presented. Detailed examples of some hydrological forecasting systems that are operational or in a research/pre-operational phase using the large scale hydrological model MGB-IPH are also presented. Finally, some suggestions are given about how the forecasting practices in Brazil can be understood nowadays, and what are the perspectives for the future.

Support of Graduate Students and Postdoctoral Researchers in the Sciences and Engineering: Impact of Related Policies and Practices. Workshop Report

ERIC Educational Resources Information Center

Barnhill, Robert E.; Stanzione, Dan

2004-01-01

On June 17-18th, 2004, the National Science Foundation (NSF), the National Institutes of Health (NIH), and the Council of Graduate Schools (CGS) sponsored a workshop at the Washington, D.C. headquarters of the American Association for the Advancement of Science (AAAS) to discuss emerging issues, research, and current practices related to financial…

Standards of Practice in Continuing Education: A Status Study. Research Report: CCEU Project for the Development of Standards and Criteria for Good Practice in Continuing Education.

ERIC Educational Resources Information Center

House, Richard M.

A major purpose of this study was to determine the attitudes toward standards of practice and the nature and scope of standards of practice as they currently exist in governmental agencies, professional associations and licensing agencies, business and industry, health-related organizations, and colleges and universities. A second purpose was to…

ICU nurses' oral-care practices and the current best evidence.

PubMed

DeKeyser Ganz, Freda; Fink, Naomi Farkash; Raanan, Ofra; Asher, Miriam; Bruttin, Madeline; Nun, Maureen Ben; Benbinishty, Julie

2009-01-01

The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics. A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices. Nurses rated their perceived level of priority concerning oral care on a scale from 0 to 100. A score was computed representing the sum of 14 items related to equipment, solutions, assessments, and techniques associated with the current best evidence. This score was then statistically analyzed using ANOVA to determine differences of EBP based on demographic and professional characteristics. The most commonly used equipment was gauze pads (84%), followed by tongue depressors (55%), and toothbrushes (34%). Chlorhexidine was the most common solution used (75%). Less than half (44%) reported brushing their patients' teeth. The majority performed an oral assessment before beginning oral care (71%); however, none could describe what assessment tool was used. Only 57% of nurses reported documenting their oral care. Nurses rated oral care of intubated patients with a priority of 67+/-27.1. Wide variations were noted within and between units in terms of which techniques, equipment, and solutions were used. No significant relationships were found between the use of an evidence-based protocol and demographic and professional characteristics or with the priority given to oral care. While nurses ranked oral care a high priority, many did not implement the latest evidence into their current practice. The level of research utilization was not related to personal or professional characteristics. Therefore attempts should be made to encourage all ICU nurses to introduce and use evidence-based, oral-care protocols. Practicing ICU nurses in this survey were often not adhering to the latest evidence-based practice and therefore need to be educated and encouraged to do so in order to improve patient care.

Evaluating the impact of irrigation on surface water - groundwater interaction and stream temperature in an agricultural watershed.

PubMed

Essaid, Hedeff I; Caldwell, Rodney R

2017-12-01

Changes in groundwater discharge to streams caused by irrigation practices can influence stream temperature. Observations along two currently flood-irrigated reaches in the 640-square-kilometer upper Smith River watershed, an important agricultural and recreational fishing area in west-central Montana, showed a downstream temperature decrease resulting from groundwater discharge to the stream. A watershed-scale coupled surface water and groundwater flow model was used to examine changes in streamflow, groundwater discharge to the stream and stream temperature resulting from irrigation practices. The upper Smith River watershed was used to develop the model framework including watershed climate, topography, hydrography, vegetation, soil properties and current irrigation practices. Model results were used to compare watershed streamflow, groundwater recharge, and groundwater discharge to the stream for three scenarios: natural, pre-irrigation conditions (PreIrr); current irrigation practices involving mainly stream diversion for flood and sprinkler irrigation (IrrCurrent); and a hypothetical scenario with only groundwater supplying sprinkler irrigation (IrrGW). Irrigation increased groundwater recharge relative to natural PreIrr conditions because not all applied water was removed by crop evapotranspiration. Groundwater storage and groundwater discharge to the stream increased relative to natural PreIrr conditions when the source of irrigation water was mainly stream diversion as in the IrrCurrent scenario. The hypothetical IrrGW scenario, in which groundwater withdrawals were the sole source of irrigation water, resulted in widespread lowering of the water table and associated decreases in groundwater storage and groundwater discharge to the stream. A mixing analysis using model predicted groundwater discharge along the reaches suggests that stream diversion and flood irrigation, represented in the IrrCurrent scenario, has led to cooling of stream temperatures relative to natural PreIrr conditions improving fish thermal habitat. However, the decrease in groundwater discharge in the IrrGW scenario resulting from large-scale groundwater withdrawal for irrigation led to warmer than natural stream temperatures and possible degradation of fish habitat. Published by Elsevier B.V.

Evaluating the impact of irrigation on surface water – groundwater interaction and stream temperature in an agricultural watershed

USGS Publications Warehouse

Essaid, Hedeff I.; Caldwell, Rodney R.

2017-01-01

Changes in groundwater discharge to streams caused by irrigation practices can influence stream temperature. Observations along two currently flood-irrigated reaches in the 640-square-kilometer upper Smith River watershed, an important agricultural and recreational fishing area in west-central Montana, showed a downstream temperature decrease resulting from groundwater discharge to the stream. A watershed-scale coupled surface water and groundwater flow model was used to examine changes in streamflow, groundwater discharge to the stream and stream temperature resulting from irrigation practices. The upper Smith River watershed was used to develop the model framework including watershed climate, topography, hydrography, vegetation, soil properties and current irrigation practices. Model results were used to compare watershed streamflow, groundwater recharge, and groundwater discharge to the stream for three scenarios: natural, pre-irrigation conditions (PreIrr); current irrigation practices involving mainly stream diversion for flood and sprinkler irrigation (IrrCurrent); and a hypothetical scenario with only groundwater supplying sprinkler irrigation (IrrGW). Irrigation increased groundwater recharge relative to natural PreIrr conditions because not all applied water was removed by crop evapotranspiration. Groundwater storage and groundwater discharge to the stream increased relative to natural PreIrr conditions when the source of irrigation water was mainly stream diversion as in the IrrCurrent scenario. The hypothetical IrrGW scenario, in which groundwater withdrawals were the sole source of irrigation water, resulted in widespread lowering of the water table and associated decreases in groundwater storage and groundwater discharge to the stream. A mixing analysis using model predicted groundwater discharge along the reaches suggests that stream diversion and flood irrigation, represented in the IrrCurrent scenario, has led to cooling of stream temperatures relative to natural PreIrr conditions improving fish thermal habitat. However, the decrease in groundwater discharge in the IrrGW scenario resulting from large-scale groundwater withdrawal for irrigation led to warmer than natural stream temperatures and possible degradation of fish habitat.

Acceptance procedures for dense-graded mixes

DOT National Transportation Integrated Search

2001-03-01

Recent literature related to acceptance procedures for dense-graded mixtures is summarized. Current state of practice and development of acceptance procedures are reviewed. Many agencies are reducing the number of process control-related parameters i...

Fertility preservation in young cancer patients--too little, too late?

PubMed

Robbins, Helen Louise; Zahoor, Arooba; Jones, Kevin

2015-12-01

Fertility is an important concern for many younger women with cancer; however, evidence suggests that these matters are often inadequately addressed, potentially with long-term implications for quality of life. Increased confidence in discussing fertility-related matters and an emphasis on early discussion and referral are needed to improve current practice. Further work is needed to better assess current practice and to explore how barriers to discussion about fertility preservation may be best overcome.

Influence of Agricultural Practices on Micrometerological Spatial Variations at Local and Regional Scales

USDA-ARS?s Scientific Manuscript database

Soil-vegetation-atmosphere transfers significantly influence interactions and feedbacks between vegetation and boundary layer in relation with plant phenology and water status. The current study focused on linking micrometeorological conditions to cultural practices at the local and regional scales ...

National survey on the practice of radiation therapists in Australia.

PubMed

Sale, Charlotte; Halkett, Georgia; Cox, Jenny

2016-06-01

Radiation therapy (RT), like many allied health professions, has lacked professional practice clarity, which until 2008 had not been comprehensively investigated. This manuscript describes the first phase of a three-phase project investigating the current and future practices of radiation therapists (RTs) in Australia. The aim of phase 1 was to define the practice of RTs in Australia. A quantitative approach was used to gain an understanding of RT practice. A national survey was distributed to RTs in Australia. Descriptive statistics and content analysis were used to analyse the data. RT practice was analysed in relation to core and non-core roles, where non-core roles were further divided into basic and advanced practices. The data from the national survey were representative of the Australian RT population (n = 525). The current practice of RTs is presented in summary tables for each area of work (treatment, planning, simulation, mould room and general). This study provided clarification of RT practice and indicated there was a desire to relinquish administrative roles to focus on RT-specific practice. There was evidence that some advanced roles were currently practiced in Australia; however, there was no structure to support these roles and they were based only on local need. This study identified that the profession needs to consider how they will maintain core RT practice, while encouraging the development of new roles, and whether some roles need to be relinquished.

Assimilation or Ethnicization: An Exploration of Inland Tibet Class Education Policy and Practice

ERIC Educational Resources Information Center

Miaoyan, Yang; Dunzhu, Nima

2015-01-01

Assimilation and ethnicization are mainstream voices in current studies of ethnic relations. The former suspects that current social system arrangements are meant to assimilate minority groups into the cultural system of the mainstream ethnic group, while the latter believes that current systemic arrangements will cause minority groups to tend…

Schooling Students Placed at Risk: Research, Policy, and Practice in the Education of Poor and Minority Adolescents.

ERIC Educational Resources Information Center

Sanders, Mavis G., Ed.

This collection of papers examines historical approaches and current research and practice related to the education of adolescents placed at risk of school failure as a result of social and economic conditions. After "Preface: Research, Policy and Practice in the Education of Poor and Minority Adolescents" (Mavis G. Sanders), there are…

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

A Comparative Analysis of Internal Communication and Public Relations Audits. State of the Art.

ERIC Educational Resources Information Center

Dozier, David M.; Hellweg, Susan A.

A review of current literature regarding the state of the art in the conduct of internal communication and public relations audits by public relations practitioners reveals that these two related measurement activities are of considerable importance to the practice of public relations. Public relations audits are concerned with exploratory…

Kentucky pharmacists' opinions of the potential reclassification of pseudoephedrine as a legend drug

PubMed Central

Monson, Kathleen E.; Freeman, Patricia R.; Goodin, Amie J.; Talbert, Jeffery; Blumenschein, Karen

2015-01-01

Objectives To collect and analyze Kentucky pharmacists' opinions of the effectiveness of current methamphetamine precursor controls, to analyze proposed legislation to make pseudoephedrine (PSE) a legend drug, and to analyze the potential impact of such legislation on pharmacy practice and patients. Design Descriptive, nonexperimental survey study. Setting Kentucky; June through October 2012. Participants 431 Kentucky community pharmacists. Intervention Mailed survey. Main outcome measures Perceived efficacy of current methamphetamine precursor controls, anticipated impact on individual pharmacy practices and patients of proposed legislation to make PSE available by prescription only, and current opinions about the proposed legislation. Results Analysis of 431 community pharmacists showed that approximately 77% believed proposed legislation to make PSE available by prescription only would be effective in reducing methamphetamine abuse and methamphetamine-related laboratory incidents, with 56.2% indicating support for the proposed legislation. Pharmacists practicing in chain pharmacies were 2.9 times more likely to support the legislation than pharmacists practicing in independent pharmacies. Additional factors influencing pharmacist support included Kentucky region of practice, anticipated impact on time spent on PSE activities, pharmacy profit, methamphetamine abuse, and methamphetamine-related laboratory incidents. Pharmacists practicing in regions of Kentucky associated with higher methamphetamine abuse appear to more strongly support the proposed legislation. Conclusion Pharmacists are at the frontline of PSE distribution. Gaining a better understanding of issues surrounding the distribution of PSE will enhance the likelihood that future legislation may be crafted to reduce methamphetamine production, laboratory incidents, and abuse while minimizing inconvenience and cost. PMID:25063261

Kentucky pharmacists' opinions of the potential reclassification of pseudoephedrine as a legend drug.

PubMed

Monson, Kathleen E; Freeman, Patricia R; Goodin, Amie J; Talbert, Jeffery; Blumenschein, Karen

2014-01-01

To collect and analyze Kentucky pharmacists' opinions of the effectiveness of current methamphetamine precursor controls, to analyze proposed legislation to make pseudoephedrine (PSE) a legend drug, and to analyze the potential impact of such legislation on pharmacy practice and patients. Descriptive, nonexperimental survey study. Kentucky; June through October 2012. 431 Kentucky community pharmacists. Mailed survey. Perceived efficacy of current methamphetamine precursor controls, anticipated impact on individual pharmacy practices and patients of proposed legislation to make PSE available by prescription only, and current opinions about the proposed legislation. Analysis of 431 community pharmacists showed that approximately 77% believed proposed legislation to make PSE available by prescription only would be effective in reducing methamphetamine abuse and methamphetamine-related laboratory incidents, with 56.2% indicating support for the proposed legislation. Pharmacists practicing in chain pharmacies were 2.9 times more likely to support the legislation than pharmacists practicing in independent pharmacies. Additional factors influencing pharmacist support included Kentucky region of practice, anticipated impact on time spent on PSE activities, pharmacy profit, methamphetamine abuse, and methamphetamine-related laboratory incidents. Pharmacists practicing in regions of Kentucky associated with higher methamphetamine abuse appear to more strongly support the proposed legislation. Pharmacists are at the frontline of PSE distribution. Gaining a better understanding of issues surrounding the distribution of PSE will enhance the likelihood that future legislation may be crafted to reduce methamphetamine production, laboratory incidents, and abuse while minimizing inconvenience and cost.

Acceptance procedures for dense-graded mixes : literature review.

DOT National Transportation Integrated Search

2001-03-01

Recent literature related to acceptance procedures for dense-graded mixtures is summarized. Current state of practice and development of acceptance procedures are reviewed. Many agencies are reducing the number of process control-related parameters i...

Medical home implementation: a sensemaking taxonomy of hard and soft best practices.

PubMed

Hoff, Timothy

2013-12-01

The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. I found two distinct taxonomies of implementation best practices, which I labeled "hard" and "soft" because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. © 2013 Milbank Memorial Fund.

Computer-aided documentation. Quality, productivity, coding, and enhanced reimbursement.

PubMed

Foxlee, R H

1993-10-01

Physicians currently use technology, where appropriate, to improve patient care, for example, MRI and three-dimensional radiotherapy dose planning. One area that has seen limited benefit from current technology is in documenting of medical information. Review of related literature and directed interviews. Technology is available to assist in documenting the initial patient encounter. Patient care, quality of practice, and reimbursement may be improved with careful implementation. It will be worthwhile for practices to examine how to implement this technology to obtain the potential benefits.

The Customer Relationship Management in Terms of Business Practice in Slovakia

NASA Astrophysics Data System (ADS)

Urdziková, Jana; Jakábová, Martina; Saniuk, Sebastian

2012-12-01

The aim of the article is to present the results of the research on focus on the customer in relation to the use of customer relationship management in selected business subjects in Slovakia. The main goal of the research is the mapping of current state to ensure the principle of customer orientation and utilizing of CRM in organizations and industrial enterprises in Slovakia. This is the mapping of the current situation of that problem in practical conditions and determines potential opportunities for improvement.

Deterrence and the United States Coast Guard: Enhancing Current Practice with Performance Measures

DTIC Science & Technology

2012-03-01

Talley,  Jin , Kite Powell,  The US Coast Guard Vessel Inspection Programme (2005)  Deterrence and the United States Coast Guard: Enhancing Current...practical problem-solving, not from theory or strategy. As a result, the activities are fractured and may not even be recognized as related to...of Sun Tzu’s admonition: “Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat.” The US

Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital.

PubMed

Mulcahy, Kimberly B; Trigoboff, Eileen; Opler, Lewis; Demler, Tammie Lee

2016-01-01

Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital.

Workshop on Assurance for Autonomous Systems for Aviation

NASA Technical Reports Server (NTRS)

Brat, Guillaume; Davies, Misty; Giannakopoulou, Dimitra; Neogi, Natasha

2016-01-01

This report describes the workshop on Assurance for Autonomous Systems for Aviation that was held in January 2016 in conjunction with the SciTech 2016 conference held in San Diego, CA. The workshop explored issues related to assurance for autonomous systems and also the idea of trust in these systems. Specifically, we focused on discussing current practices for assurance of autonomy, identifying barriers specific to autonomy as related to assurance as well as operational scenarios demonstrating the need to address the barriers. Furthermore, attention was given to identifying verification techniques that may be applicable to autonomy, as well as discussing new research directions needed to address barriers, thereby involving potential shifts in current practices.

Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis.

PubMed

Pan, Yuanqing; Yang, Kehu; Wang, Yuliang; Zhang, Laiping; Liang, Haiqing

2017-04-01

To determine if yoga as a complementary and alternative therapy was associated with enhanced health and treatment-related side effects in patients with breast cancer. This systematic review examines whether yoga practice provides any measurable benefit, both physically and psychologically, for women with breast cancer. PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) throughout June 2013. We evaluated the quality of the included studies by the Cochrane Handbook 5.2 standards and analyzed the data using the Stata software, version 10.0. Meta-regression and subgroup analysis were also performed to identify additional predictors of outcome and to assess heterogeneity. Sixteen RCTs with a total of 930 participants were included. Comparing yoga groups to control groups, there was a statistically significant difference in overall health-related quality of life, depression, anxiety and gastrointestinal symptoms. Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity. Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practiced for longer than 3 months. Only the wait-list control group showed an effect of yoga on physical well-being. The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer. In future clinical studies, clinicians should consider the patient's wishes along with the current best evidence of the effects of yoga practice in their clinical decision-making. © 2015 Wiley Publishing Asia Pty Ltd.

Alcohol-related problems: emergency physicians' current practice and attitudes.

PubMed

O'Rourke, Maria; Richardson, Lynne D; Wilets, Ilene; D'Onofrio, Gail

2006-04-01

To determine whether emergency physicians' (EPs) attitudes affect their support and practice of brief intervention in the Emergency Department (ED), EPs completed an anonymous survey. EPs were asked about their attitudes toward patients with alcohol problems, current ED screening, use of brief intervention, and barriers to use of brief intervention. Chi-square analysis was used and a step-wise regression model was constructed. Respondents reported a high prevalence of patients with alcohol-related problems: 18% in a typical shift. Eighty-one percent said it is important to advise patients to change behavior; half said using a brief intervention is important. Attending physicians had significantly less alcohol education than residents, but were significantly more likely to support the use of brief intervention. Support was not associated with gender, race, census, hours of education, or personal experience. EPs who felt that brief intervention was an integral part of their job were more likely to use it in their daily practice.

The Activation, Appropriation and Practices of Student-Equity Policy in Australian Higher Education

ERIC Educational Resources Information Center

Peacock, David; Sellar, Sam; Lingard, Bob

2014-01-01

Current national reforms in Australian higher education have prioritised efforts to reduce educational disadvantage within a vernacular expression of neoliberal education policy. Student-equity policy in universities is enmeshed in a set of competitive student recruitment relations. This raises practice-based tensions as universities strive to…

Work-Life Balance: Beyond the Rhetoric. IES Report.

ERIC Educational Resources Information Center

Kodz, J.; Harper, H.; Dench, S.

The current status of British policy and practice related to work-life balance was examined through case studies of six organizations identified as having well-developed work-life balance and flexible working practices. Interviews were conducted with human resource (HR) managers at all six organizations, and interviews and focus group discussions…

Postnatal Depression and Infant Health Practices among High-Risk Women

ERIC Educational Resources Information Center

Zajicek-Farber, Michaela L.

2009-01-01

Women's postnatal depressive symptoms have been associated with many adverse outcomes for children. The current study examined the frequency association with relative risk between postnatal depressive symptoms and mothers' use of preventative infant health practices. The study used the Edinburgh Postnatal Depression Scale (EPDS) and Parental…

The Current State of Telemedicine in Urology.

PubMed

Miller, Adam; Rhee, Eugene; Gettman, Matthew; Spitz, Aaron

2018-03-01

Telemedicine use in urology is an evolving practice. In this article, the authors review the early experience of telemedicine specifically as it relates to urologic practice and discuss the future implications and the utility of telemedicine as it applies to other fields. Copyright © 2017 Elsevier Inc. All rights reserved.

Noneconomic factors influencing scrap metal disposition decisions at DOE and NRC-licensed nuclear facilities

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

Ewen, M.D.; Robinson, L.A.

1997-02-01

The U.S. Environmental Protection Agency (EPA) is currently developing radiation protection standards for scrap metal, which will establish criteria for the unconditional clearance of scrap from nuclear facilities. In support of this effort, Industrial Economics, Incorporated is assessing the costs and benefits attributable to the rulemaking. The first step in this analysis is to develop an in-depth understanding of the factors influencing scrap disposition decisions, so that one can predict current and future practices under existing requirements and compare them to the potential effects of EPA`s rulemaking. These baseline practices are difficult to predict due to a variety of factors.more » First, because decommissioning activities are just beginning at many sites, current practices do not necessarily provide an accurate indicator of how these practices may evolve as site managers gain experience with related decisions. Second, a number of different regulations and policies apply to these decisions, and the interactive effects of these requirements can be difficult to predict. Third, factors other than regulatory constraints and costs may have a significant effect on related decisions, such as concerns about public perceptions. In general, research suggests that these factors tend to discourage the unconditional clearance of scrap metal.« less

Ceramic Stereolithography: Additive Manufacturing for Ceramics by Photopolymerization

NASA Astrophysics Data System (ADS)

Halloran, John W.

2016-07-01

Ceramic stereolithography and related additive manufacturing methods involving photopolymerization of ceramic powder suspensions are reviewed in terms of the capabilities of current devices. The practical fundamentals of the cure depth, cure width, and cure profile are related to the optical properties of the monomer, ceramic, and photo-active components. Postpolymerization steps, including harvesting and cleaning the objects, binder burnout, and sintering, are discussed and compared with conventional methods. The prospects for practical manufacturing are discussed.

Nurses in Australian general practice: implications for chronic disease management.

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Salamonson, Yenna; Ollerton, Richard; Griffiths, Rhonda

2008-03-01

The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. National postal survey embedded in a sequential mixed method design. 284 practice nurses completed a postal survey during 2003-2004. Descriptive statistics and factor analysis were utilized to analyse the data. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45.8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = -0.779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0.8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions. Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease, particularly within the context of contemporary policy initiatives.

Predicting the practice effects on the blood oxygenation level-dependent (BOLD) function of fMRI in a symbolic manipulation task

NASA Astrophysics Data System (ADS)

Qin, Yulin; Sohn, Myeong-Ho; Anderson, John R.; Stenger, V. Andrew; Fissell, Kate; Goode, Adam; Carter, Cameron S.

2003-04-01

Based on adaptive control of thought-rational (ACT-R), a cognitive architecture for cognitive modeling, researchers have developed an information-processing model to predict the blood oxygenation level-dependent (BOLD) response of functional MRI in symbol manipulation tasks. As an extension of this research, the current event-related functional MRI study investigates the effect of relatively extensive practice on the activation patterns of related brain regions. The task involved performing transformations on equations in an artificial algebra system. This paper shows that the base-level activation learning in the ACT-R theory can predict the change of the BOLD response in practice in a left prefrontal region reflecting retrieval of information. In contrast, practice has relatively little effect on the form of BOLD response in the parietal region reflecting imagined transformations to the equation or the motor region reflecting manual programming.

Baby walkers--health visitors' current practice, attitudes and knowledge.

PubMed

Kendrick, Denise; Illingworth, Rachel; Hapgood, Rhydian; Woods, Amanda J; Collier, Jacqueline

2003-09-01

Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P < 0.001). Few health visitors had resources to discuss walkers. Health visitor advice regarding walkers needs to be given earlier in the postnatal period than is currently common practice, and they need more knowledge about walker use and related injuries. Education about baby walkers needs to be incorporated into undergraduate and in-service education, which may need to include the development of skills in exploring reasons why parents use walkers and in negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.

Momentary Parental Stress and Food-Related Parenting Practices.

PubMed

Berge, Jerica M; Tate, Allan; Trofholz, Amanda; Fertig, Angela R; Miner, Michael; Crow, Scott; Neumark-Sztainer, Dianne

2017-12-01

Research suggests that stress and depressed mood are associated with food-related parenting practices (ie, parent feeding practices, types of food served at meals). However, current measures of parental stress, depressed mood, and food-related parenting practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations across time and context. Identifying momentary factors that influence parent food-related parenting practices will facilitate the development of effective interventions aimed at promoting healthy food-related parenting practices. In this study, we used ecological momentary assessment to examine the association between momentary factors (eg, stress, depressed mood) occurring early in the day and food-related parenting practices at the evening meal. Children aged 5 to 7 years and their families ( N = 150) from 6 racial and/or ethnic groups ( n = 25 each African American, Hispanic/Latino, Hmong, American Indian, Somali, and white families) were recruited for this mixed-methods study through primary care clinics. Higher stress and depressed mood earlier in the day predicted pressure-to-eat feeding practices and fewer homemade foods served at meals the same night. Effect modification was found for certain racial and/or ethnic groups with regard to engaging in pressure-to-eat feeding practices (ie, America Indian, Somali) or serving fewer homemade meals (ie, African American, Hispanic/Latino) in the face of high stress or depressed mood. Clinicians may want to consider discussing with parents the influence stress and depressed mood can have on everyday food-related parenting practices. Additionally, future researchers should consider using real-time interventions to reduce parental stress and depressed mood to promote healthy parent food-related parenting practices. Copyright © 2017 by the American Academy of Pediatrics.

"That was grown folks' business": narrative reflection and response in older adults' family health history communication.

PubMed

Yamasaki, Jill; Hovick, Shelly R

2015-01-01

Given the importance of family health history and the pivotal role of older adults in communicating it, this study examines how African American older adults (a) characterize their understandings of health-related conditions in their family histories and (b) rationalize their motivations and constraints for sharing this information with current family members. Using narrative theory as a framework, we illustrate how the participants reflect on prior health-related experiences within the family to respond to moral and practical calls for communicating family health information to current relatives. Specifically, our analysis highlights how storied family secrets--as constructed by 28 participants in group and individual interviews--reveal and inform shifting cultural and generational practices that shape the lived health behaviors and communication of older adults at greater risk for health disparities.

Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces.

PubMed

Zimmermann, Wes O; Helmhout, P H; Beutler, A

2017-04-01

Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study. 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 Culture: The Challenges and Opportunities of International Public Relations.

ERIC Educational Resources Information Center

George, Amiso M.

2003-01-01

Focuses on the challenges and opportunities for international public relations practice. Looks at current United States-Arab relations issues in international crisis communication. Discusses those issues, especially the role of culture and media. Proposes strategies including a case study that teachers can use to help students become effective…

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study

PubMed Central

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-01-01

Introduction and Aims Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Design and Methods Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Results Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Discussion and Conclusions Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. [Fitzgerald N, Molloy H, MacDonald F, McCambridge J. Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study. Drug Alcohol Rev 2015;34:185–93] PMID:25196713

Educating Students with Autism Spectrum Disorders: Research-Based Principles and Practices

ERIC Educational Resources Information Center

Zager, Dianne, Ed.; Wehmeyer, Michael L., Ed.; Simpson, Richard L., Ed.

2011-01-01

Similar to a handbook in its comprehensive description of the theory and research supporting current practices in the treatment of autism spectrum disorders, this interdisciplinary text shows how the existing knowledge base can be used to explore promising new possibilities related to the field's many unanswered questions. This book is appropriate…

Accounting practice diversity in the healthcare industry.

PubMed

Robbins, W A; Turpin, R

1993-05-01

A recent study examining accounting practices currently being used to prepare annual hospital financial statements indicates relatively little diversity, regardless of organizational type or size. The study's findings should interest those concerned with healthcare accounting and financial reporting issues, especially healthcare administrators and members of standards setting boards who participate in accounting policy deliberations.

Professional Standards of Practice in Child Custody Examinations.

ERIC Educational Resources Information Center

Howell, Robert J.

Professional standards of practice for psychologists are vital in child custody work. The psychologist should examine all parties involved and should be acutely aware of and compliant with the current state laws as related to child custody. Objectivity is of paramount importance. This can best be achieved if the psychologist is appointed by the…

Practices in Home-School Cooperation--A Gendered Story?

ERIC Educational Resources Information Center

Widding, Goran

2013-01-01

Based on 30 interviews with teachers and parents conducted in a Swedish compulsory school, this article discusses the current growing body of research on home-school relations that stress the importance of parents' engagement and involvement as a key factor that influences pupils' academic performance. The focus is on gendered practices in…

Diameter Measurement in Bald Cypress

Treesearch

Bernard R. Parresol; James E. Hotvedt

1990-01-01

The usual practice of measuring diameter at 4.5 feet ( 1.3 m) or Dbh is meaningless in wetland tree species such as bald cypress (Taxodium distichum (L.) Rich.), due to the presence of fluted basal swells. Since buttress dimensions usually have no consistent relation to volume or form in the tree, the current practice among...

Managing Electronic Resources: A Survey of Current Practices in Academic Libraries.

ERIC Educational Resources Information Center

Shaw, Beth Hansen

This document reports results of an online survey that examined practices and procedures in the management of electronic resources in 65 academic library reference departments. Responses are related to: (1) student population; (2) library use by community people; (3) number of public access workstations, workstations with World Wide Web access,…

Current and Projected Modes of Delivery of Veterinary Medical Services to Animal Agriculture: Industrial/Commercial Services.

ERIC Educational Resources Information Center

Glick, Phillip Ray

1980-01-01

Veterinary education must re-establish its teaching objectives. Students need practical knowledge in areas such as business management, communications, marketing, public relations, facility management, and personnel management. Industry must also meet its obligations to continue to provide safe, dependable products that fill a practice need. (MLW)

A Longitudinal Study of Changes in Marketing Practices at Private Christian Colleges

ERIC Educational Resources Information Center

Vander Schee, Brian A.

2009-01-01

This article presents the results of a longitudinal study investigating current marketing practices at selected church-related, private, four-year compared to those in place in 1997. The role that institutional selectivity plays in the use of marketing activities was also investigated. The researcher surveyed the admissions directors or enrollment…

Online Education and Adult Learning: New Frontiers for Teaching Practices

ERIC Educational Resources Information Center

Kidd, Terry T., Ed.

2010-01-01

The expanding field of adult learning encompasses the study and practice of utilizing sound instructional design principals, technology, and learning theory as a means to solve educational challenges and human performance issues relating to adults, often occurring online. This book disseminates current issues and trends emerging in the field of…

Transforming High School Counseling: Counselors' Roles, Practices, and Expectations for Students' Success

ERIC Educational Resources Information Center

Mau, Wei-Cheng J.; Li, Jiaqi; Hoetmer, Kimberly

2016-01-01

This study examined the current roles and practices of American high school counselors in relation to the ASCA [American School Counselor Association] National Model. Expectations for student success by high school counselors were also examined and compared to those of teachers' and school administrators'. A nationally representative sample of 852…

Practical ethical theory for nurses responding to complexity in care.

PubMed

Fairchild, Roseanne Moody

2010-05-01

In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses' work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or even the profession. This article presents a theoretical conceptual model for professional nurses to review and make sense of the ethical reasoning skills needed to maintain a caring stance in relation to the competing values that must coexist among nurses, health care administrators, patients and families in the context of the complex health care work environments in which nurses are expected to practice. A model, Nurses' Ethical Reasoning Skills, is presented as a framework for nurses' thinking through and problem solving ethical issues in clinical practice in the context of complexity in health care.

Assessment practices of professionals serving students who are deaf or hard of hearing: an initial investigation.

PubMed

Luckner, John L; Bowen, Sandy

2006-01-01

Assessment currently plays a critical role in American schools and society, in tasks ranging from ranking schools' effectiveness, to determining individual placement, to planning instruction. The purpose of the study was to gather data about the formal and informal assessment instruments and processes used by professionals in deaf education. Respondents indicated that statewide annual assessments are the most frequently used measures, followed by the Stanford Achievement Test series and the Woodcock-Johnson III Test of Achievement. Commonly used assessment instruments and procedures for each academic area are reported in rank order. Issues about current practices are raised, and suggestions for additional research related to assessment practices in deaf education are provided.

Evaluation of the general public's knowledge, views and practices relating to appropriate antibiotic use in Qatar.

PubMed

Moienzadeh, Atefeh; Massoud, Tasnim; Black, Emily

2017-04-01

Studies completed internationally have demonstrated an alarming number of patients believed antibiotics are indicated in the treatment of viral infections and other self-limited illnesses. Evaluation of patient practices relating to antibiotics have also demonstrated inappropriate use. Antibiotic misuse by patients and practitioners has been identified as a factor in the development of resistance. Current knowledge, views and practices relating to antibiotic use in Qatar is unknown. The primary objective of this study was to evaluate the general population's current antimicrobial knowledge, views and practices in Qatar. This study was designed as a self-administered cross-sectional survey. Eligible participants were residents of Qatar who were over the age of 18 and spoke English or Arabic. The questionnaire was developed based on previously published literature and objectives of this study. Data were collected at community pharmacies in Doha, Qatar. The majority of participants (95.8%) had taken antibiotics in the past. The median knowledge score of the study population was 4/8. Misconceptions relating to use of antibiotics for treatment of viral infections were common. Inappropriate use as evident by hoarding of antibiotics for future use and sharing antibiotics with family or friends was also identified in this study population. Community pharmacists in Qatar have an opportunity to improve knowledge of the general population regarding appropriate indications of antibiotics and risk of resistance with inappropriate use. © 2015 Royal Pharmaceutical Society.

A systematic review of neurobiological and clinical features of mindfulness meditations.

PubMed

Chiesa, A; Serretti, A

2010-08-01

Mindfulness meditation (MM) practices constitute an important group of meditative practices that have received growing attention. The aim of the present paper was to systematically review current evidence on the neurobiological changes and clinical benefits related to MM practice in psychiatric disorders, in physical illnesses and in healthy subjects. A literature search was undertaken using Medline, ISI Web of Knowledge, the Cochrane collaboration database and references of retrieved articles. Controlled and cross-sectional studies with controls published in English up to November 2008 were included. Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-term meditation practice is associated with an enhancement of cerebral areas related to attention. From a clinical viewpoint, Mindfulness-Based Stress Reduction (MBSR) has shown efficacy for many psychiatric and physical conditions and also for healthy subjects, Mindfulness-Based Cognitive Therapy (MBCT) is mainly efficacious in reducing relapses of depression in patients with three or more episodes, Zen meditation significantly reduces blood pressure and Vipassana meditation shows efficacy in reducing alcohol and substance abuse in prisoners. However, given the low-quality designs of current studies it is difficult to establish whether clinical outcomes are due to specific or non-specific effects of MM. Despite encouraging findings, several limitations affect current studies. Suggestions are given for future research based on better designed methodology and for future directions of investigation.

Evidence-based practice and research utilization activities among rural nurses.

PubMed

Olade, Rosaline A

2004-01-01

To identify the extent to which rural nurses utilize evidence-based practice guidelines from scientific research in their practice; to describe both previous and current research utilization activities in which they have participated, and to identify the specific barriers they face in their practice settings. Data for this descriptive study were collected through questionnaires with open-ended questions focused on (a) current utilization of nursing research findings, (b) previous involvement in nursing research activities, and (c) participation in medical research activities. The participants were 106 nurses from various practice areas in six rural counties of a southwestern state in the United States. Results revealed that only 20.8% of the participants stated they were currently involved in research utilization, and they were mostly nurses with bachelor's degrees. The two most common areas of current research utilization were pain management and pressure ulcer prevention and management. Barriers to research utilization, such as rural isolation and lack of nursing research consultants, were identified. The types of research utilization activities identified by these nurses indicate how much the facilities in which these nurses work in the rural areas are striving with the utilization of available scientific evidence. Rural nurses face unique barriers related to situational and geographic factors, with implications for nursing administrators, researchers, and educators.

Food Recall Attitudes and Behaviors of School Nutrition Directors

ERIC Educational Resources Information Center

Grisamore, Amber; Roberts, Kevin R.

2014-01-01

Purpose/Objectives: The purpose of this study was to explore school nutrition directors' attitudes and behaviors about food recalls. Specific objectives included: 1) Determine current food recall attitudes and the relationship between demographics and these attitudes; 2) Determine current practices of school nutrition directors related to…

Art Portraying Medicine

ERIC Educational Resources Information Center

Koski, Kaisu

2011-01-01

A number of art projects are currently tackling the medical domain. This activity stems from a perceived need to increase the transparency and democracy of the medical domain, and it often questions the power relations and the one-dimensionality in current medical practices. This article sheds light on how artists process medical themes,…

Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives.

PubMed

Fealy, Gerard M; Rohde, Daniela; Casey, Mary; Brady, Anne-Marie; Hegarty, Josephine; Kennedy, Catriona; McNamara, Martin; O'Reilly, Pauline; Prizeman, Geraldine

2015-12-01

The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal consequences, time restrictions and lack of remuneration. Professional satisfaction, patients' needs, organisational support and having access to continuing professional education were perceived as facilitators of practice expansion. Older nurses and midwives as well as nurses and midwives holding more senior promotional grades, such as clinical nurse manager grades, perceived fewer barriers than their younger and more junior counterparts. Nurses and midwives continue to experience difficulties in relation to expanding their practice. Practitioners can operate to optimal scope of practice when practitioner-centred and workplace-based circumstances are optimal. The optimal circumstances for practice expansion exist when the facilitators of practice expansion outweigh the barriers. Given the critical role that nurses and midwives play in modern health services, it is important that they are empowered and enabled to expand their practice and to work to full scope of practice when patient needs and service requirements warrant it. © 2015 John Wiley & Sons Ltd.

Validating Prehistoric and Current Social Phenomena Upon the Landscape of the Peten, Guatemala

NASA Technical Reports Server (NTRS)

Sever, Thomas L.

1997-01-01

The Peten, once inhabited by a population of several million before the collapse of the ancient Maya in the 10th and 11th centuries, is being repopulated toward its former demographic peak. Environmental dynamics, however, impose severe constraints to further development. Current practices in subsistence, commercial agriculture, and cattle raising are causing rapid deforestation on a scale that can only result in soil loss and regional degradation. In view of the current deforestation trends, the question emerges as to how millions of ancient Maya lived successfully in the area for centuries when relatively fewer occupants today threaten the sustainability of the landscape with current agricultural practices. The use of remote sensing technology is a cost-effective methodology for addressing issues in Maya archeology as well as monitoring the environmental impacts being experienced by the current population.

Evidence, Engagement, and Technology: Themes of and the State of Primary Care Practice-based Network Research.

PubMed

Nease, Donald E

2016-01-01

Practice-based research supported by practice-based research network (PBRN) infrastructure has historically provided an important method for challenging guidelines and evidence arising from secondary and tertiary care settings. This sample of current practice-based research in this issue of the JABFM provides an opportunity to ask whether practice-based research continues to address questions relevant to primary care practices and clinicians and whether a PBRN infrastructure is instrumental to maintaining the relevance and feasibility of practice-based research. Based on this issue's articles, the current state of practice-based research seems to be good, at face value addressing relevant issues for primary care practices. Less clear is the degree to which PBRN infrastructures and relationships informed the questions asked and facilitated the implementation of the studies presented. Practice-based research-related articles that routinely report about how study questions arose-from practices and their clinicians, staff and communities, or elsewhere-could help directly answer questions of relevance. In addition, reporting how practices are recruited to practice-based research studies could inform the degree to which ongoing relationships central to PBRNs facilitate the recruitment and conduct of practice-based research. © Copyright 2016 by the American Board of Family Medicine.

Evidence of African-American women's frustrations with chronic recurrent bacterial vaginosis.

PubMed

Payne, Sandra C; Cromer, Pamela R; Stanek, Michele K; Palmer, Allyson A

2010-02-01

The purpose of this study was to explore the impact of recurrent bacterial vaginosis (BV) and its treatment on quality of life (QOL), acceptance of current treatment options, and psychosocial issues related to lifestyle practices associated with BV. Qualitative and quantitative data were obtained from 23 African American women with recurrent BV. Participants completed a short survey, developed by the researchers based on a prior study which examined factors associated with recurrent BV, and a one-on-one interview assessing the impact of BV, current treatment modalities, and lifestyle practices related to recurrent BV. Emerging themes suggest that recurrent BV is associated with psychosocial issues that are currently not addressed in a typical office visit. Reported feelings of shame and embarrassment often cause women to engage in hypervigilant routines of hygiene that negatively impact their professional, personal, and intimate relationships, significantly affecting their QOL. Without proper education, advice, and support, BV is perpetuated by lifestyle practices leading to recurrent infection and associated symptoms. With proper guidance, it is expected that women with recurrent BV will see an improvement in their QOL, with fewer complications from BV infection, and healthy relationships with intimate partners, family, and friends.

Patient Dose Management: Focus on Practical Actions

PubMed Central

2016-01-01

Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place. PMID:26908988

Large-Eddy Simulation: Current Capabilities, Recommended Practices, and Future Research

NASA Technical Reports Server (NTRS)

Georgiadis, Nicholas J.; Rizzetta, Donald P.; Fureby, Christer

2009-01-01

This paper presents the results of an activity by the Large Eddy Simulation (LES) Working Group of the AIAA Fluid Dynamics Technical Committee to (1) address the current capabilities of LES, (2) outline recommended practices and key considerations for using LES, and (3) identify future research needs to advance the capabilities and reliability of LES for analysis of turbulent flows. To address the current capabilities and future needs, a survey comprised of eleven questions was posed to LES Working Group members to assemble a broad range of perspectives on important topics related to LES. The responses to these survey questions are summarized with the intent not to be a comprehensive dictate on LES, but rather the perspective of one group on some important issues. A list of recommended practices is also provided, which does not treat all aspects of a LES, but provides guidance on some of the key areas that should be considered.

Dentists' leadership-related educational experiences, attitudes, and past and current behavior.

PubMed

Taichman, L Susan; Taichman, Russell S; Inglehart, Marita R

2014-06-01

The purpose of this study was to assess practicing dentists' perceptions of their leadership-related educational experiences during predoctoral education and after graduation, to investigate if these perceptions differed as a function of the respondents' graduation year and gender, and to explore the relationships between educational experiences and the respondents' understanding/perceptions of leadership, leadership-related attitudes, self-perceived effectiveness, and past and current leadership- related behavior. Of the 3,000 general dentist members of the American Dental Association who were invited to participate, 593 returned the survey for a response rate of 20 percent. Between 37 and 65 percent of the respondents indicated that their predoctoral dental education had not prepared them well on a series of factors related to being leaders in their practice, community, state, or at the national level. However, 33 to 77 percent of these dentists responded that educational experiences after graduation prepared them well for different types of leadership activities. Overall, respondents rated their predoctoral experiences significantly less positively than their experiences after graduation for each content area. The more recently the respondents had graduated, the higher they rated their leadership-related educational experiences. The better their educational experiences, the more important the respondents evaluated leadership activities in their practice, organized dentistry, and research/teaching, the more important they assessed leadership to be, and the more effective they evaluated themselves to be as leaders. The perceived quality of the respondents' predoctoral education was not correlated with their past and current leadership activities. The results of this study may suggest that improving leadership training during predoctoral education could positively affect future dentists' attitudes about leadership and ratings of their own effectiveness as leaders.

In Health-Related Tasks, Where Does the School Nurse Function?

ERIC Educational Resources Information Center

Berg, Beryl; And Others

1973-01-01

The study provided a composite picture of health-related tasks performed in one school district. Nurses were able to evaluate their current practices and recommend specific improvements in nursing actions. Other school districts seeking a profile of their involvement in health-related tasks may request copies of the questionnaire or the entire…

Factors influencing evidence-based practice in prosthetics and orthotics.

PubMed

Andrysek, Jan; Christensen, James; Dupuis, Annie

2011-03-01

The importance of evidence-based practice is being recognized across a broad range of healthcare disciplines as a means for improving patient outcomes and also efficiently managing healthcare resources. The objective of this work was to obtain information from clinicians about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Cross sectional survey. An internet survey was developed and distributed to 300 prosthetists and orthotists currently practicing in Canada. A principal component factor analysis of the survey results revealed ten primary factors affecting evidence-based practice. These include time constraints, workload and system demands, limited relevant evidence from research, and gaps in skills and knowledge required to perform evidence-based practice. Clinicians value research as a means of improving clinical practice, but they are faced with a number of practical barriers in performing evidence-based practice. This study provides empirical data about the underlying barriers and facilitators relating to evidence-based practice in prosthetics and orthotics. Such data are essential in order to inform those involved in improving existing clinical practices, including educators, professional organizations, and governing bodies.

Dyslexia Policy and Practice: Cross-Professional and Parental Perspectives on the Northern Ireland Context

ERIC Educational Resources Information Center

Beck, Gillian J.; Hazzard, Donna; McPhillips, Therése; Tiernan, Barbara; Casserly, Ann-Marie

2017-01-01

This article considers policy and practice in relation to dyslexia provision in Northern Ireland since the 2002 Task Group Report. Using interviews with original and current stakeholders, this research, funded by SCoTENS (Standing Conference on Teacher Education, North and South), examined the extent to which recommendations have been met in the…

Multicultural Education Policy in South Korea: Current Struggles and Hopeful Vision

ERIC Educational Resources Information Center

Grant, Carl A.; Ham, Sejung

2013-01-01

The global immigration of people has increased the call by governments for multicultural education. Across the globe, in country after country, multicultural education have come to represent the theory and practice to teach majority and minority citizens and immigrants and to explore issues of policy and practice as it relates to: ethnicity,…

Standardized Predictive Testing: Practices, Policies, and Outcomes

ERIC Educational Resources Information Center

Barton, Lisette; Willson, Pamela; Langford, Rae; Schreiner, Barbara

2014-01-01

The aims of this study were to describe current policy practice related to the use of the HESI™ Exit Exam in schools of nursing and to determine which policies result in higher HESI Exit Scores. Deans and directors of nursing schools that administered Elsevier HESI Exit Exam to students during the 2010 academic year were queried. Data were…

Language Choice and Education Quality in Eastern and Southern Africa: A Review

ERIC Educational Resources Information Center

Trudell, Barbara

2016-01-01

In 2014, UNICEF commissioned a review of language policy and education quality in the 21 countries of UNICEF's Eastern and Southern Africa Region. This paper examines findings from the review, related to the role of English and local languages in current education practice in the region. National language policies and implementation practices are…

Training MSSW Students for Military Social Work Practice and Doctoral Students in Military Resilience Research

ERIC Educational Resources Information Center

DuMars, Tyler; Bolton, Kristin; Maleku, Arati; Smith-Osborne, Alexa

2015-01-01

The demand for social workers with military-related practice and research experience exceeds the current supply. To advance military social work education, we developed an interlevel master's of science in social work (MSSW) field practicum and doctoral research practicum that provides military social work field experiences and contributes to…

Colorado's AgrAbility Project's Effects on KASA and Practice Changes with Agricultural Producers and Professionals

ERIC Educational Resources Information Center

Fetsch, Robert J.; Jackman, Danielle M.

2015-01-01

Disability rates resulting from work-related injuries remain steadily high among farmers and ranchers. To address the gap in services within this population, USDA implemented AgrAbility nationally. Using part of Bennett's hierarchical model, the current study evaluated the KASA and practice change levels of 401 farmers and ranchers and compared…

Exploration and Practice of Blended Teaching Model Based Flipped Classroom and SPOC in Higher University

ERIC Educational Resources Information Center

Wang, Xin-Hong; Wang, Jing-Ping; Wen, Fu-Ji; Wang, Jun; Tao, Jian-Qing

2016-01-01

SPOC is characterized by improving teaching effectiveness. Currently open teaching mode is the popular trend, which is mainly related to several aspects: how to carry out teaching practice by using MOOC proprietary, high-quality online teaching resources in open education, that is, deep integration of curriculum resources and teaching design. On…

A Study of the Relationship between Middle School and High School Teachers Instructional and Behavior Management Practices and Demographic Variables

ERIC Educational Resources Information Center

Santiago, Deborah Albright

2012-01-01

Although teachers implement differentiated instructional techniques to provide students with enriching hands-on activities related to real life experiences, the implementation of instructional techniques has required teachers to rethink and revise their approaches to classroom management (CM). While a gap in research exists on current practices in…

Medical Home Implementation: A Sensemaking Taxonomy of Hard and Soft Best Practices

PubMed Central

Hoff, Timothy

2013-01-01

Context The patient-centered medical home (PCMH) model of care is currently a central focus of U.S. health system reform, but less is known about the model's implementation in the practice of everyday primary care. Understanding its implementation is key to ensuring the approach's continued support and success nationally. This article addresses this gap through a qualitative examination of the best practices associated with PCMH implementation for older adult patients in primary care. Methods I used a multicase, comparative study design that relied on a sensemaking approach and fifty-one in-depth interviews with physicians, nurses, and clinic support staff working in six accredited medical homes located in various geographic areas. My emphasis was on gaining descriptive insights into the staff's experiences delivering medical home care to older adult patients in particular and then analyzing how these experiences shaped the staff's thinking, learning, and future actions in implementing medical home care. Findings I found two distinct taxonomies of implementation best practices, which I labeled “hard” and “soft” because of their differing emphasis and content. Hard implementation practices are normative activities and structural interventions that align well with existing national standards for medical home care. Soft best practices are more relational in nature and derive from the existing practice social structure and everyday interactions between staff and patients. Currently, external stakeholders are less apt to recognize, encourage, or incentivize soft best practices. Conclusions The results suggest that there may be no standardized, one-size-fits-all approach to making medical home implementation work, particularly for special patient populations such as the elderly. My study also raises the issue of broadening current PCMH assessments and reward systems to include implementation practices that contain heavy social and relational components of care, in addition to the emphasis now placed on building structural supports for medical home work. Further study of these softer implementation practices and a continued call for qualitative methodological approaches that gain insight into everyday practice behavior are warranted. PMID:24320169

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: a qualitative interview study.

PubMed

Fitzgerald, Niamh; Molloy, Heather; MacDonald, Fiona; McCambridge, Jim

2015-03-01

Few studies of the implementation of alcohol brief interventions (ABI) have been conducted in community settings such as mental health, social work and criminal justice teams. This qualitative interview study sought to explore the impact of training on ABI delivery by staff from a variety of such teams. Fifteen semi-structured telephone interviews were carried out with trained practitioners and with managers to explore the use of, perceived need for and approaches to ABI delivery and recording with clients, and compatibility of ABIs with current practice. Interviews were analysed thematically using an inductive approach. Very few practitioners reported delivery of any ABIs following training primarily because they felt ABIs to be inappropriate for their clients. According to practitioners, this was either because they drank too much or too little to benefit. Practitioners reported a range of current activities relating to alcohol, and some felt that their knowledge and confidence were improved following training. One practitioner reported ABI delivery and was considered a training success, while expectations of ABIs did not fit with current practice including assessment procedures for the remainder. Identified barriers to ABI delivery included issues relating to individual practitioners, their teams, current practice and the ABI model. They are likely to be best addressed by strategic team- and setting-specific approaches to implementation, of which training is only one part. © 2014 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

What is the current practice of therapists in the measurement of somatosensation in children with cerebral palsy and other neurological disorders?

PubMed

Walmsley, Corrin; Taylor, Susan; Parkins, Timothy; Carey, Leeanne; Girdler, Sonya; Elliott, Catherine

2018-04-01

Somatosensation is the ability to detect and recognise body sensations such as touch, vibration, pressure, pain, temperature and proprioception. Cerebral palsy is a neurological disorder that is often accompanied by impairments in somatosensation. Current somatosensory assessments have limited psychometrics established for use with these children. The aim of this study was to identify therapists' current practice and perspectives related to the assessment of somatosensation in children with neurological disorders. A cross-sectional questionnaire was used to identify the somatosensory assessments currently used in clinical practice, time allocated to assessment, and therapists' satisfaction and confidence using the available assessments of somatosensation. The questionnaire was adapted from a previously utilised questionnaire that identified therapists' use of somatosensory assessments with adults post-stroke. A total of 135 therapists responded to the questionnaire. Seventy-nine (92%) occupational therapists and 44 (89.7%) physiotherapists indicated that they currently assessed or treated children with somatosensory deficits. Sixty-four (82.1%) occupational therapists and 38 (86.3%) physiotherapists regarded assessment of somatosensation in children with neurological disorders as important to very important. However, only seven (8.8%) occupational therapists and seven (15.9%) physiotherapists reported confidence in their ability to do so. The methods with which therapists detect and measure somatosensory impairment in children with neurological disorders are variable, with non-standardised and/or informal assessments most frequently used. Despite there being recommendations of best practice for the assessment of specific domains of somatosensation in children with cerebral palsy, current practice does not yet mirror these recommendations. Additionally, therapists have low satisfaction and confidence with what they are currently using, highlighting the need for a comprehensive and standardised assessment of somatosensation for use in children with neurological disorders. © 2017 Occupational Therapy Australia.

Second Language Vocabulary Assessment: Current Practices and New Directions

ERIC Educational Resources Information Center

Read, John

2007-01-01

This paper surveys some current developments in second language vocabulary assessment, with particular attention to the ways in which computer corpora can provide better quality information about the frequency of words and how they are used in specific contexts. The relative merits of different word lists are discussed, including the Academic Word…

An Examination of Current Assessment Practices in Northeastern School Districts

ERIC Educational Resources Information Center

Madaus, Joseph; Rinaldi, Claudia; Bigaj, Stephen; Chafouleas, Sandra M.

2009-01-01

Despite the central role of assessment in special education, there is a paucity of current research on instruments and methods used in schools. Special education directors (N = 164) in five northeastern states responded to an electronic survey related to the use of assessment instruments and methods in their districts. Data are presented regarding…

Eddy Current Influences on the Dynamic Behaviour of Magnetic Suspension Systems

NASA Technical Reports Server (NTRS)

Britcher, Colin P.; Bloodgood, Dale V.

1998-01-01

This report will summarize some results from a multi-year research effort at NASA Langley Research Center aimed at the development of an improved capability for practical modelling of eddy current effects in magnetic suspension systems. Particular attention is paid to large-gap systems, although generic results applicable to both large-gap and small-gap systems are presented. It is shown that eddy currents can significantly affect the dynamic behavior of magnetic suspension systems, but that these effects can be amenable to modelling and measurement. Theoretical frameworks are presented, together with comparisons of computed and experimental data particularly related to the Large Angle Magnetic Suspension Test Fixture at NASA Langley Research Center, and the Annular Suspension and Pointing System at Old Dominion University. In both cases, practical computations are capable of providing reasonable estimates of important performance-related parameters. The most difficult case is seen to be that of eddy currents in highly permeable material, due to the low skin depths. Problems associated with specification of material properties and areas for future research are discussed.

The Baby Care Questionnaire: A measure of parenting principles and practices during infancy☆

PubMed Central

Winstanley, Alice; Gattis, Merideth

2013-01-01

The current report provides a new framework to explore the role of parenting practices and principles during infancy. We identify structure and attunement as key parenting principles during infancy. Structure represents reliance on regularity and routines in daily life. Attunement represents reliance on infant cues and close physical contact. We suggest parents’ relative endorsement of these parenting principles is related to their choices about practices such as feeding, holding and night-time sleeping. We designed the Baby Care Questionnaire to measure parents’ endorsement of structure and attunement, as well as their daily parenting practices. We report data demonstrating the factor structure, reliability and validity of the BCQ. The BCQ, to our knowledge, is the first comprehensive measure of parenting practices and principles during infancy. We conclude with a discussion of future directions for the measure. PMID:24050932

Competitive retrieval is not a prerequisite for forgetting in the retrieval practice paradigm.

PubMed

Camp, Gino; Dalm, Sander

2016-09-01

Retrieving information from memory can lead to forgetting of other, related information. The inhibition account of this retrieval-induced forgetting effect predicts that this form of forgetting occurs when competition arises between the practiced information and the related information, leading to inhibition of the related information. In the standard retrieval practice paradigm, a retrieval practice task is used in which participants retrieve the items based on a category-plus-stem cue (e.g., FRUIT-or___). In the current experiment, participants instead generated the target based on a cue in which the first 2 letters of the target were transposed (e.g., FRUIT-roange). This noncompetitive task also induced forgetting of unpracticed items from practiced categories. This finding is inconsistent with the inhibition account, which asserts that the forgetting effect depends on competitive retrieval. We argue that interference-based accounts of forgetting and the context-based account of retrieval-induced forgetting can account for this result. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

From theory to practice: what drives the core business of public health?

PubMed

Smith, Tina Anderson; Minyard, Karen J; Parker, Christopher A; Van Valkenburg, Rachel Ferencik; Shoemaker, John A

2007-01-01

In 1994, the Public Health Functions Steering Committee proffered a description of the Essential Public Health Services (Essential Services). Questions remain, however, about the relationship between the roles defined therein and current public health practice at state and local levels. This case study describes the core business of public health in Georgia relative to the theoretical ideal and elucidates the primary drivers of the core business, thus providing data to inform future efforts to strengthen practice in the state. The principal finding was that public health in Georgia is not aligned with the Essential Services. Further analysis revealed that the primary drivers or determinants of public health practice are finance-related rather than based in need or strategy, precluding an integrated and intentional focus on health improvement. This case study provides a systems context for public health financing discussions, suggests leverage points for public health system change, and furthers the examination of applications for systems thinking relative to public health finance, practice, and policy.

Program directors in surgery agree that residents should be formally trained in business and practice management.

PubMed

Lusco, Vincent C; Martinez, Serge A; Polk, Hiram C

2005-01-01

Surgical residents typically receive limited exposure to business and practice management during their training. As a result, residents are ill-prepared for issues related to starting a practice, coding, collecting, and taking a meaningful role within the medical community in promoting quality and safety and in containing health care costs. With the introduction of the core competencies and the current overhaul of surgical education, we believe there is an opportunity to include business and practice management into resident training. Program directors in general surgery (189 of 242) responded to a 9-question mailed survey inquiring about their opinions regarding training surgical residents in business and practice management. Most program directors agreed or strongly agreed (87%) that residents should be trained in business and practice management. Seventy percent believed that their current trainees were inadequately trained in this area. Over half (63%) believed that this training should begin during postgraduate years 2 to 5. Development of simple curricula aimed at preparing surgical residents for business and practice management could promote the contemporary education of surgeons.

Goal setting practice in chronic low back pain. What is current practice and is it affected by beliefs and attitudes?

PubMed

Gardner, Tania; Refshauge, Kathryn; McAuley, James; Hübscher, Markus; Goodall, Stephen; Smith, Lorraine

2018-01-18

Goal setting, led by the patient, is promising as an effective treatment for the management of chronic low back pain (CLBP); however, little is known about current practice. The aims of the study were to explore (1) current goal setting practice in CLBP among physiotherapists; (2) perceived barriers to goal setting in CLBP; and (3) relationship between clinician's attitudes and beliefs and goal setting practice. A cross-sectional observational survey. The majority of respondents used goal setting with the main aim of facilitating self-management. The greatest number of goals were set with 50% therapist/50% patient involvement. The most common perceived barriers to goal setting related to time constraints and lack of skill and confidence. A higher biomedical score for treatment orientation of the therapist was associated with a lower patient involvement score. Goal setting is common practice for CLBP and is perceived as a high priority. It is more often a collaboration between therapist and patient rather than patient-led with treatment orientation of the physiotherapist a predictor of patient involvement. Education of healthcare professionals needs to include better understanding of chronic pain to orient them away from a biomedical treatment approach, as well as to enhance skills in facilitating patient involvement in goal setting.

Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork.

PubMed

Zwarenstein, Merrick; Reeves, Scott

2006-01-01

Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the 'current best practices.' A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Existing Whole-House Solutions Case Study: Applying Best Practices to Florida Local Government Retrofit Programs - Central Florida

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

None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This case study describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs, Central Florida (Fact Sheet)

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

None, None

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multi-year field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. Our new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Applying Best Practices to Florida Local Government Retrofit Programs

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

McIlvaine, J.; Sutherland, K.

In some communities, local government and non-profit entities have funds to purchase and renovate distressed, foreclosed homes for resale in the affordable housing market. Numerous opportunities to improve whole house energy efficiency are inherent in these comprehensive renovations. BA-PIRC worked together in a multiyear field study making recommendations in individual homes, meanwhile compiling improvement costs, projected energy savings, practical challenges, and labor force factors surrounding common energy-related renovation measures. The field study, Phase 1 of this research, resulted in a set of best practices appropriate to the current labor pool and market conditions in central Florida to achieve projected annualmore » energy savings of 15%-30% and higher. This report describes Phase 2 of the work where researchers worked with a local government partner to implement and refine the "current best practices". A simulation study was conducted to characterize savings potential under three sets of conditions representing varying replacement needs for energy-related equipment and envelope components. The three scenarios apply readily to the general remodeling industry as for renovation of foreclosed homes for the affordable housing market. The new local government partner, the City of Melbourne, implemented the best practices in a community-scale renovation program that included ten homes in 2012.« less

Responses to concerns about child maltreatment: a qualitative study of GPs in England

PubMed Central

Woodman, Jenny; Gilbert, Ruth; Allister, Janice; Glaser, Danya; Brandon, Marian

2013-01-01

Objectives To provide a rich description of current responses to concerns related to child maltreatment among a sample of English general practitioners (GPs). Design In-depth, face-to-face interviews (November 2010 to September 2011). Participants selected and discussed families who had prompted ‘maltreatment-related concerns’. Thematic analysis of data. Setting 4 general practices in England. Participants 14 GPs, 2 practice nurses and 2 health visitors from practices with at least 1 ‘expert’ GP (expertise in child safeguarding/protection). Results The concerns about neglect and emotional abuse dominated the interviews. GPs described intense and long-term involvement with families with multiple social and medical problems. Narratives were distilled into seven possible actions that GPs took in response to maltreatment-related concerns. These were orientated towards whole families (monitoring and advocating), the parents (coaching) and children (opportune healthcare), and included referral to or working with other services and recording concerns. Facilitators of the seven actions were: trusting relationships between GPs and parents, good working relationships with health visitors and framing the problem/response as ‘medical’. Narratives indicated significant time and energy spent building facilitating relationships with parents with the aim of improving the child's well-being. Conclusions These GPs used core general practice skills for on-going management of families who prompted concerns about neglect and emotional abuse. Policy and research focus should be broadened to include strategies for direct intervention and on-going involvement by GPs, such as using their core skills during consultations and practice systems for monitoring families and encouraging presentation to general practice. Exemplars of current practice, such as those identified in our study, should be evaluated for feasibility and acceptability in representative general practice settings as well as tested for efficacy, safety and cost. The seven actions could form the basis for the ‘lead professional’ role in general practice as proposed in the 2013 version of ‘Working Together ’guidance. PMID:24302506

The theory-practice gap and skill acquisition: an issue for nursing education.

PubMed

Scully, Natashia Josephine

2011-01-01

Matching textbook descriptions of clinical situations with the reality of practice is an ongoing problem faced by members of the nursing profession and is commonly referred to as the "theory-practice gap". This ubiquitous gap is inevitably encountered by all nurses at various times; yet it is widely agreed that it is student nurses--given their novice, rule governed status--who find themselves in the midst of the theory-practice void. This paper will discuss the nature of the theory-practice gap and skill acquisition, in relation to a personal experience of mine as an undergraduate nursing student, and its significance in relation to student anxiety levels, nurse education (specifically the roles of the classroom teacher and clinical educators), teaching methods and the responsibility of the student to become accountable for their own education. I intend to communicate how my personal situation was dealt with and evaluate that experience in relation to current nursing literature. Ultimately, this discussion will demonstrate the value of reflection underpinning the development of competency in nursing and its role in bridging the theory-practice gap.

Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice.

PubMed

Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

2017-01-01

During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians' practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine.

Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice

PubMed Central

Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

2017-01-01

During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians’ practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine. PMID:29282423

Embouchure Dysfunction in Air Force Band Brass Musicians.

PubMed

Storms, Patrick R; Elkins, Candice P; Strohecker, Eric M

2016-06-01

Occupational injuries and medical problems in musicians are well described, but relatively less attention has been paid to orofacial and embouchure-related problems in professional brass players. This study addressed embouchure-related problems in Air Force Band members, a population of musicians with an intense practice and performance schedule. A survey was developed and distributed via the Air Force Survey Office to 599 active-duty Air Force Band members and 201 Air National Guard members. The survey assessed practice patterns, practice and performance venues, and presence of symptoms suggesting embouchure dysfunction. Responses were obtained from 167 Air Force Band brass players. Of the 157 responding to the question about embouchure dysfunction, 42% reported having experienced an embouchure problem at some point in the past, and 53% of those respondents reported that they were currently experiencing an embouchure problem. Forty-one percent of those with embouchure problems cited practice venues that were not conducive to effective and efficient practice at the time their embouchure problems began, and 48% of those with embouchure problems reported having to overblow in rehearsal at the time their problems began. Embouchure disorders were reported in a large proportion of Air Force Band brass survey respondents, and specific concerns related to practice venues and the need to overblow in practice settings suggest factors suitable to remediation and preventive strategies.

Benefits arising from SEA application -- a comparative review of North West England, Noord-Holland, and Brandenburg-Berlin

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

Fischer, T.B.

1999-03-01

This article seeks to determine the extent to which current assessment practice of transport infrastructure-related policies, plans, and programs (PPPs) results in certain benefits of strategic environmental assessment (SEA) in three European Union regions, namely, the region of North West England (UK), the provincie (administrative region) Noord-Holland (The Netherlands), and the engerer Verflechtungsraum (planning region) Brandenburg-Berlin (Germany). The number of assessments of transport infrastructure-related PPPs that potentially may be called SEA in the three regions is estimated. Benefits that should result from the application of SEA can be determined based on a review of existing academic literature. An analytical frameworkmore » is prepared, introducing evaluation criteria that are based on principles of SEA frameworks and procedures. The framework is used to analyze transport infrastructure-related PPPs at all administrative levels of decision-making in the three study regions. It is concluded that current assessment practice indeed results in certain related experience in the European Union than is frequently anticipated in the academic literature. It is observed that case studies that were reviewed on a number of previous occasions and those that are included in this analysis do not necessarily appear to be good practice cases.« less

The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

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

Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

Electronic health records to support obesity-related patient care: Results from a survey of United States physicians.

PubMed

Bronder, Kayla L; Dooyema, Carrie A; Onufrak, Stephen J; Foltz, Jennifer L

2015-08-01

Obesity-related electronic health record functions increase the rates of measuring Body Mass Index, diagnosing obesity, and providing obesity services. This study describes the prevalence of obesity-related electronic health record functions in clinical practice and analyzes characteristics associated with increased obesity-related electronic health record sophistication. Data were analyzed from DocStyles, a web-based panel survey administered to 1507 primary care providers practicing in the United States in June, 2013. Physicians were asked if their electronic health record has specific obesity-related functions. Logistical regression analyses identified characteristics associated with improved obesity-related electronic health record sophistication. Of the 88% of providers with an electronic health record, 83% of electronic health records calculate Body Mass Index, 52% calculate pediatric Body Mass Index percentile, and 32% flag patients with abnormal Body Mass Index values. Only 36% provide obesity-related decision support and 17% suggest additional resources for obesity-related care. Characteristics associated with having a more sophisticated electronic health record include age ≤45years old, being a pediatrician or family practitioner, and practicing in a larger, outpatient practice. Few electronic health records optimally supported physician's obesity-related clinical care. The low rates of obesity-related electronic health record functions currently in practice highlight areas to improve the clinical health information technology in primary care practice. More work can be done to develop, implement, and promote the effective utilization of obesity-related electronic health record functions to improve obesity treatment and prevention efforts. Published by Elsevier Inc.

Evaluating Mediation and Moderation Effects in School Psychology: A Presentation of Methods and Review of Current Practice

ERIC Educational Resources Information Center

Fairchild, Amanda J.; McQuillin, Samuel D.

2010-01-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described…

Assessment of current practice and barriers to antimicrobial prophylaxis in peritoneal dialysis patients.

PubMed

Campbell, Denise J; Brown, Fiona G; Craig, Jonathan C; Gallagher, Martin P; Johnson, David W; Kirkland, Geoffrey S; Kumar, Subramanian K; Lim, Wai H; Ranganathan, Dwarakanathan; Saweirs, Walaa; Sud, Kamal; Toussaint, Nigel D; Walker, Rowan G; Williams, Lesley A; Yehia, Maha; Mudge, David W

2016-04-01

Existing Australasian and international guidelines outline antibiotic and antifungal measures to prevent the development of treatment-related infection in peritoneal dialysis (PD) patients. Practice patterns and rates of PD-related infection vary widely across renal units in Australia and New Zealand and are known to vary significantly from guideline recommendations, resulting in PD technique survival rates that are lower than those achieved in many other countries. The aim of this study was to determine if there is an association between current practice and PD-related infection outcomes and to identify the barriers and enablers to good clinical practice. This is a multicentre network study involving eight PD units in Australia and New Zealand, with a focus on adherence to guideline recommendations on antimicrobial prophylaxis in PD patients. Current practice was established by asking the PD unit heads to respond to a short survey about practice/protocols/policies and a 'process map' was constructed following a face-to-face interview with the primary PD nurse at each unit. The perceived barriers/enablers to adherence to the relevant guideline recommendations were obtained from the completion of 'cause and effect' diagrams by the nephrologist and PD nurse at each unit. Data on PD-related infections were obtained for the period 1 January 2011 to 31 December 2011. Perceived barriers that may result in reduced adherence to guideline recommendations included lack of knowledge, procedural lapses, lack of a centralized patient database, patients with non-English speaking background, professional concern about antibiotic resistance, medication cost and the inability of nephrologists and infectious diseases staff to reach consensus on unit protocols. The definitions of PD-related infections used by some units varied from those recommended by the International Society for Peritoneal Dialysis, particularly with exit-site infection (ESI). Wide variations were observed in the rates of ESI (0.06-0.53 episodes per patient-year) and peritonitis (0.31-0.86 episodes per patient-year). Despite the existence of strongly evidence-based guideline recommendations, there was wide variation in adherence to these recommendations between PD units which might contribute to PD-related infection rates, which varied widely between units. Although individual patient characteristics may account for some of this variability, inconsistencies in the processes of care to prevent infection in PD patients also play a role. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Preparing School Social Work for the Future: An Update of School Social Workers' Tasks in Iowa

ERIC Educational Resources Information Center

Peckover, Christopher A.; Vasquez, Matthew L.; Van Housen, Stephanie L.; Saunders, Jeanne A.; Allen, Larry

2013-01-01

The authors begin this article by highlighting clinical social casework as a historic trend in school social work practice. They then identify two major shifts in current education policy related to school social work practice. One shift is an emphasis on a multilevel intervention approach, and the other is the differentiation between academic and…

Is Social Work Evidence-Based? Does Saying So Make It So? Ongoing Challenges in Integrating Research, Practice and Policy

ERIC Educational Resources Information Center

Gambrill, Eileen

2016-01-01

The integration of research and practice is of concern in all helping professions. Has social work become an evidence-based profession as some claim? Characteristics of current-day social work are presented that dispute this view, related continuing concerns are suggested, and promising developments (mostly outside social work) are described that…

LEADERSHIP FOR VOCATIONAL EDUCATION IN CALIFORNIA--THEORY AND PRACTICE OF PROGRAM DEVELOPMENT, SUMMARY REPORT OF THE COASTAL, NORTHERN, AND SOUTHERN REGIONAL CONFERENCES (NOVEMBER, 1965).

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Vocational Education Services.

APPROXIMATELY 105 SUPERVISORS AND COORDINATORS OF PUBLIC SCHOOL VOCATIONAL EDUCATION PROGRAMS IN CALIFORNIA PARTICIPATED IN CONFERENCES TO STUDY CURRENT LEADERSHIP PRACTICES AND VOCATIONAL EDUCATION PROGRAMS AS RELATED TO NATIONAL, STATE, AND LOCAL REQUIREMENTS. PRESENTATIONS WERE--(1) "A THEORETICAL MODEL FOR VOCATIONAL EDUCATION IN A…

Embedding evidence-based practice among nursing undergraduates: Results from a pilot study.

PubMed

André, Beate; Aune, Anne G; Brænd, Jorunn A

2016-05-01

Evidence-based practice is currently one of the most important developments in health care. Research in nursing science is rapidly growing; however, translating the knowledge based on this research into clinical practice is often hampered, and may be dependent on reflective skills. The aim of this study was to see how undergraduate nursing students in nursing should increase their skills and knowledge related to evidence-based practice through participation in clinical research projects. A qualitative approach was used in collecting and analyzing the data. Students participated in a pilot clinical research project and a received guidance related to their bachelor thesis. After the project was completed, all students filled in a questionnaire. The students' motivation to participate in this study was reported to be high, but they reported low knowledge related to evidence-based practice. All students reported that their attitude towards evidence-based practice changed in a positive direction during their participation in the project. Evidence-based practice influenced nursing practices by putting more focus on critical thinking, increasing pride and giving a sense of ownership in the clinical field. The curricula and the pedagogical perspectives in nursing education can influence the attitude towards evidence-based practice and skills among nursing bachelor students. Copyright © 2016 Elsevier Ltd. All rights reserved.

Series: Pragmatic trials and real world evidence: Paper 7. Safety, quality and monitoring.

PubMed

Irving, Elaine; van den Bor, Rutger; Welsing, Paco; Walsh, Veronica; Alfonso-Cristancho, Rafael; Harvey, Catherine; Garman, Nadia; Grobbee, Diederick E

2017-11-01

Pragmatic trials offer the opportunity to obtain real-life data on the relative effectiveness and safety of a treatment before or after market authorization. This is the penultimate paper in a series of eight, describing the impact of design choices on the practical implementation of pragmatic trials. This paper focuses on the practical challenges of collecting and reporting safety data and of monitoring trial conduct while maintaining routine clinical care practice. Current ICH guidance recommends that all serious adverse events and all drug-related events must be reported in an interventional trial. In line with current guidance, we propose a risk-based approach to the collection of non-drug-related non-serious adverse events and even serious events not related to treatment based on the risk profile of the medicine/class in the patient population of interest. Different options available to support the collection and reporting of safety data while minimizing study-related follow-up visits are discussed. A risk-based approach to monitoring trial conduct is also discussed, highlighting the difference in the balance of risks likely to occur in a pragmatic trial compared to traditional clinical trials and the careful consideration that must be given to the mitigation and management of these risks to maintain routine care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Gender relations and health research: a review of current practices

PubMed Central

2011-01-01

Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a) as emergent findings; and b) as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women) are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health. PMID:22151578

Treatment Effects of a Primary Care Intervention on Parenting Behaviors: Sometimes It's Relative.

PubMed

Shaffer, Anne; Lindhiem, Oliver; Kolko, David

2017-04-01

The goal of this brief report is to demonstrate the utility of quantifying parental discipline practices as relative frequencies in measuring changes in parenting behavior and relations to child behavior following intervention. We explored comparisons across methodological approaches of assessing parenting behavior via absolute and relative frequencies in measuring improvements in parent-reported disciplinary practices (increases in positive parenting practices in response to child behavior; decreases in inconsistent discipline and use of corporal punishment) and child behavior problems. The current study was conducted as part of a larger clinical trial to evaluate the efficacy of a collaborative care intervention for behavior problems, ADHD, and anxiety in pediatric primary care practices (Doctor Office Collaborative Care; DOCC). Participants were 321 parent-child dyads (M child age = 8.00, 65 % male children) from eight pediatric practices that were cluster randomized to DOCC or enhanced usual care (EUC). Parents reported on their own discipline behaviors and child behavior problems. While treatment-related decreases in negative parenting were found using both the absolute and relative frequencies of parenting behaviors, results were different for positive parenting behaviors, which showed decreases when measured as absolute frequencies but increases when measured as relative frequencies. In addition, positive parenting was negatively correlated with child behavior problems when using relative frequencies, but not absolute frequencies, and relative frequencies of positive parenting mediated relations between treatment condition and outcomes. Our findings indicate that the methods used to measure treatment-related change warrant careful consideration.

A mixed methods investigation of an online intervention to facilitate student midwives' engagement in effective conversations about weight-related behaviour change with pregnant women.

PubMed

Hart, Jo; Furber, Christine; Chisholm, Anna; Aspinall, Samantha; Lucas, Charlotte; Runswick, Emma; Mann, Karen; Peters, Sarah

2018-05-16

(1) To identify whether an online training intervention could increase midwifery students' knowledge of behaviour change techniques (BCTs) and intentions to use them in practice. (2) To identify students' views and current experiences of talking to women about weight-related behaviour change. Mixed methods study involving pre- and post-training assessments, and qualitative interviews with midwifery students. Online training course delivered at a University in the North of England, UK. Midwifery students in the third year of their undergraduate degree during 2015-2016. Online training focused on equipping students with knowledge of theoretically-informed BCTs, and the skills to use them opportunistically in existing practice settings. Likelihood of discussing obesity with women was assessed via a 12-item, 7-point Likert scale assessing students' attitudes, subjective norms, perceived behavioural control, and intentions. A 14-item checklist was used to assess BCT knowledge whereby students selected recognised BCTs (of 7 correct, 7 false). Students' views and experiences of current practice was explored through in-depth, semi-structured one-on-one interviews with a member of the research team. Students' subjective norms, perceived behavioural control, and knowledge of BCTs increased post-training but intention and attitudes did not. Interviews revealed three themes accounting for students experiences and views of behaviour change practice: (1) 'How training fits with current encounters with maternal obesity in midwifery training' (2) 'TEnT PEGS prepares students for practice', and (3) 'Value of tailored training'. Online BCT training can improve the midwifery students' confidence, knowledge and beliefs that this is part of their role. They also reported finding the training helpful in better preparing them for this challenging element of their routine practice. Online BCT training can be used to prepare undergraduate midwifery students for practice. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Allocating Practice Expense Under the Medicare Fee Schedule

PubMed Central

Pope, Gregory C.; Burge, Russel T.

1993-01-01

Currently, relative value units for practice expense are determined under the Medicare fee schedule (MFS) using historical physician charges. This seems inconsistent with the goal of a resource-based fee schedule. A specialty resource-based method of determining practice expense payments is presented and simulated here. The method assumes that, for each service, the payment for practice expense should be the same proportion of the total payment as actual physician practice expenses are of total practice revenues. A comparison with the approach developed by the Physician Payment Review Commission (PPRC) shows similar fees, but the specialty-based method proposed here requires no data beyond what is already employed in the MFS. PMID:10130574

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

Managing fever in children: a national survey of parents' knowledge and practices in France.

PubMed

Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Chalumeau, Martin

2013-01-01

Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs) were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. In all, 1,534 HPs (participation rate 13%) included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature) and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children.

Managing Fever in Children: A National Survey of Parents' Knowledge and Practices in France

PubMed Central

Bertille, Nathalie; Fournier-Charrière, Elisabeth; Pons, Gérard; Chalumeau, Martin

2013-01-01

Introduction Identifying targets to improve parental practices for managing fever in children is the first step to reducing the overloaded healthcare system related to this common symptom. We aimed to study parents' knowledge and practices and their determinants in managing fever symptoms in children in France as compared with current recommendations. Methods We conducted an observational national study between 2007 and 2008 of French general practitioners, primary care pediatricians and pharmacists. These healthcare professionals (HPs) were asked to include 5 consecutive patients from 1 month to 12 years old with fever for up to 48 hr who were accompanied by a family member. Parents completed a questionnaire about their knowledge of fever in children and their attitudes about the current fever episode. We used a multilevel logistic regression model to assess the joint effects of patient- and HP-level variables. Results In all, 1,534 HPs (participation rate 13%) included 6,596 children. Parental concordance with current recommendations for temperature measurement methods, the threshold for defining fever, and physical (oral hydration, undressing, room temperature) and drug treatment was 89%, 61%, 15%, and 23%, respectively. Multivariate multi-level analyses revealed a significant HP effect. In general, high concordance with recommendations was associated with high educational level of parents and the HP consulted being a pediatrician. Conclusions In France, parents' knowledge and practices related to managing fever symptoms in children frequently differ from recommendations. Targeted health education interventions are needed to effectively manage fever symptoms in children. PMID:24391772

Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS).

PubMed

Einstein, Andrew J; Pascual, Thomas N B; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V; Mahmarian, John J; Better, Nathan; Bouyoucef, Salah E; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V Peter C; Alexánderson, Erick; Allam, Adel H; Al-Mallah, Mouaz H; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A; Luxenburg, Osnat; Shaw, Leslee J; Underwood, S Richard; Rehani, Madan M; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

2015-07-07

To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing 'best practices' worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March-April 2013. Eight 'best practices' relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more 'best practices' had lower EDs. Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

Transfusion medicine and solid organ transplant - Update and review of some current issues.

PubMed

Sarkar, R S; Philip, J; Yadav, Pramod

2013-04-01

Transfusion medicine holds a place of prime importance in organ transplant surgeries. There is a huge demand of organs worldwide with long waiting periods before the organ is available for transplant. Currently the dependency on ABO and HLA matching has decreased considerably with the use of modern immunosuppressant drugs and transplant techniques. The greatest advance in clinical implementation of ABO-incompatible transplants came about through desensitization and isoagglutinin elimination techniques with immunoadsorption and anti-CD20 antibodies becoming the norm, and spleenectomy fading out. The implications and practices of transfusion medicine in organ transplant are also undergoing drastic changes. The practice of infusion of one unit of donor's blood preoperatively for immunomodulation is no longer practiced. Use of leuco-reduced products has shown decreasing trends of alloimmunization and graft rejection in cases of multiple surgeries related to organ transplants. Worldwide donor and recipient registry programmes are being setup and existing ones are being upgraded. Such a registry system has been opened in India for kidney transplant cases very recently. Due to such registry programmes the dependency on siblings and directed donations have decreased considerably. This review deals with some of the current issues contributing to the successful outcome of mismatched transplants and the changing concepts of transfusion medicine related to it.

Cancer related fatigue: implementing guidelines for optimal management.

PubMed

Pearson, Elizabeth J M; Morris, Meg E; McKinstry, Carol E

2017-07-18

Cancer-related fatigue (CRF) is a key concern for people living with cancer and can impair physical functioning and activities of daily living. Evidence-based guidelines for CRF are available, yet inconsistently implemented globally. This study aimed to identify barriers and enablers to applying a cancer fatigue guideline and to derive implementation strategies. A mixed-method study explored the feasibility of implementing the CRF guideline developed by the Canadian Association for Psychosocial Oncology (CAPO). Health professionals, managers and consumers from different practice settings participated in a modified Delphi study with two survey rounds. A reference group informed the design of the study including the surveys. The first round focused on guideline characteristics, compatibility with current practice and experience, and behaviour change. The second survey built upon and triangulated the first round. Forty-five health practitioners and managers, and 68 cancer survivors completed the surveys. More than 75% of participants endorsed the CAPO cancer related fatigue guidelines. Some respondents perceived a lack of resources for accessible and expert fatigue management services. Further barriers to guideline implementation included complexity, limited practical details for some elements, and lack of clinical tools such as assessment tools or patient education materials. Recommendations to enhance guideline applicability centred around four main themes: (1) balancing the level of detail in the CAPO guideline with ease of use, (2) defining roles of different professional disciplines in CRF management, (3) how best to integrate CRF management into policy and practice, (4) how best to ensure a consumer-focused approach to CRF management. Translating current knowledge on optimal management of CRF into clinical practice can be enhanced by the adoption of valid guidelines. This study indicates that it is feasible to adopt the CAPO guidelines. Clinical application may be further enhanced with guideline adaptation, professional education and integration with existing practices.

Evaluation of LOINC for Representing Constitutional Cytogenetic Test Result Reports

PubMed Central

Heras, Yan Z.; Mitchell, Joyce A.; Williams, Marc S.; Brothman, Arthur R.; Huff, Stanley M.

2009-01-01

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future. PMID:20351857

Evaluation of LOINC for representing constitutional cytogenetic test result reports.

PubMed

Heras, Yan Z; Mitchell, Joyce A; Williams, Marc S; Brothman, Arthur R; Huff, Stanley M

2009-11-14

Genetic testing is becoming increasingly important to medical practice. Integrating genetics and genomics data into electronic medical records is crucial in translating genetic discoveries into improved patient care. Information technology, especially Clinical Decision Support Systems, holds great potential to help clinical professionals take full advantage of genomic advances in their daily medical practice. However, issues relating to standard terminology and information models for exchanging genetic testing results remain relatively unexplored. This study evaluates whether the current LOINC standard is adequate to represent constitutional cytogenetic test result reports using sample result reports from ARUP Laboratories. The results demonstrate that current standard terminology is insufficient to support the needs of coding cytogenetic test results. The terminology infrastructure must be developed before clinical information systems will be able to handle the high volumes of genetic data expected in the near future.

Review of sports-related concussion: Potential for application in military settings.

PubMed

Lew, Henry L; Thomander, Darryl; Chew, Kelvin T L; Bleiberg, Joseph

2007-01-01

This article reviews current issues and practices in the assessment and clinical management of sports-related concussion. An estimated 300,000 sports-related concussions occur annually in the United States. Much of what has been learned about concussion in the sports arena can be applied to the diagnosis and management of concussion in military settings. Current military guidelines for assessing and managing concussion in war zones incorporate information and methods developed through sports-concussion research. We discuss the incidence, definition, and diagnosis of concussion; concussion grading scales; sideline evaluation tools; neuropsychological assessment; return-to-action criteria; and complications of concussion.

Interventions for improving upper limb function after stroke.

PubMed

Pollock, Alex; Farmer, Sybil E; Brady, Marian C; Langhorne, Peter; Mead, Gillian E; Mehrholz, Jan; van Wijck, Frederike

2014-11-12

Improving upper limb function is a core element of stroke rehabilitation needed to maximise patient outcomes and reduce disability. Evidence about effects of individual treatment techniques and modalities is synthesised within many reviews. For selection of effective rehabilitation treatment, the relative effectiveness of interventions must be known. However, a comprehensive overview of systematic reviews in this area is currently lacking. To carry out a Cochrane overview by synthesising systematic reviews of interventions provided to improve upper limb function after stroke. We comprehensively searched the Cochrane Database of Systematic Reviews; the Database of Reviews of Effects; and PROSPERO (an international prospective register of systematic reviews) (June 2013). We also contacted review authors in an effort to identify further relevant reviews. We included Cochrane and non-Cochrane reviews of randomised controlled trials (RCTs) of patients with stroke comparing upper limb interventions with no treatment, usual care or alternative treatments. Our primary outcome of interest was upper limb function; secondary outcomes included motor impairment and performance of activities of daily living. When we identified overlapping reviews, we systematically identified the most up-to-date and comprehensive review and excluded reviews that overlapped with this. Two overview authors independently applied the selection criteria, excluding reviews that were superseded by more up-to-date reviews including the same (or similar) studies. Two overview authors independently assessed the methodological quality of reviews (using a modified version of the AMSTAR tool) and extracted data. Quality of evidence within each comparison in each review was determined using objective criteria (based on numbers of participants, risk of bias, heterogeneity and review quality) to apply GRADE (Grades of Recommendation, Assessment, Development and Evaluation) levels of evidence. We resolved disagreements through discussion. We systematically tabulated the effects of interventions and used quality of evidence to determine implications for clinical practice and to make recommendations for future research. Our searches identified 1840 records, from which we included 40 completed reviews (19 Cochrane; 21 non-Cochrane), covering 18 individual interventions and dose and setting of interventions. The 40 reviews contain 503 studies (18,078 participants). We extracted pooled data from 31 reviews related to 127 comparisons. We judged the quality of evidence to be high for 1/127 comparisons (transcranial direct current stimulation (tDCS) demonstrating no benefit for outcomes of activities of daily living (ADLs)); moderate for 49/127 comparisons (covering seven individual interventions) and low or very low for 77/127 comparisons.Moderate-quality evidence showed a beneficial effect of constraint-induced movement therapy (CIMT), mental practice, mirror therapy, interventions for sensory impairment, virtual reality and a relatively high dose of repetitive task practice, suggesting that these may be effective interventions; moderate-quality evidence also indicated that unilateral arm training may be more effective than bilateral arm training. Information was insufficient to reveal the relative effectiveness of different interventions.Moderate-quality evidence from subgroup analyses comparing greater and lesser doses of mental practice, repetitive task training and virtual reality demonstrates a beneficial effect for the group given the greater dose, although not for the group given the smaller dose; however tests for subgroup differences do not suggest a statistically significant difference between these groups. Future research related to dose is essential.Specific recommendations for future research are derived from current evidence. These recommendations include but are not limited to adequately powered, high-quality RCTs to confirm the benefit of CIMT, mental practice, mirror therapy, virtual reality and a relatively high dose of repetitive task practice; high-quality RCTs to explore the effects of repetitive transcranial magnetic stimulation (rTMS), tDCS, hands-on therapy, music therapy, pharmacological interventions and interventions for sensory impairment; and up-to-date reviews related to biofeedback, Bobath therapy, electrical stimulation, reach-to-grasp exercise, repetitive task training, strength training and stretching and positioning. Large numbers of overlapping reviews related to interventions to improve upper limb function following stroke have been identified, and this overview serves to signpost clinicians and policy makers toward relevant systematic reviews to support clinical decisions, providing one accessible, comprehensive document, which should support clinicians and policy makers in clinical decision making for stroke rehabilitation.Currently, no high-quality evidence can be found for any interventions that are currently used as part of routine practice, and evidence is insufficient to enable comparison of the relative effectiveness of interventions. Effective collaboration is urgently needed to support large, robust RCTs of interventions currently used routinely within clinical practice. Evidence related to dose of interventions is particularly needed, as this information has widespread clinical and research implications.

Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

2017-12-01

In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

Perceptions of firearms and suicide: The role of misinformation in storage practices and openness to means safety measures.

PubMed

Anestis, Michael D; Butterworth, Sarah E; Houtsma, Claire

2018-02-01

Firearm ownership and unsafe storage increase risk for suicide. Little is known regarding factors that influence storage practices and willingness to engage in means safety. Utilizing Amazon's Mechanical Turk program, we recruited an online sample of 300 adults living in the US who own at least one firearm. Firearm storage practices and openness to means safety measures were assessed using items designed for this study. Data were collected and analyzed in 2017. Firearms stored in non-secure locations and without a locking device were associated with lower beliefs in the relationship between firearm storage and suicide risk. Fearlessness about death moderated the association between current secure versus non-secure storage and beliefs regarding firearm storage and suicide risk, in that storage practices and beliefs were more strongly related at higher levels of fearlessness about death. For both secure and locked storage of a firearm, there was a significant indirect effect of current storage practices on willingness to engage in means safety in the future through current beliefs regarding the relationship between firearm storage and suicide risk. Unsafe storage practices were largely associated with an unwillingness to store firearms more safely or to allow a trusted peer to temporarily store the firearm outside the home in order to prevent their own or someone else's suicide. Self-report and cross-sectional data were used. Results may not generalize to non-firearm owners. Firearm owners are prone to inaccurate beliefs about the relationship between firearms and suicide. These beliefs may influence both current firearm storage practices and the willingness to engage in means safety. Copyright © 2017 Elsevier B.V. All rights reserved.

Transfusion in critically ill children: indications, risks, and challenges.

PubMed

Parker, Robert I

2014-03-01

To provide a concise review of transfusion-related issues and practices in the pediatric patient population, with a focus on those issues of particular importance to the care of critically ill children. Electronic search of the PubMed database using the search terms "pediatric transfusion," "transfusion practices," "transfusion risks," "packed red blood cell transfusion," "white blood cell transfusion," "platelet transfusion," "plasma transfusion," and "massive transfusion" either singly or in combination. All identified articles published since 2000 were manually reviewed for study design, content, and support for indicated conclusions, and the bibliographies were scrutinized for pertinent references not identified in the PubMed search. Selected studies from this group were then manually reviewed for possible inclusion in this review. Well-designed studies have demonstrated the benefit of "restrictive" transfusion practices across the entire age spectrum of pediatric patients across a wide spectrum of pediatric illness. However, clinician implementation of the more restrictive transfusion practices supported by these studies is variable. Additionally, the utilization of both platelet and plasma transfusions in either a "prophylactic" or "therapeutic" setting appears to be greater than that supported by published data. The preponderance of prospective, randomized trials and retrospective analyses support the use of a restrictive packed RBC transfusion policy in most clinical conditions in children. Neonatal transfusions guidelines rely largely on "expert opinion" rather than experimental data. Current transfusion practices for both platelets and coagulant products (e.g., fresh-frozen plasma and recombinant-activated factor VII) are poorly aligned with recommended transfusion guidelines. As with adults, current transfusion practices in children often do not reflect implementation of our current knowledge on the need for transfusion. Greater efforts to implement current evidence-based transfusion practices are needed.

Analyses of Recruit Training Practices Related to the Military Performance of Enlisted Navy Women

DTIC Science & Technology

1983-12-01

currently addresses pregnancy and child care issues indirectly through instruction in birth control . 20 Technical Note 10-83 policy change will increase...recruit, lacking sufficient experience, is unlikely to associate the information, and a learning opportunity is diminished. BIRTH CONTROL . This...hygiene practices necessary in communal living environments, venereal diseases, birth control , and cancer detection. Two training periods are allotted

Possible legislative constraints to intensive silvicultural practices in northern forest types

Treesearch

Brendan J. Whittaker

1977-01-01

The question of legal constraints to forest practice is currently active again. Two sources of restriction are the historic concern for timber supply and related amenities, and the mandates of the Federal Water Pollution Law. Legislators by and large, both State and Federal, realize the need of the nation for timber and will give due weight to the data presented to...

Toward an Integrated Theory of Relational Youth Violence: Bridging a Gap among the Theory, Research, and Practice of Bullying Prevention

ERIC Educational Resources Information Center

Brion-Meisels, Gretchen; Garnett, Bernice Raveche

2016-01-01

Despite an increased interest in bullying prevention programming over the last 10 years, significant gaps remain among theory, research, and practice in this critical area of school psychology. This article argues that the current Centers for Disease Control and Prevention (CDC) definition of bullying does not fully capture the experiences of many…

Examining Teacher Perceptions of the Relationship between Evaluation Policy and Teacher Practice in a North Carolina School System

ERIC Educational Resources Information Center

Frasier, Amanda Marie Slaten

2017-01-01

Examining the justification for current evaluation policy reveals that such policy rests on two assumptions related to the impact on the work of teachers: (1) evaluations are necessary because teachers need to be rated, sanctioned, or rewarded in order to be motivated to improve their practice; and (2) evaluations yield information that is useful…

How To Make a Curriculum: The 1987 Guidelines for Curriculum Development in the Norwegian High School--A New Paradigma in Curriculum Development Practice?

ERIC Educational Resources Information Center

Gundem, Bjorg B.

This paper relates to a research project on the history and current practice of curriculum administration in Norway. An elaboration is provided on the changing high school system and the growing impact of curriculum scholarship on curriculum development. The discussion revolves around three objectives: (1) to determine if the newly formulated set…

The potential of ecological theory for building an integrated framework to develop the public health contribution of health visiting.

PubMed

Bryans, Alison; Cornish, Flora; McIntosh, Jean

2009-11-01

In line with recent UK and Scottish policy imperatives, there is increasing pressure for the health visiting service to assume an enhanced role in improving public health. Although health visiting has so far maintained its unique position as a primarily preventive service within the UK health service, its distinctive contribution now appears under threat. The continuing absence of a comprehensive and integrated conceptual basis for practice has a negative impact on the profession's ability to respond to current challenges. Establishing an integrative framework to conceptualise health visiting practice would enable more sensitive, focused and appropriate research, education and evaluation in relation to practice. Work in this area could thus usefully contribute to the future development of the service at a difficult time. Our paper aims to make such a contribution. In support of our conceptual aims, we draw on a study of health visiting practice undertaken within a large conurbation in central Scotland. The study used a mixed method, collaborative approach involving 12 audio-recorded and observed health visitor-client interactions, semi-structured interviews with the 12 HVs and 12 clients, examination of related documentation and workshops with the HV participants. We critically consider prevalent models of health visiting practice and describe the more integrative conceptual approach provided by Bronfenbrenner's ecological, 'person-in-context' framework. The paper subsequently explores relationships between this framework and understandings of need demonstrated by health visitors who participated in our study. Current policy emphasises the need to focus on public health and social inclusion in order to improve health. However, if this policy is to be translated into practice, we must develop a more adequate understanding of how practitioners work effectively with families and individuals in a sensitive and context-specific manner. Bronfenbrenner's framework appears to offer a promising means of building on the current strengths of the health visiting service to further develop a 'person-in-context' approach to health improvement that is mindful of and responsive to multiple, inter-related influences on health. We therefore recommend further research to directly test the utility of this framework.

Saudi views on consenting for research on medical records and leftover tissue samples

PubMed Central

2010-01-01

Background Consenting for retrospective medical records-based research (MR) and leftover tissue-based research (TR) continues to be controversial. Our objective was to survey Saudis attending outpatient clinics at a tertiary care hospital on their personal preference and perceptions of norm and current practice in relation to consenting for MR and TR. Methods We surveyed 528 Saudis attending clinics at a tertiary care hospital in Saudi Arabia to explore their preferences and perceptions of norm and current practice. The respondents selected one of 7 options from each of 6 questionnaires. Results Respondents' mean (SD) age was 33 (11) years, 42% were males, 56% were patients, 84% had ≥ secondary school education, and 10% had previously volunteered for research. Respectively, 40% and 49% perceived that the norm is to conduct MR and TR without consent and 38% and 37% with general or proposal-specific consent; the rest objected to such research. There was significant difference in the distribution of choices according to health status (patients vs. companions) for MR (adjusted Kruskal-Wallis test P = 0.03) but not to age group, gender, education level, or previous participation in research (unadjusted P = 0.02 - 0.59). The distributions of perceptions of current practice and norm were similar (unadjusted Marginal Homogeneity test P = 0.44 for MR and P = 0.89 for TR), whereas the distributions of preferences and perceptions of norm were different (adjusted P = 0.09 for MR and P = 0.02 for TR). The distributions of perceptions of norm, preferences, and perceptions of current practice for MR were significantly different from those of TR (adjusted P < 0.009 for all). Conclusions We conclude that: 1) there is a considerable diversity among Saudi views regarding consenting for retrospective research which may be related to health status, 2) the distribution of perceptions of norm was similar to the distribution of perceptions of current practice but different from that of preferences, and 3) MR and TR are perceived differently in regard to consenting. PMID:20955580

Chlorinated pesticides in stream sediments from organic, integrated and conventional farms.

PubMed

Shahpoury, Pourya; Hageman, Kimberly J; Matthaei, Christoph D; Magbanua, Francis S

2013-10-01

To determine if current sheep/beef farming practices affect pesticide residues in streams, current-use and legacy chlorinated pesticides were quantified in 100 sediment samples from 15 streams on the South Island of New Zealand. The study involved five blocks of three neighboring farms, with each block containing farms managed by organic, integrated and conventional farming practices. Significantly higher concentrations of dieldrin, ∑ endosulfans, ∑ current-use pesticides, and ∑ chlorinated pesticides were measured in sediments from conventional farms compared to organic and integrated farms. However, streams in the latter two farming categories were not pesticide-free and sometimes contained relatively high concentrations of legacy pesticides. Comparison of measured pesticide concentrations with sediment quality guidelines showed that, regardless of farming practice, mean pesticide concentrations were below the recommended toxicity thresholds. However, up to 23% of individual samples contained chlorpyrifos, endosulfan sulfate, ∑ DDT, dieldrin, or ∑ chlordane concentrations above these thresholds. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impaired practice effects following mild traumatic brain injury: an event-related potential investigation.

PubMed

Rogers, Jeffrey M; Fox, Allison M; Donnelly, James

2015-01-01

The negative effects of mild traumatic brain injury (mTBI) on attention are well established. Effects of practice on neuropsychological test performance have also been long recognized and more recently linked to electrophysiological indices of information processing. The current study examined the behavioural and electrophysiological impact of mTBI on consistent practice of a neuropsychological test of attention. Prospective cohort study. Adult participants with a history of mild TBI (n = 10; time since injury > 2 months, mean = 15.2 months) and healthy matched controls (n = 10) completed the Paced Auditory Serial Addition Task (PASAT) at four separate sessions. Event-related potentials (ERPs) were simultaneously recorded. Accuracy of PASAT performance in both groups improved significantly with practice. In healthy controls behavioural improvements were associated with significant attenuation of a frontally distributed ERP component marker of executive attention. These executive attention demands did not appear to ease with consistent practice in the mTBI group, who also endorsed more concussion-related symptoms. These preliminary results suggest sustained mental effort is required to achieve 'normal' performance levels following mTBI and support the use of practice-related, ERP indices of recovery from mTBI as a sensitive correlate of persistent post-concussion symptoms.

Sharing and re-use of phylogenetic trees (and associated data) to facilitate synthesis.

PubMed

Stoltzfus, Arlin; O'Meara, Brian; Whitacre, Jamie; Mounce, Ross; Gillespie, Emily L; Kumar, Sudhir; Rosauer, Dan F; Vos, Rutger A

2012-10-22

Recently, various evolution-related journals adopted policies to encourage or require archiving of phylogenetic trees and associated data. Such attention to practices that promote sharing of data reflects rapidly improving information technology, and rapidly expanding potential to use this technology to aggregate and link data from previously published research. Nevertheless, little is known about current practices, or best practices, for publishing trees and associated data so as to promote re-use. Here we summarize results of an ongoing analysis of current practices for archiving phylogenetic trees and associated data, current practices of re-use, and current barriers to re-use. We find that the technical infrastructure is available to support rudimentary archiving, but the frequency of archiving is low. Currently, most phylogenetic knowledge is not easily re-used due to a lack of archiving, lack of awareness of best practices, and lack of community-wide standards for formatting data, naming entities, and annotating data. Most attempts at data re-use seem to end in disappointment. Nevertheless, we find many positive examples of data re-use, particularly those that involve customized species trees generated by grafting to, and pruning from, a much larger tree. The technologies and practices that facilitate data re-use can catalyze synthetic and integrative research. However, success will require engagement from various stakeholders including individual scientists who produce or consume shareable data, publishers, policy-makers, technology developers and resource-providers. The critical challenges for facilitating re-use of phylogenetic trees and associated data, we suggest, include: a broader commitment to public archiving; more extensive use of globally meaningful identifiers; development of user-friendly technology for annotating, submitting, searching, and retrieving data and their metadata; and development of a minimum reporting standard (MIAPA) indicating which kinds of data and metadata are most important for a re-useable phylogenetic record.

GP Networks as enablers of quality of care: implementing a practice engagement framework in a General Practice Network.

PubMed

Pearce, Christopher; Shearer, Marianne; Gardner, Karina; Kelly, Jill; Xu, Tony Baixian

2012-01-01

This paper describes how the Melbourne East General Practice Network supports general practice to enable quality of care, it describes the challenges and enablers of change, and the evidence of practice capacity building and improved quality of care. Primary care is well known as a place where quality, relatively inexpensive medical care occurs. General practice is made up of multiple small sites with fragmented systems and a funding system that challenges a whole-of-practice approach to clinical care. General Practice Networks support GPs to synthesise complexity and crystallise solutions that enhance general practice beyond current capacity. Through a culture of change management, GP Networks create the link between the practice and the big picture of the whole health system and reduce the isolation of general practice. They distribute information (evidence-based learning and resources) and provide individualised support, responding to practice need and capacity.

Team deliberate practice in medicine and related domains: a consideration of the issues.

PubMed

Harris, Kevin R; Eccles, David W; Shatzer, John H

2017-03-01

A better understanding of the factors influencing medical team performance and accounting for expert medical team performance should benefit medical practice. Therefore, the aim here is to highlight key issues with using deliberate practice to improve medical team performance, especially given the success of deliberate practice for developing individual expert performance in medicine and other domains. Highlighting these issues will inform the development of training for medical teams. The authors first describe team coordination and its critical role in medical teams. Presented next are the cognitive mechanisms that allow expert performers to accurately interpret the current situation via the creation of an accurate mental "model" of the current situation, known as a situation model. Following this, the authors propose that effective team performance depends at least in part on team members having similar models of the situation, known as a shared situation model. The authors then propose guiding principles for implementing team deliberate practice in medicine and describe how team deliberate practice can be used in an attempt to reduce barriers inherent in medical teams to the development of shared situation models. The paper concludes with considerations of limitations, and future research directions, concerning the implementation of team deliberate practice within medicine.

Changes to nurses' practice environment over time.

PubMed

Roche, Michael A; Duffield, Christine; Friedman, Sarah; Twigg, Di; Dimitrelis, Sofia; Rowbotham, Samantha

2016-07-01

To examine changes in the nursing practice environment, retention-related factors, unit stability and patient care tasks delayed or left undone, over two periods between 2004 and 2013. Positive nurse practice environments have been linked to nurse retention and care quality outcomes. The collection of the Practice Environment Scale of the Nursing Work Index, job satisfaction, intent to leave, unit instability and tasks delayed or not done at six acute-care hospitals across three Australian states, in two waves between 2004 and 2013; results from the two waves are compared. On average, practice environment scores declined slightly; nurses reported a greater difficulty in finding another nursing position, lower intent to leave their current job and greater instability in their current position. Rates of delayed tasks increased over the period, whereas rates of tasks left undone have decreased over the period. The decline in nurses' perceptions of the quality of the practice environment is disappointing, particularly given the protracted workforce shortages that have persisted. Significant organisational restructuring and turnover of nurse executives may have contributed to this decline. Managers need to apply existing evidence to improve nurse practice environments and manage instability. © 2016 John Wiley & Sons Ltd.

Practice patterns of image guided particle therapy in Europe: A 2016 survey of the European Particle Therapy Network (EPTN).

PubMed

Bolsi, Alessandra; Peroni, Marta; Amelio, Dante; Dasu, Alexandru; Stock, Markus; Toma-Dasu, Iuliana; Nyström, Petra Witt; Hoffmann, Aswin

2018-03-28

Image guidance is critical in achieving accurate and precise radiation delivery in particle therapy, even more than in photon therapy. However, equipment, quality assurance procedures and clinical workflows for image-guided particle therapy (IGPT) may vary substantially between centres due to a lack of standardization. A survey was conducted to evaluate the current practice of IGPT in European particle therapy centres. In 2016, a questionnaire was distributed among 19 particle therapy centres in 12 European countries. The questionnaire consisted of 30 open and 37 closed questions related to image guidance in the general clinical workflow, for moving targets, current research activities and future perspectives of IGPT. All centres completed the questionnaire. The IGPT methods used by the 10 treating centres varied substantially. The 9 non-treating centres were in the process to introduce IGPT. Most centres have developed their own IGPT strategies, being tightly connected to their specific technical implementation and dose delivery methods. Insight into the current clinical practice of IGPT in European particle therapy centres was obtained. A variety in IGPT practices and procedures was confirmed, which underlines the need for harmonisation of practice parameters and consensus guidelines. Copyright © 2018 Elsevier B.V. All rights reserved.

Areas for improvement in community optometry: flashes and floaters take priority.

PubMed

Duncan, Eilidh M; Cassie, Heather; Pooley, Janet; Elouafakoui, Paula; Prior, Maria; Gibb, Elizabeth; Ramsay, Craig; Young, Linda

2018-07-01

A common response to rising demand for healthcare is to extend the role of health professionals and the range of their service provision. Community optometry in Scotland is a recent example of this. Within this context of innovation and change there are challenges to ensuring quality in optometry practice. The purpose of this research is to establish what the priorities are for practice improvement within community optometry and to start a programme to inform strategies to improve practice. A four stage study was conducted: (1) a service-driven topic prioritisation exercise to identify priorities for optometry practice improvement; (2) a review of national and international guidance and UK protocols relating to the identified priority topic; (3) a national theory-based survey identifying current practice and the barriers and facilitators to the target behaviour; and (4) the identification of theory-based intervention options to improve practice. The Behaviour Change Wheel approach to behaviour change intervention development and Theoretical Domains Framework (TDF) provided the underlying theoretical framework. Stakeholders identified 'patients presenting with flashes and floaters' as an important priority for practice improvement. The decision about whether or not to refer patients on to secondary care for further examination is the target behaviour. Guidance for optometrists on this topic is lacking. Six TDF domains were related to the decision about whether or not to refer patients with flashes and floaters to secondary care - 'social influences', 'emotion', 'beliefs about capabilities', 'beliefs about consequences', 'behavioural regulation' and 'reinforcement'. This study has examined current practice in relation to the management of patients with flashes and floaters, identified the most salient targets for future strategies to improve optometry practice and highlighted what form these strategies may take. It demonstrates the use of a flexible, theory-informed approach, which can be used to engage with stakeholders and professionals to inform the design and development of efforts to improve practice in a variety of healthcare settings. © 2018 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

Using Coaching as a Professional Development Modality to Train Teachers in the Use of Evidence-Based Practices for Students with Autism Spectrum Disorders

ERIC Educational Resources Information Center

Hollins, Samantha Marsh

2013-01-01

Professional development for teachers currently working in the classroom is an important focus of educational programs and school systems. Continuous professional development is especially important for special education teachers to maintain current information related to strategies and supports that are effective in educating students with…

Selection, Placement and Instatement of School Managers in Turkey: Evaluation of the Current Situation

ERIC Educational Resources Information Center

Memisoglu, Salih Pasa

2015-01-01

The aim of this study is to evaluate the new regulations and current practices in terms of how they apply--to the selection, training and instatement of school administrators in Turkey. The successful implementation of Turkish National Development Plans is closely related to the knowledge and skills of managers working at various levels in every…

A call for research exploring social media influences on mothers' child feeding practices and childhood obesity risk.

PubMed

Doub, Allison E; Small, Meg; Birch, Leann L

2016-04-01

There is increasing interest in leveraging social media to prevent childhood obesity, however, the evidence base for how social media currently influences related behaviors and how interventions could be developed for these platforms is lacking. This commentary calls for research on the extent to which mothers use social media to learn about child feeding practices and the mechanisms through which social media influences their child feeding practices. Such formative research could be applied to the development and dissemination of evidence-based childhood obesity prevention programs that utilize social media. Mothers are identified as a uniquely important target audience for social media-based interventions because of their proximal influence on children's eating behavior and their high engagement with social media platforms. Understanding mothers' current behaviors, interests, and needs as they relate to their social media use and child feeding practices is an integral first step in the development of interventions that aim to engage mothers for obesity prevention. This commentary highlights the importance of mothers for childhood obesity prevention; discusses theoretical and analytic frameworks that can inform research on social media and mothers' child feeding practices; provides evidence that social media is an emerging context for social influences on mothers' attitudes and behaviors in which food is a salient topic; and suggests directions for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bidirectional relations between parenting practices and child externalizing behavior: a cross-lagged panel analysis in the context of a psychosocial treatment and 3-year follow-up.

PubMed

Shaffer, Anne; Lindhiem, Oliver; Kolko, David J; Trentacosta, Christopher J

2013-02-01

In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or CD. Parenting practices and child behavior problems were assessed at six time-points using multiple measures and multiple reporters. The data were analyzed using cross-lagged panel analyses. Results indicated robust temporal stabilities of parenting practices and child behavior problems, in the context of treatment-related improvements, but bidirectional effects between parenting practices and child behavior were less frequently detected. Our findings suggest that bidirectional effects are relatively smaller than the temporal stability of each construct for school-age children with ODD/CD and their parents, following a multi-modal clinical intervention that is directed at both parents and children. Implications for treatment and intervention are discussed.

Feedback from the European Bioanalysis Forum: focus workshop on current analysis of immunogenicity: best practices and regulatory hurdles.

PubMed

Goodman, Joanne; Cowen, Simon; Devanarayan, Viswanath; Egging, David; Emrich, Thomas; Golob, Michaela; Kramer, Daniel; McNally, Jim; Munday, James; Nelson, Robert; Pedras-Vasconcelos, João A; Piironen, Timo; Sickert, Denise; Skibeli, Venke; Fjording, Marianne Scheel; Timmerman, Philip

2018-02-01

European Bioanalysis Forum Workshop, Lisbon, Portugal, September 2016: At the recent European Bioanalysis Forum Focus Workshop, 'current analysis of immunogenicity: best practices and regulatory hurdles', several important challenges facing the bioanalytical community in relation to immunogenicity assays were discussed through a mixture of presentations and panel sessions. The main areas of focus were the evolving regulatory landscape, challenges of assay interferences from either drug or target, cut-point setting and whether alternative assays can be used to replace neutralizing antibody assays. This workshop report captures discussions and potential solutions and/or recommendations made by the speakers and delegates.

Analysis of air quality management with emphasis on transportation sources

NASA Technical Reports Server (NTRS)

English, T. D.; Divita, E.; Lees, L.

1980-01-01

The current environment and practices of air quality management were examined for three regions: Denver, Phoenix, and the South Coast Air Basin of California. These regions were chosen because the majority of their air pollution emissions are related to mobile sources. The impact of auto exhaust on the air quality management process is characterized and assessed. An examination of the uncertainties in air pollutant measurements, emission inventories, meteorological parameters, atmospheric chemistry, and air quality simulation models is performed. The implications of these uncertainties to current air quality management practices is discussed. A set of corrective actions are recommended to reduce these uncertainties.

Precursors to the Development of Flexible Expertise: Metacognitive Self-Evaluations as Antecedences and Consequences in Adult Learning

ERIC Educational Resources Information Center

Birney, Damian P.; Beckmann, Jens F.; Wood, Robert E.

2012-01-01

The current study investigates a conceptualization of "flexible expertise" as it relates to adult learning within the context of management and leadership training. Three research domains and their relation to metacognitive outcomes are integrated: 1) individual differences in abilities, personality, and mindsets, 2) deliberate practice and…

Adolescents' Perceptions of Parental Goals, Practices, and Styles in Relation to Their Motivation and Achievement

ERIC Educational Resources Information Center

Spera, Christopher

2006-01-01

The current study examines research questions proposed by an expanded version of Darling and Steinberg's contextual model of parenting. Using a sample of 184 adolescents, the analyses indicated that adolescents' perceptions of parental educational goals and values were related positively and significantly to their reports of parental school…

Significance of the NCA's "Dialogue on Public Relations Education" Conference.

ERIC Educational Resources Information Center

Kruckeberg, Dean; Paluszek, John L.

1999-01-01

Contends that the 1998 Summer Conference of the National Communication Association, and the massive formative research in preparation for it, were seminal in examining current public-relations practice and education, in advocating education norms for the future, and in contributing to a much-needed ecumenism among the diverse public-relations…

The History of Legislation and Regulations Related to Children with Developmental Disabilities: Implications for School Nursing Practice Today

ERIC Educational Resources Information Center

Dang, Michelle T.

2010-01-01

A significant number of children in the United States have developmental disabilities. Historically, many children with developmental disabilities were institutionalized and rarely seen in public. Currently, children with developmental disabilities are entitled to education and health-related support services that permit them access to public…

Pediatricians' Knowledge, Training, and Experience in the Care of Children with Fetal Alcohol Syndrome

ERIC Educational Resources Information Center

Gahagan, Sheila; Sharpe, Tanya Telfair; Brimacombe, Michael; Fry-Johnson, Yvonne; Levine, Robert; Mengel, Mark; O'Connor, Mary; Paley, Blair; Adubato, Susan; Brenneman, George

2007-01-01

Objectives: Prenatal exposure to alcohol interferes with fetal development and is the leading preventable cause of birth defects and developmental disabilities. The purpose of this study was to identify current knowledge, diagnosis, prevention, and intervention practices related to fetal alcohol syndrome and related conditions by members of the…

Presentation and Impact of Experimental Techniques in Chemistry

ERIC Educational Resources Information Center

Sojka, Zbigniew; Che, Michel

2008-01-01

Laboratory and practical courses, where students become familiar with experimental techniques and learn to interpret data and relate them to appropriate theory, play a vital role in chemical education. In the large panoply of currently available techniques, it is difficult to find a rational and easy way to classify the techniques in relation to…

Physical therapist vs. family practitioner knowledge of simple low back pain management in the U.S. Air Force.

PubMed

Ross, Michael D; Childs, John D; Middel, Cory; Kujawa, Julie; Brown, Daniel; Corrigan, Molly; Parsons, Nate

2014-02-01

The purpose of this study was to compare knowledge in managing low back pain (LBP) between physical therapists and family practice physicians. Fifty-four physical therapists and 130 family practice physicians currently serving in the U.S. Air Force completed standardized examinations assessing knowledge, attitudes, the usefulness of clinical practice guidelines, and management strategies for patients with LBP. Beliefs of physical therapists and family practice physicians about LBP were compared using relative risks and independent t tests. Scores related to knowledge, attitudes, and the usefulness of clinical practice guidelines were generally similar between the groups. However, physical therapists were more likely to recommend the correct drug treatments for patients with acute LBP compared to family practice physicians (85.2% vs. 68.5%; relative risk: 1.24 [95% confidence interval: 1.06-1.46]) and believe that patient encouragement and explanation is important (75.9% vs. 56.2%; relative risk: 1.35 [95% confidence interval: 1.09-1.67]). In addition, physical therapists showed significantly greater knowledge regarding optimal management strategies for patients with LBP compared to family practice physicians. The results of this study may have implications for health policy decisions regarding the utilization of physical therapists to provide care for patients with LBP without a referral. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

The role of traditional Japanese medicine (Kampo) in the practice of psychosomatic medicine: the usefulness of Kampo in the treatment of the stress-related symptoms of women, especially those with peri-menopausal disorder.

PubMed

Ushiroyama, Takahisa

2013-10-22

A serious problem currently plaguing the medical field is the widening gap between academic medicine, which studies the features and causes of illness, and the medical care that patients desire. An example of this gap can be observed in the practice of psychotherapy, which is effective only for certain patients. Kampo medicine that combines the advantages of Western medicine with those of traditional Japanese medicine is currently undergoing a revival in the healthcare sector. The therapeutic policies underlying Kampo medicine are based on the physical constitution and current symptoms of each patient. For this reason, Kampo medicine is referred to as "tailor-made medicine" and has properties similar to "mind and body" or psychosomatic medicine. Some women exhibit multiple undefined stress-related symptoms during the peri-menopausal period. In order to accurately diagnose and provide patient-specific treatment, physicians should not only investigate the various stress factors in patients' lives but should also provide a Sho, or a Kampo diagnosis. The therapeutic approach in Kampo medicine is aimed at harmonizing the mind, body, and spirit; this practice involves the use of narrative and holistic medication that treats the entire being of the patient, resulting in an increased number of specialized treatment plans.There are many Kampo prescriptions tailored to treat women who exhibit various stress-related symptoms. Both Kampo and psychosomatic medicine are based on the principles of narrative-based medicine, and by integrating these two medical systems, an ideal system can be devised to better cope with the various needs of patients. This new medical system established by integrating and harmonizing Western and Eastern medicine can be used for the treatment of women with stress-related symptoms.

Judgments of learning are significantly higher following feedback on relatively good versus relatively poor trials despite no actual learning differences.

PubMed

Carter, Michael J; Smith, Victoria; Ste-Marie, Diane M

2016-02-01

Studies have consistently shown that prospective metacognitive judgments of learning are often inaccurate because humans mistakenly interpret current performance levels as valid indices of learning. These metacognitive discrepancies are strongly related to conditions of practice. Here, we examined how the type of feedback (after good versus poor trials) received during practice and awareness (aware versus unaware) of this manipulation affected judgments of learning and actual learning. After each six-trial block, participants received feedback on their three best trials or three worst trials and half of the participants were made explicitly aware of the type of feedback they received while the other half were unaware. Judgments of learning were made at the end of each six-trial block and before the 24-h retention test. Results indicated no motor performance differences between groups in practice or retention; however, receiving feedback on relatively good compared to relatively poor trials resulted in significantly higher judgments of learning in practice and retention, irrespective of awareness. These results suggest that KR on relatively good versus relatively poor trials can have dissociable effects on judgments of learning in the absence of actual learning differences, even when participants are made aware of their feedback manipulation. Copyright © 2015 Elsevier B.V. All rights reserved.

Molecular testing for cystic fibrosis carrier status practice guidelines: recommendations of the National Society of Genetic Counselors.

PubMed

Langfelder-Schwind, Elinor; Karczeski, Barbara; Strecker, Michelle N; Redman, Joy; Sugarman, Elaine A; Zaleski, Christina; Brown, Trisha; Keiles, Steven; Powers, Amy; Ghate, Sumheda; Darrah, Rebecca

2014-02-01

To provide practice recommendations for genetic counselors whose clients are considering cystic fibrosis (CF) carrier testing or seeking information regarding CF molecular test results. The goals of these recommendations are to: 1) Provide updated information about the natural history, diagnosis, and treatment of CF and related conditions. 2) Supplement genetic counselors' knowledge and understanding of the available carrier screening and diagnostic testing options. 3) Describe the current state of genotype/phenotype correlations for CFTR mutations and an approach to interpreting both novel and previously described variants. 4) Provide a framework for genetic counselors to assist clients' decision-making regarding CF carrier testing, prenatal diagnosis, and pregnancy management. Disclaimer The practice guidelines of the National Society of Genetic Counselors (NSGC) are developed by members of the NSGC to assist genetic counselors and other health care providers in making decisions about appropriate management of genetic concerns; including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue, and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recommendations within the NSGC practice guidelines reflect the current scientific and clinical knowledge at the time of publication, are only current as of their publication date, and are subject to change without notice as advances emerge.In addition, variations in practice, which take into account the needs of the individual patient and the resources and limitations unique to the institution or type of practice, may warrant approaches, treatments and/or procedures that differ from the recommendations outlined in this guideline. Therefore, these recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. Genetic counseling practice guidelines are never intended to displace a health care provider's best medical judgment based on the clinical circumstances of a particular patient or patient population.Practice guidelines are published by NSGC for educational and informational purposes only, and NSGC does not "approve" or "endorse" any specific methods, practices, or sources of information.

Bridging the research-practice gap: breaking new ground in health care.

PubMed

Mulhall, A

2001-08-01

Many theorists have discussed the existence of a gap between nursing research and practice. Consequently much time and effort has been expended in trying to devise strategies to bridge this divide. This article explores what the research-practice gap is and discusses five important reasons for it. The issue is then raised as to whether or not there is a gap between evidence and practice, despite the existence of the gap between research and practice. This is explored in relation to the potential conflict between the 'know how' knowledge important in practice and the 'know that' knowledge important in academia. Finally, the concept of practitioner-centred research is described as one strategy that would effectively obliterate the research-practice gap as it is currently conceived.

36 CFR 219.16 - Relationships with interested individuals and organizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... information about current and historic public uses within an assessment or plan area, about the location of unique and sensitive resources and values and cultural practices related to issues in the plan area; and...

Guidelines for the Bioremediation of Marine Shorelines and Freshwater Wetlands

EPA Pesticide Factsheets

For oil spill responders:presents rational approach, evaluates current practices and state-of-the-art research results pertaining to bioremediation of hydrocarbon contamination relative to types and amounts of amendments used, application frequency, extent

Report of a Meeting on Contemporary Topics in Zebrafish Husbandry and Care

PubMed Central

Osborne, Nikki; Paull, Gregory; Grierson, Adam; Dunford, Karen; Busch-Nentwich, Elisabeth M.; Sneddon, Lynne U.; Wren, Natalie; Higgins, Joe

2016-01-01

Abstract A meeting on Contemporary Topics in Zebrafish Husbandry and Care was held in the United Kingdom in 2014, with the aim of providing a discussion forum for researchers, animal technologists, and veterinarians from academia and industry to share good practice and exchange ideas. Presentation topics included protocols for optimal larval rearing, implementing the 3Rs (replacement, reduction, and refinement) in large-scale colony management, and environmental enrichment. The audience also participated in a survey of current practice relating to practical husbandry, cryopreservation, and the provision of enrichment. PMID:27537782

Report of a Meeting on Contemporary Topics in Zebrafish Husbandry and Care.

PubMed

Osborne, Nikki; Paull, Gregory; Grierson, Adam; Dunford, Karen; Busch-Nentwich, Elisabeth M; Sneddon, Lynne U; Wren, Natalie; Higgins, Joe; Hawkins, Penny

2016-12-01

A meeting on Contemporary Topics in Zebrafish Husbandry and Care was held in the United Kingdom in 2014, with the aim of providing a discussion forum for researchers, animal technologists, and veterinarians from academia and industry to share good practice and exchange ideas. Presentation topics included protocols for optimal larval rearing, implementing the 3Rs (replacement, reduction, and refinement) in large-scale colony management, and environmental enrichment. The audience also participated in a survey of current practice relating to practical husbandry, cryopreservation, and the provision of enrichment.

European American and African American Mothers’ Emotion Socialization Practices Relate Differently to their Children’s Academic and Social-Emotional Competence

PubMed Central

Nelson, Jackie A.; Leerkes, Esther M.; Perry, Nicole B.; O’Brien, Marion; Calkins, Susan D.; Marcovitch, Stuart

2012-01-01

The current study examines whether the relation between mothers’ responses to their children’s negative emotions and teachers’ reports of children’s academic performance and social-emotional competence are similar or different for European American and African American families. Two hundred mothers (137 European American, 63 African American) reported on their responses to their 5-year-old children’s negative emotions and 150 kindergarten teachers reported on these children’s current academic standing and skillfulness with peers. Problem-focused responses to children’s negative emotions, which have traditionally been considered a supportive response, were positively associated with children’s school competence for European American children, but expressive encouragement, another response considered supportive, was negatively associated with children’s competence for African American children. The findings highlight the need to examine parental socialization practices from a culturally-specific lens. PMID:23914076

Genetics, biometrics and the informatization of the body.

PubMed

van der Ploeg, Irma

2007-01-01

"Genetics" is a term covering a wide set of theories, practices, and technologies, only some of which overlap with the practices and technologies of biometrics. In this paper some current technological developments relating to biometric applications of genetics will be highlighted. Next, the author will elaborate the notion of the informatization of the body, by means of a brief philosophical detour on the dualisms of language and reality, words and things. In the subsequent sections she will then draw out some of the questions relevant to the purposes of Biometrics Identification Technology Ethics (BITE), and discuss the ethical problems associated with the informatization of the body. There are, however some problems and limitations to the currently dominant ethical discourse to deal with all things ethical in relation to information technology in general, and biometrics or genetics in particular. The final section will discuss some of these meta-problems.

Transmasculine People's Voice Function: A Review of the Currently Available Evidence.

PubMed

Azul, David; Nygren, Ulrika; Södersten, Maria; Neuschaefer-Rube, Christiane

2017-03-01

This study aims to evaluate the currently available discursive and empirical data relating to those aspects of transmasculine people's vocal situations that are not primarily gender-related, to identify restrictions to voice function that have been observed in this population, and to make suggestions for future voice research and clinical practice. We conducted a comprehensive review of the voice literature. Publications were identified by searching six electronic databases and bibliographies of relevant articles. Twenty-two publications met inclusion criteria. Discourses and empirical data were analyzed for factors and practices that impact on voice function and for indications of voice function-related problems in transmasculine people. The quality of the evidence was appraised. The extent and quality of studies investigating transmasculine people's voice function was found to be limited. There was mixed evidence to suggest that transmasculine people might experience restrictions to a range of domains of voice function, including vocal power, vocal control/stability, glottal function, pitch range/variability, vocal endurance, and voice quality. More research into the different factors and practices affecting transmasculine people's voice function that takes account of a range of parameters of voice function and considers participants' self-evaluations is needed to establish how functional voice production can be best supported in this population. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Configurations of power relations in the Brazilian emergency care system: analyzing a context of visible practices.

PubMed

Velloso, Isabela; Ceci, Christine; Alves, Marilia

2013-09-01

In this paper, we make explicit the changing configurations of power relations that currently characterize the Brazilian Emergency Care System (SAMU) team in Belo Horizonte, Brazil. The SAMU is a recent innovation in Brazilian healthcare service delivery. A qualitative case study methodology was used to explore SAMU's current organizational arrangements, specifically the power relations that have developed and that demonstrate internal team struggles over space and defense of particular occupational interests. The argument advanced in this paper is that these professionals are developing their work in conditions of exposure, that is, they are always being observed by someone, and that such observational exposure provides the conditions whereby everyday emergency care practices are enacted such that practice is shaped by, as well as shapes, particular, yet recognizable power relationships. Data were collected through the observation of the SAMU's work processes and through semi-structured interviews. Research materials were analyzed using discourse analysis. In the emergency care process of work, visibility is actually embedded in the disciplinary context and can thus be analyzed as a technique applied to produce disciplined individuals through the simple mechanisms elaborated by Foucault such as hierarchical surveillance, normalizing judgment, and the examination. © 2012 John Wiley & Sons Ltd.

Cognitive flexibility and religious disbelief.

PubMed

Zmigrod, Leor; Rentfrow, P Jason; Zmigrod, Sharon; Robbins, Trevor W

2018-06-11

Cognitive flexibility is operationalized in the neuropsychological literature as the ability to shift between modes of thinking and adapt to novel or changing environments. Religious belief systems consist of strict rules and rituals that offer adherents certainty, consistency, and stability. Consequently, we hypothesized that religious adherence and practice of repetitive religious rituals may be related to the persistence versus flexibility of one's cognition. The present study investigated the extent to which tendencies towards cognitive flexibility versus persistence are related to three facets of religious life: religious affiliation, religious practice, and religious upbringing. In a large sample (N = 744), we found that religious disbelief was related to cognitive flexibility across three independent behavioural measures: the Wisconsin Card Sorting Test, Remote Associates Test, and Alternative Uses Test. Furthermore, lower frequency of religious service attendance was related to cognitive flexibility. When analysing participants' religious upbringing in relation to their current religious affiliation, it was manifest that current affiliation was more influential than religious upbringing in all the measured facets of cognitive flexibility. The findings indicate that religious affiliation and engagement may shape and be shaped by cognitive control styles towards flexibility versus persistence, highlighting the tight links between flexibility of thought and religious ideologies.

Identifying and addressing sexual health in serious mental illness: Views of mental health staff working in two National Health Service organizations in England.

PubMed

Hughes, Elizabeth; Edmondson, Amanda J; Onyekwe, Ijeoma; Quinn, Chris; Nolan, Fiona

2018-06-01

People with serious mental illness (service users) have needs related to sexual health and sexuality, yet these have been poorly addressed in mental health services. In the present study, we report the current practice of mental health professionals in relation to sexual health. Focus groups conducted in two mental health trusts explored routine practice in relation to discussing, assessing, and planning care in relation to sexual health. A thematic analysis identified seven themes: (i) sexual health provision is a complex issue; (ii) mental health staff are aware of sexual health needs; (iii) current provision regarding sexual health is 'neglected'; (iv) barriers to sexual health provision; (v) enabling a discussion around sexual health; (vi) sexual health provision is a role for mental health professionals; and (vii) training needs. Mental health staff are aware of complex issues related to sexual health for service users, but this is mainly seen through the lens of risk management and safeguarding. We need to develop the mental health workforce to be able to incorporate sexual health into routine health care. © 2017 Australian College of Mental Health Nurses Inc.

Professional and economic factors affecting access to mammography: a crisis today, or tomorrow? Results from a national survey.

PubMed

Farria, Dione M; Schmidt, Maria E; Monsees, Barbara S; Smith, Robert A; Hildebolt, Charles; Yoffie, Roberta; Monticciolo, Debra L; Feig, Stephen A; Bassett, Lawrence W

2005-08-01

Objective data and anecdotal reports have suggested that access to mammography may be declining because of facility closures and difficulty in recruiting and retaining radiologists and radiologic technologists. To gain insight into the practice patterns, use of emerging technologies, and concerns of breast imagers in current practice, the Society of Breast Imaging (SBI) conducted a national survey of breast imaging practices in the U.S. Between October 2003 and April 2004, the SBI conducted a survey of the SBI membership database, and received completed surveys from 575 breast imaging practices in the U.S. Responses to the survey regarding practice characteristics, the utilization of standard and emerging technologies, staffing, malpractice, finance, and morale were analyzed. Job vacancies for radiologists who read mammograms were reported in 163 practices (29%), 59 of which (10%) had 2 or more openings. A higher proportion of practices with job openings had long appointment waiting times for asymptomatic women when compared with fully staffed practices. Unfilled fellowship positions also were common, with 41 of 65 practices that offer fellowships reporting 47 openings. Among 554 responding practices, 55% reported that someone in their practice was sued because of a mammography related case within the past 5 years, and 50% of practices reported that the threat of lawsuits made radiologist staffing "moderately" or "a lot" more difficult. Of 521 responding practices, 35% reported financial losses in 2002. One in 5 respondents reported that they would prefer to spend less time in mammography, and fewer than 1 in 3 would recommend a breast imaging fellowship to a relative or friend. Emerging technologies, such as breast magnetic resonance imaging and screening ultrasound, currently are being performed in many practices. The survey results provide support for anecdotal reports that breast imaging practices face significant challenges and stresses, including shortages of key personnel, a lack of trainees, malpractice concerns, financial constraints, increased workload due to emerging technologies, low appeal of breast imaging as a career specialty, and the steady rise in the population of women of screening age. (c) 2005 American Cancer Society.

Pressure area care: an exploration of Greek nurses' knowledge and practice.

PubMed

Panagiotopoulou, Kalliopi; Kerr, Susan M

2002-11-01

Despite a plethora of information on the prevention of pressure sores, they remain a significant problem in both hospital and community settings. The need to reduce the incidence of pressure sores has been well documented; unfortunately there is little evidence to suggest improvement. The reasons for this lack of improvement have been explored, but the picture remains unclear. While some studies have suggested that nurses have the appropriate knowledge to prevent pressure sores developing (but do not use their knowledge), others suggest that nurses' knowledge of preventive strategies is deficient. In Greece, similarly to the United Kingdom (UK), the incidence of pressure sores is high. There is currently no evidence on Greek nurses' knowledge and practice and therefore no baseline on which to build, in terms of improving practice. The purpose of this study was to explore Greek nurses' knowledge of 'risk factors', 'areas at risk' and 'recommended preventive strategies' in relation to pressure area care. In addition, information was sought on nurses' 'current preventive practice' and any barriers to 'good practice'. The study was exploratory and descriptive, adopting a cross-sectional survey approach. The sample was drawn from the population of nurses working in a military hospital near Athens. The data were collected over a 4-week period in June 2000, using a self-completed questionnaire. Although the knowledge-base of many of the nurses was good in relation to 'risk factors' and 'areas at risk', a significant proportion were unaware that methods such as 'massage' and 'donuts' are no longer recommended. This lack of knowledge influenced practice with these methods commonly being used. In relation to barriers to good practice, a significant proportion of nurses reported that they could not access, read or understand research findings. This has obvious implications for the implementation of evidence-based practice. The results of this study suggest that the knowledge and practice of participants could be improved. It is of particular concern that methods known to be detrimental were in common use. Finally, there is a need to improve the research skills of Greek nurses in order to provide them with the appropriate knowledge to use research findings.

Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice

PubMed Central

Fairchild, Amanda J.; McQuillin, Samuel D.

2017-01-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described. PMID:20006988

Evaluating mediation and moderation effects in school psychology: a presentation of methods and review of current practice.

PubMed

Fairchild, Amanda J; McQuillin, Samuel D

2010-02-01

Third variable effects elucidate the relation between two other variables, and can describe why they are related or under what conditions they are related. This article demonstrates methods to analyze two third-variable effects: moderation and mediation. The utility of examining moderation and mediation effects in school psychology is described and current use of the analyses in applied school psychology research is reviewed and evaluated. Proper statistical methods to test the effects are presented, and different effect size measures for the models are provided. Extensions of the basic moderator and mediator models are also described.

People with insomnia: experiences with sedative hypnotics and risk perception.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Ellis, Jason G; Saini, Bandana

2016-08-01

Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia. To explore patient medication-taking beliefs, experiences and behavioural practices relating to the use of pharmacological/complementary sleep aids for insomnia. Specialist sleep/psychology clinics and the general community in Sydney, Australia. Semi-structured interviews were conducted with 51 people with insomnia using a schedule of questions to gauge their experiences, beliefs and current practices relating to insomnia medication use. Interviews were audio-recorded, transcribed verbatim and subjected to Framework Analysis to identify emergent themes. Participants held distinctive views about the safety and efficacy of complementary and pharmacological agents but do not intuitively turn to medications to resolve their sleep complaint. Medication use was affirmed through tangible medication-taking cues due to the ambivalence in current instructions and labelling. Practices such as dosage modification, medication substitution and delaying medication use might be important drivers for psychological dependence. Current labelling and instructions do not necessarily promote the quality use of sedative hypnotics due to the variability in patient interpretations. Clarifying the timing, quantity and frequency of medication administration as well as insomnia symptom recognition would play a significant role in optimizing the role of pharmacotherapy in the management of insomnia. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study.

PubMed

Leineweber, Constanze; Chungkham, Holendro Singh; Lindqvist, Rikard; Westerlund, Hugo; Runesdotter, Sara; Smeds Alenius, Lisa; Tishelman, Carol

2016-06-01

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied. The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction. Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied. Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied. We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Conceptions of How a Learning or Teaching Curriculum, Workplace Culture and Agency of Individuals Shape Medical Student Learning and Supervisory Practices in the Clinical Workplace

ERIC Educational Resources Information Center

Strand, Pia; Edgren, Gudrun; Borna, Petter; Lindgren, Stefan; Wichmann-Hansen, Gitte; Stalmeijer, Renée E.

2015-01-01

The role of workplace supervisors in the clinical education of medical students is currently under debate. However, few studies have addressed how supervisors conceptualize workplace learning and how conceptions relate to current sociocultural workplace learning theory. We explored physician conceptions of: (a) medical student learning in the…

In-service inspection methods for graphite-epoxy structures on commercial transport aircraft

NASA Technical Reports Server (NTRS)

Phelps, M. L.

1981-01-01

In-service inspection methods for graphite-epoxy composite structures on commercial transport aircraft are determined. Graphite/epoxy structures, service incurred defects, current inspection practices and concerns of the airline and manufacturers, and other related information were determind by survey. Based on this information, applicable inspection nondestructive inspection methods are evaluated and inspection techniques determined. Technology is developed primarily in eddy current inspection.

Current Proceedings in the Molecular Dissection of Hepatocellular Adenomas: Review and Hands-on Guide for Diagnosis

PubMed Central

Goltz, Diane; Fischer, Hans-Peter

2015-01-01

Molecular dissection of hepatocellular adenomas has brought forward a diversity of well-defined entities. Their distinction is important for routine practice, since prognosis is tightly related to the individual subgroup. Very recent activity has generated new details on the molecular background of hepatocellular adenoma, which this article aims to integrate into the current concepts of taxonomy. PMID:26404250

Current Proceedings in the Molecular Dissection of Hepatocellular Adenomas: Review and Hands-on Guide for Diagnosis.

PubMed

Goltz, Diane; Fischer, Hans-Peter

2015-09-02

Molecular dissection of hepatocellular adenomas has brought forward a diversity of well-defined entities. Their distinction is important for routine practice, since prognosis is tightly related to the individual subgroup. Very recent activity has generated new details on the molecular background of hepatocellular adenoma, which this article aims to integrate into the current concepts of taxonomy.

Contemporary management of pericardial effusion: practical aspects for clinical practice.

PubMed

Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

2017-03-01

A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

Current management practices and interventions prioritised as part of a nationwide mastitis control plan

PubMed Central

Bradley, A. J.; Breen, J. E.; Hudson, C. D.; Green, M. J.

2016-01-01

The objectives of this study were to report performance and management data taken from a sample of UK dairy farms that have participated in the Agriculture and Horticulture Development Board Dairy Mastitis Control Plan (DMCP) and to identify important mastitis prevention practices that are not currently widely implemented. A total of 234 UK dairy herds were included in the study from which farm management and udder health data were collected. Herds were grouped according to their mastitis epidemiology and could be classed as (i) environmental dry period (EDP) (i.e. environmental pathogen with majority of infections being acquired during the dry period), (ii) environmental lactation (EL), (iii) contagious dry period (CDP) or (iv) contagious lactation (CL). The results of this study showed that many mastitis-related management practices that are generally considered to be important were not widely performed. A better understanding of those practices not widely adopted by UK dairy farmers at present may aid practitioners in identifying and overcoming potential barriers to improved mastitis control. PMID:26966249

Computing the Average Square: An Agent-Based Introduction to Aspects of Current Psychometric Practice

ERIC Educational Resources Information Center

Stroup, Walter M.; Hills, Thomas; Carmona, Guadalupe

2011-01-01

This paper summarizes an approach to helping future educators to engage with key issues related to the application of measurement-related statistics to learning and teaching, especially in the contexts of science, mathematics, technology and engineering (STEM) education. The approach we outline has two major elements. First, students are asked to…

Implications of Outcomes-Based Education for Children with Disabilities. Synthesis Report 6.

ERIC Educational Resources Information Center

Thurlow, Martha L.

This paper examines the concept of "outcomes-based education" (OBE), how it was developed, how it relates to other current reforms that encompass the notion of outcomes, and how it relates to students with disabilities in theory and in practice. Outcomes-based education holds that all children can learn and succeed and that schools are…

Species-area relations of song birds in the Black Hills, South Dakota

Treesearch

Mark A. Rumble; Brian L. Dykstra; Lester D. Flake

2000-01-01

We investigated the effects of stand size resulting from current logging practices on occurrence and species richness of song birds in the Black Hills. Richness of forest interior and forest interior/edge songbirds was not related to stand area (P > 0.40) in stands of ponderosa pine (Pinus ponderosa) in the Black Hills. Brown creepers (...

Flexible Learning in a Digital World: Experiences and Expectations. Open & Distance Learning Series.

ERIC Educational Resources Information Center

Collis, Betty; Moonen, Jef

This book provides a series of proven, practical guidelines for using technology in education, giving the reader an overview of how technological applications in education can be harnessed and developed. The book presents an integrated vision of how technology is related to learning-related change, and how current and emerging experiences can…

Social Media as a Practical Approach in Engaging Key Stakeholders in School Crisis Communication Plans: A Qualitative Analysis

ERIC Educational Resources Information Center

Agozzino, Alisa; Kaiser, Candace

2014-01-01

The current study examined how public relations specialists within school systems are developing, implementing, and revising their communication crisis plans in an effort to fully engage all key stakeholders. Four research questions and two hypotheses were posed. Members from a state public relations association for schools were asked to…

European-American and African-American Mothers' Emotion Socialization Practices Relate Differently to Their Children's Academic and Social-Emotional Competence

ERIC Educational Resources Information Center

Nelson, Jackie A.; Leerkes, Esther M.; Perry, Nicole B.; O'Brien, Marion; Calkins, Susan D.; Marcovitch, Stuart

2013-01-01

The current study examines whether the relation between mothers' responses to their children's negative emotions and teachers' reports of children's academic performance and social-emotional competence are similar or different for European-American and African-American families. Two hundred mothers (137 European-American, 63 African-American)…

Bullying in Early Childhood and the Construction of Young Children as Premoral Agents: Implications for Practice

ERIC Educational Resources Information Center

Sims-Schouten, Wendy

2015-01-01

Bullying continues to be common, despite extensive research and policy focus. With few studies concentrating specifically on early childhood, there are indications that more research is needed to establish the different mechanisms related to direct and relational victimisation in young children. The current paper sets out to analyse parents' and…

Greek Environments: An Update on the Effects of Fraternities and Sororities on Health-Related Behaviors

ERIC Educational Resources Information Center

Collins, Christopher S.; Liu, Min

2014-01-01

The authors investigate whether Greek affiliation and living in Greek housing significantly influence college students' health-related behaviors. In addition, based on the findings, this study provides some important implications about the current practice of Greek society in higher education. The authors empirically tested a path model using…

Global trends in critical values practices and their harmonization.

PubMed

Kost, Gerald J; Hale, Kristin N

2011-02-01

The objectives of this article were 1) to identify current trends in critical values practices in North America, Europe, and other regions; 2) to describe progress toward harmonization of critical limits; and 3) to synthesize strategies that will encourage global consensus. Critical limits are described in national surveys. Critical value practices are guided by federal statutes, The Joint Commission regulations, and accreditation requirements in the US; by provincial healthcare agencies in Canada; by thought leaders and ISO EN 15189:2007 in Europe; and in SE Asia, mostly by ad hoc policies lacking statutory grip. Review of databases, literature, websites, federal statutes, litigation, official policies, current affairs, and accreditation agency requirements. Practical strategies will accelerate harmonization of critical values practices, as follows: a) continue national and international survey comparisons; b) clarify age, ethnic, and subject dependencies; c) standardize qualitative and quantitative decision levels for urgent clinician notification; d) monitor compliance and timeliness for safety; and e) alert high frequencies of critical values related to adverse events. New expectations and communication technologies present opportunities for enhanced performance using wireless closed-loop reporting with recipient acknowledgment to reduce phone calls and improve efficiency. Hospitals worldwide can benefit from developing consensus for critical values practices.

[Effects of agricultural practices on community structure of arbuscular mycorrhizal fungi in agricultural ecosystem: a review].

PubMed

Sheng, Ping-Ping; Li, Min; Liu, Run-Jin

2011-06-01

Arbuscular mycorrhizal (AM) fungi are rich in diversity in agricultural ecosystem, playing a vital role based on their unique community structure. Host plants and environmental factors have important effects on AM fungal community structure, so do the agricultural practices which deserve to pay attention to. This paper summarized the research advances in the effects of agricultural practices such as irrigation, fertilization, crop rotation, intercropping, tillage, and pesticide application on AM fungal community structure, analyzed the related possible mechanisms, discussed the possible ways in improving AM fungal community structure in agricultural ecosystem, and put forward a set of countermeasures, i.e., improving fertilization system and related integrated techniques, increasing plant diversity in agricultural ecosystem, and inoculating AM fungi, to enhance the AM fungal diversity in agricultural ecosystem. The existing problems in current agricultural practices and further research directions were also proposed.

Innovating With Rehabilitation Technology in the Real World: Promises, Potentials, and Perspectives.

PubMed

Chua, Karen Sui Geok; Kuah, Christopher Wee Keong

2017-10-01

In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies.

Innovating With Rehabilitation Technology in the Real World

PubMed Central

Chua, Karen Sui Geok; Kuah, Christopher Wee Keong

2017-01-01

Abstract In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies. PMID:28708632

A multi-level examination of how the organizational context relates to readiness to implement prevention and evidence-based programming in community settings.

PubMed

Chilenski, Sarah M; Olson, Jonathan R; Schulte, Jill A; Perkins, Daniel F; Spoth, Richard

2015-02-01

Prior theoretical and empirical research suggests that multiple aspects of an organization's context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization's readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization's readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization's morale was also found to be a strong predictor of an organization's readiness. The findings of the current study are discussed in terms of implications for prevention and intervention.

A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

PubMed Central

Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

2015-01-01

Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

Female arsonists: key features, psychopathologies, and treatment needs.

PubMed

Gannon, Theresa A

2010-01-01

Female-perpetrated arson is a topic that has received relatively little research attention from either psychiatrists or psychologists. In this review, available research regarding the characteristics, psychopathologies, and current treatment efforts with female arsonists is reviewed. Evaluation of current research with female arsonists suggests that very few researchers have compared female arsonists either to suitable female offender control groups or male arsons. Consequently, clinical knowledge and practice regarding female-perpetrated arson is underdeveloped relative to both other areas of forensic-clinical psychiatry and to knowledge of male arsonists. Suggestions are made for translating current research into arson interventions with female arsonists. Core arenas for future treatment and research provision are also highlighted.

Design criteria for post and beam bents with drilled shafts.

DOT National Transportation Integrated Search

2007-12-01

The research work presented in the report addresses the potential areas of conservatism in the current practice related to bridge : bents supported by drilled shafts and piles. The research encompasses modeling efforts and an experimental program. Mo...

Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey

PubMed Central

2014-01-01

Background As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession’s progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. Methods A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X2 =13.4, p = 0.0002). Conclusion Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession’s factions is important to the anticipation of care delivery when considering interprofessional referral. PMID:24512507

Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey.

PubMed

McGregor, Marion; Puhl, Aaron A; Reinhart, Christine; Injeyan, H Stephen; Soave, David

2014-02-10

As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession's progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X(2) =13.4, p = 0.0002). Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession's factions is important to the anticipation of care delivery when considering interprofessional referral.

Staff Perception on Biomedical or Health Care Waste Management: A Qualitative Study in a Rural Tertiary Care Hospital in India

PubMed Central

Joshi, Rita; Shah, Harshada; Sharma, Megha; Pathak, Ashish; Macaden, Ragini; Stålsby Lundborg, Cecilia

2015-01-01

Background Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. Results Two themes were identified: Theme (A), ‘Challenges in integration of HCWM in organizational practice,’ with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), ‘Interventions to improve HCWM,’ with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusion A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. PMID:26023783

21 CFR 110.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria and...

Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

PubMed

Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

2008-07-01

Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

The effect of recent amblyopia research on current practice in the UK.

PubMed

Newsham, D

2010-10-01

Several studies have recently provided insights into how amblyopia may be most effectively managed. Despite the new evidence, a US study reported that a recent randomised controlled trial had made little influence on clinical practice. The aims of this research are to assess current practice of amblyopia management in the UK and to determine the comparability with the evidence-based recommendations. A questionnaire was constructed to assess current amblyopia management practice, particularly in relation to areas investigated by recent research and emailed to every head orthoptist within the UK. There was a great deal of variability in the amount of occlusion that was prescribed for moderate and severe amblyopia. Sixty per cent of clinicians indicated that the maximum they would prescribe was in excess of the 6 h recommended by research. Atropine was rarely recommended as a first-line treatment, with occlusion generally being considered to be more effective. Despite recommendations regarding education as a means of reducing non-compliance, only 39% of clinicians always gave written information, although various other methods of enhancing compliance were used. A period of refractive adaptation was allowed by most clinicians but often far less than recommended. The uptake of recent research evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention.

Trauma-informed juvenile justice systems: A systematic review of definitions and core components.

PubMed

Branson, Christopher Edward; Baetz, Carly Lyn; Horwitz, Sarah McCue; Hoagwood, Kimberly Eaton

2017-11-01

The U.S. Department of Justice has called for the creation of trauma-informed juvenile justice systems in order to combat the negative impact of trauma on youth offenders and frontline staff. Definitions of trauma-informed care have been proposed for various service systems, yet there is not currently a widely accepted definition for juvenile justice. The current systematic review examined published definitions of a trauma-informed juvenile justice system in an effort to identify the most commonly named core elements and specific interventions or policies. A systematic literature search was conducted in 10 databases to identify publications that defined trauma-informed care or recommended specific practices or policies for the juvenile justice system. We reviewed 950 unique records, of which 10 met criteria for inclusion. The 10 publications included 71 different recommended interventions or policies that reflected 10 core domains of trauma-informed practice. We found 8 specific practice or policy recommendations with relative consensus, including staff training on trauma and trauma-specific treatment, while most recommendations were included in 2 or less definitions. The extant literature offers relative consensus around the core domains of a trauma-informed juvenile justice system, but much less agreement on the specific practices and policies. A logical next step is a review of the empirical research to determine which practices or policies produce positive impacts on outcomes for youth, staff, and the broader agency environment, which will help refine the core definitional elements that comprise a unified theory of trauma-informed practice for juvenile justice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

An international Delphi study examining health promotion and health education in nursing practice, education and policy.

PubMed

Whitehead, Dean

2008-04-01

To arrive at an expert consensus in relation to health promotion and health education constructs as they apply to nursing practice, education and policy. Nursing has often been maligned and criticized, both inside and outside of the profession, for its ability to understand and conduct effective health promotion and health education-related activities. In the absence of an expert-based consensus, nurses may find it difficult to progress beyond the current situation. In the absence of any previously published nursing-related consensus research, this study seeks to fill that knowledge-gap. A two-round Delphi technique via email correspondence. A first-round qualitative questionnaire used open-ended questions for defining health promotion and health education. This was both in general terms and as participants believed these concepts related to the clinical, theoretical (academic/educational) and the policy (political) setting in nursing. Line-by-line qualitative content and thematic analysis of the first-round data generated 13 specific categories. These categories contained 134 statement items. The second-round questionnaire comprised the identified 134 statements. Using a five-point Likert scale (ranging from 1 = strongly disagree to 5 = strongly agree) participants scored and rated their level of agreement/disagreement against the listed items. Data from the second-round was descriptively analysed according to distribution and central tendency measures. An expert consensus was reached on 65 of the original 134 statements. While some minor contradiction was demonstrated, strong consensus emerged around the issues of defining health promotion and health education and the emergence of a wider health promotion and health education role for nursing. No consensus was reached on only one of the 13 identified topic categories - that of 'nurses working with other disciplines and agencies in a health education and health promotion role.' This study provides a hitherto previously absent expert consensus on the current position of health promotion and health education, in nursing and predictions for their future course. Its findings represent an important step for nurses as they seek to become increasingly active and influential within wider health promotion and health education arenas. Relevance to clinical practice. Delphi studies do not necessarily offer indisputable fact. This study, however, with its strong consensus on the majority of original statements is a good indicator as to how nursing experts currently view health promotion and health education constructs. Expert consensus offers a useful form of measure against current and future clinical practice and helps to build a firm foundation for change. Nurses, then, are advised here to refer to the findings presented, that they remain contextually and conceptually clear, as they embark on current and future health promotion-related activities.

Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

PubMed

Klaess, Cynthia C; Jungquist, Carla R

2018-06-01

Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Impact of a State Law on Physician Practice in Sports-Related Concussions.

PubMed

Flaherty, Michael R; Raybould, Toby; Jamal-Allial, Aziza; Kaafarani, Haytham M A; Lee, Jarone; Gervasini, Alice; Ginsburg, Richard; Mandell, Mark; Donelan, Karen; Masiakos, Peter T

2016-11-01

To determine physician-reported adherence to and support of the 2010 Massachusetts youth concussion law, as well as barriers to care and clinical practice in the context of legislation. Primary care physicians (n = 272) in a large pediatric network were eligible for a cross-sectional survey in 2014. Survey questions addressed key policy and practice provisions: concussion knowledge, state regulations and training, practice patterns, referrals, patient characteristics, and barriers to care. Analyses explored relationships between practice and policy, adjusting for physician demographic and practice characteristics. The survey response rate was 64% among all responders (173 of 272). A total of 146 respondents who had evaluated, treated, or referred patients with a suspected sports-related concussion in the previous year were eligible for analysis. The vast majority (90%) of providers agreed that the current Massachusetts laws regarding sports concussions are necessary and support the major provisions. Three-quarters (74%) had taken a required clinician training course on concussions. Those who took training courses were significantly more likely to develop individualized treatment plans (OR, 3.6; 95% CI, 1.1-11.0). Physician training did not improve screening of youth with concussion for depression or substance use. Most physicians (77%) advised patients to refrain from computer, telephone, or television for various time periods. Physicians reported limited communication with schools. Primary care physicians report being comfortable with the diagnosis and management of concussions, and support statewide regulations; however, adherence to mandated training and specific legal requirements varied. Broader and more frequent training may be necessary to align current best evidence with clinical care and state-mandated practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Current trials to reduce surgical intervention in ductal carcinoma in situ of the breast: Critical review.

PubMed

Toss, M; Miligy, I; Thompson, A M; Khout, H; Green, A R; Ellis, I O; Rakha, E A

2017-10-01

The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach. Despite the undisputable fact of our need to address the obvious overtreatment of screen-detected DCIS, some important questions need to be considered regarding these trials including the eligibility criteria and definition of risk, the proportion of patient eligible for inclusion, and the length of time required for proper analysis of the trials' outcome in view of the long-term natural history of DCIS progression particularly the low-risk group. These factors can potentially affect the practicality and future impact of such trials. This review provides critical analysis of current DCIS management trials and highlights critical issues related to their practicality and the expected outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

21 CFR 225.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic Act...

21 CFR 210.1 - Status of current good manufacturing practice regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice regulations...

21 CFR 226.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115, inclusive...

Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

ERIC Educational Resources Information Center

Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.; Trentacosta, Christopher J.

2013-01-01

In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or…

Work-Related Child-Care Centres in Canada, 2001 = Les garderies en milieu de travail au Canada, 2001.

ERIC Educational Resources Information Center

Barbeau, Carole

Noting that the number of work-related child care centers has nearly doubled in the past 10 years in Canada, this report, in both English and French, details a study examining the current practices pertaining to work-related child care in Canada. The report highlights the best examples in this area and discusses what has been learned from the…

Dissemination 2.0: closing the gap between knowledge and practice with new media and marketing.

PubMed

Bernhardt, Jay M; Mays, Darren; Kreuter, Matthew W

2011-01-01

Despite substantial investments in public health and clinical research at the national level, and significant advancements in these areas of science, few evidence-based programs and services are rapidly implemented in health care or public health practice as a result of failures of dissemination. A significant gap in current processes to disseminate and implement effective programs relates to the lack of systems and infrastructure to facilitate distribution of scientific research products to potential end users, including clinicians and other practitioners. In this article, the authors assert that Web 2.0 technologies can be leveraged to enhance dissemination efforts and increase the implementation of evidence-based programs and services in everyday practice. The authors describe the research-to-practice delivery process and highlight gaps in the supply chain necessary to translate research findings into evidence-based practice. The authors critically evaluate the 4 most prominent strategies currently used to promote dissemination and implementation of research evidence in practice, and they detail how each can be improved by leveraging Web 2.0 technologies to enhance dissemination of research evidence. Last, the authors provide examples and suggestions for capitalizing on Web 2.0 technologies to enhance dissemination efforts and ensure that evidence-based research products reach intended end users and are implemented in clinical practice.

A proposal for funding and monitoring medical education supervision in expanded clinical settings--a 'meducation' card.

PubMed

DeWitt, D E; McColl, G J

2011-01-01

Entry to practice medical programs (graduate- and undergraduate-entry) in Australia are under considerable pressure to provide clinical training as a result of increased student numbers. At the same time modern medical curricula require the development of active placements in expanded settings to achieve graduate medical practitioners who are clinically able. These dual imperatives require a mechanism to fund and maintain the quality of clinical placements outside the traditional hospital setting. For teaching outside traditional teaching hospitals the Australian government's Practice Incentives Program (PIP) currently provides a student-related payment of AU$100 for each half-day teaching session in a general practice setting. This payment is not linked to the quality of the placement and does not support clinical placements in other settings, for example specialist consulting rooms or allied health practices. This short communication proposes a 'meducation' card as an efficient funding mechanism to facilitate an expansion of quality clinical placements in expanded settings including specialist and allied health practices. This student meducation card would use current Medicare Australia infrastructure to facilitate the payment of clinical teachers in expanded settings. Meducation payments would only be available to practitioners and practices that maintain quality teaching practices certified by medical or allied health schools.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

Hepatitis C Virus: A Critical Appraisal of New Approaches to Therapy

PubMed Central

Nelson, David R.; Jensen, Donald M.; Sulkowski, Mark S.; Everson, Greg; Fried, Michael W.; Gordon, Stuart C.; Jacobson, Ira; Reau, Nancy S.; Sherman, Kenneth; Terrault, Nora; Thomas, David

2012-01-01

The HCV council 2011 convened 11 leading clinicians and researchers in hepatitis C virus from academic medical centers in the United States to provide a forum for the practical and comprehensive evaluation of current data regarding best practices for integrating new direct-acting antiviral agents into existing treatment paradigms. The council investigated 10 clinical practice statements related to HCV treatment that reflect key topical areas. Faculty members reviewed and discussed the data related to each statement, and voted on the nature of the evidence and their level of support for each statement. In this new era of DAAs, a comprehensive and critical analysis of the literature is needed to equip clinicians with the knowledge necessary to design, monitor, and modify treatment regimens in order to optimize patient outcomes. PMID:23094146

Child rights and Child and Adolescent Mental Health Services (CAMHS) in Ireland.

PubMed

Damodaran, J; Sherlock, C

2013-12-01

This paper explores children's rights in the child and adolescent mental health arena in Ireland. It begins by outlining the legal and policy contexts of both children's services and mental health policy and practice. It specifically focuses on the notion of participation as a key factor in addressing rights-based approaches in the provision of services. The article explores current practice in Child and Adolescent Mental Health Services, highlights some of the disparities in services, which result in questions about human rights. Mainly reflective in its approach, it does, however, provide data from a small scale qualitative study carried out in relation to young people diagnosed with ADHD and their perceptions of psychopharmacological approach. The issue of consent is explored as an example of how current practice approaches fall short of a rights-based framework. It concludes with recommendations for changes incorporating a more participatory and collaborative approach.

Wise Additions Bridge the Gap between Social Psychology and Clinical Practice: Cognitive-Behavioral Therapy as an Exemplar

PubMed Central

Folk, Johanna B.; Disabato, David J.; Goodman, Fallon R.; Carter, Sarah P.; DiMauro, Jennifer C.; Riskind, John H.

2017-01-01

Progress in clinical science, theory, and practice requires the integration of advances from multiple fields of psychology, but much integration remains to be done. The current article seeks to address the specific gap that exists between basic social psychological theories and the implementation of related therapeutic techniques. We propose several “wise additions,” based upon the principles outlined by Walton (2014), intended to bridge current social psychological research with clinical psychological therapeutic practice using cognitive behavioral therapy as an example. We consider how recent advances in social psychological theories can inform the development and implementation of wise additions in clinical case conceptualization and interventions. We specifically focus on self and identity, self-affirmation, transference, social identity, and embodied cognition, five dominant areas of interest in the field that have clear clinical applications. PMID:28919701

Green polymer chemistry: biocatalysis and biomaterials

USDA-ARS?s Scientific Manuscript database

This overview briefly surveys the practice of green chemistry in polymer science. Eight related themes can be discerned from the current research activities: 1) biocatalysis, 2) bio-based building blocks and agricultural products, 3) degradable polymers, 4) recycling of polymer products and catalys...

Fundamentals of Aqueous Microwave Chemistry

EPA Science Inventory

The first chemical revolution changed modern life with a host of excellent amenities and services, but created serious problems related to environmental pollution. After 150 years of current chemistry principles and practices, we need a radical change to a new type of chemistry k...

Using mass media within health-promoting practice: a nursing perspective.

PubMed

Whitehead, D

2000-10-01

For some time health professionals have recognized the growing importance of utilizing mass media strategies as part of their health-promoting practice. The ever-evolving climate of technology and increasing reliance on mass communications has further reinforced the position of mass media initiatives. The enormous potential for mass media resources to reach certain audiences and influence their health-related behaviours has become particularly well established. Despite these facts, however, it is argued that the nursing profession has been less than pro-active in acknowledging, accommodating and adopting such practices. Consequently, the incorporation of health-related mass media initiatives into nursing's health-promotional role remains an elusive exercise. The maintenance of such a position, it is claimed, is potentially damaging for the profession as a whole. In light of this state of affairs, this paper seeks to review the literature surrounding the nature and processes of mass media strategies, their relevance to health promotion and nursing, how they are currently utilized and how they can be incorporated further into nursing practice. In conclusion, it is argued that nursing should seek to become a more active user of mass communication/media technology--especially in relation to its health-promotional practices.

Approaches for Advancing Girls' Education in Ghana: A Symposium To Examine Current Practices and Identify Future Directions (1st, Ajumako, Central Region, Ghana, June 25-26, 2001).

ERIC Educational Resources Information Center

Academy for Educational Development, Washington, DC.

The Girls' Education Unit (GEU) of the Basic Education Division of Ghana Education Service (GES) organized this Approaches for Advancing Girls' Education (AAGE) symposium to address the issues of girls' education, to construct a comprehensive picture of what interventions related to girls' education are currently being implemented, and identify…

Is There Any Point in Wearing Dead Men's Spectacles? How the Theoretical Insights of Adler and Colleagues Relate to Current Practice with Children Experiencing EBD

ERIC Educational Resources Information Center

Blamires, Mike

2006-01-01

This article explores the legacy of Adlerian approaches to behaviour. Mike Blamires offers an opportunity to consider the impact of Adler's premise that education is fundamentally about encouragement and the promotion of democratic principles. In so doing he challenges us to interrogate the term "behaviour management", and its current use by…

Education for the Aging; Living with a Purpose as Older Adults through Education: An Overview of Current Developments.

ERIC Educational Resources Information Center

Grabowski, Stanley M., Ed.; Mason, W. Dean, Ed.

Directed toward the practitioner, the book is a compilation by 18 knowledgeable, experienced authors of some of the recent literature and current practices in the field relating to aging. The book consists of seven parts: (1) The Older Adult as Learner, (2) The Role of Education in an Aging Society, (3) The Aging Individual and the Changing Nature…

Air Force Geophysics Laboratory Management Information System Study.

DTIC Science & Technology

1985-11-01

management information system (MIS) at AFGL. The study summarizes current management and administrative practices at AFGL. Requirements have been identified for automating several currently manual functions to compile accurate and timely information to better manage and plan AFGL programs. This document describes the functions and relative priorities of five MIS subsystems and provides suggestions for implementation solutions. Creation of a detailed Development Plan is recommended as the follow-on task.

21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice for...

21 CFR 1271.150 - Current good tissue practice requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part set...

FEAR OF PAST ABUSIVE PARTNER(S) IMPACTS CURRENT POSTTRAUMATIC STRESS AMONG WOMEN EXPERIENCING PARTNER VIOLENCE

PubMed Central

Jaquier, Véronique; Sullivan, Tami P.

2014-01-01

This study examines the impact of fear of past abusive partner(s) on posttraumatic stress among 212 community-recruited women currently exposed to intimate partner violence (IPV). The path analysis model tested explained 60% of the variation in IPV-related posttraumatic stress. Findings revealed that fear of past abusive partner(s) was uniquely associated with the severity of current posttraumatic stress symptoms over and above the impact of current IPV or childhood abuse and neglect. Future research should continue examining women's subjective emotional experience of past and current victimization so as to further inform both clinical practice and intervention planning. PMID:24590514

Implementing best practice into the emergency department triage process.

PubMed

Burgess, Luke; Kynoch, Kathryn; Hines, Sonia

2018-05-17

Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system. This project aimed to compare current triage practice within a metropolitan ED with evidence-based practice guidelines produced by the Australasian College for Emergency Medicine and College of Emergency Nurses Australasia. The clinical audit project was undertaken in an ED in a large metropolitan hospital. Two hundred episodes of triage were audited, 100 in the preimplementation and 100 in the postimplementation phase. Current practice was compared with triage guidelines, barriers to adherence to evidence-based practice identified, and interventions were planned and implemented to address these. The audits of practice focused on five key areas and were assessed against 12 criteria: arrival and triage, documentation, compliance with policy, communication, and triage staff. Overall five criteria showed improvement, with reassessment of patients waiting for treatment, and the time taken for each triage episode achieving the greatest amount of improvement. Four criteria showed no improvement or a decline, and two achieved 100% adherence in both audits. The project sought to undertake a clinical audit of triage practice to evaluate the adherence of practice to evidence-based guidelines. The project has provided strong support for the implementation of a formal nursing role to support the care of waiting room patients, and act as a second triage nurse during periods of high activity. The physical triage environment has been identified as a barrier to optimal adherence to evidence-based practice guidelines. Using effective communication to manage the waiting experience of patients can have positive benefits for both patients and staff.

Attitudes among Vietnamese Educators towards Students with Disabilities and Their Implications Relative to Inclusive Practices: The Findings of a Preliminary Investigation

ERIC Educational Resources Information Center

Austin, Vance L.

2011-01-01

This article presents the findings of a short-term quantitative/qualitative study concerning the attitudes of Vietnamese educators towards individuals with disabilities and its possible implications relative to the development of inclusion and special education in Vietnam. The current conditions regarding the education of students with and without…

Maternal Representations of their Children in relation to Feeding Beliefs and Practices among Low-Income Mothers of Young Children

PubMed Central

Leung, Christy Y.Y.; Miller, Alison L.; Lumeng, Julie C.; Kaciroti, Niko A.; Rosenblum, Katherine L.

2015-01-01

Identifying maternal characteristics in relation to child feeding is important for addressing the current childhood obesity epidemic. The present study examines whether maternal representations of their children are associated with feeding beliefs and practices. Maternal representations refer to mothers' affective and cognitive perspectives regarding their children and their subjective experiences of their relationships with their children. This key maternal characteristic has not been examined in association with maternal feeding. Thus the purpose of the current study was to examine whether maternal representations of their children, reflected by Working Model of the Child Interview typologies (Balanced, Disengaged, or Distorted), were associated with maternal feeding beliefs (Authority, Confidence, and Investment) and practices (Pressure to Eat, Restriction, and Monitoring) among low-income mothers of young children, with maternal education examined as a covariate. Results showed that Balanced mothers were most likely to demonstrate high authority, Distorted mothers were least likely to demonstrate confidence, and Disengaged mothers were least likely to demonstrate investment in child feeding. Moreover, Balanced mothers were least likely to pressure their children to eat. Findings are discussed with regard to implications for the study of childhood obesity and for applied preventions. PMID:26145277

The prevalence of occupational health-related problems in dentistry: A review of the literature.

PubMed

Moodley, Rajeshree; Naidoo, Saloshni; Wyk, Jacqueline van

2018-03-27

The study was conducted to report on the scope and prevalence of occupational health related-problems experienced by dentists, dental therapists, and oral hygienists in their practice of dentistry. Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The prevalence of conditions related to the musculoskeletal system, stress, percutaneous injuries, ears, and eyes are of concern. The dental team should also not forget hepatitis B, hepatitis C, and HIV as risks in practice. Dental practitioners should protect themselves by self-recognizing risk factors and by maintaining proper working conditions. The study targeted all empirical research, case studies, and systematic literature reviews written in English. All articles selected were subjected to a data analysis process. Data were captured on an Excel spreadsheet and reported in a comprehensive table. The literature addressing occupational health among dental practitioners included mainly cross-sectional studies and review papers (2001-2016). Forty-nine studies were included in the review. Musculoskeletal disorders remain the most researched occupational health-related problems in dentistry. Eye protection compliance was low among practitioners. Percutaneous injuries especially among young dentists and students were still a concern. Occupational health-related problems are still prevalent in current dentistry practice, despite changes in equipment and surgery design. The reported prevalence of occupational related-health problems and other findings of investigative studies highlight the need for continuous professional education and a need to improve clinical practice aspects of dentistry curricula.

Interviews of living kidney donors to assess donation-related concerns and information-gathering practices.

PubMed

Ruck, Jessica M; Van Pilsum Rasmussen, Sarah E; Henderson, Macey L; Massie, Allan B; Segev, Dorry L

2018-06-08

Efforts are underway to improve living kidney donor (LKD) education, but current LKD concerns and information-gathering preferences have not been ascertained to inform evidence-based resource development. As a result, prior studies have found that donors desire information that is not included in current informed consent and/or educational materials. We conducted semi-structured interviews with 50 LKDs who donated at our center to assess (1) concerns about donation that they either had personally before or after donation or heard from family members or friends, (2) information that they had desired before donation, and (3) where they sought information about donation. We used thematic analysis of verbatim interview transcriptions to identify donation-related concerns. We compared the demographic characteristics of participants reporting specific concerns using Fisher's exact test. We identified 19 unique concerns that participants had or heard about living kidney donation. 20% of participants reported having had no pre-donation concerns; 38% reported no post-donation concerns. The most common concern pre-donation was future kidney failure (22%), post-donation was the recovery process (24%), and from family was endangering their family unit (16%). 44% of participants reported being less concerned than family. 26% of participants wished they had had additional information prior to donating, including practical advice for recovery (10%) and information about specific complications (14%). Caucasian participants were more likely to hear at least one concern from family (76% vs. 33%, p = 0.02). The most commonly consulted educational resources were health care providers (100%) and websites (79% of donors since 2000). 26% of participants had had contact with other donors; an additional 20% desired contact with other LKDs. Potential donors not only have personal donation-related concerns but frequently hear donation-related concerns from family members and friends. Current gaps in donor education include an absence of practical, peer-to-peer advice about donation from other prior donors and materials directed and potential donors' family members and friends. These findings can inform the development of new educational practices and resources targeted not only at LKDs but at their social networks.

Translational ethics? The theory-practice gap in medical ethics.

PubMed

Cribb, Alan

2010-04-01

Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be 'made practical'. This paper considers the prospects of a corresponding movement of 'translational ethics'. Some of the advantages and disadvantages of focusing upon the translation of ethical scholarship are reviewed. While emphasising the difficulties of crossing the gap between scholarship and practice, the paper concludes that a debate about the business of translation would be useful for medical ethics.

Gratitude as a psychotherapeutic intervention.

PubMed

Emmons, Robert A; Stern, Robin

2013-08-01

Gratitude practice can be a catalyzing and relational healing force, often untapped in clinical practice. In this article, we provide an overview of current thinking about gratitude's defining and beneficial properties, followed by a brief review of the research on mental health outcomes that result from gratitude practice. Following an analysis of our case study of the use of gratitude as a psychotherapeutic intervention, we present various self-strategies and techniques for consciously choosing and cultivating gratitude. We conclude by describing ways in which gratitude might be capitalized upon for beneficial outcomes in therapeutic settings. © 2013 Wiley Periodicals, Inc.

Pharmacy technician self-efficacies: Insight to aid future education, staff development, and workforce planning.

PubMed

Desselle, Shane P; Hoh, Ryan; Holmes, Erin R; Gill, Amanpreet; Zamora, Lemuel

2017-07-15

The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles. A total of 5000 pharmacy technicians from 8 U.S. states were sent an electronic survey eliciting data on current involvement, self-efficacies, and attitudes for practicing in an expansive list of practice activities. The 8 states from which the sample was drawn were selected from a stratified randomized procedure using U.S. Census Bureau geographically defined regions. Pre-notification and response reminders were employed. Data were analyzed descriptively and with univariate, inferential tests, as appropriate, to determine associations with commitment, practice environment, experience level, and other variables. Of the 612 participants who responded, 494 were currently working as a technician and not enrolled in a PharmD program of study. Participants reported various activities in which they were highly engaged. Overall, attitudes toward performing most of the activities and self-efficacies were quite favorable, even for those activities in which technicians were currently less involved. There were some notable differences between technicians practicing in community versus hospital settings. Years of experience, profession commitment, and advanced employee ranking were associated with higher levels of self-efficacy, overall. This initial examination of pharmacy technician self-efficacies identified areas that along with other factors could help employers with further expanding technician practice activities and vocational institutions with considerations for education and development of these key members of the workforce. The results would suggest technicians to be ready for continued evolution in their practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Inefficiencies and high-value improvements in U.S. cervical cancer screening practice: A cost-effectiveness analysis

PubMed Central

Kim, Jane J.; Campos, Nicole G.; Sy, Stephen; Burger, Emily A.; Cuzick, Jack; Castle, Philip E.; Hunt, William C.; Waxman, Alan; Wheeler, Cosette M.

2016-01-01

Background Studies suggest that cervical cancer screening practice in the United States is inefficient. The cost and health implications of non-compliance in the screening process compared to recommended guidelines are uncertain. Objective To estimate the benefits, costs, and cost-effectiveness of current cervical cancer screening practice and assess the value of screening improvements. Design Model-based cost-effectiveness analysis. Data Sources New Mexico HPV Pap Registry; medical literature. Target Population Cohort of women eligible for routine screening. Time Horizon Lifetime. Perspective Societal. Interventions Current cervical cancer screening practice; improved compliance to guidelines-based screening interval, triage testing, diagnostic referrals, and precancer treatment referrals. Outcome Measures Reductions in lifetime cervical cancer risk, quality-adjusted life-years (QALYs), lifetime costs, incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs Results of Base-Case Analysis Current screening practice was associated with lower health benefit and was not cost-effective relative to guidelines-based strategies. Improvements in the screening process were associated with higher QALYs and small changes in costs. Perfect c4mpliance to a 3-yearly screening interval and to colposcopy/biopsy referrals were associated with the highest INMBs ($759 and $741, respectively, at a willingness-to-pay threshold of $100,000 per QALY gained); together, the INMB increased to $1,645. Results of Sensitivity Analysis Current screening practice was inefficient in 100% of simulations. The rank ordering of screening improvements according to INMBs was stable over a range of screening inputs and willingness-to-pay thresholds. Limitations The impact of HPV vaccination was not considered. Conclusions The added health benefit of improving compliance to guidelines, especially the 3-yearly interval for cytology screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice. Funding Source U.S. National Cancer Institute. PMID:26414147

Understanding the use of standardized nursing terminology and classification systems in published research: A case study using the International Classification for Nursing Practice(®).

PubMed

Strudwick, Gillian; Hardiker, Nicholas R

2016-10-01

In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International. However, the influence of these systems on demonstrating the value of nursing and the professions' impact on quality, safety and patient outcomes in published research is relatively unknown. This paper seeks to understand the use of standardized nursing terminology and classification systems in published research, using the International Classification for Nursing Practice(®) as a case study. A systematic review of international published empirical studies on, or using, the International Classification for Nursing Practice(®) were completed using Medline and the Cumulative Index for Nursing and Allied Health Literature. Since 2006, 38 studies have been published on the International Classification for Nursing Practice(®). The main objectives of the published studies have been to validate the appropriateness of the classification system for particular care areas or populations, further develop the classification system, or utilize it to support the generation of new nursing knowledge. To date, most studies have focused on the classification system itself, and a lesser number of studies have used the system to generate information about the outcomes of nursing practice. Based on the published literature that features the International Classification for Nursing Practice, standardized nursing terminology and classification systems appear to be well developed for various populations, settings and to harmonize with other health-related terminology systems. However, the use of the systems to generate new nursing knowledge, and to validate nursing practice is still in its infancy. There is an opportunity now to utilize the well-developed systems in their current state to further what is know about nursing practice, and how best to demonstrate improvements in patient outcomes through nursing care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Advancing practice relating to SEA alternatives

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

González, Ainhoa, E-mail: agonzal@tcd.ie; Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop; Fry, John, E-mail: john.fry@ucd.ie

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

Promoting healthy diets and tackling obesity and diet-related chronic diseases: what are the agricultural policy levers?

PubMed

Hawkes, Corinna

2007-06-01

Diet-related chronic diseases are now a serious global public health problem. Public health groups are calling for the agricultural sector to play a greater role in tackling the threat. To identify potential points of policy intervention in the agricultural sector that could be leveraged to promote healthy diets and tackle obesity and diet-related chronic diseases. A review of the literature on the dietary implications of agriculture, a conceptual analysis of the issues, and the identification of relevant examples. There are two main potential points of intervention in the agricultural sector that could be leveraged to promote healthy diets: agricultural policies and agricultural production practices. Agricultural policies and practices affect diet through their influence on food availability, price, and nutrient quality, which in turn affects food choices available to consumers. Agricultural policies amenable to intervention include input, production, and trade policies; agricultural production practices amenable to intervention include crop breeding, crop fertilization practices, livestock-feeding practices, and crop systems diversity. It is well-known that agricultural policies and production practices influence what farmers choose to grow. Agricultural policies and production practices could also play a role in influencing what consumers choose to eat. To identify how agricultural policies and practices can usefully contribute toward promoting healthy diets and tackling obesity and diet-related chronic diseases, health policymakers need to examine whether current agricultural policies and production practices are contributing to-or detracting from-efforts to attain dietary goals; where and how could agricultural intervention help achieve dietary goals; and whether there are trade-offs between these interventions and other important concerns, such as undernutrition and the livelihoods of agricultural producers. Given the potential of agriculture to contribute to large-scale, population-level dietary improvements, these questions warrant closer attention from health policymakers.

The effects of amount of home meditation practice in Mindfulness Based Cognitive Therapy on hazard of relapse to depression in the Staying Well after Depression Trial

PubMed Central

Crane, Catherine; Crane, Rebecca S.; Eames, Catrin; Fennell, Melanie J.V.; Silverton, Sarah; Williams, J. Mark G.; Barnhofer, Thorsten

2014-01-01

Few empirical studies have explored the associations between formal and informal mindfulness home practice and outcome in Mindfulness-based Cognitive Therapy (MBCT). In this study ninety-nine participants randomised to MBCT in a multi-centre randomised controlled trial completed self-reported ratings of home practice over 7 treatment weeks. Recurrence of Major Depression was assessed immediately after treatment, and at 3, 6, 9, and 12-months post-treatment. Results identified a significant association between mean daily duration of formal home practice and outcome and additionally indicated that participants who reported that they engaged in formal home practice on at least 3 days a week during the treatment phase were almost half as likely to relapse as those who reported fewer days of formal practice. These associations were independent of the potentially confounding variable of participant-rated treatment plausibility. The current study identified no significant association between informal home practice and outcome, although this may relate to the inherent difficulties in quantifying informal home mindfulness practice. These findings have important implications for clinicians discussing mindfulness-based interventions with their participants, in particular in relation to MBCT, where the amount of participant engagement in home practice appears to have a significant positive impact on outcome. PMID:25261599

Practices and opinions on nitrous oxide/oxygen sedation from dentists licensed to perform relative analgesia in Brazil

PubMed Central

2012-01-01

Background Relative analgesia (RA), defined as the use of inhalation sedation with nitrous oxide and oxygen, is one of the most common pharmacological behavior management techniques used to provide sedation and analgesia for dental patients. This study aimed to assess RA licensed Brazilian dentists’ practices and opinions about nitrous oxide/oxygen sedation in the dental setting. Methods A cross sectional national survey was conducted with 281 dentists who were certified to perform RA, using an electronically mailed self-administered questionnaire containing closed questions about their practices and opinions regarding RA. Practice and opinion were individually analyzed by descriptive statistics. Non-parametric tests assessed the relationships between RA practice and independent variables. To test the interplay between practices and opinions, a k-means clusters analysis was used to divide the group for statistical comparisons. Results The response rate was 45.2%. Women made up 64.6% of the respondents, the mean age was 39.1 years (SD = 9.8), and the mean time since graduation in dentistry was 16 years (SD = 9.7). Seventy-seven percent of respondents reported the use of RA in clinical practice, most of them ‘sometimes’ (53.5%), and focusing more on adult patients. Patients with certain physical or mental deficiencies were indications associated with RA practice. ‘Equipment acquisition’ (p < 0.001) and ‘living in Southeast and South regions’ (p < 0.02) were also associated with RA practice. The scores for dentists’ opinions ranged from 15 to 41 points (mean 29.2, SD = 5.6), based on nine items scored from 1 to 5. Two clusters representing more favorable (n = 65) and less favorable (n = 55) opinions were established. Dentists who were women (p = 0.04), practiced RA in dental settings (p < 0.01) or practiced it frequently (p < 0.001), had more favorable opinions about RA. Conclusion Most of the RA licensed Brazilian dentists interviewed currently use RA. Current practice of RA and frequency of use determined the degree of favorable opinion about this inhalation sedation among this group of respondents. PMID:22808942

High School Teachers’ Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate

PubMed Central

Pas, Elise T.; Loh, Deanna; Debnam, Katrina J.; Bradshaw, Catherine P.

2016-01-01

Although evidence-based practices for students’ social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers’ openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers’ openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers’ openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers’ openness to new program adoption are discussed. PMID:28533823

High School Teachers' Openness to Adopting New Practices: The Role of Personal Resources and Organizational Climate.

PubMed

Johnson, Stacy R; Pas, Elise T; Loh, Deanna; Debnam, Katrina J; Bradshaw, Catherine P

2017-03-01

Although evidence-based practices for students' social, emotional, and behavioral health are readily available, their adoption and quality implementation in schools are of increasing concern. Teachers are vital to implementation; yet, there is limited research on teachers' openness to adopting new practices, which may be essential to successful program adoption and implementation. The current study explored how perceptions of principal support, teacher affiliation, teacher efficacy, and burnout relate to teachers' openness to new practices. Data came from 2,133 teachers across 51 high schools. Structural equation modeling assessed how organizational climate (i.e., principal support and teacher affiliation) related to teachers' openness directly and indirectly via teacher resources (i.e., efficacy and burnout). Teachers with more favorable perceptions of both principal support and teacher affiliation reported greater efficacy, and, in turn, more openness; however, burnout was not significantly associated with openness. Post hoc analyses indicated that among teachers with high levels of burnout, only principal support related to greater efficacy, and in turn, higher openness. Implications for promoting teachers' openness to new program adoption are discussed.

Role of food preoccupation and current dieting in the associations of parental feeding practices to emotional eating in young adults: A moderated mediation study.

PubMed

Williams, Natalie A; Dev, Dipti A; Hankey, Maren; Blitch, Kimberly

2017-04-01

Parental feeding practices reflecting coercive control are related to children's later eating behaviors, but the mechanisms underlying these effects remain poorly understood. This study examined the relationships between recalled childhood experiences of parental pressure to eat and restriction and current food preoccupation, dieting, and emotional eating in a racially diverse sample of college students (N = 711). Results revealed that parental restriction, but not pressure to eat, was associated with more emotional eating (r = 0.18, p < 0.0001). Food preoccupation mediated the association between restriction and emotional eating (95% CI [3.6495-7.2231]); however, a moderated mediation model revealed that the strength of the indirect effect of restrictive feeding on emotional eating through food preoccupation was significantly different for dieters and non-dieters (index of moderated mediation = 1.79, Boot SE = 0.79; 95% bias-corrected bootstrap CI [-3.5490 to -0.4515]). These findings provide unique insight into the mechanisms linking parental feeding practices with emotional eating in young adulthood. Future studies attempting to clarify the processes through which child feeding practices impact later eating behaviors should consider the role of current dieting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

PubMed

Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

2015-12-15

Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

Vitex agnus-castus (Chaste-Tree/Berry) in the treatment of menopause-related complaints.

PubMed

van Die, Margaret Diana; Burger, Henry G; Teede, Helena J; Bone, Kerry M

2009-08-01

The origin of the current practice of administering Vitex agnus-castus in menopause-related complaints is uncertain, but appears to be relatively recent. Here we review the evidence for this application of Vitex based on evidence from pharmacological studies and clinical research. The mechanisms of potential relevance in the context of menopause are explored with reference to the current understanding of the endocrinology and neuroendocrinology of menopause and associated symptoms. We conclude that, while evidence from rigorous randomized controlled trials is lacking for the individual herb in this context, emerging pharmacological evidence supports a role for V. agnus-castus in the alleviation of menopausal symptoms and suggests that further investigation may be appropriate.

Plastic apron wear during direct patient care.

PubMed

Candlin, Josie; Stark, Sheila

To identify factors that influence nurses' practice in apron use during direct patient care. A small-scale documentary analysis of a purposive sample of 15 journal articles relating to nurses' apron use during patient care was undertaken. The analysis sought to address what factors affect nurses' decisions in relation to apron use. Nurses' decisions regarding apron use during patient care tend to be ritualistic rather than evidence-based. Their knowledge of infection control is limited. Although there is current literature available on infection control, as well as health and safety regulations, if local policy regarding apron use in nursing care is scant this can result in inconsistent and, perhaps, less desirable practices.

Exploring in teaching mode of Optical Fiber Sensing Technology outcomes-based education (OBE)

NASA Astrophysics Data System (ADS)

Fu, Guangwei; Fu, Xinghu; Zhang, Baojun; Bi, Weihong

2017-08-01

Combining with the characteristics of disciplines and OBE mode, also aiming at the phenomena of low learning enthusiasm for the major required courses for senior students, the course of optical fiber sensing was chosen as the demonstration for the teaching mode reform. In the light of "theory as the base, focus on the application, highlighting the practice" principle, we emphasis on the introduction of the latest scientific research achievements and current development trends, highlight the practicability and practicality. By observation learning and course project, enables students to carry out innovative project design and implementation means related to the practical problems in science and engineering of this course.

Wound Care Nursing: Professional Issues and Opportunities

PubMed Central

Corbett, Lisa Q.

2012-01-01

As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. PMID:24527304

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.

Challenges to laboratory hematology practice: Egypt perspective.

PubMed

Rizk, S H

2018-05-01

Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2-3 years masters' degree followed by 2-4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the "Egyptian Accreditation Council" (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading. © 2018 John Wiley & Sons Ltd.

Faculty perceptions of the strengths, weaknesses and future prospects of the current medical undergraduate experimental physiology curriculum in Gujarat, India.

PubMed

Paralikar, Swapnil; Shah, Chinmay

2015-01-01

Over the past several years, an opinion has emerged in India that the current practical curricula in medical schools fail to meet many of the objectives for which they were instituted. Hence, this study has assessed the perception of physiology faculty members regarding the current experimental physiology curriculum in one Indian state, Gujarat. The faculty were of the opinion that many of the topics currently taught in experimental physiology (amphibian nerve-muscle and heart muscle experiments) were outdated and clinically irrelevant: Therefore, the faculty advocated that duration of teaching time devoted to some of these topics should be reduced and topics with clinical relevance should be introduced at the undergraduate level. The faculty also felt that more emphasis should be laid on highlighting the clinical aspect related to each concept taught in experimental physiology . Moreover, a majority of faculty members were in favour of replacing the current practice in Gujarat of teaching experimental physiology only by explanation of graphs obtained from experiments conducted in the previous years, with computer assisted learning in small groups.

Routes of pesticide exposure in solitary, cavity-nesting bees

USDA-ARS?s Scientific Manuscript database

The declines of pollinator health and populations are a current commercial and ecological concern. In particular, challenges related to maintaining healthy commercial honey bee (Apis mellifera L.) populations continue. Agricultural practices, such as the use of agrochemicals, are among factors that ...

Developing a national strategic plan for consumer horticulture

USDA-ARS?s Scientific Manuscript database

Consumer Horticulture encompasses a wide-array of activities that are practiced by and of interest to the gardening public, garden-focused non-governmental organizations, and gardening-related industries. In a previous publication, we described the current lack of funding support for research, exten...

Knowledge and Preventive Practices related to Avian Influenza among Poultry Workers of Kamalamai Municipality, Sindhuli, Nepal.

PubMed

Shrestha, R; Shrestha, K B; Ghimire, S; Shrestha, N

2016-01-01

Avian influenza (AI) is currently a threat to global health. Prevention and control of AI depends on the knowledge and preventive practices of the poultry workers as well as of general population. This study aims to assess knowledge and preventive practices related to AI among poultry workers. Cross-sectional study was carried out among poultry workers of Kamalamai Municipality, Sindhuli. Data was collected from randomly selected 122 respondents through face-to-face interview. The collected data was entered in Epi-data version 3.1 and analyzed in terms of descriptive statistics (proportion, 95% CI, mean and standard deviation) by using SPSS, version 20. A scoring system was used to assess knowledge and preventive practices. Out of total, 93.4% (95% CI, 87.6- 96.6%) of the respondents had heard about AI. More than half (54.9%) of the respondents had poor knowledge on AI. Only 5.3% of respondents had good preventive practice against AI. 30.3% respondents had good knowledge and good practice and 24.6% had poor knowledge as well as poor practice. 20.5% of the respondents had good practice but poor knowledge, whereas, 24.6% had good knowledge but poor practice towards prevention. The knowledge and practice of AI among poultry workers were low. The groups should be targeted for appropriate intervention based on whether they lack knowledge or practice or both.

Perinatal pathology: practice suggestions for limited-resource settings.

PubMed

Roberts, Drucilla J

2013-06-01

The practice of perinatal pathology in much of the world suffers, as do all subspecialties of anatomic pathology, from inadequate resources (equipment, consumables, and both professional and technical personnel), from lack of education (not only of the pathologist but also of the clinicians responsible for sending the specimens, and the technicians processing the specimens), and from lack of appropriate government sector support. Perinatal pathology has significant public health-related utility and should be championing its service by providing maternal and fetal/infant mortality and morbidity data to governmental health ministries. It is with this pathologic data that informed decisions can be made on health-related courses of action and allocation of resources. These perinatal pathology data are needed to develop appropriate public health initiatives, specifically toward achieving the Millennium Developmental Goals as the best way to effectively decrease infant and maternal deaths and to determine causes of perinatal mortality and morbidity. The following overview will focus on the utility of perinatal pathology specifically as related to its public health function and will suggest methods to improve its service in resource-poor settings. This article is offered not as a critique of the current practice that most pathologists find themselves working in globally, but to provide suggestions for improving perinatal pathology services, which could be implemented with the limited available resources and manpower most pathology departments currently have. In addition, we offer suggestions for graded improvements ("ramping up") over time.

Vascular access cannulation in hemodialysis patients - a survey of current practice and its relation to dialysis dose.

PubMed

Gauly, Adelheid; Parisotto, Maria Teresa; Skinder, Aleksandra; Schoder, Volker; Furlan, Andreja; Schuh, Erika; Marcelli, Daniele

2011-01-01

The appropriate use of vascular access is of fundamental importance in the treatment of hemodialysis (HD) patients. This survey entailed collecting data on current practice of vascular access cannulation to assess its relation to dialysis dose. This international, multicenter, observational, cross-sectional survey was performed in 171 dialysis centers of the European dialysis network of Fresenius Medical Care in Europe and South Africa during April 2009. Practice patterns of vascular access cannulations were documented by means of a 24-item questionnaire. Dialysis dose from the documented hemodialysis treatments was derived from the clinical database EuCliD®. In total, 10,807 cannulations in hemodialysis patients with either arteriovenous fistula (91%) or arteriovenous graft (9%) were documented. For the puncture, the area technique was applied most frequently using 15G and 16G needles. Blood flow rates were mostly between 300 and 400 mL/min and adjusted to the needle size used. In two-thirds of cases the arterial needle was placed first, mostly in an antegrade direction, with an average distance to the venous needle of 7.0±3.7 cm. More than two-thirds of the cannulations were performed by nurses with more than 5 years of experience in dialysis. A logistic regression model revealed a significantly higher odds ratio to attain Kt/V = 1.2 for retrograde placement of the arterial needle, and for using needles with bigger diameter. This survey covered a broad number of countries and centers and provides information on current practice of vascular access cannulation, their effect on dialysis dose, and serves as feedback to the dialysis centers for their quality management process.

Factors influencing emergency medicine physicians' management of sports-related concussions: a community-wide study.

PubMed

Giebel, Stephen; Kothari, Rashmi; Koestner, Amy; Mohney, Gretchen; Baker, Robert

2011-12-01

Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions. To evaluate the current practice of EP evaluation and management of sports-related concussions. All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding their management of sports-related concussions. The surveys obtained demographic data, participants' use of guidelines, and the importance of clinical and non-clinical factors in deciding when to allow a player to return to play. Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no significant difference between attending and resident EPs. The symptomatic complaints of loss of consciousness, amnesia of the event, and difficulty concentrating were ranked most important by EPs in assessing patients with sports-related concussions. Among non-clinical factors, residents were significantly more likely than attendings to report that medical-legal, parental, and players' concerns were more likely to influence their decision in allowing a patient to return to play. EPs take into consideration important clinical factors in assessing patients with sports-related concussion. However, almost 75% do not use any nationally recognized guideline in their evaluation. Residents are more likely than attendings to be influenced by non-clinical factors. Copyright © 2011 Elsevier Inc. All rights reserved.

Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians.

PubMed

Lempp, Thomas; Heinzel-Gutenbrunner, Monika; Bachmann, Christian

2016-04-01

Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skills and knowledge PCPs say they require in their daily practice. A questionnaire was generated, employing a modified two-step Delphi approach. Besides socio-demographic items, the questionnaire contained 17 CAP-related knowledge items and 13 CAP-related skills items, which had to be rated by importance in daily practice. The questionnaire was distributed to 348 office-based paediatricians and 500 general practitioners (GPs) in Germany. The overall return rate was 51.3% (435/848). Regarding CAP-related knowledge, both paediatricians and GPs rated somatoform disorders and obesity as highly important for daily practice. Moreover, paediatricians also deemed regulatory disorders during infancy (e.g. crying, sleep disorders) as important, while GPs assessed knowledge on paediatric depression as relevant. For paediatricians and GPs, the most relevant CAP-related skills were communicating with children and adolescents and their parents. Additionally, paediatricians rated differentiating between non-pathologic and clinically relevant behaviour problems very relevant, while GPs considered basic psychotherapeutic skills essential. The CAP-related knowledge and skills perceived relevant for doctors in primary care differ from the majority of current medical school CAP curricula, which cover mainly typical, epitomic CAP disorders and are predominantly knowledge-oriented. Therefore, medical education in CAP should be amended to reflect the needs of PCPs to improve healthcare for children and adolescents with mental health problems.

Hydrogen Storage Materials for Mobile and Stationary Applications: Current State of the Art.

PubMed

Lai, Qiwen; Paskevicius, Mark; Sheppard, Drew A; Buckley, Craig E; Thornton, Aaron W; Hill, Matthew R; Gu, Qinfen; Mao, Jianfeng; Huang, Zhenguo; Liu, Hua Kun; Guo, Zaiping; Banerjee, Amitava; Chakraborty, Sudip; Ahuja, Rajeev; Aguey-Zinsou, Kondo-Francois

2015-09-07

One of the limitations to the widespread use of hydrogen as an energy carrier is its storage in a safe and compact form. Herein, recent developments in effective high-capacity hydrogen storage materials are reviewed, with a special emphasis on light compounds, including those based on organic porous structures, boron, nitrogen, and aluminum. These elements and their related compounds hold the promise of high, reversible, and practical hydrogen storage capacity for mobile applications, including vehicles and portable power equipment, but also for the large scale and distributed storage of energy for stationary applications. Current understanding of the fundamental principles that govern the interaction of hydrogen with these light compounds is summarized, as well as basic strategies to meet practical targets of hydrogen uptake and release. The limitation of these strategies and current understanding is also discussed and new directions proposed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Education of Pharmacists in Canada

PubMed Central

Ensom, Mary H.H.

2008-01-01

In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada. PMID:19325948

Fourfold increased detection of Lynch syndrome by raising age limit for tumour genetic testing from 50 to 70 years is cost-effective.

PubMed

Sie, A S; Mensenkamp, A R; Adang, E M M; Ligtenberg, M J L; Hoogerbrugge, N

2014-10-01

Recognising colorectal cancer (CRC) patients with Lynch syndrome (LS) can increase life expectancy of these patients and their close relatives. To improve identification of this under-diagnosed disease, experts suggested raising the age limit for CRC tumour genetic testing from 50 to 70 years. The present study evaluates the efficacy and cost-effectiveness of this strategy. Probabilistic efficacy and cost-effectiveness analyses were carried out comparing tumour genetic testing of CRC diagnosed at age 70 or below (experimental strategy) versus CRC diagnosed at age 50 or below (current practice). The proportions of LS patients identified and cost-effectiveness including cascade screening of relatives, were calculated by decision analytic models based on real-life data. Using the experimental strategy, four times more LS patients can be identified among CRC patients when compared with current practice. Both the costs to detect one LS patient (€9437/carrier versus €4837/carrier), and the number needed to test for detecting one LS patient (42 versus 19) doubled. When family cascade screening was included, the experimental strategy was found to be highly cost-effective according to Dutch standards, resulting in an overall ratio of €2703 per extra life-year gained in additionally tested patients. Testing all CRC tumours diagnosed at or below age 70 for LS is cost-effective. Implementation is important as relatives from the large number of LS patients that are missed by current practice, can benefit from life-saving surveillance. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Statistical Relational Learning to Predict Primary Myocardial Infarction from Electronic Health Records

PubMed Central

Weiss, Jeremy C; Page, David; Peissig, Peggy L; Natarajan, Sriraam; McCarty, Catherine

2013-01-01

Electronic health records (EHRs) are an emerging relational domain with large potential to improve clinical outcomes. We apply two statistical relational learning (SRL) algorithms to the task of predicting primary myocardial infarction. We show that one SRL algorithm, relational functional gradient boosting, outperforms propositional learners particularly in the medically-relevant high recall region. We observe that both SRL algorithms predict outcomes better than their propositional analogs and suggest how our methods can augment current epidemiological practices. PMID:25360347

Practices Regarding Rape-related Pregnancy in U.S. Abortion Care Settings.

PubMed

Perry, Rachel; Murphy, Molly; Rankin, Kristin M; Cowett, Allison; Harwood, Bryna

2016-01-01

We aimed to explore current practices regarding screening for rape and response to disclosure of rape-related pregnancy in the abortion care setting. We performed a cross-sectional, nonprobability survey of U.S. abortion providers. Individuals were recruited in person and via emailed invitations to professional organization member lists. Questions in this web-based survey pertained to providers' practice setting, how they identify rape-related pregnancy, the availability of support services, and their experiences with law enforcement. Providers were asked their perceptions of barriers to care for women who report rape-related pregnancy. Surveys were completed by 279 providers (21% response rate). Most respondents were female (93.1%), and the majority were physicians in a clinical role (69.4%). One-half (49.8%) reported their practice screens for pregnancy resulting from rape, although fewer (34.8%) reported that screening is the method through which most patients with this history are identified. Most (80.6%) refer women with rape-related pregnancy to support services such as rape crisis centers. Relatively few (19.7%) have a specific protocol for care of women who report rape-related pregnancy. Clinics that screen were 79% more likely to have a protocol for care than centers that do not screen. Although the majority (67.4%) reported barriers to identification of women with rape-related pregnancy, fewer (33.3%) reported barriers to connecting them to support services. Practices for identifying and providing care to women with rape-related pregnancy in the abortion care setting are variable. Further research should address barriers to care provision, as well as identifying protocols for care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Relationship Between Past Food Deprivation and Current Dietary Practices and Weight Status Among Cambodian Refugee Women in Lowell, MA

PubMed Central

Wilde, Parke E.; Liang, Sidney; Bermudez, Odilia I.; Silka, Linda; Rogers, Beatrice Lorge

2010-01-01

Objectives. We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Methods. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Results. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27–point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Conclusions. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity. PMID:20724691

Relationship between past food deprivation and current dietary practices and weight status among Cambodian refugee women in Lowell, MA.

PubMed

Peterman, Jerusha Nelson; Wilde, Parke E; Liang, Sidney; Bermudez, Odilia I; Silka, Linda; Rogers, Beatrice Lorge

2010-10-01

We investigated Cambodian refugee women's past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27-point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity.

Update in perioperative medicine: practice changing evidence published in 2016.

PubMed

Regan, Dennis W; Kashiwagi, Deanne; Dougan, Brian; Sundsted, Karna; Mauck, Karen

2017-10-01

This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change. We integrated the new evidence into the existing body of medical knowledge and identified practical implications for real world patient care. The articles address issues related to anticoagulation, transfusion threshold, immunosuppressive medications, postoperative delirium, myocardial injury after noncardiac surgery, postoperative pain management, perioperative management of antihypertensives, perioperative fasting, and perioperative diabetic control.

Three Collaborative Models for Scaling Up Evidence-Based Practices

PubMed Central

Roberts, Rosemarie; Jones, Helen; Marsenich, Lynne; Sosna, Todd; Price, Joseph M.

2015-01-01

The current paper describes three models of research-practice collaboration to scale-up evidence-based practices (EBP): (1) the Rolling Cohort model in England, (2) the Cascading Dissemination model in San Diego County, and (3) the Community Development Team model in 53 California and Ohio counties. Multidimensional Treatment Foster Care (MTFC) and KEEP are the focal evidence-based practices that are designed to improve outcomes for children and families in the child welfare, juvenile justice, and mental health systems. The three scale-up models each originated from collaboration between community partners and researchers with the shared goal of wide-spread implementation and sustainability of MTFC/KEEP. The three models were implemented in a variety of contexts; Rolling Cohort was implemented nationally, Cascading Dissemination was implemented within one county, and Community Development Team was targeted at the state level. The current paper presents an overview of the development of each model, the policy frameworks in which they are embedded, system challenges encountered during scale-up, and lessons learned. Common elements of successful scale-up efforts, barriers to success, factors relating to enduring practice relationships, and future research directions are discussed. PMID:21484449

Arts practices in unreasonable doubt? Reflections on understandings of arts practices in healthcare contexts.

PubMed

Broderick, Sheelagh

2011-09-01

This article suggests that the discourse on arts and health encompass contemporary arts practices as an active and engaged analytical activity. Distinctions between arts therapy and arts practice are made to suggest that clinical evidence-based evaluation, while appropriate for arts therapy, is not appropriate for arts practice and in effect cast them in unreasonable doubt. Themes in current discourse on "arts" and "health" are broadly sketched to provide a context for discussion of arts practices. Approaches to knowledge validation in relation to each domain are discussed. These discourses are applied to the Irish healthcare context, offering a reading of three different art projects; it suggests a multiplicity of analyses beyond causal positive health gains. It is suggested that the social turn in medicine and the social turn in arts practices share some similar pre-occupations that warrant further attention.

Current marketing practices in the nursing home sector.

PubMed

Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

2006-01-01

Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

Early sport practice is related to lower prevalence of cardiovascular and metabolic outcomes in adults independently of overweight and current physical activity.

PubMed

Fernandes, Rômulo Araújo; Zanesco, Angelina

2015-01-01

Early sport practice prevents development of diseases in children/adolescents, but still unclear its effect over health in adulthood. Therefore, the purpose of this study was to analyze the association between sport practice in early life and chronic diseases in adulthood. A retrospective population-based survey carried out in eight Brazilian cities with adults of both genders. Throughout a multistage random process 2720 adults (1096 male and 1624 female) were selected and interviewed. Type 2 diabetes mellitus and arterial hypertension were assessed in a face-to-face interview through a self-report, which was necessarily based on previous medical diagnosis. Early sport practice was assessed in childhood (7-10 years old) and adolescence (11-17 years old). Current physical activity and body mass index were assessed in adulthood throughout a face-to-face interview. Type 2 diabetes mellitus and arterial hypertension were identified in 8.1% (95% CI, 7.1-9.2) and 23.5% (95% CI, 21.9-25.1) of the sample, respectively. Early sport practice during childhood and adolescence was associated with lower occurrence of arterial hypertension (OR, 0.49; 95% CI, 0.33-0.73) and type 2 diabetes (OR, 0.46; 95% CI, 0.24-0.88) in adulthood. Independently of obesity and current physical activity, early sport practice in early life was positively associated with lower occurrence of chronic diseases in adulthood. Copyright © 2015 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

The current state of cancer family history collection tools in primary care: a systematic review.

PubMed

Qureshi, Nadeem; Carroll, June C; Wilson, Brenda; Santaguida, Pasqualina; Allanson, Judith; Brouwers, Melissa; Raina, Parminder

2009-07-01

Systematic collection of family history is a prerequisite for identifying genetic risk. This study reviewed tools applicable to the primary care assessment of family history of breast, colorectal, ovarian, and prostate cancer. MEDLINE, EMBASE, CINAHL, and Cochrane Central were searched for publications. All primary study designs were included. Characteristics of the studies, the family history collection tools, and the setting were evaluated. Of 40 eligible studies, 18 relevant family history tools were identified, with 11 developed for use in primary care. Most collected information on more than one cancer and on affected relatives used self-administered questionnaires and paper-based formats. Eleven tools had been evaluated relative to current practice, demonstrating 46-78% improvement in data recording over family history recording in patient charts and 75-100% agreement with structured genetic interviews. Few tools have been developed specifically for primary care settings. The few that have been evaluated performed well. The very limited evidence, which depends in part on extrapolation from studies in settings other than primary care, suggests that systematic tools may add significant family health information compared with current primary care practice. The effect of their use on health outcomes has not been evaluated.

Gender in clinical neuropsychology: practice survey trends and comparisons outside the specialty.

PubMed

Sweet, Jerry J; Lee, Catherine; Guidotti Breting, Leslie M; Benson, Laura M

2018-02-01

This paper describes gender-related trends within clinical neuropsychology, based primarily on recurrent practice surveys within the specialty and, to a lesser extent, job-related information from medical specialties and the general U.S. labor market. Chronological and cross-sectional analyses of professional practice survey data from 2005, 2010, and 2015 relevant to gender. As is common with survey data, descriptive analysis and independent samples t-tests were conducted. Longitudinal data allowed for examination of gender trends, as well as observations of change and stability of factors associated with gender, over time. Women have become dominant in number in clinical neuropsychology, and also comprise a vast majority of practitioners entering the specialty. Gender differences are noted in professional identity, work status, work settings, types of career satisfaction, and retirement expectations. Women are more likely to identify work environment and personal/family obstacles to aspects of career satisfaction. A gender pay gap was found at all time points and is not narrowing. As is true nationally, multiple factors appear related to the gender pay gap in clinical neuropsychology. Women in neuropsychology are now dominant in number, and their presence is strongly associated with specific practice patterns, such as greater institutional employment, less involvement in forensic practice, and strong involvement in pediatric practice, which may be maintaining the sizeable gender pay gap in neuropsychology. As the proportion of women neuropsychologists continues to increase, flexible work hours, and alternative means of remuneration may be needed to offset current disproportionate family-related responsibilities.

Early Childhood Caries-Related Knowledge, Attitude, and Practice: Discordance between Pediatricians and Dentists toward Medical Office-Based Prevention in Taiwan.

PubMed

Dima, Shinechimeg; Chang, Wei-Jen; Chen, Jung-Wei; Teng, Nai-Chia

2018-05-24

The aim of this study was to assess the knowledge, attitude, and practice regarding early childhood caries (ECC) prevention and implementation of medical setting-based caries prevention among pediatricians and dentists in Taiwan. Data were collected from currently practicing pediatricians and general and pediatric dentists using self-administered questionnaires. A total of 301 questionnaires were completed by the pediatricians ( n = 105), general dentists ( n = 117), and pediatric dentists ( n = 79). The pediatric dentists obtained significantly higher knowledge and practice scores than the general dentists and pediatricians ( p < 0.0001). The pediatricians' attitude score related to engaging physicians in medical office-based caries prevention was significantly higher than the attitude scores of the general and pediatric dentists ( p < 0.05). A Spearman rank correlation analysis indicated a significant positive correlation between knowledge and practice among the general dentists (r s = 0.271, p < 0.01) and pediatricians (r s = 0.262, p < 0.01). The correlation between knowledge and attitude among the pediatricians was significantly positive (r s = 0.242, p < 0.05). Attitude and practice among the pediatricians were significantly positively correlated (r s = 0.271, p < 0.01). Pediatricians lacked ECC-related knowledge; however, they had a more positive attitude toward medical office-based prevention when they had a higher level of knowledge. Oral health-related education for pediatricians is necessary if such medical office-based caries prevention programs are to be implemented in Taiwan.

Relating management practices and nutrient export in agricultural watersheds of the United States

USGS Publications Warehouse

Sprague, Lori A.; Gronberg, Jo Ann M.

2012-01-01

Relations between riverine export (load) of total nitrogen (N) and total phosphorus (P) from 133 large agricultural watersheds in the United States and factors affecting nutrient transport were evaluated using empirical regression models. After controlling for anthropogenic inputs and other landscape factors affecting nutrient transport-such as runoff, precipitation, slope, number of reservoirs, irrigated area, and area with subsurface tile drains-the relations between export and the area in the Conservation Reserve Program (CRP) (N) and conservation tillage (P) were positive. Additional interaction terms indicated that the relations between export and the area in conservation tillage (N) and the CRP (P) progressed from being clearly positive when soil erodibility was low or moderate, to being close to zero when soil erodibility was higher, to possibly being slightly negative only at the 90th to 95th percentile of soil erodibility values. Possible explanations for the increase in nutrient export with increased area in management practices include greater transport of soluble nutrients from areas in conservation tillage; lagged response of stream quality to implementation of management practices because of nitrogen transport in groundwater, time for vegetative cover to mature, and/or prior accumulation of P in soils; or limitations in the management practice and stream monitoring data sets. If lags are occurring, current nutrient export from agricultural watersheds may still be reflecting the influence of agricultural land-use practices that were in place before the implementation of these management practices.

Current worldwide nuclear cardiology practices and radiation exposure: results from the 65 country IAEA Nuclear Cardiology Protocols Cross-Sectional Study (INCAPS)

PubMed Central

Einstein, Andrew J.; Pascual, Thomas N. B.; Mercuri, Mathew; Karthikeyan, Ganesan; Vitola, João V.; Mahmarian, John J.; Better, Nathan; Bouyoucef, Salah E.; Hee-Seung Bom, Henry; Lele, Vikram; Magboo, V. Peter C.; Alexánderson, Erick; Allam, Adel H.; Al-Mallah, Mouaz H.; Flotats, Albert; Jerome, Scott; Kaufmann, Philipp A.; Luxenburg, Osnat; Shaw, Leslee J.; Underwood, S. Richard; Rehani, Madan M.; Kashyap, Ravi; Paez, Diana; Dondi, Maurizio

2015-01-01

Aims To characterize patient radiation doses from nuclear myocardial perfusion imaging (MPI) and the use of radiation-optimizing ‘best practices’ worldwide, and to evaluate the relationship between laboratory use of best practices and patient radiation dose. Methods and results We conducted an observational cross-sectional study of protocols used for all 7911 MPI studies performed in 308 nuclear cardiology laboratories in 65 countries for a single week in March–April 2013. Eight ‘best practices’ relating to radiation exposure were identified a priori by an expert committee, and a radiation-related quality index (QI) devised indicating the number of best practices used by a laboratory. Patient radiation effective dose (ED) ranged between 0.8 and 35.6 mSv (median 10.0 mSv). Average laboratory ED ranged from 2.2 to 24.4 mSv (median 10.4 mSv); only 91 (30%) laboratories achieved the median ED ≤ 9 mSv recommended by guidelines. Laboratory QIs ranged from 2 to 8 (median 5). Both ED and QI differed significantly between laboratories, countries, and world regions. The lowest median ED (8.0 mSv), in Europe, coincided with high best-practice adherence (mean laboratory QI 6.2). The highest doses (median 12.1 mSv) and low QI (4.9) occurred in Latin America. In hierarchical regression modelling, patients undergoing MPI at laboratories following more ‘best practices’ had lower EDs. Conclusion Marked worldwide variation exists in radiation safety practices pertaining to MPI, with targeted EDs currently achieved in a minority of laboratories. The significant relationship between best-practice implementation and lower doses indicates numerous opportunities to reduce radiation exposure from MPI globally. PMID:25898845

Transnational gestational surrogacy: does it have to be exploitative?

PubMed

Kirby, Jeffrey

2014-01-01

This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings (such as rural, western India), is exploitative of surrogate women. Arising out of consideration of the heuristic's exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative.

Ethics Education in CACREP-Accredited Counselor Education Programs

ERIC Educational Resources Information Center

Urofsky, Robert; Sowa, Claudia

2004-01-01

The authors present the results of a survey investigating ethics education practices in counselor education programs accredited by the Council for Accreditation of Counseling and Related Educational Programs and counselor educators' beliefs regarding ethics education. Survey responses describe current curricular approaches to ethics education,…

Employment Retention after Vision Loss: Intensive Case Studies.

ERIC Educational Resources Information Center

Crudden, Adele; Fireison, Cara K.

This study examined the lives of 10 individuals with blindness or severe visual impairment who maintained competitive employment despite their vision loss. The study was designed to provide information regarding the personal characteristics and current practices related to work environment alterations which enhance competitive employment…

Gifted Education and the Spectre of Elitism.

ERIC Educational Resources Information Center

Howley, Aimee

1986-01-01

Explains current practices in gifted education as they relate to the schools' role in legitimating existing patterns of social stratification. Argues that schools provide noncognitive instruction to gifted students to thwart their development as intellectuals. Evaluates the extent to which gifted education programs are elitist. (KH)

Is the Classroom Obsolete in the Twenty-First Century?

ERIC Educational Resources Information Center

Benade, Leon

2017-01-01

Lefebvre's triadic conception of "spatial practice, representations of space and representational spaces" provides the theoretical framework of this article, which recognises a productive relationship between space and social relations. Its writing stems from a current and ongoing qualitative study of innovative teaching and learning…

Listening from the Inside Out.

ERIC Educational Resources Information Center

Joiner, Elizabeth G.

1984-01-01

Examines studies in brain research which are closely related to language learning. Discusses Asher's Total Physical Response and Lozanov's Suggestopedia as approaches which activate the right brain hemisphere and involve it in the language learning process. Discusses practical applications for what is currently known about listening. (SED)

Chaos Modeling: An Introduction and Research Application.

ERIC Educational Resources Information Center

Newman, Isadore; And Others

1993-01-01

Introduces the basic concepts of chaos theory and chaos modeling. Relates chaos theory to qualitative research and factor analysis. Describes some current research in education and psychology using chaos theory. Claims that the philosophical implications of chaos theory have been misapplied in practical terms. (KS)

Alternatives to current fumigation practices in western states raspberry

USDA-ARS?s Scientific Manuscript database

Red raspberry production systems in the western United States are heavily reliant on preplant soil fumigation to ensure the successful establishment and productivity of a planting. However, due to issues related to the regulation, availability, and economics of soil fumigation alternatives are need ...

ADAP: A Divorce Assessment Proposal.

ERIC Educational Resources Information Center

Ferreiro, Beverly Webster; And Others

1986-01-01

Proposed guidelines for mental health clinicians in assessing clients' divorce-related concerns. Current empirical information on factors affecting individual and family adjustment after divorce is organized into a practical format for clinical application. Details a comprehensive assessment that will help the clinician to understand the client's…

Evaluation of Project Processes in Relation to Transportation System Management and Operations (TSM&O)

DOT National Transportation Integrated Search

2018-01-01

This study was conducted to explore the current state-of-the-practice of Transportation Systems Management and Operations (TSM&O) in the Florida Department of Transportation (FDOT) and determine what would be required to mainstream TSM&O throughout t...

Utilizing the long-term pavement performance database in evaluating the effectiveness of pavement smoothness

DOT National Transportation Integrated Search

2002-03-01

This research project was performed in two phases. The first phase concentrated on previous related literature review and a nationwide survey to find out the current practices of smoothness specifications. The second phase dealt with collecting and a...

Grading--Why Are School Policies Necessary? What Are the Issues?

ERIC Educational Resources Information Center

Thomas, William C.

1986-01-01

Argues that current grading practices in some schools lack consistency in several critical areas, including criteria for failure, absolute or relative standards, and motivation of slower students. Policies are suggested that will help educators develop fairer and more humane marking systems. (TE)

Intelligent Computer-Assisted Language Learning.

ERIC Educational Resources Information Center

Harrington, Michael

1996-01-01

Introduces the field of intelligent computer assisted language learning (ICALL) and relates them to current practice in computer assisted language learning (CALL) and second language learning. Points out that ICALL applies expertise from artificial intelligence and the computer and cognitive sciences to the development of language learning…

Do specific parenting practices and related parental self-efficacy associate with physical activity and screen time among primary schoolchildren? A cross-sectional study in Belgium

PubMed Central

De Lepeleere, Sara; De Bourdeaudhuij, Ilse; Cardon, Greet; Verloigne, Maïté

2015-01-01

Objectives To assess the association between specific parenting practices and related parental self-efficacy with children's physical activity (PA) and screen time. Parental body mass index (BMI), family socioeconomic status (SES), and child's age and gender were examined as possible influencing factors. Design Cross-sectional. Setting January 2014, Flanders (Belgium). Participants 207 parents (87.4% mothers) of children aged 6–12 years. Outcome measures Specific parenting practices, related parental self-efficacy, and children's PA and screen time. Results The majority of investigated parenting practices and related parental self-efficacy were not significantly associated with children's PA or screen time. However, children were more physically active if sports equipment was available at home (p<0.10) and if parents did not find it difficult to motivate their child to be physically active (p<0.05). Children had a lower screen time if parents limited their own gaming (p<0.01). The associations between parenting practices and related parental self-efficacy with children's PA or screen time were significant for parents with a normal BMI, for medium-high SES families and for parents of younger children. Furthermore, the association between the parenting relating factors and children's PA and screen time differed for boys and girls. Conclusions In contrast to what we expected, the findings of the current study show that only a very few specific parenting practices and related parental self-efficacy were associated with children's PA and screen time. It was expected that parental self-efficacy would play a more important role. This can be due to the fact that parental self-efficacy was already high in this group of parents. Therefore, it is possible that parents do not realise how difficult it is to perform certain parenting practices until they are faced with it in an intervention. Trial registration number EC/2012/317. PMID:26346871

Synthesizing Econometric Evidence: The Case of Demand Elasticity Estimates.

PubMed

DeCicca, Philip; Kenkel, Don

2015-06-01

Econometric estimates of the responsiveness of health-related consumer demand to higher prices are often key ingredients for risk policy analysis. We review the potential advantages and challenges of synthesizing econometric evidence on the price-responsiveness of consumer demand. We draw on examples of research on consumer demand for health-related goods, especially cigarettes. We argue that the overarching goal of research synthesis in this context is to provide policy-relevant evidence for broad-brush conclusions. We propose three main criteria to select among research synthesis methods. We discuss how in principle and in current practice synthesis of research on the price-elasticity of smoking meets our proposed criteria. Our analysis of current practice also contributes to academic research on the specific policy question of the effectiveness of higher cigarette prices to reduce smoking. Although we point out challenges and limitations, we believe more work on research synthesis in this area will be productive and important. © 2015 Society for Risk Analysis.

Predictors of HIV-Risk Sexual Behavior: Examining Lifetime Sexual and Physical Abuse Histories in Relation to Substance Use and Psychiatric Problem Severity Among Ex-Offenders

PubMed Central

Majer, John M.; Rodriquez, Jaclyn; Bloomer, Craig; Jason, Leonard A.

2015-01-01

Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient treatment for substance dependence. Hierarchical linear regression was conducted to examine increases in participants’ number of sexual partners in relation to sociodemographic characteristics, recent substance use and current psychiatric problem severity in addition to lifetime histories of sexual and physical abuse. Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behaviors beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in the frequency of these practices based on lifetime abuse histories and gender were not significant. Findings suggest recent substance use and current psychiatric problem severity are risk-factors for HIV-risk sexual behavior among ex-offenders with and without lifetime abuse histories. PMID:24717831

Current knowledge related to intelligence and thinking with implications for the development and use of case studies.

PubMed

Lunney, Margaret

2008-01-01

This paper reviews current knowledge regarding intelligence and thinking, and relates this knowledge to learning to diagnose human responses and to select health outcomes and nursing interventions. Knowledge from relevant literature sources was summarized. The provision of high-quality nursing care requires use of critical thinking with three elements of nursing care: nursing diagnosis, health outcomes, and nursing interventions. Metacognition (thinking about thinking) should be used with knowledge of the subject matter and repeated practice in using the knowledge. Because there are limited clinical opportunities to practice using metacognition and knowledge of these nursing care elements, case studies can be used to foster nurses' expertise. Simulations of clinical cases are needed that illustrate application of the nursing knowledge represented in NANDA International, Nursing Outcomes Classification, and Nursing Interventions Classification. The International Journal of Nursing Terminologies and Classifications will promote the dispersion of case studies as a means of facilitating the implementation and use of nursing languages and classifications.

Research gaps related to forest management and stream sediment in the United States.

PubMed

Anderson, Christopher J; Lockaby, B Graeme

2011-02-01

Water quality from forested landscapes tends to be very high but can deteriorate during and after silvicultural activities. Practices such as forest harvesting, site preparation, road construction/use, and stream crossings have been shown to contribute sediment, nutrients, and other pollutants to adjacent streams. Although advances in forest management accompanied with Best Management Practices (BMPs) have been very effective at reducing water quality impacts from forest operations, projected increases in demand for forest products may result in unintended environmental degradation. Through a review of the pertinent literature, we identified several research gaps related to water yield, aquatic habitat, sediment source and delivery, and BMP effectiveness that should be addressed for streams in the United States to better understand and address the environmental ramifications of current and future levels of timber production. We explored the current understanding of these topics based on relevant literature and the possible implications of increased demand for forest products in the United States.

Early-Care and Education Teachers' Perception of High Quality Early-Care and Education Programming in Relation to Their Educational Attainment Level and Experience

ERIC Educational Resources Information Center

Bechtold, Joy Marie

2011-01-01

Early-care and education research, relative to positive outcomes for young children, birth through age five, enrolled in high quality early-care and education programs is compelling. This same research also names the classroom teacher as pivotal in establishing and maintaining high quality within their classrooms and practices. Currently, within…

Security Personnel Practices and Policies in U.S. Hospitals: Findings From a National Survey.

PubMed

Schoenfisch, Ashley L; Pompeii, Lisa A

2016-06-27

Concerns of violence in hospitals warrant examination of current hospital security practices. Cross-sectional survey data were collected from members of a health care security and safety association to examine the type of personnel serving as security in hospitals, their policies and practices related to training and weapon/restraint tool carrying/use, and the broader context in which security personnel work to maintain staff and patient safety, with an emphasis on workplace violence prevention and mitigation. Data pertaining to 340 hospitals suggest security personnel were typically non-sworn officers directly employed (72%) by hospitals. Available tools included handcuffs (96%), batons (56%), oleoresin capsicum products (e.g., pepper spray; 52%), hand guns (52%), conducted electrical weapons (e.g., TASERs®; 47%), and K9 units (12%). Current workplace violence prevention policy components, as well as recommendations to improve hospital security practices, aligned with Occupational Safety and Health Administration guidelines. Comprehensive efforts to address the safety and effectiveness of hospital security personnel should consider security personnel's relationships with other hospital work groups and hospitals' focus on patients' safety and satisfaction. © 2016 The Author(s).

Evidence and resources to implement Pharmacogenetic Knowledge for Precision Medicine

PubMed Central

Caudle, Kelly E.; Gammal, Roseann S.; Whirl-Carrillo, Michelle; Hoffman, James M.; Relling, Mary V.; Klein, Teri E.

2016-01-01

Purpose Implementation of pharmacogenetics into clinical practice has been relatively slow despite substantial scientific progress over the last decade. One barrier that inhibits uptake of pharmacogenetics into routine clinical practice is the lack of knowledge of how to translate a genetic test into a clinical action based on current evidence. The purpose of this paper is to describe the current state of pharmacogenetic evidence and evidence-based resources that facilitate the uptake of pharmacogenetics into clinical practice. Summary Controversy exists over the required evidence threshold needed for routine clinical implementation of pharmacogenetics. Large randomized controlled trials are not clinically feasible or necessary for many pharmacogenetic applications. Online resources exist like the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Pharmacogenomics Knowledgebase (PharmGKB) that provide freely available, evidence-based resources that facilitate the translation of genetic laboratory test results into actionable prescribing recommendations for specific drugs. Conclusion Resources provided by organizations such as CPIC and PharmGKB that use standardized approaches to evaluate the literature and provide clinical guidance are essential for the implementation of pharmacogenetics into routine clinical practice. PMID:27864205

Significance chasing in research practice: causes, consequences and possible solutions.

PubMed

Ware, Jennifer J; Munafò, Marcus R

2015-01-01

The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives which, in turn, can misdirect research effort and waste money. We review factors that may contribute to poor study reproducibility and an excess of 'significant' findings within the published literature. Specifically, we consider the influence of current incentive structures and the impact of these on research practices. The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g. unplanned post-hoc tests) to the calculated and serious (e.g. fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasize the research question and study design, rather than the results obtained. This has the potential to minimize significance chasing and non-publication of null findings. Significance chasing, questionable research practices and poor study reproducibility are the unfortunate consequence of a 'publish or perish' culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g. funders and journals) will be required to address problems of poor reproducibility. © 2014 Society for the Study of Addiction.

Significance chasing in research practice: Causes, consequences, and possible solutions

PubMed Central

Ware, Jennifer J.; Munafò, Marcus R.

2016-01-01

Background and Aims The low reproducibility of findings within the scientific literature is a growing concern. This may be due to many findings being false positives, which in turn can misdirect research effort and waste money. Methods We review factors that may contribute to poor study reproducibility and an excess of ‘significant’ findings within the published literature. Specifically, we consider the influence of current incentive structures, and the impact of these on research practices. Results The prevalence of false positives within the literature may be attributable to a number of questionable research practices, ranging from the relatively innocent and minor (e.g., unplanned post hoc tests), to the calculated and serious (e.g., fabrication of data). These practices may be driven by current incentive structures (e.g. pressure to publish), alongside the preferential emphasis placed by journals on novelty over veracity. There are a number of potential solutions to poor reproducibility, such as new publishing formats that emphasise the research question and study design, rather than the results obtained. This has the potential to minimise significance chasing and non-publication of null findings. Conclusions Significance chasing, questionable research practices, and poor study reproducibility are the unfortunate consequence of a “publish or perish” culture and a preference among journals for novel findings. It is likely that top-down change implemented by those with the ability to modify current incentive structure (e.g., funders and journals) will be required to address problems of poor reproducibility. PMID:25040652

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2018-03-01

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.

Defensive medicine among obstetricians and gynaecologists in Turkey.

PubMed

Küçük, Mert

2018-02-01

In recent years, there has been a remarkable increase in medical malpractice litigations against OB/GYNs in Turkey and globally. This high litigation atmosphere may have changed attitudes, behaviour and practice of OB/GYNs. In the current study, opinions and attitudes of OB/GYNs regarding defensive medicine and to what extent they practice it were investigated. One hundred and eight OB/GYNs participated in the study. All participants found obstetrics and gynaecology riskier when compared with other medical branches and reported that they were increasingly practising defensive medicine. The majority of the OB/GYNs stated that they abstained from many risky interventions and expressed their belief that the high caesarean section (C-section) rate was associated with medico-legal concerns. The majority of the participants supported enacting of a specific medical malpractice law and supported the establishment of medically specialised courts. These regulations demanded by OB/GYNs should be taken into account by health authorities. Impact statement What is already known on this subject: In recent years, there has been a remarkable increase in medical malpractice litigations against OB/GYNs in Turkey and globally. Turkey has serious problems with the high C-section rate, which has been suggested to be related to medicolegal issues in a previous research. Fifty-one percent of babies, namely most of them, are delivered via C-section. There is no specific medical malpractice law and medically specialised court in Turkey. What the results of this study add: It seems like there is a professional liability crisis among OB/GYNs in Turkey. OB/GYNs reported that they were increasingly practising defensive medicine, and stated that they abstained from many risky interventions. A high C-section rate was found to be related to medicolegal concerns in OB/GYNs' perspective in the current study. OB/GYNs demanded some reasonable regulations. What the implications are of these findings for clinical practice and/or further research: Regulations demanded by OB/GYNs, which were probed in the current study, such as enacting a specific medical malpractice law and establishment of a medically specialised court, should be taken into account by health authorities in Turkey. The findings of the current study is believed to produce important results for the success of Health transformation programme put into practice in Turkey, which was not able to stop increasing C-section rates. Studies evaluating the direct or indirect costs related to defensive medicine practices of OB/GYNs in Turkey should be performed in subsequent research.

76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

...] Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' FDA has... consistent with FDA's good guidance practices regulation (21 CFR 10.115). The guidance represents the Agency...

21 CFR 129.1 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

Nutritional requirements and assessing nutritional status in camelids.

PubMed

Van Saun, Robert J

2009-07-01

It has been nearly 30 years since the first imported llamas and alpacas have been commercially raised in the United States. Nutritional requirements for these animals have not been well understood and most feeding practices were based on extrapolated and experiential information. Only recently has a National Research Council committee reviewed the available published information relative to nutrient requirements of llamas and alpacas. This article summarizes current nutrient requirement recommendations and provides some practical feeding recommendations and methods to assess nutritional status.

Response to: Practice of first aid in burn related injuries in a developing country.

PubMed

Baker, Benjamin; Amin, Kavit; Khor, Wee Sim; Khwaja, Nadeem

2015-12-01

Traditional remedies for burns first aid are rarely compliant with current best practice. Greater Manchester is one of the most ethnically diverse regions in the UK. Our burns centre has noted the prevalent use of traditional remedies over recognised first aid prior to presentation. We review traditional burns remedies and highlight the importance of burns first aid education that is accessible to migrant communities. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Food consumption by young children: a function of parental feeding goals and practices.

PubMed

Kiefner-Burmeister, Allison E; Hoffmann, Debra A; Meers, Molly R; Koball, Afton M; Musher-Eizenman, Dara R

2014-03-01

Staggering health implications are associated with poor child diet. Given the importance of parents in impacting children's eating outcomes, the current study examined a theoretical framework in which both parental feeding goals and practices impact specific healthy and unhealthy child eating behaviors. Participants were 171 mothers of 3-6year old children who were diverse both socioeconomically and with regard to BMI. Mothers completed questionnaires via Mechanical Turk, an online workforce through Amazon.com. Structural Equation Modeling showed an adequate model fit in which Negative Feeding Practices (e.g., using food as a reward) mediated the relationship between Health-Related Feeding Goals (i.e., feeding children with health-oriented goals in mind) and Negative Eating Behaviors (e.g., consumption of candy and snacks). However, Negative Feeding Practices did not mediate the relationship between Health-Related Feeding Goals and Positive Eating Behaviors (i.e., fruits and vegetables). These findings suggest the important role of habitual food parenting practices in children's eating and have implications for parental health education programs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Shame as a Cultural Artifact: A Call for Self-Awareness and Reflexivity in Personality Assessment.

PubMed

Aschieri, Filippo

2016-01-01

It has become common for assessors to face therapeutic impasses and dilemmas when practicing within the Therapeutic Assessment (TA) model. This is due to the explicit goal of producing therapeutic changes in clients. In this article the author discusses the importance of assessors being aware of how their clinical practices relate to their assessment outcomes. To enhance such awareness, the author reviews the characteristics of psychological assessment practices as derived from 3 paradigms developed almost 1.5 centuries ago in Europe by the forefathers of psychology as a scientific discipline. Current assessment practices are deeply ingrained in specific cultural, social, and political frameworks originating in these paradigms. Being aware of such a historical and cultural background might help the assessor avoid blindly reenacting the values, norms, and latent relational schemas implied by different assessment methods, and instead use assessment tools as potent aids in the service of clients' change. Finally, the author illustrates how the experience of clients' shame in psychological assessment might also be understood as a by-product of the specific cultural and historical background of certain common assessment practices.

An exploration of role model influence on adult nursing students' professional development: A phenomenological research study.

PubMed

Felstead, Ian S; Springett, Kate

2016-02-01

Patients' expectations of being cared for by a nurse who is caring, competent, and professional are particularly pertinent in current health and social care practice. The current drive for NHS values-based recruitment serves to strengthen this. How nursing students' development of professionalism is shaped is not fully known, though it is acknowledged that their practice experience strongly shapes behaviour. This study (in 2013-14) explored twelve adult nursing students' lived experiences of role modelling through an interpretive phenomenological analysis approach, aiming to understand the impact on their development as professional practitioners. Clinical nurses influenced student development consistently. Some students reported that their experiences allowed them to learn how not to behave in practice; a productive learning experience despite content. Students also felt senior staff influence on their development to be strong, citing 'leading by example.' The impact of patients on student professional development was also a key finding. Through analysing information gained, identifying and educating practice-based mentors who are ready, willing, and able to role model professional attributes appear crucial to developing professionalism in nursing students. Those involved in nurse education, whether service providers or universities, may wish to acknowledge the influence of clinical nurse behaviour observed by students both independent of and in direct relation to care delivery and the impact on student nurse professional development. A corollary relates to how students should be guided and briefed/debriefed to work with a staff to ensure their exposure to a variety of practice behaviours. Copyright © 2015 Elsevier Ltd. All rights reserved.

Introduction of assistive devices: home nurses' practices and beliefs.

PubMed

Roelands, Marc; Van Oost, Paulette; Depoorter, Anne Marie; Buysse, Ann; Stevens, Veerle

2006-04-01

This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.

Patterns of cultural consensus and intracultural diversity in Ghanaian complementary feeding practices.

PubMed

Kalra, Nikhila; Pelto, Gretel; Tawiah, Charlotte; Zobrist, Stephanie; Milani, Peiman; Manu, Grace; Laar, Amos; Parker, Megan

2018-01-01

Designing effective interventions to improve infant and young child (IYC) feeding requires knowledge about determinants of current practices, including cultural factors. Current approaches to obtaining and using research on culture tend to assume cultural homogeneity within a population. The purpose of this study was to examine the extent of cultural consensus (homogeneity) in communities where interventions to improve IYC feeding practices are needed to address undernutrition during the period of complementary feeding. A second, related objective was to identify the nature of intracultural variation, if such variation was evident. Selected protocols from the Focused Ethnographic Study for Infant and Young Child Feeding Manual were administered to samples of key informants and caregivers in a peri-urban and a rural area in Brong-Ahafo, Ghana. Cultural domain analysis techniques (free listing, caregiver assessment of culturally significant dimensions, and food ratings on these dimensions), as well as open-ended questions with exploratory probing, were used to obtain data on beliefs and related practices. Results reveal generally high cultural consensus on the 5 dimensions that were assessed (healthiness, appeal, child acceptance, convenience, and modernity) for caregiver decisions and on their ratings of individual foods. However, thematic analysis of caregiver narratives indicates that the meanings and content of the constructs connoted by the dimensions differed widely among individual mothers. These findings suggest that research on cultural factors that affect IYC practices, particularly cultural beliefs, should consider the nature and extent of cultural consensus and intracultural diversity, rather than assuming cultural homogeneity. © 2017 John Wiley & Sons Ltd.

A survey of manufacturing and handling practices for monoclonal antibodies by pharmacy, nursing and medical personnel.

PubMed

Alexander, M; King, J; Lingaratnam, S; Byrne, J; MacMillan, K; Mollo, A; Kirsa, S; Green, M

2016-04-01

There is a paucity of data available to assess the occupational health and safety risk associated with exposure to monoclonal antibodies. Industry standards and published guidelines are conflicting or outdated. Guidelines offer contrary recommendations based on an array of methodological approaches. This survey aimed to describe current practices, beliefs and attitudes relating to the handling of monoclonal antibodies by Australian medical, nursing and pharmacy clinicians. An electronic survey was distributed between June and September 2013. Respondents were surveyed on three focus areas: institutional guideline availability and content, current practices and attitudes. Demographic data relating to respondent and primary place of practice were also collected. A total of 222 clinicians completed the survey, with representation from all targeted professional groups and from a variety of geographic locations. 92% of respondents reported that their institution prepared or administered monoclonal antibodies, with 87% specifically handling anti-cancer monoclonal antibodies. Monoclonal antibodies were mostly prepared onsite (84-90%) and mostly within pharmacy clean-rooms (75%) and using cytotoxic cabinets (61%). 43% of respondents reported access to institutional monoclonal antibody handling guidelines with risk reduction strategies including training and education (71%), spill and waste management (71%), procedures for transportation (57%) and restricted handling (50%). Nurses had a stronger preference towards pharmacy manufacturing than both doctors and pharmacists for a range of clinical scenarios. 95% of all respondents identified that professional or regulatory body guidelines are an important resource when considering handling practices. Monoclonal antibodies are most commonly handled according to cytotoxic drug standards and often in the absence of formal guidelines. © The Author(s) 2014.

Isolated Sub-Dehumidification Strategies in Large Supermarkets and Grocery Stores

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

Fricke, Brian A; Sharma, Vishaldeep

2011-10-01

The objective of this project was to determine the potential energy savings associated with reducing the relative humidity in the vicinity of refrigerated display cases in supermarkets, as compared to the widely accepted current practice of maintaining a relatively higher and uniform humidity level throughout the entire supermarket. Existing and new strategies for maintaining lower relative humidity levels near the vicinity of refrigerated display cases were analyzed to determine their effectiveness and limits of application.

Survey of expert practice and perceptions of the supporting clinical evidence for the management of uveitis-related cataract and cystoid macular oedema.

PubMed

Sreekantam, Sreekanth; Denniston, Alastair K O; Murray, Philip I

2011-10-01

To survey the practice of uveitis experts in the management of uveitic cataract and cystoid macular oedema (CMO). A structured questionnaire containing two clinical scenarios was sent to members of the International Uveitis Study Group (IUSG). The questionnaire surveyed both respondents' current practice and their perception of the supporting clinical evidence. For uveitic cataract, 70% required a 3-month inflammation-free period before surgery, and 76% gave a prophylactic preoperative systemic corticosteroid. For uveitic CMO, 87% gave corticosteroids, usually orally. Preferred second-line agents were methotrexate (39%), cyclosporin (24%), azathioprine (17%), and mycophenolate (7%). Respondents suggested the evidence underlying their decisions was either absent or relatively weak (levels III or IV), and in most cases personal experience was a factor. This survey highlights areas of consensus and variation among uveitis experts in managing uveitic cataract and CMO, and emphasizes the need for further clinical trials to establish the best practice.

A cost-effectiveness analysis comparing different strategies to implement noninvasive prenatal testing into a Down syndrome screening program.

PubMed

Ayres, Alice C; Whitty, Jennifer A; Ellwood, David A

2014-10-01

Currently, noninvasive prenatal testing (NIPT) is only recommended in high-risk women following conventional Down syndrome (DS) screening, and it has not yet been included in the Australian DS screening program. To evaluate the cost-effectiveness of different strategies of NIPT for DS screening in comparison with current practice. A decision-analytic approach modelled a theoretical cohort of 300,000 singleton pregnancies. The strategies compared were the following: current practice, NIPT as a second-tier investigation, NIPT only in women >35 years, NIPT only in women >40 years and NIPT for all women. The direct costs (low and high estimates) were derived using both health system costs and patient out-of-pocket expenses. The number of DS cases detected and procedure-related losses (PRL) were compared between strategies. The incremental cost per case detected was the primary measure of cost-effectiveness. Universal NIPT costs an additional $134,636,832 compared with current practice, but detects 123 more DS cases (at an incremental cost of $1,094,608 per case) and avoids 90 PRL. NIPT for women >40 years was the most cost-effective strategy, costing an incremental $81,199 per additional DS case detected and avoiding 95 PRL. The cost of NIPT needs to decrease significantly if it is to replace current practice on a purely cost-effectiveness basis. However, it may be beneficial to use NIPT as first-line screening in selected high-risk patients. Further evaluation is needed to consider the longer-term costs and benefits of screening. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

A qualitative investigation of specialist orthodontists in New Zealand. Part 1. Orthodontists and orthodontic practice.

PubMed

Soma, Kieran J; Thomson, W Murray; Morgaine, Kate C; Harding, Winifred J

2012-05-01

Current knowledge of orthodontic practice is largely anecdotal and the lack of systematic knowledge can create barriers to better identifying the factors that make a successful orthodontist. The aim of this study was to investigate the routine practising lives of New Zealand orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on their professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) throughout New Zealand.Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontists' was derived, and related themes were grouped under the sub-categories of: (a) NZ orthodontic specialist practice; (b) NZ specialist orthodontists; and (c) work-life balance. The present paper reports on the first two subcategories. Themes elucidated under the specialist practice sub-category included modernisation, changing social norms, practice arrangement, branch practice, staffing, competition, legislation, advertising, the future and the provision of orthodontics by non-specialists. Themes in the orthodontic specialist sub-category were prior experience, postgraduate training, recent graduates, reasons for specialising, generational differences, females in orthodontics, NZ and overseas practice, the ageing profession and the prospect of an orthodontist shortage. This investigation has shed light on orthodontists and the practice of orthodontics in New Zealand and determined aspects rarely discussed in the current or previous literature. It will be valuable to observe how orthodontists and orthodontic practice continue to evolve in response to changes in NZ society.

The prevalence of occupational health-related problems in dentistry: A review of the literature

PubMed Central

Naidoo, Saloshni; van Wyk, Jacqueline

2017-01-01

The study was conducted to report on the scope and prevalence of occupational health related-problems experienced by dentists, dental therapists, and oral hygienists in their practice of dentistry. Background: Professional practice and dental training have many risk factors, and the dental team should be able to recognize these factors to protect themselves. The prevalence of conditions related to the musculoskeletal system, stress, percutaneous injuries, ears, and eyes are of concern. The dental team should also not forget hepatitis B, hepatitis C, and HIV as risks in practice. Dental practitioners should protect themselves by self-recognizing risk factors and by maintaining proper working conditions. Methods: The study targeted all empirical research, case studies, and systematic literature reviews written in English. All articles selected were subjected to a data analysis process. Data were captured on an Excel spreadsheet and reported in a comprehensive table. Results: The literature addressing occupational health among dental practitioners included mainly cross-sectional studies and review papers (2001-2016). Forty-nine studies were included in the review. Musculoskeletal disorders remain the most researched occupational health-related problems in dentistry. Eye protection compliance was low among practitioners. Percutaneous injuries especially among young dentists and students were still a concern. Conclusion: Occupational health-related problems are still prevalent in current dentistry practice, despite changes in equipment and surgery design. The reported prevalence of occupational related-health problems and other findings of investigative studies highlight the need for continuous professional education and a need to improve clinical practice aspects of dentistry curricula. PMID:29213011

Knowledge, Practices and Attitudes Towards Adverse Drug Reaction Reporting by Private Practitioners from Klang Valley in Malaysia

PubMed Central

Agarwal, Renu; Daher, Aqil Mohammad; Mohd Ismail, Nafeeza

2013-01-01

Background: The study aimed to determine current status of knowledge, practices, and attitudes towards adverse drug reaction (ADR) reporting among private practitioners in Klang region of Malaysia. Methods: A total of 238 private practitioners in Klang valley were distributed a questionnaire consisting of seven questions, two knowledge-related, two practice-related and three attitude-related. Each favourable and unfavourable response was given a score of 1 and 0 respectively. Total score of 70% or more for each domain was considered “satisfactory” whereas less than 70% as “unsatisfactory”. Results: One hundred forty-five participants completed questionnaire. Knowledge assessment showed 83.4% responses stating that ADR reporting helps to identify safe drugs and 91.7% responded that it measures ADR incidence. Regarding practices, 76.6% respondents were willing to report only if confident that reaction is an ADR. Regarding attitudes, 81.9%, 66.9% and 23.5% participants showed complacency, ignorance, and indifference respectively. Unsatisfactory knowledge, practices, and attitudes were observed in 57.2%, 56.6%, and 73.1% respondents respectively. Satisfactory knowledge was significantly higher in respondent with higher qualification with odds ratio of 2.96 with 95% confidence interval of 1.48–5.93. Conclusion: The study showed unsatisfactory level of knowledge, practices, and attitudes towards ADR reporting among high proportion of private practitioners in Klang valley, Malaysia. PMID:23983578

75 FR 52627 - Disenrollment Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... program that has been discontinued. It also amends the regulation to reflect current VA practice and to... conform with current VA practice, which does not disenroll veterans based on their failure to file VA Form 10-10EZ. Current practice is reflected in current paragraph (d)(3)(iv). Removing paragraph (d)(5)(iii...

The national sports safety in secondary schools benchmark (N4SB) study: defining athletic training practice characteristics.

PubMed

McLeod, Tamara C Valovich; Bliven, Kellie C Huxel; Lam, Kenneth C; Bay, R Curtis; Valier, Alison R Snyder; Parsons, John T

2013-01-01

Increased rates of sport participation and sport-related injury have led to greater emphasis on and attention to medical care of student-athletes in the secondary school setting. Access to athletic training services is seen as a critical factor for delivering adequate injury prevention and medical care to student-athletes. However, few data are available regarding practice characteristics of athletic trainers (ATs) in this setting. To characterize the practices of secondary school athletic trainers (ATs). Descriptive study. Web-based survey. A total of 17 558 ATs with current National Athletic Trainers' Association membership were identified for survey distribution. Of these, 4232 ATs indicated that they practiced in the secondary school setting, and 4045 completed some part of the survey. A Web-based survey was used to obtain demographic information about ATs and their secondary schools and characteristics of athletic training practice. Descriptive data regarding the athletic trainer's personal characteristics, secondary school characteristics, and practice patterns are reported as percentages and frequencies. Most respondents were in the early stages of their careers and relatively new to the secondary school practice setting. Nearly two-thirds (62.4%; n = 2522) of respondents had 10 or fewer years of experience as secondary school ATs, 52% (n = 2132) had been certified for 10 or fewer years, and 53.4% (n = 2164) had 10 or fewer years of experience in any practice setting. The majority of respondents (85%) worked in public schools with enrollment of 1000 to 1999 (35.5%) and with football (95.5%). More than half of respondents were employed directly by their school. Most respondents (50.6%) reported an athletic training budget of less than $4000. The majority of ATs performed evaluations (87.5%) on-site all of the time, with a smaller percentage providing treatments (73.3%) or rehabilitation (47.4%) services all of the time. This is the first study to describe secondary school athletic training that reflects national practice trends. To improve the quality of athletic training care and to support and improve current working conditions, the profession must examine how its members practice on a day-to-day basis.

Advancing Kinesiology through Improved Peer Review

ERIC Educational Resources Information Center

Knudson, Duane V.; Morrow, James R., Jr.; Thomas, Jerry R.

2014-01-01

Peer review of scholarship is essential to journal quality, evidence, knowledge advancement, and application of that knowledge in any field. This commentary summarizes recent literature on issues related to peer-review quality and current review practice in kinesiology and provides recommendations to improve peer review in kinesiology journals. We…

Myths about Technology-Supported Professional Learning

ERIC Educational Resources Information Center

Killion, Joellen; Treacy, Barbara

2014-01-01

The future of professional learning is shaped by its present and past. As new technologies emerge to increase affordability, access, and appropriateness of professional learning, three beliefs are visible in current practices related to online learning. Each contains a premise that merits identification and examination. The authors call these…

Current knowledge and practices related to seed transmission of sugarcane pathogens and movement of seed

USDA-ARS?s Scientific Manuscript database

Sugarcane breeding programs benefit from sharing genetic resources. Traditionally, this has been accomplished by exchanging vegetative planting material of clones of interest. Diseases can spread during this process, and quarantines were established to enable continued sharing of germplasm while min...

Distinguishing between Poor/Dysfunctional Parenting and Child Emotional Maltreatment

ERIC Educational Resources Information Center

Wolfe, David A.; McIsaac, Caroline

2011-01-01

Objective: This paper was intended to distinguish between poor parenting and child emotional maltreatment (CEM), to inform child welfare and public health policymakers of the need for differentiated responses. Methods: Scientific literature was integrated with current practice and assumptions relating to poor/dysfunctional parenting and child…

Cognitive Neuroscience Discoveries and Educational Practices

ERIC Educational Resources Information Center

Sylwester, Robert

2006-01-01

In this article, the author describes seven movement-related areas of cognitive neuroscience research that will play key roles in shifting the current behavioral orientation of teaching and learning to an orientation that also incorporates cognitive neuroscience discoveries. These areas of brain research include: (1) mirroring system; (2) plastic…

Identifying Specific Learning Disabilities: Legislation, Regulation, and Court Decisions

ERIC Educational Resources Information Center

Zumeta, Rebecca O.; Zirkel, Perry A.; Danielson, Louis

2014-01-01

Specific learning disability (SLD) identification and eligibility practices are evolving and sometimes contentious. This article describes the historical context and current status of the SLD definition, legislation, regulation, and case law related to the identification of students eligible for special education services. The first part traces…

Examining Teacher Ethical Dilemmas in Classroom Assessment

ERIC Educational Resources Information Center

Pope, Nakia; Green, Susan K.; Johnson, Robert L.; Mitchell, Mark

2009-01-01

The current spotlight on assessment in education raises ethical issues as practices evolve. This study documents ethical conflicts faced by teachers in the United States regarding assessment of students. Critical incidents generated by practising teachers revealed a majority of reported conflicts related to score pollution, and conflicts…

Academic and Vocational Integration. Myths and Realities.

ERIC Educational Resources Information Center

Brown, Bettina Lankard

This newsletter attempts to clarify the importance of academic and vocational integration in relation to emerging pedagogy, teaching and learning practices, and school-to-work efforts. One misconception about academic-vocational integration is that new theories overshadow its value. However, current research on teaching and learning supports a…

Nutrition in the Curriculum: Medical Experience.

ERIC Educational Resources Information Center

Shils, Maurice E.

1990-01-01

A review of current curricula in United States medical schools indicates a continued need for more adequate instruction of clinical nutrition to physicians in training and in practice. A major problem is failure to provide patient-oriented, case-related teaching in clinical years to all clinical clerks. (Author/MSE)

22 CFR 1701.110 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Self-evaluation. 1701.110 Section 1701.110...-evaluation. (a) The agency shall, by November 28, 1994, evaluate its current policies and practices, and the... handicaps or organizations representing individuals with handicaps, to participate in the self-evaluation...

"Paideia," Then and Now.

ERIC Educational Resources Information Center

Keppel, Francis

1990-01-01

Discusses two widely practiced principles of management (protecting the rear and knowing the limits of a job) as they relate to the philosophy of education. The article examines Werner Jaeger's definition of education in his 1939 book, "Paideia," as well as other definitions that have helped shape current educational management. (SM)

Sequence skill learning in persons who stutter: implications for cortico-striato-thalamo-cortical dysfunction.

PubMed

Smits-Bandstra, Sarah; De Nil, Luc F

2007-01-01

The basal ganglia and cortico-striato-thalamo-cortical connections are known to play a critical role in sequence skill learning and increasing automaticity over practice. The current paper reviews four studies comparing the sequence skill learning and the transition to automaticity of persons who stutter (PWS) and fluent speakers (PNS) over practice. Studies One and Two found PWS to have poor finger tap sequencing skill and nonsense syllable sequencing skill after practice, and on retention and transfer tests relative to PNS. Studies Three and Four found PWS to be significantly less accurate and/or significantly slower after practice on dual tasks requiring concurrent sequencing and colour recognition over practice relative to PNS. Evidence of PWS' deficits in sequence skill learning and automaticity development support the hypothesis that dysfunction in cortico-striato-thalamo-cortical connections may be one etiological component in the development and maintenance of stuttering. As a result of this activity, the reader will: (1) be able to articulate the research regarding the basal ganglia system relating to sequence skill learning; (2) be able to summarize the research on stuttering with indications of sequence skill learning deficits; and (3) be able to discuss basal ganglia mechanisms with relevance for theory of stuttering.

Psychotherapy, psychopathology, research and practice: pathways of connections and integration.

PubMed

Castonguay, Louis G

2011-03-01

This paper describes three pathways of connections between different communities of knowledge seekers: integration of psychotherapeutic approaches, integration of psychotherapy and psychopathology, and integration of science and practice. Some of the issues discussed involve the delineation and investigation of common factors (e.g., principles of change), improvement of major forms of psychotherapy, clinical implications of psychopathology research, as well as current and future directions related to practice-research networks. The aim of this paper is to suggest that building bridges across theoretical orientations, scientific fields, professional experiences, and epistemological views may be a fruitful strategy to improve our understanding and the impact of psychotherapy.

Three common faults in current practice that influence the validity of data obtained from electronic air pollution instrumentation.

PubMed

Dowd, G; Thomas, R S; Monkman, J L

1975-01-01

Instrumental development is now entering a more logical era, where the former artistic character of electronics is being replaced by cold technology. Because of this, one should be expect more reliability; however, there still exist many weak links in practical application. Digital readout systems and computer processing induce a false sense of security. In reality, it is the sample-measurement relationship that determines an instrument's credibility and not the number of digits on its meter. In describing three faulty practices that greatly influence an instrument's performance, it is hoped that measurement may be more closely related to the sample!

The pregnancy that doesn't stay: the practice and perception of abortion by Ekiti Yoruba women.

PubMed

Renne, E P

1996-02-01

Ekiti Yoruba village women in southwest Nigeria make use of traditional and 'patent' medicines as abortifacients as well as D&Cs performed in urban centers to terminate unwanted pregnancies. This paper examines present day abortion practices and attitudes and relates them to traditional beliefs about conception, fetal development and infertility. These beliefs, along with factors of economy and access, help to explain the continued use of abortion as a form of birth control, despite the presence of other options. The paper concludes with a discussion of the current debate about legalizing abortion in Nigeria and a recommendation consonant with everyday village practice.

Lightweight, Room-Temperature CO2 Gas Sensor Based on Rare-Earth Metal-Free Composites-An Impedance Study.

PubMed

Willa, Christoph; Schmid, Alexander; Briand, Danick; Yuan, Jiayin; Koziej, Dorota

2017-08-02

We report a light, flexible, and low-power poly(ionic liquid)/alumina composite CO 2 sensor. We monitor the direct-current resistance changes as a function of CO 2 concentration and relative humidity and demonstrate fast and reversible sensing kinetics. Moreover, on the basis of the alternating-current impedance measurements we propose a sensing mechanism related to proton conduction and gas diffusion. The findings presented herein will promote the development of organic/inorganic composite CO 2 gas sensors. In the future, such sensors will be useful for numerous practical applications ranging from indoor air quality control to the monitoring of manufacturing processes.

Preservice Science Teachers' Informal Reasoning about Socioscientific Issues: The influence of issue context

NASA Astrophysics Data System (ADS)

Sami Topcu, Mustafa; Sadler, Troy D.; Yilmaz-Tuzun, Ozgul

2010-12-01

The purpose of the current study is to explicitly test the extent to which issue contexts affect the informal reasoning processes engaged in by individuals. In order to address the research question framing this study, we engaged 39 Turkish preservice science teachers (PSTs) in interviews designed to elicit argumentation related to multiple socioscientific scenarios. Three scenarios related to gene therapy, another three related to human cloning, and the final scenario related to global warming. The data were analyzed using an interpretive qualitative research approach. Our work builds on a framework initially proposed by Toulmin in 1958. This study has provided new evidence related to informal reasoning in the context of socioscientific issues (SSI). At the sample level, there was strong consistency in informal reasoning quality among varying socioscientific scenarios. However, finer-grained analyses indicated a greater level of variability in the informal reasoning practices of individual PSTs. These results support previous conclusions that suggest context dependence for informal reasoning related to SSI. This study provides an initial picture of the reasoning practices of preservice teachers as opposed to science learners. The results indicate that teachers, at least those in this Turkish setting, would benefit from learning experiences that support their own informal reasoning practices as well as their ability to foster development of these practices among their students. We encourage the field to continue the investigation of SSI as contexts for education particularly as it relates to the education of teachers.

21 CFR 113.5 - Current good manufacturing practice.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10, 113.40..., methods, practices, and controls used by the commercial processor in the manufacture, processing, or...

Integration of simulation in postgraduate studies in Saudi Arabia: The current practice in anesthesia training program

PubMed Central

Arab, Abeer; Alatassi, Abdulaleem; Alattas, Elias; Alzoraigi, Usamah; AlZaher, Zaki; Ahmad, Abdulaziz; Albabtain, Hesham; Boker, Abdulaziz

2017-01-01

The educational programs in the Saudi Commission for Health Specialties are developing rapidly in the fields of technical development. Such development is witnessed, particularly in the scientific areas related to what is commonly known as evidence-based medicine. This review highlights the critical need and importance of integrating simulation into anesthesia training and assessment. Furthermore, it describes the current utilization of simulation in anesthesia and critical care assessment process. PMID:28442961

Physicians' Current Practices and Opportunities for DNA Banking of Dying Patients With Cancer

PubMed Central

Quillin, John M.; Bodurtha, Joann N.; Siminoff, Laura A.; Smith, Thomas J.

2011-01-01

Purpose: The availability of genetic tests for cancer susceptibility is increasing. Current tests, however, have limited clinical sensitivity. Even when clinically valid tests are available, the genetic counseling and informed consent process might not be feasible for dying patients with cancer. DNA banking preserves the opportunity for future research or clinical testing and may provide critical opportunities for surviving relatives. This study explored the current practices and potential for DNA banking for cancer susceptibility among oncologists specializing in palliative care. Methods: Palliative care oncologists actively providing clinical care for dying patients with cancer were recruited for an online survey. Descriptive statistics for DNA banking practices, perceived qualification to recommend banking, and potential predictors were assessed. Results: Data were collected from 49 physicians (37% recruitment rate). Eighty percent reported assessing at least some patients for genetic cancer susceptibility in the past 12 months. No participants reported banking DNA for patients in the past 12 months. Only 5% reported feeling at least somewhat qualified to order DNA banking. A Web-based risk assessment tool and genetic counselor on staff were perceived as the most helpful potential resources. Conclusion: Despite its potential, DNA banking is not being used by palliative care oncologists. PMID:21886501

The effects of amount of home meditation practice in Mindfulness Based Cognitive Therapy on hazard of relapse to depression in the Staying Well after Depression Trial.

PubMed

Crane, Catherine; Crane, Rebecca S; Eames, Catrin; Fennell, Melanie J V; Silverton, Sarah; Williams, J Mark G; Barnhofer, Thorsten

2014-12-01

Few empirical studies have explored the associations between formal and informal mindfulness home practice and outcome in Mindfulness-based Cognitive Therapy (MBCT). In this study ninety-nine participants randomised to MBCT in a multi-centre randomised controlled trial completed self-reported ratings of home practice over 7 treatment weeks. Recurrence of Major Depression was assessed immediately after treatment, and at 3, 6, 9, and 12-months post-treatment. Results identified a significant association between mean daily duration of formal home practice and outcome and additionally indicated that participants who reported that they engaged in formal home practice on at least 3 days a week during the treatment phase were almost half as likely to relapse as those who reported fewer days of formal practice. These associations were independent of the potentially confounding variable of participant-rated treatment plausibility. The current study identified no significant association between informal home practice and outcome, although this may relate to the inherent difficulties in quantifying informal home mindfulness practice. These findings have important implications for clinicians discussing mindfulness-based interventions with their participants, in particular in relation to MBCT, where the amount of participant engagement in home practice appears to have a significant positive impact on outcome. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hydration and Cooling Practices Among Farmworkers in Oregon and Washington

PubMed Central

Bethel, Jeffrey W.; Spector, June T.; Krenz, Jennifer

2018-01-01

Objectives Although recommendations for preventing occupational heat-related illness among farmworkers include hydration and cooling practices, the extent to which these recommendations are universally practiced is unknown. The objective of this analysis was to compare hydration and cooling practices between farmworkers in Oregon and Washington. Methods A survey was administered to a purposive sample of Oregon and Washington farmworkers. Data collected included demographics, work history and current work practices, hydration practices, access and use of cooling measures, and headwear and clothing worn. Results Oregon farmworkers were more likely than those in Washington to consume beverages containing sugar and/or caffeine. Workers in Oregon more frequently reported using various cooling measures compared with workers in Washington. Availability of cooling measures also varied between the two states. Conclusions These results highlight the large variability between workers in two states regarding access to and use of methods to stay cool while working in the heat. PMID:28402203

Hydration and Cooling Practices Among Farmworkers in Oregon and Washington.

PubMed

Bethel, Jeffrey W; Spector, June T; Krenz, Jennifer

2017-01-01

Although recommendations for preventing occupational heat-related illness among farmworkers include hydration and cooling practices, the extent to which these recommendations are universally practiced is unknown. The objective of this analysis was to compare hydration and cooling practices between farmworkers in Oregon and Washington. A survey was administered to a purposive sample of Oregon and Washington farmworkers. Data collected included demographics, work history and current work practices, hydration practices, access and use of cooling measures, and headwear and clothing worn. Oregon farmworkers were more likely than those in Washington to consume beverages containing sugar and/or caffeine. Workers in Oregon more frequently reported using various cooling measures compared with workers in Washington. Availability of cooling measures also varied between the two states. These results highlight the large variability between workers in two states regarding access to and use of methods to stay cool while working in the heat.

Primary Care Physicians' Beliefs and Practices Regarding E-Cigarette Use by Patients Who Smoke: A Qualitative Assessment.

PubMed

El-Shahawy, Omar; Brown, Richard; Elston Lafata, Jennifer

2016-04-26

We explored primary care physicians' (PCPs') beliefs and practices about e-cigarettes. Cross-sectional, semi-structured interviews with PCPs in 2014 were conducted and audio-recorded. Participants were 15 general internal and family medicine physicians practicing in two settings in Virginia, USA. Interview recordings were transcribed, and the content analyzed using the Constant Comparative Method to identify key themes regarding PCPs' reported current practices and beliefs. Five themes were identified: (1) existing clinic processes do not include mechanisms to screen for noncombustible tobacco products (such as e-cigarettes); (2) e-cigarette discussions are becoming commonplace with patients initiating the discussions and seeking physician guidance regarding e-cigarette use; (3) a lack of knowledge regarding the potential harms and benefits of e-cigarettes, yet a willingness to support their patients' desire to use e-cigarettes (4) believing e-cigarettes are a safer alternative to smoking combustible tobacco products; and (5) abandoning concerns regarding the potential harms of e-cigarettes in the context of highly addicted patients and those with extensive comorbidities. Despite acknowledging limited knowledge regarding e-cigarettes, findings suggest that some PCPs are currently recommending e-cigarettes to their patients for smoking cessation and relative harm reduction, often personalizing recommendations based on the patient's perceived addiction level and current health status. Physicians need to be informed about the evolving evidence regarding the risks and benefits of e-cigarettes.

Pharmacologic management of asymptomatic bacteriuria and urinary tract infections in women.

PubMed

O'Dell, Katharine K

2011-01-01

Many factors influence the decision to institute treatment for the common problems of urinary tract symptoms and/or the presence of microorganisms in the urine of women. This article summarizes current evidence related to treatment choice and compares selected treatment practice guidelines. Evidence related to prevention of recurrent infection without the use of antibiotics is included. © 2011 by the American College of Nurse-Midwives.

76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... CDC-2011-0008] Assessing the Current Research, Policy, and Practice Environment in Public Health... information helpful to assess the current research, policy, and practice environment in public health genomics. HHS/CDC is currently leading a process to assess the most important steps for public health genomics...

Maternal representations of their children in relation to feeding beliefs and practices among low-income mothers of young children.

PubMed

Leung, Christy Y Y; Miller, Alison L; Lumeng, Julie C; Kaciroti, Niko A; Rosenblum, Katherine L

2015-12-01

Identifying maternal characteristics in relation to child feeding is important for addressing the current childhood obesity epidemic. The present study examines whether maternal representations of their children are associated with feeding beliefs and practices. Maternal representations refer to mothers' affective and cognitive perspectives regarding their children and their subjective experiences of their relationships with their children. This key maternal characteristic has not been examined in association with maternal feeding. Thus the purpose of the current study was to examine whether maternal representations of their children, reflected by Working Model of the Child Interview typologies (Balanced, Disengaged, or Distorted), were associated with maternal feeding beliefs (Authority, Confidence, and Investment) and practices (Pressure to Eat, Restriction, and Monitoring) among low-income mothers of young children, with maternal education examined as a covariate. Results showed that Balanced mothers were most likely to demonstrate high authority, Distorted mothers were least likely to demonstrate confidence, and Disengaged mothers were least likely to demonstrate investment in child feeding. Moreover, Balanced mothers were least likely to pressure their children to eat. Findings are discussed with regard to implications for the study of childhood obesity and for applied preventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Holistic Nursing in the Genetic/Genomic Era.

PubMed

Sharoff, Leighsa

2016-06-01

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base. © The Author(s) 2015.

Reducing the Shared Burden of Chronic Conditions among Persons Aging with Disability and Older Adults in the United States through Bridging Aging and Disability

PubMed Central

Campbell, Margaret L.; Putnam, Michelle

2017-01-01

Persons aging with long-term disabilities such as spinal cord injury or multiple sclerosis and older adults share similar chronic conditions in mid and later life in the United States. The rising general interest and more prevalent federal requirements for use of evidence-based practices (EBP) in health promotion and chronic condition interventions highlight the gap between demand and the availability of EBPs for persons aging with disability in particular. Addressing this gap will require focused efforts that will benefit substantially by bridging the fields of aging and disability/rehabilitation to develop new EBPs, translate existing EBPs across populations, and borrow best practices across fields where there are few current EBPs. Understanding distinctions between disability-related secondary conditions and age-related chronic conditions is a first step in identifying shared conditions that are important to address for both mid-life and older adults with disabilities. This review articulates these distinctions, describes shared conditions, and discusses the current lack of EBPs for both populations. It also provides recommendations for bridging activities in the United States by researchers, professionals, and consumer advocates. We argue that these can more efficiently move research and practice than if activities were undertaken separately in each field (aging and disability/rehabilitation). PMID:28895898

Grappling with the Literature of Education Research and Practice

PubMed Central

2007-01-01

The absence of a central database and use of specialized language hinder nonexperts in becoming familiar with the science teaching and learning literature and using it to inform their work. The challenge of locating articles related to a specific question or problem, coupled with the difficulty of comprehending findings based on a variety of different perspectives and practices, can be prohibitively difficult. As I have transitioned from bench to classroom-based research, I have become familiar with how to locate, decipher, and evaluate the education research literature. In this essay, I point out analogies to the literature of science research and practice, and I reference some of the literature that I have found useful in becoming an education researcher. I also introduce a new regular feature, “Current Insights: Recent Research in Science Teaching and Learning,” which is designed to point CBE—Life Sciences Education (CBE-LSE) readers to current articles of interest in life sciences education, as well as more general and noteworthy publications in education research. PMID:18056300

Grappling with the literature of education research and practice.

PubMed

Dolan, Erin L

2007-01-01

The absence of a central database and use of specialized language hinder nonexperts in becoming familiar with the science teaching and learning literature and using it to inform their work. The challenge of locating articles related to a specific question or problem, coupled with the difficulty of comprehending findings based on a variety of different perspectives and practices, can be prohibitively difficult. As I have transitioned from bench to classroom-based research, I have become familiar with how to locate, decipher, and evaluate the education research literature. In this essay, I point out analogies to the literature of science research and practice, and I reference some of the literature that I have found useful in becoming an education researcher. I also introduce a new regular feature, "Current Insights: Recent Research in Science Teaching and Learning," which is designed to point CBE--Life Sciences Education (CBE-LSE) readers to current articles of interest in life sciences education, as well as more general and noteworthy publications in education research.

Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

PubMed

Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

2018-05-01

Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

On the optimal degree of fluctuations in practice for motor learning.

PubMed

Hossner, Ernst-Joachim; Käch, Boris; Enz, Jonas

2016-06-01

In human movement science, it is widely accepted that random practice generally enhances complex motor-skill learning compared to repetitive practice. In two experiments, a particular variability-related concept is put to empirical test, namely the concept of differencial learning (DL), which assumes (i) that learners should not be distracted from task-space exploration by corrections, and (ii) that learning is facilitated by large inter-trial fluctuations. In both experiments, the advantage of DL over repetitive learning was not statistically significant. Moreover, learning was more pronounced when participants either received corrections in addition to DL (Exp. 1) or practiced in an order in which differences between consecutive trials were relatively small (Exp. 2). These findings suggest that the positive DL effects reported in literature cannot be attributed to the reduction of feedback or to the increase of inter-trial fluctuations. These results are discussed in the light of the structural-learning approach and the two-state model of motor learning in which structure-related learning effects are distinguished from the capability to adapt to current changes. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Current trends in lifestyle-related disease management by general practitioners: a report from the "Heart Care Network" groups.

PubMed

2009-01-01

In Japan, it is believed that guidelines for lifestyle-related disease are used in routine clinical practice, however, there are few reports on the actual rate of healthcare conducted in accordance with these guidelines by general practitioners and on their usefulness in preventing cardiovascular events. Therefore, the Heart Care Network (HCN) groups were organized mainly by general practitioners treating lifestyle diseases in 62 areas of Japan. The HCN has collected data on lifestyle diseases in high-risk patients in routine practices and investigated management conditions, guideline target achievement rates and medication. Additionally, the incidence of cardiovascular events was assessed. We analyzed 14,064 cases. The lipid profile, blood pressure, glycemic control were significantly improved over the 3 years. The incidence of cardiovascular events were significantly reduced by the achievement of target LDL cholesterol, systolic blood pressure and hemoglobin A1c and even after adjustment for age, gender, history of myocardial infarction, the reduction of these lifestyle-related parameters remains significant. These results revealed the current trends in the healthcare activities of general practitioners, the management conditions for lifestyle diseases in CHD high-risk patients and their effects on reducing cardiovascular events.

Managing Asthma in Elementary and Middle Schools: Adherence to Federal Laws and National Guidelines

ERIC Educational Resources Information Center

Schilling, Ethan J.; Neuharth-Pritchett, Stacey; Getch, Yvette Q.; Lease, A. Michele

2017-01-01

The current study examined teacher-reported asthma management practices in school and adherence to federal guidelines for students with asthma. 593 kindergarten-eighth grade teachers completed surveys regarding compliance with federal laws and policies, information-seeking behavior, asthma-related professional development, and asthma management…

12 CFR 226.35 - Prohibited acts or practices in connection with higher-priced mortgage loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., and other loan pricing terms currently offered to consumers by a representative sample of creditors for mortgage transactions that have low-risk pricing characteristics. The Board publishes average... and premiums for mortgage-related insurance required by the creditor, such as insurance against loss...

Study of recidivism rates among drivers administratively sanctioned by the New Jersey motor vehicle commission : final report, December 2009.

DOT National Transportation Integrated Search

2009-12-01

The purpose of this study was to examine the current state of practice related to driver improvement countermeasures : used in the United States and to assess the effectiveness of New Jerseys negligent driver interventions. As part of the : study,...

Sexual Health and Canadian Youth: How Do We Measure Up?

ERIC Educational Resources Information Center

Maticka-Tyndale, Eleanor

2001-01-01

Assesses the current sexual health status of Canadian youth in relation to sexually transmitted diseases, pregnancy rates, and sexual practices, discussing the social and historical context of adolescence and adolescent sexuality in Canada. The paper draws insights from international comparisons of adolescent sexual health indicators and discusses…

Practicality of Evaluating Soft Errors in Commercial sub-90 nm CMOS for Space Applications

NASA Technical Reports Server (NTRS)

Pellish, Jonathan A.; LaBel, Kenneth A.

2010-01-01

The purpose of this presentation is to: Highlight space memory evaluation evolution, Review recent developments regarding low-energy proton direct ionization soft errors, Assess current space memory evaluation challenges, including increase of non-volatile technology choices, and Discuss related testing and evaluation complexities.

Understanding Immigrants, Schooling, and School Psychology: Contemporary Science and Practice

ERIC Educational Resources Information Center

Frisby, Craig L.; Jimerson, Shane R.

2016-01-01

Immigration into the United States is a particularly salient topic of current contemporary educational, social, and political discussions. The school-related needs of immigrant children and youth can be well served by rigorous research and effective school psychology preservice training and preparation. This overview highlights key definitions,…

Technologies for Education: A Practical Guide. Fourth Edition.

ERIC Educational Resources Information Center

Barron, Ann E.; Orwig, Gary W.; Ivers, Karen S.; Lilavois, Nick

This book offers an updated look at the technologies that are impacting education. Designed for educators who are interested in the instructional applications of technology, the book provides information about current technology standards for students and teachers, as well as research related to the effectiveness of technology in education. It…

Language Learning in Higher Education: Portuguese Student Voices

ERIC Educational Resources Information Center

Pinto, Susana; Araújo e Sá, Maria Helena

2016-01-01

This paper begins by reviewing European language education policies in higher education and relating these to the bottom-up language provision practices currently applied in higher education institutions. The paper then focuses on a case study at the University of Aveiro (Portugal) that sets out to identify students' social representations…

Equipping Preservice Elementary Teachers for Data Use in the Classroom

ERIC Educational Resources Information Center

Reeves, Todd D.

2017-01-01

Current preservice teacher education practice related to data use has been deemed inadequate, in that it is unevenly distributed and often superficial. In response, this article describes a course-based classroom assessment data-literacy experience for preservice elementary teachers. Grounded in extant theory and research concerning data literacy…

Gender bias affects forests worldwide

Treesearch

Marlène Elias; Susan S Hummel; Bimbika S Basnett; Carol J.P. Colfer

2017-01-01

Gender biases persist in forestry research and practice. These biases result in reduced scientific rigor and inequitable, ineffective, and less efficient policies, programs, and interventions. Drawing from a two-volume collection of current and classic analyses on gender in forests, we outline five persistent and inter-related themes: gendered governance, tree tenure,...

Critical Thinking Assessment across Four Sustainability-Related Experiential Learning Settings

ERIC Educational Resources Information Center

Heinrich, William F.; Habron, Geoffrey B.; Johnson, Heather L.; Goralnik, Lissy

2015-01-01

Today's complex societal problems require both critical thinking and an engaged citizenry. Current practices in higher education, such as service learning, suggest that experiential learning can serve as a vehicle to encourage students to become engaged citizens. However, critical thinking is not necessarily a part of every experiential learning…

Curriculum Development and Discursive Practices: Building a Training Culture around Dual Diagnosis.

ERIC Educational Resources Information Center

Goldsmith, Steve

Dual diagnosis of comorbid substance abuse and mental disorder is currently presenting great difficulties across Australia's health and community service sectors. Historically, mental health professionals have received relatively little formal education or training in substance abuse issues. A new curriculum on dual diagnosis was developed and…

Tourette Syndrome: A Training Day for Teachers.

ERIC Educational Resources Information Center

Chowdhury, Uttom; Christie, Deborah

2002-01-01

This article describes a Tourette syndrome training day for teachers facilitated by members of the Tic Disorders Clinic at Great Ormond Street Hospital in England. The day provided a mix of information giving and discussion of current practice. Outcomes of the day are related to professional knowledge and experience. (Contains references.) (CR)

School Executive Website Study

ERIC Educational Resources Information Center

Thiede, Robert

2009-01-01

The School Executive Website will be a one-stop, online site for officials who are looking for educational data, best practices, product reviews, school documents, professional opinions, and/or job-related networking. The format of the website is designed in certain sections similar to other current and popular websites, such as Angie's List.com,…

Justice and Disability

ERIC Educational Resources Information Center

Wilson, John

2004-01-01

Conceptual problems about justice and disability relate directly to practice. Current thinking tends (1) to consider only distributive justice (the allocation of resources); (2) to assume that educators have the right to impose their own values on the disabled; and (3) to classify people as disabled, and treat those people, in accordance with a…

The Health and Wellbeing of International Students at an Australian University

ERIC Educational Resources Information Center

Rosenthal, Doreen Anne; Russell, Jean; Thomson, Garry

2008-01-01

A representative sample of undergraduate and postgraduate international students at a large Australian university (n=979, 64% females) completed a mail-back survey of their health and wellbeing. Most students evaluated their current and previous physical and mental health positively. Health-related risk practices such as unprotected sexual…

Motivation Terminology in Reading Research: A Conceptual Review

ERIC Educational Resources Information Center

Conradi, Kristin; Jang, Bong Gee; McKenna, Michael C.

2014-01-01

Despite the importance of motivation in understanding the development and practices of reading, problems persist in how motivation-related constructs are defined and investigated. This article reports a concept analysis of how 12 terms have been used in current reading research. Selection criteria resulted in the identification of 92 data-based…

A Critical Analysis of the Child and Adolescent Wellness Scale (CAWS)

ERIC Educational Resources Information Center

Weller-Clarke, Alandra

2006-01-01

Current practice for assessing children and adolescents rely on objectively scored deficit-based models and/or informal assessments to determine how maladaptive behaviors affect performance. Social-emotional assessment instruments are used in schools and typically provide information related to behavioral and emotional deficits, but provide little…

Recent Case Law Regarding Functional Behavioral Assessments: Implications for Practice

ERIC Educational Resources Information Center

Losinski, Mickey L.; Katsiyannis, Antonis; Ryan, Joseph B.

2014-01-01

While functional behavioral assessments (FBAs) are currently federally mandated requirements, public schools have not been provided clear federal guidance concerning what constitutes an acceptable FBA through Individuals With Disabilities Education Act or related regulations. The purpose of this article is to examine recent rulings regarding FBAs…

Economic and phosphorus-related effects of precision feeding and forage management at a farm scale

USDA-ARS?s Scientific Manuscript database

A system-level redesign of farm management is needed to maintain economic viability of the farm while addressing phosphorous imbalance problems caused by many current practices. One innovative strategy, precision feed management (PFM), reduces soil-phosphorus build-up by limiting feed and fertilizer...

Vocational Training and the Environment: Sustainability and Employment

ERIC Educational Resources Information Center

Villar, Alberto Martinez

2008-01-01

The inclusion of an Environmental Awareness Module (EAM) within Vocational Education and Training (VET) in Spain is considered a factor of overriding importance due to the current need to incorporate environmental awareness within society as a whole but also within particular occupations and professional practices involved both in jobs relating to…

Peer Observation--A Case for Doing It Online

ERIC Educational Resources Information Center

Bennett, Shirley; Barp, Donatella

2008-01-01

Peer observation is increasingly a feature of higher education (HE) practice. We argue that the principal drivers of quality assurance and professional development apply online as offline, given the growing importance of e-learning and related teacher development needs. Currently, discussion is largely restricted to traditional classroom-based…

The Assessment of Hands-On Elementary Science Programs.

ERIC Educational Resources Information Center

Hein, George, Ed.

This document contains 15 chapters on various topics related to elementary science assessment. A comprehensive description of efforts to introduce alternatives to multiple-choice, paper and pencil tests to assess science learning is provided. The monograph includes an analysis of assessment issues, descriptions of current practice, and suggestions…

Toward a Broader Understanding of Teacher Technology Integration Beliefs and Values

ERIC Educational Resources Information Center

Kimmons, Royce; Hall, Cassidy

2016-01-01

In authentic K-12 settings, technology integration is influenced by the decisions and perspectives of a variety of stakeholders, but current research and practice related to teacher technology integration tends to revolve only around pedagogical and technical skill factors influencing integration, thereby ignoring the institutional realities that…

Psychopharmacology Training and Canadian Counsellors: Are We Getting What We Want and Need?

ERIC Educational Resources Information Center

Schaefer, David; Wong-Wylie, Gina

2008-01-01

The psychopharmacology training experiences and attitudes of Canadian counsellors were the focus of our national Internet-based survey. This study was part of a larger investigation on Canadian counsellors' attitudes, practices, and training experiences related to clients on antidepressants. Results of the current study indicate Canadian…

The Geology and Sociology of Consumption: Team-Teaching Sustainability in an Interdisciplinary First-Year Seminar

ERIC Educational Resources Information Center

Walsh, Emily O.; Davis, Emily Calhoun

2017-01-01

The complex consequences of current consumption practices, such as climate change and ecosystem degradation, necessitate increased interdisciplinary exploration. In order to raise student awareness of these consumption-related issues, we designed a first-year team-taught seminar on sustainability. This innovative interdisciplinary course links…

Examining the potential impacts of maintenance investment and capital reinvestment in Vermont's roadway infrastructure network : final report.

DOT National Transportation Integrated Search

2017-01-01

This report summarizes the current state of practice related to the implementation of different reinvestment / disinvestment strategies at the state level and examines how some of these strategies may be employed in the state of Vermont. In this repo...

Examining the potential impacts of maintenance investment and capital reinvestment in Vermont's roadway infrastructure network : final report.

DOT National Transportation Integrated Search

2017-01-06

This report summarizes the current state of practice related to the implementation of different reinvestment / disinvestment strategies at the state level and examines how some of these strategies may be employed in the state of Vermont. In this repo...

Perspectives on Cultural Geography in AP® Human Geography

ERIC Educational Resources Information Center

Hall, Christopher; Johnston-Anumonwo, Ibipo

2016-01-01

This article provides an overview of selected current concerns in cultural geography and the way it is taught. It includes coverage of cultural convergence and divergence, race and gender as culturally defined topics, and best teaching practices, including those related to analyzing controversial issues. Two important geographical models are laid…

Phonological Memory and Rule Learning

ERIC Educational Resources Information Center

Williams, John N.; Lovatt, Peter

2005-01-01

Our research reflects the current trend to relate individual differences in second language learning to underlying cognitive processes e.g., Robinson, 2002. We believe that such investigations, apart from being of practical importance, can also shed light on the cognitive mechanisms underlying the language learning process. Here we focus on the…

Exploring the Discourses of Our Own Practice: A Case Study.

ERIC Educational Resources Information Center

Sanguinetti, Jill

1994-01-01

Reflects on ideas of feminism and critical literacy and their significance in relation to the current policy environment. Topics explored include the dilemmas of personal development; issues of culture, power, and coercion; shifting the focus to teaching; personal and pedagogical influences; pedagogical praxis; and developing a collective…

Think Globally and Act Locally.

ERIC Educational Resources Information Center

Alger, Chadwick F.

1985-01-01

Suggests ways teachers can involve themselves and their students in local action as a means of furthering effective and practical global education. Considers possible barriers related to the ideology of the state system, and current breakthroughs, e.g., the nuclear freeze movement, anti-apartheid activism, and the sanctuary movement for Salvadoran…

Secondary School Tracking and Educational Inequality: Compensation, Reinforcement, or Neutrality?

ERIC Educational Resources Information Center

Gamoran, Adam; Mare, Robert D.

1989-01-01

Using data from the High School and Beyond Survey, the author examines the effects of secondary educational academic tracking on educational stratification relative to racial, sexual, and socioeconomic inequality. Finds that current tracking practices produce less inequality among Blacks and females. Also finds that noncollege programs are not…

Collection Evaluation Techniques: A Short, Selective, Practical, Current, Annotated Bibliography, 1990-1998. RUSA Occasional Papers Number 24.

ERIC Educational Resources Information Center

Strohl, Bonnie, Comp.

This bibliography contains annotations of 110 journal articles on topics related to library collection evaluation techniques, including academic library collections, access-vs-ownership, "Books for College Libraries," business collections, the OCLC/AMIGOS Collection Analysis CD, circulation data, citation-checking, collection bias,…

Human Resource Management in Australian Registered Training Organisations

ERIC Educational Resources Information Center

Smith, Andrew; Hawke Geof

2008-01-01

This report forms part of a comprehensive research program that has examined issues related to building the organisational capability of vocational education and training providers. In particular, this report focuses on the current state of human resource management practice in both technical and further education and private registered training…

Assessment of Second Language Performance.

ERIC Educational Resources Information Center

Lumley, Tom

1996-01-01

A discussion of current second language testing trends and practices in Australia focuses on the use of performance assessment, providing examples of its application in four specific contexts: an occupational English test used for to assess job-related English language skills as part of the certification procedure for health professionals;…

Information Literacy in Mathematics Undergraduate Education: Where Does It Stand Today?

ERIC Educational Resources Information Center

Bussmann, Jeffra Diane; Bond, Jeffrey D.

2015-01-01

The published literature on information literacy in mathematics is relatively sparse. This article explores the current state of information literacy initiatives in undergraduate mathematics. The authors survey academic librarians (n = 118) who liaise with mathematics departments in order to gain an understanding of their practices and attitudes…

10 Guidelines for Ecosystem Researchers: Lessons from Missouri

Treesearch

David R. Larsen; Stephen R. Shifley; Frank R., III Thompson; Brian L. Brookshire; Daniel C. Dey; Eric W. Kurzejeski; Kristine England

1997-01-01

In the early 1990s managers in natural resource agencies in Missouri began asking, "How does ecosystem management relate to our current practices? How might we do a better job of managing large ecosystems?" As they started addressing these questions, several points emerged:Planning and managing ecosystems requires expertise in more...

A Review of Combat Support Training.

ERIC Educational Resources Information Center

Montague, Ernest K.; Showel, Morris

This report presents a review of current training practices and problems as they relate to the broad spread of individual ability among soldiers, and to the increasing need for functionalization of training. Combat support training was observed at four army training centers, with particular reference to training objectives, methods, and student…

Participants' Evaluation of Consultation: Implications for Training in School Psychology

ERIC Educational Resources Information Center

Klose, Laurie McGarry; Plotts, Cynthia; Lasser, Jon

2012-01-01

Evaluation of graduate students' consultation skills is essential to competent practice in school settings. Congruence of evaluation of the consultation experience has been shown as an important factor in the development of competent consultants in other, related disciplines. The current study analysed student consultant and teacher consultee…

Hybrid Practices? Contributions to the Debate on the Mutation of Science and University

ERIC Educational Resources Information Center

Tuunainen, Juha

2005-01-01

This article reflects on current debate over transformations of scientific research and universities. Four well-known mutation theories (Mode-2 knowledge production, triple helix of university-industry-government relations, academic capitalism and enterprise university), and their recent critiques, are reviewed. It is suggested that a better…

Four Pillars for Improving the Quality of Safety-Critical Software-Reliant Systems

DTIC Science & Technology

2013-04-01

Studies of safety-critical software-reliant systems developed using the current practices of build-then-test show that requirements and architecture ... design defects make up approximately 70% of all defects, many system level related to operational quality attributes, and 80% of these defects are

Undergraduate Single Mothers' Experiences in Postsecondary Education

ERIC Educational Resources Information Center

Beeler, Sydney

2016-01-01

Using Astin's (1993) College Impact Model, this chapter explores the current literature as it relates to single mothers in undergraduate postsecondary education. The chapter looks at the ways that undergraduates who are single mothers are counter to the "ideal-student" norms. Policy and best-practice recommendations conclude the chapter.

School Absenteeism and the Implementation of Truancy-Related Penalty Notices

ERIC Educational Resources Information Center

Zhang, Ming

2007-01-01

This paper derives from the author's recent research into disadvantaged children's access to compulsory education in England. Examining the national attendance strategies and practice, the author interrogates the current trend towards a more punitive approach to addressing the problem of school absenteeism while debating the issue of irresponsible…

A Survey of Library Support for Formal Undergraduate Research Programs

ERIC Educational Resources Information Center

Hensley, Merinda Kaye; Shreeves, Sarah L.; Davis-Kahl, Stephanie

2014-01-01

Undergraduate research is defined by the Council on Undergraduate Research (CUR) as "an inquiry or investigation conducted by an undergraduate student that makes an original intellectual or creative contribution to the discipline." This study serves as a snapshot of current library practices in relation to formal undergraduate research…

The Sami Languages(s), Maintenance and Intellectualistion.

ERIC Educational Resources Information Center

Bull, Tove

2002-01-01

Gives an overview of the current socioliniguistic situation of the Sami language in Northern Scandinavia, focusing on the situation in North Norway in particular. Describes the historical development and discusses issues, problems, and practices relating to Sami language politics and planning in reaction to the use of this language in…

NASA preferred reliability-practices for design and test

NASA Technical Reports Server (NTRS)

Lisk, Ronald C.

1992-01-01

NASA HQ established the NASA R&M Steering Committee (R&MSC) comprised of membership from each NASA field center. The primary charter of the R&MSC is to obtain, record, and share the best design practices that NASA has applied to successful space flight programs and current design considerations (guidelines) that should enhance flight reliability on emerging programs. The practices and guidelines are being assembled in a living document for distribution to NASA centers and the aerospace community. The document will be updated annually with additional practices and guidelines as contributions from the centers are reviewed and approved by the R&MSC. Practices and guidelines are not requirements, but rather a means of sharing procedures and techniques that a given center and the R&MSC together feel have strong technical merit and application to the design of space-related equipment.

Development of quality measures for monitoring and improving care in gastroenterology.

PubMed

Germansky, Katharine A; Leffler, Daniel A

2011-06-01

Over the past decade, most quality assurance (QA) efforts in gastroenterology have been aimed at endoscopy. Endoscopic quality improvement was the rational area to begin QA work in gastroenterology due to the relatively acute nature of complications and the high volume of procedures performed. While endoscopy is currently the focus of most quality assurance (QA) measures in gastroenterology, more recent efforts have begun to address clinical gastroenterology practices both in the outpatient and inpatient settings. Clinical outpatient and inpatient gastroenterology is laden with areas where standardization could benefit patient care. While data and experience in clinical gastroenterology QA is relatively limited, it is clear that inconsistent use of guidelines and practice variations in gastroenterology can lead to lower quality care. In this review, we review a variety of areas in clinical gastroenterology where existing guidelines and published data suggest both the need and practicality of active QA measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Ethical pharmaceutical promotion and communications worldwide: codes and regulations

PubMed Central

2014-01-01

The international pharmaceutical industry has made significant efforts towards ensuring compliant and ethical communication and interaction with physicians and patients. This article presents the current status of the worldwide governance of communication practices by pharmaceutical companies, concentrating on prescription-only medicines. It analyzes legislative, regulatory, and code-based compliance control mechanisms and highlights significant developments, including the 2006 and 2012 revisions of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Practice. Developments in international controls, largely built upon long-established rules relating to the quality of advertising material, have contributed to clarifying the scope of acceptable company interactions with healthcare professionals. This article aims to provide policy makers, particularly in developing countries, with an overview of the evolution of mechanisms governing the communication practices, such as the distribution of promotional or scientific material and interactions with healthcare stakeholders, relating to prescription-only medicines. PMID:24679064

Ethical pharmaceutical promotion and communications worldwide: codes and regulations.

PubMed

Francer, Jeffrey; Izquierdo, Jose Zamarriego; Music, Tamara; Narsai, Kirti; Nikidis, Chrisoula; Simmonds, Heather; Woods, Paul

2014-03-29

The international pharmaceutical industry has made significant efforts towards ensuring compliant and ethical communication and interaction with physicians and patients. This article presents the current status of the worldwide governance of communication practices by pharmaceutical companies, concentrating on prescription-only medicines. It analyzes legislative, regulatory, and code-based compliance control mechanisms and highlights significant developments, including the 2006 and 2012 revisions of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) Code of Practice.Developments in international controls, largely built upon long-established rules relating to the quality of advertising material, have contributed to clarifying the scope of acceptable company interactions with healthcare professionals. This article aims to provide policy makers, particularly in developing countries, with an overview of the evolution of mechanisms governing the communication practices, such as the distribution of promotional or scientific material and interactions with healthcare stakeholders, relating to prescription-only medicines.

Management in the Ministry of Health: what are the vital signs?

PubMed

Benjamin, S; Ahmed, A A; al-Darazi, F

1997-01-01

Effective and efficient management of health services is becoming more and more important in all countries and in all organizations whether profit or non-profit. Management practices and attitudes which may have been accepted in previous years are no longer appropriate. A study was conducted in the Ministry of Health, State of Bahrain to determine the current status of management skills and attitudes. Participants were asked to identify the best and the worst practices of managers. Eight key areas of concern were identified: participative vs. non-participative style, communication, motivation, delegation, human relations skills, style of supervision, goal-oriented behavior, and use of supervisory power. In each of these management-related skill areas, examples of best and worst practices are provided in order to aid the manager/leader in self-assessing his/her abilities as a first step toward improving management.

Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.

PubMed

Galbany-Estragués, Paola; Comas-d'Argemir, Dolors

2017-10-01

Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.

School Practices to Foster LGBT-Supportive Climate: Associations with Adolescent Bullying Involvement.

PubMed

Gower, Amy L; Forster, Myriam; Gloppen, Kari; Johnson, Abigail Z; Eisenberg, Marla E; Connett, John E; Borowsky, Iris W

2017-10-14

Lesbian, gay, bisexual, and transgender (LGBT) youth experience disproportionate rates of bullying compared to their heterosexual peers. Schools are well-positioned to address these disparities by creating supportive school climates for LGBT youth, but more research is needed to examine the variety of practices and professional development opportunities put in place to this end. The current study examines how school practices to create supportive LGBT student climate relate to student reports of bullying. Student-level data come from the 2013 Minnesota Student Survey, a state-wide survey of risk and protective factors. Ninth and eleventh grade students (N = 31,183) reported on frequency of physical and relational bullying victimization and perpetration and sexual orientation-based harassment. School administrators reported on six practices related to creating supportive LGBT school climate (N = 103 schools): having a point person for LGBT student issues, displaying sexual orientation-specific content, having a gay-straight alliance, discussing bullying based on sexual orientation, and providing professional development around LGBT inclusion and LGBT student issues. An index was created to indicate how many practices each school used (M = 2.45; SD = 1.76). Multilevel logistic regressions indicated that students attending schools with more supportive LGBT climates reported lower odds of relational bullying victimization, physical bullying perpetration, and sexual orientation-based harassment compared to students in schools with less supportive LGBT climates. Sexual orientation did not moderate these relations, indicating that LGBT-supportive practices may be protective for all students, regardless of their sexual orientation. Findings support school-wide efforts to create supportive climates for LGBQ youth as part of a larger bullying prevention strategy.

An assessment of the Bhutanese traditional medicine for its ethnopharmacology, ethnobotany and ethnoquality: Textual understanding and the current practices.

PubMed

Wangchuk, Phurpa; Pyne, Stephen G; Keller, Paul A

2013-06-21

: This study involves the assessment of the Bhutanese traditional medicine (BTM) which was integrated with the mainstream biomedicine in 1967 to provide primary health care services in the country. It caters to 20-30% of the daily out-patients within 49 traditional medicine units attached to 20 district modern hospitals and 29 Basic Health Units in the country. : This study presents the ethnopharmacological, ethnobotanical and the ethnoquality concepts in relation to mainstream Tibetan medicine and describes the current practices of BTM. : Experienced BTM practitioners (Drung-tshos and Smen-pas) were selected using a convenience sampling method and were interviewed using an open questionnaire followed by informal discussions. The corpus of BTM, Tibetan and scientific literature was obtained and the information on ethnopharmacological, ethnoquality and ethnobotanical concepts and current practices of BTM was extracted. : This study found that the BTM shares many similarities in terms of materia medica, pharmacopoeia and the principles and concepts of ethnopharmacology and ethnobotany with its mainstream Tibetan medicine. However, the resourceful Bhutanese Drung-tshos and Smen-pas have adapted this medical system based on the local language, culture, disease trend, health care needs and their familiarity with the locally available medicinal ingredients making it particular to the country. A number of notable distinctions observed in the current practices include a code of classification of diseases (only 79 of 404 types of disorders recognized), formulations (currently used only 103 of thousands formulation types), usage of medicinal plants (only 229 species of thousands described) and selected treatment procedures (golden needle and water therapy). This BTM was found to cater to 20-30% of daily out-patients visiting 49 modern hospitals and basic health units in the country. : The BTM has been evolved from the Tibetan medicine. While the pharmacopoeia, ethnopharmacology, ethnobotany and the ethnoquality aspects shares commonalities with the mainstream Tibetan medicine, there are some practices unique to BTM. Such uniqueness observed in the current practices of BTM include formulations, medicinal plants collection and usage, and the treatment procedures including golden needle and water therapy. This could be a promising source of information for the rediscovery of useful remedies, the development of modern phytotherapeutics and the establishment of efficient quality control measures. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Microsurgery Training for the Twenty-First Century

PubMed Central

Myers, Simon Richard; Froschauer, Stefan; Akelina, Yelena; Tos, Pierluigi; Kim, Jeong Tae

2013-01-01

Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices. PMID:23898422

New Strategies in Radiation Therapy: Exploiting the Full Potential of Protons

PubMed Central

Mohan, Radhe; Mahajan, Anita; Minsky, Bruce D.

2013-01-01

Protons provide significant dosimetric advantages compared with photons due to their unique depth-dose distribution characteristics. However, they are more sensitive to the effects of intra- and inter-treatment fraction anatomic variations and uncertainties in treatment setup. Furthermore, in the current practice of proton therapy, the biological effectiveness of protons relative to photons is assumed to have a generic fixed value of 1.1. However, this is a simplification, and it is likely higher in different portions of the proton beam. Current clinical practice and trials have not fully exploited the unique physical and biological properties of protons. Intensity-modulated proton therapy, with its ability to manipulate energies (in addition to intensities), provides an entirely new dimension, which, with ongoing research, has considerable potential to increase the therapeutic ratio. PMID:24077353

New strategies in radiation therapy: exploiting the full potential of protons.

PubMed

Mohan, Radhe; Mahajan, Anita; Minsky, Bruce D

2013-12-01

Protons provide significant dosimetric advantages compared with photons because of their unique depth-dose distribution characteristics. However, they are more sensitive to the effects of intra- and intertreatment fraction anatomic variations and uncertainties in treatment setup. Furthermore, in the current practice of proton therapy, the biologic effectiveness of protons relative to photons is assumed to have a generic fixed value of 1.1. However, this is a simplification, and it is likely higher in different portions of the proton beam. Current clinical practice and trials have not fully exploited the unique physical and biologic properties of protons. Intensity-modulated proton therapy, with its ability to manipulate energies (in addition to intensities), provides an entirely new dimension, which, with ongoing research, has considerable potential to increase the therapeutic ratio. ©2013 AACR.

A qualitative exploration of key informant perspectives regarding the nature and impact of contemporary legislation on professional development: a grounded theory study of chiropractic in Denmark.

PubMed

Myburgh, Corrie

2014-01-01

The purpose of this study was to construct a substantive framework of the manner in which the Danish government interacts with the Danish chiropractic profession and influences professional practice. An exploratory, qualitative study was performed using a substantive grounded theory (GT) approach. Unstructured, face-to-face, individual interviews were conducted during the years 2012 and 2013 and thematically analyzed. Six people were interviewed for this study including a gatekeeper and witness to legislative history, a previous chiropractic political representative and witness to legislative history, a previous Department of Health negotiator and previous administrator of chiropractic affairs and witness to legislative history, a current administrator of chiropractic affairs, an active chiropractic political representative and witness to legislative history, and a chief negotiator for Danish Regional Health Care Services. Open and axial coding yielded 2 themes centering on licensing chiropractors in Denmark and the resultant developmental issues encountered. Through further selective coding, the GT core construct, "chiropractic practice in the Danish heath care system" emerged. The GT highlights the tension between the strategic political importance of legislation and the restrictive nature of the overly specific act currently regulating chiropractic practice. Moreover, the GT also revealed the perceived negative effect that the National Board of Health may exert on clinical practice due to its conservative interpretation of the act. The Danish government is perceived to act as a countervailing power related to chiropractic practice. The derived substantive GT suggests that the Danish government's dualistic action relative to the Danish chiropractic community may inhibit the spontaneous evolution of contemporary Danish chiropractic practice. Although historically narrow legislation may limit chiropractic practice, conservative interpretations by the Danish National Board of Health may also play an important role. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Alternative industrial carbon emissions benchmark based on input-output analysis

NASA Astrophysics Data System (ADS)

Han, Mengyao; Ji, Xi

2016-12-01

Some problems exist in the current carbon emissions benchmark setting systems. The primary consideration for industrial carbon emissions standards highly relate to direct carbon emissions (power-related emissions) and only a portion of indirect emissions are considered in the current carbon emissions accounting processes. This practice is insufficient and may cause double counting to some extent due to mixed emission sources. To better integrate and quantify direct and indirect carbon emissions, an embodied industrial carbon emissions benchmark setting method is proposed to guide the establishment of carbon emissions benchmarks based on input-output analysis. This method attempts to link direct carbon emissions with inter-industrial economic exchanges and systematically quantifies carbon emissions embodied in total product delivery chains. The purpose of this study is to design a practical new set of embodied intensity-based benchmarks for both direct and indirect carbon emissions. Beijing, at the first level of carbon emissions trading pilot schemes in China, plays a significant role in the establishment of these schemes and is chosen as an example in this study. The newly proposed method tends to relate emissions directly to each responsibility in a practical way through the measurement of complex production and supply chains and reduce carbon emissions from their original sources. This method is expected to be developed under uncertain internal and external contexts and is further expected to be generalized to guide the establishment of industrial benchmarks for carbon emissions trading schemes in China and other countries.

Pharmacovigilance in oncology: evaluation of current practice and future perspectives.

PubMed

Baldo, Paolo; De Paoli, Paolo

2014-10-01

Pharmacovigilance (PV), or drug safety monitoring, aims to improve patient safety through the detection and management of drug-related adverse reactions. It is implemented both by spontaneous reporting of adverse drug reactions (ADRs) and by careful detection of signals suggestive of drug toxicity. PV is an important clinical topic in clinical practice and pharmacotherapy, assuring the maintenance of a safe risk/benefit ratio throughout the commercial life cycle of a drug. We conducted a structured literature search on PubMed, Scopus, Cinahl and the Cochrane Library. We also performed manual searches in international databases of ADR individual reports to outline a structured profile on the topic. Our goal was to review key elements that affect safety monitoring of cancer drugs and their appropriate use, highlighting the strengths and weaknesses of PV in oncology. This paper provides an understanding of the methodologies used by PV in current clinical practice and particularly in cancer drug therapy; a focus upon reporting of ADRs by health professionals and patients; and a focus upon methods used by PV to detect new signals of risk/harm related to medicines utilization. To our knowledge, few articles focus upon the importance of PV and post-marketing surveillance of cancer drug therapies. Structured management of spontaneous reports of ADRs and data collection is essential to monitoring the safe use of drugs in this field in which pharmacotherapy is affected by high incidence of drug-related complications and by a narrow benefit/risk ratio. © 2014 John Wiley & Sons, Ltd.

The role of ethics in data governance of large neuro-ICT projects.

PubMed

Stahl, Bernd Carsten; Rainey, Stephen; Harris, Emma; Fothergill, B Tyr

2018-05-14

We describe current practices of ethics-related data governance in large neuro-ICT projects, identify gaps in current practice, and put forward recommendations on how to collaborate ethically in complex regulatory and normative contexts. We undertake a survey of published principles of data governance of large neuro-ICT projects. This grounds an approach to a normative analysis of current data governance approaches. Several ethical issues are well covered in the data governance policies of neuro-ICT projects, notably data protection and attribution of work. Projects use a set of similar policies to ensure users behave appropriately. However, many ethical issues are not covered at all. Implementation and enforcement of policies remain vague. The data governance policies we investigated indicate that the neuro-ICT research community is currently close-knit and that shared assumptions are reflected in infrastructural aspects. This explains why many ethical issues are not explicitly included in data governance policies at present. With neuro-ICT research growing in scale, scope, and international involvement, these shared assumptions should be made explicit and reflected in data governance.

Improving Hospital Services Based on Patient Experience Data: Current Feedback Practices and Future Opportunities.

PubMed

Kaipio, Johanna; Stenhammar, Hanna; Immonen, Susanna; Litovuo, Lauri; Axelsson, Minja; Lantto, Minna; Lahdenne, Pekka

2018-01-01

Patient feedback is considered important for healthcare organizations. However, measurement and analysis of patient reported data is useful only if gathered insights are transformed into actions. This article focuses on gathering and utilization of patient experience data at hospitals with the aim of supporting the development of patient-centered services. The study was designed to explore both current practices of collecting and utilizing patient feedback at hospitals as well as future feedback-related opportunities. Nine people working at different hierarchical levels of three university hospitals in Finland participated in in-depth interviews. Findings indicate that current feedback processes are poorly planned and inflexible. Some feedback data are gathered, but not systematically utilized. Currently, it is difficult to obtain a comprehensive picture of the situation. One future hope was to increase the amount of patient feedback to be able to better generalize and utilize the data. Based on the findings the following recommendations are given: attention to both patients' and healthcare staff's perspectives when collecting feedback, employing a coordinated approach for collecting and utilizing patient feedback, and organizational transformation towards a patient-centric culture.

Imaging transcranial direct current stimulation (tDCS) of the prefrontal cortex-correlation or causality in stimulation-mediated effects?

PubMed

Wörsching, Jana; Padberg, Frank; Ertl-Wagner, Birgit; Kumpf, Ulrike; Kirsch, Beatrice; Keeser, Daniel

2016-10-01

Transcranial current stimulation approaches include neurophysiologically distinct non-invasive brain stimulation techniques widely applied in basic, translational and clinical research: transcranial direct current stimulation (tDCS), oscillating transcranial direct current stimulation (otDCS), transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS). Prefrontal tDCS seems to be an especially promising tool for clinical practice. In order to effectively modulate relevant neural circuits, systematic research on prefrontal tDCS is needed that uses neuroimaging and neurophysiology measures to specifically target and adjust this method to physiological requirements. This review therefore analyses the various neuroimaging methods used in combination with prefrontal tDCS in healthy and psychiatric populations. First, we provide a systematic overview on applications, computational models and studies combining neuroimaging or neurophysiological measures with tDCS. Second, we categorise these studies in terms of their experimental designs and show that many studies do not vary the experimental conditions to the extent required to demonstrate specific relations between tDCS and its behavioural or neurophysiological effects. Finally, to support best-practice tDCS research we provide a methodological framework for orientation among experimental designs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Enhancing links between visual short term memory, visual attention and cognitive control processes through practice: An electrophysiological insight.

PubMed

Fuggetta, Giorgio; Duke, Philip A

2017-05-01

The operation of attention on visible objects involves a sequence of cognitive processes. The current study firstly aimed to elucidate the effects of practice on neural mechanisms underlying attentional processes as measured with both behavioural and electrophysiological measures. Secondly, it aimed to identify any pattern in the relationship between Event-Related Potential (ERP) components which play a role in the operation of attention in vision. Twenty-seven participants took part in two recording sessions one week apart, performing an experimental paradigm which combined a match-to-sample task with a memory-guided efficient visual-search task within one trial sequence. Overall, practice decreased behavioural response times, increased accuracy, and modulated several ERP components that represent cognitive and neural processing stages. This neuromodulation through practice was also associated with an enhanced link between behavioural measures and ERP components and with an enhanced cortico-cortical interaction of functionally interconnected ERP components. Principal component analysis (PCA) of the ERP amplitude data revealed three components, having different rostro-caudal topographic representations. The first component included both the centro-parietal and parieto-occipital mismatch triggered negativity - involved in integration of visual representations of the target with current task-relevant representations stored in visual working memory - loaded with second negative posterior-bilateral (N2pb) component, involved in categorising specific pop-out target features. The second component comprised the amplitude of bilateral anterior P2 - related to detection of a specific pop-out feature - loaded with bilateral anterior N2, related to detection of conflicting features, and fronto-central mismatch triggered negativity. The third component included the parieto-occipital N1 - related to early neural responses to the stimulus array - which loaded with the second negative posterior-contralateral (N2pc) component, mediating the process of orienting and focusing covert attention on peripheral target features. We discussed these three components as representing different neurocognitive systems modulated with practice within which the input selection process operates. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

A review of Acalypha indica L. (Euphorbiaceae) as traditional medicinal plant and its therapeutic potential.

PubMed

Zahidin, Nor Syahiran; Saidin, Syafiqah; Zulkifli, Razauden Mohamed; Muhamad, Ida Idayu; Ya'akob, Harisun; Nur, Hadi

2017-07-31

Acalypha indica is an herbal plant that grows in wet, temperate and tropical region, primarily along the earth's equator line. This plant is considered by most people as a weed and can easily be found in these regions. Although this plant is a weed, Acalypha indica has been acknowledged by local people as a useful source of medicine for several therapeutic treatments. They consume parts of the plant for many therapeutics purposes such as anthelmintic, anti-ulcer, bronchitis, asthma, wound healing, anti-bacterial and other applications. As this review was being conducted, most of the reports related to ethnomedicinal practices were from Asian and African regions. The aim of this review is to summarize the current studies on ethnomedicinal practices, phytochemistry, pharmacological studies and a potential study of Acalypha indica in different locations around the world. This review updates related information regarding the potential therapeutic treatments and also discusses the toxicity issue of Acalypha indica. This review was performed through a systematic search related to Acalypha indica including the ethnomedicinal practices, phytochemistry and pharmacological studies around the world. The data was collected from online journals, magazines, and books, all of which were published in English, Malay and Indonesian. Search engine websites such as Google, Google Scholar, PubMed, Science Direct, Researchgate and other online collections were utilized in this review to obtain information. The links between ethnomedicinal practices and scientific studies have been discussed with a fair justification. Several pharmacological properties exhibited certain potentials based on the obtained results that came from different related studies. Based on literature studies, Acalypha indica has the capability to serve as anthelmintic, anti-inflammation, anti-bacterial, anti-cancer, anti-diabetes, anti-hyperlipidemic, anti-obesity, anti-venom, hepatoprotective, hypoxia, and wound healing medicine. For the traditional practices, the authors also mentioned several benefits of consuming the raw plant and decoction. This review summarizes the current studies of Acalypha indica collected from many regions. This review hopefully will provide a useful and basic knowledge platform for anyone interested in gaining information regarding Acalypha indica. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

The home literacy and numeracy environment in preschool: Cross-domain relations of parent-child practices and child outcomes.

PubMed

Napoli, Amy R; Purpura, David J

2018-02-01

There is a growing body of evidence indicating that home literacy and numeracy environments are predictive of children's literacy and numeracy skills within their respective domains. However, there is limited research on the relations between the home literacy environment and numeracy outcomes and between the home numeracy environment and literacy outcomes. Specifically, there is limited information on relations between the home numeracy environment and specific literacy outcomes (e.g., vocabulary). The purpose of the current study was to investigate the relations of the home literacy and numeracy environments to children's literacy and numeracy outcomes both within and across domains. Participants were 114 preschool children and their parents. Children ranged in age from 3.01 to 5.17 years (M = 4.09 years) and were 54% female and 72% Caucasian. Parents reported the frequency of parent-child literacy (code-related practices and storybook reading) and numeracy practices. Children were assessed in the fall and spring of their preschool year on their literacy (definitional vocabulary, phonological awareness, and print knowledge) and numeracy skills. Four mixed-effects regression analyses were conducted to predict each of the child outcomes. Results indicate that although code-related literacy practices and storybook reading were not broadly predictive of children's literacy and numeracy outcomes, the home numeracy environment was predictive of numeracy and definitional vocabulary outcomes. These findings demonstrate a relation between the home numeracy environment and children's language development and contribute to the growing body of research indicating the important relations between early numeracy and language development. Copyright © 2017 Elsevier Inc. All rights reserved.

Reading instruction in science: Teachers' practices, beliefs, & self-efficacy

NASA Astrophysics Data System (ADS)

Morales, Christina M.

The Common Core State Standards (CCSS, 2010) and the Next Generation Science Standards (NGSS, 2013) call on science teachers to play a stronger role in helping students learn from informational science texts. Curriculum implementation efforts aimed at addressing these new standards should build on what teachers are already doing to help students with reading in their classrooms and the pedagogical issues that they feel are important to science learning. However, few current studies have gathered these important insights from science teachers. Aiming to fill this gap in the literature, this study attempted to describe middle school science teachers' current practices, beliefs, and self-efficacy regarding reading and reading instruction in their classrooms. A conceptual model hypothesizing that self-efficacy mediates the relationship between teachers' beliefs about how important reading instruction is to science learning and how often they provide reading instruction in their science classes was also tested. Participants (N = 247) reported that students regularly engaged in reading-related tasks in science class. Somer's D correlation analyses highlighted positive associations between the frequency with which teachers reported that students engaged in various reading-related tasks and the frequency with which they reported providing reading instruction for those tasks, suggesting that students tended to receive explicit instruction or coaching for the reading-related tasks they engaged in most often. Middle school science teachers also expressed positive beliefs about the importance of reading-related tasks and explicit instruction or coaching for reading in science and tended to take on responsibility for helping students become better readers of science texts. Last, a path analysis confirmed that the association between teachers' beliefs and practices was mediated through teachers' self-efficacy (beta = .07, p < .001). This suggests that self-efficacy can influence teacher practice: even if teachers believe that reading instruction is important or even essential to science learning, they might avoid or resist providing reading instruction if they do not feel efficacious in helping students become stronger readers of science texts.

Practices and perceptions among pediatricians regarding adolescent contraception with emphasis on intrauterine contraception.

PubMed

Wilson, S F; Strohsnitter, W; Baecher-Lind, L

2013-10-01

This study was conducted to characterize pediatricians' current practice patterns and perceived barriers related to adolescent contraception counseling with an emphasis on intrauterine contraception (IUC). We performed a mailed survey study to 400 general pediatricians. Surveys were mailed to pediatricians at their individual office locations. General pediatricians belonging to the Massachusetts Pediatric Society were included in the study. The survey instrument assessed current practice patterns and perspectives as related to contraception counseling for adolescents. Use of contraception among adolescent patients, policy to recommend IUC to adolescents in various clinical scenarios, and barriers to adolescent contraceptive counseling. Over 50% of pediatricians considered abstinence their favored method of contraception for adolescents, while fewer than 20% reported discussing IUC as an option. Female pediatricians were more likely to discuss IUC (25% vs 8%, P = .01), as were younger pediatricians (28% vs 14%, P = .13). Given 8 clinical scenarios suitable for IUC use, less than 25% of pediatricians would offer IUC to a teen unless she had a history of a vaginal delivery or abortion. Seventy percent of pediatricians reported lack of training with IUC, and more than 30% reported legal, fertility and parental concerns as barriers to discussing IUC with adolescents. Efforts are warranted to improve the education of pediatricians regarding the most current guidelines for proper IUC use in adolescents with the goal to increase the frequency with which this effective contraceptive method is discussed with this vulnerable population. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Design of a Genomics Curriculum: Competencies for Practicing Pathologists.

PubMed

Laudadio, Jennifer; McNeal, Jeffrey L; Boyd, Scott D; Le, Long Phi; Lockwood, Christina; McCloskey, Cindy B; Sharma, Gaurav; Voelkerding, Karl V; Haspel, Richard L

2015-07-01

The field of genomics is rapidly impacting medical care across specialties. To help guide test utilization and interpretation, pathologists must be knowledgeable about genomic techniques and their clinical utility. The technology allowing timely generation of genomic data is relatively new to patient care and the clinical laboratory, and therefore, many currently practicing pathologists have been trained without any molecular or genomics exposure. Furthermore, the exposure that current and recent trainees receive in this field remains inconsistent. To assess pathologists' learning needs in genomics and to develop a curriculum to address these educational needs. A working group formed by the College of American Pathologists developed an initial list of genomics competencies (knowledge and skills statements) that a practicing pathologist needs to be successful. Experts in genomics were then surveyed to rate the importance of each competency. These data were used to create a final list of prioritized competencies. A subset of the working group defined subtopics and tasks for each competency. Appropriate delivery methods for the educational material were also proposed. A final list of 32 genomics competency statements was developed. A prioritized curriculum was created with designated subtopics and tasks associated with each competency. We present a genomics curriculum designed as a first step toward providing practicing pathologists with the competencies needed to practice successfully.

Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students.

PubMed

Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan

2016-11-01

With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Anesthesia Practices for Interventional Radiology in Europe.

PubMed

Vari, Alessandra; Gangi, Afshin

2017-06-01

The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology. Predictable differences between countries and national regulations were confirmed, showing how significantly many "local" factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care. Significant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

Consumer-oriented social data fusion: controlled learning in social environments, social advertising, and more

NASA Astrophysics Data System (ADS)

Grewe, L.

2013-05-01

This paper explores the current practices in social data fusion and analysis as it applies to consumer-oriented applications in a slew of areas including business, economics, politics, sciences, medicine, education and more. A categorization of these systems is proposed and contributions to each area are explored preceded by a discussion of some special issues related to social data and networks. From this work, future paths of consumer-based social data analysis research and current outstanding problems are discovered.

Physician practice participation in accountable care organizations: the emergence of the unicorn.

PubMed

Shortell, Stephen M; McClellan, Sean R; Ramsay, Patricia P; Casalino, Lawrence P; Ryan, Andrew M; Copeland, Kennon R

2014-10-01

To provide the first nationally based information on physician practice involvement in ACOs. Primary data from the third National Survey of Physician Organizations (January 2012-May 2013). We conducted a 40-minute phone survey in a sample of physician practices. A nationally representative sample of practices was surveyed in order to provide estimates of organizational characteristics, care management processes, ACO participation, and related variables for four major chronic illnesses. We evaluated the associations between ACO participation, organizational characteristics, and a 25-point index of patient-centered medical home processes. We found that 23.7 percent of physician practices (n = 280) reported joining an ACO; 15.7 percent (n = 186) were planning to become involved within the next 12 months and 60.6 percent (n = 717) reported no involvement and no plans to become involved. Larger practices, those receiving patients from an IPA and/or PHO, those that were physician-owned versus hospital/health system-owned, those located in New England, and those with greater patient-centered medical home (PCMH) care management processes were more likely to have joined an ACO. Physician practices that are currently participating in ACOs appear to be relatively large, or to be members of an IPA or PHO, are less likely to be hospital-owned and are more likely to use more care management processes than nonparticipating practices. © Health Research and Educational Trust.

STEM professional volunteers in K-12 competition programs: Educator practices and impact on pedagogy

NASA Astrophysics Data System (ADS)

Zintgraff, Alfred Clifton

This mixed methods dissertation study explored how secondary school educators in specific K-12 competition programs recruited and deployed STEM professional volunteers. The study explored which practices were viewed as most important, and how practices related to constructivist pedagogy, all from the viewpoint of educators. The non-positivist approach sought new knowledge without pursuing generalized results. Review of the literature uncovered extensive anecdotal information about current practices, and suggested that large investments are made in engaging volunteers. One National Science Foundation-sponsored study was identified, and its recommendations for a sustained research agenda were advanced. Three study phases were performed, one to explore practices and operationalize definitions, a second to rate practice's importance and their relation to pedagogy, and a third to seek explanations. Educators preferred recruiting local, meaning recruiting parents and former students, versus from industry or other employers. Most educators preferred volunteers with mentoring skills, and placing them in direct contact with students, versus deploying volunteers to help with behind-the-scenes tasks supporting the educator. Relationships were identified between the highest-rated practices and constructivism in programs. In STEM professional volunteers, educators see affordances, in the same way a classroom tool opens affordances. A model is proposed which shows educators considering practicality, pedagogy, knowledge and skills, and rapport when accessing the affordances opened by STEM professional volunteers. Benefits are maximized when programs align with strong industry clusters in the community.

Pharmacists' self-perceptions in relation to the 'Advanced Pharmacy Practice Framework'.

PubMed

Ali, A S; Fejzic, J; Grant, G D; Nissen, L M

2016-01-01

The Australian Pharmacy Practice Framework was developed by the Advanced Pharmacy Practice Steering Committee and endorsed by the Pharmacy Board of Australia in October 2012. The Steering Committee conducted a study that found practice portfolios to be the preferred method to assess and credential Advanced Pharmacy Practitioner, which is currently being piloted by the Australian Pharmacy Council. Credentialing is predicted to open to all pharmacists practising in Australia by November 2015. To explore how Australian pharmacists self-perceived being advanced in practice and how they related their level of practice to the Australian Advanced Pharmacy Practice Framework. This was an explorative, cross-sectional study with mixed methods analysis. Advanced Pharmacy Practice Framework, a review of the recent explorative study on Advanced Practice conducted by the Advanced Pharmacy Practice Framework Steering Committee and semi-structured interviews (n = 10) were utilized to create, refine and pilot the questionnaire. The questionnaire was advertised across pharmacy-organizational websites via a purposive sampling method. The target population were pharmacists currently registered in Australia. Seventy-two participants responded to the questionnaire. The participants were mostly female (56.9%) and in the 30-40 age group (26.4%). The pharmacists self-perceived their levels of practice as either entry, transition, consolidation or advanced, with the majority selecting the consolidation level (38.9%). Although nearly half (43.1%) of the participants had not seen the Framework beforehand, they defined Advanced Pharmacy Practice similarly to the definition outlined in the Framework, but also added specialization as a requirement. Pharmacists explained why they were practising at their level of practice, stating that not having more years of practice, lacking experience, or postgraduate/post-registration qualifications, and more involvement and recognition in practice were the main reasons for not considering themselves as an Advanced Pharmacy Practitioner. To be considered advanced by the Framework, pharmacists would need to fulfill at least 70% of the Advanced Practice competency standards at an advanced level. More than half of the pharmacists (64.7%) that self-perceived as being advanced managed to fulfill 70% or more of these Advanced Practice competency standards at the advanced level. However, none of the self-perceived entry level pharmacists managed to match at least 70% of the competencies at the entry level. Participants' self-perception of the term Advanced Practice was similar to the definition in the Advanced Pharmacy Practice Framework. Pharmacists working at an advanced level were largely able to demonstrate and justify their reasons for being advanced practitioners. However, pharmacists practising at the other levels of practice (entry, transition, consolidation) require further guidance regarding their advancement in practice. Copyright © 2016 Elsevier Inc. All rights reserved.

A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

PubMed

Lee, Joy L; Matthias, Marianne S; Menachemi, Nir; Frankel, Richard M; Weiner, Michael

2018-04-01

Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area. To understand how existing guidelines align with current practice, evidence, and technology. We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices. Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed. Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.

Practice patterns for the radical treatment of nasopharyngeal cancer by head and neck oncologists in the United Kingdom.

PubMed

Petkar, Imran; Bhide, Shreerang; Newbold, Kate; Harrington, Kevin; Nutting, Chris

2018-05-01

Advances in radiation delivery, imaging techniques, and chemotherapy have significantly improved treatment options for non-metastatic nasopharyngeal cancers (NPC). However, their impact on the practice in the United Kingdom (UK), where this tumour is rare, is unknown. This study examined the current attitudes of UK head and neck oncologists to the treatment of NPC. UK head and neck oncologists representing 19/23 cancer networks were sent an invitation email with a personalised link to a web-based survey designed to identify the influence of tumour and nodal staging on current NPC management practices. 26/42 (61%) of clinicians responded. Induction chemotherapy followed by concomitant chemoradiation was the treatment of choice for Stage III (69%) and IVa/b (96%), with cisplatin and 5-fluorouracil combination being the most commonly used induction chemotherapy regimen (88%). 16 centres (61%) used a geometric approach, adding variable margins of 0-10 mm to the gross tumour volume to define their therapeutic dose clinical target volume. 54% of respondents used 3 radiotherapy (RT) prescription doses to treat NPC. Retropharyngeal nodal region irradiation policy was inconsistent, with nearly one-quarter treating the entire group to a radical dose. Significant heterogeneity currently exists in the RT practice of NPC in the UK. A consensus regarding the optimal curative, function-sparing treatment paradigm for NPC is necessary to ensure cancer survivors have satisfactory long-term health-related quality of life. Advances in knowledge: This is the first study to highlight the significant variation in RT practice of NPC in the UK.

Nutritional rehabilitation after ICU - does it happen: a qualitative interview and observational study.

PubMed

Merriweather, Judith; Smith, Pam; Walsh, Timothy

2014-03-01

To compare and contrast current nutritional rehabilitation practices against recommendations from National Institute for Health and Excellence guideline Rehabilitation after critical illness (NICE) (2009, http://www.nice.org.uk/cg83). Recovery from critical illness has gained increasing prominence over the last decade but there is remarkably little research relating to nutritional rehabilitation. The study is a qualitative study based on patient interviews and observations of ward practice. Seventeen patients were recruited into the study at discharge from the intensive care unit (ICU) of a large teaching hospital in central Scotland in 2011. Semi-structured interviews were conducted on transfer to the ward and weekly thereafter. Fourteen of these patients were followed up at three months post-ICU discharge, and a semi-structured interview was carried out. Observations of ward practice were carried out twice weekly for the duration of the ward stay. Current nutritional practice for post-intensive care patients did not reflect the recommendations from the NICE guideline. A number of organisational issues were identified as influencing nutritional care. These issues were categorised as ward culture, service-centred delivery of care and disjointed discharge planning. Their influence on nutritional care was compounded by the complex problems associated with critical illness. The NICE guideline provides few nutrition-specific recommendations for rehabilitation; however, current practice does not reflect the nutritional recommendations that are detailed in the rehabilitation care pathway. Nutritional care of post-ICU patients is problematic and strategies to overcome these issues need to be addressed in order to improve nutritional intake. © 2013 John Wiley & Sons Ltd.

Communication about family members' risk of melanoma: self-reported practices of dermatologists in the United States.

PubMed

Oliveria, Susan A; Heneghan, Maureen K; Halpern, Allan C; Hay, Jennifer L; Geller, Alan C

2012-05-01

To assess current self-reported communication and screening practices of dermatologists to their patients with melanoma about family members' risk of melanoma at the time of diagnosis and to understand the barriers that dermatologists encounter in communicating risk to patients. Descriptive survey study. Office-based practicing physicians in the United States. One thousand dermatologists. Melanoma risk communication practices. Of 974 eligible dermatologists, 406 completed the survey (response rate, 41.7%). Almost 85% of dermatologists reported that they often or always communicate risk to patients with melanoma about their first-degree relatives, and almost 80% reported that they often or always advise their patients with melanoma that their older children (18 years) may be at greater risk of skin cancer. However, less than 50% of dermatologists routinely offered to screen first-degree relatives who live nearby, while only 19.7% used medical record reminders to note communication of melanoma risk to family members. Most dermatologists reported no major barriers to melanoma risk communication. However, the presence of "any risk communication barrier" (time constraints, absence of guidelines, or lack of written material) was associated with reduced melanoma risk communication practices by dermatologists. The observed high rates of self-reported risk communication by dermatologists to patients with melanoma about their first-degree family members are encouraging. However, the reported low rates of actual screening of first-degree relatives warrant easy-to-administer office-based medical record reminders to facilitate and optimize screening of at-risk relatives.

Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa - a qualitative study.

PubMed

Muhwava, Lorrein Shamiso; Murphy, Katherine; Zarowsky, Christina; Levitt, Naomi

2018-05-10

Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders' perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant's first year of life. Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa's two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided.

North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues.

PubMed

Colwell, Janice C; McNichol, Laurie; Boarini, Joy

The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. Descriptive study. Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged.

Improving access to yoga: barriers to and motivators for practice among health professions students.

PubMed

Brems, Christiane; Justice, Lauren; Sulenes, Kari; Girasa, Lisa; Ray, Julia; Davis, Madison; Freitas, Jillian; Shean, Margaret; Colgan, Dharmakaya

2015-01-01

Yoga is gaining momentum as a popular and evidence-based, integrative health care and self-care practice. The characteristics of yoga practitioners are not proportional to the demographics of the general population, especially with respect to gender and ethnicity. Several access barriers have been implicated (eg, time, cost, and access to teachers). No studies have explored the barriers to practice among health professions students. Their participation in yoga is deemed important because they are future health professionals who will make referrals to other services. Research has shown that providers who practice yoga refer more patients to yoga. To increase yoga practice among health professions students, an understanding must be developed of factors that interfere with or facilitate a regular yoga practice. The current study intended to identify such barriers and motivators. This study was a small population survey. The setting was a private university in the northwestern United States, including students in 3 of its colleges and 10 professional programs. All students (N = 1585) in the programs of the 10 health professions received e-mail requests for participation. The Acceptability of Yoga Survey was developed for purposes of a larger yoga perceptions study and implemented with health professions students. Participants were solicited via e-mail; the survey was administered online. The current study used data from that survey. Of the 498 usable, completed surveys (ie, a response rate of approximately 30%), 478 were relevant to the current study. The sample's demographics--78% women and 79% white--did not differ significantly from the population's demographics. The findings revealed the existence of common barriers that were related to (1) time; (2) cost; (3) lack of pragmatic information about access to yoga classes and teachers; and (4) stereotypes related to flexibility, athleticism, and typical yoga practitioners. Motivators included athleticism, health promotion, and emotional well-being as well as the seeking of pain relief and a sense of community. A referral by health care providers was the least-frequently cited motivator. The findings have implications for strategies that may help motivate health professionals toward a yoga practice, because having done yoga personally may be related to a willingness to perceive the benefits of and to refer patients to yoga as a viable integrative treatment for patients. Improved access can be developed in 3 ways: (1) integration of yoga research into health curricula to acquaint care providers with yoga's benefits to patients and care givers; (2) have yoga available as close to the workplace as possible to obviate some of the larger access barriers; and (3) societally, project yoga as a healing art and science, not simply as a weight loss strategy or athletic endeavor.

Projected cancer risks potentially related to past, current, and future practices in paediatric CT in the United Kingdom, 1990-2020.

PubMed

Journy, Neige M Y; Lee, Choonsik; Harbron, Richard W; McHugh, Kieran; Pearce, Mark S; Berrington de González, Amy

2017-01-03

To project risks of developing cancer and the number of cases potentially induced by past, current, and future computed tomography (CT) scans performed in the United Kingdom in individuals aged <20 years. Organ doses were estimated from surveys of individual scan parameters and CT protocols used in the United Kingdom. Frequencies of scans were estimated from the NHS Diagnostic Imaging Dataset. Excess lifetime risks (ELRs) of radiation-related cancer were calculated as cumulative lifetime risks, accounting for survival probabilities, using the RadRAT risk assessment tool. In 2000-2008, ELRs ranged from 0.3 to 1 per 1000 head scans and 1 to 5 per 1000 non-head scans. ELRs per scan were reduced by 50-70% in 2000-2008 compared with 1990-1995, subsequent to dose reduction over time. The 130 750 scans performed in 2015 in the United Kingdom were projected to induce 64 (90% uncertainty interval (UI): 38-113) future cancers. Current practices would lead to about 300 (90% UI: 230-680) future cancers induced by scans performed in 2016-2020. Absolute excess risks from single exposures would be low compared with background risks, but even small increases in annual CT rates over the next years would substantially increase the number of potential subsequent cancers.

Menopause, the metabolic syndrome, and mind-body therapies

PubMed Central

Innes, Kim E.; Selfe, Terry Kit; Taylor, Ann Gill

2009-01-01

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

Management of Helicobacter Pylori in the United States: Results from a national survey of gastroenterology physicians.

PubMed

Murakami, Traci T; Scranton, Rebecca A; Brown, Heidi E; Harris, Robin B; Chen, Zhao; Musuku, Sunitha; Oren, Eyal

2017-07-01

We sought to determine current knowledge and practices among gastroenterology physicians and assess adherence to current guidelines for H. pylori management. Online surveys were distributed in 2014 to practicing gastroenterology physicians for information related to the diagnosis and treatment of H. pylori infection. A total of 582 completed surveys were reviewed. The H. pylori screening test used "almost always" was gastric biopsy obtained during endoscopy (histology) (59%) followed by stool antigen test (20%). Standard triple therapy for 14days was commonly prescribed by 53% of respondents. The stool antigen test was most frequently chosen to confirm H. pylori eradication (51%), although only 58% of physicians checked for eradication in patients who underwent treatment. Adherence to current American College of Gastroenterology guidelines is low. Although more physicians treat patients with a positive H. pylori test, only half ensure eradication after treatment. Improving knowledge of the resistance patterns of H. pylori may be critical to ensure successful eradication. Copyright © 2017 Elsevier Inc. All rights reserved.

Actual versus desired initiation patterns among a sample of college men: tapping disjunctures within traditional male sexual scripts.

PubMed

Dworkin, Shari L; O'Sullivan, Lucia

2005-05-01

Research on men's sexual scripts has tended to overlook that some men do not endorse traditional scripts or that one or both members of a couple might desire a departure from culturally dominant sexual scripts. This study used in-depth interviews with 32 college-aged men from a community college in New York City to examine disjunctures between current and desired sexual initiation patterns. Results show that although men currently practice male-dominated patterns of sexual initiation, many men desire egalitarian patterns of initiation. Men offered clear preference to be an object of desire to their female partners, deployed narratives of wanting to share the "labor" of sexual initiation, and expressed ideologies of sexual egalitarianism. We consider how shifting terrains of gender relations in contemporary U.S. culture may shape masculinities and sexual scripts. We also consider how an examination of disjunctures between current and desired practices might be useful to HIV researchers interested in interviewing across multiple levels of the sexual script.

Inhaled therapies in patients with moderate COPD in clinical practice: current thinking

PubMed Central

Ariel, Amnon; Altraja, Alan; Belevskiy, Andrey; Boros, Piotr W; Danila, Edvardas; Fležar, Matjaz; Koblizek, Vladimir; Fridlender, Zvi G; Kostov, Kosta; Krams, Alvils; Milenkovic, Branislava; Somfay, Attila; Tkacova, Ruzena; Tudoric, Neven; Ulmeanu, Ruxandra; Valipour, Arschang

2018-01-01

COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups. PMID:29317810

A Strategy for Assessing Costs of Implementing New Practices in the Child Welfare System: Adapting the English Cost Calculator in the United States

PubMed Central

Snowden, Lonnie R.; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2015-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided. PMID:20976620

Outcome science in practice: an overview and initial experience at the Vanderbilt Spine Center.

PubMed

McGirt, Matthew J; Speroff, Theodore; Godil, Saniya Siraj; Cheng, Joseph S; Selden, Nathan R; Asher, Anthony L

2013-01-01

In terms of policy, research, quality improvement, and practice-based learning, there are essential principles--namely, quality, effectiveness, and value of care--needed to navigate changes in the current and future US health care environment. Patient-centered outcome measurement lies at the core of all 3 principles. Multiple measures of disease-specific disability, generic health-related quality of life, and preference-based health state have been introduced to quantify disease impact and define effectiveness of care. This paper reviews the basic principles of patient outcome measurement and commonly used outcome instruments. The authors provide examples of how utilization of outcome measurement tools in everyday neurosurgical practice can facilitate practice-based learning, quality improvement, and real-world comparative effectiveness research, as well as promote the value of neurosurgical care.

Responding to the global economic crisis: inclusive social work practice.

PubMed

Strier, Ron

2013-10-01

The present global economic crisis raises new concerns for social workers. One of its most visible results is the further socioeconomic decline and marginalization of excluded populations. This article suggests that the current circumstances require a much more engaged, egalitarian, and reflexive practice-a practice, based on social rights, that matches the magnitude of the crisis and its negative impact on traditional social work constituencies. Consequently, the article suggests the concept of inclusive social work practice (ISWP), a conceptual framework whose main principles respond to four processes of social exclusion closely related to the present global crisis: extreme social isolation, growing dependency, multiple deprivation, and internalized oppression. The author describes the impact of the global crisis on patterns of social exclusion and presents the methodological foundations of the ISWP framework.

A strategy for assessing costs of implementing new practices in the child welfare system: adapting the English cost calculator in the United States.

PubMed

Chamberlain, Patricia; Snowden, Lonnie R; Padgett, Courtenay; Saldana, Lisa; Roles, Jennifer; Holmes, Lisa; Ward, Harriet; Soper, Jean; Reid, John; Landsverk, John

2011-01-01

In decisions to adopt and implement new practices or innovations in child welfare, costs are often a bottom-line consideration. The cost calculator, a method developed in England that can be used to calculate unit costs of core case work activities and associated administrative costs, is described as a potentially helpful tool for assisting child welfare administrators to evaluate the costs of current practices relative to their outcomes and could impact decisions about whether to implement new practices. The process by which the cost calculator is being adapted for use in US child welfare systems in two states is described and an illustration of using the method to compare two intervention approaches is provided.

The Changing Pattern of Doctoral Education in Public Health From 1985 to 2006 and the Challenge of Doctoral Training for Practice and Leadership

PubMed Central

Declercq, Eugene; Caldwell, Karen; Hobbs, Suzanne Havala; Guyer, Bernard

2008-01-01

We examined trends in doctoral education in public health and the challenges facing practice-oriented doctor of public health (DrPH) programs. We found a rapid rise in the numbers of doctoral programs and students. Most of the increase was in PhD students who in 2006 composed 73% of the total 5247 current public health doctoral students, compared with 53% in 1985. There has also been a substantial increase (40%) in students in DrPH programs since 2002. Challenges raised by the increased demand for DrPH practice-oriented education relate to admissions, curriculum, assessment processes, and faculty hiring and promotion. We describe approaches to practice-based doctoral education taken by three schools of public health. PMID:18633094

Yoga, breast cancer-related lymphoedema and well-being: A descriptive report of women's participation in a clinical trial.

PubMed

Loudon, Annette; Barnett, Tony; Williams, Andrew

2017-12-01

To describe the experiences of women taking part in a yoga intervention trial for breast cancer-related lymphoedema. Around 20% of women will experience lymphoedema as a consequence of treatment for breast cancer. Specialist lymphoedema clearing, along with self-management, remains the mainstay of therapy. Yoga, an increasingly popular complementary therapeutic practice, may provide another tool to augment self-management. A qualitative, descriptive design. Interviews were conducted with 15 women with stage one breast cancer-related lymphoedema who had completed an 8-week yoga intervention trial. The intervention consisted of a weekly teacher-led 1.5-hr yoga class and a daily home practice using a 45-min DVD. Interviews were audio-taped and transcribed. These data were then analysed using an iterative-thematic approach. Participants reported improved well-being, increased awareness of their physical body as well as improved physical, mental and social functioning. They gained from being part of the yoga group that also provided a forum for them to share their experiences. Nine women felt empowered to describe their yoga participation as a transformative journey through illness. When safe to do so, the holistic practice of yoga may augment and provide additional benefit to current self-management and treatment practices for women with breast cancer-related lymphoedema. Patients with breast cancer-related lymphoedema may seek advice and guidance from nurses and other healthcare professionals on a range of complementary therapies to help relieve symptoms and promote recovery. Patients who choose to augment their treatment of breast cancer-related lymphoedema by practicing yoga should be carefully assessed, be taught an appropriate technique by a qualified yoga teacher/therapist and its impact monitored by their yoga teacher/therapist, breast care nurse, lymphoedema therapist or treating clinician. © 2017 John Wiley & Sons Ltd.

Evidence for Masturbation and Prostate Cancer Risk: Do We Have a Verdict?

PubMed

Aboul-Enein, Basil H; Bernstein, Joshua; Ross, Michael W

2016-07-01

Prostate cancer (PCa) is one of the leading causes of cancer death in men and remains one of the most diagnosed malignancies worldwide. Ongoing public health efforts continue to promote protective factors, such as diet, physical activity, and other lifestyle modifications, against PCa development. Masturbation is a nearly universal safe sexual activity that transcends societal boundaries and geography yet continues to be met with stigma and controversy in contemporary society. Although previous studies have examined associations between sexual activity and PCa risk, anecdotal relations have been suggested regarding masturbation practice and PCa risk. To provide a summary of the published literature and examine the contemporary evidence for relations between masturbation practice and PCa risk. A survey of the current literature using seven academic electronic databases was conducted using search terms and key words associated with masturbation practice and PCa risk. The practice of masturbation and its relation to PCa risk. The literature search identified study samples (n = 16) published before October 2015. Sample inclusions varied by study type, sample size, and primary objective. Protective relations (n = 7) between ejaculation through masturbation and PCa risk were reported by 44% of the study sample. Age range emerged as a significant variable in the relation between masturbation and PCa. Findings included relations among masturbation, ejaculation frequency, and age range as individual factors of PCa risk. No universally accepted themes were identified across the study sample. Throughout the sample, there was insufficient agreement in survey design and data reporting. Potential avenues for new research include frequency of ejaculation and age range as covarying factors that could lead to more definitive statements about masturbation practice and PCa risk. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.