Management of Neurogenic Bladder.

PubMed

Sripathi, Venkataramani; Mitra, Aparajita

2017-07-01

This article provides a comprehensive summary of the clinical approach, investigative modalities and management of a child with neurogenic bladder disease due to myelodysplasia. It is aimed at pediatric physicians and surgeons working in developing nations. The methodologies suggested are simple and can be practised even in resource poor regions. The goal of management is avoidance of Chronic kidney disease and for this, meticulous bladder management is the key.

Effect of Sahaja yoga practice on stress management in patients of epilepsy.

PubMed

Panjwani, U; Gupta, H L; Singh, S H; Selvamurthy, W; Rai, U C

1995-04-01

An attempt was made to evaluate the effect of Sahaja yoga meditation in stress management in patients of epilepsy. The study was carried out on 32 patients of epilepsy who were rendomly divided into 3 groups: group I subjects practised Sahaja yoga meditation for 6 months, group II subjects practised postural exercises mimicking Sahaja yoga and group III served as the epileptic control group. Galvanic skin resistance (GSR), blood lactate and urinary vinyl mandelic acid (U-VMA) were recorded at 0, 3 and 6 months. There were significant changes at 3 & 6 months as compared to 0 month values in GSR, blood lactate and U-VMA levels in group I subjects, but not in group II and group III subjects. The results indicate that reduction in stress following Sahaja yoga practice may be responsible for clinical improvement which had been earlier reported in patients who practised Sahaja yoga.

Student performance and appreciation using 3D vs. 2D vision in a virtual learning environment.

PubMed

de Boer, I R; Wesselink, P R; Vervoorn, J M

2016-08-01

The aim of this study was to investigate the differences in the performance and appreciation of students working in a virtual learning environment with two (2D)- or three (3D)-dimensional vision. One hundred and twenty-four randomly divided first-year dental students performed a manual dexterity exercise on the Simodont dental trainer with an automatic assessment. Group 1 practised in 2D vision and Group 2 in 3D. All of the students practised five times for 45 min and then took a test using the vision they had practised in. After test 1, all of the students switched the type of vision to control for the learning curve: Group 1 practised in 3D and took a test in 3D, whilst Group 2 practised in 2D and took the test in 2D. To pass, three of five exercises had to be successfully completed within a time limit. The students filled out a questionnaire after completing test 2. The results show that students working with 3D vision achieved significantly better results than students who worked in 2D. Ninety-five per cent of the students filled out the questionnaire, and over 90 per cent preferred 3D vision. The use of 3D vision in a virtual learning environment has a significant positive effect on the performance of the students as well as on their appreciation of the environment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

These terrifying three words: A qualitative, mixed methods study of students' and mentors' understandings of 'fitness to practise'.

PubMed

Haycock-Stuart, Elaine; MacLaren, Jessica; McLachlan, Alison; James, Christine

2016-08-01

There is little empirical published research pertaining to fitness to practise and pre-registration nursing students. Much of the existing fitness to practise literature focuses on medical students and there is a preponderance of literature reviews and descriptive or discursive papers. The multicentre study aimed to explore students' and mentor's understandings of fitness to practise processes in pre-registration nursing programmes. A qualitative study in the interpretive paradigm with interpretive analysis involving 6 focus groups and 4 face-to-face interviews with nursing students and mentors. Eleven Higher Education Institutions providing pre-registration nursing education in the UK. Data were collected January 2014-March 2015 following ethical approval. Purposive sampling was used to recruit mentors and nursing (but not midwifery) students from pre-registration nursing programmes at different stages of educational preparation. Qualitatively driven semi-structured focus groups (n=6) and interviews (n=4) were conducted with a total of 35 participants (17 pre-registration nursing students and 18 nursing mentors). Three themes identified from the student and mentor data are considered: Conceptualising Fitness to Practise; Good Health and Character; and Fear and Anxiety Surrounding Fitness to Practise Processes. Uncertainty about understandings of fitness to practise contributed to a pervasive fear among students and reluctance among mentors to raise concerns about a student's fitness to practise. Both students and mentors expressed considerable anxiety and engaged in catastrophic thinking about fitness to practise processes. Higher Education Institutes should reinforce to students that they are fit to practise the majority of the time and reduce the negative emotional loading of fitness to practise processes and highlight learning opportunities. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Chromosome damage and cytotoxicity in oral mucosa cells after 2 months of exposure to anabolic steroids (decadurabolin and winstrol) in weight lifting.

PubMed

Martins, Renato A; Gomes, Guilherme A S; Aguiar, Odair; Medalha, Carla C; Ribeiro, Daniel A

2010-12-01

The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells from anabolic steroid users after 2 months of exposure. Two experimental groups consisting of 15 adult males who practise weight lifting and are anabolic steroid users or 15 adult males who practise weight lifting, but are non-anabolic steroid users, were recruited. In addition, 20 sedentary males, who do not practise any physical activity regularly, were matched by age with experimental groups. No significant statistical differences (p>0.05) were noticed in individuals who practise physical activity only. On the other hand, an increase of micronucleated cells (MNCs) in anabolic steroid (decadurabulin and Winstrol) users was observed. Regarding cytotoxic parameters, the same observation has occurred, that is, significant statistical differences (p<0.05) were noticed in the group exposed to anabolic steroids when compared with other controls, as depicted by high frequencies of pyknosis, karyolysis and karyorrhexis. Taken together, our results suggest that genomic instability and cytotoxicity are induced by anabolic steroid administration in oral mucosa cells as assessed by the micronucleus test. Copyright 2010 Elsevier Inc. All rights reserved.

[The changing picture of practicing dentistry].

PubMed

Hokwerda, O

2006-03-01

Originally, dentists were particularly technical and curative practitioners. Nowadays, patient care is brought into focus, directed at maintaining oral health permanently by prevention and necessary curative treatments as a contribution to general health and well-being. The changing picture of praccising does not develop as a matter-of-course since many factors have an effect on dental practice. Effecting factors are: content concerning developments, technological advancements, legislation, government policies, organizational aspects, and typical characteristics of dental practitioners. The changing picture of practising dentistry is connected with uncertainty, proves to be hard to control, and some adjustments occur around practising.

Effects of virtual reality training on functional reaching movements in people with Parkinson's disease: a randomized controlled pilot trial.

PubMed

Ma, Hui-Ing; Hwang, Wen-Juh; Fang, Jing-Jing; Kuo, Jui-Kun; Wang, Ching-Yi; Leong, Iat-Fai; Wang, Tsui-Ying

2011-10-01

To investigate whether practising reaching for virtual moving targets would improve motor performance in people with Parkinson's disease. Randomized pretest-posttest control group design. A virtual reality laboratory in a university setting. Thirty-three adults with Parkinson's disease. The virtual reality training required 60 trials of reaching for fast-moving virtual balls with the dominant hand. The control group had 60 practice trials turning pegs with their non-dominant hand. Pretest and posttest required reaching with the dominant hand to grasp real stationary balls and balls moving at different speeds down a ramp. Success rates and kinematic data (movement time, peak velocity and percentage of movement time for acceleration phase) from pretest and posttest were recorded to determine the immediate transfer effects. Compared with the control group, the virtual reality training group became faster (F = 9.08, P = 0.005) and more forceful (F = 9.36, P = 0.005) when reaching for real stationary balls. However, there was no significant difference in success rate or movement kinematics between the two groups when reaching for real moving balls. A short virtual reality training programme improved the movement speed of discrete aiming tasks when participants reached for real stationary objects. However, the transfer effect was minimal when reaching for real moving objects.

Current physical activity improves balance control during sensory conflicting conditions in older adults.

PubMed

Buatois, S; Gauchard, G C; Aubry, C; Benetos, A; Perrin, P

2007-01-01

Aging process is characterized by difficulties in ensuring balance control, especially in conditions of reduced or conflicting sensory information, leading to an increased risk of falling. Conversely, the practise of physical activities (PA) has been recognized as a good approach to improve the quality of balance control. This study aimed to investigate the influence of current and/or past PA on balance-related neurosensorial organization in older adults on the maintenance of the upright stance, especially during sensory conflicting situations. Postural control was evaluated by means of the Sensory Organization Test on 130 healthy noninstitutionalized volunteers aged over 65, split into four groups according to the presence or absence of PA before or after retirement. Subjects who practised PA for a long time (Gr1) and subjects who started PA after retirement (Gr2) displayed the best postural performances and better managed sensory conflicting situations compared to subjects who had stopped PA for many years (Gr3) and subjects who had never practised PA (Gr4). Multiple regression analyses revealed that current PA was the major determinant for postural parameters during sensorial conflict compared to age, gender, body mass index and past PA. Regular PA, even when started late in life, allows appropriate reorganization of the different components of postural control during sensory conflicting situations. Indeed, active subjects were more able to compensate for suppressed or perturbed sensory information by an increased usage of another referential and so to correct their posture by adopting a more appropriate balance strategy. Thus, PA counteracts the age-related decline of postural control and could consequently reduce the risk of falling.

Variations in hemostatic parameters after near-maximum exercise and specific tests in athletes.

PubMed

Cerneca, F; Crocetti, G; Gombacci, A; Simeone, R; Tamaro, G; Mangiarotti, M A

1999-03-01

The clotting state of the blood changes according to the type of physical exercise to which a group of healthy subjects are subjected. We studied the behaviour of the coagulation system before and after near-maximum, specific and standardized exercise tests in three groups of males practising sports defined as demanding in terms of cardiovascular output. The study was a comparative investigation between athletes and the group of controls composed of presumably healthy males. athletes training for competitions such as marathon, rowing and weightlifting. we tested 7 rowers using the rowing machine, 12 marathon runners using the treadmill, 7 weightlifters using their own exercise equipment, and 7 healthy subjects (controls) using the cycle ergometer. during the tests we monitored heart rates, maximal oxygen intake, anaerobic threshold, respiratory quotient, maximum ventilation, and lactic acid. The following coagulation tests were performed before and after near-maximum exercise: prothrombin time (PT), partial activated thromboplastin time (PTT), fibrinogen (FBG), antithrombin III (ATIII), protein C (PC), protein S (PS), prothrombin fragment 1 + 2 (F1 + 2), tissue activator of plasminogen (t-PA) and its inhibitor (PAI). The most significant results showed a low basal PC in the rowers which decreased further after near-maximum exercise; significantly higher basal activities of ATIII, PC and PS in the marathon runners compared to the rowers; a high proportion of weightlifters showed a reduction in t-PA after exercise and an increase of PAI; the controls were the only group in which fibrinolytic activity and all the circulating anticoagulants increased after near-maximum exercise. Thus subjects who practise aerobic sports differ principally in terms of variations in inhibitors (low PC in rowers and marathon runners, increased presence of inhibitors in controls). The weightlifters did not show any significant variations, and so the kind of exercise involved (training to increase resistance and maximum strength) and the recovery times between the exercises do not seem to trigger changes in coagulation/fibrinolysis. We can therefore confirm that only relatively prolonged effort can trigger a mechanism beneficial to the cardiovascular system. In conclusion, physical activity benefits the coagulation system particularly as regards fibrinolysis, but certain subjects may be at risk of thrombosis and these must be identified and followed. We suggest that fibrinolytic activity be studied in athletes who practise weightlifting and have a history of cardiovascular disease, and that inhibitors (protein C in particular) be studied in rowers with a family history of thromboembolism.

Outcome of an education and home-based exercise programme for patients with ankylosing spondylitis: a nationwide randomized study.

PubMed

Rodríguez-Lozano, Carlos; Juanola, Xavier; Cruz-Martínez, Juan; Peña-Arrébola, Andrés; Mulero, Juan; Gratacós, Jordi; Collantes, Eduardo

2013-01-01

This study aims to assess the impact of a structured education and home exercise programme in daily practice patients with ankylosing spondylitis. A total of 756 patients with ankylosing spondylitis (72% males, mean age 45 years) participated in a 6-month prospective multicentre controlled study, 381 of whom were randomised to an education intervention (a 2-hour informative session about the disease and the implementation of a non-supervised physical activity programme at home) and 375 to standard care (controls). Main outcome measures included Bath Ankylosing Spondylitis Disease Activity and Functional Index (BASDAI, BASFI). Secondary outcome measures were 0-10 cm visual analog scale (VAS) for total pain, nocturnal pain and global disease activity and quality of life (ASQoL), knowledge of disease (self-evaluation ordinal scale) and daily exercise (diary card). At 6 months, the adjusted mean difference between control and educational groups for BASDAI was 0.32, 95% confidence interval (CI) 0.10-0.54, p=0.005, and for BASFI 0.31, 95%CI 0.12-0.51, p=0.002. Significant differences were found also in VAS for total pain, patient´s global assessment and in ASQoL. Patients in the education group increased their knowledge about the disease and its treatments significantly (p<0.001) and practised more regular exercise than controls (p<0.001). A structured education and home exercise programme for patients with ankylosing spondylitis in daily practice was feasible and helped to increase knowledge and exercise. Although statistically significant, the magnitudes of the clinical benefits in terms of disease activity and physical function were poor.

Best practise use in stroke rehabilitation: from trials and tribulations to solutions!

PubMed

Menon, Anita; Bitensky, Nicol Korner; Straus, Sharon

2010-01-01

This article explores the use of best practises among stroke rehabilitation professionals, salient barriers that influence their knowledge uptake/application and effective knowledge translation (KT) strategies that meet the needs of this clinician group. Relevant literature on evidence-based practise in stroke rehabilitation and the use of KT strategies among rehabilitation professionals is summarised and discussed. Although adherence to rehabilitation guidelines translates into improved patient outcomes, best practises are not routinely applied by clinicians when treating individuals with a stroke. Lack of protected work time to search and appraise the research literature is by far the largest organisational barrier to knowledge uptake/application. Personal barriers, such as the lack of confidence and skills to interpret, synthesise and apply research findings, also limit clinicians' uptake of best practises. Studies involving rehabilitation professionals found that active KT strategies were more effective than passive strategies to produce change in their evidence-based knowledge and practise behaviours. As such, interactive e-learning resources are likely to be a relevant KT solution to meet rehabilitation professionals' specific learning needs, guide their clinical decision-making and ultimately increase their best practise behaviours. We have the knowledge of best practises in stroke rehabilitation, a means to disseminate that knowledge internationally through interactive e-learning resources, and information about effective KT interventions. With these opportunities in place, rehabilitation professionals can expand their capacity by adopting stroke best practises and producing better outcomes for patients.

A review of feral cat control.

PubMed

Robertson, Sheilah A

2008-08-01

Animal overpopulation including feral cats is an important global problem. There are many stakeholders involved in the feral cat debate over 'what to do about the problem', including those who consider them a nuisance, the public at risk from zoonotic disease, people who are concerned about the welfare of feral cats, those concerned with wildlife impacts, and the cats themselves. How best to control this population is controversial and has ranged from culling, relocation, and more recently 'trap neuter return' (TNR) methods. Data support the success of TNR in reducing cat populations, but to have a large impact it will have to be adopted on a far greater scale than it is currently practised. Non-surgical contraception is a realistic future goal. Because the feral cat problem was created by humans, concerted educational efforts on responsible pet ownership and the intrinsic value of animals is an integral part of a solution.

Prefrontal involvement in imitation learning of hand actions: effects of practice and expertise.

PubMed

Vogt, Stefan; Buccino, Giovanni; Wohlschläger, Afra M; Canessa, Nicola; Shah, N Jon; Zilles, Karl; Eickhoff, Simon B; Freund, Hans-Joachim; Rizzolatti, Giacomo; Fink, Gereon R

2007-10-01

In this event-related fMRI study, we demonstrate the effects of a single session of practising configural hand actions (guitar chords) on cortical activations during observation, motor preparation and imitative execution. During the observation of non-practised actions, the mirror neuron system (MNS), consisting of inferior parietal and ventral premotor areas, was more strongly activated than for the practised actions. This finding indicates a strong role of the MNS in the early stages of imitation learning. In addition, the left dorsolateral prefrontal cortex (DLPFC) was selectively involved during observation and motor preparation of the non-practised chords. This finding confirms Buccino et al.'s [Buccino, G., Vogt, S., Ritzl, A., Fink, G.R., Zilles, K., Freund, H.-J., Rizzolatti, G., 2004a. Neural circuits underlying imitation learning of hand actions: an event-related fMRI study. Neuron 42, 323-334] model of imitation learning: for actions that are not yet part of the observer's motor repertoire, DLPFC engages in operations of selection and combination of existing, elementary representations in the MNS. The pattern of prefrontal activations further supports Shallice's [Shallice, T., 2004. The fractionation of supervisory control. In: Gazzaniga, M.S. (Ed.), The Cognitive Neurosciences, Third edition. MIT Press, Cambridge, MA, pp. 943-956] proposal of a dominant role of the left DLPFC in modulating lower level systems and of a dominant role of the right DLPFC in monitoring operations.

Applications of biomechanics for prevention of work-related musculoskeletal disorders.

PubMed

Garg, Arun; Kapellusch, Jay M

2009-01-01

This paper summarises applications of biomechanical principles and models in industry to control musculoskeletal disorders of the low back and upper extremity. Applications of 2-D and 3-D biomechanical models to estimate compressive force on the low back, the strength requirements of jobs, application of guidelines for overhead work and application of strain index and threshold limit value to address distal upper extremity musculoskeletal disorders are presented. Several case studies applied in the railroad industry, manufacturing, healthcare and warehousing are presented. Finally, future developments needed for improved biomechanical applications in industry are discussed. The information presented will be of value to practising ergonomists to recognise how biomechanics has played a significant role in identifying causes of musculoskeletal disorders and controlling them in the workplace. In particular, the information presented will help practising ergonomists with how physical stresses can be objectively quantified.

Karaoke therapy in the rehabilitation of mental patients.

PubMed

Leung, C M; Lee, G; Cheung, B; Kwong, E; Wing, Y K; Kan, C S; Lau, J

1998-04-01

To study the efficacy of karaoke singing and its implications in the rehabilitation of mental patients in Hong Kong Chinese. A double blind controlled trial was conducted over six weeks in a small sample of chronic schizophrenic patients matched in age, sex and duration of illness. The index group practised karaoke and the controlled group practised simple singing. Subjects were assessed in changes in mood and social interaction. No significant difference was detectable within the 2 groups. However, significant differences of anxiety and social interaction at the end of the third and sixth weeks respectively, were detectable between the 2 groups. Karaoke therapy may be more effective than simple singing in improving social interaction. There is preliminary evidence that it may be anxiety-provoking for unstable schizophrenic patients. More research is required for further elucidation of the characteristics of favourable candidates, optimal schedule and active components of the therapy.

Progress towards the eradication of Aujeszky's disease in New Zealand by vaccination with a subunit vaccine.

PubMed

Motha, M X; Atkinson, G; Hoyle, F P

1994-08-27

Attempts to control Aujeszky's disease by vaccination with a glycoprotein-I negative subunit vaccine have been made on nine New Zealand pig farms. Thirty-one to 42 months after the programme of vaccination began, its progress was assessed by measuring the gI-antibody response in pigs from seven of the farms. Three farms had totally eradicated the 'wild' virus infection, one farm was close to achieving complete eradication and the other three farms had made little or no progress. One of the farms which eradicated the 'wild' virus infection achieved this status in two years by combining vaccination with an intensive testing and culling programme; the other two farms had eradicated the 'wild' virus infection by a combination of vaccination and good standards of hygiene without undertaking an intensive culling programme. The farms that had made little or no progress had less satisfactory standards of hygiene and did not practise an intensive testing and culling programme.

The Development of Practising Strategies in Young People

ERIC Educational Resources Information Center

Hallam, Susan; Rinta, Tiija; Varvarigou, Maria; Creech, Andrea; Papageorgi, Ioulia; Gomes, Teresa; Lanipekun, Jennifer

2012-01-01

There has been considerable research considering how instrumental practice changes as expertise develops. Much of that research has been relatively small scale and restricted in the range of instrumentalists included. This paper aimed to explore the development of practising strategies and motivation to practise as expertise develops with a large…

Development and application of modern agricultural biotechnology in Botswana: The potentials, opportunities and challenges

PubMed Central

Batlang, Utlwang; Tsurupe, Gorata; Segwagwe, Amogelang; Obopile, Motshwari

2014-01-01

In Botswana, approximately 40% of the population live in rural areas and derive most of their livelihood from agriculture by keeping livestock and practising arable farming. Due to the nature of their farming practises livestock and crops are exposed to diseases and environmental stresses. These challenges offer opportunities for application of biotechnology to develop adaptable materials to the country's environment. On the other hand, the perceived risk of genetically modified organisms (GMOs) has dimmed the promise of the technology for its application in agriculture. This calls for a holistic approach to the application of biotechnology to address issues of biosafety of GMOs. We have therefore assessed the potentials, challenges and opportunities to apply biotechnology with specific emphasis on agriculture, taking cognisance of requirement for its research, development and application in research and teaching institutions. In order to achieve this, resource availability, infrastructure, human and laboratory requirements were analyzed. The analysis revealed that the country has the capacity to carry out research in biotechnology in the development and production of genetically modified crops for food and fodder crops. These will include gene discovery, genetic transformation and development of systems to comply with the world regulatory framework on biosafety. In view of the challenges facing the country in agriculture, first generation biotech crops could be released for production. Novel GM products for development may include disease diagnosis kits, animal disease vaccines, and nutrient use efficiency, drought, and pest and disease resistant food and fodder crops. PMID:25437237

Development and application of modern agricultural biotechnology in Botswana: the potentials, opportunities and challenges.

PubMed

Batlang, Utlwang; Tsurupe, Gorata; Segwagwe, Amogelang; Obopile, Motshwari

2014-07-03

In Botswana, approximately 40% of the population live in rural areas and derive most of their livelihood from agriculture by keeping livestock and practising arable farming. Due to the nature of their farming practises livestock and crops are exposed to diseases and environmental stresses. These challenges offer opportunities for application of biotechnology to develop adaptable materials to the country's environment. On the other hand, the perceived risk of genetically modified organisms (GMOs) has dimmed the promise of the technology for its application in agriculture. This calls for a holistic approach to the application of biotechnology to address issues of biosafety of GMOs. We have therefore assessed the potentials, challenges and opportunities to apply biotechnology with specific emphasis on agriculture, taking cognisance of requirement for its research, development and application in research and teaching institutions. In order to achieve this, resource availability, infrastructure, human and laboratory requirements were analyzed. The analysis revealed that the country has the capacity to carry out research in biotechnology in the development and production of genetically modified crops for food and fodder crops. These will include gene discovery, genetic transformation and development of systems to comply with the world regulatory framework on biosafety. In view of the challenges facing the country in agriculture, first generation biotech crops could be released for production. Novel GM products for development may include disease diagnosis kits, animal disease vaccines, and nutrient use efficiency, drought, and pest and disease resistant food and fodder crops.

[Computer-assisted education in problem-solving in neurology; a randomized educational study].

PubMed

Weverling, G J; Stam, J; ten Cate, T J; van Crevel, H

1996-02-24

To determine the effect of computer-based medical teaching (CBMT) as a supplementary method to teach clinical problem-solving during the clerkship in neurology. Randomized controlled blinded study. Academic Medical Centre, Amsterdam, the Netherlands. 103 Students were assigned at random to a group with access to CBMT and a control group. CBMT consisted of 20 computer-simulated patients with neurological diseases, and was permanently available during five weeks to students in the CBMT group. The ability to recognize and solve neurological problems was assessed with two free-response tests, scored by two blinded observers. The CBMT students scored significantly better on the test related to the CBMT cases (mean score 7.5 on a zero to 10 point scale; control group 6.2; p < 0.001). There was no significant difference on the control test not related to the problems practised with CBMT. CBMT can be an effective method for teaching clinical problem-solving, when used as a supplementary teaching facility during a clinical clerkship. The increased ability to solve problems learned by CBMT had no demonstrable effect on the performance with other neurological problems.

Factors Associated with Induced Abortion in Women Prostitutes in Asturias (Spain)

PubMed Central

Tsakiridu, Domingo Ojer; Franco Vidal, Amalia; Vázquez Valdés, Fernando; Junquera Llaneza, Maria Luisa; Varela Uría, Jose Antonio; Cuesta Rodríguez, Mar; López Sanchez, Carmen; Busto Folgosa, Margarita; Fernández Ollero, Maria Jesús

2008-01-01

Background The aim is to investigate the factors that might be associated with the presence of induced abortion (IA) in women prostitutes in Asturias (Spain). Methodology/Principal Findings Cross-sectional descriptive study by self-completion questionnaire of 212 women prostitutes who attended the three Sexually Transmitted Disease Clinics in Asturias, between January–December 2003. The questionnaire was designed to investigate the women's perceived knowledge (what they claimed to know), their real knowledge (what they really knew), the use of contraceptive methods and socio-demographic variables. Multivariate analysis was carried out. 92% of the participants were immigrants. 76% were practising at brothel. 37.6% (95%CI:30.7–44.4%) reported to have undergone at least one IA during their life. According to the logistic regression the “presence of IA” was directly associated with the variables “number of pregnancies”(OR:65.82;95%IC:7.73–560.14) and “years of practising prostitution”(OR:1.13;95%CI:0.99–1.29); and inversely associated with “children”(0 = no children;1 = one or more children; OR:0.005;95%CI:0.000–0.057), “women's age”(OR:0.89;95%CI:0.82–0.97) and “real contraceptive knowledge”(OR:0.50; 95%CI:0.34–0.75). Married women were more likely to have undergone an IA (OR:2.74;95%IC:1.05–7.13). No association with “perceived contraceptive knowledge” was found. Conclusions/Significance The characteristics more closely linked to the reproductive history of the women (such as “pregnancies”, “children”), together with the “real contraceptive knowledge” and the “time practising prostitution” explain the presence of IA better than factors more closely linked to the conditions in which the women practise prostitution (“place of activity”, “other activities compatible with prostitution”, “use of safe method in commercial relation”). It is possible that IA is being used as a birth control method, hypothesis suggested by the inverse association observed between the variable “children” and the “presence of IA”. Therefore, the promotion of the use of safe contraceptive methods should be a high-priority. If the real contraceptive knowledge was measured correctly, all strategies to increase it would be justified because it was inversely associated with the presence of IA. PMID:18523646

Practising Leadership in Newly Multi-Ethnic Schools: Tensions in the Field?

ERIC Educational Resources Information Center

Devine, Dympna

2013-01-01

This paper explores the leadership practices of three principals following a period of intensive immigration in Ireland. Drawing on the work of Bourdieu, it conceptualises schools as structured social spaces and of their leadership work as a form of "practising". This practising is an outcome of the intersection between deeply embedded…

Student professional suitability: lessons from how the regulator handles fitness to practise cases.

PubMed

Unsworth, John

2011-07-01

A self regulating profession, such as nursing, has to have in place systems which deal with practitioners considered unfit to practise. In addition, students studying to enter the profession may also be subject to systems to address concerns about their professional suitability. While the NMC have left it up to each Higher Education Institution (HEI) to identify the systems which should be in place for students, there is a body of case law and statutory legislation which governs how the NMC deals with fitness to practise amongst qualified nurses and midwives. This paper examines the content of fitness to practise policies in place across HEIs and compares this with how the regulator handles fitness to practise cases. Data was collected using unobtrusive methods and was analysed using content analysis. The results suggest that many HEI's policies have significant gaps which may result in challenges to decision making. In addition, the power of some Vice Chancellors to overturn fitness to practise decisions on appeals calls into question the whole notion of professional self regulation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Spanish adaptation of the Creative Potential and Practised Creativity scale (CPPC-17) in the workplace and inside the organization.

PubMed

Boada-Grau, Joan; Sánchez-García, José-Carlos; Prizmic-Kuzmica, Aldo-Javier; Vigil-Colet, Andreu

2014-01-01

This study follows the theoretical framework put forward by Hinton on creative potential and practised creativity. The objective was to adapt the 17-item Creative Potential and Practised Creativity scale into Spanish and examine its psychometric properties. The study sample was made up of 975 Spanish employees (48.5% men and 51.5% women). After performing a confirmatory factor analysis, the findings revealed a three-factor structure: Creative potential, Practised creativity and Perception of organizational support. Furthermore, appropriate reliability was found for all three factors as well as initial evidence of construct validity in relation to certain external correlates and a series of scales measuring workaholism, irritation, burnout and personality. The present scale may prove ideal for adequately identifying Creative potential, Practised creativity and Perceived organizational support.

Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.

PubMed

van Houtum, L; Heijmans, M; Rijken, M; Groenewegen, P

2016-04-01

Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management. Survey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics. Chronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not. Chronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management. Copyright © 2016. Published by Elsevier Ireland Ltd.

Role of physical activity and sport in oncology: scientific commission of the National Federation Sport and Cancer CAMI.

PubMed

Bouillet, T; Bigard, X; Brami, C; Chouahnia, K; Copel, L; Dauchy, S; Delcambre, C; Descotes, J M; Joly, F; Lepeu, G; Marre, A; Scotte, F; Spano, J P; Vanlemmens, L; Zelek, L

2015-04-01

This overview reports published data about the interaction between physical activity and sport during and after cancer on one hand and improvement in psychological parameters, survival and biological mechanisms underlying this effect on the other hand. Practising physical activity and sport during cancer modifies parameters assessing fatigue and quality of life and reduces symptoms of depression. An association also exists between the practise of physical activity and sport and overall and cancer-specific survivals, especially after breast cancer, colon cancer and prostate cancer. These benefits seem to be mediated by a modification of circulating levels of estrogens, insulin, IGF-1 and by a decrease in insulin-resistance, by alterations in the secretion of adipokines, and by a reduction in chronic inflammation through decreased levels of cytokines. There exist some obstacles to the practise of physical activity. These obstacles are mainly related to a fear of pain induced by physical activity and to overweight. These programmes of physical activity and sport cannot be offered to all patients since there are several contra-indications, with some being present since the initial visit and others appearing during cancer management either due to disease progression or related to iatrogenic effects. Whereas benefits from physical activity and sport among cancer patients seem obvious, there are still several pending clinical and biological issues. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The challenges and effects of globalisation on forensic dentistry.

PubMed

Bernitz, Herman

2009-08-01

This paper deals with the challenges faced by forensic dentists in a world in which globalisation has become a reality. People travelling across the globe on a daily basis become victims of violent crime, terrorist attacks, human displacement, natural and man made disasters. This has forced colleagues in the profession to participate in joint operations exposing inadequacies which need urgent attention. Forensic dentists practise in isolation creating their own rules and regulations oblivious to the greater global community. No international protocols exist for the many procedures practised by the profession. Possible solutions to the complex problems are offered. These include co-operation with colleagues around the globe while striving for the highest levels of quality control, standardisation, reliability, impartiality, reproducibility and ethical accountability.

[The economic margins of activities of a bovine practitioner on dairy farms].

PubMed

van Genugten, A J M; van Haaften, J A; Hogeveen, H

2011-11-01

Because of lower margins and market liberalisation veterinarians and farmers are increasingly negotiating rates. Therefore, the margins of veterinarians are under pressure. In addition, the sales if drugs, performance of operations or giving of advice are more and more separated. These developments give veterinarians uncertainty about the profitability of their activities for dairy farmers. Not much is known about margins on veterinary activities on dairy farms. Moreover, it is interesting to see how much margins of the bovine practitioner differ between veterinary practises and dairy farms. In this study, invoices for bovine activities of 14 veterinary practises were combined with milk production registration data of the dairy farms of these practices. This way, the gross margin per bovine practitioner could be studied for the different veterinary practise. Moreover the relation between gross margin and specification of the veterinary practise could be studied. Finally, the gross margin per dairy farm and the factors that influenced this gross margin were studied. The most important result was the observation that the gross margin per bovine practitioner was dependent on the number of dairy farms per practitioner, the margin on drugs and the region of the veterinary practise. The size of the veterinary practise, the share of the dairy farming within the practise and the source of the gross margin (drugs, time or operations) did not influence the gross margin. Variables that explained the gross margin per dairy farm were, amongst others, the number of dairy cows, the milk production level of the farms and participation in PIR-DAP (a system to support the veterinarians herd health and management program). There is no relation of gross margin per dairy farm and the veterinary practise or region.

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques.

PubMed

Solberg, E E; Ingjer, F; Holen, A; Sundgot-Borgen, J; Nilsson, S; Holme, I

2000-08-01

To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise. Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention. After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety. Meditation training may reduce the lactate response to a standardised exercise bout.

The effect of the publication of a major clinical trial in a high impact journal on clinical practise: the ORACLE Trial experience.

PubMed

Kenyon, Sara; Taylor, David J

2002-12-01

To estimate the short term effect of the publication of a major clinical trial on clinical practise. Questionnaire survey of clinical practise. UK. All maternity units in the UK. A self-administered questionnaire completed by lead consultants on delivery suite of maternity units. Changes in antibiotic prescription. Within six months of publication, approximately 50% of maternity units had changed their guidelines for the care of women with preterm prelabour rupture of the fetal membranes. Publication of a major clinical trial does impact on clinical practise but the impact is heterogeneous in terms of time and consistency.

Future practice of graduates of the New Zealand Diploma of Obstetrics and Gynaecology or Certificate in Women's Health.

PubMed

Miller, Dawn; Roberts, Helen; Wilson, Don

2008-09-22

To determine: why Diploma of Obstetrics (DipObs), Diploma of Obstetrics and Medical Gynaecology (DipOMG), or Certificate in Women's Health graduates enrolled; course usefulness; and subsequent practice. 588 University of Otago DipObs, DipOMG, and Certificate in Women's Health graduates (1992-2006) plus Auckland University graduates (1996-2006) were identified. All were doctors. Questionnaires were sent to the 477 with New Zealand medical registration and responses analysed. 334 of the 477 graduates returned completed questionnaires--70% response rate. 73% had worked as GPs, 10% at family planning clinics, 6% at sexual health clinics; and 13% specialised in OandG. 80% enrolled to further knowledge in women's health, 20% in children's health, and 43% to practise GP obstetrics. Most respondents who enrolled in the 1990s intended to practise GP obstetrics but by 2000 most did not. Of 137 New Zealand-based GP respondents who enrolled to practise GP obstetrics, only 5 (3.6%) currently practise intrapartum obstetric care. Twenty-three GPs still practise shared maternity care. Of 220 primary care practitioners, 90% provide early antenatal care. 93% described the course as useful-extremely useful. The DipObs, Dip OMG and Certificate in Women's Health have continued to provide useful postgraduate training in women's health during a changing time in New Zealand pregnancy care. While many graduates of the 1990s enrolled to practise GP obstetrics, most recent graduates did not, and few GPs still practise intrapartum obstetrics.

The Social-Psychological Outcomes of Martial Arts Practise Among Youth: A Review

PubMed Central

Vertonghen, Jikkemien; Theeboom, Marc

2010-01-01

Martial arts involvement among the youth has been described in controversial terms. Studies regarding the effects of martial arts practise on youth show contrasting images. While some refer to enhanced personal and social opportunities for those that participate, others warn against increased levels of aggressiveness and antisocial behavior among its participants. The aim of the present review is to provide, firstly, an overview of the major findings of studies concerning the social-psychological outcomes of martial arts practise. Secondly, the limitations of those studies are discussed. From more than 350 papers, collected during a two-year lasting literature study, 27 papers met all criteria to be included in this study. This review revealed that even though a considerable amount of research on social-psychological outcomes of martial arts practise has been conducted over the years, to date, it has not brought clarity in the existing duality regarding the possible effects of martial arts involvement. It is proposed that a better understanding can be provided if specific influential factors are taken into account in future research (i.e., participants' characteristics, type of guidance, social context and structural qualities of the sport). Key points Many common beliefs exist about the positive and negative outcomes of martial arts practise. Studies regarding the effects of martial arts practise on youth show contrasting images. Several influential factors have to be taken into account when examining the social-psychological outcomes of martial arts practise. PMID:24149778

The social-psychological outcomes of martial arts practise among youth: a review.

PubMed

Vertonghen, Jikkemien; Theeboom, Marc

2010-01-01

Martial arts involvement among the youth has been described in controversial terms. Studies regarding the effects of martial arts practise on youth show contrasting images. While some refer to enhanced personal and social opportunities for those that participate, others warn against increased levels of aggressiveness and antisocial behavior among its participants. The aim of the present review is to provide, firstly, an overview of the major findings of studies concerning the social-psychological outcomes of martial arts practise. Secondly, the limitations of those studies are discussed. From more than 350 papers, collected during a two-year lasting literature study, 27 papers met all criteria to be included in this study. This review revealed that even though a considerable amount of research on social-psychological outcomes of martial arts practise has been conducted over the years, to date, it has not brought clarity in the existing duality regarding the possible effects of martial arts involvement. It is proposed that a better understanding can be provided if specific influential factors are taken into account in future research (i.e., participants' characteristics, type of guidance, social context and structural qualities of the sport). Key pointsMany common beliefs exist about the positive and negative outcomes of martial arts practise.Studies regarding the effects of martial arts practise on youth show contrasting images.Several influential factors have to be taken into account when examining the social-psychological outcomes of martial arts practise.

[Simulation in health to improve the delivery of care].

PubMed

Tesnière, Antoine; Fleury, Cynthia

2017-11-01

Simulation in health care is a very effective training tool. Using mannequins, 'standardised patients' or virtual care environments, it encourages participants to reflect on nursing practices while practising in a safe and controlled space. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Social and behavioural aspects of venereal disease among resident male university students.

PubMed

Babu, D S; Marwah, S M; Singh, G

1976-06-01

A study of 1500 male students at Banaras Hindu University, Varanasi, India was conducted to establish the prevalence and related social and behavioural aspects of venereal diseases. The prevalence was found to be 3.93 per cent. The majority of the students (86.4 per cent) belonged to the Hindu religion which is based on the caste system. Students from the Vaishya caste were more affected with venereal diseases. The social acceptability of having more than one wife had a definite impact on the incidence of venereal diseases. Students who practised masturbation and homosexuality were also more affected with venereal diseases. Prostitutes were the main source of infection. It was found that 28.8 per cent of these students had been infected on a previous occasion.

Another Breakthrough, Another Baby Thrown out with the Bathwater

ERIC Educational Resources Information Center

Bell, David M.

2009-01-01

"Process-oriented pedagogy: facilitation, empowerment, or control?" claims that process-oriented pedagogy (POP) represents the methodological perspective of most practising teachers and that outcomes-based education (OBE) poses a real and present danger to stakeholder autonomy. Whereas POP may characterize methodological practices in the inner…

Knowledge of sickle cell disease and haemoglobin electrophoresis: a survey of students of a tertiary institution.

PubMed

Alao, O O; Araoye, M; Ojabo, C

2009-01-01

Sickle Cell Disease (SCD) is the commonest genetic disease worldwide. Of the sickle cell control strategies, premarital genetic counselling is increasingly practised in many countries of the world. Knowledge of the citizenry of a nation about SCD constitutes an important variable that influences the acceptability, practice and success of premarital genetic counselling. A study of students of Benue State University, Makurdi was carried out to determine their current level of knowledge. A cross sectional study involving 300 students of Benue State University, Makurdi; selected by a multistage stratified sampling technique, using self administered structured questionnaire, was carried out. Virtually all study respondents had at one time or the other heard about sickle cell disease. Based on the criteria used for knowledge scoring, less than half of the students (48%) demonstrated good knowledge. Overall Mean Score Knowledge (MSK) was 4.65 +/- 1.65. MSK was 4.58 +/- 1.66 and 4.74 +/- 1.64 for males and females respectively; there was no statistically significant difference (P > 0.05). However, having an affected relative suffering from sickle cell disease significantly influenced level of knowledge among study respondents (P < 0.05), but was not significantly associated with respondents knowing their haemoglobin phenotype. Only 141 students (47%) knew their haemoglobin phenotype. Level of knowledge about SCD did not significantly increase with age. Also, sex and religion did not significantly influence level of knowledge. The knowledge about SCD was poor and only a few knew their haemoglobin phenotype. If sickle cell disease control strategies must yield any significant results, more education about SCD, especially among students in tertiary institutions in Nigeria is recommended. The use of persons with SCD as peer educators/counsellors should be explored.

[Between individuality and "evidence-based medicine"--the role of the general practitioner within the scope of disease management programs].

PubMed

Szecsenyi, Joachim; Schneider, Antonius

2003-06-01

In Germany, the change from the "traditional", experience-based general practitioner (GP) to the evidence-based practising co-ordinator may be accelerated by the introduction of disease management programmes. Here, we will discuss some tools that can help to meet this challenge. Also, a set of requirements will be defined that the health care system will have to provide in support of GPs. Maintaining the relationship between doctor and patient and also allowing for individual care on the basis of evidence-based medicine will remain a challenge.

The influence of participation in target-shooting sport for children with inattentive, hyperactive and impulsive symptoms - A controlled study of best practice.

PubMed

Månsson, Annegrete Gohr; Elmose, Mette; Dalsgaard, Søren; Roessler, Kirsten K

2017-03-28

Practising target-shooting sport requires focused attention and motoric steadiness. A previous non-controlled pilot study suggests that children with impairing symptoms of attention-deficit/hyperactivity disorder (ADHD) benefit from participating in target-shooting sport in local shooting associations, as rated by parents and teachers. This study aims at examining if, and to which extent, target-shooting sport reduces parent- and teacher-reported severity of inattentiveness, hyperactivity, and impulsivity in children with attention difficulties, and if, and to which extend, target-shooting sport improves the children's wellbeing and quality of life. A mixed method approach is applied. A non-blinded, waiting list controlled study is combined with a case study, consisting of interviews and observations. The intervention consists of children practising target-shooting sport, by attending a local shooting association, once a week for six months, during regular school hours. Data from questionnaires (ADHD-RS, SDQ, Kidscreen-27), as well as a computerized continued performance test (Qb test), measure the children's activity and attention. The study includes 50 children in an intervention group and 50 children in a waiting list control group. The Qb test collects data from at least 20 children from the intervention group and at least 20 children from the waiting list control group. Data from the questionnaires and Qb-test is collected at baseline, and six months post intervention. In addition, a case study is carried out, consisting of interviews of at least five children from the intervention group, their parents, teachers and shooting instructors. Observations are carried out, when children are in school and while they are attending the local shooting association. The case study adds to an in-depth understanding of children's participation in target-shooting sports. At present, little is known about the effects and influence of practising target-shooting sport for children experiencing difficulties with inattentiveness, hyperactivity and impulsivity. This study is expected to contribute to an understanding of the influence of participating in target-shooting sports on inattentive, hyperactive and impulsive symptoms, and the effects on the children's psychological wellbeing and quality of life. Current Controlled Trials NCT02898532 . Retrospectively registered 14 September 2016.

[Recent developments in the field of infectious diseases].

PubMed

Freedman, L R

1978-12-02

A résumé is presented of recent developments in the field of infectious diseases of particular interest of practising physicians. Examples are given to illustrate recent discoveries concerning the frequent misuse of antibiotics, the problem of infections developing in hospitalized patients, the biology of microbial infection, the etiology of well-known illnesses, new infectious diseases, and the development of vaccines. It is evident that the rate at which new and important information is evident that the rate at which new and important information is being reported demands particular effort in medical school teaching to ensure that students learn how to acquire and evaluate new information as well as how to discard ideas which are no longer valid.

Simulating changes in cropping practises in conventional and glyphosate-tolerant maize. I. Effects on weeds.

PubMed

Colbach, Nathalie; Fernier, Alice; Le Corre, Valérie; Messéan, Antoine; Darmency, Henri

2017-04-01

Herbicide-tolerant (HT) crops such as those tolerant to glyphosate simplify weed management and make it more efficient, at least at short-term. Overreliance on the same herbicide though leads to the spread of resistant weeds. Here, the objective was to evaluate, with simulations, the impact on the advent of glyphosate resistance in weeds of modifications in agricultural practises resulting from introducing HT maize into cropping systems. First, we included a single-gene herbicide resistance submodel in the existing multispecific FLORSYS model. Then, we (1) simulated current conventional and probable HT cropping systems in two European regions, Aquitaine and Catalonia, (2) compared these systems in terms of glyphosate resistance, (3) identified pertinent cultural practises influencing glyphosate resistance, and (4) investigated correlations between cultural practises and species traits, using RLQ analyses. The simulation study showed that, during the analysed 28 years, (1) glyphosate spraying only results in glyphosate resistance in weeds when combined with other cultural factors favouring weed infestation, particularly no till; (2) pre-sowing glyphosate applications select more for herbicide resistance than post-sowing applications on HT crops; and (3) glyphosate spraying selects more for species traits avoiding exposure to the herbicide (e.g. delayed early growth, small leaf area) or compensating for fitness costs (e.g. high harvest index) than for actual resistance to glyphosate, (4) actual resistance is most frequent in species that do not avoid glyphosate, either via plant size or timing, and/or in less competitive species, (5) in case of efficient weed control measures, actual resistance proliferates best in outcrossing species. An advice table was built, with the quantitative, synthetic ranking of the crop management effects in terms of glyphosate-resistance management, identifying the optimal choices for each management technique.

Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

PubMed

Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane

2015-04-21

The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation. A retrospective cohort design was used to determine an association between year of primary medical qualification and doctors' test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman's correlation and regression models. Doctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p < 0.001 and OSCE r = 0.37, p < 0.001). Qualification year was associated with test performance in doctors under investigation even when controlling for sex, ethnicity and qualification region. Regression analyses showed that qualification year was associated with knowledge test, OSCE and communication skills performance of doctors under investigation when other variables were controlled for. Among volunteer doctors this was not the case and their performance was more strongly related to where they qualified and their ethnic background. Furthermore, volunteer doctors who qualified before the introduction of Single Best Answer and OSCE assessments, still outperformed their peers under investigation. Earlier graduates under fitness to practise investigation performed less well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC's fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.

Postural Effects of Vestibular Manipulation Depend on the Physical Activity Status

PubMed Central

Maitre, Julien; Paillard, Thierry

2016-01-01

The purpose of this study was to compare the effects of galvanic vestibular stimulation (GVS) on postural control for participants of different physical activity status (i.e. active and non-active). Two groups of participants were recruited: one group of participants who regularly practised sports activities (active group, n = 17), and one group of participants who did not practise physical and/or sports activities (non-active group, n = 17). They were compared in a reference condition (i.e bipedal stance with eyes open) and four vestibular manipulation condition (i.e. GVS at 0.5 mA and 3 mA, in accordance with two designs) lasting 20 seconds. The centre of foot pressure displacement velocities were compared between the two groups. The main results indicate that the regular practice of sports activities counteracts postural control disruption caused by GVS. The active group demonstrated better postural control than the non-active group when subjected to higher vestibular manipulation. The active group may have developed their ability to reduce the influence of inaccurate vestibular signals. The active participants could identify the relevant sensory input, thought a better central integration, which enables them to switch faster between sensory inputs. PMID:27627441

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques

PubMed Central

Solberg, E; Ingjer, F; Holen, A; Sundgot-Borgen, J; Nilsson, S; Holme, I

2000-01-01

Objective—To compare the efficacy in runners of two relaxation techniques with regard to exercise reactivity and recovery after exercise. Methods—Thirty one adult male runners were studied prospectively for six months in three groups practising either meditation (n = 11) or autogenic training (n = 11) or serving as controls (n = 10). Before and after the six months relaxation intervention, indicators of reactivity to exercise and metabolism after exercise (blood lactate concentration, heart rate (HR), and oxygen consumption (VO2)), were tested immediately after and 10 minutes after exercise. Resting HR was also assessed weekly at home during the trial. State anxiety was measured before and after the intervention. Results—After the relaxation training, blood lactate concentration after exercise was significantly (p<0.01) decreased in the meditation group compared with the control group. No difference was observed in lactate responses between the autogenic training group and the control group. There were no significant differences among the groups with regard to HR, VO2, or levels of anxiety. Conclusion—Meditation training may reduce the lactate response to a standardised exercise bout. Key Words: autogenic training; lactate; meditation; recovery; relaxation; psychology PMID:10953899

Why doctors don't use computers: some empirical findings.

PubMed Central

Anderson, J G; Jay, S J; Schweer, H M; Anderson, M M

1986-01-01

The attitudes of 148 medical students, 141 residents, and 644 practising physicians towards computer applications in medicine were studied. The results indicate that physicians recognize the potential of computers to improve patient care, but are concerned about the possibility of increased governmental and hospital control, threats to privacy, and legal and ethical problems. In general, all three groups are uncertain as to the potential effects of computers on their traditional professional role and on the organization of practice. Practising physicians, however, express more concern about these potential effects of computers than do medical students and residents. While attitudes appear to be somewhat independent of prior computer experience, they significantly affect the extent to which physicians use a computer-based hospital information system. This may be a major reason for the slow introduction of clinical computer systems. PMID:3701749

The effect of learner's control of self-observation strategies on learning of front crawl.

PubMed

Marques, Priscila Garcia; Corrêa, Umberto Cesar

2016-02-01

This study investigated the effect of learner's control of self-observation strategies on motor skill learning. For this purpose, beginner and intermediate learner swimmers practised the front crawl. Seventy college students took part in this experiment. They comprised 40 novice learners, both male (n=19) and female (n=21), with an average age of 20.7 years (±0.44), and 30 intermediate learners, both male (n=17) and female (n=13), with an average age of 21.1 years (±0.86). The design involved a pretest (one day), four acquisition sessions (four days), and a retention test (one day). They were divided into three groups: (1) choice, which could choose to watch a video with their best or overall performance during practise; (2) yoked, which were paired to those of the choice group; and (3) control (did not watch any video). The measures included the performance of front crawl and self-efficacy. The results showed that: (1) beginners who chose a type of observation strategy had superior motor skill learning; (2) for intermediate learners, self-observation promoted better motor learning, regardless of the control of choices; (3) self-observation improved self-efficacy beliefs. Copyright © 2016 Elsevier B.V. All rights reserved.

Risk, knowledge and preventive measures of smallholder dairy farmers in northern Malawi with regard to zoonotic brucellosis and bovine tuberculosis.

PubMed

Tebug, Stanly Fon; Njunga, Gilson R; Chagunda, Mizeck G G; Mapemba, Jacob P; Awah-Ndukum, Julius; Wiedemann, Steffi

2014-02-28

Milk production using local cattle breed-types is an age-old practice in Malawi. Although dairy farming is becoming more common as a result of the increasing population and demand for milk and milk products, there is limited knowledge of the farmers' awareness of zoonotic disease risks, their preventative practices and the disease burden in animals. This study determined dairy farmers' general knowledge of zoonoses, assessed their risks for infection with zoonotic bovine tuberculosis (bTB) and brucellosis, and evaluated farm practices to prevent disease transmission. A questionnaire was drawn up and administered by the authors. It was used to collect information about the knowledge and preventive practices of 140 out of 684 registered dairy farmers at Mzuzu Agricultural Development Division, northern Malawi. During a second visit to 60 out of the 140 farms, a total of 156 and 95 cattle were tested for brucellosis and tuberculosis, respectively. Most farmers (77.1%) knew or had heard of zoonotic diseases, whilst 75.0% correctly named at least one zoonotic disease. More survey participants named tuberculosis as a zoonotic disease compared to brucellosis (74.3% versus 2.9%). The most commonly named means of transmission were milk (67.0%) and meat (56.0%). Almost all survey participants (96.4%) practised at least one farm activity that could lead to potential transmission of brucellosis or bTB, including sale (67.0%) and consumption (34.0%) of unpasteurised milk. Antibodies against brucellosis were found in 12 cattle (7.7%), whilst one animal (1.1%) reacted to the tuberculin skin test. General knowledge about possible transmission of diseases between humans and animals was high, although most farmers practised risk behaviours that could potentially expose the public to milk-borne zoonotic diseases such as brucellosis and bTB. Furthermore, some animals had positive results for brucellosis and tuberculosis tests. Therefore, improvement of zoonotic disease prevention programmes, as well as further investigation into the prevalence and risk factors for zoonoses, is recommended.

[Experience in using cluster analysis and the prognosis of the stages of epizootic risk for Newcastle disease in poultry].

PubMed

Elitsina, P; Parannzhilova, M; Vukov, M

1985-01-01

An attempt was made to use clastic analysis and projection of the steps of the epizootic hazard with regard to Newcastle disease. There were no records of the disease after 1982 but still it is the object of consideration on the part of specialists. A clastic analysis was made on the base of a factorial model of Newcastle disease in this country for the 1970-1979. Used was a programme already worked out and practised at the Pilot Computor Center of the Medical Academy, Sofia. The districts in the country were grouped in a dendogramme, 16 groups being distinguished out of a total of 27 districts. This showed that regardless of the small territory of the country the districts are sufficiently differing between each other (due to the various degrees of integration) so that they could not be grouped together by similar values of intensity of poultry breeding and epizootic conjuncture with regard to Newcastle disease. Districts of epizootic hazard ranging from 1st to 5th degree substantiate the use of a differential approach in building up the tactics of prophylaxis and control of the disease, while measures concerning the poultry dressing combines should be at a high level regardless of the category of the respective district. The grouping of neighboring districts on a territorial principle disclosed the existence of reasons of climatic-and-geographic nature that could predispose equal degrees of intensity of poultry breeding and epizootic hazard.

A novel process for updating recommendations for managing hypertension: rationale and methods.

PubMed

Zarnke, K B; Campbell, N R; McAlister, F A; Levine, M

2000-09-01

There are numerous hypertension consensus recommendations intended for practising physicians. However, recommendations in their current format have limited impact on improving hypertension control. A group of national societies, headed by the Canadian Hypertension Society, the Heart and Stroke Foundation of Canada, the Canadian Coalition for High Blood Pressure Prevention and Control, and Health Canada has developed strategies to maintain annually updated recommendations for hypertension management and to provide greater opportunities for their implementation into clinical practice. The process is overseen by a steering committee. Subcommittees have been formed for each of a list of topics seen as important to the control of hypertension. The subcommittees, with the aid of a central librarian, conduct annual literature reviews in accordance with Cochrane Collaboration strategies. Modified existing and new recommendations are forwarded to a group with expertise in clinical epidemiology. Grades of evidence are assigned to each recommendation. Revised recommendations based on the above process will be presented annually at the conjoint Canadian Hypertension Society/Canadian Cardiovascular Congress meeting. Under the leadership of the Cardiovascular Disease Division of the Laboratory Centre for Disease Control, Health Canada, a committee has been charged with the implementation process. The improvements of the current process over previous national hypertension recommendations are four-fold. First, the recommendations will be updated annually. Second, the methodology has been improved. Third, the grading system can be used in the evaluation of complex study designs. Finally, the implementation process is extended. The authors are optimistic that these changes will contribute to the improvement of hypertension control in the Canadian population.

Value(s)-Driven Decision-Making: The Ethics Work of English Headteachers within Discourses of Constraint

ERIC Educational Resources Information Center

Hammersley-Fletcher, Linda

2015-01-01

This article considers the experiences and perceptions of practising English headteachers and the tensions that they face when juggling government prescription and government initiatives, which may be antagonistic to their educational values and beliefs. Managerial control over teachers work has been particularly acute and destructive to…

Using Computer-Aided Instruction to Support the Systematic Practice of Phonological Skills in Beginning Readers

ERIC Educational Resources Information Center

Wild, Mary

2009-01-01

The paper reports the results of a randomised control trial investigating the use of computer-aided instruction (CAI) for practising phonological awareness skills with beginning readers. Two intervention groups followed the same phonological awareness programme: one group undertook practice exercises using a computer and the other group undertook…

Watch and Learn: Seeing Is Better than Doing when Acquiring Consecutive Motor Tasks

PubMed Central

Larssen, Beverley C.; Ong, Nicole T.; Hodges, Nicola J.

2012-01-01

During motor adaptation learning, consecutive physical practice of two different tasks compromises the retention of the first. However, there is evidence that observational practice, while still effectively aiding acquisition, will not lead to interference and hence prove to be a better practice method. Observers and Actors practised in a clockwise (Task A) followed by a counterclockwise (Task B) visually rotated environment, and retention was immediately assessed. An Observe-all and Act-all group were compared to two groups who both physically practised Task A, but then only observed (ObsB) or did not see or practice Task B (NoB). The two observer groups and the NoB control group better retained Task A than Actors, although importantly only the observer groups learnt Task B. RT data and explicit awareness of the rotation suggested that the observers had acquired their respective tasks in a more strategic manner than Actor and Control groups. We conclude that observational practice benefits learning of multiple tasks more than physical practice due to the lack of updating of implicit, internal models for aiming in the former. PMID:22723909

CAGS and ACS evidence based reviews in surgery. Is a diverting loop ileostomy and colonic lavage an alternative to colectomy for the treatment of severe Clostridium difficile-associated disease?

PubMed

Brown, Carl J; Boutros, Marylise; Morris, Andrew; Divino, Celia M

2014-06-01

The term “evidence-based medicine” was first coined by Sackett and colleagues as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”1 The key to practising evidencebased medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding. For clinicians to practise evidence-based medicine, they must have the skills to read and interpret the medical literature so that they can determine the validity, reliability, credibility and utility of individual articles. These skills are known as critical appraisal skills, and they require some knowledge of biostatistics, clinical epidemiology, decision analysis and economics, and clinical knowledge. Evidence Based Reviews in Surgery (EBRS) is a program jointly sponsored by the Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS). The primary objective of EBRS is to help practising surgeons improve their critical appraisal skills. During the academic year, 8 clinical articles are chosen for review and discussion. They are selected for their clinical relevance to general surgeons and because they cover a spectrum of issues im -port ant to surgeons, including causation or risk factors for disease, natural history or prognosis of disease, how to quantify disease, diagnostic tests, early diagnosis and the effectiveness of treatment. A methodological article guides the reader in critical appraisal of the clinical article. Methodological and clinical reviews of the article are performed by experts in the relevant areas and posted on the EBRS website, where they are archived indefinitely. In addition, a listserv allows participants to discuss the monthly article. Surgeons who participate in the monthly packages can obtain Royal College of Physicians and Surgeons of Canada Maintenance of Certification credits and/or continuing medical education credits for the current article only by reading the monthly articles, participating in the listserv discussion, reading the methodological and clinical reviews and completing the monthly online evaluation and multiple choice questions. We hope readers will find EBRS useful in improving their critical appraisal skills and in keeping abreast of new developments in general surgery. Four reviews are published in condensed versions in the Canadian Journal of Surgery, 4 are published in the Journal of the American College of Surgeons and 4 are published in Diseases of the Colon and Rectum. For further information about EBRS, please refer to the CAGS or ACS websites. Questions and comments can be directed to the program administrator, Marg McKenzie, at mmckenzie@mtsinai.on.ca.

Postmortem procedures in the emergency department: using the recently dead to practise and teach.

PubMed Central

Iserson, K V

1993-01-01

In generations past, it was common practice for doctors to learn lifesaving technical skills on patients who had recently died. But this practice has lately been criticised on religious, legal, and ethical grounds, and has fallen into disuse in many hospitals and emergency departments. This paper uses four questions to resolve whether doctors in emergency departments should practise and teach non-invasive and minimally invasive procedures on the newly dead: Is it ethically and legally permissible to practise and teach non-invasive and minimally invasive procedures on the newly dead emergency-department patient? What are the alternatives or possible consequences of not practising non-invasive and minimally invasive procedures on newly dead patients? Is consent from relatives required? Should doctors in emergency departments allow or even encourage this use of newly dead patients? PMID:8331644

Sequential effects after practice with the dominant and non-dominant hand on the acquisition of a sliding task in schoolchildren.

PubMed

Senff, Oliver; Weigelt, Matthias

2011-03-01

This study was designed to investigate sequential effects after practice with the dominant and non-dominant hand on the acquisition of a new motor task. A total of 64 middle school children were asked to practise a cent-slide task, which required them to slide coins from one side of a cardboard into a circular target on the opposite side. Four groups practised this task within different practice schedules: (1) participants practised only with their dominant hand (right-only group); (2) participants used only their non-dominant hand (left-only group); (3) participants started to practise the skill with their dominant hand and then switched to their non-dominant hand (right-to-left group); or (4) participants started to practise the skill with their non-dominant hand and then switched to their dominant hand (left-to-right group). The acquisition of the task was facilitated after initial practice with the non-dominant hand. This was reflected in a better retention of the task and a stronger performance under a modified testing situation of the left-to-right group when compared to all other groups. Also, the left-only group showed larger interlimb transfer effects to the untrained hand than the right-only group. It is concluded that the sequence in which the dominant and non-dominant hands are used to practise influences the acquisition of new motor tasks.

Recommendations for participation in competitive sport and leisure-time physical activity in individuals with cardiomyopathies, myocarditis and pericarditis.

PubMed

Pelliccia, Antonio; Corrado, Domenico; Bjørnstad, Hans Halvor; Panhuyzen-Goedkoop, Nicole; Urhausen, Axel; Carre, Francois; Anastasakis, Aris; Vanhees, Luc; Arbustini, Eloisa; Priori, Silvia

2006-12-01

Several relatively uncommon, but important cardiovascular diseases are associated with increased risk for acute cardiac events during exercise (including sudden death), such as hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC) and myo-pericarditis. Practising cardiologists are frequently asked to advise on exercise programmes and sport participation in young individuals with these cardiovascular diseases. Indeed, many asymptomatic (or mildly symptomatic) patients with cardiomyopathies aspire to a physically active lifestyle to take advantage of the many documented benefits of exercise. While recommendations dictating the participation in competitive sport for athletes with cardiomyopathies and myo-pericarditis have recently been published as a consensus document of the European Society of Cardiology, no European guidelines have addressed the possible participation of patients with cardiomyopathies in recreational and amateur sport activities. The present document is intended to offer a comprehensive overview to practising cardiologists and sport physicians of the recommendations governing safe participation in different types of competitive sport, as well as the participation in a variety of recreational physical activities and amateur sports in individuals with cardiomyopathies and myo-pericarditis. These recommendations, based largely on the experience and insights of the expert panel appointed by the European Society of Cardiology, include the most up-to-date information concerning regular exercise and sports activity in patients with cardiomyopathies and myo-pericarditis.

Mandatory continuing professional education in pharmacy: the Singapore experience.

PubMed

Ang, Hui-Gek; Pua, Yong-Hao; Subari, Nur Azah

2013-08-01

Mandatory Continuing Professional Education (CPE) for the renewal of pharmacists' practising certificate was implemented in Singapore in 2008 OBJECTIVE: To study pharmacists' perceptions and attitudes about the impact of mandatory CPE in Singapore. Singapore. Internet-based questionnaire survey, conducted between May and June 2011. Pharmacists' perceptions and attitudes toward mandatory CPE and the perceived difficulty in fulfilling the CPE requirements. The overall survey response rate was 52 % (840/1,609). Of the respondents, 32 % were non-practising, 49 % were practising in patient care areas, and 19 % were practising in non-patient care areas. More than half the pharmacists agreed that mandatory CPE (1) enhanced or increased their knowledge base and skills (70 %; 95 % CI 67-73 %), (2) motivated them to continually learn (64 %; 95 % CI, 60-67 %), and (3) motivated them to reflect on their professional practice or work (58 %; 95 % CI, 54-61 %). Mandatory CPE was not perceived to enhance or increase employability. Non-practising pharmacists appeared to have the greatest difficulty meeting the CPE requirements. In general, pharmacists value mandatory CPE more for positive professional reasons than for employability reasons. The survey results may serve as useful baseline data for future studies of pharmacists' perceptions and attitudes toward CPE in Singapore.

Should I cancel my NMC registration?

PubMed

Cornock, Marc

2017-04-05

To practise as a nurse, you must be registered with the Nursing and Midwifery Council (NMC). Your entry on to the register shows you have met the competencies and standards required to practise as a nurse.

A long-term self-managed handwriting intervention for people with Parkinson's disease: results from the control group of a phase II randomized controlled trial.

PubMed

Collett, Johnny; Franssen, Marloes; Winward, Charlotte; Izadi, Hooshang; Meaney, Andy; Mahmoud, Wala; Bogdanovic, Marko; Tims, Martin; Wade, Derick; Dawes, Helen

2017-12-01

To report on the control group of a trial primarily designed to investigate exercise for improving mobility in people with Parkinson's disease (pwP). The control group undertook a handwriting intervention to control for attention and time spent practising a specific activity. Secondary analysis of a two-arm parallel phase II randomized controlled trial with blind assessment. Community. PwP able to walk ⩾100 m and with no contraindication to exercise were recruited from the Thames Valley, UK, and randomized (1:1) to exercise or handwriting, via a concealed computer-generated list. Handwriting was undertaken at home and exercise in community facilities; both were delivered through workbooks with monthly support visits and involved practice for 1 hour, twice weekly, over a period of six months. Handwriting was assessed, at baseline, 3, 6 and 12 months, using a pangram giving writing speed, amplitude (area) and progressive reduction in amplitude (ratio). The Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (UPDRS) item 2.7 measured self-reported handwriting deficits. In all, 105 pwP were recruited (analysed: n  = 51 handwriting, n  = 54 exercise). A total of 40 pwP adhered to the handwriting programme, most completing ⩾1 session/week. Moderate effects were found for amplitude (total area: d = 0.32; 95% confidence interval (CI): -0.11 to 0.7; P = 0.13) in favour of handwriting over a period of12 months; effects for writing speed and ratio parameters were small ≤0.11. Self-reported handwriting difficulties also favoured handwriting (UPDRS 2.7: odds ratio (OR) = 0.55; 95% CI: 0.34 to 0.91; P = 0.02). No adverse effects were reported. PwP generally adhere to self-directed home handwriting which may provide benefit with minimal risk. Encouraging effects were found in writing amplitude and, moreover, perceived ability.

The GDC - lifting the lid. Part 4: fitness to practise.

PubMed

Mathewson, H; Rudkin, D

2008-07-26

As an organisation whose function is to protect the public, the General Dental Council's role in investigating complaints about dentists and dental care professionals dealing suitably with those who have been shown to practise in an unprofessional or dangerous manner is obviously of paramount importance. This article looks at the GDC's fitness to practise procedures - the system that looks into complaints and allegations of malpractice about dental practitioners. It outlines the different stages in the process and introduces some of the many people involved with the efficient running of this vital service.

Retrieval of past and future positive and negative autobiographical experiences.

PubMed

García-Bajos, Elvira; Migueles, Malen

2017-09-01

We studied retrieval-induced forgetting for past or future autobiographical experiences. In the study phase, participants were given cues to remember past autobiographical experiences or to think about experiences that may occur in the future. In both conditions, half of the experiences were positive and half negative. In the retrieval-practice phase, for past and future experiences, participants retrieved either half of the positive or negative experiences using cued recall, or capitals of the world (control groups). Retrieval practice produced recall facilitation and enhanced memory for the practised positive and negative past and future experiences. While retrieval practice on positive experiences did not impair the recall of other positive experiences, we found inhibition for negative past and future experiences when participants practised negative experiences. Furthermore, retrieval practice on positive future experiences inhibited negative future experiences. These positivity biases for autobiographical memory may have practical implications for treatment of emotional disorders.

Samuel Holden Parsons Lee (1772-1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut.

PubMed

Mattie, James K; Desai, Sukumar P

2015-02-01

Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered. In 1798 he served selflessly as the only physician in town who was willing to battle the Yellow Fever outbreak of New London, Connecticut. Because he practised at the dawn of the age of patent medicine, unfortunately his name also came to be associated with medical quackery. We argue that his contributions have been grossly underestimated. He compounded and vended medications - including bilious pills and bitters - that were gold standards of the day. Moreover, one preparation for treatment of kidney stones led to his sub-specialization in this field and was met with such success that its sale continued for nearly 100 years after his death. While a talented medical man, Lee also had a knack for business, finding success in trading, whaling and real estate. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Assessing the limitations of the existing physician directory for measuring electronic health record (EHR) adoption rates among physicians in Connecticut, USA: cross-sectional study.

PubMed

Tikoo, Minakshi

2012-01-01

To assess the limitations of the existing physician directory in measuring electronic health record adoption rates among a cohort of Connecticut physicians. A population-based mailing assessed the number of physicians practising in Connecticut. Information about practice site, practises pertaining to storing of patient information, sources of revenue and preferred method for receiving survey. Practice status in Connecticut, measured by yes and no. Demographic information was collected on gender, year of birth, race and ethnicity. The response rate for the postcard mailing was 19% (3105/16 462). Of the 16 462 unduplicated consumers, 233 (1%) were retired and 5828 (35%) did not practise in Connecticut. Of the 3105 valid postcard responses we received, 2159 were for physicians practising in Connecticut. Nine (0.4%) of these responses did not specify a preferred method for receiving the full physician survey; 91 physicians refused to participate in the survey; 2159 surveys were sent out using each physician's requested method for receiving the survey, that is, web-based, regular mail or telephone. As of August 2012, 898 physicians had returned surveys, resulting in a response rate of 42%. The postcard response rate based on the unduplicated lists adjusted for exclusions, such as death, retired and do not practise in Connecticut, is 30%, which is low. We may be missing physicians' population which could greatly affect the indicators being used to measure change in electronic health record adoption rates. It is difficult to obtain an accurate physician count of practising physicians in Connecticut from the existing lists. States that are participating in the projects funded under various Office of the National Coordinator for Health Information Technology (ONC) initiatives must focus on getting an accurate count of the physicians practising in their state, since their progress is being measured based on this key number.

A preliminary investigation into the moral reasoning abilities of UK veterinarians.

PubMed

Batchelor, C E M; Creed, A; McKeegan, D E F

2015-08-01

Veterinary medicine is an ethically challenging profession, but the ethical reasoning abilities of practising veterinarians in the UK have never been formally assessed. This study investigated moral reasoning ability in 65 qualified veterinarians (38 practising and 27 academic) and 33 members of the public in the UK using the Defining Issues Test. Academic veterinarians had higher scores than members of the public but practising veterinarians did not. There was large variation in moral reasoning abilities among qualified veterinarians. Moral reasoning score in veterinarians did not improve with years of experience. These results show that despite having a professional degree moral reasoning skills of practising veterinarians may be insufficient to deal with the demands of their profession. This could have implications for animal welfare, client services and veterinarian wellbeing. The results highlight the need for more training in this area. British Veterinary Association.

Characterization of mathematics instructional practises for prospective elementary teachers with varying levels of self-efficacy in classroom management and mathematics teaching

NASA Astrophysics Data System (ADS)

Lee, Carrie W.; Walkowiak, Temple A.; Nietfeld, John L.

2017-03-01

The purpose of this study was to investigate the relationship between prospective teachers' (PTs) instructional practises and their efficacy beliefs in classroom management and mathematics teaching. A sequential, explanatory mixed-methods design was employed. Results from efficacy surveys, implemented with 54 PTs were linked to a sample of teachers' instructional practises during the qualitative phase. In this phase, video-recorded lessons were analysed based on tasks, representations, discourse, and classroom management. Findings indicate that PTs with higher levels of mathematics teaching efficacy taught lessons characterised by tasks of higher cognitive demand, extended student explanations, student-to-student discourse, and explicit connections between representations. Classroom management efficacy seems to bear influence on the utilised grouping structures. These findings support explicit attention to PTs' mathematics teaching and classroom management efficacy throughout teacher preparation and a need for formative feedback to inform development of beliefs about teaching practises.

David, Mr Bear and Bernstein: Searching for an Equitable Pedagogy through Guided Group Work

ERIC Educational Resources Information Center

Boyle, Bill; Charles, Marie

2012-01-01

The authors' experiences of observing teaching and learning in schools have led them to become concerned at the dominant paradigm of a "pedagogy of poverty" at the expense of a "pedagogy of plenty". Bernstein's theory of power and control of education knowledge is overtly practised in classrooms globally. This is evidenced in…

Practising Mental Rotation Using Interactive Desktop Mental Rotation Trainer (iDeMRT)

ERIC Educational Resources Information Center

Rafi, Ahmad; Samsudin, Khairulanuar

2009-01-01

An experimental study involving 30 undergraduates (mean age = 20.5 years) in mental rotation (MR) training was conducted in an interactive Desktop Mental Rotation Trainer (iDeMRT). Stratified random sampling assigned students into one experimental group and one control group. The former trained in iDeMRT and the latter trained in conventional…

Positive implications from socially accountable, community-engaged medical education across two Philippines regions.

PubMed

Woolley, Torres; Cristobal, Fortunato; Siega-Sur, Jusie; Ross, Simone; Neusy, Andre-Jacques; Halili, Servando; Reeve, Carole

2018-02-01

Hundreds of millions of people worldwide lack access to quality health services, largely because of geographic and socioeconomic maldistribution of qualified practitioners. This study describes differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education (SAHPE) schools and the practice locations of graduates from two 'conventionally trained' medical schools located in the same respective geographic regions. Licensed medical graduates were currently practising in the Philippines and had been practising for at least 6 months. Graduates were from two Philippines SAHPE schools (Ateneo de Zamboanga University-School of Medicine (ADZU-SOM) on the Zamboanga Peninsula (n=212) and the University of the Philippines Manila-School of Health Sciences (SHS-Palo) in Eastern Visayas (n=71), and from two 'conventional' medical schools Methods: Current graduate practice locations in municipalities or cities were linked with their respective population size and socioeconomic income class, and geocoded using Geographical Information System software onto a geospatial map of the Philippines. Bivariate analysis compared the population size and socioeconomic class of communities where the SAHPE medical graduates practised to communities where 'conventional' medical school graduates practised. Thirty-one percent of ADZU-SOM medical graduates practised in communities <100 000 population versus 7% of graduates from the conventional school in the Zamboanga region (p<0.001), while 61% of SHS-Palo medical graduates practised in communities <100 000 population versus 12% of graduates from the conventional school in the Visayas region (p<0.001). Twenty-seven percent of ADZU-SOM graduates practised in lower income category communities (categories 2-6) versus 8% of graduates from the conventional school in the same region (p<0.001), while 49% of SHS-Palo graduates practised in lower income category communities (categories 2-6) versus 11% of graduates from the conventional school in the same region (p<0.001). SAHPE has contributed to increased medical coverage across rural and/or economically disadvantaged areas in two Philippines regions. The extensive community-based medical student placements associated with SAHPE likely play a significant role in graduates choosing to practice in rural and/or economically disadvantaged communities. Governments experiencing medical workforce maldistributions similar to those in the Philippines should consider SAHPE as a potentially cost-effective strategy in recruiting and retaining health graduates to underserved areas.

Is Bone Tissue Really Affected by Swimming? A Systematic Review

PubMed Central

Gómez-Bruton, Alejandro; Gónzalez-Agüero, Alejandro; Gómez-Cabello, Alba; Casajús, José A.; Vicente-Rodríguez, Germán

2013-01-01

Background Swimming, a sport practiced in hypogravity, has sometimes been associated with decreased bone mass. Aim This systematic review aims to summarize and update present knowledge about the effects of swimming on bone mass, structure and metabolism in order to ascertain the effects of this sport on bone tissue. Methods A literature search was conducted up to April 2013. A total of 64 studies focusing on swimmers bone mass, structure and metabolism met the inclusion criteria and were included in the review. Results It has been generally observed that swimmers present lower bone mineral density than athletes who practise high impact sports and similar values when compared to sedentary controls. However, swimmers have a higher bone turnover than controls resulting in a different structure which in turn results in higher resistance to fracture indexes. Nevertheless, swimming may become highly beneficial regarding bone mass in later stages of life. Conclusion Swimming does not seem to negatively affect bone mass, although it may not be one of the best sports to be practised in order to increase this parameter, due to the hypogravity and lack of impact characteristic of this sport. Most of the studies included in this review showed similar bone mineral density values in swimmers and sedentary controls. However, swimmers present a higher bone turnover than sedentary controls that may result in a stronger structure and consequently in a stronger bone. PMID:23950908

Achilles tenotomy as an office procedure and current practising trends among New Zealand orthopaedic surgeons.

PubMed

Agius, Lewis; Wickham, Angus; Walker, Cameron; Knudsen, Joshua

2018-05-18

Percutaneous Achilles tenotomy (PAT) is performed during the final phase of casting with Ponseti method. Several settings have been proposed as venues for this procedure, however it is increasingly being performed in theatre under a general anaesthetic (GA). General anaesthesia, however, is expensive and not without risks. The purpose of the present study was to compare results of outpatient releases to theatre releases, and assess current practising trends among orthopaedic surgeons. Retrospective comparison of patients with idiopathic clubfoot managed by Ponseti method who had Achilles tenotomy performed in outpatient clinic and in theatre. Surveys were sent to all POSNZ members to determine current practising trends in New Zealand. Parental satisfaction surveys were performed. Comparative cost analysis was performed using hospital billing information. The current study includes 64 idiopathic congenital clubfeet (19 bilateral cases). PAT was performed on 26 clubfeet under local anaesthetic in an outpatient setting, and 33 clubfeet under GA in a theatre setting. There was no significant difference for post-operative complications, or recurrence (p=0.67). Those in theatre group were exposed to a greater number of general anaesthetics before the age of four. Among practising New Zealand paediatric orthopaedic surgeons, 77.78% perform this in theatre under general anaesthesia, while only 22.22% perform PAT in outpatient clinic. The main barriers included concerns regarding pain control, concerns regarding incomplete release, concerns regarding distress to family and concerns regarding sterility. Parental satisfaction surveys found pain management to be excellent. Financial data was analysed and indicative costs were $6,061 NZD per procedure in theatre, compared to $378 NZD per procedure in clinic. PAT performed in a clinic setting is both safe and efficacious with results comparative to that performed in theatre. There was no difference in post-operative complications or recurrence. Parental satisfaction to this procedure is excellent. There are significant financial advantages. Based on this data, our institution now performs all releases in an outpatient setting.

Anthropometric and Physical Fitness Differences Among Brazilian Adolescents who Practise Different Team Court Sports.

PubMed

Silva, Diego Augusto Santos; Petroski, Edio Luiz; Gaya, Adroaldo Cesar Araujo

2013-03-01

The objective of this work was to compare the anthropometric and physical fitness characteristics of Brazilian adolescents who practise team court sports and to compare specific parameters obtained for adolescents with data from the general population. This was a cross-sectional study of 1,348 male adolescents grouped as follows: basketball players (n = 287), indoor soccer players (n = 665), handball players (n = 108) and volleyball players (n = 288), all between 10 and 14 years of age. Anthropometric (body mass, body height, arm span, and body mass index) and physical fitness data (flexibility, muscular strength, explosive power, speed, aerobic fitness and agility) were collected. The Brazilian population was used as a reference and compared to the adolescent subjects using Z scores for all variables. Anthropometric characteristics and performances in physical fitness tests differed (p<0.05) among players of different sports. In addition, for each variable assessed, adolescents who practised team court sports showed similar or improved results compared to their counterparts in the general population (p<0.05). Furthermore, the anthropometric and physical fitness characteristics differed depending on the team court sport practised. These findings may elucidate which physical abilities are most impacted by the practise of a particular team sport as well as help teachers and physical education and sport professionals identify talented adolescents.

Pathways to rural family practice at Memorial University of Newfoundland

PubMed Central

Rourke, James; O’Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle

2018-01-01

Abstract Objective To assess Memorial University of Newfoundland’s (MUN’s) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Design Analysis of anonymized secondary data. Setting Canada. Participants Memorial’s medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN’s 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). Main outcome measures National effect was measured by the proportion of MUN’s family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN’s MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN’s 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Results Memorial’s comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN’s MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial’s 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. Conclusion A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. PMID:29540400

Pathways to rural family practice at Memorial University of Newfoundland.

PubMed

Rourke, James; O'Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle

2018-03-01

To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Analysis of anonymized secondary data. Canada. Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). National effect was measured by the proportion of MUN's family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN's MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN's 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Memorial's comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN's MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial's 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. Copyright© the College of Family Physicians of Canada.

Influence of Judaism and Jewish physicians on Greek and Byzantine medicine and their contribution to nephrology.

PubMed

Massry, S G; Smogorzewski, M; Hazani, E; Shasha, S M

1997-01-01

Both the Old Testament and the Talmud contain a great deal of information on medicine, nephrology, health and disease. The basic premise of early Jewish medicine is based on the notion that disease is due to structural changes in internal organs. This is in contrast to the mythical dogma of humoralism as the basis of health and disease espoused by Hippocrates and Galen. The Old Testament and the Mosaic Codes provided the basis for modern public health and for the hygienic rules practised in our times. The Talmudists laid the foundations for the science of pathology as we know it today. These issues are discussed in detail and the contributions of three prominent medieval physicians (Asaph Judaeus, Isaac Judaeus and Maimonides) are presented.

Interpreting patient-reported outcomes from clinical trials in COPD: a discussion

PubMed Central

Jones, Paul W; Rennard, Stephen; Tabberer, Maggie; Riley, John H; Vahdati-Bolouri, Mitra; Barnes, Neil C

2016-01-01

One of the challenges faced by the practising physician is the interpretation of patient-reported outcomes (PROs) in clinical trials and the relevance of such data to their patients. This is especially true when caring for patients with progressive diseases such as COPD. In an attempt to incorporate the patient perspective, many clinical trials now include assessments of PROs. These are formalized methods of capturing patient-centered information. Given the importance of PROs in evaluating the potential utility of an intervention for a patient with COPD, it is important that physicians are able to critically interpret (and critique) the results derived from them. Therefore, in this paper, a series of questions is posed for the practising physician to consider when reviewing the treatment effectiveness as assessed by PROs. The focus is on the St George’s Respiratory Questionnaire for worked examples, but the principles apply equally to other symptom-based questionnaires. A number of different ways of presenting PRO data are discussed, including the concept of the minimum clinically important difference, whether there is a ceiling effect to PRO results, and the strengths and weaknesses of responder analyses. Using a worked example, the value of including a placebo arm in a study is illustrated, and the influence of the study on PRO results is considered, in terms of the design, patient withdrawal, and the selection of the study population. For the practising clinician, the most important consideration is the importance of individualization of treatment (and of treatment goals). To inform such treatment, clinicians need to critically review PRO data. The hope is that the questions posed here will help to build a framework for this critical review. PMID:27994447

Interpreting patient-reported outcomes from clinical trials in COPD: a discussion.

PubMed

Jones, Paul W; Rennard, Stephen; Tabberer, Maggie; Riley, John H; Vahdati-Bolouri, Mitra; Barnes, Neil C

2016-01-01

One of the challenges faced by the practising physician is the interpretation of patient-reported outcomes (PROs) in clinical trials and the relevance of such data to their patients. This is especially true when caring for patients with progressive diseases such as COPD. In an attempt to incorporate the patient perspective, many clinical trials now include assessments of PROs. These are formalized methods of capturing patient-centered information. Given the importance of PROs in evaluating the potential utility of an intervention for a patient with COPD, it is important that physicians are able to critically interpret (and critique) the results derived from them. Therefore, in this paper, a series of questions is posed for the practising physician to consider when reviewing the treatment effectiveness as assessed by PROs. The focus is on the St George's Respiratory Questionnaire for worked examples, but the principles apply equally to other symptom-based questionnaires. A number of different ways of presenting PRO data are discussed, including the concept of the minimum clinically important difference, whether there is a ceiling effect to PRO results, and the strengths and weaknesses of responder analyses. Using a worked example, the value of including a placebo arm in a study is illustrated, and the influence of the study on PRO results is considered, in terms of the design, patient withdrawal, and the selection of the study population. For the practising clinician, the most important consideration is the importance of individualization of treatment (and of treatment goals). To inform such treatment, clinicians need to critically review PRO data. The hope is that the questions posed here will help to build a framework for this critical review.

The integration of minimally invasive surgery in surgical practice in a Canadian setting: results from 2 consecutive province-wide practice surveys of general surgeons over a 5-year period

PubMed Central

Hallet, Julie; Mailloux, Olivier; Chhiv, Mony; Grégoire, Roger C.; Gagné, Jean-Pierre

2015-01-01

Background Although minimally invasive surgery (MIS) has been quickly embraced, the introduction of advanced procedures appears more complex. We assessed the evolution of MIS in the province of Quebec over a 5-year period to identify areas for improvement in the modern surgical era. Methods We developed, test-piloted and conducted a self-administered questionnaire among Quebec general surgeons in 2007 and 2012 to examine stated MIS practice, MIS training and barriers and facilitators to the use of MIS. Results Response rates were 51.3% (251 of 489) in 2007 and 31.3% (153 of 491) in 2012. A significant increase was observed for performance of most advanced MIS procedures, especially for colectomy for benign (66.0% v. 84.3%, p < 0,001) and malignant diseases (43.3% v. 77.8%, p < 0,001) and for rectal surgery for malignancy (21.0% v. 54.6%, p < 0.001). More surgeons practised 3 or more advanced MIS procedures in 2012 than in 2007 (82.3% v. 64.3%, p < 0,001). At multivariate analysis, the 2007 survey administration was associated with fewer surgeons practising advanced MIS (odds ratio 0.13, 95% confidence interval 0.06–0.29). In 2012, more respondents stated they gained their skills during residency (p = 0.028). Conclusion From 2007 to 2012 there was a significant increase in advanced MIS procedures practised by general surgeons in Québec. This technique appears well established in current surgical practice. The growing place of MIS in residency training seems to be a paramount part of this development. Results from this study could be used as a baseline for studies focusing on ways to further improve the MIS practice. PMID:25598180

Practising Democracy: Business Community Representatives in the Control of English and Welsh Schools.

ERIC Educational Resources Information Center

Thody, Angela

The 1986 Education Act required that business community members in England and Wales be appointed to the governing boards of local public schools. Since the passage of the law, the idea of sponsored governors has developed. Sponsored governors receive financial supported from their companies to serve on the boards. A survey of employees of three…

A first estimate of the structure and density of the populations of pet cats and dogs across Great Britain

PubMed Central

Fouracre, David; Smith, Graham C.

2017-01-01

Policy development, implementation, and effective contingency response rely on a strong evidence base to ensure success and cost-effectiveness. Where this includes preventing the establishment or spread of zoonotic or veterinary diseases infecting companion cats and dogs, descriptions of the structure and density of the populations of these pets are useful. Similarly, such descriptions may help in supporting diverse fields of study such as; evidence-based veterinary practice, veterinary epidemiology, public health and ecology. As well as maps of where pets are, estimates of how many may rarely, or never, be seen by veterinarians and might not be appropriately managed in the event of a disease outbreak are also important. Unfortunately both sources of evidence are absent from the scientific and regulatory literatures. We make this first estimate of the structure and density of pet populations by using the most recent national population estimates of cats and dogs across Great Britain and subdividing these spatially, and categorically across ownership classes. For the spatial model we used the location and size of veterinary practises across GB to predict the local density of pets, using client travel time to define catchments around practises, and combined this with residential address data to estimate the rate of ownership. For the estimates of pets which may provoke problems in managing a veterinary or zoonotic disease we reviewed the literature and defined a comprehensive suite of ownership classes for cats and dogs, collated estimates of the sub-populations for each ownership class as well as their rates of interaction and produced a coherent scaled description of the structure of the national population. The predicted density of pets varied substantially, with the lowest densities in rural areas, and the highest in the centres of large cities where each species could exceed 2500 animals.km-2. Conversely, the number of pets per household showed the opposite relationship. Both qualitative and quantitative validation support key assumptions in the model structure and suggest the model is useful at predicting the populations of cats at geographical scales important for decision-making, although it also indicates where further research may improve model performance. In the event of an animal health crisis, it appears that almost all dogs could be brought under control rapidly. For cats, a substantial and unknown number might never be bought under control and would be less likely to receive veterinary support to facilitate surveillance and disease management; we estimate this to be at least 1.5 million cats. In addition, the lack of spare capacity to care for unowned cats in welfare organisations suggests that any increase in their rate of acquisition of cats, or any decrease in the rate of re-homing might provoke problems during a period of crisis. PMID:28403172

Initiating undergraduate medical students into communities of research practise: what do supervisors recommend?

PubMed Central

2010-01-01

Background Much has been written in the educational literature on the value of communities of practise in enhancing student learning. Here, we take the experience of senior undergraduate medical students involved in short-term research as a member of a team as a paradigm for learning in a community of practise. Based on feedback from experienced supervisors, we offer recommendations for initiating students into the research culture of their team. In so doing, we endeavour to create a bridge between theory and practise through disseminating advice on good supervisory practise, where the supervisor is perceived as an educator responsible for designing the research process to optimize student learning. Methods Using the questionnaire design tool SurveyMonkey and comprehensive lists of contact details of staff who had supervised research projects at the University of Edinburgh during 1995 - 2008, current and previous supervisors were invited to recommend procedures which they had found successful in initiating students into the research culture of a team. Text responses were then coded in the form of derivative recommendations and categorized under general themes and sub-themes. Results Using the chi-square tests of linear trend and association, evidence was found for a positive trend towards more experienced supervisors offering responses (χ2 = 16.833, p < 0.0005, n = 215) while there was a lack of evidence of bias in the gender distribution of respondents (χ2 = 0.482, p = 0.487, n = 203), respectively. A total of 126 codes were extracted from the text responses of 65 respondents. These codes were simplified to form a complete list of 52 recommendations, which were in turn categorized under seven derivative overarching themes, the most highly represented themes being Connecting the student with others and Cultivating self-efficacy in research competence. Conclusions Through the design of a coding frame for supervisor responses, a wealth of ideas has been captured to make communities of research practise effective mediums for undergraduate student learning. The majority of these recommendations are underpinned by educational theory and have the potential to take the learner beyond the stage of initiation to that of integration within their community of research practise. PMID:21092088

Tsetse flies: their biology and control using area-wide integrated pest management approaches.

PubMed

Vreysen, Marc J B; Seck, Momar Talla; Sall, Baba; Bouyer, Jérémy

2013-03-01

Tsetse flies are the cyclical vectors of trypanosomes, the causative agents of 'sleeping sickness' or human African trypanosomosis (HAT) in humans and 'nagana' or African animal trypanosomosis (AAT) in livestock in Sub-saharan Africa. Many consider HAT as one of the major neglected tropical diseases and AAT as the single greatest health constraint to increased livestock production. This review provides some background information on the taxonomy of tsetse flies, their unique way of reproduction (adenotrophic viviparity) making the adult stage the only one easily accessible for control, and how their ecological affinities, their distribution and population dynamics influence and dictate control efforts. The paper likewise reviews four control tactics (sequential aerosol technique, stationary attractive devices, live bait technique and the sterile insect technique) that are currently accepted as friendly to the environment, and describes their limitations and advantages and how they can best be put to practise in an IPM context. The paper discusses the different strategies for tsetse control i.e. localised versus area-wide and focusses thereafter on the principles of area-wide integrated pest management (AW-IPM) and the phased-conditional approach with the tsetse project in Senegal as a recent example. We argue that sustainable tsetse-free zones can be created on Africa mainland provided certain managerial and technical prerequisites are in place. Copyright © 2012 International Atomic Energy Agency. Published by Elsevier Inc. All rights reserved.

Practising Empathy: Enacting Alternative Perspectives through Imaginative Play

ERIC Educational Resources Information Center

Waite, Sue; Rees, Sarah

2014-01-01

This article reports on a collaborative study using an innovative methodology, based on "insiders" who are Steiner practitioners knowledgeable and practised in Steiner philosophy and "outsiders" from UK mainstream early years and primary perspectives. Although the study as a whole focused on assessment and observation used in…

Facilitating and obstructing factors for development of learning in clinical practice: a student perspective.

PubMed

Löfmark, A; Wikblad, K

2001-04-01

The aim of this study was to provide information on what the student nurses found facilitating and obstructing for their learning during clinical practice. Earlier studies of experiences of learning in clinical practice have shown that factors as the possibilities of variations of experiences, the culture of the workplace, and communication between the educational institution and health care facilities are of importance. Less is known about the opportunities which students are given in order to practise the skills that they will be expected to perform as new graduate nurses. The experiences of 47 degree student nurses from two colleges in Sweden were gathered in weekly diaries during their final period of clinical practice. A content analysis technique was used to analyse their diaries. The students emphasized responsibility and independence, opportunities to practise different tasks, and receiving feedback as facilitating factors. Other perceived promoting factors included perceptions of control of the situation and understanding of the 'total picture'. Examples of obstructing factors were the nurses as supervisors not relying on the students, supervision that lacked continuity and lack of opportunities to practise. Perception of their own insufficiency and low self-reliance were drawbacks for some students. Recommended proposals are presented to lecturers and supervising staff concerning organizational and educational changes, and changes of attitudes for elucidating the students' experiences of different facilitating and obstructing factors. Changes may contribute to making easier the students' transition into the nursing profession.

[Antirheumatic therapy and reproduction. The influence on fertility, pregnancy and breast feeding].

PubMed

Ostensen, M

2006-05-01

Antirheumatic drugs can have a negative effect on reproduction in both men and women. Possible negative effects are impairment of fertility, harmful effects on the fetus and adverse effects on the breastfed child. In women non-steroidal antiinflammatory drugs (NSAID) and cyclophosphamide can impair fertility. In men infertility can result from the use of salazopyrine and cyclophosphamide. A desire for children should be taken into account before the start of disease modifying drugs (DMARD). Treatment with NSAID is possible at some stages of pregnancy as well as during lactation. A limited number of DMARD is compatible with pregnancy and is presented. Cytostatic drugs and leflunomide must be prophylactically withdrawn before a planned pregnancy. TNF alpha antagonists should be discontinued at the start of pregnancy. Safe birth control must be practised during therapy with drugs that are gonadotoxic or teratogenic. Treatment with immunosuppressive drugs during lactation is limited because of insufficient documentation of safety for the breastfed child.

Female family physicians in obstetrics: achieving personal balance.

PubMed Central

Carroll, J C; Brown, J B; Reid, A J

1995-01-01

OBJECTIVE: To describe the experiences of female family physicians who practise obstetrics in balancing professional obligations with personal and family needs, given the unique challenges that such practice poses for these physicians. DESIGN: Qualitative study. SETTING: Ontario. PARTICIPANTS: A purposefully selected sample of nine female family physicians who met the criteria of being married, having children and currently practising obstetrics. OUTCOME MEASURES: Experiences of female family physicians and their strategies in their personal, family and professional lives that enable them to continue practising obstetrics. RESULTS: All participants continued to practise obstetrics because of the pleasure they derived from it, despite the challenges of balancing the unpredictable demands of obstetrics with their personal and family needs. To continue in obstetrics, they needed to make changes in their lives, either through a gradual, evolutionary process or in response to a critical event. Alterations to work and family arrangements permitted them to meet the challenges and led to increased satisfaction. Changes included making supportive call-group arrangements, limiting work hours and the number of births attended and securing help with household duties. CONCLUSIONS: An in-depth examination, through the use of qualitative methods, showed the reasons why some female family physicians continue to practise obstetrics despite the stressful aspects of doing so. This knowledge may be useful for women who are residents or experienced clinicians and who are considering including obstetrics in their practice. PMID:7497390

Caring presence in practice: facilitating an appreciative discourse in nursing.

PubMed

du Plessis, E

2016-09-01

To report on an appreciation of caring presence practised by nurses in South Africa in order to facilitate an appreciative discourse in nursing and a return to caring values and attitudes. Appreciative reports on caring presence are often overlooked. Media may provide a platform for facilitating appreciation for caring presence practised by nurses. Such an appreciation may foster further practice of caring presence and re-ignite a caring ethos in nursing. This article provides an appreciative discourse on caring presence in nursing in the form of examples of caring presence practised by nurses. An anecdotal approach was followed. Social media, namely narratives on caring presence shared by nurses on a Facebook page, and formal media, namely news reports in which nurses are appreciated for their efforts, were used. Deductive content analysis was applied to analyse the narratives and news reports in relation to a definition of caring presence and types of caring presence. The analysis of the narratives and news reports resulted in an appreciative discourse in which examples of nurses practising caring presence could be provided. Examples of nurses practising caring presence could be found, and an appreciative discourse could be initiated. Appreciation ignites positive action and ownership of high-quality health care. Leadership should thus cultivate a culture of appreciating nurses, through using media, and encourage nurses to share how caring presence impact on quality in health care. © 2016 International Council of Nurses.

Training in Project-Based Education: Practise as You Preach

ERIC Educational Resources Information Center

Weenk, Wim; Govers, Elly; Vlas, Helma

2004-01-01

Several years of experience in training lecturers for developing and tutoring project-based learning (PBL) courses have resulted in a 'practise as you preach' based and flexible training programme. This programme was successfully incorporated in the teacher training programmes of the University of Twente and other universities and polytechnics in…

[Medical science and the human image--on the theory of medical tasks].

PubMed

Jenny, S

1993-06-22

Our science-determined medicine interprets the non-individual partial aspects of disease that are approachable by causal analytical thought; therefore, it becomes only then an art of healing when it is complemented by medical craftsmanship and philosophic reflection. Naturopathy perceives the individual as an open self-regulatory system whose innumerable mechanisms and strategies for maintenance of integrity have to be supported. In medical practise both concepts have always to be available concomitantly and and in equal rights, not only for repair of lesions but also for real healing.

A Comparison between Flash and Second Life Programs as Aids in the Learning of Basic Laboratory Procedures

ERIC Educational Resources Information Center

Booth, Paula; Henderson-Begg, Stephanie

2011-01-01

Invited as a paper from E-Learn 2009 This study compared two programmes developed as a learning tool for students to practise basic laboratory procedures. One was a Flash simulation programme, the other a Second Life virtual reality programme. A cohort of 93 bioscience students participated in the between trial. A control group was used to…

Effect of domestic violence training

PubMed Central

Zaher, Eman; Keogh, Kelly; Ratnapalan, Savithiri

2014-01-01

Abstract Objective To describe and evaluate the effectiveness of domestic violence education in improving physicians’ knowledge, recognition, and management of abused women. Data sources The Cochrane Database of Systematic Reviews, MEDLINE, PubMed, PsycINFO, ERIC, and EMBASE were searched for articles published between January 1, 2000, and November 1, 2012. This search was supplemented by manual searches for relevant articles using a combined text-word and MeSH-heading search strategy. Study selection Randomized controlled trials were selected that used educational interventions among physicians and provided data on the effects of the interventions. Synthesis Nine randomized controlled trials were included that described different educational approaches with various outcome measures. Three studies examined the effects of educational interventions among postgraduate trainee physicians and found an increase in knowledge but no change in behaviour with regard to identifying victims of domestic violence. Six studies examined educational interventions for practising physicians. Three of these studies used multifaceted physician training that combined education with system support interventions to change physician behaviour, such as increasing general awareness of domestic violence with brochures and posters, providing aids to remind physicians how to identify victims, facilitating physician access to victim support services, and providing audits and feedback. Multifaceted educational interventions included interactive workshops, Web-based learning, and experiential training. Another study used focus-group discussions and training, and showed improved domestic violence reporting among physicians. The remaining 2 studies showed improved perceptions of practising physicians’ self-efficacy using problem-based online learning. Conclusion It was difficult to determine the most effective educational strategy, as the educational interventions and the outcome measures varied among the selected studies. Brief interventions for postgraduate trainee physicians improved knowledge but did not seem to affect behaviour. Online education using a problem-based learning format improved practising physicians’ perceptions, knowledge, and skills in managing domestic violence. Physician training combined with system support interventions seemed to benefit domestic violence victims and increase referrals to domestic violence support resources. PMID:25022633

Developing the Practising Model in Physical Education: An Expository Outline Focusing on Movement Capability

ERIC Educational Resources Information Center

Barker, D. M.; Aggerholm, K.; Standal, O.; Larsson, H.

2018-01-01

Background: Physical educators currently have a number of pedagogical (or curricular) models at their disposal. While existing models have been well-received in educational contexts, these models seek to extend students' capacities within a limited number of "human activities" (Arendt, 1958). The activity of "human practising,"…

Making Links between Maths and Science

ERIC Educational Resources Information Center

Hiscock, Naomi

2012-01-01

For some children maths and science are exciting subjects that work side by side, one providing the opportunity to practise and hone skills and knowledge gained from the other. For other children the subjects are disjointed and seem to bear no relationship to each other. Science can provide a wonderful opportunity to practise a variety of math…

Work Factors and Teacher Satisfaction: The Mediating Effect of Cynicism toward Educational Change

ERIC Educational Resources Information Center

Yim, Joanne Sau-Ching; Moses, Priscilla

2016-01-01

This study investigated teachers' cynicism toward a major education transformation blueprint and their job satisfaction with a sample of 628 practising teachers. Participants were practising teachers in primary (n = 326) and secondary (n = 302) schools located in a school district in Malaysia. A self-reporting questionnaire was used, where the…

Australian Public Universities: Are They Practising a Corporate Approach to Governance?

ERIC Educational Resources Information Center

Christopher, Joseph

2014-01-01

This article draws on the multi-theoretical approach to governance and a qualitative research method to examine the extent to which the corporate approach is practised in Australian public universities. The findings reveal that in meeting the needs of multiple stakeholders, universities are faced with a number of structural, legalistic, and…

Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain.

PubMed

Shanahan, E M; Ahern, M; Smith, M; Wetherall, M; Bresnihan, B; FitzGerald, O

2003-05-01

Shoulder pain from inflammatory arthritis and/or degenerative disease is a common cause of morbidity in the community. It is difficult to treat and there are limited data on the efficacy of most interventions. Suprascapular nerve block has shown promise in limited trials in reducing shoulder pain. There have been no large randomised placebo controlled trials examining the efficacy of suprascapular nerve block for shoulder pain in arthritis and/or degenerative disease using pain and disability end points. To perform a randomised, double blind, placebo controlled trial of the efficacy of suprascapular nerve block for shoulder pain in rheumatoid arthritis (RA) and/or degenerative disease of the shoulder. 83 people with chronic shoulder pain from degenerative disease or RA took part in the trial. If a person had two painful shoulders, these were randomised separately. A total of 108 shoulders were randomised. Patients in the group receiving active treatment had a single suprascapular nerve block following the protocol described by Dangoisse et al, while those in the other group received a placebo injection of normal saline administered subcutaneously. The patients were followed up for 12 weeks by an observer who was unaware of the randomisation and reviewed at weeks 1, 4, and 12 after the injection. Pain, disability, and range of movement data were gathered. Clinically and statistically significant improvements in all pain scores, all disability scores, and some range of movement scores in the shoulders receiving suprascapular nerve block compared with those receiving placebo were seen at weeks 1, 4, and 12. There were no significant adverse effects in either group. Suprascapular nerve block is a safe and efficacious treatment for the treatment of shoulder pain in degenerative disease and/or arthritis. It improves pain, disability, and range of movement at the shoulder compared with placebo. It is a useful adjunct treatment for the practising clinician to assist in the management of a difficult and common clinical problem.

Quality nursing care in the words of nurses.

PubMed

Burhans, Linda Maas; Alligood, Martha Raile

2010-08-01

This paper is a report of a study of the meaning of quality nursing care for practising nurses. Healthcare quality continues to be a subject of intense criticism and debate. Although quality nursing care is vital to patient outcomes and safety, meaningful improvements have been disturbingly slow. Analysis of quality care literature reveals that practising nurses are rarely involved in developing or defining improvement programs for quality nursing care. Therefore, two major study premises were that quality nursing care must be meaningful and relevant to nurses and that uncovering their meaning of quality nursing care could facilitate more effective improvement approaches. Using van Manen's hermeneutic phenomenology, meaning was revealed through analysis of interviews to answer the research question 'What is the lived meaning of quality nursing care for practising nurses?' Twelve nurses practising on medical or surgical adult units at general or intermediate levels of care within acute care hospitals in the United States of America were interviewed. Emerging themes were discovered through empirical and reflective analysis of audiotapes and transcripts. The data were collected in 2008. The revealed lived meaning of quality nursing care for practising nurses was meeting human needs through caring, empathetic, respectful interactions within which responsibility, intentionality and advocacy form an essential, integral foundation. Nurse managers could develop strategies that support nurses better in identifying and delivering quality nursing care reflective of responsibility, caring, intentionality, empathy, respect and advocacy. Nurse educators could modify education curricula to model and teach students the intrinsic qualities identified within these meanings of quality nursing care.

Colocating an accredited practising dietitian to an adult community mental health service: An exploratory study.

PubMed

Furness, Trentham; Wallace, Elizabeth; McElhinney, Jo; McKenna, Brian; Cuzzillo, Celeste; Foster, Kim

2018-04-27

For people with severe mental illness, accredited practising dietitians may assist with a nutrition care plan that considers the medical, psychiatric, psychological, social, spiritual, and pharmacological aspects of their care. However, consumers' access to care has been limited by difficulties attending appointments and suboptimal interface between nutritional and mental health services. Therefore, the objectives of this exploratory study were to describe access to, and key stakeholder perspectives of, the accredited practising dietitian role colocated in a community mental health service. A total of 16 key stakeholders participated in one-to-one interviews. Two main themes with subthemes were derived from analysis of interviews: (i) 'building empowerment and collaboration' and included the subthemes, (a) nutrition awareness and education and (b) healthy lifestyle changes, and (ii) 'overcoming challenges to optimal nutrition and effective health care'. In addition, improved access to the role was demonstrated with 124 (79%) consumers attending at least one appointment with an accredited practising dietitian. A total of 15 (12%) consumers attended more than 10 appointments during their outpatient admission to the community mental health service. Colocating an accredited practising dietitian was perceived to build empowerment and collaboration, and overcome challenges to optimal nutrition and effective health care for consumers, carers, and clinicians. The colocation of a dietitian can empower consumers' to make health-informed decisions and support their willingness to engage with physical healthcare provision when it is prioritized alongside mental healthcare provision. © 2018 Australian College of Mental Health Nurses Inc.

[Predictors of successful transfer to everyday live of a relaxation method acquired in psychosomatic rehabilitation].

PubMed

Bernardy, K; Krampen, G; Köllner, V

2008-12-01

The aim of the present study was to identify factors at the beginning and at the end of an inpatient psychosomatic rehabilitation predicting the successful transfer of Progressive Relaxation (PR) according to Jacobson three months after the stay. Eighty patients in a psychosomatic rehabilitation centre were studied in the beginning (T1), at discharge (T2) and three months after discharge (T3). Every patient participated in courses on PR. To evaluate the course, parts of the "Diagnostisches und evaluatives Instrumentarium für Entspannungstraining und Entspannungstherapie" were used. Transfer was defined as successful if patients practised PR at least once a week three months after their stay. Potential predictors were: diagnosis, age, symptoms, previous experiences, and motives at T1 and frequency of practising, adequateness of group size and change of symptoms at T2. Stepwise logistic regression analysis was used to identify predictors. Three months after the course 52,5% of the patients were able to transfer PR successfully into their daily lives. 68,8% of cases had been correctly classified by logistic regression through: participation motive "positive thoughts" (T1) and "frequency of practising PR outside the course" (T2). Intrinsic participation motives and practising independently are significant predictors of long-term transfer of PR. This indicates the necessity of discussing motives at the beginning as well as frequency of practising during the PR course. It would be particularly interesting to know whether specific encouraging of motivation would improve the transfer to everyday life.

The challenge of improving boiling: lessons learned from a randomized controlled trial of water pasteurization and safe storage in Peru.

PubMed

Heitzinger, K; Rocha, C A; Quick, R E; Montano, S M; Tilley, D H; Mock, C N; Carrasco, A J; Cabrera, R M; Hawes, S E

2016-07-01

Boiling is the most common method of household water treatment in developing countries; however, it is not always effectively practised. We conducted a randomized controlled trial among 210 households to assess the effectiveness of water pasteurization and safe-storage interventions in reducing Escherichia coli contamination of household drinking water in a water-boiling population in rural Peru. Households were randomized to receive either a safe-storage container or a safe-storage container plus water pasteurization indicator or to a control group. During a 13-week follow-up period, households that received a safe-storage container and water pasteurization indicator did not have a significantly different prevalence of stored drinking-water contamination relative to the control group [prevalence ratio (PR) 1·18, 95% confidence interval (CI) 0·92-1·52]. Similarly, receipt of a safe-storage container alone had no effect on prevalence of contamination (PR 1·02, 95% CI 0·79-1·31). Although use of water pasteurization indicators and locally available storage containers did not increase the safety of household drinking water in this study, future research could illuminate factors that facilitate the effective use of these interventions to improve water quality and reduce the risk of waterborne disease in populations that boil drinking water.

Ethno-veterinary control of bovine dermatophilosis and ticks in Zhombe, Njelele and Shamrock resettlement in Zimbabwe.

PubMed

Ndhlovu, Daud Nyosi; Masika, Patrick J

2013-02-01

A structured questionnaire survey was conducted to determine the ethno-veterinary practices and other control methods used by smallholder farmers for the management of bovine dermatophilosis and ticks. A total of 153 farmers were interviewed from Njelele, Zhombe communal and Shamrock resettlement areas. Crop production contributed most to livelihoods (83.2 %) while livestock contributed 9.0 %. Over 90 % of the respondents had attended school up to primary level, with 11.4 % undergoing animal health and husbandry training. Treatment of livestock diseases was practised by 96 % of the farmers, and 49.7 % of these farmers used ethno-veterinary medicines. Across the study sites, dermatophilosis was controlled using the following plants: Cissus quadrangularis (59.7 %), Catunaregam spinosa (10.5 %), Pterocarpus angolensis (10.5 %), Kalanchoe lanceolata (5.3 %), Aloe chabaudii (3.5 %), Cassia abbreviata (1.8 %), Dichrostachys cinerea (1.8 %), Urginea sanguinea (1.8 %), Ximenia caffra (1.8 %) and a plant locally called umfanawembila (1.8 %). Carica papaya and two plants, locally called mugimbura and umdungudungu, were used for tick control, and these were reported once from Njelele communal. Other control methods, besides plants or conventional drugs, were used by 28 % of the farmers for the treatment of dermatophilosis and ticks. Some farmers (14.4 %) claimed that ethno-veterinary medicines performed better than conventional drugs. The study revealed that farmers used ethno-veterinary medical practices for the treatment of dermatophilosis but rarely for tick control.

Study of Chrysopogon Zizanioides ability to decontaminate irrigation water in Southwest Spain

NASA Astrophysics Data System (ADS)

Galea Grajera, F. A.

2009-04-01

Conventional agriculture is characterized by the increasing use of agrochemicals to maintain and improve soil fertility. One of the main problems arising from this practise is the generation of leachates, which contain a high concentration of nitrate, nitrite, phosphate and other contaminating components, causing soil and water pollution. This is a common problem in irrigated areas such as Las Vegas Bajas del Guadiana (Extremadura, Spain). Different techniques are being developed and used to control leachate generation, however, these practises happen to be very expensive. In this situation, the emergence of alternative technologies such as phytoremediation, based on the ability of some plants to absorb and accumulate high concentrations of pollutants such as heavy metals, organic compounds and radiactive components, is being explored to restore the degraded lands and it seems very feasible, economical and environment-friendly. The Vetiver grass (Chrysopogon zizanioides) is a perennial grass originally from India, widely known for its ability to retain soil and prevent erosion. Recently, the new use of this grass for phytoremediation has stimulated research in this area. It produces up to two meter high plant with a strong dense and mainly vertical root system with emerging secondary roots which form a dense and strong network that grows horizontally and vertically to depths greater than 5 meters, useful in soil erosion control. It is vegetatively propagated and is non-invasive, resistant to pests and diseases and widely used worldwide for soil and moisture conservation and soil restoration. This study, carried out in Badajoz, in the Southwest of the Iberian Peninsula, focuses in the use of Vetiver in the area. Its adaptation to climatic and soil conditions was tested for three years. Bunches of selected species were first grown in pots and later planted in experimental plots exposed to the weather conditions in the area. When adaptation to edaphic and climatic conditions was confirmed, several tests were developed to analyze its characteristics and abilities as a phytoremediation species. These tests were developed in a greenhouse by controlling both the plant and its ability to decontaminate leachate from conventional agriculture irrigation. The analysis of water and leachates indicated that the species is able to significantly decrease the concentration of some chemicals such as nitrates, nitrites and phosphates.

Bovine Mastitis: Frontiers in Immunogenetics

PubMed Central

Thompson-Crispi, Kathleen; Atalla, Heba; Miglior, Filippo; Mallard, Bonnie A.

2014-01-01

Mastitis is one of the most prevalent and costly diseases in the dairy industry with losses attributable to reduced milk production, discarded milk, early culling, veterinary services, and labor costs. Typically, mastitis is an inflammation of the mammary gland most often, but not limited to, bacterial infection, and is characterized by the movement of leukocytes and serum proteins from the blood to the site of infection. It contributes to compromised milk quality and the potential spread of antimicrobial resistance if antibiotic treatment is not astutely applied. Despite the implementation of management practises and genetic selection approaches, bovine mastitis control continues to be inadequate. However, some novel genetic strategies have recently been demonstrated to reduce mastitis incidence by taking advantage of a cow’s natural ability to make appropriate immune responses against invading pathogens. Specifically, dairy cattle with enhanced and balanced immune responses have a lower occurrence of disease, including mastitis, and they can be identified and selected for using the high immune response (HIR) technology. Enhanced immune responsiveness is also associated with improved response to vaccination, increased milk, and colostrum quality. Since immunity is an important fitness trait, beneficial associations with longevity and reproduction are also often noted. This review highlights the genetic regulation of the bovine immune system and its vital contributions to disease resistance. Genetic selection approaches currently used in the dairy industry to reduce the incidence of disease are reviewed, including the HIR technology, genomics to improve disease resistance or immune response, as well as the Immunity+™ sire line. Improving the overall immune responsiveness of cattle is expected to provide superior disease resistance, increasing animal welfare and food quality while maintaining favorable production levels to feed a growing population. PMID:25339959

Aspects of black-fly control and entomology in the New World in relation to the Simulium problem in Nigeria*

PubMed Central

Crosskey, R. W.

1959-01-01

A general account is given of insecticidal control of black-flies in North and Central America, and the problems are contrasted with those arising in the control of Simulium damnosum Theo. in Nigeria. Some recent biological observations on Canadian black-flies are described, and it is emphasized that these have materially contributed to successful control. It is pointed out that S. damnosum control is being practised in the absence of much fundamental biological knowledge of this pest. Entomological aspects of onchocerciasis in Mexico and Guatemala are discussed, and compared with S. damnosum and its relationship to onchocerciasis in Nigeria. PMID:13813021

[The oncologist and his patient].

PubMed

Obrecht, J P

1991-04-23

The motifs of medical practise, in particular by the oncologist and the basic experience of the patient notably the cancer patient are presented. They represent the prerequisite for an individually taylored, solid relationship between physician and patient founding on mutual trust. Medical practise is nowadays founded on a scientific rationale. In contrast to earlier times the ethos of compassion pertains the private sphere. It is the physicians individual choice to proffer the traditional compassion as interest in the fate of an individual patient or not. The fundamental experience of an individual that his destiny lies no longer in his own hands expresses itself in a paradigmatic way by the perception of his illness. The cancer patient experiences--as other patients do--the threats but also his healing as occurrences not caused by him. He therefore does not identify his disease with objective impairments or pathologic findings. On the contrary, he perceives it as a threat to himself, his existence and his personality. The patient experiences his fate, to depend on circumstances and particularly on other individuals, their benevolence, their acceptance, their help. Trust is the basis for relationship between the cancer patient and his physician. Trust is also acceptance of dependence. Dependence is only acceptable if the physician is trustworthy. Trustworthiness cannot be gained by scientific competence alone but requires personal affection by compassion with the patients fate. The physician needs ethical competence to fulfill his task. Information of the patient gains a particular importance in this context. It, as well as the divergent assessment of the disease by patient and physician--the anthropologic difference--and the "equilibrating systems" are exposed.

"Part of Me Feels Like There Must Be Something Missing": A Phenomenological Exploration of Practising Psychotherapy as a Clinical Psychologist

ERIC Educational Resources Information Center

McMahon, Aisling

2018-01-01

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: "Feeling there's something missing", "Being able to get in there emotionally" and "Needing somewhere to go for…

Addressing the Baseline: Erving Goffman and Ethics in a Postgraduate Degree for Practising Teachers

ERIC Educational Resources Information Center

McDonald, Geraldine; Higgins, Joanna; Shuker, Mary Jane

2008-01-01

In response to the claim that students who have received an undergraduate degree in education lack adequate preparation for postgraduate study, the designers of a masters course in research methods set an assignment at the first meeting which asked practising teachers to match Goffman's dramaturgical concepts to observation of behaviour in public.…

Please Touch the Children: Appropriate Touch in the Primary Classroom

ERIC Educational Resources Information Center

Owen, Pamela M.; Gillentine, Jonathan

2011-01-01

This study proposes to shift the current theoretical framework in which teachers practise a guarded approach regarding the touching of children in early childhood settings, towards a practice of acceptance. A brief historical context of touching is presented and supplemented with a survey of 63 currently practising K-3rd grade teachers. The survey…

Music behind Scores: Case Study of Learning Improvisation with "Playback Orchestra" Method

ERIC Educational Resources Information Center

Juntunen, P.; Ruokonen, I.; Ruismäki, H.

2015-01-01

For music students in the early stages of learning, the music may seem to be hidden behind the scores. To support home practising, Juntunen has created the "Playback Orchestra" method with which the students can practise with the support of the notation program playback of the full orchestra. The results of testing the method with…

Documenting with Early Childhood Education Teachers: Pedagogical Documentation as a Tool for Developing Early Childhood Pedagogy and Practises

ERIC Educational Resources Information Center

Rintakorpi, Kati

2016-01-01

The Finnish social pedagogical curriculum for early childhood education directs early childhood teachers to use documentation to assess and develop pedagogy and practise. This empirical study examines the challenges and benefits a group of Finnish preschool teachers experienced when they learned to document their work. Although the idea of…

Reality-based practice under pressure improves handgun shooting performance of police officers.

PubMed

Oudejans, R R D

2008-03-01

The current study examined whether reality-based practice under pressure may help in preventing degradation of handgun shooting performance under pressure for police officers. Using a pre-post-test design, one group of nine police officers practised handgun shooting under pressure evoked by an opponent who also fired back using marking (coloured soap) cartridges. The control group (n = 8) practised handgun shooting on standard cardboard targets instead of real opponents. Within a fortnight after the pre-test, both groups received three training sessions of 1 h, in which each person fired a total of 72 rounds. During the pre- and post test each participant took 30 shots without pressure (cardboard targets) and 30 shots under additional pressure (with an opponent firing back). While during the pre-test both groups performed worse in front of an opponent firing back compared to the cardboard targets, after the training sessions shooting performance of the experimental group no longer deteriorated with an opponent while performance of the control group was equally harmed as during the pre-test. These results indicate that training exercises involving increased pressure can acclimatize shooting performance of ordinary police officers to those situations with elevated pressure that they may encounter during their police work.

Role of the dorsolateral prefrontal cortex in context-dependent motor performance.

PubMed

Lee, Y-Y; Winstein, C J; Fisher, B E

2016-04-01

Context-dependent motor performance is a phenomenon in which people perform better in the environmental context where they originally practised a task. Some animal and computer simulation studies have suggested that context-dependent performance may be associated with neural activation of the dorsolateral prefrontal cortex (DLPFC). This study aimed to determine the role of the DLPFC in context-dependent motor performance by perturbing the neural processing of the DLPFC with repetitive transcranial magnetic stimulation (rTMS) in healthy adults. Thirty healthy adults were recruited into the Control, rTMS DLPFC and rTMS Vertex groups. The participants practised three finger sequences associated with a specific incidental context (a coloured circle and a location on the computer screen). One day following practice, the rTMS groups received 1 Hz rTMS prior to the testing conditions in which the sequence-context associations remained the same as practice (SAME) or changed (SWITCH). All three groups improved significantly over practice on day 1. The second day testing results showed that the DLPFC group had a significantly lower decrease in motor performance under the SWITCH condition than the Control and Vertex groups. This finding suggests a specific role of the DLPFC in context-dependent motor performance. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

The impact of urinary stress incontinence in young and middle-age women practising recreational sports activity: an epidemiological study.

PubMed

Salvatore, S; Serati, M; Laterza, R; Uccella, S; Torella, M; Bolis, P-F

2009-12-01

To evaluate the prevalence of urinary stress incontinence (USI) in menstruating women practising recreational sports activity, to detect specific sports with a stronger association with urinary incontinence (UI) and to evaluate risk factors possibly related to this condition. Epidemiological study. Non-competitive sports organisations in the province of Varese, Italy. 679 women of fertile age, practising recreational sports activity. Anonymous questionnaire on UI. The questionnaire included questions about patients' general characteristics, occurrence of UI in relation to sport or daily general activities, time of onset of this condition, frequency of leakage episodes, correlation of incontinence with types of movements or sports, subjective impression of being limited on such occasions and/or necessity to modify the type of sport. UI was reported by 101 women (14.9%). Of these, 32 (31.7%) complained of UI only during sports activity, 48 (47.5%) only during daily life and 21 (20.8%) in both circumstances. Body mass index and parity were significantly associated with the risk of UI. Looking at the different sports activities, a higher rate of incontinence was found in women participating in basketball (16.6%), athletics (15%), and tennis or squash (11%). 10.4% of women abandoned their favourite sport, because of USI, and a further 20% limited the way they practised their favourite sport to reduce leakage episodes. Female UI affects a significant proportion of young women practising non-competitive sports activity; it can cause abandonment of the sport or limitation of its practice.

Vibration control in smart coupled beams subjected to pulse excitations

NASA Astrophysics Data System (ADS)

Pisarski, Dominik; Bajer, Czesław I.; Dyniewicz, Bartłomiej; Bajkowski, Jacek M.

2016-10-01

In this paper, a control method to stabilize the vibration of adjacent structures is presented. The control is realized by changes of the stiffness parameters of the structure's couplers. A pulse excitation applied to the coupled adjacent beams is imposed as the kinematic excitation. For such a representation, the designed control law provides the best rate of energy dissipation. By means of a stability analysis, the performance in different structural settings is studied. The efficiency of the proposed strategy is examined via numerical simulations. In terms of the assumed energy metric, the controlled structure outperforms its passively damped equivalent by over 50 percent. The functionality of the proposed control strategy should attract the attention of practising engineers who seek solutions to upgrade existing damping systems.

CSIR Contribution to Defining Adaptive Capacity in the Context of Environmental Change

DTIC Science & Technology

2014-03-31

Pollution rates Cultural norms Roads Agricultu ral practises / norms Level of Income Access to safe water Gender based discriminati on Fear of...internal conflicts Civil rights Quality of nutrition Status of environm ental policies Spiritual practises Dams Food for sale ... Fertility rates Literacy rates These developed categories are currently being tested by using both qualitative and

Characterization of Mathematics Instructional Practises for Prospective Elementary Teachers with Varying Levels of Self-Efficacy in Classroom Management and Mathematics Teaching

ERIC Educational Resources Information Center

Lee, Carrie W.; Walkowiak, Temple A.; Nietfeld, John L.

2017-01-01

The purpose of this study was to investigate the relationship between prospective teachers' (PTs) instructional practises and their efficacy beliefs in classroom management and mathematics teaching. A sequential, explanatory mixed-methods design was employed. Results from efficacy surveys, implemented with 54 PTs were linked to a sample of…

Improving clinical handover in a paediatric ward: implications for nursing management.

PubMed

Mannix, Trudi; Parry, Yvonne; Roderick, Allison

2017-04-01

To describe how nursing staff in a paediatric ward improved the conduct of clinical handover, using a practise development approach. ISBAR (Identify, Situation, Background, Assessment and Recommendation) is a mnemonic tool to aid the safe transfer of patient information in clinical handover. The nurses identified the need to improve the use of ISBAR, and other issues related to handover that could compromise patient safety and constrain family-centred care. Sixty-one percent of nurses on the ward contributed to issue identification and the design of the educational material, including a set of written and video resources and incorporating the role of a handover coach. Staff performance was evaluated before and after access to the resources using self-administered Likert scales, observation and a focus group. After the intervention, there was a stronger relationship between the participants' understanding of ISBAR and their application of it in handover. Further, there were statistically significant increases in improved handover practises, including family inclusion and safety checks. A practise development approach is useful in the provision of education to guide clinical performance in patient handover. Nurse managers can use this approach to empower their staff to make positive changes to practise. © 2017 John Wiley & Sons Ltd.

[Practicing veterinarians' perception of bovine ringworm as herd health problem].

PubMed

Kleen, Joachim L; Andres, Tatjana; Exner, Ulrike; Strie, Regina

2017-04-19

Bovine ringworm (tinea) is generally described as a disease occurring regularly in cattle. Actual data are rare, whereas the disease is regularly reported in case reports. To eradicate bovine ringworm, perception as well as measures, including hygiene and disinfection, are required. In a course for continuing education, 378 practicing veterinarians were asked in a questionnaire to state their view on bovine ringworm. The majority of the participants stated that ringworm was not satisfactorily perceived as an animal health problem and that the zoonotic potential was underestimated. A majority of participants agreed to diagnose ringworm on farms regularly and stated that they were involved in treating the disease. The participating veterinarians felt, however, that perception of ringworm by the farms themselves was inadequate. Vaccination was generally judged as being helpful. Generally, practising veterinarians feel that bovine ringworm is being perceived as less important by farms than by themselves. It is to be concluded that more information and offers regarding the treatment for ringworm could contribute to more effective engagement in the disease.

Psychosomatic approaches to obstetrics, gynaecology and andrology--a review.

PubMed

Lal, Mira

2009-01-01

This review aims to clarify the scope and clinical importance of psychosomatic approaches to obstetrics, gynaecology and andrology. This gradually expanding sub-specialty covers a wide domain of complex disease conditions that can be managed more effectively if the various biological, psychological and social aspects are recognised at the start and concurrent treatment initiated. The current need to practise biopsychosocial management of disease conditions is highlighted along with a description of what this would involve. The nine-field psychosomatic approach, which can be applied to everyday clinical encounters, has been illustrated. Clinical applications of the psychosomatic approach are discussed for various conditions including chronic pelvic pain, eating disorders, tokophobia, post-traumatic stress disorder, depression, menstrual disorders, infertility, bereavement and testicular cancer. Cultural considerations and the need for further research are also briefly discussed.

Problems of Adolescence

PubMed Central

Medovy, Harry

1964-01-01

Adolescence is a period of active growth and development-physical, sexual, social and emotional. There are wide normal variations between the time of onset and the attainment of full maturity. Many adolescents present few if any problems during this potentially turbulent period, and make the necessary adjustments without undue stress to themselves, their family or their friends. Problems in growth and hormonal balance, presenting as short and tall teenagers, menstrual irregularities, obesity and acne are discussed. The impact of chronic disease-diabetes, convulsive disorders and rheumatic carditis-is a challenge to the skills and patience of the practising physician. PMID:14156831

Globalisation and global health: issues for nursing.

PubMed

Bradbury-Jones, Caroline; Clark, Maria

2017-05-24

'Globalisation' is the term used to describe the increasing economic and social interdependence between countries. Shifting patterns of health and disease are associated with globalisation. Global health refers to a health issue that is not contained geographically and that single countries cannot address alone. In response to globalisation and global health issues, nurses practise in new and emerging transnational contexts. Therefore, it is important that nurses respond proactively to these changes and understand the effects of globalisation on health worldwide. This article aims to increase nurses' knowledge of, and confidence in, this important area of nursing practice.

Review of the bioenvironmental methods for malaria control with special reference to the use of larvivorous fishes and composite fish culture in central Gujarat, India.

PubMed

Kant, Rajni; Haq, S; Srivastava, H C; Sharma, V P

2013-03-01

Mosquito control with the use of insecticides is faced with the challenges of insecticide resistance in disease vectors, community refusal, their high cost, operational difficulties, and environmental concern. In view of this, integrated vector control strategies with the use of larvivorous fishes such as Guppy (Poecilia reticulata) and Gambusia (G. affinis) as biological control agents were used in controlling mosquito breeding in different types of breeding places such as intradomestic containers, various types of wells, rice-fields, pools, ponds and elsewhere in malaria prone rural areas of central Gujarat. Attempts were also made to demonstrate composite fish culture in unused abandoned village ponds by culturing Guppy along with the food fishes such as Rohu (Labeo rohita), Catla (Catla catla) and Mrigal (Cirrhinus mrigala). Income generated from these ponds through sale of fishes was utilized for mosquito control and village development. The technology was later adopted by the villagers themselves and food fish culture was practised in 23 ponds which generated an income of Rs 1,02,50,992 between 1985 and 2008. The number of villages increased from 13 to 23 in 2008 and there was also gradual increase of income from Rs 3,66,245 in 1985-90 to Rs 55,06,127 in 2002-08 block. It is concluded that larvivorous fishes can be useful tool in controlling mosquito breeding in certain situations and their use along with composite fish culture may also generate income to make the programme self-sustainable.

Self-reported optometric practise patterns in age-related macular degeneration.

PubMed

Ly, Angelica; Nivison-Smith, Lisa; Zangerl, Barbara; Assaad, Nagi; Kalloniatis, Michael

2017-11-01

The use of advanced imaging in clinical practice is emerging and the use of this technology by optometrists in assessing patients with age-related macular degeneration is of interest. Therefore, this study explored contemporary, self-reported patterns of practice regarding age-related macular degeneration diagnosis and management using a cross-sectional survey of optometrists in Australia and New Zealand. Practising optometrists were surveyed on four key areas, namely, demographics, clinical skills and experience, assessment and management of age-related macular degeneration. Questions pertaining to self-rated competency, knowledge and attitudes used a five-point Likert scale. Completed responses were received from 127 and 87 practising optometrists in Australia and New Zealand, respectively. Advanced imaging showed greater variation in service delivery than traditional techniques (such as slitlamp funduscopy) and trended toward optical coherence tomography, which was routinely performed in age-related macular degeneration by 49 per cent of respondents. Optical coherence tomography was also associated with higher self-rated competency, knowledge and perceived relevance to practice than other modalities. Most respondents (93 per cent) indicated that they regularly applied patient symptoms, case history, visual function results and signs from traditional testing, when queried about their management of patients with age-related macular degeneration. Over half (63 per cent) also considered advanced imaging, while 31 per cent additionally considered all of these as well as the disease stage and clinical guidelines. Contrary to the evidence base, 68 and 34 per cent rated nutritional supplements as highly relevant or relevant in early age-related macular degeneration and normal aging changes, respectively. These results highlight the emergence of multimodal and advanced imaging (especially optical coherence tomography) in the assessment of age-related macular degeneration by optometrists. Clinically significant variations in self-rated test competency and the understanding regarding nutritional supplements for different stages of age-related macular degeneration suggest that further work to up-skill optometrists may be required. © 2017 Optometry Australia.

The effectiveness of a nurse-led illness perception intervention in COPD patients: a cluster randomised trial in primary care

PubMed Central

Schuurmans, Marieke J.; Zanen, Pieter; Heijmans, Monique J.W.M.; Sachs, Alfred P.E.; Lammers, Jan-Willem J.

2017-01-01

The new COPD-GRIP (Chronic Obstructive Pulmonary Disease – Guidance, Research on Illness Perception) intervention translates evidence regarding illness perceptions and health-related quality of life (HRQoL) into a nurse intervention to guide COPD patients and to improve health outcomes. It describes how to assess and discuss illness perceptions in a structured way. This study aimed to assess the effectiveness of the intervention in primary care. A cluster randomised controlled trial was conducted within 30 general practices and five home-care centres, including 204 COPD patients. 103 patients were randomly assigned to the intervention group and 101 patients to the usual-care group. To assess differences, repeated multilevel linear mixed modelling analyses were used. Primary outcome was change in health status on the Clinical COPD Questionnaire (CCQ) at 9 months. Secondary outcomes were HRQoL, daily activities, health education impact and changes in illness perceptions. There was no significant difference between the groups in the CCQ at 9 months. We found a significant increase in health-directed behaviour at 6 weeks (p=0.024) and in personal control (p=0.005) at 9 months in favour of the intervention group. The COPD-GRIP intervention, practised by nurses, did not improve health status in COPD patients in primary care. However, the intervention has benefits in improving the ability to control the disease and health-related behaviours in the short term. Therefore, taking illness perceptions into account when stimulating healthy behaviours in COPD patients should be considered. Further study on influencing the health status and HRQoL is needed. PMID:29250529

Effects of physical and sporting activities on balance control in elderly people

PubMed Central

Perrin, P. P.; Gauchard, G. C.; Perrot, C.; Jeandel, C.

1999-01-01

OBJECTIVE: Balance disorders increase with aging and raise the risk of accidental falls in the elderly. It has been suggested that the practice of physical and sporting activities (PSA) efficiently counteracts these age related disorders, reducing the risk of falling significantly. METHODS: This study, principally based on a period during which the subjects were engaged in PSA, included 65 healthy subjects, aged over 60, who were living at home. Three series of posturographic tests (static, dynamic with a single and fast upward tilt, and dynamic with slow sinusoidal oscillations) analysing the centre of foot pressure displacements or electromyographic responses were conducted to determine the effects of PSA practice on balance control. RESULTS: The major variables of postural control were best in subjects who had always practised PSA (AA group). Those who did not take part in PSA at all (II group) had the worst postural performances, whatever the test. Subjects having lately begun PSA practice (IA group) had good postural performances, close to those of the AA group, whereas the subjects who had stopped the practice of PSA at an early age (AI group) did not perform as well. Overall, the postural control in the group studied decreased in the order AA > IA > AI > II. CONCLUSIONS: The period during which PSA are practised seems to be of major importance, having a positive bearing on postural control. It seems that recent periods of practice have greater beneficial effects on the subject's postural stability than PSA practice only at an early age. These data are compatible with the fact that PSA are extremely useful for elderly people even if it has not been a lifelong habit. 


 PMID:10205695

Toward Active Control of Noise from Hot Supersonic Jets

DTIC Science & Technology

2013-11-15

several laboratory - and full- scale data sets. Two different scaling scenarios are presented for the practising scientist to choose from. The first...As will be detailed below, this simple proof-of-concept experiment yielded good quality data that reveals details about the large-scale 3D structure...the light-field. Co-PI Thurow has recently designed and assembled a plenoptic camera in his laboratory with its key attributes being its compact

Effect of different agronomic practises on greenhouse gas emissions, especially N2O and nutrient cycling

NASA Astrophysics Data System (ADS)

Koal, Philipp; Schilling, Rolf; Gerl, Georg; Pritsch, Karin; Munch, Jean Charles

2014-05-01

In order to achieve a reduction of greenhouse gas emissions, management practises need to be adapted by implementing sustainable land use. At first, reliable field data are required to assess the effect of different farming practises on greenhouse gas budgets. The conducted field experiment covers and compares two main aspects of agricultural management, namely an organic farming system and an integrated farming system, implementing additionally the effects of diverse tillage systems and fertilisation practises. Furthermore, the analysis of the alterable biological, physical and chemical soil properties enables a link between the impact of different management systems on greenhouse gas emissions and the monitored cycle of matter, especially the nitrogen cycle. Measurements were carried out on long-term field trials at the Research Farm Scheyern located in a Tertiary hilly landscape approximately 40 km north of Munich (South Germany). The long-term field trials of the organic and integrated farming system were started in 1992. Since then, parcels in a field (each around 0,2-0,4 ha) with a particular interior plot set-up have been conducted. So the 20 years impacts of different tillage and fertilisation practises on soil properties including trace gases were examined. Fluxes of CH4, N2O and CO2 are monitored since 2007 for the integrated farming system trial and since 2012 for the organic farming system trial using an automated system which consists of chambers (per point: 4 chambers, each covering 0,4 m2 area) with a motor-driven lid, an automated gas sampling unit, an on-line gas chromatographic analysis system, and a control and data logging unit (Flessa et al. 2002). Each chamber is sampled 3-4 times in 24 hours. The main outcomes are the analysis of temporal and spatial dynamics of greenhouse gas fluxes as influenced by management practice events (fertilisation and tillage) and weather effects (drying-rewetting, freezing-thawing, intense rainfall and dry periods) in both established systems and the creation of an impact study comparing the minimum tillage system with the conventional tillage system. Physical, chemical and biological soil properties (i.a. texture, mineral nitrogen and soil organic carbon) were monitored to aggregate the parameters and processes influencing the greenhouse gas fluxes. Moreover, to understand processes leading the greenhouse gas emissions, additional experiments under laboratory conditions (e.g. soil potential for trace gas formation) are included. Furthermore, with the comparison of the similar long-term field experiments (organic vs. integrated) more relevant data are ascertained to assess and calculate the global warming potential of different management and tillage systems.

A survey analysis of indigenous goat production in communal farming systems of Botswana.

PubMed

Monau, P I; Visser, C; Nsoso, S J; Van Marle-Köster, E

2017-08-01

A total of 153 communal farmers in four agro-ecological regions of Botswana were interviewed using a structured questionnaire. The aims of the survey were to characterise existing communal goat production systems, evaluate the importance of goats to farmers and identify breeding practices and constraints encountered in goat production in Botswana. Data was collected on socio-economic parameters, general and breeding management practices and major constraints limiting goat production in Botswana. All respondents were small-scale communal farmers with 63% respondents practising mixed crop-livestock farming and 37% keeping livestock as their primary activity. The majority (33%) of respondents were older than 60 years. Over 80% of the farmers kept goats for cash required for tuition, school uniforms and household commodities as well as re-stocking of animals. Most farmers (62%) kept indigenous crossed genotypes. Generally, uncontrolled mating was practised with the majority of farmers (41%) using on-farm reared bucks for more than two years of breeding and communal bucks (36%) as an alternative. The major constraints limiting goat productivity in communal areas included uncontrolled breeding, predators, theft and diseases. Issues raised by farmers should be considered in designing and implementing effective breeding programs for goats to improve their overall productivity and contribution to poverty alleviation in these communities.

Sexually transmitted diseases among psychiatric patients in Brazil.

PubMed

Dutra, Maria Rita Teixeira; Campos, Lorenza Nogueira; Guimarães, Mark Drew Crosland

2014-01-01

Sexually transmitted diseases are still highly prevalent worldwide and represent an important public health problem. Psychiatric patients are at increased risk of sexually transmitted diseases but there are scarce published studies with representative data of this population. We sought to estimate the prevalence and correlates of self-reported sexually transmitted diseases among patients with mental illnesses under care in a national representative sample in Brazil (n=2145). More than one quarter of the sample (25.8%) reported a lifetime history of sexually transmitted disease. Multivariate analyses showed that patients with a lifetime sexually transmitted disease history were older, had history of homelessness, used more alcohol and illicit drugs, suffered violence, perceived themselves to be at greater risk for HIV and had high risk sexual behavioral: practised unprotected sex, started sexual life earlier, had more than ten sexual partners, exchanged money and/or drugs for sex and had a partner that refused to use condom. Our findings indicate a high prevalence of self-reported sexually transmitted diseases among psychiatric patients in Brazil, and emphasize the need for implementing sexually transmitted diseases prevention programs in psychiatric settings, including screening, treatment, and behavioral modification interventions. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

Perceiving the target's state or state provoked by the target? An analysis of the descriptive and evaluative knowledge in person perception.

PubMed

Mignon, Astrid; Mollaret, Patrick

2012-12-01

In line with the theory of traits as generalized affordances, the present article argues that target's states (TSs) and states provoked by a target (other's states (OSs) towards target) are two components of the meaning of traits referring, respectively, to a descriptive and to an evaluative knowledge of people. A preliminary study confirmed that TS and OS were equally representative of a trait. Two studies were designed to study the effects of practising the use of traits as either TS or OS categories (an induction procedure) on a subsequent person perception task, requiring participants to rate photographed targets on a series of traits. Results show that both the differentiation between targets and evaluative consistency of ratings were enhanced under the OS condition compared to TS and control (with no practice of traits) conditions. Importantly, Study 2 tends to show that the effects of the induction procedure are not limited to the practised traits but also generalize to unpractised traits. Implications of these findings for social perception research are discussed. ©2011 The British Psychological Society.

Sensori-motor experience leads to changes in visual processing in the developing brain.

PubMed

James, Karin Harman

2010-03-01

Since Broca's studies on language processing, cortical functional specialization has been considered to be integral to efficient neural processing. A fundamental question in cognitive neuroscience concerns the type of learning that is required for functional specialization to develop. To address this issue with respect to the development of neural specialization for letters, we used functional magnetic resonance imaging (fMRI) to compare brain activation patterns in pre-school children before and after different letter-learning conditions: a sensori-motor group practised printing letters during the learning phase, while the control group practised visual recognition. Results demonstrated an overall left-hemisphere bias for processing letters in these pre-literate participants, but, more interestingly, showed enhanced blood oxygen-level-dependent activation in the visual association cortex during letter perception only after sensori-motor (printing) learning. It is concluded that sensori-motor experience augments processing in the visual system of pre-school children. The change of activation in these neural circuits provides important evidence that 'learning-by-doing' can lay the foundation for, and potentially strengthen, the neural systems used for visual letter recognition.

Speech Skill Learning of Persons Who Stutter and Fluent Speakers under Single and Dual Task Conditions

ERIC Educational Resources Information Center

Smits-Bandstra, Sarah; De Nil, Luc

2009-01-01

Two studies compared the accuracy and efficiency of initiating oral reading of nonsense syllables by persons who stutter (PWS) and fluent speakers (PNS) over practise. Findings of Study One, comparing 12 PWS and 12 PNS, replicated previous findings of slow speech sequence initiation over practise by PWS relative to PNS. In Study Two, nine PWS and…

Attitudes on cost-effectiveness and equity: a cross-sectional study examining the viewpoints of medical professionals

PubMed Central

Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb

2017-01-01

Objective To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. Design In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Setting Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. Participants 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Main outcome(s) and measure(s) Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. Results A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; p<0.001) were more likely to favour the equitable option compared with medical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; p<0.001). Conclusions Cost-effectiveness analysis does not accurately reflect the importance that medical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. PMID:28765138

Attitudes on cost-effectiveness and equity: a cross-sectional study examining the viewpoints of medical professionals.

PubMed

Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb

2017-08-01

To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; p<0.001) were more likely to favour the equitable option compared with medical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; p<0.001). Cost-effectiveness analysis does not accurately reflect the importance that medical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Big data in Parkinson's disease: using smartphones to remotely detect longitudinal disease phenotypes.

PubMed

Prince, John; Arora, Siddharth; de Vos, Maarten

2018-04-26

To better understand the longitudinal characteristics of Parkinson's disease (PD) through the analysis of finger tapping and memory tests collected remotely using smartphones. Using a large cohort (312 PD subjects and 236 controls) of participants in the mPower study, we extract clinically validated features from a finger tapping and memory test to monitor the longitudinal behaviour of study participants. We investigate any discrepancy in learning rates associated with motor and non-motor tasks between PD subjects and healthy controls. The ability of these features to predict self-assigned severity measures is assessed whilst simultaneously inspecting the severity scoring system for floor-ceiling effects. Finally, we study the relationship between motor and non-motor longitudinal behaviour to determine if separate aspects of the disease are dependent on one another. We find that the test performances of the most severe subjects show significant correlations with self-assigned severity measures. Interestingly, less severe subjects do not show significant correlations, which is shown to be a consequence of floor-ceiling effects within the mPower self-reporting severity system. We find that motor performance after practise is a better predictor of severity than baseline performance suggesting that starting performance at a new motor task is less representative of disease severity than the performance after the test has been learnt. We find PD subjects show significant impairments in motor ability as assessed through the alternating finger tapping (AFT) test in both the short- and long-term analyses. In the AFT and memory tests we demonstrate that PD subjects show a larger degree of longitudinal performance variability in addition to requiring more instances of a test to reach a steady state performance than healthy subjects. Our findings pave the way forward for objective assessment and quantification of longitudinal learning rates in PD. This can be particularly useful for symptom monitoring and assessing medication response. This study tries to tackle some of the major challenges associated with self-assessed severity labels by designing and validating features extracted from big datasets in PD, which could help identify digital biomarkers capable of providing measures of disease severity outside of a clinical environment.

Milestones on the social accountability journey: Family medicine practice locations of Northern Ontario School of Medicine graduates.

PubMed

Hogenbirk, John C; Timony, Patrick E; French, Margaret G; Strasser, Roger; Pong, Raymond W; Cervin, Catherine; Graves, Lisa

2016-03-01

To assess the effect of different levels of exposure to the Northern Ontario School of Medicine's (NOSM's) distributed medical education programs in northern Ontario on FPs' practice locations. Cross-sectional design using longitudinal survey and administrative data. Canada. All 131 Canadian medical graduates who completed FP training in 2011 to 2013 and who completed their undergraduate (UG) medical degree or postgraduate (PG) residency training or both at NOSM. Exposure to NOSM's medical education program at the UG (n = 49) or PG (n = 31) level or both (n = 51). Primary practice location in September of 2014. Approximately 16% (21 of 129) of FPs were practising in rural northern Ontario, 45% (58 of 129) in urban northern Ontario, and 5% (7 of 129) in rural southern Ontario. Logistic regression found that more rural Canadian background years predicted rural practice in northern Ontario or Ontario, with odds ratios of 1.16 and 1.12, respectively. Northern Canadian background, sex, marital status, and having children did not predict practice location. Completing both UG and PG training at NOSM predicted practising in rural and northern Ontario locations with odds ratios of 4.06 to 48.62. Approximately 61% (79 of 129) of Canadian medical graduate FPs who complete at least some of their training at NOSM practise in northern Ontario. Slightly more than a quarter (21 of 79) of these FPs practise in rural northern Ontario. The FPs with more years of rural background or those with greater exposure to NOSM's medical education programs had higher odds of practising in rural northern Ontario. This study shows that NOSM is on the road to reaching one of its social accountability milestones.

Antimicrobial drug use and related management practices among Ontario swine producers.

PubMed

Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

1998-02-01

A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials were tylosin, carbadox, and furazolidone in weanling pigs, and tylosin, lincomycin, and tetracycline in finishers. Water medication of grower-finisher pigs was practised on 25% of farms; 80% of farms had injected at least some grower-finisher pigs with antimicrobials in the 12 mo preceding the survey. Approximately 20% of operations that added antimicrobials to finisher rations did so for growth promotion purposes only, while others used them for disease treatment, prevention, control, or a combination of reasons. Among those not using antimicrobials in finisher rations, 83% did not believe they were necessary and 37% were concerned about the potential for residues in marketed hogs.

Antimicrobial drug use and related management practices among Ontario swine producers.

PubMed Central

Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

1998-01-01

A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials were tylosin, carbadox, and furazolidone in weanling pigs, and tylosin, lincomycin, and tetracycline in finishers. Water medication of grower-finisher pigs was practised on 25% of farms; 80% of farms had injected at least some grower-finisher pigs with antimicrobials in the 12 mo preceding the survey. Approximately 20% of operations that added antimicrobials to finisher rations did so for growth promotion purposes only, while others used them for disease treatment, prevention, control, or a combination of reasons. Among those not using antimicrobials in finisher rations, 83% did not believe they were necessary and 37% were concerned about the potential for residues in marketed hogs. PMID:10051955

Equine metabolic syndrome

PubMed Central

Morgan, R.; Keen, J.; McGowan, C.

2015-01-01

Laminitis is one of the most common and frustrating clinical presentations in equine practice. While the principles of treatment for laminitis have not changed for several decades, there have been some important paradigm shifts in our understanding of laminitis. Most importantly, it is essential to consider laminitis as a clinical sign of disease and not as a disease in its own right. Once this shift in thinking has occurred, it is logical to then question what disease caused the laminitis. More than 90 per cent of horses presented with laminitis as their primary clinical sign will have developed it as a consequence of endocrine disease; most commonly equine metabolic syndrome (EMS). Given the fact that many horses will have painful protracted and/or chronic recurrent disease, a good understanding of the predisposing factors and how to diagnose and manage them is crucial. Current evidence suggests that early diagnosis and effective management of EMS should be a key aim for practising veterinary surgeons to prevent the devastating consequences of laminitis. This review will focus on EMS, its diagnosis and management. PMID:26273009

A look at the thoracic surgery workforce in Canada: how demographics and scope of practice may impact future workforce needs

PubMed Central

Grondin, Sean C.; Schieman, Colin; Kelly, Elizabeth; Darling, Gail; Maziak, Donna; Mackay, Moné Palacios; Gelfand, Gary

2013-01-01

Background The purpose of this study is to describe the demographics, training and practice characteristics of physicians performing thoracic surgery across Canada to better assess workforce needs. Methods We developed a questionnaire using a modified Delphi process to generate questionnaire items. The questionnaire was administered to all Canadian thoracic surgeons via email (n = 102) or mail (n = 35). Results In all, 97 surgeons completed the survey (71% response rate). The mean age of respondents was 47.7 (standard deviation 9.1) years; 10.3% were older than 60. Ninety respondents (88.7%) were men, 95 (81.1%) practised in English and 93 (76%) were born in Canada. Most (90.4%) had a medical school affiliation, with an equal proportion practising in community or university teaching hospitals. Only 18% of respondents reported working fewer than 60 hours per week, and 34% were on call more than 1 in 3. Three-quarters of work hours were devoted to clinical care, with the remaining time split among research, administration and teaching. Malignant lung disease accounted for 61.2% of practice time, with the remaining time equally split between benign and malignant thoracic diseases. Preoperative testing (49.4%) and insufficient operating time (49.5%) were the most common factors delaying delivery of care. More than 80% of respondents reported being satisfied with their careers, with 62.1% planning on retiring after age 60. Conclusion This survey characterizes Canadian thoracic surgeons by providing specific demographic, satisfaction and scope of practice information. Despite challenges in obtaining adequate resources for providing timely care, job satisfaction remains high, with a balanced workforce supply and demand anticipated for the foreseeable future. PMID:23883508

"Become a Reporter", the Four Skills News Project: Applying and Practising Language Skills Using Digital Tools for Level C1/C2 Students

ERIC Educational Resources Information Center

Magedera-Hofhansl, Hanna

2016-01-01

The Four Skills News Project is an example of communicative language learning, developed for final year German students at the University of Liverpool. It focuses on how students use and practise their reading, writing, listening and speaking skills via the creative use of news reports and digital technology. Each student creates an avatar using…

Clinical simulation practise framework.

PubMed

Khalili, Hossein

2015-02-01

Historically, simulation has mainly been used to teach students hands-on skills in a relatively safe environment. With changes in the patient population, professional regulations and clinical environments, clinical simulation practise (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking, clinical judgement, prioritisation, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patients. CSP holds great potential to derive a positive transformation in students' transition into the workplace, by associating and consolidating learning from classrooms to clinical settings, and creating bridges between theory and practice. For CSP to be successful in filling the gap, the design and management of the simulation is crucial. In this article a new framework called 'Clinical simulation practise framework: A knowledge to action strategy in health professional education' is being introduced that aims to assist educators and curriculum developers in designing and managing their simulations. This CSP framework theorises that simulation as an experiential educational tool could improve students' competence, confidence and collaboration in performing professional practice in real settings if the CSP provides the following three dimensions: (1) a safe, positive, reflective and fun simulated learning environment; (2) challenging, but realistic, and integrated simulated scenarios; and (3) interactive, inclusive, interprofessional patient-centred simulated practise. © 2015 John Wiley & Sons Ltd.

Brain lateralisation and motor learning: selective effects of dominant and non-dominant hand practice on the early acquisition of throwing skills.

PubMed

Stöckel, Tino; Weigelt, Matthias

2012-01-01

Findings from neurosciences indicate that the two brain hemispheres are specialised for the processing of distinct movement features. How this knowledge can be useful in motor learning remains unclear. Two experiments were conducted to investigate the influence of initial practice with the dominant vs non-dominant hand on the acquisition of novel throwing skills. Within a transfer design two groups practised a novel motor task with the same amount of practice on each hand, but in opposite hand-order. In Experiment 1, participants acquired the position throw in basketball, which places high demands on throwing accuracy. Participants practising this task with their non-dominant hand first, before changing to the dominant hand, showed better skill acquisition than participants practising in opposite order. In Experiment 2 participants learned the overarm throw in team handball, which requires great throwing strength. Participants initially practising with their dominant hand benefited more from practice than participants beginning with their non-dominant hand. These results indicate that spatial accuracy tasks are learned better after initial practice with the non-dominant hand, whereas initial practice with the dominant hand is more efficient for maximum force production tasks. The effects are discussed in terms of brain lateralisation and bilateral practice schedules.

Referral for secondary restorative dental care in rural and urban areas of Scotland: findings from the Highlands Et Islands Teledentistry Project.

PubMed

Nuttall, N M; Steed, M S; Donachie, M A

2002-02-23

To compare the reported level of use of secondary care services for restorative dental care in rural and urban areas of Scotland. Postal questionnaire survey Postal questionnaire sent to all dentists in the Highland region, the island regions in Scotland and Dumfries Et Galloway (n = 150) and an equal number were sampled from the remainder of Scotland stratified by health board area. Non-respondents were sent 2 reminders after which 62% of the sample had responded. Most dentists (85%) who practised in what they considered were urban areas of Scotland said they felt that they had good access to a secondary referral service. Whereas most of those who practised in what they considered were rural areas either said they had no access to such a service (26%) or that access was difficult (53%), only 3% of those in urban areas said they had no access to a secondary restorative consultative service compared with 14% of dentists practising in rural areas of mainland Scotland and 54% of those practising on Scottish islands. The survey suggests the people of the Scottish islands and some of the remoter parts of the Scottish mainland would be among those who might benefit from improvement in access to a restorative dentistry consultant service.

Exploring Native American Students' Perceptions of Scientists

NASA Astrophysics Data System (ADS)

Laubach, Timothy A.; Crofford, Geary Don; Marek, Edmund A.

2012-07-01

The purpose of this descriptive study was to explore Native American (NA) students' perceptions of scientists by using the Draw-A-Scientist Test and to determine if differences in these perceptions exist between grade level, gender, and level of cultural tradition. Data were collected for students in Grades 9-12 within a NA grant off-reservation boarding school. A total of 133 NA students were asked to draw a picture of a scientist at work and to provide a written explanation as to what the scientist was doing. A content analysis of the drawings indicated that the level of stereotype differed between all NA subgroups, but analysis of variance revealed that these differences were not significant between groups except for students who practised native cultural tradition at home compared to students who did not practise native cultural tradition at home (p < 0.05). The results suggest that NA students who practise cultural traditions at home are more able to function fluidly between indigenous knowledge and modern western science than their non-practising counterparts. Overall, these NA students do not see themselves as scientists, which may influence their educational and career science, technology, engineering, and mathematics paths in the future. The educational implication is that once initial perceptions are identified, researchers and teachers can provide meaningful experiences to combat the stereotypes.

Training propositional reasoning.

PubMed

Klauer, K C; Meiser, T; Naumer, B

2000-08-01

Two experiments compared the effects of four training conditions on propositional reasoning. A syntactic training demonstrated formal derivations, in an abstract semantic training the standard truth-table definitions of logical connectives were explained, and a domain-specific semantic training provided thematic contexts for the premises of the reasoning task. In a control training, an inductive reasoning task was practised. In line with the account by mental models, both kinds of semantic training were significantly more effective than the control and the syntactic training, whereas there were no significant differences between the control and the syntactic training, nor between the two kinds of semantic training. Experiment 2 replicated this pattern of effects using a different set of syntactic and domain-specific training conditions.

Effect of animal and vegetable protein intake on oxalate excretion in idiopathic calcium stone disease.

PubMed

Marangella, M; Bianco, O; Martini, C; Petrarulo, M; Vitale, C; Linari, F

1989-04-01

Oxalate excretion was measured in healthy subjects and idiopathic calcium stone-formers on dietary regimens which differed in the type and amount of protein allowed; 24-h urine collections were obtained from 41 practising vegetarians and 40 normal persons on a free, mixed, "mediterranean" diet. Twenty idiopathic calcium stone-formers were also studied while on two low calcium, low oxalate diets which differed in that animal protein was high in one and restricted in the other. Vegetarians had higher urinary oxalate levels than controls and although the calcium levels were markedly lower, urinary saturation with calcium/oxalate was significantly higher. This mild hypercalciuria was interpreted as being secondary to both a higher intake and increased fractional intestinal absorption of oxalate. Changing calcium stone-formers from a high to a low animal protein intake produced a significant decrease in calcium excretion but there was no variation in urinary oxalate. As a result, the decrease in calcium oxalate saturation was only marginal and not significant. It was concluded that dietary animal protein has a minimal effect on oxalate excretion. Mild hyperoxaluria of idiopathic calcium stone disease is likely to be intestinal in origin. Calcium stone-formers should be advised to avoid an excess of animal protein but the risks of a vegetable-rich diet should also be borne in mind.

Impact of short-term meditation and expectation on executive brain functions.

PubMed

Prätzlich, Martin; Kossowsky, Joe; Gaab, Jens; Krummenacher, Peter

2016-01-15

Meditation improves executive functions such as attention and working memory processes. However, it remains unclear to what extent contextual effects contribute to these improvements, since the role of meditation-associated expectations has not been investigated so far. In a randomized, single-blind, deceptive, between-subject design we compared the impact of short-term meditation (MG) on executive functioning with an expectation (ECG) and a passive control group (CG) as well as the effect of positive and negative outcome expectations. Fifty-nine healthy meditation-naïve volunteers participated on three consecutive days (20 min/session). Five groups were examined: 2 MGs, 2 ECGs and 1 CG. While one MG and one ECG were given positive suggestions concerning the effect of meditation on attention, the other two groups were given negative suggestions. MGs practised a focused attention meditation technique; ECGs were told that they were practising meditation but were given instructions for a sham meditation. CG participants sat in silence with their eyes closed. Interference control (Stroop task), selective sustained attention (d2 task), figural and verbal fluency measures of executive functions were assessed. Results indicate that suggestions have a substantial impact on interference control and verbal fluency, with positive suggestions leading to an increase in performance, whereas negative suggestions impeded improvement. This proof of concept study demonstrates the importance of the implementation of a credible ECG to elucidate context effects in meditation processes. It also indicates that suggestions can modulate the small effect of meditation on verbal fluency. Copyright © 2015 Elsevier B.V. All rights reserved.

Multiplicity of experimental approaches to therapy for genetic muscle diseases and necessity for population screening.

PubMed

Laing, Nigel G

2008-01-01

Currently a multiplicity of experimental approaches to therapy for genetic muscle diseases is being investigated. These include replacement of the missing gene, manipulation of the gene message, repair of the mutation, upregulation of an alternative gene and pharmacological interventions targeting a number of systems. A number of these approaches are in current clinical trials. There is considerable anticipation that perhaps more than one of the approaches will finally prove of clinical benefit, but there are many voices of caution. No matter which approaches might ultimately prove effective, there is a consensus that for most benefit to the patients it will be necessary to start treatment as early as possible. A consensus is also developing that the only way to do this is to implement population-based newborn screening to identify affected children shortly after birth. Population-based newborn screening is currently practised in very few places in the world and it brings with it implications for prevention rather than cure of genetic muscle diseases.

Volunteer involvement in the support of self-managed computerised aphasia treatment: The volunteer perspective.

PubMed

Palmer, Rebecca; Enderby, Pam

2016-10-01

The speech-language pathology profession has explored a number of approaches to support efficient delivery of interventions for people with stroke-induced aphasia. This study aimed to explore the role of volunteers in supporting self-managed practice of computerised language exercises. A qualitative interview study of the volunteer support role was carried out alongside a pilot randomised controlled trial of computer aphasia therapy. Patients with aphasia practised computer exercises tailored for them by a speech-language pathologist at home regularly for 5 months. Eight of the volunteers who supported the intervention took part in semi-structured interviews. Interviews were audio recorded, transcribed verbatim and analysed thematically. Emergent themes included: training and support requirements; perception of the volunteer role; challenges facing the volunteer, in general and specifically related to supporting computer therapy exercises. The authors concluded that volunteers helped to motivate patients to practise their computer therapy exercises and also provided support to the carers. Training and ongoing structured support of therapy activity and conduct is required from a trained speech-language pathologist to ensure the successful involvement of volunteers supporting impairment-based computer exercises in patients' own homes.

Development of a Tablet-based symbol digit modalities test for reliably assessing information processing speed in patients with stroke.

PubMed

Tung, Li-Chen; Yu, Wan-Hui; Lin, Gong-Hong; Yu, Tzu-Ying; Wu, Chien-Te; Tsai, Chia-Yin; Chou, Willy; Chen, Mei-Hsiang; Hsieh, Ching-Lin

2016-09-01

To develop a Tablet-based Symbol Digit Modalities Test (T-SDMT) and to examine the test-retest reliability and concurrent validity of the T-SDMT in patients with stroke. The study had two phases. In the first phase, six experts, nine college students and five outpatients participated in the development and testing of the T-SDMT. In the second phase, 52 outpatients were evaluated twice (2 weeks apart) with the T-SDMT and SDMT to examine the test-retest reliability and concurrent validity of the T-SDMT. The T-SDMT was developed via expert input and college student/patient feedback. Regarding test-retest reliability, the practise effects of the T-SDMT and SDMT were both trivial (d=0.12) but significant (p≦0.015). The improvement in the T-SDMT (4.7%) was smaller than that in the SDMT (5.6%). The minimal detectable changes (MDC%) of the T-SDMT and SDMT were 6.7 (22.8%) and 10.3 (32.8%), respectively. The T-SDMT and SDMT were highly correlated with each other at the two time points (Pearson's r=0.90-0.91). The T-SDMT demonstrated good concurrent validity with the SDMT. Because the T-SDMT had a smaller practise effect and less random measurement error (superior test-retest reliability), it is recommended over the SDMT for assessing information processing speed in patients with stroke. Implications for Rehabilitation The Symbol Digit Modalities Test (SDMT), a common measure of information processing speed, showed a substantial practise effect and considerable random measurement error in patients with stroke. The Tablet-based SDMT (T-SDMT) has been developed to reduce the practise effect and random measurement error of the SDMT in patients with stroke. The T-SDMT had smaller practise effect and random measurement error than the SDMT, which can provide more reliable assessments of information processing speed.

Problematising risk in stroke rehabilitation.

PubMed

Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

2016-11-01

Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or more severe stroke. Viewing individuals affected by stroke as possessing a range of independence and diverse personally valued activities that exist within a network of relations offers wider possibilities for action in rehabilitation.

Unsafe sexual behaviour in domestic and foreign migrant male workers in multinational workplaces in Jordan: occupational-based and behavioural assessment survey

PubMed Central

Al Rifai, Rami; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi; Morita, Ayako

2015-01-01

Objectives To examine the prevalence of unsafe sexual behaviour, sexually transmitted infection (STI)-related knowledge, health and work-related conditions, and correlates of practising unsafe sex among domestic and foreign male workers in multinational workplaces in Jordan. Design Cross-sectional behavioural assessment survey. Setting Multinational workplaces in Jordan. Participants 230 Jordanian and 480 foreign male workers aged ≥18 years who had worked in a Qualified Industrial Zone (QIZ) for 12 months or more. Outcomes The primary outcome was the prevalence of practising unsafe sex. ‘Unsafe sex’ was defined as sex with a non-regular sexual partner with inconsistent condom usage. Results Overall, 74.3% of workers reported lifetime sexual experience. The proportion of lifetime unsafe sex was similar among domestic (31.8%) and foreign (35.6%) workers. Of those, 59.2% of domestic and 68.1% of foreign workers started practising unsafe sex after joining the QIZ. Rates of lifetime unsafe sex were significantly higher among those who had their sexual debut after joining the QIZ in domestic (aOR, 2.2, 95% CI 1.1 to 4.4) and foreign workers (aOR, 2.4, 95% CI 1.4 to 4.1). Among the domestic workers, being 18–24 years old (aOR, 4.9), unmarried (aOR, 4.8), working in the QIZ for 5–8 years (aOR, 5.0), sometimes/frequently shopped with foreign workers (aOR, 2.1) or were current/ex-alcohol drinkers (aORs, 3.4) were independently significantly associated with higher odds of practising unsafe sex. Conclusions A significant proportion of domestic and foreign male workers had been practising unsafe sex. The findings indicated that not only foreigners but also domestic male workers associating with foreign workers are at high risk of unsafe sex. Tailored interventions to promote safer sex in multinational workplaces in Jordan are needed. PMID:26068511

Cost Structure and Life Cycle Costs for Military Systems

DTIC Science & Technology

2003-09-01

LCC 1-1 Chapter 2 – Scope of the Study 2-1 2.1 Contribution of other NATO Entities 2-1 2.2 Review of National Practises and CBS 2-1 2.3 Development...Office – NCO) gave a positive answer and designated a representative in the working group. 2.2 REVIEW OF NATIONAL PRACTISES AND CBS The two first...time preference when spending money obtained through taxation ) with the effectiveness of alternate ways of meeting an objective. By combining the

[Physiological characteristics and the level of risk factors for ischemic heart disease in marathon runners between 30 and 59 years of age].

PubMed

Kostka, T; Drygas, W; Mrozek, P

1989-02-06

The results of anthropometric, biochemical, cardiological and performance capacity studies in the 37 marathon runners, 113 men systematically practising recreational training programme with a domination of endurance exercises and 44 healthy men with little leisure time physical activity have been compared. In comparison with a group of physically non-active persons, the marathon runners are characterized by considerably higher physical working capacity, slimmer figure, lower resting heart rate, lower diastolic blood pressure, high concentration of HDL cholesterol and lower cholesterol: HDL cholesterol index. However, these differences are minimal in comparison with other systematically training persons, and with regard to the majority of factors statistically insignificant. It seems that for reaching the physiological effects desired from the point of view of ischemic heart disease prevention the endurance training of lower capacity and intensity would be sufficient.

Prostitution in Sheffield: differences between prostitutes.

PubMed

Woolley, P D; Bowman, C A; Kinghorn, G R

1988-12-01

This study to assess differences between street walking prostitutes and sauna girls who attended this clinic in 1986 and 1987 showed that fewer street walkers used barrier methods for disease prevention with clients or accepted tests for antibody to human immunodeficiency virus (HIV) when offered and more street walkers practised their profession in both Sheffield and London. They therefore represent a potential pathway for the heterosexual spread of HIV to the region. Trichomonas vaginalis was the only organism more commonly isolated from street walkers. Other sexually transmitted diseases diagnosed, and the sources of acquisition of gonococcal cervicitis, were similar in both groups of prostitutes. Prostitutes rarely used barrier methods with their regular consorts, who were found to be responsible for most cases of gonorrhoea in both groups. As 11 out of 58 prostitutes attending were found to have dysplasia on routine cervical cytological examination, we suggest that all prostitutes be advised to undergo cytology yearly.

Prostitution in Sheffield: differences between prostitutes.

PubMed Central

Woolley, P D; Bowman, C A; Kinghorn, G R

1988-01-01

This study to assess differences between street walking prostitutes and sauna girls who attended this clinic in 1986 and 1987 showed that fewer street walkers used barrier methods for disease prevention with clients or accepted tests for antibody to human immunodeficiency virus (HIV) when offered and more street walkers practised their profession in both Sheffield and London. They therefore represent a potential pathway for the heterosexual spread of HIV to the region. Trichomonas vaginalis was the only organism more commonly isolated from street walkers. Other sexually transmitted diseases diagnosed, and the sources of acquisition of gonococcal cervicitis, were similar in both groups of prostitutes. Prostitutes rarely used barrier methods with their regular consorts, who were found to be responsible for most cases of gonorrhoea in both groups. As 11 out of 58 prostitutes attending were found to have dysplasia on routine cervical cytological examination, we suggest that all prostitutes be advised to undergo cytology yearly. PMID:3224974

Detecting space-time disease clusters with arbitrary shapes and sizes using a co-clustering approach.

PubMed

Ullah, Sami; Daud, Hanita; Dass, Sarat C; Khan, Habib Nawaz; Khalil, Alamgir

2017-11-06

Ability to detect potential space-time clusters in spatio-temporal data on disease occurrences is necessary for conducting surveillance and implementing disease prevention policies. Most existing techniques use geometrically shaped (circular, elliptical or square) scanning windows to discover disease clusters. In certain situations, where the disease occurrences tend to cluster in very irregularly shaped areas, these algorithms are not feasible in practise for the detection of space-time clusters. To address this problem, a new algorithm is proposed, which uses a co-clustering strategy to detect prospective and retrospective space-time disease clusters with no restriction on shape and size. The proposed method detects space-time disease clusters by tracking the changes in space-time occurrence structure instead of an in-depth search over space. This method was utilised to detect potential clusters in the annual and monthly malaria data in Khyber Pakhtunkhwa Province, Pakistan from 2012 to 2016 visualising the results on a heat map. The results of the annual data analysis showed that the most likely hotspot emerged in three sub-regions in the years 2013-2014. The most likely hotspots in monthly data appeared in the month of July to October in each year and showed a strong periodic trend.

Tobacco-related medical education and physician interventions with parents who smoke: Survey of Canadian family physicians and pediatricians.

PubMed

Victor, J Charles; Brewster, Joan M; Ferrence, Roberta; Ashley, Mary Jane; Cohen, Joanna E; Selby, Peter

2010-02-01

To examine the relationship between physicians' tobacco-related medical training and physicians' confidence in their tobacco-related skills and smoking-related interventions with parents of child patients. Mailed survey. Canada. The survey was mailed to 800 family physicians and 800 pediatricians across Canada, with a corrected response rate of 65% (N = 900). Physicians' self-reported tobacco-related education, knowledge, and skills, as well as smoking-related interventions with parents of child patients. Cochran-Mantel-Haenszel chi(2) tests were used to examine relationships between variables, controlling for tobacco-control involvement and physician specialty. Data analysis was conducted in 2008. Physicians reporting tobacco-related medical education were more likely to report being "very confident" in advising parents about the effects of smoking and the use of a variety of cessation strategies (P < .05). Furthermore, physicians with tobacco-related training were more likely to help parents of child patients quit smoking whether or not the children had respiratory problems (P < .05). Physicians with continuing medical education in this area were more likely to report confidence in their tobacco-related skills and to practise more smoking-related interventions than physicians with other forms of training. There is a strong relationship between medical education and physicians' confidence and practices in protecting children from secondhand smoke. Physicians with continuing medical education training are more confident in their tobacco-related skills and are more likely to practise smoking-related interventions than physicians with other tobacco-related training.

May we practise endotracheal intubation on the newly dead?

PubMed Central

Ardagh, M

1997-01-01

Endotracheal intubation (ETI) is a valuable procedure which must be learnt and practised, and performing ETI on cadavers is probably the best way to do this, although lesser alternatives do exist. Performing ETI on a cadaver is viewed with a real and reasonable repugnance and if it is done without proper authorisation it might be illegal. Some form of consent is required. Presumed consent would preferably be governed by statute and should only occur if the community is well informed and therefore in a position of being able to decline. Currently neither statute nor adequate informing exists. Endotracheal intubation on the newly dead may be justifiable according to a Guttman scale if the patient has already consented to organ donation and if further research supports the relevance of the Guttman scale to this question. A "mandated choice" with prior individual consent as a matter of public policy is the best of these solutions, however until such a solution is in place we may not practise endotracheal intubation on the newly dead. PMID:9358348

Tai Chi and older people in the community: a preliminary study.

PubMed

Morris Docker, Sara

2006-05-01

This paper outlines a qualitative exploratory study of the individual experiences of older people who practise Tai Chi for health. The study aimed to identify factors that influence the attraction of Tai Chi for older people. Participants were recruited from a selection of Tai Chi clubs in the north of England. Participant and non-participant observation of a selection of Tai Chi practice sessions was undertaken along with interviews with 7 older people. Findings show that individuals who practice Tai Chi report a variety of immediate and lasting physical and mental benefits. Being part of a group that both learns and practises Tai Chi together appears to be important to the experience and awareness of the spiritual nature of Tai Chi was also reported. It is argued that older people who practise Tai Chi may have a particular view on ageing, health and well-being that the activity of Tai Chi allows them to express and future study intends to investigate this in more detail.

UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation

PubMed Central

Surman, Geraldine; Goldacre, Michael J

2017-01-01

Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates’ intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ‘Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would ‘definitely or probably’ practise medicine in the UK in the surveys of 1977–1986, 81% in 1996–2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977–1986, 8% in 1996–2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys. PMID:29116902

Psychosocial determinants of nurses' intention to practise euthanasia in palliative care.

PubMed

Lavoie, Mireille; Godin, Gaston; Vézina-Im, Lydi-Anne; Blondeau, Danielle; Martineau, Isabelle; Roy, Louis

2016-02-01

Most studies on euthanasia fail to explain the intentions of health professionals when faced with performing euthanasia and are atheoretical. The purpose of this study was to identify the psychosocial determinants of nurses' intention to practise euthanasia in palliative care if it were legalised. A cross-sectional study using a validated anonymous questionnaire based on an extended version of the Theory of Planned Behaviour. A random sample of 445 nurses from the province of Quebec, Canada, was selected for participation in the study. The study was reviewed and approved by the Ethics Committee of the Centre hospitalier universitaire de Québec. The response rate was 44.2% and the mean score for intention was 4.61 ± 1.90 (range: 1-7). The determinants of intention were the subjective (odds ratio = 3.08; 95% confidence interval: 1.50-6.35) and moral (odds ratio = 2.95; 95% confidence interval: 1.58-5.49) norms. Specific beliefs which could discriminate nurses according to their level of intention were identified. Overall, nurses have a slightly positive intention to practise euthanasia. Their family approval seems particularly important and also the approval of their medical colleagues. Nurses' moral norm was related to beneficence, an ethical principle. To our knowledge, this is the first study to identify nurses' motivations to practise euthanasia in palliative care using a validated psychosocial theory. It also has the distinction of identifying the ethical principles underlying nurses' moral norm and intention. © The Author(s) 2014.

Practice and payment preferences of newly practising family physicians in British Columbia

PubMed Central

Brcic, Vanessa; McGregor, Margaret J.; Kaczorowski, Janusz; Dharamsi, Shafik; Verma, Serena

2012-01-01

Abstract Objective To examine the remuneration model preferences of newly practising family physicians. Design Mixed-methods study comprising a cross-sectional, Web-based survey, as well as qualitative content analysis of answers to open-ended questions. Setting British Columbia. Participants University of British Columbia family practice residents who graduated between 2000 and 2009. Main outcome measures Preferred remuneration models of newly practising physicians. Results The survey response rate was 31% (133 of 430). Of respondents, 71% (93 of 132) preferred non–fee-for-service practice models and 86% (110 of 132) identified the payment model as very or somewhat important in their choice of future practice. Three principal themes were identified from content analysis of respondents’ open-ended comments: frustrations with fee-for-service billing, which encompassed issues related to aggravations with “the business side of things” and was seen as impeding “the freedom to focus on medicine”; quality of patient care, which embraced the importance of a payment model that supported “comprehensive patient care” and “quality rather than quantity”; and freedom to choose, which supported the plurality of practice preferences among providers who strived to provide quality care for patients, “whatever model you happen to be working in.” Conclusion Newly practising physicians in British Columbia preferred alternatives to fee-for-service payment models, which were perceived as contributing to fewer frustrations with billing systems, improved quality of work life, and better quality of patient care. PMID:22586205

Factors influencing palliative care. Qualitative study of family physicians' practices.

PubMed Central

Brown, J. B.; Sangster, M.; Swift, J.

1998-01-01

OBJECTIVE: To examine factors that influence family physicians' decisions to practise palliative care. DESIGN: Qualitative method of in-depth interviews. SETTING: Southwestern Ontario. PARTICIPANTS: Family physicians who practise palliative care on a full-time basis, who practise on a part-time basis, or who have retired from active involvement in palliative care. METHOD: Eleven in-depth interviews were conducted to explore factors that influence family physicians' decisions to practise palliative care and factors that sustain their interest in palliative care. All interviews were audiotaped and transcribed verbatim. The analysis strategy used a phenomenological approach and occurred concurrently rather than sequentially. All interview transcriptions were read independently by the researchers, who then compared and combined their analyses. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. MAIN OUTCOME FINDINGS: The overriding theme was a common philosophy of palliative care focusing on acceptance of death, whole person care, compassion, communication, and teamwork. Participants' philosophies were shaped by their education and by professional and personal experiences. In addition, participants articulated personal and systemic factors currently affecting their practice of palliative care. CONCLUSIONS: Participants observed that primary care physicians should be responsible for their patients' palliative care within the context of interdisciplinary teams. For medical students to be knowledgeable and sensitive to the needs of dying patients, palliative care should be given higher priority in the curriculum. Finally, participants argued compellingly for transferring the philosophy of palliative care to the overall practice of medicine. PMID:9612588

UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation.

PubMed

Surman, Geraldine; Goldacre, Michael J; Lambert, Trevor W

2017-12-01

Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates' intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ' Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would 'definitely or probably' practise medicine in the UK in the surveys of 1977-1986, 81% in 1996-2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977-1986, 8% in 1996-2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys.

Nursing work in NHS Direct: constructing a nursing identity in the call-centre environment.

PubMed

Snelgrove, Sherrill Ray

2009-12-01

The introduction of nurse-led telephone helplines for patients to have access to information and advice has led to the development of a new kind of practise for nurses. This study focuses on the ways NHS Direct (NHSD) nurses construct a nursing identity and shape their work in a call-centre environment. The empirical findings are drawn from a study investigating the impact of NHSD on professional nursing issues that was part of a wider evaluation of the service in South Wales, UK. Data were gathered from responses to free text questions included in a questionnaire sent to nurses in three NHSD sites. Further data were collected from focus groups held with NHSD nurses. The nurses defend their identity as nurses rather than call-centre workers. The discourses of the nurses show a strong alignment with the traditional values of nursing, encompassing holistic and empathetic practise that has moved with the nurses across locales. We argue that the nurses frame a nursing identity in NHSD around the importance of previous experience and claim to practise holistic nursing. However, the development of new skills and adaptation of old skills in response to the demand of NHSD work challenges normative notions of traditional 'hands-on' models of practise and indicates a possible movement towards a cognitive model of nursing based upon knowledge, analytical and communication skills that reflects the transformative and dynamic nature of professional identity and boundaries.

The history of syphilis in Uganda

PubMed Central

Davies, J. N. P.

1956-01-01

The circumstances of an alleged first outbreak of syphilis in Uganda in 1897 are examined and attention is drawn to certain features which render possible alternative explanations of the history of syphilis in that country. It is suggested that an endemic form of syphilis was an old disease of southern Uganda and that protective infantile inoculation was practised. The country came under the observation of European clinicians at a time when endemic syphilis was being replaced by true venereal syphilis. This process has now been completed, endemic syphilis has disappeared, and venereal syphilis is now widespread and a more serious problem than ever. This theory explains the observations of other writers and reconciles the apparent discrepancies between various reports. PMID:13404471

The prevention and eradication of smallpox: a commentary on Sloane (1755) ‘An account of inoculation’

PubMed Central

Weiss, Robin A.; Esparza, José

2015-01-01

Sir Hans Sloane's account of inoculation as a means to protect against smallpox followed several earlier articles published in Philosophical Transactions on this procedure. Inoculation (also called ‘variolation’) involved the introduction of small amounts of infectious material from smallpox vesicles into the skin of healthy subjects, with the goal of inducing mild symptoms that would result in protection against the more severe naturally acquired disease. It began to be practised in England in 1721 thanks to the efforts of Lady Mary Wortley Montagu who influenced Sloane to promote its use, including the inoculation of the royal family's children. When Edward Jenner's inoculation with the cow pox (‘vaccination’) followed 75 years later as a safer yet equally effective procedure, the scene was set for the eventual control of smallpox epidemics culminating in the worldwide eradication of smallpox in 1977, officially proclaimed by WHO in 1980. Here, we discuss the significance of variolation and vaccination with respect to scientific, public health and ethical controversies concerning these ‘weapons of mass protection’. This commentary was written to celebrate the 350th anniversary of the journal Philosophical Transactions of the Royal Society. PMID:25750241

Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings: a systematic review and meta-analysis.

PubMed

Prost, Audrey; Colbourn, Tim; Seward, Nadine; Azad, Kishwar; Coomarasamy, Arri; Copas, Andrew; Houweling, Tanja A J; Fottrell, Edward; Kuddus, Abdul; Lewycka, Sonia; MacArthur, Christine; Manandhar, Dharma; Morrison, Joanna; Mwansambo, Charles; Nair, Nirmala; Nambiar, Bejoy; Osrin, David; Pagel, Christina; Phiri, Tambosi; Pulkki-Brännström, Anni-Maria; Rosato, Mikey; Skordis-Worrall, Jolene; Saville, Naomi; More, Neena Shah; Shrestha, Bhim; Tripathy, Prasanta; Wilson, Amie; Costello, Anthony

2013-05-18

Maternal and neonatal mortality rates remain high in many low-income and middle-income countries. Different approaches for the improvement of birth outcomes have been used in community-based interventions, with heterogeneous effects on survival. We assessed the effects of women's groups practising participatory learning and action, compared with usual care, on birth outcomes in low-resource settings. We did a systematic review and meta-analysis of randomised controlled trials undertaken in Bangladesh, India, Malawi, and Nepal in which the effects of women's groups practising participatory learning and action were assessed to identify population-level predictors of effect on maternal mortality, neonatal mortality, and stillbirths. We also reviewed the cost-effectiveness of the women's group intervention and estimated its potential effect at scale in Countdown countries. Seven trials (119,428 births) met the inclusion criteria. Meta-analyses of all trials showed that exposure to women's groups was associated with a 37% reduction in maternal mortality (odds ratio 0.63, 95% CI 0.32-0.94), a 23% reduction in neonatal mortality (0.77, 0.65-0.90), and a 9% non-significant reduction in stillbirths (0.91, 0.79-1.03), with high heterogeneity for maternal (I(2)=58.8%, p=0.024) and neonatal results (I(2)=64.7%, p=0.009). In the meta-regression analyses, the proportion of pregnant women in groups was linearly associated with reduction in both maternal and neonatal mortality (p=0.026 and p=0.011, respectively). A subgroup analysis of the four studies in which at least 30% of pregnant women participated in groups showed a 55% reduction in maternal mortality (0.45, 0.17-0.73) and a 33% reduction in neonatal mortality (0.67, 0.59-0.74). The intervention was cost effective by WHO standards and could save an estimated 283,000 newborn infants and 41,100 mothers per year if implemented in rural areas of 74 Countdown countries. With the participation of at least a third of pregnant women and adequate population coverage, women's groups practising participatory learning and action are a cost-effective strategy to improve maternal and neonatal survival in low-resource settings. Wellcome Trust, Ammalife, and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Birmingham and the Black Country programme. Copyright © 2013 Elsevier Ltd. All rights reserved.

"A costly turn on": patterns of use and perceived consequences of mephedrone based head shop products amongst Irish injectors.

PubMed

Van Hout, Marie Claire; Bingham, Tim

2012-05-01

Mephedrone injecting has recently been reported in Romania, Slovenia, Guernsey and Ireland. The research reported here aimed to describe the experiences of a group of Irish injecting drug users, who were injecting mephedrone based headshop products prior to the introduction of legislative controls in Ireland, with particular focus on pre- and post-legislative use, effects of injecting mephedrone, settings and contexts for injecting, polydrug use and serial drug injecting, risk perceptions and harm reduction practises. Following a predevelopment phase with a Privileged Access Interviewer, in-depth interviews using a phenomenological approach were conducted with eleven attendees of a low threshold harm reduction service. The findings describe the abuse potential of these mephedrone based headshop products when used by intravenous injection. Although participants were aware of risks and safe injecting practises, compulsive re injecting with excessive binge use over long periods of time was common. Nasal to injection route transitions, intense paranoia, violent behaviour and aggression, emergence of Parkinson type symptomatologies (in the form of spasms and 'wobbling'), and permanent numbness in lower extremities were reported. Multi and serial drug injecting with heroin was used in efforts to manage the intense rush and avoid unpleasant comedown. Participants reported limb abscesses, vein clotting, damage and recession resulting from product toxicity, crystallisation of the products when diluted and flushing practises. Seven participants were homeless, with groin and street injecting common. Following legislative changes use of mephedrone products declined due to closure of headshops, increased street prices, concerns around contamination and the emergence of new street stimulant drugs. Continued monitoring of drug displacement patterns in post legislative time frames is advised, alongside longitudinal ethnographic research to track the diffusion of mephedrone and other cathinone derivatives within injecting networks. Further investigation of the adverse health consequences of these drugs on injection is warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

Rabies in Kazakhstan.

PubMed

Sultanov, Akmetzhan A; Abdrakhmanov, Sarsenbay K; Abdybekova, Aida M; Karatayev, Bolat S; Torgerson, Paul R

2016-08-01

Rabies is a neglected zoonotic disease. There is a sparsity of data on this disease with regard to the incidence of human and animal disease in many low and middle income countries. Furthermore, rabies results in a large economic impact and a high human burden of disease. Kazakhstan is a large landlocked middle income country that gained independence from the Soviet Union in 1991 and is endemic for rabies. We used detailed public health and veterinary surveillance data from 2003 to 2015 to map where livestock rabies is occurring. We also estimate the economic impact and human burden of rabies. Livestock and canine rabies occurred over most of Kazakhstan, but there were regional variations in disease distribution. There were a mean of 7.1 officially recorded human fatalities due to rabies per year resulting in approximately 457 Disability Adjusted Life Years (DALYs). A mean of 64,289 individuals per annum underwent post exposure prophylaxis (PEP) which may have resulted in an additional 1140 DALYs annually. PEP is preventing at least 118 cases of human rabies each year or possibly as many as 1184 at an estimated cost of $1193 or $119 per DALY averted respectively. The estimated economic impact of rabies in Kazakhstan is $20.9 million per annum, with nearly half of this cost being attributed to the cost of PEP and the loss of income whilst being treated. A further $5.4 million per annum was estimated to be the life time loss of income for fatal cases. Animal vaccination programmes and animal control programmes also contributed substantially to the economic losses. The direct costs due to rabies fatalities of agricultural animals was relatively low. This study demonstrates that in Kazakhstan there is a substantial economic cost and health impact of rabies. These costs could be reduced by modifying the vaccination programme that is now practised. The study also fills some data gaps on the epidemiology and economic effects of rabies in respect to Kazakhstan.

The perils of working abroad.

PubMed

Lockhart-Mirams, A R

1991-05-25

There may come a time in a dentist's life when thoughts turn to the possibility of working abroad. We have all heard of those who have successfully practised abroad, with large financial incomes and spectacular lifestyles. But are these stories accurate, and what is it really like to work and live abroad? This article will endeavour to reveal some of the realities, and to examine the position of a dentist who wants to practise abroad using Germany as a particular example, on the basis that Germany is the most common target country for emigration.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

PubMed

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Animal research ethics in Africa: is Tanzania making progress?

PubMed

Seth, Misago; Saguti, Fredy

2013-12-01

The significance of animals in research cannot be over-emphasized. The use of animals for research and training in research centres, hospitals and schools is progressively increasing. Advances in biotechnology to improve animal productivity require animal research. Drugs being developed and new interventions or therapies being invented for cure and palliation of all sorts of animal diseases and conditions need to be tested in animals for their safety and efficacy at some stages of their development. Drugs and interventions for human use pass through a similar development process and must be tested pre-clinically in laboratory animals before clinical trials in humans can be conducted. Therefore, animals are important players in research processes which directly and indirectly benefit animals and humans. However, questions remain as to whether these uses of animals consider the best interests of animals themselves. Various research and training institutions in Tanzania have established some guidelines on animal use, including establishing animal ethics committees. However, most institutions have not established oversight committees. In institutions where there may be guidelines and policies, there are no responsible committees or units to directly oversee if and how these guidelines and policies are enforced; thus, implementation becomes difficult or impossible. This paper endeavours to raise some issues associated with the responsible use of animals in research and training in Tanzania and highlights suggestions for improvement of deficiencies that exist in order to bridge the gap between what ought to be practised and what is practised. © 2012 John Wiley & Sons Ltd.

Unsafe sexual behaviour in domestic and foreign migrant male workers in multinational workplaces in Jordan: occupational-based and behavioural assessment survey.

PubMed

Al Rifai, Rami; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi; Morita, Ayako

2015-06-11

To examine the prevalence of unsafe sexual behaviour, sexually transmitted infection (STI)-related knowledge, health and work-related conditions, and correlates of practising unsafe sex among domestic and foreign male workers in multinational workplaces in Jordan. Cross-sectional behavioural assessment survey. Multinational workplaces in Jordan. 230 Jordanian and 480 foreign male workers aged ≥ 18 years who had worked in a Qualified Industrial Zone (QIZ) for 12 months or more. The primary outcome was the prevalence of practising unsafe sex. 'Unsafe sex' was defined as sex with a non-regular sexual partner with inconsistent condom usage. Overall, 74.3% of workers reported lifetime sexual experience. The proportion of lifetime unsafe sex was similar among domestic (31.8%) and foreign (35.6%) workers. Of those, 59.2% of domestic and 68.1% of foreign workers started practising unsafe sex after joining the QIZ. Rates of lifetime unsafe sex were significantly higher among those who had their sexual debut after joining the QIZ in domestic (aOR, 2.2, 95% CI 1.1 to 4.4) and foreign workers (aOR, 2.4, 95% CI 1.4 to 4.1). Among the domestic workers, being 18-24 years old (aOR, 4.9), unmarried (aOR, 4.8), working in the QIZ for 5-8 years (aOR, 5.0), sometimes/frequently shopped with foreign workers (aOR, 2.1) or were current/ex-alcohol drinkers (aORs, 3.4) were independently significantly associated with higher odds of practising unsafe sex. A significant proportion of domestic and foreign male workers had been practising unsafe sex. The findings indicated that not only foreigners but also domestic male workers associating with foreign workers are at high risk of unsafe sex. Tailored interventions to promote safer sex in multinational workplaces in Jordan are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Educational Intervention among Barbers to Improve Their Knowledge regarding HIV/AIDS: A Pilot Study from a South Asian Country.

PubMed

Kumar Krishanani, Mukesh; Ali, Faridah Amir; Khuwaja Late, Ali Khan; Qidwai, Waris; Ali, Badar Sabir

2014-09-01

One of the Millennium Development Goals is to combat HIV, the burden of which continues to increase in developing countries, like Pakistan. The prevalence is high among the high-risk population, and the use of unsterilized surgical instruments, traditional straight razors, and blades adds to the spread of this disease. This study assesses the effect of an educational intervention on the knowledge of 70 barbers practising in a suburban community in Pakistan regarding HIV and its symptoms and transmission. At baseline, only 10% of the barbers reported that they had ever heard about HIV compared to 49% after the intervention. Similarly, 4% and 6% of them had good knowledge at baseline about symptoms and transmission of the disease, increasing to 39% and 43% respectively, after the intervention (p<0.001). The results of this educational intervention warrant consideration of activation of mass campaigns to increase public awareness about bloodborne diseases and to educate personnel who might harm the persons in their communities by unsafe practices.

Aged over 50 years and practising: separation and changes in nursing practice among New Zealand's older Registered Nurses.

PubMed

North, Nicola; Leung, William; Lee, Rochelle

2014-12-01

To describe temporary and permanent separation patterns and changes in nursing practice over 5 years, for the 2006 cohort of nurses aged ≥50 years in New Zealand. As ageing populations increase demand on nursing services, workforce projections need better information on work and retirement decision-making of large 'baby-boomer' cohorts. Retrospective cohort analysis using the Nursing Council of New Zealand administrative dataset. A cohort of all nurses aged ≥50 years on the register and practising in 2006 (n = 12,606) was tracked until 2011. After 5 years, a quarter (n = 3161) of the cohort (equivalent to 8·4% of all 2006 practising nurses) was no longer practising. There were no significant differences in permanent separation rates between the ages of 50-58; between 18-54% of annual separations re-entered the workforce. On re-entry, 56% returned to the same clinical area. Annual separations from the workforce declined sharply during the global financial crisis and more of those leaving re-entered the workforce. In 2006, half the cohort worked in hospitals. After 5 years, the number of cohort nurses working in hospitals fell by 45%, while those in community settings increased by 12%. Over 5 years, weekly nursing practice hours declined significantly for every age-band. To retain the experience of older nurses for longer, workforce strategies need to take account of patterns of leaving and re-entering the workforce, preferences for work hours and the differences between the sub-groups across employment settings and practice areas. © 2014 John Wiley & Sons Ltd.

Current practice patterns and training status of selected graduates at the King Abdulaziz University College of Medicine, Saudi Arabia.

PubMed

Mira, S A; Fatani, H H; Abduljabbar, H S; Scott, C S; Strand, D A

1991-01-01

Graduate doctors are the primary output of medical education programmes. It is important for institutions to identify systematically the types of medical activities in which their former students are involved in order to determine the effectiveness of the curriculum, assessing academic standards and reviewing admissions policies. Information was obtained from a survey of men and women graduates from three of the early graduation classes of King Abdulaziz University College of Medicine in Saudi Arabia about postgraduate medical training, certification, practice patterns, and other curriculum issues. Information collected from 151 graduates (90%) indicated that 96% were practising medicine in a variety of medical specialties and subspecialties. Six were not practising at the time of the study. Significant differences were found in the specialties being practised when men and women were compared. Men tended to practise in medicine, surgery, dermatology, urology, ENT, ophthalmology and orthopaedics, while women concentrated in obstetrics and gynaecology and paediatrics. Certification beyond medical school was earned by 49% with no significant difference being found comparing men to women. Men earned the majority of their postgraduate certifications outside Saudi Arabia while most women earned theirs in Saudi Arabia. Graduates indicated that departments in the basic sciences were least helpful in preparing them as doctors, while selected clinical departments were most helpful. It was concluded from the study that the curriculum goals of the College of Medicine, namely a curriculum of international standards producing graduates to take leadership roles in both teaching and medical practice, were realized in part by the graduates surveyed.

Learning physical examination skills outside timetabled training sessions: what happens and why?

PubMed

Duvivier, Robbert J; van Geel, Koos; van Dalen, Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M

2012-08-01

Lack of published studies on students' practice behaviour of physical examination skills outside timetabled training sessions inspired this study into what activities medical students undertake to improve their skills and factors influencing this. Six focus groups of a total of 52 students from Years 1-3 using a pre-established interview guide. Interviews were recorded, transcribed and analyzed using qualitative methods. The interview guide was based on questionnaire results; overall response rate for Years 1-3 was 90% (n = 875). Students report a variety of activities to improve their physical examination skills. On average, students devote 20% of self-study time to skill training with Year 1 students practising significantly more than Year 3 students. Practice patterns shift from just-in-time learning to a longitudinal selfdirected approach. Factors influencing this change are assessment methods and simulated/real patients. Learning resources used include textbooks, examination guidelines, scientific articles, the Internet, videos/DVDs and scoring forms from previous OSCEs. Practising skills on fellow students happens at university rooms or at home. Also family and friends were mentioned to help. Simulated/real patients stimulated students to practise of physical examination skills, initially causing confusion and anxiety about skill performance but leading to increased feelings of competence. Difficult or enjoyable skills stimulate students to practise. The strategies students adopt to master physical examination skills outside timetabled training sessions are self-directed. OSCE assessment does have influence, but learning takes place also when there is no upcoming assessment. Simulated and real patients provide strong incentives to work on skills. Early patient contacts make students feel more prepared for clinical practice.

A multiple linear regression analysis of factors affecting the simulated Basic Life Support (BLS) performance with Automated External Defibrillator (AED) in Flemish lifeguards.

PubMed

Iserbyt, Peter; Schouppe, Gilles; Charlier, Nathalie

2015-04-01

Research investigating lifeguards' performance of Basic Life Support (BLS) with Automated External Defibrillator (AED) is limited. Assessing simulated BLS/AED performance in Flemish lifeguards and identifying factors affecting this performance. Six hundred and sixteen (217 female and 399 male) certified Flemish lifeguards (aged 16-71 years) performed BLS with an AED on a Laerdal ResusciAnne manikin simulating an adult victim of drowning. Stepwise multiple linear regression analysis was conducted with BLS/AED performance as outcome variable and demographic data as explanatory variables. Mean BLS/AED performance for all lifeguards was 66.5%. Compression rate and depth adhered closely to ERC 2010 guidelines. Ventilation volume and flow rate exceeded the guidelines. A significant regression model, F(6, 415)=25.61, p<.001, ES=.38, explained 27% of the variance in BLS performance (R2=.27). Significant predictors were age (beta=-.31, p<.001), years of certification (beta=-.41, p<.001), time on duty per year (beta=-.25, p<.001), practising BLS skills (beta=.11, p=.011), and being a professional lifeguard (beta=-.13, p=.029). 71% of lifeguards reported not practising BLS/AED. Being young, recently certified, few days of employment per year, practising BLS skills and not being a professional lifeguard are factors associated with higher BLS/AED performance. Measures should be taken to prevent BLS/AED performances from decaying with age and longer certification. Refresher courses could include a formal skills test and lifeguards should be encouraged to practise their BLS/AED skills. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Medical practice in rural Saskatchewan: factors in physician recruitment and retention.

PubMed

Wasko, Kevin; Jenkins, Jacqueline; Meili, Ryan

2014-01-01

The recruitment and retention of physicians in rural communities is a challenge throughout Canada and across the globe. In 1976, a group of medical students profiled rural communities with medical practices and produced a summary report entitled Medical Practice in Saskatchewan. Our objective was to repeat the 1976 study and to identify factors that motivate physicians to select rural locations for practice. Physicians practising in rural Saskatchewan were interviewed in 2011 and 2012. Through qualitative, inductive analysis, we identified themes that drove the recruitment and retention of physicians. Sixty-two physicians were interviewed and 105 communities profiled. Of the physicians interviewed, 21 noted that the ability to practise full-scope family medicine and having the freedom to practise as they desire was important for recruitment, and 43 reported that these factors influenced their decision to remain in a community. Attraction to a rural lifestyle (cited by 17 physicians), having a rural background (13) and having ties to a specific community (12) were important for recruitment. Feeling appreciated by patients (45), one's spouse and/or family enjoying the community (41), and integration into the community (38) were important factors for retention. The decision to practise in a rural location correlates with a desire for a broad and varied scope of practice, being attracted to a rural lifestyle and having rural roots. Once physicians establish a rural practice, they are more likely to stay if they can continue a broad scope of practice, if they feel appreciated by their patients, and if their spouses and family are happy in the community.

Job characteristics, well-being and risky behaviour amongst pharmacists.

PubMed

Phipps, Denham L; Walshe, Kieran; Parker, Dianne; Noyce, Peter R; Ashcroft, Darren M

2016-12-01

Healthcare practitioners' fitness to practise has often been linked to their personal and demographic characteristics. It is possible that situational factors, such as the work environment and physical or psychological well-being, also have an influence on an individual's fitness to practise. However, it is unclear how these factors might be linked to behaviours that risk compromising fitness to practise. The aim of this study was to examine the association between job characteristics, well-being and behaviour reflecting risky practice amongst a sample of registered pharmacists in a region of the United Kingdom. Data were obtained from a cross-sectional self-report survey of 517 pharmacists. These data were subjected to principal component analysis and path analysis, with job characteristics (demand, autonomy and feedback) and well-being (distress and perceived competence) as the predictors and behaviour as the outcome variable. Two aspects of behaviour were found: Overloading (taking on more work than one can comfortably manage) and risk taking (working at or beyond boundaries of safe practice). Separate path models including either job characteristics or well-being as independent variables provided a good fit to the data-set. Of the job characteristics, demand had the strongest association with behaviour, while the association between well-being and risky behaviour differed according to the aspect of behaviour being assessed. The findings suggest that, in general terms, situational factors should be considered alongside personal factors when assessing, judging or remediating fitness to practise. They also suggest the presence of different facets to the relationship between job characteristics, well-being and risky behaviour amongst pharmacists.

Pastoralists' knowledge and practices towards clinical bovine dermatophilosis in cattle herds of North-Central Nigeria: the associated factors, burden and economic impact.

PubMed

Alhaji, Nma Bida; Isola, Tajudeen Opeyemi

2018-02-01

Dermatophilosis is a contagious disease of high economic importance. The study assessed knowledge/awareness and clinical burden of and mitigation measures practised against clinical bovine dermatophilosis in pastoral herds of North-Central Nigeria and associated socio-cultural factors that predisposed to its occurrence in herds. A cross-sectional survey was conducted between October 2015 and September 2016. Questionnaires were administered on pastoralists and clinical assessment of cattle with gross pathological lesions indicative of dermatophilosis conducted. Associated economic impact was estimated. All 384 selected pastoralists participated in the survey. The majorities of nomadic (97.4%) and sedentary (68.2%) pastoralists significantly (p < 0.05) reported to have heard about dermatophilosis. Majorities of the sedentary (91.7%) and nomadic (97.4%) pastoralists mentioned the use antibiotics to manage the disease. Pastoralists in age group 70-79 years were more likely (OR 15.22; 95% CI 4.69, 49.34) to possess satisfactory knowledge about the disease. Culture of giving out cattle as gift or payment for dowry was more likely (OR 28.56; 95% CI 15.64, 52.12) to influence dermatophilosis occurrence in herds. Overall clinical dermatophilosis burden was 3.6% (95% CI 3.46, 3.80) and the annual economic impact was estimated at 908,463.9 USD. This study has given an idea to the status of pastoralists' levels of awareness about dermatophilosis in Nigeria, which can be harnessed by policy makers to develop its mitigation measures. Significant influence of pastoralists' socio-cultural activities on dermatophilosis occurrence in herds was identified. Surveillance and control programmes towards dermatophilosis that take these factors into consideration will be beneficial to the herders.

The genomic architecture of mastitis resistance in dairy sheep.

PubMed

Banos, G; Bramis, G; Bush, S J; Clark, E L; McCulloch, M E B; Smith, J; Schulze, G; Arsenos, G; Hume, D A; Psifidi, A

2017-08-16

Mastitis is the most prevalent disease in dairy sheep with major economic, hygienic and welfare implications. The disease persists in all dairy sheep production systems despite the implementation of improved management practises. Selective breeding for enhanced mastitis resistance may provide the means to further control the disease. In the present study, we investigated the genetic architecture of four mastitis traits in dairy sheep. Individual animal records for clinical mastitis occurrence and three mastitis indicator traits (milk somatic cell count, total viable bacterial count in milk and the California mastitis test) were collected monthly throughout lactation for 609 ewes of the Greek Chios breed. All animals were genotyped with a custom-made 960-single nucleotide polymorphism (SNP) DNA array based on markers located in quantitative trait loci (QTL) regions for mastitis resistance previously detected in three other distinct dairy sheep populations. Heritable variation and strong positive genetic correlations were estimated for clinical mastitis occurrence and the three mastitis indicator traits. SNP markers significantly associated with these mastitis traits were confirmed on chromosomes 2, 3, 5, 16 and 19. We identified pathways, molecular interaction networks and functional gene clusters for mastitis resistance. Candidate genes within the detected regions were identified based upon analysis of an ovine transcriptional atlas and transcriptome data derived from milk somatic cells. Relevant candidate genes implicated in innate immunity included SOCS2, CTLA4, C6, C7, C9, PTGER4, DAB2, CARD6, OSMR, PLXNC1, IDH1, ICOS, FYB, and LYFR. The results confirmed the presence of animal genetic variability in mastitis resistance and identified genomic regions associated with specific mastitis traits in the Chios sheep. The conserved genetic architecture of mastitis resistance between distinct dairy sheep breeds suggests that across-breed selection programmes would be feasible.

Is active participation in specific sport activities linked with back pain?

PubMed

Mogensen, A M; Gausel, A M; Wedderkopp, N; Kjaer, P; Leboeuf-Yde, C

2007-12-01

A cross-sectional survey of 439 children/adolescents aged 12-13, living in Odense, Denmark, in the year 2001. To investigate (1) if there is any difference in back pain reporting among those practising specific sports as compared with non-performers and (2) if there is an association between specific kinds of sports and self-reported back problems. Back pain is a common complaint in young people and physical inactivity is generally thought to contribute to this. However, some specific sport activities may be detrimental or beneficial to the spine. Information was collected through a semi-structured interview, a physical examination, and a questionnaire. Associations for back pain, low back pain, mid back pain and neck pain in the preceding month were investigated in relation to specific sports. Associations were controlled for body mass index, puberty stage and sex. There was no association between back problems and the practising of sports in general. However, some sports were either positively or negatively associated with back pain. Taking into account the relatively small subgroups and multiple testing, some sports seem to be potentially harmful or beneficial. These sports should be investigated in proper longitudinal study designs, in relation to their effects on back problems in the young.

Retrieval practice with short-answer, multiple-choice, and hybrid tests.

PubMed

Smith, Megan A; Karpicke, Jeffrey D

2014-01-01

Retrieval practice improves meaningful learning, and the most frequent way of implementing retrieval practice in classrooms is to have students answer questions. In four experiments (N=372) we investigated the effects of different question formats on learning. Students read educational texts and practised retrieval by answering short-answer, multiple-choice, or hybrid questions. In hybrid conditions students first attempted to recall answers in short-answer format, then identified answers in multiple-choice format. We measured learning 1 week later using a final assessment with two types of questions: those that could be answered by recalling information verbatim from the texts and those that required inferences. Practising retrieval in all format conditions enhanced retention, relative to a study-only control condition, on both verbatim and inference questions. However, there were little or no advantages of answering short-answer or hybrid format questions over multiple-choice questions in three experiments. In Experiment 4, when retrieval success was improved under initial short-answer conditions, there was an advantage of answering short-answer or hybrid questions over multiple-choice questions. The results challenge the simple conclusion that short-answer questions always produce the best learning, due to increased retrieval effort or difficulty, and demonstrate the importance of retrieval success for retrieval-based learning activities.

Exploring family physicians' reasons to continue or discontinue providing intrapartum care: Qualitative descriptive study.

PubMed

Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo

2017-08-01

To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.

Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial.

PubMed

Varekamp, Inge; de Vries, Gabe; Heutink, Annelies; van Dijk, Frank J H

2008-11-04

Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness. DEVELOPMENT AND DESCRIPTION OF INTERVENTION: A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1) Consequences of a chronic disease in the workplace, 2) Insight into feelings and thoughts about having a chronic disease, 3) Communication in daily work situations, 4) Facilities for disabled employees and work disability legislation, 5) How to stand up for oneself, 6) A plan to solve problems, 7) Follow-up. Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8, 12 and 24 months. Primary outcome measures are job retention, self efficacy, fatigue and work pleasure. Secondary outcome measures are work-related problems, sick leave, quality of life, acquired work accommodations, burnout, and several quality of work measures. A process evaluation will be conducted and satisfaction with the training, its components and the training methods will be assessed. Many employees with a chronic condition experience problems in performing tasks and in managing social relations at work. We developed an innovative intervention that addresses practical as well as psychosocial problems. The results of the study will be relevant for employees, employers, occupational health professionals and human resource professionals (HRM). ISRCTN77240155.

Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial

PubMed Central

Varekamp, Inge; de Vries, Gabe; Heutink, Annelies; van Dijk, Frank JH

2008-01-01

Background Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness. Development and description of intervention A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1) Consequences of a chronic disease in the workplace, 2) Insight into feelings and thoughts about having a chronic disease, 3) Communication in daily work situations, 4) Facilities for disabled employees and work disability legislation, 5) How to stand up for oneself, 6) A plan to solve problems, 7) Follow-up. Methods Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8, 12 and 24 months. Primary outcome measures are job retention, self efficacy, fatigue and work pleasure. Secondary outcome measures are work-related problems, sick leave, quality of life, acquired work accommodations, burnout, and several quality of work measures. A process evaluation will be conducted and satisfaction with the training, its components and the training methods will be assessed. Discussion Many employees with a chronic condition experience problems in performing tasks and in managing social relations at work. We developed an innovative intervention that addresses practical as well as psychosocial problems. The results of the study will be relevant for employees, employers, occupational health professionals and human resource professionals (HRM). Trial registration ISRCTN77240155 PMID:18983652

Educating about female genital mutilation.

PubMed

Holmes, Victoria; Farrington, Rebecca; Mulongo, Peggy

2017-01-01

Female genital mutilation (FGM) is illegal in the UK but nevertheless practised in some immigrant communities. Effective educational approaches are required to inform policy and to direct resources, often in the voluntary sector. The opinions in this article arise from discussions with professionals and members of FGM-practising communities. We highlight the importance of sharing experiences and expertise across health and social care professionals as well as working in partnership with culturally sensitive Non-Governmental Organisations. Enlisting the support of men and religious leaders is crucial to breaking down barriers in male-dominated communities and dispelling myths about FGM being a 'requirement' of faith.

Efficacy of a self-management education program for people with type 2 diabetes: results of a 12 month trial.

PubMed

Moriyama, Michiko; Nakano, Masumi; Kuroe, Yuriko; Nin, Kazuko; Niitani, Mayumi; Nakaya, Takashi

2009-06-01

Patient education that enhances one's self-management ability is of utmost importance for improving patient outcomes in chronic diseases. We developed a 12 month self-management education program for type 2 diabetes, based on a previous 6 month program, and examined its efficacy. A randomized controlled trial was carried out on outpatients with type 2 diabetes from two hospitals who met the criteria and gave consent to participate. They were randomly divided into an intervention group that followed the program and a control group that followed usual clinical practise. The intervention group received <30 min of monthly interviews based on the program's textbook and biweekly telephone calls from a nurse educator throughout the 12 months. Of the 50 participants in the intervention group and the 25 participants in the control group, 42 and 23, respectively, completed the program (a completion rate of 84.0%). The body weight, HbA1c, self-efficacy, dietary and exercise stages, quality of life, diastolic blood pressure, and total cholesterol level were significant by two-way repeated-measures anova. As for changes over time within the groups, only the intervention group showed significant differences by Friedman's test. The complication prevention behaviors showed a high implementation rate in the intervention group. The overall evaluation of this program by the participants was very high and, therefore, they highly recognized the need for this type of program. Self-management education works successfully in relation to patients' behavior modification skills, degree of goal attainment, and self-efficacy, consequently improving their health outcomes.

Critical incidents and mortality reporting in pediatric anesthesia: the Australian experience.

PubMed

Ragg, Philip

2011-07-01

Since 1960, the collection and analysis of mortality data for anesthesia in Australia has been of significant benefit to practising anesthetists. These figures include pediatric deaths which fortunately have been rare and often inevitable because of severe underlying disease and patient risk factors. The reporting of critical incidents and serious morbidity, on the other hand, has been far less impressive. Only one state in Australia, Victoria, currently has a committee that collects morbidity data and, as this reporting is voluntary, is likely to under-represent the true numbers of critical events. There is no specific pediatric morbidity database in Australia so much of this discussion will be regarding overall anesthesia critical event reporting which includes pediatrics as a subset. © 2011 Blackwell Publishing Ltd.

How can Doctors Improve their Communication Skills?

PubMed Central

Kumari, Archana; Chakrawarty, Avinash

2015-01-01

The process of curing a patient requires a holistic approach which involves considerations beyond treating a disease. It warrants several skills in a doctor along with technical expertise. Studies have shown that good communication skill in a doctor improve patient’s compliance and overall satisfaction. There are certain basic principles of practicing good communication. Patient listening, empathy, and paying attention to the paraverbal and non verbal components of the communication are the important ones that are frequently neglected. Proper information about the nature, course and prognosis of the disease is important. Besides, patients and attendants should always be explained about the necessity and yield of expensive investigations and risks/benefits involved in invasive procedures. One should be extremely cautious while managing difficult encounters and breaking bad news. Formal training of the doctors in improving communication skills is necessary and has proven to improve overall outcome. The authors recommend inclusion of formal training in communication skills in medical curriculum and training of practising doctors in the form of CMEs and CPEs. PMID:25954636

Dental treatment for people with cystic fibrosis.

PubMed

Harrington, N; Barry, P J; Barry, S M

2016-06-01

To describe the nature and consequences of the multi-system genetic condition cystic fibrosis with a view to ensuring optimal dental treatment planning for these patients. A literature search was conducted to identify the key medical and dental manifestations of cystic fibrosis. These findings are discussed and utilised to create recommendations for treatment planning in patients with cystic fibrosis for the practising dental practitioner. Cystic fibrosis is a complex, lethal, multisystem autosomal recessive disorder resulting from mutations on chromosome 7 which result in dysfunction of an ion channel that sits on epithelial surfaces. Respiratory disease remains the leading cause of mortality. Survival has greatly increased in recent decades secondary to improved treatment and specialist care. Specific dental manifestations of the disease may result from the condition itself or complications of treatment. Modification of patient management may be necessary to provide optimum patient care. The pathophysiology and clinical manifestations are relevant to practicing dental practitioners and inform recommendations to be utilised to ensure optimal treatment planning for these patients.

Mortality in Norwegian Seventh-Day Adventists 1962-1986.

PubMed

Fønnebø, V

1992-02-01

The standardized mortality ratio (SMR) was studied in Norwegian Seventh-Day Adventists, a religious group practising a life-style regarded as protective against cancer and cardiovascular disease. Persons converting before the age of 19 had a SMR of 69 (men) and 59 (women). This was both significantly lower than the general population and those converting at age 35 or above. The site mainly responsible for the low SMR in young converts was cardiovascular disease (men, 44; women, 52). Overall SMR in Seventh-Day Adventists compared to the general population was 82 (95% CI: 77-88, p less than 0.001) in men and 95 (95% CI: 91-100, NS) in women. SMR for cancer was significantly lower only in men before the age of 75 (SMR: 78, 95% CI: 61-99, p less than 0.05). Adopting a healthful lifestyle early in life seems to be of decisive importance with regard to mortality, later lifestyle changes have a smaller effect on death risk.

[Forced sterilisation based on the Law for the Prevention of Hereditarily Diseased Offspring. The role of the Heil- und Pflegeanstalt (State Hospital) Günzburg].

PubMed

Steger, F; Schmer, B; Strube, W; Becker, T

2012-03-01

From 1934 to 1945, 350,000-400,000 human beings were sterilised by force in the German Reich. Forced sterilisation was based on the Gesetz zur Verhütung erbkranken Nachwuchses (Law for the Prevention of Hereditarily Diseased Offspring). The Heil- und Pflegeanstalt (State Hospital) Günzburg was one of the institutions where compulsory sterilisation was practised. Data evaluation was based on patient documents and annual reports of the archives of today's district hospital at Günzburg. Patient records were analysed with respect to predefined criteria. The municipal archives of Günzburg provided further historical sources and data. Between 1934 and 1943, 366 patients were sterilised in the Heil- und Pflegeanstalt (State Hospital) Günzburg. Age, sex and diagnosis were found to be criteria relevant for selection of patients for sterilisation. The study was able to show the active involvement of the Heil- und Pflegeanstalt (State Hospital) Günzburg in the compulsory sterilisation programme.

Doctor performance assessment in daily practise: does it help doctors or not? A systematic review.

PubMed

Overeem, Karlijn; Faber, Marjan J; Arah, Onyebuchi A; Elwyn, Glyn; Lombarts, Kiki M J M H; Wollersheim, Hub C; Grol, Richard P T M

2007-11-01

Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy-makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the feasibility of methods, the psychometric properties of instruments that are especially important for summative assessments, and the effectiveness of methods serving formative assessments used in routine practise to assess the performance of individual doctors. We searched the MEDLINE (1966-January 2006), PsychINFO (1972-January 2006), CINAHL (1982-January 2006), EMBASE (1980-January 2006) and Cochrane (1966-2006) databases for English language articles, and supplemented this with a hand-search of reference lists of relevant studies and bibliographies of review articles. Studies that aimed to assess the performance of individual doctors in routine practise were included. Two reviewers independently abstracted data regarding study design, setting and findings related to reliability, validity, feasibility and effectiveness using a standard data abstraction form. A total of 64 articles met our inclusion criteria. We observed 6 different methods of evaluating performance: simulated patients; video observation; direct observation; peer assessment; audit of medical records, and portfolio or appraisal. Peer assessment is the most feasible method in terms of costs and time. Little psychometric assessment of the instruments has been undertaken so far. Effectiveness of formative assessments is poorly studied. All systems but 2 rely on a single method to assess performance. There is substantial potential to assess performance of doctors in routine practise. The longterm impact and effectiveness of formative performance assessments on education and quality of care remains hardly known. Future research designs need to pay special attention to unmasking effectiveness in terms of performance improvement.

Participants' sports characteristics related to heavy episodic drinking among French students.

PubMed

Martha, C; Grélot, L; Peretti-Watel, P

2009-03-01

The relationships between involvement in sports and alcohol consumption appear to be complex in the alcohol literature. In this study we aimed to examine this link among French students, taking into account their sports characteristics. We also examined variations in alcohol use among sport sciences students between 2002 and 2006, and the difference in alcohol use and heavy episodic drinking among sport sciences, law and pharmacy students. repeated survey; cross-sectional study; self-questionnaire survey; French (south-east France) sport sciences (n=693), law (n=325) and pharmacy (n=338) students (females=58%). In 2002, 38% of the male sport sciences students reported repeated heavy episodic drinking, and this proportion has risen to 48% in 2006 (p<0.05). When compared to law and pharmacy students, female and male sport sciences students were less likely to report repeated heavy episodic drinking (p<0.05). Engaging in physical activity (whether or not it takes place within an institution) and practising martial art were negatively related to heavy episodic drinking (p<0.05). Other factors related to heavy episodic drinking were gender-specific: among males, practising sport in a formal context, team sports, and competitive participation at a departmental or regional level represented risk factors (p<0.05), while practising an individual sport was a protective factor among females (p<0.05). This study corroborated the importance to take into account the context of practice and the type of sport practised to examine the link between sport participation and alcohol consumption. The normative context of peer socialization among competitive and team sports participants seemed to play a role in alcohol use. Further studies are needed to confirm the role of this putative factor.

Vaccination and blood sampling acceptability during Ramadan fasting month: A cross-sectional study in Conakry, Guinea.

PubMed

Peiffer-Smadja, Nathan; Ouedraogo, Ramatou; D'Ortenzio, Eric; Cissé, Papa Ndiaga; Zeggani, Zahra; Beavogui, Abdoul Habib; Faye, Sylvain Landry; Le Marcis, Frédéric; Yazdanpanah, Yazdan; Nguyen, Vinh-Kim

2017-05-02

There are few data on the acceptability of vaccination or blood sampling during Ramadan fasting month in Muslim countries. This could impact vaccination campaigns, clinical trials or healthcare during Ramadan. Using a semi-structured questionnaire, we conducted a cross-sectional study on 201 practising Muslims and 10 religious leaders in Conakry, Guinea in the wake of the recent epidemic Ebola epidemic. Acceptability of vaccination and blood sampling during Ramadan were investigated as well as reasons for refusal. Vaccination was judged acceptable during Ramadan by 46% (93/201, 95% CI 0.40-0.53) of practising Muslims versus 80% (8/10, 95% CI 0.49-0.94) of religious leaders (p=0.11). Blood sampling was judged acceptable during Ramadan by 54% (108/201, 95% CI 0.47-0.60) of practising Muslims versus 80% (8/10, 95% CI 0.49-0.94) of religious leaders (p=0.19). The percentage of participants that judged both blood sampling and vaccination acceptable during Ramadan was 40% (81/201, 95% CI 0.34-0.47) for practising Muslims versus 80% (8/10, 95% CI 0.49-0.94) for religious leaders (p=0.048). The most common reasons for refusal of vaccination or blood sampling were that nothing should enter or leave the body during Ramadan (43%), that adverse events could lead to breaking the fast (32%), that blood should not be seen during Ramadan (9%) and that the Quran explicitly forbids it (9%). Although most Muslims leaders and scientists consider that injections including immunization and blood sampling should be authorized during Ramadan, many Muslims in our study judged vaccination or blood sampling unacceptable when fasting. Widely available recommendations on healthcare during Ramadan would be useful to inform Muslims. Copyright © 2017. Published by Elsevier Ltd.

Dietary management of a patient with diabetes mellitus: a case report.

PubMed

Sidik, Sherina Mohd; Ahmad, Rozali

2003-09-01

The Ministry of Health has launched healthy lifestyle and diabetes campaigns. However, adopting healthy lifestyle practices is not easy as revealed in this case. Patients and their families need to be supervised personally and counseled regularly. Healthy lifestyle habits such as maintaining a balanced diet, ideal body weight and physical activities need to be cultivated and practised. Dietary counseling sessions need to be implemented, preferably by dietitians as this has been shown to be effective in motivating diabetic patients to achieve a better food choice, as well as better glycaemic, lipid and weight control, as shown in this case.

Oral health status and behaviours of children with Autism Spectrum Disorder: a case-control study.

PubMed

El Khatib, Amira A; El Tekeya, Magda M; El Tantawi, Maha A; Omar, Tarek

2014-07-01

Autism Spectrum Disorder (ASD) is a lifelong neuro-developmental disorder characterized by abnormalities in social interactions and communication and by stereotyped, repetitive activities. Assess the oral health status and behaviours of children with ASD. The study included 100 children with ASD and 100 healthy children from Alexandria, Egypt. Data were collected using a questionnaire and clinical examination. Questionnaire assessed socio-demographics, medical history, dental history, oral hygiene, dietary habits, and presence of self-injurious behaviours. Clinical examination assessed behaviour during examination, gingival condition, plaque accumulation, caries, and other oral conditions. Children with ASD had significantly poorer oral hygiene and gingival condition than healthy children (P < 0.001 for both). No significant differences were found in caries prevalence or experience in primary or permanent dentition. More children with ASD behaved 'negatively' or 'definitely negatively' (37% and 11%) than did healthy controls (11% and 2%) (P < 0.0001). Self-injurious behaviour and bruxism were more practised by children with ASD (32% of children with ASD and 2% of healthy children, P < 0.001). More children with ASD had difficulty in accessing dental care (P = 0.002). The oral condition of children with ASD might increase the risk of developing dental diseases. Their behaviour and life factors may complicate provision of services and limit access to dental care. Therefore, individualized oral health education programmes should be implemented for those children. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A randomized control trial of the effect of yoga on Gunas (personality) and Health in normal healthy volunteers.

PubMed

Deshpande, Sudheer; Nagendra, H R; Raghuram, Nagarathna

2008-01-01

To study the efficacy of yoga on Guna (yogic personality measure) and general health in normal adults. Of the 1228 persons who attended introductory lectures, 226 subjects aged 18-71 years, of both sexes, who satisfied the inclusion and exclusion criteria and who consented to participate in the study were randomly allocated into two groups. The Yoga(Y) group practised an integrated yoga module that included asanas, pranayama, meditation, notional correction and devotional sessions. The control group practised mild to moderate physical exercises (PE). Both groups had supervised practice sessions (by trained experts) for one hour daily, six days a week for eight weeks. Guna (yogic personality) was assessed before and after eight weeks using the self-administered Vedic Personality Inventory (VPI) which assesses Sattva (gentle and controlled), Rajas (violent and uncontrolled) and Tamas (dull and uncontrolled). The general health status (total health), which includes four domains namely somatic symptoms (SS), anxiety and insomnia (AI), social dysfunction (SF) and severe depression (SP), was assessed using a General Health Questionnaire (GHQ). Baseline scores for all the domains for both the groups did not differ significantly (P > 0.05, independent samples t test). Sattva showed a significant difference within the groups and the effect size was more in the Y than in the PE group. Rajas showed a significant decrease within and between the groups with a higher effect size in the PE group. Tamas showed significant reduction within the PE group only. The GHQ revealed that there was significant decrease in SS, AI, SF and SP in both Y and PE groups (Wilcoxcon Singed Rank t test). SS showed a significant difference between the groups (Mann Whitney U Test). There was an improvement in Sattva in both the Yoga and control groups with a trend of higher effect size in Yoga; Rajas reduced in both but significantly better in PE than in Yoga and Tamas reduced in PE. The general health status improved in both the Yoga and control groups.

Individualised patient care: a framework for guidelines.

PubMed

Redfern, S

It is assumed that individualised patient care (IPC) benefits both patients and nurses. This study set out to clarify what IPC means to nurses and how they practise it, as well as how it is experienced by patients. With some exceptions, IPC was not practised widely in the seven wards used as case studies. Even in the wards where it was more common, there were some examples of bad practice. Factors that facilitated IPC were: the personal qualities of the nurses; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; effective leadership and management of nursing work.

Changes in sexual behaviour and the fall in incidence of HIV infection among homosexual men.

PubMed Central

van Griensven, G. J.; de Vroome, E. M.; Goudsmit, J.; Coutinho, R. A.

1989-01-01

To investigate the epidemiology and normal course of infection with HIV the prevalence and incidence of the infection were studied among two cohorts of homosexual men in Amsterdam in 1980-7. The cumulative incidence of infection increased from a weighted 2.2% in 1980 to 39.0% in 1987. The estimated yearly incidence of HIV was 3.0% in 1981, rose to 8.8% in 1984, and fell gradually to 0% in 1987. During the study the sexual behaviour of the cohorts was examined. The number of men with whom anopenetrative intercourse was practised fell from a mean of 10.6 to 1.4 for those positive for HIV antibody, whereas the number with whom anoreceptive intercourse was practised fell from a mean of 3.7 to 0.5 for those negative for the antibody. In addition, there was a reduction in the number of cases of hepatitis B and syphilis among men in general. The decline in infection with HIV was assumed to be linked to changes in sexual behaviour. Such changes practised early in the course of the epidemic probably had a strong effect on the number of cases of AIDS among homosexual men in Amsterdam. PMID:2493866

The fitness to practise hearing. 1. Where's your evidence? Keeping good records.

PubMed

Solon, Mark

2011-04-01

To some midwives, record keeping may be a chore. However, getting your records right will provide you with the best possible defence if you have the misfortune to be called to a 'Fitness to Practise Hearing'. In this article I shall consider what makes good records and next month, examine the hearing itself. It is important to note that if called to a hearing, it may be several years after the event in question and you must be able to verify what actually happened and why. Considering that a midwife delivers hundreds of babies each year, it would be very difficult to prove your fitness to practise from memory alone; in cross-examination you will need some concrete evidence of what actually happened. You should keep your notes for at least six years as breach of contract cases can be brought for up to six years after the breach is discovered (whereas negligence cases need to be brought by three years after the negligent act). In the case of a minor, a case can be brought three years after a child reaches adulthood and may therefore be up to 21 years after the event.

Nurse turnover in New Zealand: costs and relationships with staffing practises and patient outcomes.

PubMed

North, Nicola; Leung, William; Ashton, Toni; Rasmussen, Erling; Hughes, Frances; Finlayson, Mary

2013-04-01

To determine the rates and costs of nurse turnover, the relationships with staffing practises, and the impacts on outcomes for nurses and patients. In the context of nursing shortages, information on the rates and costs of nursing turnover can improve nursing staff management and quality of care. Quantitative and qualitative data were collected prospectively for 12 months. A re-analysis of these data used descriptive statistics and correlational analysis techniques. The cost per registered nurse turnover represents half an average salary. The highest costs were related to temporary cover, followed by productivity loss. Both are associated with adverse patient events. Flexible management of nursing resources (staffing below budgeted levels and reliance on temporary cover), and a reliance on new graduates and international recruitment to replace nurses who left, contributed to turnover and costs. Nurse turnover is embedded in staffing levels and practises, with costs attributable to both. A culture of turnover was found that is inconsistent with nursing as a knowledge workforce. Nurse managers did not challenge flexible staffing practices and high turnover rates. Information on turnover and costs is needed to develop strategies that retain nurses as knowledge-based workers. © 2012 Blackwell Publishing Ltd.

[Claude Perrault, famous architect, unknown physician, untiring researcher].

PubMed

Hazard, Jean

2007-01-01

As a famous architect Charles Perrault persuaded Colbert to appoint a committee of the "Bâtiments du Roi" made up of three persons: Le Vau, Le Brun and one of his brothers Claude whose Louis XIV chose the plan. While Le Vau was busy in Versailles Perrault's influence became dominating. Although he was an unknown medical practitioner he managed to be allowed to practise and to teach medicine and to be a member of theses' jury for twenty five years. He was highly regarded by his colleagues who did not hesitate to hold a consultation. His trip in Bordeaux was consecrated to look after his brother but because of his numerous occupations he gave up practising medicine and he only treated the members of his family, his friends and some poor. He was a tireless researcher and at the "Académie des Sciences" he looked after the "Histoire naturelle des animaux" (Natural History of the Animals). In "Les Essais de Physique" he tackled numerous problems of physiology such as elasticity and contractility of arteries, studied the sense organs and did some experiments about blood transfusion. As an exceptional man he could practise the three of the occupations.

The GP tests of competence assessment: which part best predicts fitness to practise decisions?

PubMed

Jayaweera, Hirosha Keshani; Potts, Henry W W; Keshwani, Karim; Valerio, Chris; Baker, Magdalen; Mehdizadeh, Leila; Sturrock, Alison

2018-01-02

The General Medical Council (GMC) conducts Tests of Competence (ToC) for doctors referred for Fitness to Practise (FtP) issues. GPs take a single best answer knowledge test, an Objective Structured Clinical Examination (OSCE), and a Simulated Surgery (SimSurg) assessment which is a simulated GP consultation. The aim of this study was to examine the similarities between OSCEs and SimSurg to determine whether each assessment contributed something unique to GP ToCs. A mixed methods approach was used. Data were collated on 153 GPs who were required to undertake a ToC as a part of being investigated for FtP issues between February 2010 and October 2016. Using correlation analysis, we examined to what degree performance on the knowledge test, OSCE, and SimSurg related to case examiner recommendations and FtP outcomes, including the unique predictive power of these three assessments. The outcome measures were case examiner recommendations (i) not fit to practise; ii) fit to practise on a limited basis; or iii) fit to practise) as well as FtP outcomes (i) erased/removed from the register; ii) having restrictions/conditions; or iii) be in good standing). For the qualitative component, 45 GP assessors were asked to rate whether they assess the same competencies and which assessment provides better feedback about candidates. There was significant overlap between OSCEs and SimSurg, p < 0.001. SimSurg had additional predictive power in the presence of OSCEs and the knowledge test (p = 0.030) in distinguishing doctors from different FtP categories, while OSCEs did not (p = 0.080). Both the OSCEs (p = 0.004) and SimSurg (p < 0.001) had significant negative correlations with case examiner recommendations when accounting for the effects of the other two assessments. Inductive thematic analysis of the responses to the questionnaire showed that assessors perceived OSCEs to be better suited to target specific knowledge and skills. SimSurg was thought to produce a more global picture as the scenarios more accurately portray a patient consultation. While all three assessments are strong predictors of both case examiner recommendations and FtP outcomes, our findings suggest that the efficiency of GP ToCs can be improved by removing some of this overlapping content.

The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey

PubMed Central

Bourne, Tom; Wynants, Laure; Peters, Mike; Van Audenhove, Chantal; Timmerman, Dirk; Van Calster, Ben; Jalmbrant, Maria

2015-01-01

Objectives The primary aim was to investigate the impact of complaints on doctors’ psychological welfare and health. The secondary aim was to assess whether doctors report exposure to a complaints process is associated with defensive medical practise. Design This was a cross-sectional anonymous survey study. Participants were stratified into recent/current, past, no complaints. Each group completed tailored versions of the survey. Participants 95 636 doctors were invited to participate. A total of 10 930(11.4%) responded, 7926 (8.3%) completed the full survey and were included in the complete analysis. Main outcome measures Anxiety and depression were assessed using the standardised Generalised Anxiety Disorder scale and Physical Health Questionnaire. Defensive practise was evaluated using a new measure. Single-item questions measured stress-related illnesses, complaints-related experience, attitudes towards complaints and views on improving complaints processes. Results 16.9% of doctors with current/recent complaints reported moderate/severe depression (relative risk (RR) 1.77 (95% CI 1.48 to 2.13) compared to doctors with no complaints (9.5%)). Fifteen per cent reported moderate/severe anxiety (RR=2.08 (95% CI 1.61 to 2.68) compared to doctors with no complaints (7.3%)). Distress increased with complaint severity, with highest levels after General Medical Council (GMC) referral (26.3% depression, 22.3% anxiety). Doctors with current/recent complaints were 2.08 (95% CI 1.61 to 2.68) times more likely to report thoughts of self-harm or suicidal ideation. Most doctors reported defensive practise: 82–89% hedging and 46–50% avoidance. Twenty per cent felt victimised after whistleblowing, 38% felt bullied, 27% spent over 1 month off work. Over 80% felt processes would improve with transparency, managerial competence, capacity to claim lost earnings and action against vexatious complainants. Conclusions Doctors with recent/current complaints have significant risks of moderate/severe depression, anxiety and suicidal ideation. Morbidity was greatest in cases involving the GMC. Most doctors reported practising defensively, including avoidance of procedures and high-risk patients. Many felt victimised as whistleblowers or reported bullying. Suggestions to improve complaints processes included transparency and managerial competence. PMID:25592686

Raccoon roundworm (Baylisascaris procyonis) as an occupational hazard: 2. Use of personal protective equipment and infection control practices among raccoon rehabilitators.

PubMed

Sapp, S G H; Murray, B; Hoover, E R; Green, G T; Yabsley, M J

2018-03-30

Baylisascaris procyonis, the raccoon roundworm, is a zoonotic ascarid of importance to human and animal health. Wildlife rehabilitators who care for raccoons may be at an increased risk for exposure to the parasite, especially if proper precautions are not taken. In a wider effort to evaluate awareness regarding B. procyonis in the wildlife rehabilitation community, an online survey (38-39 questions) including questions about B. procyonis knowledge and attitudes was developed and administered to wildlife rehabilitators. To assess precautions taken among raccoon rehabilitators, participants who rehabilitated raccoons (n = 447) answered additional questions about use of personal protective equipment (PPE) and infection control practices (ICPs). Reported use of gloves was variable, but hand hygiene was generally consistent. Masks and gowns were seldom used. Part-time or infrequent volunteers and rehabilitators located in the Central, Midwest and Southeast were significantly less likely to report consistent use of PPE. A total knowledge score from the survey was used to predict the likelihood of reporting the use of particular ICPs/PPE. Knowledge score had a highly significant but small effect on the likelihood of prophylactic use of anthelmintics, anthelmintics use for B. procyonis specifically, cleaning appropriately, and using species-dedicated housing. Risk factor analysis was performed on data from a prior serologic survey to evaluate factors associated with exposure to B. procyonis and inconsistent handwashing after contact with live raccoons and their faeces; practising rehabilitation in B. procyonis hyperendemic regions and practising rehabilitation in the western region were significant risk factors for being seropositive. These data further demonstrate that correct PPE/ICPs are critical in mitigating the risk of B. procyonis exposure among raccoon rehabilitators and among other captive species. © 2018 Blackwell Verlag GmbH.

A randomized control trial of the effect of yoga on Gunas (personality) and Self esteem in normal healthy volunteers

PubMed Central

Deshpande, Sudheer; Nagendra, H R; Nagarathna, Raghuram

2009-01-01

Background/Aims: To study the efficacy of yoga on Gunas (personality) and self esteem in normal adults through a randomized comparative study. Materials and Methods: Of the 1228 persons who attended motivational lectures, 226 subjects aged 18–71 years, of both sexes, who satisfied the inclusion and exclusion criteria, and who consented to participate in the study were randomly allocated into two groups. The Yoga (Y) group practised an integrated yoga module that included asanas, pranayama, meditation, notional correction, and devotional sessions. The comparison group practised mild to moderate physical exercises (PE). Both groups had supervised practices for one hour daily, six days a week, for eight weeks. Guna (personality) was assessed before and after eight weeks using the self-administered “The ’Gita” Inventory of Personality” (GIN) to assess Sattva, Rajas, and Tamas. Self esteem in terms of competency (COM), global self esteem (GSE), moral and self esteem (MSE), social esteem (SET), family self esteem (FSE), body and physical appearance (BPA), and the lie scale (LIS) were assessed using the self esteem questionnaire (SEQ). Results: The baseline scores for all domains for both the groups did not differ significantly (P > 0.05 independent samples t-test). There were significant pre-post improvements in all domains in both groups (P < 0.001 paired t-test). The number of persons who showed improvement in Sattva and decrease in Tamas was significant in the Y but not in the PE group (McNemar test). The effect size for self esteem in the Y group is greater than for the PE group in three out of seven domains. Conclusions: This randomized controlled study has shown the influence of Yoga on Gunas and self esteem in comparison to physical exercise. PMID:21234210

Multiple Oral Re-reading treatment for alexia: The parts may be greater than the whole.

PubMed

Lacey, Elizabeth H; Lott, S N; Snider, S F; Sperling, A; Friedman, R B

2010-08-01

This study examines the reasons for the success of Multiple Oral Re-reading (MOR; Moyer, 1979), a non-invasive, easily administered alexia treatment that has been reported in the literature and is currently in clinical use. The treatment consists of reading text passages aloud multiple times a day. Findings that MOR improves reading speed on practised as well as novel text have been inconsistent, making MOR's role in the rehabilitation of alexia unclear. We hypothesised that MOR's treatment mechanism works through repetition of high frequency words (i.e., bottom-up processing). We designed and controlled our text passages to test the hypothesis that participants would not improve on all novel text but would improve on text that includes a critical mass of the words contained in the passages they were re-reading. We further hypothesised that the improvement would be at the level of their specific alexic deficit. We tested four participants with phonological alexia and two with pure alexia during 8 weeks of MOR treatment. Contrary to the conclusions of previous studies, our results indicate that improvements in top-down processing cannot explain generalisation in MOR and that much of the improvement in reading is through repetition of the practised words. However, most patients also showed improvement when specific phrases were re-used in novel passages, indicating that practice of difficult words in context may be crucial to reading improvement.

Validity and everyday clinical applicability of lumbar muscle fatigue assessment methods in patients with chronic non-specific low back pain: a systematic review.

PubMed

Villafañe, Jorge H; Gobbo, Massimiliano; Peranzoni, Matteo; Naik, Ganesh; Imperio, Grace; Cleland, Joshua A; Negrini, Stefano

2016-09-01

This systematic literature review aimed at examining the validity and applicability in everyday clinical rehabilitation practise of methods for the assessment of back muscle fatiguability in patients with chronic non-specific low back pain (CNSLBP). Extensive research was performed in MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Physiotherapy Evidence Database (PEDro) and Cochrane Central Register of Controlled Trials (CENTRAL) databases from their inception to September 2014. Potentially relevant articles were also manually looked for in the reference lists of the identified publications. Studies examining lumbar muscle fatigue in people with CNSLBP were selected. Two reviewers independently selected the articles, carried out the study quality assessment and extracted the results. A modified Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) scale was used to evaluate the scientific rigour of the selected works. Twenty-four studies fulfilled the selection criteria and were included in the systematic review. We found conflicting data regarding the validity of methods used to examine back muscle fatigue. The Biering-Sorensen test, performed in conjunction with surface electromyography spectral analysis, turned out to be the most widely used and comparatively, the most optimal modality currently available to assess objective back muscle fatigue in daily clinical practise, even though critical limitations are discussed. Future research should address the identification of an advanced method for lower back fatigue assessment in patients with CNSLBP which, eventually, might provide physical therapists with an objective and reliable test usable in everyday clinical practise. Implications for Rehabilitation Despite its limitations, the Biering-Sorensen test is currently the most used, convenient and easily available fatiguing test for lumbar muscles. To increase validity and reliability of the Biering-Sorensen test, concomitant activation of synergistic muscles should be taken into account. Pooled mean frequency and half-width of the spectrum are currently the most valid electromyographic parameters to assess fatigue in chronic non-specific low back pain. Body mass index, grading of pain and level of disability of the study population should be reported to enhance research quality.

What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

PubMed

Guinness, Lorna

2011-06-01

This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X's contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these contracting programmes. Copyright © 2011 Elsevier Ltd. All rights reserved.

What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

PubMed Central

Guinness, Lorna

2011-01-01

This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X’s contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these contracting programmes. PMID:21349622

Temperament as a modulating factor of pain sensitivity in combat sport athletes.

PubMed

Leźnicka, Katarzyna; Starkowska, Anna; Tomczak, Maciej; Cięszczyk, Paweł; Białecka, Monika; Ligocka, Maria; Żmijewski, Piotr; Pawlak, Maciej

2017-10-15

The aim of this study was to characterise the temperament of combat athletes in comparison to that of individuals who do not practise any sports with regard to pain sensitivity measured with the cold pressor test (CPT) and pressure pain threshold (PPT). The study involved 284 healthy men, aged 18 to 43years. The first group consisted of 198 combat athletes, including boxing (n=19), mixed martial arts (MMA) (n=97) and karate (n=82), aged from 18 to 43years. The control group consisted of 86 subjects between the ages of 18 and 26years, academic students not practising any sport professionally. Pain threshold and pain tolerance were evaluated using the CPT and a pressure algometer. Temperament was measured with the Formal Characteristics of Behaviour - Temperament Inventory (FCB-TI). The contact athletes showed much higher tolerance to pain than the control group using both tools: CPT (p=0.007) and PPT (p<0.001). In athletes, but not in controls, relationships were noted between BMI and endurance (r=0.20; p=0.004), BMI and activity (r=-0.283; p<0.001), BMI and pain threshold (r=0.15; p<0.05), and BMI and pain tolerance (r=0.30; p<0.001), when measured by the algometer - this necessitating adjustment for further analysis. The athletes and students in the study groups differed significantly with regard to intensity of four temperamental traits, but after BMI adjustments only group differences in Preservation, Sensory sensitivity and Emotional reactivity remained significant'. These differences indicate individual differences in perception and reaction to external stimuli. Significantly higher pain tolerance (CPT and PPT) in the athletes studied was related to specific psychological features. The obtained results of temperamental characteristics may indicate higher resilience of the nervous system in combat athletes in comparison to non-athletes. Copyright © 2017 Elsevier Inc. All rights reserved.

The impact of adjusted work conditions and disease-modifying drugs on work ability in multiple sclerosis.

PubMed

Wickström, Anne; Fagerström, Maria; Wickström, Lucas; Granåsen, Gabriel; Dahle, Charlotte; Vrethem, Magnus; Sundström, Peter

2017-07-01

Multiple sclerosis (MS) is a neurological disorder that causes significantly reduced ability to work, and the Expanded Disability Status Scale (EDSS) is one of the main predictors for reduced work ability. To investigate how work requirements, flexible work conditions and disease-modifying drugs (DMDs) influence the work ability in relation to different EDSS grades in two MS populations. Work ability was studied in two MS populations: one in the southern and one in the northern part of Sweden, both demographically similar. In the latter population, more active work-promoting interventions have been practised and second-generation DMDs have been widely used from the onset of disease for several years. The proportion of MS patients who participated in the workforce or studied was significantly higher in the northern compared with the southern population ( p < 0.001). The employees in the northern population had significantly lower requirements, greater adapted work conditions and were able to work more hours per week. Higher EDSS was associated with lower reduction in number of worked hours per week in the northern population ( p = 0.042). Our data indicated that treatment strategy and adjusted work conditions have impact on work ability in MS.

PubMed Central

Baillargeon, L.

1997-01-01

OBJECTIVE: To familiarize family physicians with cognitive and behavioural treatments for insomnia. DATA SOURCES: MEDLINE was searched from 1983 to 1995 and Psychlit from 1974 to 1995 using the key words "behaviour therapy," "cognitive therapy," "phototherapy," and "insomnia." STUDY SELECTION: We chose randomized trials and meta-analyses on the treatment of insomnia. Information was extracted on time-lag before sleep, frequency and duration of wakeful periods during the night, consumption of hynotics, and subjects' own assessment of their sleep before and after treatment. SYNTHESIS: The most effective interventions were relaxation training, sleep restriction, and stimulus control. Practising good sleeping habits was only somewhat effective and should always be used in conjunction with other interventions. CONCLUSION: Stimulus control for insomnia has been demonstrated to be effective when used by primary care physicians. Other nonpharmacologic treatments should be evaluated in a similar manner. PMID:9063996

What is it to do good medical ethics? From the perspective of a practising doctor who is in Parliament.

PubMed

Finlay, Ilora G

2015-01-01

This article is a personal reflection on work as a physician with work as a member of the UK Parliament's House of Lords. Ethical thinking should underpin everything we do; the 'four principles' of medical ethics provide an applicable and relevant ethical framework. This article explores its application in both domains of work-as a clinician and as a legislator-with some examples of its use 'to do good medical ethics' in both roles. Debates around tobacco and drug control, pandemic control, abortion and assisted suicide are explored. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Physical activity of elderly patients after total hip arthroplasty.

PubMed

Cukras, Zbigniew; Praczko, Katarzyna; Kostka, Tomasz; Jegier, Anna

2007-01-01

Total hip arthroplasty (THA) is the most common method of treatment of severe hip osteoarthritis. There is little data concerning the physical activity of total hip arthroplasty patients in Poland and investigations to explore this area are useful. The aim of the study was to describe the post-operative physical activity of total hip arthroplasty patients. A total of 146 adult people were examined, among which 28 men and 41 women had undergone total hip arthroplasty due to primary osteoarthritis of the hip, while another 32 men and 41 women matched for age who had not undergone hip surgery for osteoarthritis served as controls. The physical activity of study participants was assessed with the 7-Day Physical Activity Recall Questionnaire. All participants were also asked about the type and amount of physical activity they engaged in to maintain good health. Physical activity measured as the total amount of calories expended through physical activity per week was similar in the post-THA patients compared to the controls. The only differences were a smaller amount of calories expended during low-intensity physical activity by men after total hip arthroplasty compared to men who had not undergone surgery for osteoarthritis and a smaller amount of calories expended through high-intensity physical activity by women after total hip arthroplasty compared to female controls. The kinds of recreational physical activity most commonly practised by patients a mean of two years after total hip arthroplasty were marching, bicycling and general body conditioning exercises (usually the continuation of exercises recommended during post-operative rehabilitation). The percentage of post-THA patients undertaking physical activity for the prevention of non-communicable diseases was low. Physical activity should be more effectively encouraged in patients after total hip arthroplasty.

The use of virtual reality tools in surgical education.

PubMed

Smith, Andrew

2010-03-01

Advances in computing, specifically those used for simulation and games technology has allowed for exciting developments in dental and surgical education. At the same time concerns are being raised that students with relatively little training, practise to improve their skill on patients with all of the inherent risks that may occur. Simulation in dentistry has been practised for many years and so the concept is not new to the profession. New tools have been developed that both enhance teaching and learning and are also useful for assessment of students and trainees. The challenge of virtual and simulated reality tools is to have the required fidelity to improve teaching and learning outcomes over the currently utilized methodology.

Topics of internal medicine for undergraduate dental education: a qualitative study.

PubMed

Kunde, A; Harendza, S

2015-08-01

Due to the ageing population, internal medicine has become increasingly important for dental education. Although several studies have reported dentists' dissatisfaction with their internal medicine training, no guidelines exist for internal medicine learning objectives in dental education. The aim of this study was to identify topics of internal medicine considered to be relevant for dental education by dentists and internists. Eight dentists from private dental practices in Hamburg and eight experienced internal medicine consultants from Hamburg University Hospital were recruited for semi-structured interviews about internal medicine topics relevant for dentists. Internal diseases were clustered into representative subspecialties. Dentists and internists were also asked to rate medical diseases or emergencies compiled from the literature by their relevance to dental education. Coagulopathy and endocarditis were rated highest by dentists, whilst anaphylaxis was rated highest by internists. Dentists rated hepatitis, HIV, organ transplantation and head/neck neoplasm significantly higher than internists. The largest number of different internal diseases mentioned by dentists or internists could be clustered under cardiovascular diseases. The number of specific diseases dentists considered to be relevant for dental education was higher in the subspecialties cardiovascular diseases, haematology/oncology and infectiology. We identified the internal medicine topics most relevant for dental education by surveying practising dentists and internists. The relevance of these topics should be confirmed by larger quantitative studies to develop guidelines how to design specific learning objectives for internal medicine in the dental curriculum. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Medical student career intentions at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part II.

PubMed

Gill, D; Palmer, C; Mulder, R; Wilkinson, T

2001-10-26

To record career preferences for medical students at the Christchurch School of Medicine and Health Sciences and investigate factors, including student debt, that might influence career decisions. A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. The survey included questions relating to preferred career intentions and factors influencing career decisions, including the decision to leave New Zealand to practise medicine. The response rate was 88%. 80% intend to practise medicine in New Zealand immediately after graduation, however 82% indicated that they would leave within two years of graduation. Financial opportunities overseas and level of debt were the strongest motivating factors to leave. Repayments towards student loans and increased salaries were factors that might retain people in New Zealand. Medical and surgical specialities were the most popular career choices. Personal interest was the strongest motivator for career choice. Practising in a rural community was not popular. Debt is one of a number of important factors influencing medical student career decisions including the decision to leave New Zealand. Initiatives addressing debt may be useful in retaining medical graduates in this country.

The effects of individual differences, prior experience and cognitive load on the transfer of dynamic decision-making performance.

PubMed

Nicholson, Brad; O'Hare, David

2014-01-01

Situational awareness is recognised as an important factor in the performance of individuals and teams in dynamic decision-making (DDM) environments (Salmon et al. 2014 ). The present study was designed to investigate whether the scores on the WOMBAT™ Situational Awareness and Stress Tolerance Test (Roscoe and North 1980 ) would predict the transfer of DDM performance from training under different levels of cognitive load to a novel situation. Participants practised a simulated firefighting task under either low or high conditions of cognitive load and then performed a (transfer) test in an alternative firefighting environment under an intermediate level of cognitive load. WOMBAT™ test scores were a better predictor of DDM performance than scores on the Raven Matrices. Participants with high WOMBAT™ scores performed better regardless of their training condition. Participants with recent gaming experience who practised under low cognitive load showed better practice phase performance but worse transfer performance than those who practised under high cognitive load. The relationship between task experience, situational awareness ability, cognitive load and the transfer of dynamic decision-making (DDM) performance was investigated. Results showed that the WOMBAT™ test predicted transfer of DDM performance regardless of task cognitive load. The effects of cognitive load on performance varied according to previous task-relevant experience.

Leading the rebirth of the rural obstetrician.

PubMed

Campbell, Alison M; Brown, James; Simon, David R; Young, Sari; Kinsman, Leigh

2014-12-11

To understand the factors influencing the decisions of rural general practitioners and GP registrars to practise obstetrics, and to understand the impact on these decisions of an innovative obstetric training and support program in the Gippsland region of Victoria. Qualitative approach using semistructured interviews conducted in July and August 2013 and inductive content analysis. Participants were identified from training records over the previous 5 years for the Gippsland GP obstetric training and support program. Two questions were posed during interviews: What challenges face rural GPs in practising obstetrics? What impact has the Gippsland GP obstetric program had on GP obstetric career decisions? Of 60 people invited to participate, 22 agreed. Interviews ranged in duration from 40 to 90 minutes. The major themes that emerged on the challenges facing rural GPs in practising obstetrics were isolation, work-life balance and safety. The major themes that emerged on the impact of the Gippsland GP obstetric program were professional support, structured training and effective leadership. Rural GP obstetricians are challenged by isolation, the impact of their job on work-life balance, and safety. The support, training and leadership offered by the Gippsland expanded obstetric training program helped doctors to deal with these challenges. The Gippsland model of training offers a template for GP obstetric procedural training programs for other rural settings.

A continuing education programme for general practitioners. Status report after 5 years of function.

PubMed

Wiskott, H W; Borgis, S; Simoness, M

2000-05-01

In 1992, following newly issued university regulations, the board of the School of Dental Medicine of the University of Geneva decided to establish a structured continuing education course programme for practising dentists in an effort to better meet the school's continuing education mandate. The programme started in January 1994 and was structured so that regular courses would be offered in each discipline of dentistry. The course contents were aimed at satisfying the demands of practising dentists, but it was also established that basic science issues and theoretical concepts should be included. Possible course formats were "conference", "hands-on", "clinical" and "seminar". The courses were meant as a form of knowledge transfer from the school to the practising community, but also as a means to generate revenue for research and teaching programmes. Operative aspects were supervised by a small staff which was assisted by computer software designed to handle all procedural steps of course administration, participant registration, accounting, communication. The dentists' responses were rewarding in that attendance was very satisfactory. Closer scrutiny of our data, however, indicates that our impact is still low since at best only 20% of the course-hours required by the Swiss dental association are actually taken. Both course and programme evaluations were satisfactory and are discussed using the Harden and Laidlaw CRISIS criteria.

Development of functional requirements for electronic health communication: preliminary results from the ELIN project.

PubMed

Christensen, Tom; Grimsmo, Anders

2005-01-01

User participation is important for developing a functional requirements specification for electronic communication. General practitioners and practising specialists, however, often work in small practices without the resources to develop and present their requirements. It was necessary to find a method that could engage practising doctors in order to promote their needs related to electronic communication. Qualitative research methods were used, starting a process to develop and study documents and collect data from meetings in project groups. Triangulation was used, in that the participants were organised into a panel of experts, a user group, a supplier group and an editorial committee. The panel of experts created a list of functional requirements for electronic communication in health care, consisting of 197 requirements, in addition to 67 requirements selected from an existing Norwegian standard for electronic patient records (EPRs). Elimination of paper copies sent in parallel with electronic messages, optimal workflow, a common electronic 'envelope' with directory services for units and end-users, and defined requirements for content with the possibility of decision support were the most important requirements. The results indicate that we have found a method of developing functional requirements which provides valid results both for practising doctors and for suppliers of EPR systems.

Cases relating to anaesthetists handled by the UK General Medical Council in 2009: methodological approach and patterns of referral.

PubMed

Campbell, G; Rollin, A M; Smith, A F

2013-05-01

The General Medical Council is the regulatory body charged with maintaining standards in the medical profession in the UK. We analysed cases relating to anaesthetists handled in 2009 using fitness-to-practise data, comparing them with the profession as a whole and examining patterns of referral. Complaints were made about 105 doctors practising in anaesthesia. The 81 anaesthetists who were investigated further were subject to a total of 225 separate allegations, median (IQR [range]) of 2 (1-3 ) allegations per anaesthetist. Anaesthetists had a lower rate of referral compared with doctors in general (0.095% vs 0.20%, respectively, p = 0.0001). They were less likely than doctors in general to be referred by an individual member of the public (27% vs 64%, respectively, p = 0.0001). As with other specialties, allegations were most commonly made about clinical care, probity and relationships with patients. On the basis of 2009 data, we calculated that a mean (95% CI) of 1 in 120 (1 in 100-145) doctors practising in anaesthesia in the UK will be referred to the General Medical Council every year. We have provided examples of allegations and made recommendations for maintaining good practice in anaesthesia. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

'Practising under your own Pin'- a description of the transition experiences of newly qualified midwives.

PubMed

Avis, Mark; Mallik, Maggie; Fraser, Diane M

2013-11-01

Transition experiences of newly qualified midwives were examined in depth during the third phase of a UK evaluation study of midwifery education. The fitness to practise and the retention of newly qualified nursing and midwifery graduates are pressing concerns for health care managers. The advantages of preceptorship are reported in the literature but the content and timing of schemes remain unclear. A semi-structured diary was kept for up to 6 months by 35 newly qualified midwives in 18 work sites covering all countries in the UK. The preceptor and supervisor of midwives for each newly qualified midwife completed short questionnaires about their preceptee's performance, and a further sub-sample of newly qualified midwives and preceptors participated in a semi-structured interview. Data were analysed to elicit aspects of newly qualified midwives transition experiences. Findings confirm that structured preceptorship schemes are not widely available. Newly qualified midwives primarily obtained transition support from members of the midwifery team. Although perceived as competent, there is no demarcation point in becoming confident to practise as a registered practitioner. Implications for managers include the importance of a supportive culture within clinical teams for successful transition and the introduction of structured preceptorship schemes facilitated by appropriate rotation patterns. © 2012 John Wiley & Sons Ltd.

Why women go to medical college but fail to practise medicine: perspectives from the Islamic Republic of Pakistan.

PubMed

Moazam, Farhat; Shekhani, Sualeha

2018-07-01

Female medical students outnumber men in countries such as Saudi Arabia, India and Pakistan, yet many fail to practise medicine following graduation. In Pakistan, 70% of medical students are women, yet it is estimated that half of them will not pursue medicine following graduation. This is considered a major reason for physician shortages in the country. We conducted a qualitative study drawing upon the 'role strain' theory to explore the views of final-year medical students from four medical colleges in Karachi, Pakistan, on female graduates not entering the medical field. Data were obtained through 20 individual in-depth interviews and two focus group discussions. Themes were developed inductively from the data using the constant comparison method. Pakistani parents actively channel daughters into medical education, considering medicine to be the most 'respectable' field. However, in a patrilocal society with norms of early, arranged marriages for daughters, there is a significant influence of in-laws and a husband on a woman's professional future. Parents perceive the medical degree as a 'safety net' should something go wrong with the marriage, rather than a step toward a medical career. Female respondents experience significant role conflict between their socially rooted gender roles as homemakers and mothers and their careers in medicine. Postgraduate training systems that are unfriendly to women provide further deterrents for women wishing to work. Contrary to popular belief, women not practising medicine is not the sole contributor to physician shortages. A significant factor appears to be male graduates migrating abroad for better training and financial prospects. Acceptance of traditional cultural values, including entrenched gender roles in society, deters women from practising medicine. To enable greater participation of women in the medical field, steps are required that will allow women to better manage family and work conflicts. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

"Working towards being ready": A grounded theory study of how practising midwives maintain their ongoing competence to practise their profession.

PubMed

Calvert, Susan; Smythe, Elizabeth; McKenzie-Green, Barbara

2017-07-01

to present a grounded theory research study explaining how New Zealand midwives maintain their ongoing competence to practise their profession. grounded theory, an interpretive emergent research methodology was used to examine the process of maintaining competence in midwifery practice. New Zealand urban and rural practice settings. twenty-six midwives from across New Zealand were interviewed and asked about maintaining their competence to practise. Five midwives were interviewed twice, to explore the emerging findings and as one method of member checking. the grounded theory of 'working towards being ready' describes a continuous process in which midwives engage as they work to maintain practice competence. The component parts comprise professional positioning, identifying needs, strategizing solutions and reflecting on practice. The process is contextual, diverse and is influenced by the practice setting where the salient conditions of resourcing, availability and opportunity for engagement in activities are significant. across the midwifery profession, midwives in New Zealand are currently working under the generic umbrella of midwifery practice. Midwives work across a range of practice arenas in diverse ways focussed on providing safe care and require a range of professional development activities germane to their area of practice. When the midwife has access to professional development pertinent to their practice, women and the profession benefit. As there is diversity of practice, then mandated processes for ongoing competence need to have flexibility to reflect that diversity. midwives engage in development that allows them to remain current in practice and that enables them to provide appropriate care to women and their babies. As a consequence they can develop expertise in certain aspects of midwifery. Mandated processes that require engagement in activities aimed at demonstration of competence should be evaluated and tailored to ensure they meet the needs of the developing profession. Copyright © 2017 Elsevier Ltd. All rights reserved.

Young Athletes’ Motivational Profiles

PubMed Central

Murcia, Juan Antonio Moreno; Gimeno, Eduardo Cervelló; Coll, David González-Cutre

2007-01-01

The aim of this study was to examine the relationship between motivational characteristics and dispositional flow. In order to accomplish this goal, motivational profiles emerging from key constructs within Achievement Goal Theory and Self-Determination Theory were related to the dispositional flow measures. A sample of 413 young athletes (Age range 12 to 16 years) completed the PMCSQ-2, POSQ, SMS and DFS measures. Cluster analysis results revealed three profiles: a “self-determined profile ”characterised by higher scores on the task-involving climate perception and on the task orientation; a “non-self-determined profile”, characterised by higher scores on ego-involving climate perception and ego orientation; and a “low self-determined and low non-self-determined profile ”which had the lowest dispositional flow. No meaningful differences were found between the “self-determined profile ”and the “non-self-determined profile ”in dispositional flow. The “self-determined profile ”was more commonly associated with females, athletes practising individual sports and those training more than three days a week. The “non-self-determined profile ”was more customary of males and athletes practising team sports as well as those training just two or three days a week. Key pointsThe “self-determined profile ”was characterized by high task orientation, high task-involving climate perception and was more commonly associated with females, athletes practising individual sports and those training more than three days a week.The “non-self-determined profile ”was characterized by high ego orientation, high ego-involving climate perception and was more customary of males and athletes practising team sports as well as those training two or three days a week.Both profiles revealed a moderate tendency toward dispositional flow, with no significant differences between the two profiles.The “low self-determined and low non-self-determined profile ”had low scores on all of the variables in the study. PMID:24149326

Combining principles of Cognitive Load Theory and diagnostic error analysis for designing job aids: Effects on motivation and diagnostic performance in a process control task.

PubMed

Kluge, Annette; Grauel, Britta; Burkolter, Dina

2013-03-01

Two studies are presented in which the design of a procedural aid and the impact of an additional decision aid for process control were assessed. In Study 1, a procedural aid was developed that avoids imposing unnecessary extraneous cognitive load on novices when controlling a complex technical system. This newly designed procedural aid positively affected germane load, attention, satisfaction, motivation, knowledge acquisition and diagnostic speed for novel faults. In Study 2, the effect of a decision aid for use before the procedural aid was investigated, which was developed based on an analysis of diagnostic errors committed in Study 1. Results showed that novices were able to diagnose both novel faults and practised faults, and were even faster at diagnosing novel faults. This research contributes to the question of how to optimally support novices in dealing with technical faults in process control. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

'It's showed me the skills that he has': pharmacists' and mentors' views on pharmacist supplementary prescribing.

PubMed

Lloyd, Fran; Parsons, Carole; Hughes, Carmel M

2010-02-01

Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary prescribers. The setting was primary and secondary healthcare sectors in Northern Ireland. Pharmacists and mentors who had participated in a pre-training study were invited to take part. All pharmacists (n = 47) were invited to participate in focus groups, while mentors (n = 35) were asked to participate in face-to-face semi-structured interviews. The research took place between May 2005 and September 2007. All discussions and interviews were audiotaped, transcribed and analysed using constant comparison. Nine pharmacist focus groups were convened (number per group ranging from three to six; total n = 40) and 31 semi-structured interviews with mentors were conducted. The six main themes that emerged were optimal practice setting, professional progression for prescribing pharmacists, outcomes for prescribing pharmacists, mentors and patients, relationships, barriers to implementation and the future of pharmacist prescribing. Where practised, pharmacist prescribing had been accepted, worked best for chronic disease management, was perceived to have reduced doctors' workload and improved continuity of care for patients. However, three-quarters of pharmacists qualified to practise as supplementary prescribers were not actively prescribing, largely due to logistical and organisational barriers rather than inter-professional tensions. Independent prescribing was seen as contentious by mentors, particularly because of the diagnostic element. Supplementary prescribing has been successful where it has been implemented but a number of barriers remain which are preventing the wider acceptance of this practice innovation.

SARS related preventive and risk behaviours practised by Hong Kong-mainland China cross border travellers during the outbreak of the SARS epidemic in Hong Kong

PubMed Central

Lau, J.; Yang, X.; Tsui, H; Pang, E.

2004-01-01

Objectives: To investigate patterns of behaviours and attitudes related to SARS prevention in the Hong Kong cross border traveller population. Settings: A survey was carried out at the Hong Kong-China cross border checkpoint in the middle of the epidemic. Participants: A total of 839 Hong Kong adult residents returning to Hong Kong from mainland China were surveyed. Main outcome measures: Practice of preventive measures and relevant behaviours and attitudes. Results: Around 40% of the respondents were using masks all or most of the time in public places or washing their hands frequently (>10 times per day) and about one third avoided visiting crowded places in mainland China. Such figures were however lower than those practised by the general public in Hong Kong. SARS related perceptions, such as perceived risk of transmission and efficacy, etc, were associated with mask use and not visiting crowded places, but not with hand washing, which was associated with duration of stay. Gender differences were also observed. Around 70% of the travellers would have delayed medical consultation for influenza-like illness in China; 12.7% would not wear masks during such episodes of illness. Furthermore, about 30% of the respondents used to wear masks in Hong Kong but not in mainland China. Conclusions: The findings have implications on cross border prevention of SARS. It seems that those travelling during the SARS epidemic were a "self selected" group, and they were using less preventive measures. Special attention and intervention need to be provided to travellers to prevent a second wave cross border transmission of the disease. PMID:15547057

[Euthanasia: the law, a few notions and the question of assisted suicide].

PubMed

Herremans, J

2008-09-01

Conforming to the Belgian Law on Euthanasia of 28 May 2002, the definition of euthanasia is "an act practised by a third party intentionally, ending the life of a person at that person's request". Doctors who practise euthanasia commit no offence if they follow the prescribed conditions and procedures. The voluntary, well considered request for euthanasia must be initiated by an adult patient, complaining of unbearable physical or mental suffering caused by a serious and incurable medical condition, whether accidental or pathological. Consultation with a second doctor is required. If the death is not to be expected within a short period of time--in other words, for not terminally-ill patients--, the intervention of a third doctor is required, either a psychiatrist or a specialist of the patient's pathology. In that case, a delay of at least one month between the request and the euthanasia has to be respected. The doctor must declare the act of euthanasia to a Federal Commission composed of 8 doctors, 4 lawyers and 4 persons familiar with the problems of patients suffering from an incurable disease. This Commission has also to produce every other year a statistical and evaluation report for Parliament. The living will, called "advance declaration", is officially recognized but strictly limited to the state of irreversible unconsciousness of the patient. This law on the de-criminalization of euthanasia recognizes the right of personal autonomy for the patient and the principle of freedom of conscience for everyone. The law refers explicitly to the concept of euthanasia but does not specify the method to be used by the doctor. If it is the wish of the patient, and if the physical condition of the patient allows this solution, "assisted suicide" is permitted.

Lessons from anti-thalassemia campaigns in Italy, before prenatal diagnosis.

PubMed

Canali, Stefano; Corbellini, Gilberto

2002-01-01

The essay reconstructs the antithalassemia campaign carried out by means of population screening and pre-marriage counseling for about twenty years in Italy, immediately after the relationship between microcythemia and Cooley's anemia had been established, as well as its genetic bases. We examine the Italian contributions to the understanding of the genetics and of the clinical treatment of thalassemic disorders, and analyze the approaches to prevention as well as the results obtained by the first campaign against a genetic disease, conceived and largely implemented in Italy by Ezio Silvestroni and Ida Bianco. We discuss the resistances met by the antithalassemia campaign due to the cultural and organizational backwardness of the Italian medical community and of the public health system. Moreover we analyze the explanations and interpretations of the problematic results of these experiences in terms of morbidity reduction. It will be pointed out that the objective of genetic counselling practised in that context assumed the concept of disease prevention at the population level, and it was far from the idea, emerged in the 1970s, of non directive genetic counselling.

Surgery for advanced epithelial ovarian cancer.

PubMed

Hacker, Neville F; Rao, Archana

2017-05-01

Cytoreductive surgery for patients with advanced epithelial ovarian cancer has been practised since the pioneering work of Tom Griffiths in 1975. Further research has demonstrated the prognostic significance of the extent of metastatic disease pre-operatively, and of complete cytoreduction post-operatively. Patients with advanced epithelial ovarian cancer should be referred to high volume cancer units, and managed by multidisciplinary teams. The role of thoracoscopy and resection of intrathoracic disease is presently investigational. In recent years, there has been increasing use of neoadjuvant chemotherapy and interval cytoreductive surgery in patients with poor performance status, which is usually due to large volume ascites and/or large pleural effusions. Neoadjuvant chemotherapy reduces the post-operative morbidity, but if the tumour responds well to the chemotherapy, the inflammatory response makes the surgery more difficult. Post-operative morbidity is generally tolerable, but increases in older patients, and in those having multiple, aggressive surgical procedures, such as bowel resection or diaphragmatic stripping. Primary cytoreductive surgery should be regarded as the gold standard for most patients until a test is developed which would allow the prediction of platinum resistance pre-operatively. Copyright © 2016. Published by Elsevier Ltd.

[Behavior and cognitive treatments for insomnia. An alternative to pharmacotherapy].

PubMed

Baillargeon, L

1997-02-01

To familiarize family physicians with cognitive and behavioural treatments for insomnia. MEDLINE was searched from 1983 to 1995 and Psychlit from 1974 to 1995 using the key words "behaviour therapy," "cognitive therapy," "phototherapy," and "insomnia." We chose randomized trials and meta-analyses on the treatment of insomnia. Information was extracted on time-lag before sleep, frequency and duration of wakeful periods during the night, consumption of hynotics, and subjects' own assessment of their sleep before and after treatment. The most effective interventions were relaxation training, sleep restriction, and stimulus control. Practising good sleeping habits was only somewhat effective and should always be used in conjunction with other interventions. Stimulus control for insomnia has been demonstrated to be effective when used by primary care physicians. Other nonpharmacologic treatments should be evaluated in a similar manner.

How family influences practice of obstetrics. Do married women family physicians make different choices?

PubMed

Brown, J B; Carroll, J; Reid, A

1996-07-01

To examine the influence of family, past and current, on married women family physicians' and to understand why and how some women continue to practise obstetrics. Purposive sample of nine married women family physicians who currently practise obstetrics. Qualitative in-depth interviews. Analysis identified four main influences of family on participants' practice of obstetrics: family of origin, transitions in the life cycle, children, and the marital relationship. These women described how they combined the roles of wife, mother, daughter, sister, and doctor. Family was a powerful influence throughout their practice lives. Finding a balance between the demands of practice, particularly obstetrics, and family relationships was an ongoing process. The process was also influenced by transitions in the life cycle.

[Effect of chronic nasopharyngeal diseases among 14-year-old students and extra-curricular factors on school performance].

PubMed

Ignar-Golinowska, B; Roszkowska, H

1991-01-01

On the basis of extended health balances of 3482 14-year old school children, the association between the incidence of chronic diseases of the nasopharynx and some circumstances of their living conditions was evaluated. Nasopharyngeal diseases were identified in 2.3% of children. Their incidence was unrelated to sex; it was similar in urban and rural environments. Some circumstances creating inferior living conditions were associated with higher incidence of these diseases; they included living in poverty, lack of central heating and covering by foot a large distance from home to school. Other circumstances, e.g. numerous family, crowding of the apartment, un-sanitary sleeping conditions, contrary to expectation failed to display such associations. Likewise, health-promoting behaviours (e.g. habit of teeth cleaning, practising sports) did not lead to lower incidence of these diseases. Consideration of the problem from standpoint of physical development showed that the proceeding of the maturation process failed to be paralleled by lower incidence of nasopharyngeal diseases. This incidence amounted in pupils with overweight to 4.1% of cases, and in the remaining ones to 2.0-2.3%. Nasopharyngeal diseases were recorded in 5.4-5.5% of pupils complaining of poor general feeling (headache, sleep disturbances), and in as many as 7.0% of those experiencing difficulties in falling asleep. As concerns the progress in learning, the difficulties between better and worse pupils in the incidence of nasopharyngeal diseases were insignificant. These diseases occurred somewhat more frequently in pupils with up to 14 days of justified non-attendance per semester, as compared with those without any non-attendance or with non-attendance lasting more than 14 days.

Acute effects of exercise and active video games on adults' reaction time and perceived exertion.

PubMed

Guzmán, José F; López-García, Jesús

2016-11-01

The purpose of the present study was to examine the acute effects of resting, aerobic exercise practised alone, and aerobic exercise with active video games (AVG), on complex reaction time (CRT) and the post-exercise acute rate of perceived exertion (RPE) in young healthy adults. The experimental group was composed of 92 healthy young adults, 78 males and 13 females (age M = 21.9 ± 2.7 years) who completed two sessions, A and B. In session A, participants rode 30 min on an ergometer, while in session B they exercised for 30 min on an ergometer while playing an AVG on a Wii. The control group was composed of 30 young adults, 26 males and 4 females (age M = 21.4 ± 2.9 years) who rested for 30 min. In each session, a CRT task was performed before and after exercising or resting, and post-exercise global RPE was noted. Repeated measures general linear model (GLM) and Wilcoxon tests were performed. (1) Both aerobic exercise alone and aerobic exercise combined with AVG improved CRT, while resting did not; (2) aerobic exercise combined with AVG did not improve CRT more than aerobic exercise only; and (3) RPE was lower after aerobic exercise combined with AVG compared with aerobic exercise only. In young adults, exercise produces acute benefits on CRT, and practising exercise with AVG helps to decrease RPE.

Impact of five years of rotavirus vaccination in Finland - And the associated cost savings in secondary healthcare.

PubMed

Leino, Tuija; Baum, Ulrike; Scott, Peter; Ollgren, Jukka; Salo, Heini

2017-10-09

This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme. The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999-2005) and after (2010-2014) the start of the programme among children less than five years of age. The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%-94.5%) in hospitalised RVGE and 68.5% (66.6%-70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%-96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%-9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child. The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings.

PubMed

Chua, Siew Siang; Kok, Li Ching; Yusof, Faridah Aryani Md; Tang, Guang Hui; Lee, Shaun Wen Huey; Efendie, Benny; Paraidathathu, Thomas

2012-11-12

The roles of pharmacists have evolved from product oriented, dispensing of medications to more patient-focused services such as the provision of pharmaceutical care. Such pharmacy service is also becoming more widely practised in Malaysia but is not well documented. Therefore, this study is warranted to fill this information gap by identifying the types of pharmaceutical care issues (PCIs) encountered by primary care patients with diabetes mellitus, hypertension or hyperlipidaemia in Malaysia. This study was part of a large controlled trial that evaluated the outcomes of multiprofessional collaboration which involved medical general practitioners, pharmacists, dietitians and nurses in managing diabetes mellitus, hypertension and hyperlipidaemia in primary care settings. A total of 477 patients were recruited by 44 general practitioners in the Klang Valley. These patients were counselled by the various healthcare professionals and followed-up for 6 months. Of the 477 participants, 53.7% had at least one PCI, with a total of 706 PCIs. These included drug-use problems (33.3%), insufficient awareness and knowledge about disease condition and medication (20.4%), adverse drug reactions (15.6%), therapeutic failure (13.9%), drug-choice problems (9.5%) and dosing problems (3.4%). Non-adherence to medications topped the list of drug-use problems, followed by incorrect administration of medications. More than half of the PCIs (52%) were classified as probably clinically insignificant, 38.9% with minimal clinical significance, 8.9% as definitely clinically significant and could cause patient harm while one issue (0.2%) was classified as life threatening. The main causes of PCIs were deterioration of disease state which led to failure of therapy, and also presentation of new symptoms or indications. Of the 338 PCIs where changes were recommended by the pharmacist, 87.3% were carried out as recommended. This study demonstrates the importance of pharmacists working in collaboration with other healthcare providers especially the medical doctors in identifying and resolving pharmaceutical care issues to provide optimal care for patients with chronic diseases.

Practices of traditional beef farmers in their production and marketing of cattle in Zambia.

PubMed

Mumba, Chisoni; Häsler, Barbara; Muma, John B; Munyeme, Musso; Sitali, Doreen Chilolo; Skjerve, Eystein; Rich, Karl M

2018-01-01

Understanding the practices of traditional cattle farmers in developing countries is an important factor in the development of appropriate, pro-poor disease control policies, and in formulating regional-specific production incentives that can improve productivity. This paper describes the production, husbandry practices, economics, and constraints of traditional cattle farming in Zambia. A cross-sectional study design was used to obtain data from traditional cattle farmers (n = 699) using a structured questionnaire. Data analyses were carried out using SPSS and STATA statistical packages. The results revealed that the majority [65% (95% CI: 59.3-71.1)] of farmers practised a transhumant cattle herding system under communal grazing. In these transhumant herding systems, animal husbandry and management systems were found to be of poor quality, in terms of supplementary feeding, vaccination coverage, deworming, uptake of veterinary services, usage of artificial insemination, and dip tanks all being low or absent. East Coast Fever was the most common disease, affecting 60% (95% CI: 56.4-63.7) of farmers. Cattle sales were low, as farmers only sold a median of two cattle per household per year. Crop farming was found to be the main source of farm income (47%) in agro-pastoralist communities, followed by cattle farming (28%) and other sources (25%). The median cost of production in the surveyed provinces was reported at US$316, while that of revenue from cattle and cattle products sales was estimated at US$885 per herd per year. This translates to an estimated gross margin of US$569, representing 64.3% of revenue.There is considerable diversity in disease distribution, animal husbandry practices, economics, and challenges in traditional cattle production in different locations of Zambia. Therefore, to improve the productivity of the traditional cattle sub-sector, policy makers and stakeholders in the beef value chain must develop fit-for-purpose policies and interventions that consider these variations.

Challenges in the management of rheumatoid arthritis in developing countries.

PubMed

Mody, Girish M; Cardiel, Mario H

2008-08-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease which is characterized by chronic inflammation of the joints. Patients experience chronic pain and suffering, and increasing disability; without treatment, life expectancy is reduced. It is imperative to identify patients early so that control of inflammation can prevent joint destruction and disability. Although great advances have been made in the developed nations, early diagnosis remains a great challenge for developing countries during the Bone and Joint Decade (2000-2010) and beyond. Developing countries face important and competitive social, economic, health- and poverty-related issues, and this frequently results in chronic diseases such as RA being forgotten in health priorities when urgent health needs are considered in an environment with poor education and scarce resources. Epidemiological studies in developing countries show a lower but still important prevalence in different regions when compared to that in Caucasians. It seems that the severity of RA varies among different ethnic groups, and probably starts at a younger age in developing countries. Practising rheumatologists in these regions need to take into account several important problems that include suboptimal undergraduate education, inadequate diagnosis, late referrals, lack of human and technical resources, poor access to rheumatologists, and some deficiencies in drug availability. Infections are very important in RA, and special care is needed in developing countries as some endemic infections include tuberculosis, human immunodeficiency virus (HIV), hepatitis B, and hepatitis C. These infections should be carefully taken into account when medications are prescribed and monitored. This chapter presents published information covering the main challenges faced in these environments, and suggests strategies to overcome these important problems in RA management.

Pandemic risk prevention in European countries: role of the ECDC in preparing for pandemics. Development and experience with a national self-assessment procedure, 2005-2008.

PubMed

Nicoll, A

2010-12-01

To be effective risk prevention work takes place well before pandemics through the three Ps: Planning, Preparedness and Practise. Between 2005 and 2008 the European Centre for Disease Prevention and Control (ECDC) worked with the European Commission (EC) and the WHO Regional Office for Europe (WHO-Euro) to assist European countries in preparing themselves for a future influenza pandemic. All eligible countries in the European Union and European Economic Area participated with energy and commitment. Indicators of preparedness were developed based on WHO planning guidance and these were set within a simple assessment which included a formal country visit. The procedure evolved considerably with field experience. As the complexity of pandemic preparedness was appreciated it changed from being a classical short external assessment to longer national self-assessments with demonstrable impact, especially when self-assessments were published. There were essential supporting activities undertaken including a series of pan-European pandemic preparedness workshops organised by EC, WHO-Euro, ECDC and countries holding the European Union Presidency. The self-assessments highlighted additional work and documentation that was needed by national authorities from the ECDC. This work was undertaken and the document produced. The benefits of the self-assessments were seen in the 2009 pandemic in that EU/EEA countries performed better than some others. A number of the guidance documents were updated to fit the specific features of the pandemic. However the pandemic revealed many weaknesses and brought new challenges for European countries, notably over communication and vaccines, the need to prepare for a variety of scenarios and to factor severity estimates into preparedness, to improve surveillance for severe disease and to deliver seroepidemiology. Any revised self-assessment procedure will need to respond to these challenges.

Medicalization, wish-fulfilling medicine, and disease mongering: toward a brave new world?

PubMed

Blasco-Fontecilla, H

2014-03-01

Western societies are characterized by a growing medicalization of life events, such as pregnancy, aging, or even death. Three concepts -medicalization, wish-fulfilling medicine, and disease mongering- are key in understanding the current practise of Medicine. Quite surprisingly, not a single study has addressed the relationship between all three of these concepts. The term medicalization expanded under the open-ended concept of health developed by the World Health Organization in 1946. One of the consequences of medicalization is the transition from patients to clients. Physicians are under increasing pressure to meet the insatiable demands of their clients. The term wish-fulfilling medicine refers to the increasing tendency of medicine to be used to fulfill personal wishes (i.e. enhanced work performance). The insatiable demand for healthcare is troublesome, particularly in Europe, where the welfare states are more and more under pressure. Finally, the term disease mongering refers to attempts by pharmaceutical companies to artificially enlarge their “markets” by convincing people that they suffer from some sickness and thus need medical treatment. Typical examples of disease mongering are social anxiety disorder, low bone mineral density, and premature ejaculation. Currently, some Public Health Services could be on the brink of collapse as they “navigate” between the scarce resources available and the users’ insatiable health demands. Therefore, it appears necessary to generate clear-cut Public Health Services Port-folios.

Problems in implementing a good food and nutrition policy in Britain.

PubMed Central

James, W. P.

1980-01-01

There is no co-ordinated food and nutrition policy in Britain, primarily because it is still not recognized that diet has an important role to play in the development of many diseases of affluence. The demand for absolute proof of the dietary component of disease on a population level ignores both the innate biological susceptibility in only a portion of the population to a particular nutrient as well as the increasing evidence from studies on non-human primates that diet plays a key role in several conditions including heart disease. Government remains unsure of how to implement its own current recommendations and the traditional paternalistic and conservative approach delays action. Vested interests, seeking only short-term gains, are not confined to industrial concerns. Marketing Boards are allowed almost unfettered freedom to promote nutritionally undesirable eating habits. Health education in schools remains inadequate with most of the involved teachers still promoting incorrect concepts. The medical profession is still unwilling to take a physician maintaining treatment programmes for marginal effects on a public health problem. General practitioners are better able to start practising preventive medicine but they need to be helped by community physicians who should begin on their main task of implementing policies for preventing disease rather than limiting themselves to their current preoccupation with systems analyses and operational research. PMID:7465465

Efficacy of an educational intervention in primary health care in inhalation techniques: study protocol for a pragmatic cluster randomised controlled trial.

PubMed

Leiva-Fernández, José; Vázquez-Alarcón, Rubén L; Aguiar-Leiva, Virginia; Lobnig-Becerra, Mireya; Leiva-Fernández, Francisca; Barnestein-Fonseca, Pilar

2016-03-17

Chronic obstructive pulmonary disease (COPD) accounts for 10-12 % of primary care consultations, 7 % of hospital admissions and 35 % of chronic incapacity related to productivity. The misuse of inhalers is a significant problem in COPD because it is associated with reduced therapeutic drug effects leading to lack of control of both symptoms and disease. Despite all advice, health care professionals' practice management of inhalation treatments is usually deficient. Interventions to improve inhaler technique by health care professionals are limited, especially among primary care professionals, who provide the most care to patients with COPD. The aim of this study is to evaluate the efficacy of an educational intervention to train general practitioners (GPs) in the right inhalation technique for the most commonly used inhalers. We are conducting a pragmatic cluster randomised controlled trial. The sample population is composed of 267 patients diagnosed with COPD using inhalation therapy selected from among those in 20 general practices, divided into two groups (control and intervention) by block randomisation at 8 primary care centres. The sample has two levels. The first level is patients with COPD who agree to participate in the trial and receive the educational intervention from their GPs. The second level is GPs who are primary health care professionals and receive the educational intervention. The intervention is one session of the educational intervention with a monitor given to GPs for training in the right inhalation technique. The primary outcome is correct inhalation technique in patients. Secondary outcomes are functional status (spirometry) and quality of life. The follow-up period will be 1 year. GPs will have two visits (baseline and at the 1-year follow-up visit. Patients will have four visits (at baseline and 3, 6 and 12 months). Analysis will be done on an intention-to-treat basis. We carried out three previous clinical trials in patients with COPD, which showed the efficacy of an educational intervention based on monitor training to improve the inhalation technique in patients. This intervention is suitable and feasible in the context of clinical practice. Now we are seeking to know if we can improve it when the monitor is the GP (the real care provider in daily practise). ISRCTN Registry identifier ISRCTN93725230 . Registered on 18 August 2014.

Relationships between healthcare and research records.

PubMed

Duwe, Helmut

2004-01-01

The ultimate end-point of healthcare and health-related life sciences, more or less as regulatory idea, is the prevention and cure of diseases, considering the fate of individual patients as well as the challenge of providing sufficient care for all. However, all undertakings stand under the "proviso of rightness of action". The movement of evidence-based medicine has triggered a renaissance of systematic self-assurance of best practise. The systematic utilization of healthcare records and research study recordings in an inter-linked manner provides a better enabling environment to improve evidence. Good e-health must contribute to accumulate inter-generation clinical experience. Qualified research should ensure methodological strictness via gold standards like controlled, randomised and masked trials. Building information systems for e-health as well as for e-science bears as a special focus the mutual cross-fertilization of these application domains. Analysing a variety of building blocks shows that both areas can benefit from generic solution pattern, keeping in mind that each domain has distinguished knowledge realms. Generic patterns as well as distinguished special features are illustrated by analysing state of the art solutions plus some experimental approaches, as there are: the generic part of the HL7 V3 RIM, the RCRIM work, laboratory information handling, vital sign standardization efforts, like ECG information models.Finally, the precision of the usage of the ubiquitous term "metadata" is taken as example of an open issue.

From Undang-undang Melaka to federal constitution: the dynamics of multicultural Malaysia.

PubMed

Nor, Mohd Roslan Mohd; Abdullah, Ahmad Termizi; Ali, Abdul Karim

2016-01-01

Malaysia is a multicultural state comprising three main races: Malays, Chinese and Indians. The three main religions are Islam, Buddhism and Hinduism. Other religions such as Sikhism and Christianity are also practised. Muslims are the majority comprising 67 % of the population. This paper is qualitative in nature. It applies historical comparative method in presenting its data. The Undang - undang Melaka (Malacca Laws) was obtained from the monograph available at National Library of Malaysia under the name of Hukum Kanun Melaka. Analysis was done on selected examples from this document. This paper highlights that had there been no introduction to a common law system, Malaysia would have remained with its traditional laws influenced by Islam and its local customs as evident from Undang - undang Melaka (Malacca laws). The Undang - undang Melaka was practised from 1422 to 1444 and the law of the country was developed to accommodate the introduction of civil law during the colonial period. One of the unique aspects of multicultural Malaysia is the fact that it has a parallel legal system: sharia and civil law. This paper examines histo-cultural development of the Islamic law as practised in pre-independent Malaysia, as well as the coexistence between these two laws after the independence of Malaya in 1957. This paper concludes that Islamic law in Malaysia is confined to Muslim family matters, while civil law covers all other matters.

Perceptions and practice of exclusive breastfeeding among Malay women in Kelantan, Malaysia: a qualitative approach.

PubMed

Tengku, Alina T I; Wan, Abdul Manan W M; Zaharah, S; Rohana, A J; Nik Normanieza, N M

2012-04-01

Despite evidence from various studies on exclusive breastfeeding (EBF) being best for infants, many women do not or are unable to practise EBF. This study aimed to examine perceptions on EBF and its influencing factors among a sample of Malay women in rural and urban areas in Kelantan, Malaysia. A qualitative study using in-depth interviews was conducted to examine respondents' views about EBF including their beliefs, experiences and feelings. The interviews were audio-recorded and transcribed verbatim, followed by discussion and identification of emergent concepts. Data saturation was achieved after interviewing a total of 30 women. The mean age of the women was about 30 years with most having at least secondary level schooling; the majority were working women. Thirteen of the 30 women practised EBF. They believed breastfeeding allowed them to fulfill their reproductive role and regarded it as a gift from God. The practice required sacrifice, and was therefore associated with a combination of positive and negative feelings. Differing opinions surfaced with regard to belief in the superiority of breastfeeding and feasibility of practice. Many women accepted breastfeeding practice but found it challenging to practise EBF especially when confronted with low milk production, perceived low nutritional quality breast milk, and work commitments. Women should be educated on the importance of EBF with regard to the nutritional adequacy of breast milk and long-term benefits for mother and children.

Spectators & spectacles: nurses, midwives and visuality.

PubMed

Barnard, Alan G; Sinclair, Marlene

2006-09-01

In this paper we reflect on how linear perspective vision influences the practice of nurses and midwives and to advance understanding of clinical practice in technologically intensive environments through examination of drawings by nurses and midwives and through critical analysis. There is increasing emphasis on vision in Western culture, and both nurses and midwives spend a great deal of time observing their clinical environment(s). Healthcare practitioners work increasingly in image-based realities and nurses rely on visual skills. Vision and visual representation are central to our practice and are important to examine because we look often at technology to assess people and care. The world in which we practise is one of meaning(s). Technological development is transformative in nature and produces changes that alter the way(s) we give care. Amongst all this change, it is unclear how we practise in environments characterized by increasing technology and it is unknown how nursing and midwifery practice alter as a result. Simple drawings included in this paper highlight an important and shared experience of clinical practice(s). They emphasize the importance and scope of the visual sense and expose practitioner behaviour that has enormous implications for current and future professional development and person-focussed care provision. Experiences described in this paper require further examination and highlight substantial changes to nurse-patient relationships, health care and the way we practise.

An Overview of Total Quality Management (TQM) practice in Construction Sector

NASA Astrophysics Data System (ADS)

Likita, A. J.; Zainun, N. Y.; Rahman, I. Abdul; Awal, A. S. M. Abdul; Alias, A. R.; Rahman, M. Q. Abdul; Ghazali, F. E. Mohamed

2018-04-01

In construction sector TQM can be termed as a philosophy which guides construction professionals on the proper execution of construction projects in terms of quality. The aim of this paper is to discuss on quality management practice in construction sector. This paper evaluated five previous researches and the findings were discussed to find a conclusion of TQM practise in construction sector. The study found that TQM had been successfully practice in construction sector at Saudi Arabia, India, US and South Africa. Application of Artificial Neural Network (ANN) help to improve the implementation of TQM in construction sector. In conclusion, quality management practices will give better control of processes in construction sector.

A remote assessment system with a vision robot and wearable sensors.

PubMed

Zhang, Tong; Wang, Jue; Ren, Yumiao; Li, Jianjun

2004-01-01

This paper describes an ongoing researched remote rehabilitation assessment system that has a 6-freedom double-eyes vision robot to catch vision information, and a group of wearable sensors to acquire biomechanical signals. A server computer is fixed on the robot, to provide services to the robot's controller and all the sensors. The robot is connected to Internet by wireless channel, and so do the sensors to the robot. Rehabilitation professionals can semi-automatically practise an assessment program via Internet. The preliminary results show that the smart device, including the robot and the sensors, can improve the quality of remote assessment, and reduce the complexity of operation at a distance.

Establishing best practise in the application of expert review of mutagenicity under ICH M7.

PubMed

Barber, Chris; Amberg, Alexander; Custer, Laura; Dobo, Krista L; Glowienke, Susanne; Van Gompel, Jacky; Gutsell, Steve; Harvey, Jim; Honma, Masamitsu; Kenyon, Michelle O; Kruhlak, Naomi; Muster, Wolfgang; Stavitskaya, Lidiya; Teasdale, Andrew; Vessey, Jonathan; Wichard, Joerg

2015-10-01

The ICH M7 guidelines for the assessment and control of DNA reactive (mutagenic) impurities in pharmaceuticals allows for the consideration of in silico predictions in place of in vitro studies. This represents a significant advance in the acceptance of (Q)SAR models and has resulted from positive interactions between modellers, regulatory agencies and industry with a shared purpose of developing effective processes to minimise risk. This paper discusses key scientific principles that should be applied when evaluating in silico predictions with a focus on accuracy and scientific rigour that will support a consistent and practical route to regulatory submission. Copyright © 2015 Elsevier Inc. All rights reserved.

[Effect of caffeine and phenamin on caudate inhibition of aggressive reactions in cats].

PubMed

Belozertsev, Iu A

1975-01-01

In chronic experiments conducted on cats it was shown that caffeine (10--30 mg/kg) failed to change agressive reactions developing in stimulation of the meso- or diencephalic structures. Phenamine (1--3 mg/kg) facilitated the appearance of emotional manifestations and lowered the threshold of the agressive response. Subliminal stimulation of the caudate nucleus in control experiments caused motor tranquilization and depressed the agressive behaviour to a lesser degree when practised against the background of the caffeine action. At the same time, phenamine abolished the influence not only of the threshold, but also of the subliminal stimulation of the caudate nucleus on the spontaneous motor activity and the rage behaviour.

Epidemiology of tinea pedis in marathon runners: prevalence of occult athlete's foot.

PubMed

Auger, P; Marquis, G; Joly, J; Attye, A

1993-01-01

Studies on the prevalence of tinea pedis, a frequently encountered dermatophytic infection, have been conducted mostly in swimmers although people who regularly practise other types of physical activities may also have a high rate of clinical or subclinical infection. This investigation was undertaken to establish the rate of infection in marathon runners, and to determine the incidence of occult athlete's foot disease in this population. Among samples obtained from 405 individuals, 22% were positive. The rate of infection was highest in the older age groups. The prevalence of infection was 24.2% in men and 6.1% in women. Trichophyton rubrum and Trichophyton mentagrophytes were the two species of dermatophytes most commonly isolated on culture. Occult athlete's foot disease represented 48% of cases with a positive culture. Finally, routine sampling of both feet was confirmed necessary to adequately establish the rate of infection: 26.9% of cases with a positive culture would have been missed by unilateral sampling. Other epidemiological factors were not clearly linked to the prevalence of disease in marathon runners: weight; presence of pet animals; practice of other sports; race and country of origin. In conclusion, we establish that marathon runners represent a population at risk for the occurrence of both clinical and subclinical tinea pedis infection.

Functioning and disability in adults with myotonic dystrophy type 1.

PubMed

Kierkegaard, Marie; Harms-Ringdahl, Karin; Holmqvist, Lotta Widén; Tollbäck, Anna

2011-01-01

 To provide a comprehensive description of functioning and disability with regard to stages of disease progression in adults with myotonic dystrophy type 1 (DM1). Further to explore associations of measures of manual dexterity and of walking capacity with measures of activities of daily living (ADL) and participation in social and lifestyle activities. Seventy persons with DM1 underwent examinations, tests and answered questionnaires. Stages of disease progression were based on the muscular impairment rating scale.  Overweight, cardiac dysfunctions, respiratory restrictions, fatigue and/or low physical activity levels were found in approximately 40% of those with DM1. Over 75% had muscle impairments, and activity limitations in manual dexterity and walking. Dependence in personal and instrumental ADL was found in 16% and 39%, respectively, and participation restrictions in social and lifestyle activities in 52%. The presence of concurrent body-function impairments, activity limitations and participation restrictions was high. Significant differences were found in muscle impairment, manual dexterity, mobility, ADL and social and lifestyle activities with regard to disease progression. Cut-off values in measures of manual dexterity and walking capacity associated to functioning are proposed.  This information can be used for developing clinical practise and for health promotion for persons with DM1.

[Assessment of exercise capacity in congenital heart disease].

PubMed

Bouzo-López, Raquel; González-Represas, Alicia

2016-01-01

For many years, the treatment of congenital heart diseases has been a field in which, based on the seriousness of these conditions, treatment options were viewed with the greatest deference. This has conditioned, in many cases, the interventions to be undertaken in each. In this sense, exercise was thought to have a negative impact and thus the practise of almost any physical activity was limited. Although there has recently been a change in the paradigm with respect to exercise, this idea continues to hold sway. For many cardiopathies, the information obtained through a stress test is essential in order to implement and supervise an exercise program. The aim of this study is to analyze the parameters within the stress test which allow for an adequate stratification of the risk to subjects with congenital heart diseases who undertake exercise, as well as their values in accordance with the type of pathology, the gravity of such, and the age of the patients. Furthermore, these parameters will be analyzed for both their survival markers and the protocols that can best be adjusted for patients with these characteristic. Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

IS MANUAL THERAPY A RATIONAL APPROACH TO IMPROVING HEALTH-RELATED QUALITY OF LIFE IN PEOPLE WITH ARTHRITIS?

PubMed Central

Cameron, Melainie

2002-01-01

Background: People with arthritic disease are advised to participate in gentle exercise on a regular basis, and pursue long-term medication regimes. Alternative therapies are also used by people with arthritis, and may sometimes be recommended by rheumatologists and other medical personnel. Alternative therapies may be divided into two types: active therapies, in which the patient takes a driving role, and passive therapies, in which the therapy cannot proceed unless driven by a therapist. Objective: To review the effectiveness of manual therapy in improving the health-related quality of life (HRQOL) of people with two common arthritis conditions: Osteoarthritis and rheumatoid arthritis. Discussion: Massage, and other passive (practitioner-driven) manual therapies, have been anecdotally reported to improve health-related quality of life (HRQOL) in people with arthritis. Many manual therapists consult with patients who have arthritic diseases, receive referrals from rheumatologists, and consider the arthritic diseases to be within their field of practise. Although there is empirical evidence that manual therapy with some types of arthritis is beneficial, the level of effectiveness however is under-researched. Medical authorities are reluctant to endorse manual therapies for arthritis due to a lack of scientific evidence demonstrating efficacy, safety, and cost effectiveness. PMID:17987169

Lung function imaging methods in Cystic Fibrosis pulmonary disease.

PubMed

Kołodziej, Magdalena; de Veer, Michael J; Cholewa, Marian; Egan, Gary F; Thompson, Bruce R

2017-05-17

Monitoring of pulmonary physiology is fundamental to the clinical management of patients with Cystic Fibrosis. The current standard clinical practise uses spirometry to assess lung function which delivers a clinically relevant functional readout of total lung function, however does not supply any visible or localised information. High Resolution Computed Tomography (HRCT) is a well-established current 'gold standard' method for monitoring lung anatomical changes in Cystic Fibrosis patients. HRCT provides excellent morphological information, however, the X-ray radiation dose can become significant if multiple scans are required to monitor chronic diseases such as cystic fibrosis. X-ray phase-contrast imaging is another emerging X-ray based methodology for Cystic Fibrosis lung assessment which provides dynamic morphological and functional information, albeit with even higher X-ray doses than HRCT. Magnetic Resonance Imaging (MRI) is a non-ionising radiation imaging method that is garnering growing interest among researchers and clinicians working with Cystic Fibrosis patients. Recent advances in MRI have opened up the possibilities to observe lung function in real time to potentially allow sensitive and accurate assessment of disease progression. The use of hyperpolarized gas or non-contrast enhanced MRI can be tailored to clinical needs. While MRI offers significant promise it still suffers from poor spatial resolution and the development of an objective scoring system especially for ventilation assessment.

The management of Graves' disease in New Zealand 2014.

PubMed

Cox, Stephanie C; Tamatea, Jade Au; Conaglen, John V; Elston, Marianne S

2016-06-10

Treatment options for Graves' disease (GD), namely anti-thyroid drugs (ATD), surgery or radioiodine (RAI), have not changed over the past two decades. There is no 'gold-standard' treatment for GD. To assess whether the management of GD in New Zealand has changed since the previous 1991 New Zealand survey and compare current management with that of contemporary international studies. We conducted an online survey of New Zealand physicians currently practising internal medicine, diabetes and/or endocrinology, using the cases and questions from the original European and 1991 New Zealand studies. The first-line use of RAI was 5.5%, compared to 41% in the 1991 New Zealand survey. This corresponded to an increase in ATD use, while the rates of surgery as a first-line treatment have remained static over time. New Zealand physicians use technetium scanning for diagnosis, whereas ultrasound and radioiodine uptake were the most commonly selected investigations by European and North American physicians, respectively. The pattern of ATD use in pregnancy was similar to international practice. Treatment of GD in New Zealand has shifted away from the use of RAI as first line treatment. There are significant differences in the investigation and treatment of Grave's disease between New Zealand, Europe and North America.

Primary care nursing activities with patients affected by physical chronic disease and common mental disorders: a qualitative descriptive study.

PubMed

Girard, Ariane; Hudon, Catherine; Poitras, Marie-Eve; Roberge, Pasquale; Chouinard, Maud-Christine

2017-05-01

To describe nursing activities in primary care with patients affected by physical chronic disease and common mental disorders. Patients in primary care who are affected by physical chronic disease and common mental disorders such as anxiety and depression require care and follow-up based on their physical and mental health condition. Primary care nurses are increasingly expected to contribute to the care and follow-up of this growing clientele. However, little is known about the actual activities carried out by primary care nurses in providing this service in the Province of Quebec (Canada). A qualitative descriptive study was conducted. Data were obtained through semistructured individual interviews with 13 nurses practising among patients with physical chronic disease in seven Family Medicine Groups in Quebec (Canada). Participants described five activity domains: assessment of physical and mental health condition, care planning, interprofessional collaboration, therapeutic relationship and health promotion. The full potential of primary care nurses is not always exploited, and some activities could be improved. Evidence for including nurses in collaborative care for patients affected by physical chronic disease and common mental disorders has been shown but is not fully implemented in Family Medicine Groups. Future research should emphasise collaboration among mental health professionals, primary care nurses and family physicians in the care of patients with physical chronic disease and common mental disorders. Primary care nurses would benefit from gaining more knowledge about common mental disorders and from identifying the resources they need to contribute to managing them in an interdisciplinary team. © 2016 John Wiley & Sons Ltd.

Navigating in the landscape of care: a critical reflection on theory and practise of care and ethics.

PubMed

Skærbæk, Eva

2011-03-01

The theory and practise of care is defined and enacted differently in different national as well as cultural contexts, illuminating how differently constructed the personal and societal structures in Europe are. A common trait is however that care work paid or non-paid, private or public is identified with women. To navigate in the landscape of care and ethics requires taking into account the constitutive relation between one's identity, embodiment and position. The author suggests conceiving care as an existential condition of life demanded from all human beings. This will free care from the identification with women and pave a way towards a more gender equal and just society with less gender segregation in the labour market and at the arena of education.

[Providing successful education and further training: 10 tips].

PubMed

Brand, Paul L P; Boendermaker, Peter M; Venekamp, Ruud M

2014-01-01

Almost all physicians teach or provide postgraduate medical education from time to time. Although many people assume that there are 'born teachers' and 'those who will never learn to teach', teaching is an ability. The knowledge and skills required to teach well can be learned and practised. In this review article, we present 10 tips that will help the busy clinician to teach effectively. The 10 tips, which are based on the principles of adult learning, are: prepare your teaching session, involve the learners actively, connect to the learners' level of competence, define learning objectives, make the subject of your teaching relevant to the learners, use questions, be a good role model, vary your teaching methods, practise your teaching, and limit the amount of material you are teaching in each session.

Emerging issues and current trends in assistive technology use 2007-2010: practising, assisting and enabling learning for all.

PubMed

Abbott, Chris; Brown, David; Evett, Lindsay; Standen, Penny

2014-11-01

Following an earlier review in 2007, a further review of the academic literature relating to the uses of assistive technology (AT) by children and young people was completed, covering the period 2007-2011. As in the earlier review, a tripartite taxonomy: technology uses to train or practise, technology uses to assist learning and technology uses to enable learning, was used in order to structure the findings. The key markers for research in this field and during these three years were user involvement, AT on mobile mainstream devices, the visibility of AT, technology for interaction and collaboration, new and developing interfaces and inclusive design principles. The paper concludes by locating these developments within the broader framework of the Digital Divide.

Molluscicide for the control of schistosomiasis in irrigation schemes: a study in Southern Rhodesia.

PubMed

Shiff, C J; Clarke, V de V; Evans, A C; Barnish, G

1973-01-01

The development of large areas of irrigation farming in the south-eastern lowveld of Southern Rhodesia has produced the risk of severe transmission of schistosomiasis over an extent of some 30 000 ha. Control measures instituted by the Ministry of Health were primarily directed against the large and widely distributed snail populations by using molluscicides. The chemical was applied to the irrigation water by drip-feed methods once every 6-8 months. The drains, however, were treated routinely by pairs of rangers searching for snails and applying chemical where they were found. The efficacy of control operations has been assessed by longitudinal studies in children free from infection to determine the incidence of infection. The results indicate that transmission of both Schistosoma haematobium and S. mansoni has been reduced to a level below that measured in areas of the country where irrigation is not practised. The total annual cost for this work was US$ 54 800-55 500.

Gait rehabilitation machines based on programmable footplates.

PubMed

Schmidt, Henning; Werner, Cordula; Bernhardt, Rolf; Hesse, Stefan; Krüger, Jörg

2007-02-09

Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator) or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I). For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS) revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive approach. Sophisticated technical developments and positive randomized controlled trials form the basis of a growing acceptance worldwide to the benefits or our patients.

On the use of RADARSAT-1 for monitoring malaria risk in Kenya

NASA Astrophysics Data System (ADS)

Ross, S. G.; Thomson, M. C.; Pultz, T.; Mbogo, C. M.; Regens, J. L.; Swalm, C.; Githure, J.; Yan, G.; Gu, W.; Beier, J. C.

2002-01-01

The incidence and spread of vector-borne infectious diseases are increasing concerns in many parts of the world. Earth obervation techniques provide a recognised means for monitoring and mapping disease risk as well as correlating environmental indicators with various disease vectors. Because the areas most impacted by vector-borne disease are remote and not easily monitored using traditional, labor intensive survey techniques, high spatial and temporal coverage provided by spaceborne sensors allows for the investigation of large areas in a timely manner. However, since the majority of infectious diseases occur in tropical areas, one of the main barriers to earth observation techniques is persistent cloud-cover. Synthetic Aperture Radar (SAR) technology offers a solution to this problem by providing all-weather, day and night imaging capability. Based on SAR's sensitivity to target moisture conditions, sensors such as RADARSAT-1 can be readily used to map wetland and swampy areas that are conducive to functioning as aquatic larval habitats. Irrigation patterns, deforestation practises and the effects of local flooding can be monitored using SAR imagery, and related to potential disease vector abundance and proximity to populated areas. This paper discusses the contribution of C-band radar remote sensing technology to monitoring and mapping malaria. Preliminary results using RADARSAT-1 for identifying areas of high mosquito (Anopheles gambiae s.l.) abundance along the Kenya coast will be discussed. The authors consider the potential of RADARSAT-1 data based on SAR sensor characteristics and the preliminary results obtained. Further potential of spaceborne SAR data for monitoring vector-borne disease is discussed with respect to future advanced SAR sensors such as RADARSAT-2.

[Effect of qigong exercise on the blood level of monoamine neuro-transmitters in patients with chronic diseases].

PubMed

Liu, B; Jiao, J; Li, Y

1990-04-01

In this study, the authors, by means of fluorescence spectrophotometry, observed the variations of blood contents of monoamine neuro-transmitters (5-hydroxytamine 5-HT; norepinephrine NE; dopamine DA) in 68 subjects before and after adoption of Qigong exercises. A comparison of pre- and post-exercise showed a general reduction in 5-HT, varying from 0.43 +/- 0.21 to 0.21 +/- 0.13 microgram/ml (P less than 0.001). Variations in NE and DA tended to go up, NE being from 0.27 +/- 0.13 to 0.35 +/- 0.27 microgram/ml, DA from 0.86 +/- 0.69 to 1.19 +/- 0.81 micrograms/ml (P less than 0.02). Effects of Qigong exercises on different diseases: Subjects in each group showed reduction in blood 5-HT content after they had practised Qigong exercise. (1) Cardiovascular disease: 0.47 +/- 0.34 to 0.16 +/- 0.11 microgram/ml (n = 13); (2) gastric diseases: 0.37 +/- 0.19 to 0.22 +/- 0.13 microgram/ml (n = 20); (3) joint system diseases: 0.44 +/- 0.21 to 0.18 +/- 0.13 microgram/ml (n = 10); (4) respiratory system diseases: 0.40 +/- 0.22 to 0.22 +/- 0.12 microgram/ml (n = 8); (5) other diseases (neuroasthenia, neurosis, etc.): 0.46 +/- 0.22 to 0.25 +/- 0.14 microgram/ml (n = 13). In all these groups except the fourth group, variations in 5-HT content in comparison with the pre-exercise values were respectively P less than 0.01, less than 0.01, less than 0.05, less than 0.05. The difference was obvious. The post-exercise blood content of DA in various groups rose up remarkably.(ABSTRACT TRUNCATED AT 250 WORDS)

Children's Physic: Medical Perceptions and Treatment of Sick Children in Early Modern England, c. 1580-1720.

PubMed

Newton, Hannah

2010-12-01

Historians of medicine, childhood and paediatrics have often assumed that early modern doctors neither treated children, nor adapted their medicines to suit the peculiar temperaments of the young. Through an examination of medical textbooks and doctors' casebooks, this article refutes these assumptions. It argues that medical authors and practising doctors regularly treated children, and were careful to tailor their remedies to complement the distinctive constitutions of children. Thus, this article proposes that a concept of 'children's physic' existed in early modern England. This term refers to the notion that children were physiologically distinct, requiring special medical care. Children's physic was rooted in the ancient traditions of Hippocratic and Galenic medicine: it was the child's humoral make-up that underpinned all medical ideas about children's bodies, minds, diseases and treatments. Children abounded in the humour blood, which made them humid and weak, and in need of medicines of a particularly gentle nature.

The doctrine of signatures in the medieval and Ottoman Levant.

PubMed

Lev, Efraim

2002-06-01

This study traces the use of the Doctrine of Signatures among medieval and Ottoman physicians and its subsequent appearance in the pharmacological literature of the Levant. Close examination of the historical sources of the Levant seems to support the claim that although this theory did not originate in the region, it was certainly practised there. These sources have revealed 23 substances with medicinal uses based on the Doctrine, bearing witness to the extent of its influence at the time. The main categories of the Doctrine uncovered were: similarity between the substance used and the human organ; resemblance in shape or behaviour to a specific animal; correlation between the colour of a substance and the colour of the symptoms; similarities between the substance and the patient's symptoms and the use of a substance that might produce symptoms of a particular disease in a healthy person to remedy those same symptoms in one who is sick.

Nurse had 'impaired' fitness to practise.

PubMed

2017-04-28

A nurse has been reprimanded by the Nursing and Midwifery Council (NMC) aft er depriving a care home resident of 'any chance he had to survive', by failing to commence cardiopulmonary resuscitation (CPR).

The association of health management with the health of elderly people.

PubMed

Nakanishi, N; Tatara, K; Takashima, Y; Fujiwara, H; Takamori, Y; Takabayashi, H; Scott, R

1995-07-01

To assess the effect of health management on the health of a community-based sample of people aged 65 years and over, a cross-sectional survey was carried out of 1491 people aged 65 years and over (22.3%) randomly drawn from the computerized age-sex register in Settsu City, Osaka. A total of 1473 people were contacted and complete responses were obtained from 1383 of these (a response rate of 93.9%). The proportion of the sample who had been receiving regular health checks or had been taking care of their health decreased with a decline in Activities of Daily Living (ADL). This trend was more pronounced among the younger subjects aged 65-74 years. For disability, those who had been receiving regular health checks had lower overall severity scores in both the 65-74 years and 75 years and over age groups. There were no significant differences in the severity scores for those practising health maintenance (watching diet and exercise) in both age groups, but those practising health maintenance tended to have less disability. The percentage of those who were socially active and thought life worth living also decreased with the decline in ADL for both age groups. These psycho-social factors were also associated with a lower overall severity score. A multiple linear regression analysis showed that health checks, social activity and the presence of aspects of life subjectively evaluated as making it worth living (Ikigai) were shown to have statistically significant negative associations with disability when other factors were controlled for.

Reflective intuition: defining A&E nursing.

PubMed

Cook, A

1996-01-01

A&E nurses may develop intuitive feelings about the condition of their patients. A&E nurses are practising reflective intuition, based on experience. Recognition of this skill could raise the professional status of nursing.

Educational agenda for diagnostic error reduction

PubMed Central

Trowbridge, Robert L; Dhaliwal, Gurpreet; Cosby, Karen S

2013-01-01

Diagnostic errors are a major patient safety concern. Although the majority of diagnostic errors are partially attributable to cognitive mistakes, the most effective means of improving clinician cognition in order to achieve gains in diagnostic reliability are unclear. We propose a tripartite educational agenda for improving diagnostic performance among students, residents and practising physicians. This agenda includes strengthening the metacognitive abilities of clinicians, fostering intuitive reasoning and increasing awareness of the role of systems in the diagnostic process. The evidence supporting initiatives in each of these realms is reviewed and a course of future implementation and study is proposed. The barriers to designing and implementing this agenda are substantial and include limited evidence supporting these initiatives and the challenges of changing the practice patterns of practising physicians. Implementation will need to be accompanied by rigorous evaluation. PMID:23764435

School closures during the 2009 influenza pandemic: national and local experiences

PubMed Central

2014-01-01

Background School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives. Methods Data were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data. Results Our review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area. Conclusions The single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries. PMID:24739814

Double blind randomised controlled trial of two different breathing techniques in the management of asthma

PubMed Central

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic‐Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-01-01

Background Previous studies have shown that breathing techniques reduce short acting β2 agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non‐specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. Methods After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Results Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Conclusion Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non‐specific upper body exercises. PMID:16517572

Double blind randomised controlled trial of two different breathing techniques in the management of asthma.

PubMed

Slader, C A; Reddel, H K; Spencer, L M; Belousova, E G; Armour, C L; Bosnic-Anticevich, S Z; Thien, F C K; Jenkins, C R

2006-08-01

Previous studies have shown that breathing techniques reduce short acting beta(2) agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non-specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. After a 2 week run in period, 57 subjects were randomised to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non-specific upper body exercises.

Students' experiences of learning manual clinical skills through simulation.

PubMed

Johannesson, Eva; Silén, Charlotte; Kvist, Joanna; Hult, Håkan

2013-03-01

Learning manual skills is a fundamental part of health care education, and motor, sensory and cognitive learning processes are essential aspects of professional development. Simulator training has been shown to enhance factors that facilitate motor and cognitive learning. The present study aimed to investigate the students' experiences and thoughts about their learning through simulation skills training. The study was designed for an educational setting at a clinical skills centre. Ten third-year undergraduate nursing students performed urethral catheterisation, using the virtual reality simulator UrecathVision™, which has haptic properties. The students practised in pairs. Each session was videotaped and the video was used to stimulate recall in subsequent interviews. The interviews were analysed using qualitative content analysis. The analysis from interviews resulted in three themes: what the students learn, how the students learn, and the simulator's contribution to the students' learning. Students learned manual skills, how to perform the procedure, and professional behaviour. They learned by preparing, watching, practising and reflecting. The simulator contributed by providing opportunities for students to prepare for the skills training, to see anatomical structures, to feel resistance, and to become aware of their own performance ability. The findings show that the students related the task to previous experiences, used sensory information, tested themselves and practised techniques in a hands-on fashion, and reflected in and on action. The simulator was seen as a facilitator to learning the manual skills. The study design, with students working in pairs combined with video recording, was found to enhance opportunities for reflection.

Optimising health care within given budgets: primary prevention of cardiovascular disease in different regions of Sweden.

PubMed

Löfroth, Emil; Lindholm, Lars; Wilhelmsen, Lars; Rosén, Måns

2006-01-01

This study investigated the consequences of applying strict health maximisation to the choice between three different interventions with a defined budget. We analysed three interventions of preventing cardiovascular diseases, through doctor's advice on smoking secession, through blood-pressure-lowering drugs, and through lipid-lowering drugs. A state transition model has been used to estimate the cost-utility ratios for entire population in three different county councils in Sweden, where the populations were stratified into mutually excluding risk groups. The incremental cost-utility ratios are being presented in a league table and combined with the local resources and the local epidemiological data as a proxy for need for treatment. All interventions with an incremental cost-utility ratio exceeding the threshold ratios are excluded from being funded. The threshold varied between 1687 Euro and 6192 Euro. The general reallocation of resources between the three interventions was a 60% reduction of blood-pressure-lowering drugs with redistribution of resources to advice on smoking secession and to lipid-lowering drugs. One advantage of this method is that the results are very concrete. Recommendations can thereby be more precise which hopefully will create a public debate between decision-makers, practising physicians and patient groups.

Tissue tropism, pathology and pathogenesis of enterovirus infection.

PubMed

Muehlenbachs, Atis; Bhatnagar, Julu; Zaki, Sherif R

2015-01-01

Enteroviruses are very common and cause infections with a diverse array of clinical features. Enteroviruses are most frequently considered by practising pathologists in cases of aseptic meningitis, encephalitis, myocarditis and disseminated infections in neonates and infants. Congenital infections have been reported and transplacental transmission is thought to occur. Although skin biopsies during hand, foot and mouth disease are infrequently obtained, characteristic dermatopathological findings can be seen. Enteroviruses have been implicated in lower respiratory tract infections. This review highlights histopathological features of enterovirus infection and discusses diagnostic modalities for formalin-fixed paraffin-embedded tissues and their associated pitfalls. Immunohistochemistry can detect enterovirus antigen within cells of affected tissues; however, assays can be non-specific and detect other viruses. Molecular methods are increasingly relied upon but, due to the high frequency of asymptomatic enteroviral infections, clinical-pathological correlation is needed to determine significance. Of note, diagnostic assays on central nervous system or cardiac tissues from immunocompetent patients with prolonged disease courses are most often negative. Histopathological, immunohistochemical and molecular studies performed on clinical specimens also provide insight into enteroviral tissue tropism and pathogenesis. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

[Mór Károlyi was born 150 years ago].

PubMed

Labádi, Lajos

2015-01-01

Dr. Mór Károlyi was born in Szentes (County Csongrád, South-East Hungary) in 1865 in a Jewish family. His original name was Móric Czukkermann--the name was changed to Mór Károlyi in 1883. Károlyi got his medical degree in 1889 at the Budapest Medical University. During his studies he was the student of József Arkövy, the founder of the Hungarian scientific dentistry. Károlyi later practised in Vienna from 1893 up to 1938. His main lines were the etiology of the diseases of the parodontal area and prosthetics. Thanks to his special method of treating traumatic parodontal diseases he made an international reputation. In 1932 he won the membership of the International Academy of Odontology (Buenos Aires). One of his etiological discoveries is still called Károlyi-effect in international terminology. After the so called Anschluss, Károlyi had to escape from Vienna. In 1938 he settled back to his native city, Szentes. In 1944, being a Jew he was first internated, then deported to Theresienstadt. He died a few days after the liberation of the camp, 17th May 1945.

Meditation for adults with haematological malignancies.

PubMed

Salhofer, Ines; Will, Andrea; Monsef, Ina; Skoetz, Nicole

2016-02-03

Malignant neoplasms of the lymphoid or myeloid cell lines including lymphoma, leukaemia and myeloma are referred to as haematological malignancies. Complementary and alternative treatment options such as meditation practice or yoga are becoming popular by treating all aspects of the disease including physical and psychological symptoms. However, there is still unclear evidence about meditation's effectiveness, and how its practice affects the lives of haematologically-diseased patients. This review aims to assess the benefits and harms of meditation practice as an additional treatment to standard care for adults with haematological malignancies. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 8, 2015), MEDLINE (1950 to August 2015), databases of ongoing trials, the metaRegister of Controlled Trials (mRCT) (http://www.controlled-trials.com/mrct/), conference proceedings of annual meetings of: the American Society of Hematology; American Society of Clinical Oncology; European Hematology Association; European Congress for Integrative Medicine; and Global Advances in Health and Medicine (2010 to 2015). We included randomised controlled trials (RCTs) using meditation practice for adult patients with haematological malignancies. Two review authors independently extracted data from eligible studies and assessed the risk of bias according to predefined criteria. We evaluated quality of life and depression. The other outcomes of overall survival, anxiety, fatigue, quality of sleep and adverse events could not be evaluated, because they were not assessed in the included trial. We included only one small trial published as an abstract article. The included study investigated the effects of meditation practice on patients newly hospitalised with acute leukaemia. Ninety-one participants enrolled in the study, but only 42 participants remained in the trial throughout the six-month follow-up period and were eligible for analysis. There was no information provided about the average age and sex of the study population. We found a high risk for attrition bias and unclear risk for reporting bias, performance and detection bias because of missing data due to abstract publication only, thus we judged the overall risk of bias as high. According to the GRADE criteria, we judged the overall quality of the body of evidence for all predefined outcomes as 'very low', due to the extent of missing data on the study population, and the small sample size.As the abstract publication did not provide numbers and results except P values, we are not able to give more details.Meditation practice might be beneficial for the quality of life of haematologically-diseased patients, with higher scores for participants in the mediation arms compared to the participants in the usual care control group (low quality of evidence). Levels of depression decreased for those practising meditation in both the spiritually-framed meditation group and the secularly-focused meditation group in comparison to the usual care control group, whose levels of depression remained constant (low quality of evidence). The influence of meditation practice on overall survival, fatigue, anxiety, quality of sleep and adverse events remained unclear, as these outcomes were not evaluated in the included trial. To estimate the effects of meditation practice for patients suffering from haematological malignancies, more high quality randomised controlled trials are needed. At present there is not enough information available on the effects of meditation in haematologically-diseased patients to draw any conclusion.

Report on neglect sparks FtP hearings.

PubMed

2015-07-22

A major review of neglect of older people has led to three nurses being removed from the register and a further six being involved in fitness to practise hearings, the Nursing and Midwifery Council said.

How to refer to people with disease in research outputs: The disconnection between academic practise and that preferred by people with multiple sclerosis.

PubMed

Baker, David; Anandhakrishnan, Ananthi; Tuite-Dalton, Katie A; Lockart-Jones, Hazel; Middleton, Rodden M; Ford, David V; Crowe, Christina; Giovannoni, Gavin

2016-11-01

Increasingly, Government and Charity funders require public engagement in research. Invariably these research outputs describe the condition of someone with the disease of interest. We therefore sought to identify the preferred descriptor of someone with a disease, such as multiple sclerosis (MS) and to determine what descriptors are currently used by academics. Several surveys were undertaken: one from the Research Network of the MS Society (MSSRN), a major MS Charity within the United Kingdom, who are involved in reviewing grant applications, priority setting and research governance (n=146), and surveys from both the United Kingdom MS register (MSR; n=1713) and the North American Research Committee on Multiple Sclerosis (NARCOMS) registry (n=518). People were asked to rate descriptors of someone affected with MS. These were compared to that used by academic experimenters in basic science and clinical science research papers. Although the frequency of responses varied between surveys the overall findings showed many consistencies. This included use of person/people with MS (pwMS) as the preferred descriptor for someone with MS for social media and scientific publications. This was the preferred choice in about 55-60% people from the MRS and in over 70% in the NARCOMS and the MSSRN, respectively. Although MSer was the second preferred-choice for use in social media, there was as a large range of preferences from the 'most-preferred' to the 'most-disliked.' This reflected an earlier survey by UK-based research blogs using the term MSer (n=173). In contrast, pwMS had few 'dislikes' and results were skewed towards the 'liked' and 'most-preferred' choices. Client and sufferer were generally disliked terms, although there was some regional variation in levels of choice. Patient was generally seen as a neutral term that was neither strongly liked nor disliked. However, patient gained more public support for use within scientific publications (~20-25%) compared to social media (~10-15%). This descriptor was however most commonly used (98-99%) within both pre-clinical (searched in 6-month output of preclinical autoimmune MS models; n=161) and in clinical publications (specialist MS journals; n=220), whereas pwMS was not reported in over 75% of papers published in some specialised MS journals, and did not appear in the pre-clinical animal studies examined. There is a clear disconnection between preferences by individuals living with MS and current academic practise. As pwMS are increasingly reading primary research publications and are involved in patient and public involvement in research and grant review activities, the sensitivities of lay readers should be considered when writing research outputs. This issue may affect other diseases and a change in writing style could be adopted to show that we respect the wishes of the people that we study and wish to help. Copyright © 2016 Elsevier B.V. All rights reserved.

Lime Juice and Vinegar Injections as a Cheap and Natural Alternative to Control COTS Outbreaks.

PubMed

Moutardier, Grégoire; Gereva, Sompert; Mills, Suzanne C; Adjeroud, Mehdi; Beldade, Ricardo; Ham, Jayven; Kaku, Rocky; Dumas, Pascal

2015-01-01

Outbreaks of the corallivorous crown-of-thorns seastar Acanthaster planci (COTS) represent one of the greatest disturbances to coral reef ecosystems in the Indo-Pacific, affecting not only coral reefs but also the coastal communities which rely on their resources. While injection approaches are increasingly used in an attempt to control COTS densities, most of them display severe drawbacks including logistical challenges, high residual environmental impacts or low cost-effectiveness. We tested a new alternative control method based upon acidic injections of cheap, 100% natural products. We investigated the lethal doses, intra- and inter-specific disease transmission and immune responses of COTS when injected with fresh lime juice (extracted from local Citrus arantifolia) and white spirit vinegar. High COTS mortality was achieved with small volumes: 10-20 ml per seastar induced death in 89%/97% of injected specimens after an average 34.3 h/29.8 h for lime juice and vinegar respectively. Highest efficiency was reached for both solutions with double shots of (2 × 10 ml) in two different areas on the body: 100% mortality occurred within 12-24 h, which is similar or faster compared with other current injection methods. Multiple immune measures suggested that death was very likely caused by pH stress from the acidic solutions rather than a bacterial infection. Contagion to either conspecifics or a variety of other reef species was not observed, even at COTS densities 15 times higher than the highest naturally reported. 10 to 20 l lime juice/vinegar could kill up to a thousand COTS at a cost of less than 0.05 USD per specimen; no permits or special handling procedures are required. We conclude that injections of lime juice and vinegar offer great advantages when compared to current best practises and constitute a cheap and natural option for all reefs affected by COTS.

Lime Juice and Vinegar Injections as a Cheap and Natural Alternative to Control COTS Outbreaks

PubMed Central

Moutardier, Grégoire; Gereva, Sompert; Mills, Suzanne C.; Adjeroud, Mehdi; Beldade, Ricardo; Ham, Jayven; Kaku, Rocky; Dumas, Pascal

2015-01-01

Outbreaks of the corallivorous crown-of-thorns seastar Acanthaster planci (COTS) represent one of the greatest disturbances to coral reef ecosystems in the Indo-Pacific, affecting not only coral reefs but also the coastal communities which rely on their resources. While injection approaches are increasingly used in an attempt to control COTS densities, most of them display severe drawbacks including logistical challenges, high residual environmental impacts or low cost-effectiveness. We tested a new alternative control method based upon acidic injections of cheap, 100% natural products. We investigated the lethal doses, intra- and inter-specific disease transmission and immune responses of COTS when injected with fresh lime juice (extracted from local Citrus arantifolia) and white spirit vinegar. High COTS mortality was achieved with small volumes: 10–20 ml per seastar induced death in 89%/97% of injected specimens after an average 34.3 h/29.8 h for lime juice and vinegar respectively. Highest efficiency was reached for both solutions with double shots of (2 × 10 ml) in two different areas on the body: 100% mortality occurred within 12–24 h, which is similar or faster compared with other current injection methods. Multiple immune measures suggested that death was very likely caused by pH stress from the acidic solutions rather than a bacterial infection. Contagion to either conspecifics or a variety of other reef species was not observed, even at COTS densities 15 times higher than the highest naturally reported. 10 to 20 l lime juice/vinegar could kill up to a thousand COTS at a cost of less than 0.05 USD per specimen; no permits or special handling procedures are required. We conclude that injections of lime juice and vinegar offer great advantages when compared to current best practises and constitute a cheap and natural option for all reefs affected by COTS. PMID:26356840

Effects of hand-training in persons with myotonic dystrophy type 1--a randomised controlled cross-over pilot study.

PubMed

Aldehag, Anna; Jonsson, Hans; Lindblad, Jan; Kottorp, Anders; Ansved, Tor; Kierkegaard, Marie

2013-10-01

To investigate the effects of a hand-training programme on grip, pinch and wrist force, manual dexterity and activities of daily living, in adults with myotonic dystrophy type 1 (DM1). In this randomised controlled trial with a crossover design, 35 adults with DM1 were, after stratification for grip force, assigned by lot to two groups. Group A started with 12 weeks of hand training, while group B had no intervention. After a wash-out period of 12 weeks, where none received training, the order was reversed. The Grippit® was used as primary outcome measure and the hand-held Microfet2™ myometer, the Purdue Pegboard, the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS) were secondary outcome measures. Assessments were performed before and after training and control periods, i.e. four times altogether. Ten persons dropped out and 13 had acceptable adherence. Intention-to-treat analyses revealed significant intervention effects for isometric wrist flexor force (p = 0.048), and for COPM performance (p = 0.047) and satisfaction (p = 0.027). On an individual level, improvements were in general showed after a training period. The hand-training programme had positive effects on wrist flexor force and self-perception of occupational performance, and of satisfaction with performance. No evident detrimental effects were shown. Myotonic dystrophy type 1 (DM1) is a slowly progressive neuromuscular disease characterised by myotonia and muscle weakness and wasting. People with DM1 are often concerned about their ability to carry out ADL and to participate in, e.g. work, sports and hobbies when they gradually become weaker. This pilot study showed that a hand-training programme improved wrist flexor force and self-perception and satisfaction of occupational performance. Resistance training of hand muscles with a silicon-based putty can be a therapy option for people with DM1 in clinical practise.

NMC denies prioritising new FtP cases to meet government target.

PubMed

Osborne, Katie

2015-01-27

The Nursing and Midwifery Council's success in reducing the time it takes to handle fitness to practise cases has not been achieved by neglecting older cases, according to its chief executive Jackie Smith.

Expanding collaborative care: integrating the role of dietitians and nutrition interventions in services for people with mental illness.

PubMed

Teasdale, Scott B; Latimer, Geogina; Byron, Annette; Schuldt, Vanessa; Pizzinga, Josephine; Plain, Janice; Buttenshaw, Kerryn; Forsyth, Adrienne; Parker, Elizabeth; Soh, Nerissa

2018-02-01

This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change. Selective narrative review. Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings. Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.

How and when do students use flashcards?

PubMed

Wissman, Kathryn T; Rawson, Katherine A; Pyc, Mary A

2012-01-01

Previous survey research has documented students' use of self-regulated study strategies, with a particular interest in self-testing. These surveys indicate that students frequently use flashcards to self-test and that self-testing is primarily used as a way to monitor learning. Whereas previous surveys provide information about whether and why students self-test, they provide minimal information about how and when students choose to self-test. Accordingly, the primary purpose of the current survey was to explore how and when students engage in self-testing. We surveyed 374 undergraduates about the amount of practice and the timing of practice, two factors that strongly affect the efficacy of self-testing. Results indicate that students understand the benefits of practising to higher criterion levels (amount of practice) but do not typically implement or understand the benefits of practising with longer lags (timing of practice). We discuss practical implications for supporting more successful student learning.

Long-term care planning study: strengths and learning needs of nursing staff.

PubMed

Cruttenden, Kathleen E

2006-01-01

This planning study was designed and conducted in a predominantly rural Canadian province to examine the strengths and learning needs of four categories of nursing staff practising in New Brunswick nursing homes. Participants included directors of care, registered nurses, licensed practical nurses, and resident attendants. The nursing homes ranged in size from 38 to 196 beds and were located throughout the province. In health and planning studies, ethnography conveys a coherent statement of peoples' local knowledge as culture-sharing groups (Muecke, 1994). The study derived information from the Nursing Home Act, reports, the literature, key informants, and direct observations of and interviews with participants. Leadership strengths defined the roles for categories of staff and supported the capacity of each category to identify their learning needs. In conclusion, nurses practising in nursing homes can and must take an active role in decision making for their learning.

Lifelong learning skills: how experienced are students when they enter medical school?

PubMed

Whittle, Sue R; Murdoch-Eaton, Deborah G

2004-09-01

Widening participation initiatives together with changes in school curricula in England may broaden the range of lifelong learning skills experience of new undergraduates. This project examines the experience levels of current students, as a comparative baseline. First-year medical students completed a questionnaire on arrival, investigating their practice of 31 skills during the previous two years. Responses show that most students have regularly practised transferable skills. However, significant numbers report little experience, particularly in IT skills such as email, using the Internet, spreadsheets and databases. Some remain unfamiliar with word processing. Library research, essay writing and oral presentation are also rarely practised by substantial numbers. One-third of students lack experience of evaluating their own strengths and weaknesses. Current students already show diversity of experience in skills on arrival at medical school. Changes in the near future may increase this range of experience further, and necessitate changes to undergraduate courses.

Scaling ethics up and down: moral craft in clinical genetics and in global health research

PubMed Central

Parker, Michael

2015-01-01

This paper engages with the question of what it is to ‘do good medical ethics’ in two ways. It begins with an exploration of what it might mean to say that health professionals practise good medical ethics as part of practising good ethical medicine. Using the example of the Genethics Club, a well-established national ethics forum for genetics professionals in the UK, the paper develops an account of moral craftsmanship grounded in the concepts of shared moral commitments and practices, moral work, ethics and living morality. In the light of this discussion, the paper goes on to consider what it might mean for a specialist in medical ethics, a bioethicist, to do good medical ethics. Finally, a research agenda focusing on the challenges of thinking about good medical ethics in a global context and a proposal for an innovative approach to bioethics methodology is outlined. PMID:25516955

An audit of NICE guidelines on antenatal pelvic floor exercises.

PubMed

Ismail, Sharif I M F

2009-12-01

The National Institute for Health and Clinical Excellence (NICE) recommends antenatal pelvic floor exercises during first pregnancy to reduce postpartum stress incontinence. The aim of this audit was to assess patient awareness and compliance with this guideline. An anonymous self-constructed questionnaire was given to patients after their first delivery. A total of 223 questionnaires were returned over a 6-month period. Although 95% of patients were aware of the importance of pelvic floor exercises, only a limited proportion of them had the right information and a minority practised them. Printed material seemed to be very influential in getting the message across. The importance of giving information early in pregnancy and national awareness was shown in the suggestions for improvement. Patient awareness and actual practise of antenatal pelvic floor exercises did not meet NICE guidelines, calling for strategies to improve awareness and adherence.

The English patient in post-colonial perspective, or practising surgery on the poms.

PubMed

Wilde, Sally

2005-04-01

Drawing on interviews with Australasian surgeons who trained in the 1950s and 1960s, this article discusses where, and on whom, they practised the manual skills involved in surgery, In the twentieth century, elite Australasian surgeons emphasized the importance of the science of surgery and the lengthy experience needed to acquire surgical judgement, and these concerns are reflected in the accreditation procedures adopted by the Royal Australasian College of Surgeons. However, trainee surgeons also ha to acquire th manual skills that they needed in the operating theatre. The rhetoric of training emphasized the intellectual skills needed in surgery, but in reality the manual skills remained important, and there was also a fascination with the drama and stress involved in operating. In this era, British and Australasian surgical training were closely linked and many Australasian surgeons gained significant cutting experience in Britain.

Missing people, migrants, identification and human rights.

PubMed

Nuzzolese, E

2012-11-30

The increasing volume and complexities of migratory flow has led to a range of problems such as human rights issues, public health, disease and border control, and also the regulatory processes. As result of war or internal conflicts missing person cases and management have to be regarded as a worldwide issue. On the other hand, even in peace, the issue of a missing person is still relevant. In 2007 the Italian Ministry of Interior nominated an extraordinary commissar in order to analyse and assess the total number of unidentified recovered bodies and verify the extent of the phenomena of missing persons, reported as 24,912 people in Italy (updated 31 December 2011). Of these 15,632 persons are of foreigner nationalities and are still missing. The census of the unidentified bodies revealed a total of 832 cases recovered in Italy since the year 1974. These bodies/human remains received a regular autopsy and were buried as 'corpse without name". In Italy judicial autopsy is performed to establish cause of death and identity, but odontology and dental radiology is rarely employed in identification cases. Nevertheless, odontologists can substantiate the identification through the 'biological profile' providing further information that can narrow the search to a smaller number of missing individuals even when no ante mortem dental data are available. The forensic dental community should put greater emphasis on the role of the forensic odontology as a tool for humanitarian action of unidentified individuals and best practise in human identification.

Latino mothers' beliefs about child weight and family health.

PubMed

Martinez, Suzanna M; Rhee, Kyung E; Blanco, Estela; Boutelle, Kerri

2017-04-01

There is a need to address cultural beliefs and parenting practices regarding childhood obesity to design effective weight-control programmes for overweight/obese US Latino children. The purpose of the current study was to explore cultural beliefs about children's weight, understand parent perceptions on feeding their children, and explore barriers that interfere with a healthy lifestyle. Four focus groups were conducted in Spanish with forty-one Latino mothers of elementary school-age children from San Diego County, California between April and May 2011. Cultural viewpoints about overweight status among children and barriers to leading a healthy lifestyle were explored. Focus group discussions were analysed based on a priori and emergent themes. Three themes were identified: (i) mothers' cultural beliefs about health that are barriers to family health; (ii) mothers as primary caretakers of their family's health; and (iii) attitudes about targeting children's weight. Mothers acknowledged the idea that 'chubby is better' is a misperception, yet having a 'chubby' child was preferred and even accepted. Mothers described fatalistic beliefs that contradicted existing knowledge of chronic disease and daily demands of Western culture as barriers to practising healthy behaviours in the home as the family caretaker. These findings may be used to inform more culturally appropriate research to address US Latino health. Increasing awareness of cultural beliefs and daily circumstance could help to address obesity more directly and thereby overcome some of the potential underlying barriers that might exist when involving the Latino immigrant families in obesity treatment and prevention.

Common errors of drug administration in infants: causes and avoidance.

PubMed

Anderson, B J; Ellis, J F

1999-01-01

Drug administration errors are common in infants. Although the infant population has a high exposure to drugs, there are few data concerning pharmacokinetics or pharmacodynamics, or the influence of paediatric diseases on these processes. Children remain therapeutic orphans. Formulations are often suitable only for adults; in addition, the lack of maturation of drug elimination processes, alteration of body composition and influence of size render the calculation of drug doses complex in infants. The commonest drug administration error in infants is one of dose, and the commonest hospital site for this error is the intensive care unit. Drug errors are a consequence of system error, and preventive strategies are possible through system analysis. The goal of a zero drug error rate should be aggressively sought, with systems in place that aim to eliminate the effects of inevitable human error. This involves review of the entire system from drug manufacture to drug administration. The nuclear industry, telecommunications and air traffic control services all practise error reduction policies with zero error as a clear goal, not by finding fault in the individual, but by identifying faults in the system and building into that system mechanisms for picking up faults before they occur. Such policies could be adapted to medicine using interventions both specific (the production of formulations which are for children only and clearly labelled, regular audit by pharmacists, legible prescriptions, standardised dose tables) and general (paediatric drug trials, education programmes, nonpunitive error reporting) to reduce the number of errors made in giving medication to infants.

Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

PubMed

Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Al-Meer, Nabila; Abdulmalik, Mariam; Singh, Rajvir; Chaudhry, Sofia; Fung, Tak

2015-01-22

Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ(2) tests and multivariate logistic regression analyses. Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?

PubMed Central

Donnelly, Tam Truong; Al Khater, Al-Hareth; Al Kuwari, Mohamed Ghaith; Al-Bader, Salha Bujassoum; Al-Meer, Nabila; Abdulmalik, Mariam; Singh, Rajvir; Chaudhry, Sofia; Fung, Tak

2015-01-01

Objectives Breast cancer incidence rates are rising in Qatar. Although the Qatari government provides subsidised healthcare and screening programmes that reduce cost barriers for residents, breast cancer screening (BCS) practices among women remain low. This study explores the influence of socioeconomic status on BCS among Arab women in Qatar. Setting A multicentre, cross-sectional quantitative survey was conducted with 1063 Arab women (87.5% response rate) in Qatar from March 2011 to July 2011. Women who were 35 years or older and had lived in Qatar for at least 10 years were recruited from seven primary healthcare centres and women's health clinics in urban and semiurban regions of Qatar. Associations between socioeconomic factors and BCS practice were estimated using χ2 tests and multivariate logistic regression analyses. Results Findings indicate that less than one-third of the participants practised BCS appropriately, whereas less than half of the participants were familiar with recent BCS guidelines. Married women and women with higher education and income levels were significantly more likely to be aware of and to practise BCS than women who had lower education and income levels. Conclusions Findings indicate low levels of awareness and low participation rates in BCS among Arab women in Qatar. Socioeconomic factors influence these women's participation in BCS activities. The strongest predictors for BCS practice are higher education and higher income levels. Recommendations Additional research is needed to explore the impact of economic factors on healthcare seeking behaviours in the Middle Eastern countries that have a high national gross domestic product where healthcare services are free or heavily subsidised by the government; promotion of BCS and intervention strategies in these countries should focus on raising awareness about breast cancer, the cost and benefit of early screening for this disease, particularly among low-income women. PMID:25613951

Isolation and characterization of pathogenic Vibrio alginolyticus from sea cage cultured cobia (Rachycentron canadum (Linnaeus 1766)) in India.

PubMed

Rameshkumar, P; Nazar, A K A; Pradeep, M A; Kalidas, C; Jayakumar, R; Tamilmani, G; Sakthivel, M; Samal, A K; Sirajudeen, S; Venkatesan, V; Nazeera, B M

2017-11-01

Mass mortalities of cobia, Rachycentron canadum, sub-adults occurred during August 2013 in cage culture in the Gulf of Mannar, Mandapam Tamil Nadu, India. The epizootic of disease was started with typical classical clinical signs followed by acute mortality. Grossly, severe haemorrhage and congestion were observed in the gastric mucosa. The abdomen was distended with peritoneal fluid. The heart revealed haemopericardium and fibrinous pericardium. Histologically, the gastric mucosa showed severe erosion and necrosis. Haemorrhagic pericarditis and an increased size of the melano macrophage centre (MMC) in the tail kidney were other histopathological changes. Vibrio sp. was isolated from the gastric lesions and heart blood swab of moribund fishes and it was found to be virulent to the cobia fingerlings. After the challenge, the same bacterium could be re-isolated from moribund fingerlings. The 16S ribosomal RNA of the isolate was amplified and blast analysis of the sequence confirmed that the pathogen was Vibrio alginolyticus. The confirmation was also correlated with its cultural, biochemical and pathomorphological changes. This is the second report and the first incidence of epizootics with severe pathological lesions in cultured cobia in India. The study throws light on the pathology of vibriosis. By practising cage farm management measures, occurrences of infection may be prevented. The epizootics of vibriosis caused serious economic losses to farmers. Natural blooms of the pathogen can be prevented by sea cage management measures such as, changing the inner net of the cages, changing the location of the cages to relatively clean water (about 50 m apart) from the affected site and providing shade over the cages while the water temperature rises. Supplementation of the feed with immunostimulants and mineral mixture may be practised to improve the immune response against infection. Early diagnosis and sea cage management measures may prevent occurrences of the infection. © 2017 The Society for Applied Microbiology.

Opting for rural practice: the influence of medical student origin, intention and immersion experience.

PubMed

Playford, Denese; Ngo, Hanh; Gupta, Surabhi; Puddey, Ian B

2017-08-21

To compare the influence of rural background, rural intent at medical school entry, and Rural Clinical School (RCS) participation on the likelihood of later participation in rural practice. Analysis of linked data from the Medical School Outcomes Database Commencing Medical Students Questionnaire (CMSQ), routinely collected demographic information, and the Australian Health Practitioner Regulation Agency database on practice location. University of Western Australia medical students who completed the CMSQ during 2006-2010 and were practising medicine in 2016. Medical practice in rural areas (ASGC-RAs 2-5) during postgraduate years 2-5. Full data were available for 508 eligible medical graduates. Rural background (OR, 3.91; 95% CI, 2.12-7.21; P < 0.001) and experience in an RCS (OR, 1.93; 95% CI, 1.05-3.54; P = 0.034) were significant predictors of rural practice in the multivariate analysis of all potential factors. When interactions between intention, origin, and RCS experience were included, RCS participation significantly increased the likelihood of graduates with an initial rural intention practising in a rural location (OR, 3.57; 95% CI, 1.25-10.2; P = 0.017). The effect of RCS participation was not significant if there was no pre-existing intention to practise rurally (OR, 1.38; 95% CI, 0.61-3.16; P = 0.44). For students who entered medical school with the intention to later work in a rural location, RCS experience was the deciding factor for realising this intention. Background, intent and RCS participation should all be considered if medical schools are to increase the proportion of graduates working rurally.

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.

Soil salinisation and irrigation management of date palms in a Saharan environment.

PubMed

Haj-Amor, Zied; Ibrahimi, Mohamed-Khaled; Feki, Nissma; Lhomme, Jean-Paul; Bouri, Salem

2016-08-01

The continuance of agricultural production in regions of the world with chronic water shortages depends upon understanding how soil salinity is impacted by irrigation practises such as water salinity, irrigation frequency and amount of irrigation. A two-year field study was conducted in a Saharan oasis of Tunisia (Lazala Oasis) to determine how the soil electrical conductivity was affected by irrigation of date palms with high saline water. The study area lacked a saline shallow water table. Field results indicate that, under current irrigation practises, soil electrical conductivity can build up to levels which exceed the salt tolerance of date palm trees. The effects of irrigation practises on the soil electrical conductivity were also evaluated using model simulations (HYDRUS-1D) of various irrigation regimes with different frequencies, different amounts of added water and different water salinities. The comparison between the simulated and observed results demonstrated that the model gave an acceptable estimation of water and salt dynamics in the soil profile, as indicated by the small values of root mean square error (RMSE) and the high values of the Nash-Sutcliffe model efficiency coefficient (NSE). The simulations demonstrated that, under field conditions without saline shallow groundwater, saline irrigation water can be used to maintain soil electrical conductivity and soil water content at safe levels (soil electrical conductivity <4 dS m(-1) and soil water content >0.04 cm(3) cm(-3)) if frequent irrigations with small amounts of water (90 % of the evapotranspiration requirements) were applied throughout the year.

Does medical student willingness to practise peer physical examination translate into action?

PubMed

Chen, Julie Y; Yip, Amber L M; Lam, Cindy L K; Patil, Nivritti G

2011-01-01

Peer physical examination (PPE) is commonly used in clinical skills teaching to allow students to practice physical examination techniques on each other. Previous studies have demonstrated medical students' generally positive attitudes towards PPE, but the correlation between student attitude and actual practice of PPE has yet to be examined. To determine if a positive student attitude towards PPE leads to subsequent action. The target population were MBBS I students (2006-2007 cohort) admitted to the Li Ka Shing Faculty of Medicine, The University of Hong Kong. Student attitude towards PPE and subsequent practice of PPE were assessed through self-completed written questionnaires before and after the compulsory Clinical Skills Programme (CSP). A total of 100/128 (78%) students completed both questionnaires, of which 83 (65%) could be linked to demographic data. All study participants were ethnically Chinese. A high level of willingness to conduct PPE persisted before and after the CSP for both male and female students. However, more than half of the students did not subsequently examine various non-intimate body regions of a fellow student during the CSP. Female students were more likely to exhibit attitude-behaviour inconsistency. The existing positive attitudes towards PPE need to be harnessed so that more students are encouraged to follow through and actually practise PPE, thus realizing the educational benefits of this activity. This may be done by ensuring that PPE is conducted in a safe setting while being conscientious of gender differences. Scheduled time and the use of a logbook may be useful to facilitate students practising PPE.

Educational priorities and current involvement in genetic practice: a survey of midwives in the Netherlands, UK and Sweden.

PubMed

Benjamin, Caroline M; Anionwu, Elizabeth N; Kristoffersson, Ulf; ten Kate, Leo P; Plass, Anne Marie C; Nippert, Irmgard; Julian-Reynier, Claire; Harris, Hilary J; Schmidtke, Joerg; Challen, Kirsty; Calefato, Jean Marc; Waterman, Christine; Powell, Eileen; Harris, Rodney

2009-10-01

to investigate whether practising midwives are adequately prepared to integrate genetic information into their practice. a cross-sectional, postal, structured questionnaire survey was sent to practising midwives. practising midwives from the Netherlands (NL), Sweden (SE) and the United Kingdom (UK). 1021 replies were received, achieving a response rate of 62%. 79% (799/1015) of midwives reported attending courses with some 'genetic content' during their initial training. Sixty-eight per cent (533/784) judged this to have been useful for clinical practice. Variation was seen between countries in the amount of genetic content in post-registration training (SE 87%, NL 44%, UK 17%) and most was considered useful. Questions assessing clinical activity identified a current need for genetic knowledge. Midwives described low levels of self-reported confidence both in overtly genetic procedures and in everyday tasks that were underpinned by genetic knowledge. For eight of the 12 procedures, fewer than 20% of midwives considered themselves to be confident. Differences were apparent between countries. Midwives identified psychosocial, screening and risk assessment aspects of genetic education as being important to them, rather than technical aspects or genetic science. given the low reported confidence with genetic issues in clinical practice, it is essential that this is addressed in terms of the amount, content and targeting of genetic education. This is especially important to ensure the success of national antenatal and baby screening programmes. The results of this study suggest that midwives would welcome further training in genetics, addressing genetic topics most relevant to their clinical practice.

The experiences of internationally educated nurses in the southeastern United States of America.

PubMed

Wheeler, R M; Foster, J W; Hepburn, K W

2013-09-01

US healthcare facilities have addressed nursing shortages in part by recruiting internationally educated nurses (IENs), and studies suggest IENs may make up a significant percentage of the nursing workforce in urban hospitals. Despite the economic recession of 2008-2012, international nurse migration is expected to continue. Little is known about IENs in the southeastern USA, and no studies have compared their perspectives to those of their US counterparts. The purpose of this study was to gain a deeper understanding about the experiences of IENs compared to those of US registered nurses (RNs) practising in two urban hospitals in southeastern USA. This study involved two rounds of semi-structured interviews of 82 IENs and US RNs. Interviews focused on themes relating to education, barriers to practice, intent to stay in nursing and IENs' migration experiences. Most IENs interviewed migrated to the USA after 1990 to join their family and do not plan to return to their home countries to practise. Most IENs initially received their Associate Degree in Nursing; many have obtained their Bachelor of Science in Nursing degree. IENs and newly licensed US RNs faced similar barriers when they began practising in the USA, but IENs faced additional challenges adjusting to the attitudes of US patients, the perceived lack of respect for nurses and delivering total patient care. IENs would benefit from orientation regarding the cultural differences in the USA. In other ways, their challenges are similar to those of US RNs; policies regarding education, recruitment and retention could target both groups together. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

Can early physical therapy positively affect the onset of independent walking in infants with Down syndrome? A retrospective cohort study.

PubMed

Corrado, Bruno; Sommella, Nadia; Ciardi, Gianluca; Raiano, Enza; Scala, Iris; Strisciuglio, Pietro; Servodio Iammarrone, Clemente

2018-02-19

The development of both gross and fine motor skills in a child with Down syndrome is generally delayed. The most seriously affected stage is the achievement of independent walking ability, which influences the onset of all following motor and cognityive skills. The study objectives were (a) to assess the time taken to achieve independent walking ability in a cohort of children with Down syndrome, (b) to examine differences in walking onset by patient characteristics, (c) to verify the effect of early physical therapy (Neurodevelopmental Treatment on the basis of Bobath Concept practised within the first months of life) in the achievement of that skill. A retrospective study was carried out on a cohort of 86 children with Down Syndrome. The knowledge of the exact age of walking onset and information about comorobities and rehabilitation practised since birth were the eligibility criteria. The average age at which walking began in the sample was 26 months (Standard Deviation = 9.66). Some patient characteristics proved to be related negatively to the walking onset: gender male, trisomy 21, improved joint ligamentous laxity. When practised, early physical therapy was able to contrast the delay in walking. NDT-Bobath is a well-known and valid instrument for a child with Down syndrome to attain his highest possible psychomotor functioning level. This study pointed out for the first time ever its capability to contrast the delay on walking onset, which can influences positively the development of the following motor and cognitive skills.

Under scrutiny: Midwives' experience of intrapartum transfer from home to hospital within the context of a planned homebirth in Western Australia.

PubMed

Ball, Colleen; Hauck, Yvonne; Kuliukas, Lesley; Lewis, Lucy; Doherty, Dorota

2016-06-01

Women's experience of homebirth has been a focus of research, with limited international research and no Australian evidence of the experiences of midwives in relation to their experience of intrapartum transfers within the context of a planned homebirth. To explore the experience of Western Australian midwives involved in an intrapartum transfer from home to hospital. A descriptive phenomenological study was conducted. Women who elect to have a homebirth in Western Australia have the choice of care from privately practising midwives or a publicly funded program. Midwives who were currently practising or had practised within the past three years and experienced an intrapartum transfer were invited to participate. In-depth interviews were conducted with 13 midwives and data analysed using the Stevick-Colaizzi-Keen method. Analysis revealed an overarching theme "under scrutiny" which captured four themes: "decision to transfer: getting the timing right"; "reception at the hospital: welcoming or not"; "maintaining continuity of carer" and "reflections: coming to terms with the experience". The decision to transfer to hospital represents a profound shift in expectations for the woman and midwife that is often not recognised by hospital staff. Intrapartum transfer is a challenging clinical decision for all parties; midwives, women, partners and health services. Increased effort by maternity health professionals to improve communication and collaboration must be a priority to better support women and their partners who make an informed decision to have a planned homebirth. Copyright © 2016 Elsevier B.V. All rights reserved.

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules.

PubMed

MacRae, Rhoda; Rooney, Kevin D; Taylor, Alan; Ritters, Katrina; Sansoni, Julita; Lillo Crespo, Manuel; Skela-Savič, Brigita; O'Donnell, Barbara

2016-07-01

Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare. Copyright © 2016 Elsevier Ltd. All rights reserved.

Going the distance: early results of a distributed medical education initiative for Royal College residencies in Canada.

PubMed

Myhre, Douglas L; Hohman, Stacey

2012-01-01

There is a shortage of specialty physicians practising in rural Canada: only 2.4% of Canadian specialist physicians practise rurally. Numerous strategies have been proposed and attempted that aim to increase the number of rural physicians. These include undergraduate and postgraduate distributed medical education opportunities. The Distributed Royal College Initiative at the University of Calgary is increasing the exposure of specialty residents to rural medicine through regional rotations and electives. An assessment of the initial impacts of this programme was made. Specialty residents were sent a voluntary survey following their regional rotation in academic year 2010-2011. The survey measured each resident's satisfaction with the experience, interest in undertaking another rotation and the impact of the rotation on potential rural practice location. The survey asked for written comments on the rotation. Data were analysed using descriptive statistics. A total of 73% (29) of the 40 eligible residents completed the survey that was distributed upon completion of the rotation. In the survey, 45% of respondents indicated they would have been likely to practise in a regional community prior to the experience. This changed to 76% following the rotation. Analysis of the comments revealed strong positive characteristics of the experience across all disciplines. Specialty-based, rural distributed programmes were perceived by the residents as educationally valuable and may be crucial in helping shift attitudes towards rural practice. Specific successful characteristics of the rotations provide direction to increase their quality further. These findings need to be verified in a larger sample.

Impact of an interprofessional education program on developing skilled graduates well-equipped to practise in rural and underserved areas.

PubMed

Mpofu, Ratie; Daniels, Priscilla S; Adonis, Tracy-Ann; Karuguti, Wallace M

2014-01-01

Poverty, limited access to resources and a lack of infrastructure characterise the division of rural areas from urban South Africa. Low numbers of social welfare professionals compound the problem. With education linked inextricably in social responsibility, higher education institutions (HEIs) are called upon increasingly to create conditions that encourage students and graduates to practise in more socially responsible ways, involving more than mere disciplinary expertise or technical knowledge, and that consider the problems of rural areas. Use of interprofessional education (IPE) programs, based on teamwork, could enable HEIs to train and guide health sciences students in how best to cooperate with each other and combine their skills to mutual benefit. This would enable them to develop professional skills facilitated by interactive engagement within community settings. Referencing experience gained in Australia and elsewhere, the Faculty of Community and Health Sciences (FCHS) at the University of Western Cape (UWC) has developed and applied an IPE program for South Africa. Students were placed in interdisciplinary groups in a rural and underserved municipality of the Western Cape - 17 students participated in a study on the effectiveness of this program. A quantitative self-administered questionnaire, followed by qualitative focus group discussions, established student perceptions of their IPE experience, how the experience influenced their intentions for or against future practice in rural and underserved areas, and their interest in future interprofessional collaboration and practice. More than 75% of the participating students agreed that they had learnt to develop knowledge base, procedural and healthcare practice presentation skills, along with preparing written community health histories. Student willingness to practise in rural areas was evidenced, citing community- and resource-based factors as determinants; however, concerns that some community members had 'own agendas' were expressed. Nearly all students highly appreciated their learning and service delivery development, but 47% felt that their educational experience did not go as far as expected. Student concerns were a lack of structured student placement for IPE to occur in the program, as well as limited staff supervision of students. The UWC FCHS IPE program is evidenced as a valid approach to encouraging health sciences students and graduates to choose to practise in more socially responsible ways. However, improvement of placement and supervision methodology and practice should be explored at faculty level and implemented in future IPE programs.

Predicting fitness to practise events in international medical graduates who registered as UK doctors via the Professional and Linguistic Assessments Board (PLAB) system: a national cohort study.

PubMed

Tiffin, Paul A; Paton, Lewis W; Mwandigha, Lazaro M; McLachlan, John C; Illing, Jan

2017-03-20

International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council's (GMC's) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to predict later educational performance in this group of doctors. It is unknown whether the PLAB system is also a valid predictor of unprofessional behaviour and malpractice. The findings would have implications for regulatory policy. This was an observational study linking data relating to fitness to practise events (referral or censure), PLAB performance, demographic variables and English language competence, as evaluated via the International English Language Test System (IELTS). Data from 27,330 international medical graduates registered with the GMC were analysed, including 210 doctors who had been sanctioned in relation to at least one fitness to practise issue. The main outcome was risk of eventual censure (including a warning). The significant univariable educational predictors of eventual censure (versus no censures or referrals) were lower PLAB part 1 (hazard ratio [HR], 0.99; 95% confidence interval, 0.98 to 1.00) and part 2 scores (HR, 0.94; 0.91 to 0.97) at first sitting, multiple attempts at both parts of the PLAB, lower IELTS reading (HR, 0.79; 0.65 to 0.94) and listening scores (HR, 0.76; 0.62 to 0.93) and higher IELTS speaking scores (HR, 1.28; 1.04 to 1.57). Multiple resits at either part of the PLAB and higher IELTS speaking score (HR, 1.49; 1.20 to 1.84) were also independent predictors of censure. We estimated that the proposed limit of four attempts at both parts of the PLAB would reduce the risk in this entire group by only approximately two censures per 5 years in this group of doctors. Making the PLAB, or any replacement assessment, more stringent and raising the required standards of English reading and listening may result in fewer fitness to practice events in international medical graduates. However, the number of PLAB resits permitted would have to be further capped to meaningfully impact the risk of sanctions in this group of doctors.

Retrospective analysis of census data on general practitioners who qualified in South Asia: who will replace them as they retire?

PubMed Central

Taylor, Donald H; Esmail, Aneez

1999-01-01

Objectives To determine the number and geographical distribution of general practitioners in the NHS who qualified medically in South Asia and to project their numbers as they retire. Design Retrospective analysis of yearly data and projection of future trends. Setting England and Wales. Subjects General practitioners who qualified medically in the countries of Bangladesh, India, Pakistan, and Sri Lanka and who were practising in the NHS on 1 October 1992. Main outcome measures Proportion and age of general practitioners who qualified in South Asia by health authority; the Benzeval and Judge measure of population need at the health authority level. Results 4192 of 25 333 (16.5%) of all unrestricted general practitioners practising full time on 1 October 1992 qualified in South Asian medical schools. The proportion varied by health authority from 0.007% to 56.5%. Roughly two thirds who were practising in 1992 will have retired by 2007; in some health authorities this will represent a loss of one in four general practitioners. The practices that these doctors will leave seem to be in relatively deprived areas as measured by deprivation payments and a health authority measure of population need. Conclusion Many general practitioners who qualified in South Asian medical schools will retire within the next decade. The impact will vary greatly by health authority. Those health authorities with the greatest number of such doctors are in some of the most deprived areas in the United Kingdom and have experienced the most difficulty in filling vacancies. Various responses will be required by workforce planners to mitigate the impact of these retirements. Key messagesCurrently, one in six general practitioners practising full time in the NHS qualified medically in a South Asian medical school; two thirds are likely to retire by 2007It is unlikely that doctors who qualify in South Asia will be a source of general practice recruitment in the futureThe posts from which South Asian qualifiers are retiring may be more difficult to fill because they are often in practices in areas of higher needThere is extreme variation in the proportion of total general practitioners who are South Asian qualifiers; flexibility for policy responses should be maintained PMID:9924060

Relationship between personal characteristics of specialist physicians and choice of practice location in Iran.

PubMed

Taati Keley, Elham; Ravaghi, Hamid; Salehi, Masoud; Nasiripour, Amir Ashkan; Abdi, Zhaleh; Meshkini, Ali

2016-01-01

Uneven geographic distribution of physicians is a major healthcare issue in Iran. This study aimed to explore the relationship between personal characteristics of the recently graduated specialist physicians in Iran and their choice of practice location. A cross-sectional study was conducted to extract information with regard to 3825 recently graduated specialist physicians from all medical schools across Iran between 2009 and 2012. The relationship between physicians' personal attributes and their desire to practise in underdeveloped areas was analyzed using χ2 test and logistic regression analysis. Birthplace, sex, exposure to rural practice before residency program, place of residence, and year of graduation were associated with physicians' desire to practise in an underdeveloped area. The logistic regression showed that female physicians were less likely to choose underdeveloped areas to practise as compared with their male counterparts (OR=0.659, 95%CI, 0.557-0.781, p≤0.001). Physicians who lived in underdeveloped areas were nine times more likely to choose underdeveloped areas to practise as compared with those living in other areas (OR=8.966, 95%CI, 4.717-17.041, p≤0.001). Physicians who did not have previous exposure to rural practice were 28% less likely to choose to serve in the underdeveloped areas as compared to those who had such exposure (OR=0.780, 95%CI, 0.661-0.922, p=0.004). Neither physicians' marital status nor their success in the board certification exam was associated with their choice of practice location. It seems that increasing the enrollment of physicians with a rural background in residency programs may solve the problem of uneven distribution of specialist physicians in Iran. Because female physicians are less willing to work in the underdeveloped areas than male physicians, increasing the number of male student admissions to residency programs, particularly in certain specialties that are more in demand in the underdeveloped areas, could alleviate the problem of uneven distribution of physicians in the short run. Further, programs that support raising the admissions of female students with a rural background into local medical universities along with providing incentives to encourage them to live and work in rural areas should be put on the policy agenda.

Infant feeding and HIV positive mothers in the Capricorn District of Limpopo province.

PubMed

Ramara, N S; Maputle, M S; Lekhuleni, M E

2010-03-01

HIV-positive mothers who practise infant feeding of their choice at Mankweng clinic in the Limpopo province are experiencing specific problems with various feeding methods. This study was undertaken with the aim to explore and describe the socioeconomic and cultural experiences of HIV-positive mothers who practise infant feeding of their choice. The research design was exploratory, descriptive, qualitative and contextual in nature. A phenomenological approach was adopted to focus on the lived experiences of HIV-positive mothers. The study sample was purposely selected. Ten HIV-positive mothers volunteered to participate in the study. Data were collected through in-depth unstructured interviews. All participants responded to an open-ended question: "Could you please tell me, in detail, your experience on infant feeding of your choice?" Interviews were conducted until saturation, as was reflected in repeating themes, was reached. The model of trustworthiness, as outlined in Guba and Lincoln (1985:301-318), to ensure credibility and dependability, was used in this study. The study adhered to the ethical standards as set by DENOSA (1998:2.3.2-2.3.4). Data were analysed according to Tesch's method, as outlined in Creswell (2003:192) and De Vos (1998:343). Literature control was performed to verify the results. Two main categories that emerged were guided by options for infant feeding; namely those that chose formula feeding for their babies and those participants who opted to breast-feed their babies. The study proposed to recommend guidelines for the development of relevent content for inclusion in health education programmes of registered midwives who, in turn, can use such information to educate mothers.

Family medicine residents' practice intentions: Theory of planned behaviour evaluation.

PubMed

Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W

2015-11-01

To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.

Chlorine residuals and haloacetic acid reduction in rapid sand filtration.

PubMed

Chuang, Yi-Hsueh; Wang, Gen-Shuch; Tung, Hsin-hsin

2011-11-01

It is quite rare to find biodegradation in rapid sand filtration for drinking water treatment. This might be due to frequent backwashes and low substrate levels. High chlorine concentrations may inhibit biofilm development, especially for plants with pre-chlorination. However, in tropical or subtropical regions, bioactivity on the sand surface may be quite significant due to high biofilm development--a result of year-round high temperature. The objective of this study is to explore the correlation between biodegradation and chlorine concentration in rapid sand filters, especially for the water treatment plants that practise pre-chlorination. In this study, haloacetic acid (HAA) biodegradation was found in conventional rapid sand filters practising pre-chlorination. Laboratory column studies and field investigations were conducted to explore the association between the biodegradation of HAAs and chlorine concentrations. The results showed that chlorine residual was an important factor that alters bioactivity development. A model based on filter influent and effluent chlorine was developed for determining threshold chlorine for biodegradation. From the model, a temperature independent chlorine concentration threshold (Cl(threshold)) for biodegradation was estimated at 0.46-0.5mgL(-1). The results imply that conventional filters with adequate control could be conducive to bioactivity, resulting in lower HAA concentrations. Optimizing biodegradable disinfection by-product removal in conventional rapid sand filter could be achieved with minor variation and a lower-than-Cl(threshold) influent chlorine concentration. Bacteria isolation was also carried out, successfully identifying several HAA degraders. These degraders are very commonly seen in drinking water systems and can be speculated as the main contributor of HAA loss. Copyright © 2011 Elsevier Ltd. All rights reserved.

Family medicine residents’ practice intentions

PubMed Central

Grierson, Lawrence E.M.; Fowler, Nancy; Kwan, Matthew Y.W.

2015-01-01

Abstract Objective To assess residents’ practice intentions since the introduction of the College of Family Physicians of Canada’s Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. Design A survey based on Ajzen’s theory of planned behaviour was administered on 2 occasions. Setting McMaster University in Hamilton, Ont. Participants Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. Main outcome measures The survey was modeled so as to measure the respondents’ intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. Results The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents’ intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. Conclusion The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University. PMID:26889508

Modular workcells: modern methods for laboratory automation.

PubMed

Felder, R A

1998-12-01

Laboratory automation is beginning to become an indispensable survival tool for laboratories facing difficult market competition. However, estimates suggest that only 8% of laboratories will be able to afford total laboratory automation systems. Therefore, automation vendors have developed alternative hardware configurations called 'modular automation', to fit the smaller laboratory. Modular automation consists of consolidated analyzers, integrated analyzers, modular workcells, and pre- and post-analytical automation. These terms will be defined in this paper. Using a modular automation model, the automated core laboratory will become a site where laboratory data is evaluated by trained professionals to provide diagnostic information to practising physicians. Modem software information management and process control tools will complement modular hardware. Proper standardization that will allow vendor-independent modular configurations will assure success of this revolutionary new technology.

Referrals in Primary Care: Is the Family Physician a “Gatekeeper”?

PubMed Central

Norton, Peter G.; Dunn, Earl V.; Bestvater, David

1989-01-01

The increasing financial restraints on the use of health care resources make it important to examine the appropriateness of present usage patterns. The authors studied referral patterns for a group of academic family physicians practising in a health service organization in Ontario. They found that for all consultant encounters, the family physician directly controlled 65% of these consultations, whereas 13% were continuing consultations with the specialist without direct family physician referral. The remainder were either unknown or referred from other sources, for example, emergency room or specialist-to-specialist referrals. The family physician made the exact same diagnosis as the consultant in 73.4% of cases for which data were available, and the patient was referred to an inappropriate specialist in only 2.7% of cases. PMID:21249055

Motor control and the management of musculoskeletal dysfunction.

PubMed

van Vliet, Paulette M; Heneghan, Nicola R

2006-08-01

This paper aims to develop understanding of three important motor control issues--feedforward mechanisms, cortical plasticity and task-specificity and assess the implications for musculoskeletal practice. A model of control for the reach-to-grasp movement illustrates how the central nervous system integrates sensorimotor processes to control complex movements. Feedforward mechanisms, an essential element of motor control, are altered in neurologically intact patients with chronic neck pain and low back pain. In healthy subjects, cortical mapping studies using transcranial magnetic stimulation have demonstrated that neural pathways adapt according to what and how much is practised. Neuroplasticity has also been demonstrated in a number of musculoskeletal conditions, where cortical maps are altered compared to normal. Behavioural and neurophysiological studies indicate that environmental and task constraints such as the goal of the task and an object's shape and size, are determinants of the motor schema for reaching and other movements. Consideration of motor control issues as well as signs and symptoms, may facilitate management of musculoskeletal conditions and improve outcome. Practice of entire everyday tasks at an early stage and systematic variation of the task is recommended. Training should be directed with the aim of re-educating feedforward mechanisms where necessary and the amount of practice should be sufficient to cause changes in cortical activity.

[Mindfulness meditation, a source of professional wellbeing].

PubMed

Blot, Nathalie

2016-10-01

Mindfulness meditation, by focusing attention on what we are experiencing, improves personal wellbeing which is then expressed in caregivers' professional practices. Nurses who practise mindfulness will be better positioned to help their patients. Copyright © 2016. Publié par Elsevier Masson SAS.

Now is the time to demand change to punishing FtP procedures.

PubMed

Mason, Sharon

2016-05-25

Having undergone Nursing and Midwifery Council fitness to practise (FtP) proceedings after raising and escalating concerns, I read with interest your article about nurses facing FtP hearings being 'pushed to breaking point' (analysis, May 11).

Labrador program prepares MDs for northern, remote practice

PubMed Central

Gray, S

1997-01-01

Across Canada, residency programs are attempting to train more physicians to practise in rural and remote areas. The Northern Family Education Program developed in Newfoundland and Labrador is proving that physicians can learn to like life in remote areas. PMID:9371078

Lyme disease

PubMed Central

Henry, Bonnie; Crabtree, Alexis; Roth, David; Blackman, Doug; Morshed, Muhammad

2012-01-01

Abstract Objective To determine physicians’ level of awareness and knowledge of Lyme disease (LD) in a low-prevalence area and whether physicians’ practices align with current guidelines for treatment of LD. Design A 23-item questionnaire assessing demographic characteristics, general knowledge about LD, laboratory testing for LD, and responses to 3 clinical scenarios. Setting British Columbia (BC). Participants Pediatricians, FPs, and internal medicine specialists who were licensed to practise in BC. Main outcome measures Knowledge of signs and symptoms of LD, beliefs about risk of LD, attitudes toward LD in patients in their practices, and application of accepted practice guidelines for the treatment of LD in clinical scenarios. Results Overall, 80.6% of respondents were FPs. Average knowledge score was 72.5% for FPs and 75.0% for other specialists. Most respondents (75.6% of FPs and 71.8% of other specialists) underestimated the occurrence of erythema migrans (EM), and only 26.1% and 28.3%, respectively, knew that EM alone was diagnostic for LD. A total of 30.5% of FPs and 12.1% of other specialists reported having treated a patient for the disease despite not believing that the patient had LD. Of all the respondents, 62.1% knew that LD was a reportable disease in BC. Respondents’ reports of risk of LD in their areas were appropriately associated with actual risk based on ecological niche. Conclusion Physicians are knowledgeable about the clinical signs and symptoms of LD and aware of the risk of the disease despite being in a low-endemic area. Physicians in BC are comfortable with treating patients empirically for LD. Education is needed to inform physicians that EM is diagnostic and no laboratory testing is indicated before treatment. Raising awareness among physicians that LD is reportable might improve reporting of future cases. PMID:22734172

Increasing the involvement of specialist physicians in chronic disease management.

PubMed

Taylor, Dylan; Lahey, Michele

2008-01-01

The Capital Health (CH) region in Alberta serves the population of the Edmonton area as well as a large referral population in western Canada. CH is responsible for the delivery of the spectrum of patient care, from inpatient to outpatient services. Growth in outpatient care, in particular, has led to the development of several ambulatory care facilities from which the delivery of care to several populations with a chronic disease will be coordinated. The traditional model of care delivery is unsuited to the management of chronic diseases. Physicians must be part of the planning and implementation of new models if they are to be successful and sustainable. The concept of integration into a delivery team is not well understood or practised. This is not conducive to the integration of specialist physicians into multidisciplinary teams in ambulatory care that serves the needs of patients from a large geographic area. Chronic disease management using the Chronic Care Model has proven to be an effective method of delivering care to this wide population. Specialist physicians have not always taken advantage of opportunities to be involved in the planning and development of such new health care projects. In CH, physician integration in the planning, development and implementation of this new model has proven vital to its success. We based our strategy for change on Wagner's Chronic Care Model. This involved eight steps, the first four of which have been completed and the fifth and sixth are underway. Five factors contributed to the successful integration of specialist physicians in chronic disease management: collaboration between disciplines and organizations; creating patient-centred services; organizational commitments; strong clinical leadership; and early involvement of clinicians.

Oral health education for schoolchildren: a qualitative study of dental care professionals' view of knowledge and learning.

PubMed

Hedman, E; Ringberg, K; Gabre, P

2009-08-01

The aim of the study was to describe and interpret dental professionals' view of knowledge, learning, health promotion and their expectations of and attitudes to the response from schoolchildren. A qualitative study design was used with discourse method. Nine dental hygienists and dental nurses, who have practised oral health education among schoolchildren, described their work in tape-recorded, semi-structured interviews. The discourse method stresses the variation and distinctions in the statements, and to understand the content of the text, its contextual dependence must be taken into account. The preventive discourse could be found in all interviews, but it was concentrated on disease prevention and less on maintaining health. The biomedical view of knowledge dominated. Children's and parent's own responsibility for healthy habits was stressed, but no reflection of ethical considerations associated with influencing people's life-style was found. The text revealed discrepancy between the informants, and even within the same individual, showing ambivalence towards oral health education. Some individuals suggested lessons guided by communication with the children, while others wanted to maintain methods based on information about oral diseases to a greater extent. Different perspectives were found. The expression 'oral health promotion' was frequently used and supported by all the interviewed informants, but the statements did not reveal the informant's definition of the concept. Several educators focused on signs of diseases and less on the individual's view of their own health. In the future, oral health education programme needs to focus on quality of life, behavioural variables and indicators of empowerment rather than just disease outcomes.

MAO-inhibitors in Parkinson's Disease

PubMed Central

Laux, Gerd

2011-01-01

Monoamine oxidase inhibitors (MAO-I) belong to the earliest drugs tried in Parkinson's disease (PD). They have been used with or without levodopa (L-DOPA). Non-selective MAO-I due to their side-effect/adverse reaction profile, like tranylcypromine have limited use in the treatment of depression in PD, while selective, reversible MAO-A inhibitors are recommended due to their easier clinical handling. For the treatment of akinesia and motor fluctuations selective irreversible MAO-B inhibitors selegiline and rasagiline are recommended. They are safe and well tolerated at the recommended daily doses. Their main differences are related to (1) metabolism, (2) interaction with CYP-enzymes and (3) quantitative properties at the molecular biological/genetic level. Rasagiline is more potent in clinical practise and has a hypothesis driven more favourable side effect/adverse reaction profile due to its metabolism to aminoindan. Both selegiline and rasagiline have a neuroprotective and neurorestaurative potential. A head-to head clinical trial would be of utmost interest from both the clinical outcome and a hypothesis-driven point of view. Selegiline is available as tablet and melting tablet for PD and as transdermal selegiline for depression, while rasagiline is marketed as tablet for PD. In general, the clinical use of MAO-I nowadays is underestimated. There should be more efforts to evaluate their clinical potency as antidepressants and antidementive drugs in addition to the final proof of their disease-modifying potential. In line with this are recent innovative developments of MAO-I plus inhibition of acetylcholine esterase for Alzheimer's disease as well as combined MAO-I and iron chelation for PD. PMID:22110357

Investigation of smallholder farmer biosecurity and implications for sustainable foot-and-mouth disease control in Cambodia.

PubMed

Young, J R; Suon, S; Olmo, L; Bun, C; Hok, C; Ashley, K; Bush, R D; Windsor, P A

2017-12-01

In Cambodia, the majority of the population is rural and reliant on subsistence agriculture, with cattle raised by smallholder farmers using traditional practices, resulting in low productivity and vulnerability to foot-and-mouth disease (FMD). As FMD causes deleterious impacts on rural livelihoods, known FMD risk factors were reviewed, using knowledge, attitudes and practice (KAP) surveys of smallholders (n = 240) from four regions. The study aimed to understand current biosecurity threats to smallholder livelihoods and investigate the hypothesis that smallholder farmers practising FMD risk management should be associated with higher incomes from cattle. Descriptive data were examined to demonstrate trends in KAP and a multivariable linear regression model developed to identify cattle income predictors. Results showed that baseline mean knowledge scores were low at 28.4% across all regions and basic biosecurity practices, including quarantine of new cattle, isolation of sick cattle and FMD vaccination, were lacking. As farmers purchase and sell cattle from and to various administration levels (including export), there is high risk of FMD transmission into and from smallholder communities. The final multivariable linear regression model identified significant explanatory parameters for annual cattle income, including region, number of calves born, forage plot size (ha), vaccination of cattle and the number of cattle purchased (F pr. < 0.001, R 2  = 29.9). Individual biosecurity practices including FMD vaccination were not significant predictors of income. With the current focus of farmers on treatment of FMD with inappropriate antibiotics leading to potential anti-microbial residue issues, yet receptivity to payment for vaccine in most regions, there is an urgent need for a coordinated national biosecurity and FMD management public awareness campaign. Further, to enhance the association between improved cattle health and rural livelihoods, it is recommended that livestock development programmes implement a systems approach to enhance farmer KAP in biosecurity, nutrition, reproduction and marketing of cattle. © 2017 Blackwell Verlag GmbH.

Are graft-versus-host-disease patients missing out on the vital occupational therapy services? a systematic review.

PubMed

Bakhsh, Hadeel R; Mohammed, Jaleel; Hashmi, Shahrukh K

2018-06-01

The aim of this review is to show the importance of occupational therapy/hand therapy for chronic graft-versus-host-disease (GVHD) patients and to outline the current state of the literature. GVHD of the hand can cause functional loss, reduced activities of daily life, poor social interaction, and loss of income because of limitations in work. Hand therapy, which is a specialty practised by both occupational therapists and physical therapists, has been proven to be an effective approach for hand-related musculoskeletal disorders; however, the literature search suggests that it is an underutilized specialty around the world. An electronic search was performed from 1997 to 2017 using OneFile (GALE), Medline/PubMed (NLM), Scopus (Elsevier), Science Citation Index Expanded (Web of Science), ProQuest Central (New), ProQuest Hospital Collection, Health Reference Center Academic (Gale), Health Research Premium Collection, Science Direct Journals (Elsevier), ProQuest Health & Medical Complete, Medical Database, Wiley Online Library, and SciTech Premium Collection for the period from 1994 to April 2017. Only randomized-controlled trials involving occupational therapy or hand therapy in patients with chronic hand GVHD were included in the final analysis. The search was limited to articles in English. Two reviewers independently assessed the methodological quality and extracted the data. The JADAD scoring method was used to score the articles. After the duplicates were excluded, 5466 articles were identified by the electronic database search for screening, out of which 5465 articles were excluded after reviewing. One article was further excluded on obtaining the full text as it was a case study. Hand therapy specialty, although a vital part of the recovery process for the patients with hand GVHD, is an underutilized specialty and well-designed trials are urgently needed for musculoskeletal hand GVHD, especially for focused hand therapy interventions.

Psychotherapeutic and psychosocial interventions for managing stress in multiple sclerosis: the contribution of mindfulness-based interventions.

PubMed

Muñoz San José, A; Oreja-Guevara, C; Cebolla Lorenzo, S; Carrillo Notario, L; Rodríguez Vega, B; Bayón Pérez, C

2016-03-01

Depression or anxiety in multiple sclerosis (MS) has been linked to a more severe course of the disease and higher numbers of relapses, in addition to poorer treatment adherence and exacerbated immune system dysregulation. Recent investigations indicate that psychotherapeutic interventions for stress management, such as mindfulness-based interventions (MBIs), could improve quality of life, depression, anxiety, and fatigue in MS patients. Mindfulness fosters the ability to slow down and observe experiences as they truly are, which improves affect regulation. Mindfulness is acquired through training; its advantage over other psychotherapeutic interventions is that effects may remain over time, since cultivating mindfulness depends on regular practising of abilities learned during training. The objective of this article is to review the current evidence of psychotherapeutic and psychosocial interventions, including MBIs for stress management, and their beneficial effects on MS patients. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Children’s Physic: Medical Perceptions and Treatment of Sick Children in Early Modern England, c. 1580–1720

PubMed Central

Newton, Hannah

2015-01-01

Summary Historians of medicine, childhood and paediatrics have often assumed that early modern doctors neither treated children, nor adapted their medicines to suit the peculiar temperaments of the young. Through an examination of medical textbooks and doctors’ casebooks, this article refutes these assumptions. It argues that medical authors and practising doctors regularly treated children, and were careful to tailor their remedies to complement the distinctive constitutions of children. Thus, this article proposes that a concept of ‘children’s physic’ existed in early modern England. This term refers to the notion that children were physiologically distinct, requiring special medical care. Children’s physic was rooted in the ancient traditions of Hippocratic and Galenic medicine: it was the child’s humoral make-up that underpinned all medical ideas about children’s bodies, minds, diseases and treatments. Children abounded in the humour blood, which made them humid and weak, and in need of medicines of a particularly gentle nature. PMID:26306061

Lessons from Jurassic Park: patients as complex adaptive systems.

PubMed

Katerndahl, David A

2009-08-01

With realization that non-linearity is generally the rule rather than the exception in nature, viewing patients and families as complex adaptive systems may lead to a better understanding of health and illness. Doctors who successfully practise the 'art' of medicine may recognize non-linear principles at work without having the jargon needed to label them. Complex adaptive systems are systems composed of multiple components that display complexity and adaptation to input. These systems consist of self-organized components, which display complex dynamics, ranging from simple periodicity to chaotic and random patterns showing trends over time. Understanding the non-linear dynamics of phenomena both internal and external to our patients can (1) improve our definition of 'health'; (2) improve our understanding of patients, disease and the systems in which they converge; (3) be applied to future monitoring systems; and (4) be used to possibly engineer change. Such a non-linear view of the world is quite congruent with the generalist perspective.

General practitioners’ views on radiology reports of plain radiography for back pain

PubMed Central

Espeland, Ansgar; Baerheim, Anders

2007-01-01

Objective To identify and describe general practitioners’ (GPs’) views on radiology reports, using plain radiography for back pain as the case. Design Qualitative study with three focus-group interviews analysed using Giorgi's method as modified by Malterud. Setting Southern Norway. Subjects Five female and eight male GPs aged 32–57 years who had practised for 3–15 years and were from 11 different practices. Main outcome measures Descriptions of GPs’ views. Results GPs wanted radiology reports to indicate more clearly the meaning of radiological terminology, the likelihood of disease, the clinical relevance of the findings, and/or the need for further investigations. GPs stated that good referral information leads to better reports. Conclusion These results can help to improve communication between radiologists and GPs. The issues identified in this study could be further investigated in studies that can quantify GPs’ satisfaction with radiology reports in relation to characteristics of the GP, the radiologist, and the referral information. PMID:17354154

What is narrative-based medicine?

PubMed Central

Zaharias, George

2018-01-01

Abstract Objective To raise awareness of narrative-based medicine (NBM) as a valuable approach to the consultation, which, if practised more widely by GPs, would convey considerable benefits to both patients and physicians. Sources of information Principally, the perspectives of 2 of NBM’s key proponents, Rita Charon and John Launer. Main message This first in a series of 3 articles outlines what NBM is and its benefits. In holding the patient story as central, NBM shifts the doctor’s focus from the need to problem solve to the need to understand. As a result, the patient-doctor relationship is strengthened and the patient’s needs and concerns are addressed more effectively and with improved health outcomes. Conclusion The healing power of narrative is repeatedly attested to but the scientific evidence is sparse. If NBM is to be incorporated more broadly in clinical practice, more research is needed to better define NBM’s role, understand the specific skills required for practice, and determine NBM’s outcomes with respect to illness and disease. PMID:29540381

Practising Cultures of Learning in Internationalising Universities

ERIC Educational Resources Information Center

Jin, Lixian; Cortazzi, Martin

2017-01-01

Internationalising higher education (HE) shows tensions between recruiting international students as a means of securing income and meeting their particular educational needs towards practices of caring for their social, psychological, intercultural and educational well-being. This paper briefly outlines the extent of current HE…

Validation of Algorithms for Basal Insulin Rate Reductions in Type 1 Diabetic Patients Practising Physical Activity

ClinicalTrials.gov

2013-04-19

Type 1 Diabetes With a Subcutaneous Insulin Pump; Adjustment of the Recommended Basal Insulin Flow Rate in the Event of Physical Activity; Adjustment of the Recommended Prandial Insulin in the Event of Physical Activity

Evidence of discrimination against BME nurses revealed.

PubMed

Longhurst, Chris

2017-04-27

University of Greenwich researchers responded to an advert from the Nursing and Midwifery Council (NMC) offering funding for an investigation into its fitness-to-practise (FtP) processes amid concerns about the treatment of NHS staff from black and minority ethnic (BME) backgrounds.

Pressure Groups and the Practising Administrator.

ERIC Educational Resources Information Center

Sackney, Larry

1984-01-01

Discusses the characteristics of pressure groups and how they attempt to influence decision making. Provides a synthesis of three typologies classifying pressure groups. Offers school administrators suggestions for dealing with pressure groups, emphasizing the need to accommodate various interests within the educational system. (MLF)

Being a Professional or Practising Professionally

ERIC Educational Resources Information Center

Dyer, Mary A.

2018-01-01

Research (Lloyd, E., and E. Hallet. [2010]. "Professionalising the Early Childhood Workforce in England: Work in Progress or Missed Opportunity?" "Contemporary Issues in Early Childhood" 11 (1): 75-788; Saks, M. [2012]. "Defining a Profession: The Role of Knowledge and Expertise." "Professions and…

Identification of cancer risk and associated behaviour: implications for social marketing campaigns for cancer prevention.

PubMed

Kippen, Rebecca; James, Erica; Ward, Bernadette; Buykx, Penny; Shamsullah, Ardel; Watson, Wendy; Chapman, Kathy

2017-08-17

Community misconception of what causes cancer is an important consideration when devising communication strategies around cancer prevention, while those initiating social marketing campaigns must decide whether to target the general population or to tailor messages for different audiences. This paper investigates the relationships between demographic characteristics, identification of selected cancer risk factors, and associated protective behaviours, to inform audience segmentation for cancer prevention social marketing. Data for this cross-sectional study (n = 3301) are derived from Cancer Council New South Wales' 2013 Cancer Prevention Survey. Descriptive statistics and logistic regression models were used to investigate the relationship between respondent demographic characteristics and identification of each of seven cancer risk factors; demographic characteristics and practice of the seven 'protective' behaviours associated with the seven cancer risk factors; and identification of cancer risk factors and practising the associated protective behaviours, controlling for demographic characteristics. More than 90% of respondents across demographic groups identified sun exposure and smoking cigarettes as moderate or large cancer risk factors. Around 80% identified passive smoking as a moderate/large risk factor, and 40-60% identified being overweight or obese, drinking alcohol, not eating enough vegetables and not eating enough fruit. Women and older respondents were more likely to identify most cancer risk factors as moderate/large, and to practise associated protective behaviours. Education was correlated with identification of smoking as a moderate/large cancer risk factor, and with four of the seven protective behaviours. Location (metropolitan/regional) and country of birth (Australia/other) were weak predictors of identification and of protective behaviours. Identification of a cancer risk factor as moderate/large was a significant predictor for five out of seven associated cancer-protective behaviours, controlling for demographic characteristics. These findings suggest a role for both audience segmentation and whole-of-population approaches in cancer-prevention social marketing campaigns. Targeted campaigns can address beliefs of younger people and men about cancer risk factors. Traditional population campaigns can enhance awareness of being overweight, alcohol consumption, and poor vegetable and fruit intake as cancer risk factors.

Gait rehabilitation machines based on programmable footplates

PubMed Central

Schmidt, Henning; Werner, Cordula; Bernhardt, Rolf; Hesse, Stefan; Krüger, Jörg

2007-01-01

Background Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. Results With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator) or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I). For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS) revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Conclusion Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive approach. Sophisticated technical developments and positive randomized controlled trials form the basis of a growing acceptance worldwide to the benefits or our patients. PMID:17291335

EQUAL Candida Score: An ECMM score derived from current guidelines to measure QUAlity of Clinical Candidaemia Management.

PubMed

Mellinghoff, Sibylle C; Hoenigl, Martin; Koehler, Philipp; Kumar, Anil; Lagrou, Katrien; Lass-Flörl, Cornelia; Meis, Jacques F; Menon, Vidya; Rautemaa-Richardson, Riina; Cornely, Oliver A

2018-05-01

Candida species frequently cause blood stream infections and are reported to be the third to tenth most commonly isolated pathogens. Guidelines and standardised treatment algorithms provided by professional organisations aim to facilitate decision-making regarding diagnosis, management and treatment of candidaemia. In routine clinical practise, however, it may be challenging to comply with these guidelines. The reasons include lack of familiarity or feasibility to adherence, but also their length and complexity. There is no tool to measure guideline adherence currently. To provide such a tool, we reviewed the current guidelines provided by the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and by the Infectious Diseases Society of America (IDSA), and selected the strongest recommendations for management quality as the bases for our scoring tool. Factors incorporated were diagnostic (blood cultures, echocardiography, ophthalmoscopy, species identification) and follow-up procedures (repeat blood cultures until negative result) as well as key treatment parameters (echinocandin treatment, step down to fluconazole depending on susceptibility result, CVC removal). The EQUAL Candida Score weighs and aggregates factors recommended for the ideal management of candidaemia and provides a tool for antifungal stewardship as well as for measuring guideline adherence. © 2018 Blackwell Verlag GmbH.

Cardiovascular Nursing: From Florence to Melbourne.

PubMed

Thompson, David R

2016-08-01

This paper, based on the 2015 CSANZ Cardiovascular Nursing Lecture, takes its title from the invitation to give this lecture in Melbourne being received when the author was visiting Florence, after whom Florence Nightingale, the founder of modern nursing, is named. Her work has indirectly shaped and influenced cardiovascular nursing, which has developed over the past 50 years. Despite its relatively short history, cardiovascular nursing has made a major contribution to improving the cardiovascular health and well-being of patients and families through health promotion, risk reduction and disease prevention. Examples include cardiac rehabilitation and secondary prevention and chronic heart failure disease management. Challenges, however, remain, including nurses practising to the full extent of their education and training, working as full partners with physicians and other health professionals in redesigning healthcare, ensuring better data collection and being more active in advocacy and policy initiatives. Cardiovascular nursing has a strong record of innovation but should always remember that it is there to serve the public and, bearing in mind the risk of potential harm versus benefit, be mindful of Florence Nightingale's wise counsel, "First, do no harm". Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Oral surgery in the European Union: challenges of diversity in training and practice.

PubMed

Nasseripour, M N; Hervé, C; Meningaud, J-P

2017-02-01

At the crossroads of medicine and dentistry, oral surgery with orthodontics are the only recognised dental specialties by the European Union. The goal of our study is to evaluate the current state of oral surgery in Europe from its teaching to its practice, the hypothesis being that a notable diversity persists despite European Union harmonisation process. To understand the impact of this diversity applied to European Union freedom of movement and its ethical implications for the practice of oral surgery, English and French questionnaires were sent by email to universities and organisations delivering authorisation to practise in France, Germany, Spain, Sweden and United Kingdom chosen based upon inclusion and exclusion criteria. An analysis of documents on these organisations' official websites was also conducted. Demographic information was obtained from the aforementioned organisations. The profile of practising oral surgeons is different dependent on the country. The university and hospital trainings conform to European recommendations and span 3-4 years. European Board certification is not required. Continuing education is mandatory only in France, Germany and United Kingdom. As for curricula and scope of practice, no consensus can be derived. There is potential conflict of interest between European Union principles of freedom of movement and protection of all citizens, as member countries do not uniformly apply Directives and recommendations. A new survey of all European Union oral surgery programmes as well as organisations delivering authorisation to practise is necessary to implement across the board harmonisation of training and practice to insure patient safety in light of the migration of European Union practitioners. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Factors influencing medical students' motivation to practise in rural areas in low-income and middle-income countries: a systematic review

PubMed Central

Zwanikken, Prisca A C; Pokharel, Paras K; Scherpbier, Albert J

2017-01-01

Objectives There is a shortage of doctors working in rural areas all over the world, especially in low-income and middle-income countries. The choice to practise medicine in a rural area is influenced by many factors. Motivation developed as a medical student is one key determinant of this choice. This study explores influences on medical students' motivation to practise in rural areas of low-income and middle-income countries following graduation. Design A systematic review was conducted to identify influences on medical students' motivation to work in rural areas in low-income and middle-income countries. Papers reporting influences on motivation were included, and content analysis was conducted to select the articles. Articles not published in English were excluded from this review. Results A rural background (ie, being brought up in a rural area), training in rural areas with a community-based curriculum, early exposure to the community during medical training and rural location of medical school motivate medical students to work in rural areas. Perceived lack of infrastructure, high workload, poor hospital management and isolation are among the health facility factors that demotivate medical students for medical practice in rural areas. Conclusions Medical school selection criteria focusing on a rural background factor and medical education curriculum focusing on rural area are more relevant factors in low-income and middle-income countries. The factors identified in this review may assist the planners, medical educators and policymakers in low-income and middle-income countries in designing relevant interventions to positively influence rural choices where the shortage of rural physicians is an ongoing and increasing concern. PMID:28232465

An evaluation of a public health practitioner registration programme: lessons learned for workforce development.

PubMed

Rahman, Em; Wills, Jane

2014-09-01

This article explores the lessons learned for workforce development from an evaluation of a regional programme to support the assessment and registration of public health practitioners to the UK Public Health Register (UKPHR) in England. A summative and process evaluation of the public health practitioner programme in Wessex was adopted. Data collection was by an online survey of 32 public health practitioners in the Wessex area and semi-structured interviews with 53 practitioners, programme support, employers and system leaders. All survey respondents perceived regulation of the public health workforce as very important or important. Managers and system leaders saw a register of those fit to practise and able to define themselves as a public health practitioner as a necessary assurance of quality for the public. Yet, because registration is voluntary for practitioners, less value was currently placed on this than on completing a master's qualification. The local programme supports practitioners in the compilation of a retrospective portfolio of evidence that demonstrates fitness to practise; practitioners and managers stated that this does not support current and future learning needs or the needs of those working at a senior level. One of the main purposes of statutory regulation of professionals is to protect the public by an assurance of fitness to practise where there is a potential for harm. The widening role for public health practitioners without any regulation means that there is the risk of inappropriate interventions or erroneous advice. Regulators, policy makers and system leaders need to consider how they can support the development of the public health workforce to gain professional recognition at all levels of public health, including practitioners alongside specialists, and support a professional career framework for the public health system. © Royal Society for Public Health 2014.

Pharmacist independent prescribing in critical care: results of a national questionnaire to establish the 2014 UK position.

PubMed

Bourne, Richard S; Whiting, Paul; Brown, Lisa S; Borthwick, Mark

2016-04-01

Clinical pharmacist practice is well established in the safe and effective use of medicines in the critically ill patient. In the UK, independent pharmacist prescribers are generally recognised as a valuable and desirable resource. However, currently, there are only anecdotal reports of pharmacist-independent prescribing in critical care. The aim of this questionnaire was to determine the current and proposed future independent prescribing practice of UK clinical pharmacists working in adult critical care. The questionnaire was distributed electronically to UK Clinical Pharmacy Association members (closed August 2014). There were 134 responses to the questionnaire (response rate at least 33%). Over a third of critical care pharmacists were practising independent prescribers in the specialty, and 70% intended to be prescribers within the next 3 years. Pharmacists with ≥5 years critical care experience (P < 0.001) or worked in a team (P = 0.005) were more likely to be practising independent prescribers. Pharmacists reported significant positives to the use of independent prescribing in critical care both in patient care and job satisfaction. Independently, prescribing was routine in: dose adjustment for multi-organ failure, change in route or formulation, correction prescribing errors, therapeutic drug monitoring and chronic medication. The majority of pharmacist prescribers reported they spent ≤5% of their clinical time prescribing and accounted for ≤5% of new prescriptions in critical care patients. Most critical care pharmacists intend to be practising as independent prescribers within the next 3 years. The extent and scope of critical care pharmacist prescribing appear to be of relatively low volume and within niche prescribing areas. © 2015 Royal Pharmaceutical Society.

New graduate separations from New Zealand's nursing workforce in the first 5 years after registration: a retrospective cohort analysis of a national administrative data set 2005-2010.

PubMed

North, Nicola; Leung, William; Lee, Rochelle

2014-08-01

To describe workforce separation rates and its relationship with demographic and work characteristics in the 2005 new graduate cohort's first 5 years as practising RNs in NZ. Retaining new graduate RNs is critical to nursing workforce sustainability; one study showed that if an RN is still employed in a hospital setting 5 years after graduation, he/she tends to remain active in the health industry. Retrospective analysis using the Nursing Council of New Zealand's registration data set for years 2005-2010. All newly registered NZ graduates practising in NZ in 2005 (n = 1236) were tracked for 5 years. Within 5 years of graduation, 26% of the cohort had separated from the NZ nursing workforce, 18% in the first year. The under-25s (n = 517), 42% of the cohort, had the highest loss, 32%, in 5 years. Separations were significantly lower for graduates in their 30s vs. their 20s and for those who gained postgraduate tertiary qualifications post-registration (10%) vs. those who did not (29%). Hospitals were the most frequent employment setting over 5 years, the largest increase being community settings. Five-year retention rates in the four largest practice areas were surgical 26%, medical 16%, mental health 60% and continuing care 10%. After 5 years, 24% of those still practising (n = 920) worked in a different health board region. New graduate RN losses were higher than in previous research, with younger RNs at most risk, threatening future sustainability of the nursing workforce and highlighting the need for evidence-based targeted strategies to retain them. © 2013 John Wiley & Sons Ltd.

Coping with future epidemics: Tai chi practice as an overcoming strategy used by survivors of severe acute respiratory syndrome (SARS) in post-SARS Hong Kong.

PubMed

Siu, Judy Yuen-Man

2016-06-01

Although SARS had been with a controversial topic for a decade at the time of this study, numerous SARS survivors had not yet physically, psychologically or socially recovered from the aftermath of SARS. Among chronically ill patients, the use of complementary and alternative medicine (CAM) is reported to be widespread. However, extremely little is known about the use of CAM by SARS survivors in the post-SARS period and even less is known about how the use of CAM is related to the unpleasant social and medical-treatment experiences of SARS survivors, their eagerness to re-establish social networks, and their awareness to prepare for future epidemics. To investigate the motivations for practising tai chi among SARS survivors in post-SARS Hong Kong. Using a qualitative approach, I conducted individual semi-structured interviews with 35 SARS survivors, who were purposively sampled from a tai chi class of a SARS-patient self-help group in Hong Kong. Health concerns and social experiences motivated the participants to practise tai chi in post-SARS Hong Kong. Experiencing health deterioration in relation to SARS-associated sequelae, coping with unpleasant experiences during follow-up biomedical treatments, a desire to regain an active role in recovery and rehabilitation, overcoming SARS-associated stigmas by establishing a new social network and preparing for potential future stigmatization and discrimination were the key motivators for them. The participants practised tai chi not only because they sought to improve their health but also because it provided a crucial social function and meaning to them. © 2014 John Wiley & Sons Ltd.

Use of caries-preventive agents in children: findings from the dental practice-based research network.

PubMed

Riley, J L; Richman, Joshua S; Rindal, D Brad; Fellows, Jeffrey L; Qvist, Vibeke; Gilbert, Gregg H; Gordan, Valeria V

2010-01-01

Scientific evidence supports the application of caries-preventive agents in children and adolescents, and this knowledge must be applied to the practice of dentistry. There are few multi-region data that allow for comparisons of practice patterns between types of dental practices and geographical regions. The objective of the present study was to characterise the use of specific caries-preventive agents for paediatric patients in a large multi-region sample of practising clinicians. The present study surveyed clinicians from the Dental Practice-based Research Network who perform restorative dentistry in their practices. The survey consisted of a questionnaire that presented a range of questions about caries risk assessment and the use of preventive techniques in children aged 6 to 18 years. Dental sealants (69%) or in-office fluoride (82%) were the most commonly used caries-preventive agents of the caries preventive regimens. The recommendation of at-home caries-preventive agents ranged from 36% to 7%,with the most commonly used agent being non-prescription fluoride rinse. Clinicians who practised in a large group practice model and clinicians who come from the Scandinavian region use caries risk assessment more frequently compared to clinicians who come from regions that had, predominantly, clinicians in private practice. Whether or not clinicians used caries risk assessment with their paediatric patients was poorly correlated with the likelihood of actually using caries-preventive treatments on patients. Although clinicians reported the use of some form of in-office caries-preventive agent, there was considerable variability across practices. These differences could represent a lack of consensus across practising clinicians about the benefits of caries-preventive agents, or a function of differing financial incentives, or patient pools with differing levels of overall caries risk.

Sports-specific differences in postsurgical infections after arthroscopically assisted anterior cruciate ligament reconstruction.

PubMed

Krutsch, Werner; Zellner, Johannes; Zeman, Florian; Nerlich, Michael; Koch, Matthias; Pfeifer, Christian; Angele, Peter

2017-12-01

Post-operative infection after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a rare but severe complication, particularly for young and active patients. It is unclear whether the prevalence of knee infection is correlated with the type of sports or the level of performance. From 2008 to 2012, the internal single-centre ACL registry of the FIFA Medical Centre of Excellence Regensburg was retrospectively screened for sex, age, time between isolated primary ACL rupture and surgery, surgical technique, rate of infection after ACL reconstruction and the type of sports practised. In total, 4801 ACL reconstructions had been conducted over 5 years, 4579 in amateur and 221 in professional athletes. After application of the exclusion criteria, 1809 athletes with ACL reconstruction were analysed regarding postsurgical infection and the type of sports practised. Professionals and amateurs did not significantly differ with regard to infection rates (n.s.) but in the timing of ACL repair (p < 0.001). Eleven of 1130 football players had developed postsurgical infection after ACL reconstruction (1.0%) in contrast to 557 skiers and snowboarders without infection (p = 0.02). The timing of ACL repair did not differ between the different types of sports (n.s.). Staphylococcus aureus and epidermidis were the predominant detected bacteria. All patients were hospitalised and successfully treated with arthroscopic lavage and antibiotic medication. ACL infections showed sports-related differences. Athletes practising summer outdoor sports such as football had a significantly higher risk of infection after ACL reconstruction than winter sports athletes. No difference was found between professional and amateur athletes. Relevant prevention strategies for postsurgical ACL infections should consider influencing patient factors such as the type of sports activity and attendant circumstances. III.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis.

PubMed

Sayed, Shahin; Lester, Susan C; Wilson, Michael; Berney, Daniel; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela; Guarner, Jeannette

2017-01-01

Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45-90 min to complete.Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging.New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers' feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis

PubMed Central

Wilson, Michael; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela

2017-01-01

Background Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. Objectives We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Methods Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Results Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45–90 min to complete. Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging. New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers’ feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Conclusion Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice. PMID:29147646

Efficacy of teaching methods used to develop critical thinking in nursing and midwifery undergraduate students: A systematic review of the literature.

PubMed

Carter, Amanda G; Creedy, Debra K; Sidebotham, Mary

2016-05-01

The value and importance of incorporating strategies that promote critical thinking in nursing and midwifery undergraduate programmes are well documented. However, relatively little is known about the effectiveness of teaching strategies in promoting CT. Evaluating effectiveness is important to promote 'best practise' in teaching. To evaluate the efficacy of teaching methods used to develop critical thinking skills in nursing and midwifery undergraduate students. The following six databases; CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus were searched and resulted in the retrieval of 1315 papers. After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme tool. Twenty-eight studies met the inclusion criteria and quality appraisal. Twelve different teaching interventions were tested in 8 countries. Results varied, with little consistency across studies using the same type of intervention or outcome tool. Sixteen tools were used to measure the efficacy of teaching in developing critical thinking. Seventeen studies identified a significant increase in critical thinking, while nine studies found no increases, and two found unexplained decreases in CT when using a similar educational intervention. Whilst this review aimed to identify effective teaching strategies that promote and develop critical thinking, flaws in methodology and outcome measures contributed to inconsistent findings. The continued use of generalised CT tools is unlikely to help identify appropriate teaching methods that will improve CT abilities of midwifery and nursing students and prepare them for practise. The review was limited to empirical studies published in English that used measures of critical thinking with midwifery and nursing students. Discipline specific strategies and tools that measure students' abilities to apply CT in practise are needed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Factors associated with a positive willingness to practise oral health care in the future amongst oral healthcare and nursing students.

PubMed

Haresaku, S; Monji, M; Miyoshi, M; Kubota, K; Kuroki, M; Aoki, H; Yoshida, R; Machishima, K; Makino, M; Naito, T

2018-06-06

The purpose of this study was to identify the weak points in the knowledge and attitudes of first-year oral health care and nursing students towards oral health care and to identify the factors associated with their positive willingness to practise oral health care after becoming a health professional in order to develop oral healthcare curricula. The subjects were 88 first-year dental students (DSs), 64 dental hygiene students (DHSs) and 119 nursing students (NSs) enrolled in schools in Japan, as of April 2017. A questionnaire was distributed to subjects in each school to assess their knowledge and attitudes towards oral health care. Less than half knew that oral health care was also provided in cancer hospitals, hospices, acute care hospitals, maternity wards and psychiatric wards. Only 46.2% knew that oral health care was effective in the prevention of aspiration pneumonia. The level of knowledge and attitudes in NSs regarding oral health care were likely to be lowest amongst the student groups. Only NSs' high interest towards oral health care was associated with their positive willingness to practise oral health care in the future although oral health students' high perceptions and interest regarding oral health care were associated with the willingness. This study showed oral healthcare and nursing students' weak points regarding their attitudes and knowledge of oral health care at early stages. Oral health academic staff and professionals should develop effective oral healthcare curricula for oral healthcare students and help nursing staff develop a collaborative nursing oral healthcare curriculum to motivate nursing students. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Self-medication among people living with hypertension: a review.

PubMed

Rahmawati, Riana; Bajorek, Beata V

2017-04-01

Self-medication is commonly practised by patients, underpinned by health beliefs that affect their adherence to medication regimens, and impacting on treatment outcomes. This review explores the scope of self-medication practices among people with hypertension, in terms of the scale of use, types of medication and influencing factors. A comprehensive search of English language, peer-reviewed literature published between 2000 and 2014 was performed. Twenty-seven studies met the inclusion criteria; 22 of these focused on complementary and alternative medicines (CAMs). Anti-hypertensive medications are listed among the 11% of products that patients reportedly obtain over-the-counter (OTC) for self-medication. On average, 25% of patients use CAMs, mostly herbs, to lower blood pressure. Recommendations by family, friends and neighbours are the most influential factors for self-medication with CAMs. Faith in treatment with CAMs, dissatisfaction with conventional medicine and the desire to reduce medication costs are also cited. Most (70%) patients with hypertension take OTC medicines to treat minor illnesses. The concurrent use of anti-hypertensive medications with analgesics and herbal medicines is commonly practised. The sociodemographic profile of patients engaging in self-medication differs markedly in the articles reviewed; self-medication practices cannot be attributed to a particular profile. Low disclosure of self-medication is consistently reported. This review highlights a high proportion of people with hypertension practise self-medication. Further studies are needed to assess the impact of self-medication with OTC and anti-hypertensive medications on hypertension treatment. Health professionals involved in hypertension management should be mindful of any types of self-medication practices. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A qualitative investigation of specialist orthodontists in New Zealand: part 2. Orthodontists' working lives and work-life balance.

PubMed

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

2012-11-01

Orthodontics is the most widely practised form of specialist dentistry in New Zealand. To date, no known qualitative research has been published examining the work-life balance of practitioners. The aim of this study was to investigate the working lives and work-life balance of NZ orthodontists in order to generate an understanding of the reality of orthodontic specialist practice and its effects on orthodontists' professional and personal lives. Semi-structured interviews were conducted involving 19 practising orthodontists (four females, 15 males; mean age 50 years) from throughout New Zealand and selected for maximum variation in the sample. Transcribed interviews were analysed for themes using an applied grounded theory approach. A core category of 'practising orthodontist' 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 final sub-category. Themes emerging from the work-life sub-category were further divided into two sub-themes of 'work' and 'life'. Themes in the 'work' subgroup included time off, injuries and illness, regrets, personality traits, job stress and criticism, establishing a practice, peer support and contact, and success in orthodontics. Themes in the 'life' sub-group were personal development, family life, life balance and interests outside work, and financial security. This was the first qualitative investigation of the orthodontic profession in New Zealand. The findings provided a valuable insight into the working lives of New Zealand orthodontists and effects on their day-today lives. It will be revealing and interesting to observe how the modernisation of orthodontic practice will affect the work-life balance of New Zealand orthodontists in the future.

Postural adjustments in young ballet dancers compared to age matched controls.

PubMed

Iunes, Denise H; Elias, Iara F; Carvalho, Leonardo C; Dionísio, Valdeci C

2016-01-01

The purpose of the study was to use photogrammetry to evaluate the posture of ballet practitioners compared to an age-matched control group. One hundred and eleven 7- to 24-year-old female volunteers were evaluated and were divided into two groups: the ballet practising group (n = 52) and the control group (n = 59), divided into three subgroups according to age and years of ballet experience. Dancers with 1-3 years experience compared to controls of the same age shows alterations in External Rotation Angle (P < 0.05). Dancers 4-9 years experience show alterations in Lumbar Lordosis, Pelvis Tilt Angle and Navicular Angle Right and Left (P < 0.05). Dancers with over 9 years experience show alterations in External Rotation and Navicular Angle Left (P < 0.05). Research shows there are differences between dancers and controls. In the groups 1-3 years and over 9 years of experience, the External Rotation Angle is greater. In the group 4-9 years of experience the Lumbar Lordosis Angle is greater and Pelvis Tilt, Navicular Angle Left and Right are smaller. In more than 9 years of ballet experience, the Navicular Angle Left is smaller. Copyright © 2015 Elsevier Ltd. All rights reserved.

Knowledge, attitude and practice of medical laboratory practitioners in the fight against Ebola virus disease.

PubMed

Hamid, Kabir M; Yusuf, Ibrahim; Onoja, Bernard A; Koki, Abdullahi Y

2018-01-01

Ebola virus disease (EVD) in West Africa was an enormous public health challenge. Nigeria was able to contain the spread of the virus with a concerted effort and an effective public health response in terms of identification of contacts, rapid laboratory diagnosis, quarantine and symptomatic treatment. We determined the knowledge, attitude and practice of medical laboratory practitioners (MLPs) in this post-Ebola epidemic era. This cross-sectional study was carried out in eight hospitals in Kano State for 6 months, between January and June 2016. It involved medical laboratory scientists (MLS), medical laboratory technicians (MLT) and medical laboratory assistants (MLA). Questionnaires were administered and analysed. Of the 75 participants, mean knowledge score was 5.54 (standard deviation [SD] ±1.44) while the mean attitude score was 13.72 ±2.80, and mean practice score was 3.10 ±0.80. Mean age of participants was 36.82 ± 8.07 years. There was full awareness of EVD among all 75 participants; however, many medical laboratory practitioners (52.7%) did not know EVD prevention methods. The majority (86.1%) knew the source of disease outbreak and most MLPs (66.7%) practised improper hand washing to prevent Ebola transmission. In addition, they had a negative attitude and practice towards EVD. Of 71 MLPs, 52 (73.2%) strongly disagreed that a traditional remedy was preferable in EVD treatment. Fear of EVD among MLPs has declined.

Barriers to Participatory Extension in Egypt: Agricultural Workers' Perspectives

ERIC Educational Resources Information Center

McDonough, Chris; Nuberg, Ian K.; Pitchford, Wayne S.

2015-01-01

Purpose: This paper examines extension practises of agricultural workers within the Egyptian government and the perceived barriers they face in implementing participatory approaches, identifying improvements required in research and extension processes to meet the real needs of Egyptian farming communities. Design/Methodology/Approach: Key…

Practising Conservation Biology in a Virtual Rainforest World

ERIC Educational Resources Information Center

Schedlbauer, Jessica L.; Nadolny, Larysa; Woolfrey, Joan

2016-01-01

The interdisciplinary science of conservation biology provides undergraduate biology students with the opportunity to connect the biological sciences with disciplines including economics, social science and philosophy to address challenging conservation issues. Because of its complexity, students do not often have the opportunity to practise…

The orthopaedic workforce in Queensland now and into the twenty-first century.

PubMed

Licina, P; McGuire, T P

1993-06-01

The objectives of this study were to determine the number and distribution of orthopaedic surgeons in Queensland at present and to assess the adequacy of trainee intake for the future. Characteristics of the orthopaedic workforce in Queensland in 1990 were analysed with regard to the total number of orthopaedic surgeons, their regional distribution, their ratio to the population and their age distribution. Similar statistics were derived for the years 1981 and 1986 and trends were examined. By projecting these trends, the number of surgeons likely to be practising in 2001 was estimated. Using projected population figures, the number of orthopaedic surgeons required in 2001 was calculated, assuming an optimum ratio of surgeons to population of one per 25,000. It was found that in 1990 sufficient orthopaedic surgeons were practising in Queensland but that there was some maldistribution. With the increased intake of five new training registrars per year, the number of orthopaedic surgeons in Queensland in 2001 should be appropriate, as long as current trends continue.

The place and practices of well-being in local governance.

PubMed

Atkinson, Sarah; Joyce, Kerry E

2010-10-20

The concept of well-being has become prominent within national policy goals in the UK since the end of the 1990s. However, the concept of well-being remains ill defined, an instability that is increasingly understood as problematic to policy making. We engage with this terminological instability through an exploration of how the concept of well-being is practised discursively in local governance and critically examine the place of the concept in local policy making. In contrast to the current enthusiasm to define and measure well-being, we argue that the conceptual instability has inherent value for local governance. The concept of well-being is practised through a number of potentially conflicting discourses, but it is exactly this conceptual instability that enables a local negotiation and combination of alternative policy frameworks for local place-shaping strategies. As such, well-being not only is an overarching goal of governance but also contributes to the dynamics of the policy process.

Implementation of newly adopted technology in acute care settings: a qualitative analysis of clinical staff

PubMed Central

Langhan, Melissa L.; Riera, Antonio; Kurtz, Jordan C.; Schaeffer, Paula; Asnes, Andrea G.

2015-01-01

Objective Technologies are not always successfully implemented into practise. We elicited experiences of acute care providers with the introduction of technology and identified barriers and facilitators in the implementation process. Methods A qualitative study using one-on-one interviews among a purposeful sample of 19 physicians and nurses within ten emergency departments and intensive care units was performed. Grounded theory, iterative data analysis and the constant comparative method were used to inductively generate ideas and build theories. Results Five major categories emerged: decision-making factors, the impact on practise, technology's perceived value, facilitators and barriers to implementation. Barriers included negative experiences, age, infrequent use, and access difficulties. A positive outlook, sufficient training, support staff, and user friendliness were facilitators. Conclusions This study describes strategies implicated in the successful implementation of newly adopted technology in acute care settings. Improved implementation methods and evaluation of implementation processes are necessary for successful adoption of new technology. PMID:25367721

Defining deviation: The peer professional opinion defence and its relationship to scope expansion and emerging non-medical health professions.

PubMed

Wardle, Jon

2016-03-01

The law imposes a duty to exercise reasonable care and skill in the provision of professional advice and treatment on all health practitioners, which in Australia is assessed via a modified Bolam principle. In an era of medical dominance, this standard was clearly related to the standards of the medical profession. However, the evolving nature of the Australian health workforce has fuelled speculation as to how non-medical professions are assessed to be practising in accordance with established standards. This article explores the peer-professional defence in relation to new, emerging and established non-medical professions practising in areas that were not historically part of their remit, and finds that individual health professions--even those which do not possess traits historically defined by professionalism--have ultimate discretion in determining the standards by which they are assessed, though such standards may be rejected by courts if they are deemed irrational.

Eco-pharmacovigilance of non-steroidal anti-inflammatory drugs: Necessity and opportunities.

PubMed

He, Bing-Shu; Wang, Jun; Liu, Juan; Hu, Xia-Min

2017-08-01

Eco-pharmacovigilance (EPV) is a practical and powerful approach to minimize the potential risks posed by pharmaceutical residues in environment. However, it is impracticable to practise rigorous and unitary EPV process for all the existing and new pharmaceuticals. Here, we focused on non-steroidal anti-inflammatory drugs (NSAIDs), and discussed the necessity and potential opportunities of practising EPV of NSAIDs. We found that the consumption of NSAIDs is huge and ubiquitous across the globe. NSAIDs were worldwidely reported as one of the most dominant and frequently detected groups in environmental matrices including wastewater, surface water, suspended solids, sediments, groundwater, even drinking water. Besides, there is definitive evidence for the adverse impacts of NSAID residues on scavenging birds and aquatic species. These data suggested the necessity of implementing EPV of NSAIDs. From the perspective of drug administration, we identified some things that can be done as management practice options for EPV implementation on NSAIDs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of a 10-week yoga programme on the quality of life of women after breast cancer surgery

PubMed Central

Merecz, Dorota; Wójcik, Aleksandra; Świątkowska, Beata; Sierocka, Kamilla; Najder, Anna

2014-01-01

Aim of the study The following research is aimed at determining the effect of yoga on the quality of life of women after breast cancer surgery. Material and methods A 10-week yoga programme included 90-minute yoga lessons once a week. To estimate the quality of life, questionnaires developed by the European Organisation for Research and Treatment of Cancer (QLQ-C30 and QLQ-BR23) were used. An experimental group consisted of 12 women who practised yoga, a control group – of 16 women who did not. Between groups there were no differences in age, time from operation and characteristics associated with disease, treatment and participation in rehabilitation. Results Our results revealed an improvement of general health and quality of life, physical and social functioning as well as a reduction of difficulties in daily activities among exercising women. Also their future prospects enhanced – they worried less about their health than they used to before participating in the programme. As compared to baseline, among exercising women, fatigue, dyspnoea and discomfort (pain, swelling, sensitivity) in the arm and breast on the operated side decreased. Conclusions Participation in the exercising programme resulted in an improvement of physical functioning, reduction of fatigue, dyspnoea, and discomfort in the area of the breast and arm on the operated side. Based on our results and those obtained in foreign studies, we conclude that rehabilitation with the use of yoga practice improves the quality of life of the patients after breast cancer surgery. However, we recommend further research on this issue in Poland. PMID:26327853

Girls' Bodies, Drama and Unruliness

ERIC Educational Resources Information Center

Ramsay, Alison

2014-01-01

This article examines some of the performance outcomes from a practised-based research project that took place with adolescent girls attending an after-school drama club. Participants experimented with slapstick humour in a series of workshops, before presenting their own devised physical comedy performance for a live audience. Comic performances…

Relative Importance of Professional Practice and Engineering Management Competencies

ERIC Educational Resources Information Center

Pons, Dirk

2016-01-01

Problem: The professional practice of engineering always involves engineering management, but it is difficult to know what specifically to include in the undergraduate curriculum. Approach: The population of New Zealand practising engineers was surveyed to determine the importance they placed on specific professional practice and engineering…

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…

Connecting to Community: What Do We Want in Our Special Education Graduates?

ERIC Educational Resources Information Center

Hughes, Stephen; De George-Walker, Linda

2010-01-01

With a commitment to establishing collaborative relationships with a local special education community, a consultation process was undertaken to ascertain what practising educators considered essential special education graduate characteristics. This consultation occurred against the backdrop of broad-scale university organisational restructure,…

Student Experiences with Studio Instruction

ERIC Educational Resources Information Center

Upitis, Rena; Abrami, Philip C.; Varela, Wynnpaul; King, Matthew; Brook, Julia

2017-01-01

The purpose of the study was to examine students' experiences of independent music lessons, and to ascertain what factors predicted enjoyment and success, especially those predictors arising from self-regulation learning theory. A self-report survey was used to gather data on student demographics, practising habits, musical skills, achievements,…

MUNICIPAL WASTE COMBUSTION ASSESSMENT: WASTE CO-FIRING

EPA Science Inventory

The report is an overview of waste co-firing and auxiliary fuel fired technology and identifies the extent to which co-firing and auxiliary fuel firing are practised. Waste co-firing is defined as the combustion of wastes (e. g., sewage sludge, medical waste, wood waste, and agri...

MUNICIPAL WASTE COMBUSTION ASSESSMENT: WASTE CO- FIRING

EPA Science Inventory

The report is an overview of waste co-firing and auxiliary fuel fired technology and identifies the extent to which co-firing and auxiliary fuel firing are practised. Waste co-firing is defined as the combustion of wastes (e. g., sewage sludge, medical waste, wood waste, and agri...

Conceptualizing Learning from the Everyday Activities of Digital Kids

ERIC Educational Resources Information Center

Hsi, Sherry

2007-01-01

This paper illustrates the intensified engagement that youth are having with digital technologies and introduces a framework for examining "digital fluency"--the competencies, new representational practises, design sensibilities, ownership, and strategic expertise that a learner gains or demonstrates by using digital tools to gather, design,…

Are there specific conditions for which expertise in gymnastics could have an effect on postural control and performance?

PubMed

Asseman, François B; Caron, Olivier; Crémieux, Jacques

2008-01-01

The first aim of this study was to analyse the effect of elite training, linked to expertise, in gymnastics on postural performance and control. For this purpose, body sway of expert gymnasts was compared to other sportsmen, non-experts and non-gymnasts, in two different postures: bipedal (easy and unspecific to gymnasts) and unipedal (difficult and fairly specific). The second aim was to compare the groups in the same tasks but in a visual condition for which they were not trained, i.e. with eyes closed. Postural performance was assessed by centre of gravity motion, which was computed from centre of pressure motion, estimating postural control. A significant difference between the two groups was observed for postural performance in the unipedal posture and with eyes open only. Regardless of their posture, the groups were similarly affected by removal of vision. Expertise in gymnastics seemed to improve postural performances only in situations for which their practise is related to, i.e. unipedal with eyes open. These reveal the importance of choosing a relevant postural configuration and visual condition according to the people's training or by extension experience.

Improving Students' Interpersonal Skills through Experiential Small Group Learning

ERIC Educational Resources Information Center

Skinner, Kay Lesley; Hyde, Sarah J.; McPherson, Kerstin B. A.; Simpson, Maree D.

2016-01-01

Health professional students must be equipped with the skills necessary to interact with patients. Effective interpersonal skills are difficult to both learn and teach, requiring development, practise and evaluation in both educational and clinical settings. In professions such as physiotherapy, traditional approaches to teaching these skills have…

Entrepreneur-Managers in Higher Education: (How) Do They Exist?

ERIC Educational Resources Information Center

Birds, Rachel

2014-01-01

Policy-makers in the United Kingdom increasingly emphasise the contribution of innovation and entrepreneurialism to the economy. Drawing on a recent ethnographic study of a university commercial enterprise, this article examines the notion of entrepreneurialism in a higher education institution as understood and practised by its employees. The…

Teaching Practise Utilising Embedded Indigenous Cultural Standards

ERIC Educational Resources Information Center

Gilbert, Stephanie

2017-01-01

The Wollotuka Institute, University of Newcastle, New South Wales, is the first university or organisation to enter into the accreditation process with the World Indigenous Higher Education Consortium (WINHEC). Part of that process includes identifying the local cultural standards and protocols that drive and shape our work as a cultural entity.…

"Give Courage to the Ladies:" Expansive Apprenticeship for Women in Rural Malawi

ERIC Educational Resources Information Center

Safford, Kimberly; Cooper, Deborah; Wolfenden, Freda; Chitsulo, Joyce

2013-01-01

Apprenticeship in developed and industrialised nations is increasingly understood and practised as learning which connects workplace activity and formal study. The concept of "expansive apprenticeship" defines frameworks for workforce development where participants acquire knowledge and skills which will help them in the future as well…

Practising What We Preach: Justice and Ethical Instruction in Management Education

ERIC Educational Resources Information Center

Robbins, Tina L.; Jeffords, Ben C.

2009-01-01

Building on organizational justice research, we extended the study of classroom justice to management education. In the first study, we identified the criteria that business students use to define distributive, procedural, and interactional fairness. In a second study, we found that management students' perceptions of both procedural and…

Why Literature Students Should Practise Life Writing

ERIC Educational Resources Information Center

Cardell, Kylie; Douglas, Kate

2018-01-01

This article considers our experiences teaching a hybrid literature/creative writing subject called "Life Writing." We consider the value of literature students engaging in creative writing practice--in this instance, the nonfiction subgenre of life writing--as part of their critical literary studies. We argue that in practicing life…

Practising Ethics: Bildungsroman and Community of Practice in Occupational Therapists' Professional Development

ERIC Educational Resources Information Center

Grisbrooke, Jani

2013-01-01

Professional ethics has currently raised its public profile in the UK as part of social anxiety around governance of health and social care, fuelled by catastrophically bad practice identified in particular healthcare facilities. Professional ethics is regulated by compliance with abstracted, normative codes but experienced as contextualised…

The Theological Disposition of Lay Catholic Headteachers

ERIC Educational Resources Information Center

Richardson, Christopher

2014-01-01

The differing theological perspectives evident in the literature on Catholic schools and education suggest those who appoint headteachers in Catholic schools may need to know more about candidates than that they are practising Catholics. This paper summarises a doctoral research project aimed at identifying the dominant theological motifs that…

Design and Implementation of a Project-Based Active/Cooperative Engineering Design Course for Freshmen

ERIC Educational Resources Information Center

Abdulaal, R. M.; Al-Bahi, A. M.; Soliman, A. Y.; Iskanderani, F. I.

2011-01-01

A project-based active/cooperative design course is planned, implemented, assessed and evaluated to achieve several desired engineering outcomes. The course allows freshman-level students to gain professional hands-on engineering design experience through an opportunity to practise teamwork, quality principles, communication skills, life-long…

Storytelling across the Primary Curriculum

ERIC Educational Resources Information Center

Daniel, Alastair K.

2011-01-01

Starting from the question "what is a story?" "Storytelling Across the Primary Curriculum" leads the reader through the theory and practise of storytelling as an educational method--a method taught by the author over the last ten years through Primary English teaching programmes. This practical book gives teachers the skills and confidence to use…

Learning in Global Settings: Developing Transitions for Meaning-Making

ERIC Educational Resources Information Center

Norden, Birgitta; Avery, Helen; Anderberg, Elsie

2012-01-01

Global teaching and learning for sustainable development reaches from the classroom to the world outside, and is therefore a particularly interesting setting for practising transition skills. The article suggests a number of features perceived as crucial in developing young people's capability to act in a changing world and under circumstances…

Exemplary Teachers: Teaching for Intellectual Freedom

ERIC Educational Resources Information Center

Collinson, Vivienne

2012-01-01

Intellectual freedom has long been a desirable ideal and a foundational value for supporting democratic governance. Since 1948, it has been a universal human right. Given the unique nature of education in democratic societies, schools serve as a crucible for helping children understand and practise the rudiments of intellectual freedom. Drawing on…

Sport for Older Persons.

ERIC Educational Resources Information Center

Council of Europe, Strasbourg (France).

The following papers were prepared for a seminar on sport for older people: (1) "Gerontological Aspects of Physical Exercise" (Eino Heikkinen); (2) "Sporting Activities in the Individual Life from the View of Older Persons" (Henning Allmer); (3) "Reasons Why Decision-Makers Should Urge Old People to Practise Physical and Sporting Activities"…

Practising Knowing: Emergence(y) Teleologies

ERIC Educational Resources Information Center

Manidis, Marie; Scheeres, Hermine

2013-01-01

This article presents a meta-disciplinary and institutional framework of practices used by nurses and doctors to manage the indeterminacy of knowing in emergency departments (EDs) in Australia. We draw on Schatzkian perspectives of how practices prevail and reflect particular site ontologies. We posit that nurses and doctors draw on a repertoire…

JPRS Report, Science & Technology, Europe, EC Commissioners Evaluate Electronics, Computer Industries

DTIC Science & Technology

1991-06-14

American firms of foreign origin as regards R&TD is being practised by the Department of Defense, and Sematech is one example here. As negotiations... taxation measures. Training schemes for staff in the banking sector encom- passing both the financial side and computerized sys- tems applications

An Enhanced Studio Physics Model: Which Technologies are Productive?

ERIC Educational Resources Information Center

MacKinnon, Gregory R.; Williams, Peter

2006-01-01

The notion of problem-based physics laboratories enhanced by computer technology has been coined "studio physics" (Wilson, 1994) and has been practised at various institutions for some time (Cummings, Marx, Thornton, & Kuhl, 1999; Williams, MacLatchy, Backman, & Retson, 1997). In recent years, new technology tools have been available to supplement…

Facing and Managing Dilemmas as a Clinical Educator

ERIC Educational Resources Information Center

McAllister, Lindy; Higgs, Joy; Smith, David

2008-01-01

Although clinical educators make an important and irreplaceable contribution to the education of students undertaking qualifications that will enable them to practise as health professionals, little is known about the day-to-day experiences of clinical educators and the complexities of clinical education that may contribute to the problems or to…

Counsellors' Attitudes towards Disability Equality Training (DET)

ERIC Educational Resources Information Center

Parkinson, Gill

2006-01-01

This paper explores the attitudes and conceptions held by trainee and practising counsellors towards people with disabilities. Awareness of counsellors' own views of disability and impairment can complicate the counsellor-client relationship when the latter is seen primarily from a deficiency model perspective or self-defined model of disability,…

Intercultural versus Interreligious Dialogue in a Pluralist Europe

ERIC Educational Resources Information Center

Arthur, James

2011-01-01

Intercultural dialogue, as currently theorized and practised by the Council of Europe, is limited in its capacity to contribute to social cohesion in and among religious communities who differ fundamentally from each other. Adherents of the major religions believe that their religion is uniquely true and consequently feel that their religious…

Computer-Mediated Communication in Continuing Professional Education: A Guarded Appraisal.

ERIC Educational Resources Information Center

Rees, Keith

Deakin Australia, the commercial arm of Deakin University, has included computer-mediated communication (CMC) as an element of the professional development program produced in conjunction with the Australian Society of Certified Practising Accountants (ASCPA). The CPA program is delivered by distance education to candidates seeking professional…

Repositioning Early Childhood Leadership as Action and Activism

ERIC Educational Resources Information Center

Woodrow, Christine; Busch, Gillian

2008-01-01

Robust leadership is increasingly recognised as a critical element of healthy professions, yet some research suggests that early childhood practitioners do not readily identify with the concept of leadership. This article explores some dimensions of leadership in early childhood and how it is understood and practised in Australian early childhood…

[Chemists and chemistry in the Journal of Medicine, Surgery, Pharmacy &c., from 1754 until 1791].

PubMed

Fournier, Josette

2006-01-01

Since its coming out (1754) until the publication of the Annales de chimie (1789), the Journal de Médecine, Chirurgie, Pharmacie, &c. received papers and pieces of news from chemists; many of them cultivated their love for chemistry while they practised health professions.

Online Students' Perceptions of Interactive Tools to Support Postgraduate Learning of Mathematics

ERIC Educational Resources Information Center

Prieto, Elena; Holmes, Kathryn

2014-01-01

With the advent of new technologies, methods of blended learning are used in online mathematics classrooms to facilitate interactions and provide a richer experience for students. This paper analyses data obtained from practising teachers during their participation in two postgraduate mathematics courses. We conclude that discussion forum…

Virtual Peace Education

ERIC Educational Resources Information Center

Firer, Ruth

2008-01-01

This article is based on the convictions that peace education is the basis for any sustainable non-violent relations between parties in a conflict, and that virtual peace education is almost the only feasible way to practise peace education in an open violent conflict as is the current Israeli/Palestinians one. Moreover, virtual peace education…

Leadership and Team Dynamics in Senior Executive Leadership Teams

ERIC Educational Resources Information Center

Barnett, Kerry; McCormick, John

2012-01-01

As secondary school environments become increasingly complex, shifts are occurring in the way leadership is being practised. New leadership practices emphasize shared or distributed leadership. A senior executive leadership team with responsibility for school leadership is likely to be one of the many, varied forms of new leadership practices…

Adolescent Leadership: The Female Voice

ERIC Educational Resources Information Center

Archard, Nicole

2013-01-01

This research investigated the female adolescent view of leadership by giving voice to student leaders through focus group discussions. The questions: What is leadership? Where/how was leadership taught?, and How was leadership practised? were explored within the context of girls' schools located in Australia, with one school located in South…

Developing Mathematical Fluency: Comparing Exercises and Rich Tasks

ERIC Educational Resources Information Center

Foster, Colin

2018-01-01

Achieving fluency in important mathematical procedures is fundamental to students' mathematical development. The usual way to develop procedural fluency is to practise repetitive exercises, but is this the only effective way? This paper reports three quasi-experimental studies carried out in a total of 11 secondary schools involving altogether 528…

Learning Molecular Genetics in Teacher-Led Outreach Laboratories

ERIC Educational Resources Information Center

Ben-Nun, Michal Stolarsky; Yarden, Anat

2009-01-01

Learning modern genetics is challenging and students have difficulty acquiring a coherent cognitive mental model of abstract concepts such as DNA, bacteria and enzymes. Here we investigated students' mental models of genetics through analysis and interpretation of the discourse that took place while high-school students practised hands-on…

From Birth to Sixteen: Children's Health, Social, Emotional and Linguistic Development

ERIC Educational Resources Information Center

Cowie, Helen

2012-01-01

"From Birth to Sixteen" outlines children's physical, social, emotional and language development from infancy through to adolescence. In both its practical application of research and its contribution to the assessment of child development, this text provides essential reading for those studying, or indeed practising, child development in the…

[Local anesthesia in dentistry. Additional techniques].

PubMed

Makkes, P C; Bouvy-Berends, E C; Rupreht, J

1996-05-01

Patients with insufficient coping abilities can yet be dentally treated by practising several additional techniques. Behaviour management should always be the starting point of all dental treatment strategies. In the end the administration of well selected drugs should lead, via anxiolysis, sedation or general anaesthesia, to a painfree and optimal treatable patient.

Postgraduate Programmes on Environmental Water Resources Engineering and Management in Greek Universities

ERIC Educational Resources Information Center

Latinopoulos, Pericles; Angelidis, Panagiotis

2014-01-01

The management of complex water problems is nowadays being practised through new ways and approaches. Therefore, water engineers, planners and managers should be appropriately educated through modern undergraduate curricula and by well-designed postgraduate specialisation programmes. Within this framework, a study of the specific characteristics…

Planning, Practising and Prioritising Wellness through an Integrative Behaviour Change Plan

ERIC Educational Resources Information Center

Crossman, Joanne M.

2016-01-01

Study objective: To describe a successful approach to teaching principles and practices of behaviour change through a behaviour change plan (BCP) initiative to improve personal health while advancing health knowledge and general education intellectual skills. Students' perspectives of obstacles, behaviours important towards goal attainment and the…

Online Assessment Feedback: Competitive, Individualistic, or? Preferred Form!

ERIC Educational Resources Information Center

Bower, Matt

2005-01-01

This study investigated the "the effects of receiving the preferred form of online assessment feedback upon middle school mathematics students." Students completed a Web-based quadratics equations learning module followed by a randomly generated online quiz that they could practise as often as they liked. The effect of receiving their preferred…

Learning a Practice through Practise: Presenting Knowledge in Doctoral Spoken Presentations

ERIC Educational Resources Information Center

Manidis, Marie; Addo, Rebecca

2017-01-01

Learning to "become doctor" requires PhD candidates to undertake progressive public displays--material and social--of knowledge. Knowledge in doctoral pedagogy is primarily realised textually, with speaking and writing remaining as the primary assessment rubrics of progress and of the qualification. Participating textually begins, in a…

Student Evaluation of CALL Tools during the Design Process

ERIC Educational Resources Information Center

Nesbitt, Dallas

2013-01-01

This article discusses the comparative effectiveness of student input at different times during the design of CALL tools for learning kanji, the Japanese characters of Chinese origin. The CALL software "package" consisted of tools to facilitate the writing, reading and practising of kanji characters in context. A pre-design questionnaire…

Silent Starters

ERIC Educational Resources Information Center

Morris, Emma

2011-01-01

The "silent starter" is an idea that the author was reminded of during Christopher Martin's session at the ATM conference in 2011, entitled "Big Ideas". This was a nice idea for introducing, or practising mappings, but it was not the first time the author had encountered this powerful teaching tool. The idea is best explained…

The Politics of Difference and Diversity: From Young Children's Violence to Creative Power Expressions

ERIC Educational Resources Information Center

Pacini-Ketchabaw, Veronica; Berikoff, Ahna

2008-01-01

This article reinterprets practising for diversity and difference discursively and contextually using post-colonial, anti-racist feminist, and post-structural lenses. Working with data from a participatory action research project, the article critically reflects on normalized and standardized discourses of difference and diversity by interrogating…

Practise What You Preach: The Interactive Whiteboard in Preschool Mathematics Education

ERIC Educational Resources Information Center

Bourbour, Maryam; Masoumi, Davoud

2017-01-01

The Interactive Whiteboard (IWB) is now a common technological artefact in Swedish preschools and schools. This study examines preschool teachers' thinking behind the embedding of IWB in the early years' mathematics classroom and how preschool teachers structure their mathematical activities when using IWB. Two complementary empirical studies,…

Practising English Phonetic Symbols in a Communicative Way.

ERIC Educational Resources Information Center

Chu, Wai Ling

Classroom exercises designed to help students learn phonetic symbols more effectively are described. The exercises were developed for use in a Hong Kong school. The idea behind their creation was that use of the symbols in communicative situations would emphasize their utility for learning English pronunciation. Each exercise uses contextualized…

Are satisfaction with and self-management of personal assistance services associated with the life satisfaction of persons with physical disabilities?

PubMed

Fleming-Castaldy, Rita P

2011-01-01

To examine the relationships between satisfaction with and self-management of personal assistance services (PAS) and the quality of life (QoL) of persons with disabilities. To test the postulate that consumer-directed PAS can fulfil the human need for control and contribute to a satisfactory life. A survey compared the perspectives of persons using consumer-directed PAS versus those using agency-directed. A Personal Data Form obtained demographics and PAS characteristics. The Quality of Life Inventory measured life satisfaction. A PAS questionnaire measured perceptions about the management of, desire for control of, and satisfaction with PAS. Data were analysed using SPSS®- 14. Significant relationships were found between QoL and satisfaction with PAS (p < 0.001) and between perceived control of PAS and satisfaction with PAS (p < 0.001). Significant group differences were also found. Consumer-directed participants reported higher satisfaction with their PAS (p < 0.01), greater control over services (p < 0.001) and greater QoL than agency-directed participants, (p = 0.001). The relationships found between self-management, PAS satisfaction, and QoL support the value of consumer-directed programmes. Rehabilitation professionals can use this knowledge to develop, implement and research practises that enable self-management.

RNTCP 2007: looking ahead to future challenges.

PubMed

Chauhan, L S

2007-04-01

The largest TB control programme in terms of patients treated is India's Revised National Tuberculosis Control Programme (RNTCP). The treatment success of new smear positive TB cases under RNTCP has exceeded the global benchmark of 85%. Also there are some challenges in TB control programme eg, addressing TB in HIV-infected persons and accurate diagnosis and management of multidrug resistant TB (MDR-TB). Diagnosis of MDR-TB requires sophisticated laboratories. If MDR-TB is not managed effectively, then there is possibility to emerge drug-resistant TB which is virtually untreatable. The Public-Private mix initiatives of RNTCP attempt to make quality assured treatment for TB for all patients, regardless of healthcare providers they choose. The International Standards of TB Care (ISTC) is an international effort which has articulated the diagnostic, treatment and public health standards which all providers should hold themselves and their peers accountable to. For providers the path to practise the ISTC is to diagnose and treat patients in collaboration with RNTCP. The IMA has taken up the cause of TB control in India very seriously. This organisation of the doctors (IMA) deserves recognition for becoming the first professional association to endorse the ISTC in India. All health providers should work with and support the RNTCP, so that the programme can be made into a genuine mass movement to fight TB.

How does practise of internal Chinese martial arts influence postural reaction control?

PubMed

Gorgy, Olivier; Vercher, Jean-Louis; Coyle, Thelma

2008-04-01

The aim of this study was to determine the effects of Chinese martial arts practice on postural reaction control after perturbation. Participants standing in Romberg tandem posture were subjected to an unexpected lateral platform translation with the eyes open or closed at two translation amplitudes. The peak displacement of the centre of pressure and of the centre of mass, and the onset latency of muscular activity (tibialis anterior, gastrocnemius, lumbodorsal muscular group, and rectus abdominis), were evaluated for martial arts practitioners and for sport and non-sport participants. Compared with the sport and non-sport participants, the martial arts group showed lower maximal centre of pressure and centre of mass peak displacements in both the lateral and anterior - posterior directions, but no difference was found in the onset of muscular responses. We conclude that martial arts practice influences postural reaction control during a fixed-support strategy in a tandem task. The martial arts group used the ankle joint more frequently than the sport and non-sport participants, especially in the eyes-closed conditions. Our results suggest that the better balance recovery in the martial arts group is a consequence of better control of biomechanical properties of the lower limbs (e.g. through muscular response by co-contraction), not a change in the neuromuscular temporal pattern.

Quality nursing care: a qualitative enquiry.

PubMed

Hogston, R

1995-01-01

In spite of the wealth of literature on quality nursing care, a disparity exists in defining quality. The purpose of this study was an attempt to seek out practising nurses' perceptions of quality nursing care and to present a definition of quality as described by nurses. Eighteen nurses from a large hospital in the south of England were interviewed. Qualitative analysis based on a modified grounded theory approach revealed three categories described as 'structure', 'process' and 'outcome'. This supports previous work on evaluating quality care but postulates that structure, process and outcome could also be used as a mechanism for defining quality. The categories are defined by using the words of the informants in order to explain the essential attributes of quality nursing care. The findings demonstrate how more informants cited quality in terms of process and outcome than structure. It is speculated that the significance of this rests with the fact that nurses have direct control over process and outcome whereas the political and economic climate in which nurses work is beyond their control and decisions over structure lie with their managers.

Learning cardiopulmonary resuscitation skills: does the type of mannequin make a difference?

PubMed

Noordergraaf, G J; Van Gelder, J M; Van Kesteren, R G; Diets, R F; Savelkoul, T J

1997-12-01

Resuscitation (CPR) courses stress acquisition of psychomotor skills. The number of mannequins may limit the 'hands-on' time available for each trainee to practise CPR and impede acquisition of skill. This may occur because expensive, sophisticated mannequins are favoured over individual, simple mannequins. In a blind, prospective, controlled study we compared one-rescuer CPR skills of 165 trainees in two cohorts using their own individual light-weight torso mannequins (Actar 911 and Laerdal Little Anne) and a control cohort with four to five trainees sharing a sophisticated mannequin (Laerdal Recording Resusci Anne). No major significant differences (p = 0.18) were found when using the 'Berden scoring system'. Both the Actar 911 and the Little Anne were compatible with the Recording Resusci Anne. Trainees preferred the individual mannequins. We conclude that the results indicate that the use of individual mannequins in conjunction with a sophisticated mannequin neither results in trainees learning incorrect skills nor in significant improvement. Further analysis of the actual training in lay person CPR training courses and evaluation of course didactics to optimize training time appear indicated.

Thermal behaviour of ESP ash from municipal solid waste incinerators.

PubMed

Yang, Y; Xiao, Y; Wilson, N; Voncken, J H L

2009-07-15

Stricter environmental regulations demand safer treatment and disposal of incinerator fly ashes. So far no sound technology or a process is available for a sustainable and ecological treatment of the waste incineration ashes, and only partial treatment is practised for temporary and short-term solutions. New processes and technology need to be developed for comprehensive utilization and detoxification of the municipal solid waste (MSW) incinerator residues. To explore the efficiency of thermal stabilisation and controlled vitrification, the thermal behaviour of electrostatic precipitator (ESP) ash was investigated under controlled conditions. The reaction stages are identified with the initial moisture removal, volatilization, melting and slag formation. At the temperature higher than 1100 degrees C, the ESP ashes have a quicker weight loss, and the total weight loss reaches up to 52%, higher than the boiler ash. At 1400 degrees C a salt layer and a homogeneous glassy slag were formed. The effect of thermal treatment on the leaching characteristics of various elements in the ESP ash was evaluated with the availability-leaching test. The leaching values of the vitrified slag are significantly lowered than that of the original ash.

Science, humanism, judgement, ethics: person-centered medicine as an emergent model of modern clinical practice.

PubMed

Miles, Andrew

2013-01-01

The Medical University of Plovdiv (MUP) has as its motto 'Committed to humanity". But what does humanity in modern medicine mean? Is it possible to practise a form of medicine that is without humanity? In the current article, it is argued that modern medicine is increasingly being practised in a de-personalised fashion, where the patient is understood not as a unique human individual, a person, but rather as a subject or an object and more in the manner of a complex biological machine. Medicine has, it is contended, become distracted from its duty to care, comfort and console as well as to ameliorate, attenuate and cure and that the rapid development of medicine's scientific knowledge is, paradoxically, principally causative. Signal occurrences in the 'patient as a person' movement are reviewed, together with the emergence of the evidence-based medicine (EBM) and patient-centered care (PCC) movements. The characteristics of a model of medicine evolving in response to medicine's current deficiencies--person-centered healthcare (PCH)--are noted and described. In seeking to apply science with humanism, via clinical judgement, within an ethical framework, it is contended that PCH will prove to be far more responsive to the needs of the individual patient and his/her personal circumstances than current models of practice, so that neither a reductive anatomico-pathological, disease-centric model of illness (EBM), nor an aggressive patient-directed, consumerist form of care (PCC) is allowed continued dominance within modern healthcare systems. In conclusion, it is argued that PCH will enable affordable advances in biomedicine and technology to be delivered to patients within a humanistic framework of clinical practice that recognises the patient as a person and which takes full account of his/her stories, values, preferences, goals, aspirations, fears, worries, hopes, cultural context and which responds to his/her psychological, emotional, spiritual and social necessities in addition to his/her physical needs. MUP, in assimilating such arguments and introducing person-centered medicine teaching into the University, is engaged in a notable and laudable initiative which will function as a salutary example to other medical schools within Europe and elsewhere.

Cost-Effectiveness Analysis of Three Leprosy Case Detection Methods in Northern Nigeria

PubMed Central

Ezenduka, Charles; Post, Erik; John, Steven; Suraj, Abdulkarim; Namadi, Abdulahi; Onwujekwe, Obinna

2012-01-01

Background Despite several leprosy control measures in Nigeria, child proportion and disability grade 2 cases remain high while new cases have not significantly reduced, suggesting continuous spread of the disease. Hence, there is the need to review detection methods to enhance identification of early cases for effective control and prevention of permanent disability. This study evaluated the cost-effectiveness of three leprosy case detection methods in Northern Nigeria to identify the most cost-effective approach for detection of leprosy. Methods A cross-sectional study was carried out to evaluate the additional benefits of using several case detection methods in addition to routine practice in two north-eastern states of Nigeria. Primary and secondary data were collected from routine practice records and the Nigerian Tuberculosis and Leprosy Control Programme of 2009. The methods evaluated were Rapid Village Survey (RVS), Household Contact Examination (HCE) and Traditional Healers incentive method (TH). Effectiveness was measured as number of new leprosy cases detected and cost-effectiveness was expressed as cost per case detected. Costs were measured from both providers' and patients' perspectives. Additional costs and effects of each method were estimated by comparing each method against routine practise and expressed as incremental cost-effectiveness ratio (ICER). All costs were converted to the U.S. dollar at the 2010 exchange rate. Univariate sensitivity analysis was used to evaluate uncertainties around the ICER. Results The ICER for HCE was $142 per additional case detected at all contact levels and it was the most cost-effective method. At ICER of $194 per additional case detected, THs method detected more cases at a lower cost than the RVS, which was not cost-effective at $313 per additional case detected. Sensitivity analysis showed that varying the proportion of shared costs and subsistent wage for valuing unpaid time did not significantly change the results. Conclusion Complementing routine practice with household contact examination is the most cost-effective approach to identify new leprosy cases and we recommend that, depending on acceptability and feasibility, this intervention is introduced for improved case detection in Northern Nigeria. PMID:23029580

Provision of care for chronic kidney disease by non-nephrologists in a developing nation: a national survey

PubMed Central

Al Shamsi, S; Al Dhanhani, A; Sheek-Hussein, M M

2016-01-01

Objectives The prevalence of chronic kidney disease (CKD) in developing countries has increased dramatically. This study aimed to explore the practice patterns of non-dialysis-dependent CKD care in an affluent developing country. Settings Primary and specialised healthcare facilities of public and private sectors in the United Arab Emirates. Participants 159 non-nephrologist physicians practising in the United Arab Emirates. Interventions A 28-item online self-administered questionnaire based on CKD clinical practice guidelines. Primary and secondary outcome measures The physicians' approach to identifying and managing patients with CKD. Results The survey was completed by 159 non-nephrologists, of whom 135 reported having treated patients with CKD. Almost all the respondents screen patients with hypertension and diabetes for CKD, but one-third of them do not screen patients with cardiovascular disease and elderly patients for CKD. The use of accurate CKD screening tests (estimated glomerular filtration rate and albumin/creatinine ratio) was suboptimal (77% and 59% of physicians used the procedures, respectively). One-third of the physicians do not offer treatment with inhibitors of the renin–angiotensin system to patients with CKD, and only 66% offer antilipid treatment. In general, the primary healthcare physicians are more familiar than secondary healthcare physicians with the diagnosis and management of patients with CKD. Conclusions We identified substantial physician-declared deficiencies in the practice of identifying and managing early CKD. Integration of quality CKD care within the healthcare system is required to face the increasing burden of CKD in the United Arab Emirates and possibly in other developing nations. PMID:27481619

Evaluation of nutritional status and support in children with congenital heart disease.

PubMed

Blasquez, A; Clouzeau, H; Fayon, M; Mouton, J-B; Thambo, J-B; Enaud, R; Lamireau, T

2016-04-01

The objective of this disease was to determine the prevalence of malnutrition in children with congenital heart disease (CHD). A total of 125 children with CHD, under 6 months of age, were divided into four groups: no pulmonary hypertension (PH) or cyanosis (group 1, n=47), isolated cyanosis (group 2, n=52), isolated PH (group 3, n=16), and PH and cyanosis (group 4, n=10). Six children died at 6 months (n=4), 12 months (n=1) and 19 months (n=1). The remaining children were followed-up for 24 months. Prevalence of moderate to severe malnutrition (weight/weight for height <80%), caloric intake and medications were compared between the four groups. Moderate or severe malnutrition was more frequent in group 4 (100%) compared with others groups (group 1, 20%; group 2, 16.7% and group 3, 50%; P<0.05). Low oral caloric intake was more frequent in group 3 (71.4%) and group 4 (75%) than in group 1 (28%) and 2 (28.6%) (P<0.05). Food enrichment was practised in half of the children of group 4 and rarely in other groups (group 1, 15.8%; group 2, 8.6% and group 3, 11.1%; P<0.05). Enteral feeding was used more often in groups 3 (33.3%) and 4 (50%) than in groups 1 (15.8%) or 2 (14.3%; P<0.05). Moderate or severe malnutrition is present in 15% of children with CHD, and it is more frequent in case of PH. Half of these children demonstrate low caloric intake, whereas few have proper nutritional support.

Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia.

PubMed

Makmun, Dadang

2014-04-01

Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85000 general practitioners and 25000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health-care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3-6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures. © 2014 The Author. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

Migration of the CERN IT Data Centre Support System to ServiceNow

NASA Astrophysics Data System (ADS)

Alvarez Alonso, R.; Arneodo, G.; Barring, O.; Bonfillou, E.; Coelho dos Santos, M.; Dore, V.; Lefebure, V.; Fedorko, I.; Grossir, A.; Hefferman, J.; Mendez Lorenzo, P.; Moller, M.; Pera Mira, O.; Salter, W.; Trevisani, F.; Toteva, Z.

2014-06-01

The large potential and flexibility of the ServiceNow infrastructure based on "best practises" methods is allowing the migration of some of the ticketing systems traditionally used for the monitoring of the servers and services available at the CERN IT Computer Centre. This migration enables the standardization and globalization of the ticketing and control systems implementing a generic system extensible to other departments and users. One of the activities of the Service Management project together with the Computing Facilities group has been the migration of the ITCM structure based on Remedy to ServiceNow within the context of one of the ITIL processes called Event Management. The experience gained during the first months of operation has been instrumental towards the migration to ServiceNow of other service monitoring systems and databases. The usage of this structure is also extended to the service tracking at the Wigner Centre in Budapest.

Use of augmented feedback for the modification of the pedaling mechanics of cyclists.

PubMed

Sanderson, D J; Cavanagh, P R

1990-03-01

On-line computer representation of forces applied to the pedals during a 90-degree sector of the pedaling cycle were used to train a group of cyclists to alter their pattern of force application while they cycled on a stationary cycle. The subjects rode for 32 min each day for ten days. During these training rides, three cyclists were given augmented feedback on only their pedaling rate, while three other cyclists were presented with augmented, visual feedback on the magnitude of force application in the sector of interest as well as cadence. At the end of the training period it was noted that the experimental group showed significantly reduced pedal forces in the sector of interest while the control group did not. It was concluded that this technique of modifying a well-practised task was an effective one and that it could be used to explore various training modalities and other pedaling styles.

Improving the effectiveness of psychotherapy in two public hospitals in Nairobi

PubMed Central

Falkenström, Fredrik; Gee, Matthew David; Kuria, Mary Wangari; Othieno, Caleb Joseph; Kumar, Manasi

2017-01-01

This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a ‘best practice’ approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes. PMID:29093948

Improving the effectiveness of psychotherapy in two public hospitals in Nairobi.

PubMed

Falkenström, Fredrik; Gee, Matthew David; Kuria, Mary Wangari; Othieno, Caleb Joseph; Kumar, Manasi

2017-08-01

This paper is the first in a planned series of papers studying the effectiveness of psychotherapy and counselling in Nairobi. It describes a method for checking the effectiveness of psychotherapy and improving service quality in a Kenyan context. Rather than prematurely imposing psychotherapy protocols developed in Western countries in another cultural context, we believe that first studying psychological interventions as they are practised may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems. The initial step is to assess outcome of psychological treatments as they are conducted. This is followed by statistical analyses aimed at identifying patient groups who are not improving at acceptable rates. Therapists will then be trained in a 'best practice' approach, and controlled trials are used in a final step, testing new interventions specifically targeted at patient groups with sub-optimal outcomes.

Fire and ecotoxicological aspects of polyurethane rigid foam.

PubMed

Wittbecker, F W; Giersig, M

2001-01-01

The main characteristics of fire effluents from polyurethane (PUR) foams are comparable to those from natural materials like wood, cork, or wool. This similarity has been demonstrated by comparative data from analytical and toxicological studies. It is therefore presumed that effluents of these materials present similar hazards to human beings and the environment. In almost all fires, dioxins can be found in the smoke and residues. In fires involving PURs, relevant quantities of halogenated dioxins or furans are not to be expected; this has been confirmed by investigations under controlled laboratory conditions. The insulation properties of rigid PUR foam contribute significantly to environmental protection and the conservation of resources. A number of methods for reusing and recycling PUR rigid foam waste have been developed and realized in practise. The possibilities range from reusing the material itself, generating liquid raw materials, and thermal recycling, even for (H)CFC-containing PUR rigid foams, by cocombustion in suitable plants.

Occupational stress among Swedish audiologists in clinical practice: Reasons for being stressed.

PubMed

Brännström, K Jonas; Holm, Lucas; Larsson, Josefina; Lood, Sofie; Notsten, Margareta; Turunen Taheri, Satu

2016-08-01

The present study reports on the application of a Swedish translation of the audiologist occupational stress questionnaire (AOSQ) on audiologists working in Sweden. The relations between AOSQ scores and perceived effort, perceived rewards, coping strategies at work, demographic variables such as salary, education length, practise length, and practice type were tested. A cross-sectional e-mail survey using the AOSQ, effort-reward imbalance questionnaire, and demographic questions. Four-hundred and four Swedish licensed audiologists working with clients. The Swedish AOSQ translation demonstrated high inter-item correlations and high internal consistency. Several stress factors were identified: time spent at work, accountability, leadership at the workplace, paperwork and practice demands, equipment and clinical protocols, own health concerns, and job control. The outcome on the complete AOSQ questionnaire was related to perceived effort, perceived rewards, coping strategies at work, and age. The Swedish AOSQ translation seems to provide a valid measure of occupational stress among audiologists.

[Food, health claims and drugs. Conclusions - recommendations. The National Academy of Pharmacy].

PubMed

Bourlioux, P

2008-01-01

Even if the activity of health claim foods is not relevant to the activity of drugs, we are just at the frontier of two fields which needs the greatest attention. Since foods and drugs are present in the same domain of prevention, the French Academy of Pharmacy draws attention on the necessary relevant and scientifically proven demonstration of the health claims using the same quality standard than those used for drugs (good clinical practises, methodologies correspondent to the current requirement, etc.). It is why the Academy wishes to express five recommendations fearing that the risks of confusion and abuse prevail on the possibilities of information and control. Make sure that foods are not mistaken with drugs; largely spread the lists of authorised claims; introduce the new notion of "nutrivigilance"; make sure that the only authorised health claims use advertising; reject the terms "alicaments" and "nutraceuticals" which are confusing with drugs.

Remote-controlled optics experiment for supporting senior high school and undergraduate teaching

NASA Astrophysics Data System (ADS)

Choy, S. H.; Jim, K. L.; Mak, C. L.; Leung, C. W.

2017-08-01

This paper reports the development of a remote laboratory (RemoteLab) platform for practising technologyenhanced learning of optics. The development of RemoteLab enhances students' understanding of experimental methodologies and outcomes, and enable students to conduct experiments everywhere at all times. While the initial goal of the system was for physics major undergradutes, the sytem was also made available for senior secondary school students. To gauge the impact of the RemoteLab, we evaluated two groups of students, which included 109 physics 1st-year undergraduates and 11 students from a local secondary school. After the experiments, evaluation including questionnaire survey and interviews were conducted to collect data on students' perceptions on RemoteLab and implementation issues related to the platform. The surveys focused on four main topics, including user interface, experiment setup, booking system and learning process. The survey results indicated that most of the participants' views towards RemoteLab was positive.

Ranging algebraically with more observations than unknowns

NASA Astrophysics Data System (ADS)

Awange, J. L.; Fukuda, Y.; Takemoto, S.; Ateya, I. L.; Grafarend, E. W.

2003-07-01

In the recently developed Spatial Reference System that is designed to check and control the accuracy of the three-dimensional coordinate measuring machines and tooling equipment (Metronom US., Inc., Ann Arbor: http://www.metronomus.com), the coordinates of the edges of the instrument are computed from distances of the bars. The use of distances in industrial application is fast gaining momentum just as in Geodesy and in Geophysical applications and thus necessitating efficient algorithms to solve the nonlinear distance equations. Whereas the ranging problem with minimum known stations was considered in our previous contribution in the same Journal, the present contribution extends to the case where one is faced with many distance observations than unknowns (overdetermined case) as is usually the case in practise. Using the Gauss-Jacobi Combinatorial approach, we demonstrate how one can proceed to position without reverting to iterative and linearizing procedures such as Newton's or Least Squares approach.

Digital Game-Based Learning: A Supplement for Medication Calculation Drills in Nurse Education

ERIC Educational Resources Information Center

Foss, Brynjar; Lokken, Atle; Leland, Arne; Stordalen, Jorn; Mordt, Petter; Oftedal, Bjorg F.

2014-01-01

Student nurses, globally, appear to struggle with medication calculations. In order to improve these skills among student nurses, the authors developed The Medication Game--an online computer game that aims to provide simple mathematical and medical calculation drills, and help students practise standard medical units and expressions. The aim of…

A locator list of some medieval ophthalmological texts.

PubMed

Eldredge, L M

2007-01-01

At the turn of the last century, there was a flurry of interest in medieval ophthalmological texts. Many of these were edited by practising ophthalmologists, interested in learning and applying the techniques of their distant predecessors. The editions are often difficult to find, and I have listed them along with at least one library location.

Practising Arithmetic Using Educational Video Games with an Interpersonal Computer

ERIC Educational Resources Information Center

Beserra, Vagner; Nussbaum, Miguel; Zeni, Ricardo; Rodriguez, Werner; Wurman, Gabriel

2014-01-01

Studies show the positive effects that video games can have on student performance and attitude towards learning. In the past few years, strategies have been generated to optimize the use of technological resources with the aim of facilitating widespread adoption of technology in the classroom. Given its low acquisition and maintenance costs, the…

Practising What We Teach: Vocational Teachers Learn to Research through Applying Action Learning Techniques

ERIC Educational Resources Information Center

Lasky, Barbara; Tempone, Irene

2004-01-01

Action learning techniques are well suited to the teaching of organisation behaviour students because of their flexibility, inclusiveness, openness, and respect for individuals. They are no less useful as a tool for change for vocational teachers, learning, of necessity, to become researchers. Whereas traditional universities have always had a…

Perspectives on Public Relations Training in International Schools

ERIC Educational Resources Information Center

Bunnell, Tristan

2005-01-01

Purpose: Evidence from the UK shows that public relations (PR) in schools initially met with resistance but has since entered a second phase, that of "post marketisation". But, it is still believed that unqualified and untrained administrators practise it in schools. Little formal research has been undertaken into this, especially among the…

The Preparation and Practice of Disabled Health Care Practitioners: Exploring the Issues

ERIC Educational Resources Information Center

Hargreaves, Janet; Dearnley, Christine; Walker, Stuart; Walker, Lizzie

2014-01-01

Regulatory bodies governing health professions and professional education set clear expectations regarding fitness to practise. Within the UK, the Equality Act, 2010, poses a challenge to regulators, educators and employers to ensure that people are not excluded on the basis of disability and to facilitate inclusion. This research took a mixed…

Long-Term Care Planning Study: Strengths and Learning Needs of Nursing Staff

ERIC Educational Resources Information Center

Cruttenden, Kathleen E.

2006-01-01

This planning study was designed and conducted in a predominantly rural Canadian province to examine the strengths and learning needs of four categories of nursing staff practising in New Brunswick nursing homes. Participants included directors of care, registered nurses, licensed practical nurses, and resident attendants. The nursing homes ranged…

Attitudes to Bereavement and Intellectual Disabilities in an Irish Context

ERIC Educational Resources Information Center

Dodd, Philip; McEvoy, John; Guerin, Suzanne; McGovern, Elizabeth; Smith, Elaine; Hillery, John

2005-01-01

Background: The influence of grief and bereavement on the lives of people with intellectual disabilities is currently receiving much interest. Many of the long-standing rituals associated with bereavement are still practised in Ireland, probably more than in many other Western countries. The present authors were interested in studying the…

Codified Knowledge and Embodied Learning: The Problem of Safety Training

ERIC Educational Resources Information Center

Somerville, Margaret; Lloyd, Anne

2006-01-01

The research that informs this article was focused around the relationship between how workers are trained to work safely and how workers learn to work safely in the workplace. The findings of empirical studies into learning and practising safety in aged care, fire fighting, building construction, and mining industries are summarized. A common…

Practising What We Preach: Towards a Student-Centred Definition of Feedback

ERIC Educational Resources Information Center

Scott, Shirley V.

2014-01-01

Students appear to have an almost insatiable appetite for receiving feedback and the scholarly literature has acknowledged its central importance for learning. And yet there is no widely accepted definition of feedback, most definitions reflecting the perspective of the teacher rather than student. When staff at the University of New South Wales…

The Postgraduate Chameleon. Changing Roles in Doctoral Education

ERIC Educational Resources Information Center

Harland, Tony; Plangger, Gabi

2004-01-01

This article is based on the experiences of 25 PhD students at a New Zealand university who came to do research and soon found themselves taking on substantial teaching loads. Teaching was highly valued and it helped students develop their professional identity as they broadened their subject knowledge and practised a disciplinary research…

Student and Teacher Reflections on Indirectness as a Pragmatic Feature of Pharmacist-Patient Simulations

ERIC Educational Resources Information Center

Hussin, Virginia

2013-01-01

This article reports on a research process where focussed reflection on pharmacist-patient simulations led to meta-pragmatic awareness and directions for pedagogical practice. The research participants were third-year EAL pharmacy students, who were practising being pharmacists, and pharmacy staff members, who played the part of patients. Analysis…

Static Analysis of Programming Exercises: Fairness, Usefulness and a Method for Application

ERIC Educational Resources Information Center

Nutbrown, Stephen; Higgins, Colin

2016-01-01

This article explores the suitability of static analysis techniques based on the abstract syntax tree (AST) for the automated assessment of early/mid degree level programming. Focus is on fairness, timeliness and consistency of grades and feedback. Following investigation into manual marking practises, including a survey of markers, the assessment…

Productive School Governance: Success Case Studies from New Zealand

ERIC Educational Resources Information Center

Piggot-Irvine, Eileen

2008-01-01

The rhetoric abounds concerning the types of effective, high trust, interactions that should exist for a school governing body. In practise, however, such interactions are often difficult to define, establish, maintain, and sustain. The study reported on in this paper attempted to identify interactions linked to perceptions of high trust via a…

The Impact of Preparing Mentor Teachers for Mentoring

ERIC Educational Resources Information Center

Ambrosetti, Angelina

2012-01-01

Time spent in classrooms is reported to be the component of teacher education degrees that pre-service teachers highly value as it allows them to practise teach in an authentic setting (Brandenburg & Ryan, 2001; Brett, 2006; Graves, 2010; House of Representatives, 2007; Walkington, 2005a). Despite this, the experiences pre-service teachers…

Learning Autonomously: Contextualising Out-of-Class English Language Learning

ERIC Educational Resources Information Center

Hyland, Fiona

2004-01-01

This paper examines the out-of-class English language learning activities of student teachers in Hong Kong, using questionnaires, interviews and learner diaries. The study found that while many of the students devoted considerable time to studying and practising English outside the classroom, much of this time was spent on more receptive…

The Language Exchange Programme: Plugging the Gap in Formal Learning

ERIC Educational Resources Information Center

Beaven, Tita; Gutiérrez, Mara Fuertes; Motzo, Anna

2017-01-01

In the context of distance language learning, speaking is frequently perceived as the most challenging skill; this paper reports on a 12 week summer language exchange programme providing students with new ways of practising their oral abilities. Students who completed an undergraduate beginners' language module took part in regular online,…

[Language development: psychosocial requirements for communication].

PubMed

Clemente, R A; Villanueva, L

1999-02-01

This work describes the social and psychological characteristics of attachment adults. These features are considered as sociopsychological prerequisites for the child language development. The focus is put on the so-called no formal education, suitable for these attachment adults who are involved affectively and emotionally. Some educational strategies to be practised at home are also presented.

How to Use Technology Effectively in Post-Compulsory Education

ERIC Educational Resources Information Center

Clarke, Alan

2011-01-01

The use of technology within the lifelong learning sector brings many benefits to learners, teachers and managers. Aimed at trainee and practising teachers, this book contains clear, practical guidance on how to use technology and e-learning effectively to enhance all aspects of teaching and learning in the post-compulsory sector. Alan Clarke…

Threshold Concepts, Student Learning and Curriculum: Making Connections between Theory and Practice

ERIC Educational Resources Information Center

Barradell, Sarah; Kennedy-Jones, Mary

2015-01-01

Threshold concepts, student learning and curriculum are constructs within a learning and teaching discourse foregrounded by Meyer and Land. In this paper, we introduce a conceptual model that integrates these three constructs and identifies desired outcomes at the intersects: namely the processes of (1) ways of thinking and practising, (2)…

Teaching Rhetoric Today: Ancient Exercises for Contemporary Citizens

ERIC Educational Resources Information Center

Dainville, Julie; Sans, Benoît

2016-01-01

Since July 2013, our research team has been working on a project that aims at re-introducing rhetorical exercises in Belgian secondary (high) schools and at studying their effects on the pupils. Our hypothesis is that the regular practice of rhetorical exercises, inspired by those practised in Antiquity, could stimulate skills like…

Self-Determination of Pupils with Intellectual Disabilities in Norwegian Secondary School

ERIC Educational Resources Information Center

Sagen, Line Melboe; Ytterhus, Borgunn

2014-01-01

This article examines how the self-determination of pupils with intellectual disabilities is practised in secondary school in Norway and discusses possible challenges connected to this practice. The argumentation builds on the fieldwork of qualitative interviews (N?=?55) and participant observations in schools in Norway (pupils 13-16?years old).…

Sexual History-Taking: Using Educational Interventions to Overcome Barriers to Learning

ERIC Educational Resources Information Center

Jayasuriya, Ashini N.; Dennick, Reg

2011-01-01

Sexual history-taking is a basic medical skill that is traditionally taught poorly in medical school. Practising medical professionals have frequently reported feeling inadequately trained at taking these histories or discussing sexual risk. In order to promote and enhance the learning of this basic skill, those who teach sexual history-taking…

Philosophy for Young Children: A Practical Guide

ERIC Educational Resources Information Center

Gaut, Berys; Gaut, Morag

2011-01-01

Co-written by a professor of philosophy and a practising primary school teacher, "Philosophy for Young Children" is a concise, practical guide for teachers. It contains detailed session plans for 36 philosophical enquiries--enough for a year's work--that have all been successfully tried, tested and enjoyed with young children from the age of three…

Measuring the Impact of a Community of Practice in Aboriginal Health

ERIC Educational Resources Information Center

Delbridge, Robyn; Wilson, Annabelle; Palermo, Claire

2018-01-01

Effective strategies to enhance the competence of practising health professionals are limited. Communities of Practice are proposed as strategy, yet little is known about their ability to develop cultural competency and practice. This study aimed to measure the impact of a Community of Practice on the self-assessed cultural competency and change…

Creating a Positive Environment for Widening Participation: A Taxonomy for Socially Just Higher Education Policy and Practice

ERIC Educational Resources Information Center

Wisker, Gina; Masika, Rachel

2017-01-01

Higher education (HE) systems sustain and reproduce inequalities despite intentions to redress them. However, widening participation rooted in social justice practices increases participation in HE for marginalised under-represented groups through overt, shared and practised values in action and mobilization of HE interests and resources. Drawing…

Families, Homes and Environmental Education

ERIC Educational Resources Information Center

Payne, Phillip G.

2005-01-01

The findings from a study of how Green families construct and practise versions of an environmental ethic and ecopolitic in the home are suggestive of how environmental education in schools might be revised. In this study, the green home proved to be a very different form of environmental education and practice of sustainability. Children's…

Consistency or Discrepancy? Rethinking Schools from Organizational Hypocrisy to Integrity

ERIC Educational Resources Information Center

Kiliçoglu, Gökhan

2017-01-01

Consistency in statements, decisions and practices is highly important for both organization members and the image of an organization. It is expected from organizations, especially from their administrators, to "walk the talk"--in other words, to try to practise what they preach. However, in the process of gaining legitimacy and adapting…

Sport, Gender and Ethnicity: Practises of Symbolic Inclusion/exclusion.

ERIC Educational Resources Information Center

Elling, Agnes; Knoppers, Annelies

2005-01-01

In this paper symbolic inclusion/exclusion processes in sport with respect to gender and ethnicity among adolescents (n = 1025) are analyzed from a social-critical perspective. It was found that sport participation preferences of young people are still influenced by dominant normative gendered and racial/ethnic images. Sport can serve not only as…

An "Infusion" Approach to Critical Thinking: Moore on the Critical Thinking Debate

ERIC Educational Resources Information Center

Davies, W. Martin

2006-01-01

This paper argues that general skills and the varieties of subject-specific discourse are both important for teaching, learning and practising critical thinking. The former is important because it outlines the principles of good reasoning "simpliciter" (what constitutes sound reasoning patterns, invalid inferences, and so on). The latter is…

Compering and Comparing: Stand-Up Comedy and Pedagogy

ERIC Educational Resources Information Center

McCarron, Kevin; Savin-Baden, Maggi

2008-01-01

The central argument of this paper is that adopting some of the techniques practised by stand-up comedians can help teachers in higher education challenge students in ways that will ultimately improve the student learning experience overall. It will suggest that developing co-dependent relationships and over-engaging with students is disabling…

Effects of Problem Solving after Worked Example Study on Secondary School Children's Monitoring Accuracy

ERIC Educational Resources Information Center

Baars, Martine; van Gog, Tamara; de Bruin, Anique; Paas, Fred

2017-01-01

Monitoring accuracy, measured by judgements of learning (JOLs), has generally been found to be low to moderate, with students often displaying overconfidence, and JOLs of problem solving are no exception. Recently, primary school children's overconfidence was shown to diminish when they practised problem solving after studying worked examples. The…

Standards-Driven Reform Years 1-10: Moderation an Optional Extra?

ERIC Educational Resources Information Center

Klenowski, Val; Wyatt-Smith, Claire

2010-01-01

While externally moderated standards-based assessment has been practised in Queensland senior schooling for more than three decades, there has been no such practice in the middle years. With the introduction of standards at state and national levels in these years, teacher judgement as developed in moderation practices is now vital. This paper…

On Practising in Physical Education: Outline for a Pedagogical Model

ERIC Educational Resources Information Center

Aggerholm, K.; Standal, O.; Barker, D. M.; Larsson, H.

2018-01-01

Background: Models-based approaches to physical education have in recent years developed as a way for teachers and students to concentrate on a manageable number of learning objectives, and align pedagogical approaches with learning subject matter and context. This paper draws on Hannah Arendt's account of "vita activa" to map existing…

Degrading, Devaluing and Discounting: The Qualifications of Overseas Trained Teachers (OTT) in England

ERIC Educational Resources Information Center

Miller, Paul

2008-01-01

Highly trained teachers from across the world come to England expecting to practise their chosen profession. These expectations are dashed, however, if their foreign credentials and work experience are not recognised as legitimate by potential employers and accreditation bodies. This type of social situation is the focus of the relative…

Continuity and Change in Disaster Education in Japan

ERIC Educational Resources Information Center

Kitagawa, Kaori

2015-01-01

This article aims to describe post-war continuity and change in disaster education in Japan. Preparedness for natural disasters has been a continuous agenda in Japan for geographical and meteorological reasons, and disaster education has been practised in both formal and informal settings. Post-war disaster management and education have taken a…

Inclusive Education in the Slovak Republic Two Decades after the Dissolution of Czechoslovakia

ERIC Educational Resources Information Center

Miškolci, Jozef

2016-01-01

The fall of Communist regime in 1989 and the dissolution of Czechoslovakia in 1993 significantly affected the educational system of today's Slovakia. As a sovereign state, Slovakia has ratified the Convention on the Rights of Persons with Disabilities obliging its signatories to practise "inclusive education." This article explores the…

The Coast Artillery Journal. Volume 67, Number 6, December 1927

DTIC Science & Technology

1927-12-01

of some treasonable plot or practise in an Army, the Generall must first assure the place, and then more fully search into the treason, and punish the...in Coast Artillery ~Iemorandum No. 7 for 1928_ 106 Changing Zones With Mortars, 138 The Variable Probable Error 405 Taxation : Taxes Show Staggering

Field-Based Learning: The Challenge of Practising Participatory Knowledge

ERIC Educational Resources Information Center

Morrissey, John; Clavin, Alma; Reilly, Kathy

2013-01-01

In 2009, Geography at National University of Ireland, Galway, launched a new taught master's programme, the MA in Environment, Society and Development. The vision for the programme was to engage students in the analysis and critique of the array of interventionary practices of development and securitization in our contemporary world. A range of…