Best Practices to Promote Diversity and Facilitate Inclusion

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

Rosenthal, Mark A.; Snyder, Johann D.

The intent of this guide is to provide a set of “best practices” for leaders to promote diversity and facilitate inclusion within their organization and throughout Sandia National Laboratories. These “best practices” are derived from personal experiences and build upon existing resources at Sandia to help us effect change to realize an inclusive work environment. As leaders, we play a critical role in setting the vision and shaping the culture of the organization by communicating expectations and modeling inclusive behavior. The “best practices” in this guide are presented in the spirit of promoting a learning culture that values continuous improvementmore » in the ongoing effort to make diversity and inclusion an integral part of all that we do at Sandia. This guide seeks to articulate the importance of leading through example, taking positive actions, raising awareness of practices that provide an inclusive environment, and creating a space that welcomes diverse perspectives and input.« less

The Effectiveness of Concept Mapping and Retrieval Practice as Learning Strategies in an Undergraduate Physiology Course

ERIC Educational Resources Information Center

Burdo, Joseph; O'Dwyer, Laura

2015-01-01

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving…

Supporting culturally and linguistically diverse children with speech, language and communication needs: Overarching principles, individual approaches.

PubMed

Verdon, Sarah; McLeod, Sharynne; Wong, Sandie

2015-01-01

Speech-language pathologists (SLPs) are working with an increasing number of families from culturally and linguistically diverse backgrounds as the world's population continues to become more internationally mobile. The heterogeneity of these diverse populations makes it impossible to identify and document a one size fits all strategy for working with culturally and linguistically diverse families. This paper explores approaches to practice by SLPs identified as specialising in multilingual and multicultural practice in culturally and linguistically diverse contexts from around the world. Data were obtained from ethnographic observation of 14 sites in 5 countries on 4 continents. The sites included hospital settings, university clinics, school-based settings, private practices and Indigenous community-based services. There were 652 individual artefacts collected from the sites which included interview transcripts, photographs, videos, narrative reflections, informal and formal field notes. The data were analysed using Cultural-Historical Activity Theory (Engeström, 1987). From the analysis six overarching Principles of Culturally Competent Practice (PCCP) were identified. These were: (1) identification of culturally appropriate and mutually motivating therapy goals, (2) knowledge of languages and culture, (3) use of culturally appropriate resources, (4) consideration of the cultural, social and political context, (5) consultation with families and communities, and (6) collaboration between professionals. These overarching principles align with the six position statements developed by the International Expert Panel on Multilingual Children's Speech (2012) which aim to enhance the cultural competence of speech pathologists and their practice. The international examples provided in the current study demonstrate the individualised ways that these overarching principles are enacted in a range of different organisational, social, cultural and political contexts. Tensions experienced in enacting the principles are also discussed. This paper emphasises the potential for individual SLPs to enhance their practice by adopting these overarching principles to support the individual children and families in diverse contexts around the world. Copyright © 2015 Elsevier Inc. All rights reserved.

Faculty Meetings: Hidden Conversational Dynamics

ERIC Educational Resources Information Center

Bowman, Richard F.

2015-01-01

In the everydayness of faculty meetings, collegial conversations mirror distinctive dynamics and practices, which either enhance or undercut organizational effectiveness. A cluster of conversational practices affect how colleagues connect, engage, interact, and influence others during faculty meetings in diverse educational settings. The…

Family medicine outpatient encounters are more complex than those of cardiology and psychiatry.

PubMed

Katerndahl, David; Wood, Robert; Jaén, Carlos Roberto

2011-01-01

comparison studies suggest that the guideline-concordant care provided for specific medical conditions is less optimal in primary care compared with cardiology and psychiatry settings. The purpose of this study is to estimate the relative complexity of patient encounters in general/family practice, cardiology, and psychiatry settings. secondary analysis of the 2000 National Ambulatory Medical Care Survey data for ambulatory patients seen in general/family practice, cardiology, and psychiatry settings was performed. The complexity for each variable was estimated as the quantity weighted by variability and diversity. there is minimal difference in the unadjusted input and total encounter complexity of general/family practice and cardiology; psychiatry's input is less complex. Cardiology encounters involved more input quantitatively, but the diversity of general/family practice input eliminated the difference. Cardiology also involved more complex output. However, when the duration of visit is factored in, the complexity of care provided per hour in general/family practice is 33% more relative to cardiology and 5 times more relative to psychiatry. care during family physician visits is more complex per hour than the care during visits to cardiologists or psychiatrists. This may account for a lower rate of completion of process items measured for quality of care.

"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.

Managing diversity and European policy: Towards a typology for sport pedagogy.

PubMed

Dinold, Maria; Diketmüller, Rosa; Grix, Jonathan; Phillpots, Lesley

2013-01-01

This article adds to the growing body of knowledge in sport pedagogy and focuses specifically upon the intersection of gender and disability. Its purpose is twofold, to create a typology for examining good practice in sport pedagogy that is reflective and inclusive and raises awareness of the diverse needs of all participants in physical activity 'regardless' of gender and ability for all children. We acknowledge that access to physical activity, education and sport are complex and multifaceted, however, the main purpose of this paper is to raise awareness of 'diversity' by focusing specifically upon the role of gender and ability. Through an examination of gender and disability policies in official European Union (EU) policy documents and commercial examples of policy-in-practice we propose a typology for diversity and diversity management. A close look at EU level is instructive because national policies of the member countries vary a lot with respect to diversity issues but should be in accordance in the main areas. Such a reading enables the building of a typology of recommendations for how such policy can be rendered in sport pedagogy practice. We suggest six significant, but related principles that include (1) mainstreaming; (2) teaching and coaching sensitive to difference; (3) empowerment; (4) inclusion; (5) adaptation; and (6) inner differentiation. This holistic typology seeks to 'mainstream' issues of gender and disability policy by providing a set of principles that can be applied to a range of teaching and coaching settings.

Challenges in adapting existing clinical natural language processing systems to multiple, diverse health care settings.

PubMed

Carrell, David S; Schoen, Robert E; Leffler, Daniel A; Morris, Michele; Rose, Sherri; Baer, Andrew; Crockett, Seth D; Gourevitch, Rebecca A; Dean, Katie M; Mehrotra, Ateev

2017-09-01

Widespread application of clinical natural language processing (NLP) systems requires taking existing NLP systems and adapting them to diverse and heterogeneous settings. We describe the challenges faced and lessons learned in adapting an existing NLP system for measuring colonoscopy quality. Colonoscopy and pathology reports from 4 settings during 2013-2015, varying by geographic location, practice type, compensation structure, and electronic health record. Though successful, adaptation required considerably more time and effort than anticipated. Typical NLP challenges in assembling corpora, diverse report structures, and idiosyncratic linguistic content were greatly magnified. Strategies for addressing adaptation challenges include assessing site-specific diversity, setting realistic timelines, leveraging local electronic health record expertise, and undertaking extensive iterative development. More research is needed on how to make it easier to adapt NLP systems to new clinical settings. A key challenge in widespread application of NLP is adapting existing systems to new clinical settings. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Addressing narcissistic personality features in the context of medical care: integrating diverse perspectives to inform clinical practice.

PubMed

Magidson, J F; Collado-Rodriguez, A; Madan, A; Perez-Camoirano, N A; Galloway, S K; Borckardt, J J; Campbell, W K; Miller, J D

2012-04-01

Narcissistic personality disorder (NPD) is characterized by an unrealistic need for admiration, lack of empathy toward others, and feelings of superiority. NPD presents a unique and significant challenge in clinical practice, particularly in medical settings with limited provider contact time, as health professionals treat individuals who often require excessive admiration and have competing treatment needs. This practice review highlights real case examples across three distinct medically oriented clinical settings (inpatient and outpatient behavioral medicine and a Level I trauma center) to demonstrate the difficult and compromising situations that providers face when treating patients with general medical conditions and comorbid narcissistic personality features. The main goal of this article is to discuss the various challenges and obstacles associated with these cases in medical settings and discuss some strategies that may prove successful. A second goal is to bridge diverse conceptualizations of narcissism/NPD through the discussion of theoretical and empirical perspectives that can inform understanding of the clinical examples. Despite differing perspectives regarding the underlying motivation of narcissistic behavior, this practice review highlights that these paradigms can be integrated when sharing the same ultimate goal: to improve delivery of care across medically oriented clinical settings for patients with narcissistic features.

The New Voices = Nuevas Voces Guide to Cultural and Linguistic Diversity in Early Childhood/The New Voices = Nuevas Voces Facilitator's Guide to Cultural and Linguistic Diversity in Early Childhood

ERIC Educational Resources Information Center

Castro, Dina C.; Ayankoya, Betsy; Kasprzak, Christina

2011-01-01

As early childhood programs and schools become more culturally and linguistically diverse, professionals need to create settings that welcome "new voices" and help all children succeed. This comprehensive professional development course gives them the in-depth practical guidance they need. Developed by respected scholar Dina Castro and her expert…

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

PubMed

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

2011-06-01

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

A Collaboration of School Administrators and a University Faculty to Advance School Administrator Practices Using Appreciative Inquiry

ERIC Educational Resources Information Center

Calabrese, Raymond

2015-01-01

Purpose: An appreciative inquiry (AI) collaborative study with 11 school administrators in a highly diverse suburban school district sought to understand if observing and sharing successful school practices/events in a whole group setting led to change in their perceptions, attitudes, and administrative practice. The paper aims to discuss these…

I "See" What You Are Saying: The Analytical Work of Diagrams in Online Discussions

ERIC Educational Resources Information Center

Stevens, Tony Loring

2016-01-01

Diagrams illustrating research on discussion forum content in online education practices can assist to clarify an author's thoughts and assist with the reader's comprehension. A review of past practices in the use of diagrams to explain, demonstrate or propose research findings shows a diversity of practices emerging from naturalistic settings.…

Researching Language-in-Education in Diverse, Twenty-First Century Settings

ERIC Educational Resources Information Center

Martin-Jones, Marilyn

2016-01-01

The two opening sections of this Afterword show how the studies in this collection reflect wider trends in research related to language-in-education policy and practice in contemporary contexts of linguistic and cultural diversity: namely, the turn towards interpretive research and the diversification of research sites. The third section focuses…

Innovative partnerships: the clinical nurse leader role in diverse clinical settings.

PubMed

Lammon, Carol Ann Barnett; Stanton, Marietta P; Blakney, John L

2010-01-01

The American Association of Colleges of Nursing in collaboration with leaders in the health care arena has developed a new role in nursing, the clinical nurse leader (CNL). The CNL is a master's-prepared advanced nurse generalist, accountable for providing high-quality, cost-effective care for a cohort of patients in a specific microsystem. Although initial implementation of the CNL has been predominantly in urban acute care settings, the skill set of the CNL role is equally applicable to diverse clinical settings, such as smaller rural hospitals, home-based home care providers, long-term care facilities, schools, Veteran's Administration facilities, and public health settings. This article reports the strategies used and the progress made at The University of Alabama Capstone College of Nursing in the development of innovative partnerships to develop the role of the CNL in diverse clinical settings. With academia and practice working in partnership, the goal of transforming health care and improving patient outcomes can be achieved. Copyright © 2010 Elsevier Inc. All rights reserved.

Providing oral health care to underserved population of pregnant women: retrospective review of 320 patients treated in private practice setting.

PubMed

Kerpen, Steven J; Burakoff, Ronald

2013-01-01

This article aims to quantify the impact of a novel partnership between a fee-for-service private practice and a teaching hospital dental service intended to provide oral care to an underserved population of pregnant women. Further, it seeks to ascertain the oral needs of this high-risk and diverse population. Data is presented that suggests the dire need for oral care among this pregnant population and the efficacy of treating these women in a private practice setting.

Authentic Leadership, Social Cognitive Theory, and Character Education: The Transforming of Theories Into Practices

ERIC Educational Resources Information Center

Banks, Jerome; Mhunpiew, Nathara

2012-01-01

Character development must balance academic achievement. International school environments are diverse and multicultural settings, containing a learning-focused culture. This investigation constructs the sophisticated elements of authentic leadership and the complexities of the social cognitive theory as factors that produce a practical approach…

Perspectives from practice: complexities of personal care workers.

PubMed

Martyn, Julie-Anne; Zanella, Sally; Wilkinson, Adele

2017-11-14

Personal care workers (PCWs) make up the bulk of the workforce in residential and community care services. The knowledge and skill set needed for safe and effective practice in care settings is extensive. A diverse range of registered training organisations (RTOs) offering Certificate III and IV in Individual Support (aging, home and community) are tasked with producing job-ready PCWs. However, the curricula of these programs vary. Additionally, a national code of conduct for healthcare workers became effective in October 2015 as a governance framework for PCWs. The language of the code statements is ambiguous making it unclear how this framework should be translated by RTOs and applied in the preservice practice preparation of PCWs. Employers of PCWs need to feel confident that the content of the preservice education of PCWs satisfactorily prepares them for the diverse contexts of their practice. Likewise, the health professionals who supervise PCWs must be assured about the knowledge and skills of the PCW if they are to safely delegate care activities. The perspectives presented in this discussion make it clear that investigation into the nebulous nature of PCW education, regulation and practice is needed to identify the shortcomings and enable improved practice.

Holistic nursing as a specialty: holistic nursing - scope and standards of practice.

PubMed

Mariano, Carla

2007-06-01

This article describes the Holistic Nursing: Scope and Standards of Practice. It defines holistic nursing, its five core values, and its practice standards. These include holistic philosophy, theory, and ethics; holistic caring process; holistic communication, therapeutic environment, and cultural diversity; holistic education and research; and holistic nurse self-care. Educational preparation for holistic nursing and settings in which holistic nurses practice are also explored.

Multiculturalism on Campus: Theory, Models, and Practices for Understanding Diversity and Creating Inclusion

ERIC Educational Resources Information Center

Cuyjet, Michael J., Ed.; Howard-Hamilton, Mary F., Ed.; Cooper, Diane L., Ed.

2011-01-01

As the diversity of the students on campus increases, the importance for everyone in authority to understand students' distinct cultures and how they perceive institutions, and equally, to understand their own privilege, and often unconscious cultural assumptions, has never been greater. This book presents a comprehensive set of resources to guide…

Vowels--Sonic Gems of Emotion for Social Communication: Practical Singing Strategies for Non-Musician Teachers with Developmentally Diverse Young Children

ERIC Educational Resources Information Center

Weeks, Kaja

2015-01-01

Communicative and social capacities are known to be of primary developmental importance to all children and often present a particular difficulty for children with neurodevelopmental disorders. A recurring challenge for teachers is achieving effective communication with children who span developmental diversity (e.g. inclusive settings or those…

Inspiring science achievement: a mixed methods examination of the practices and characteristics of successful science programs in diverse high schools

NASA Astrophysics Data System (ADS)

Scogin, Stephen C.; Cavlazoglu, Baki; LeBlanc, Jennifer; Stuessy, Carol L.

2017-08-01

While the achievement gap in science exists in the US, research associated with our investigation reveals some high school science programs serving diverse student bodies are successfully closing the gap. Using a mixed methods approach, we identified and investigated ten high schools in a large Southwestern state that fit the definition of "highly successful, highly diverse". By conducting interviews with science liaisons associated with each school and reviewing the literature, we developed a rubric identifying specific characteristics associated with successful science programs. These characteristics and practices included setting high expectations for students, providing extensive teacher support for student learning, and utilizing student-centered pedagogy. We used the rubric to assess the successful high school science programs and compare them to other high school science programs in the state (i.e., less successful and less diverse high school science programs). Highly successful, highly diverse schools were very different in their approach to science education when compared to the other programs. The findings from this study will help schools with diverse students to strengthen hiring practices, enhance teacher support mechanisms, and develop student-focused strategies in the classroom that increase science achievement.

Congestion game scheduling for virtual drug screening optimization

NASA Astrophysics Data System (ADS)

Nikitina, Natalia; Ivashko, Evgeny; Tchernykh, Andrei

2018-02-01

In virtual drug screening, the chemical diversity of hits is an important factor, along with their predicted activity. Moreover, interim results are of interest for directing the further research, and their diversity is also desirable. In this paper, we consider a problem of obtaining a diverse set of virtual screening hits in a short time. To this end, we propose a mathematical model of task scheduling for virtual drug screening in high-performance computational systems as a congestion game between computational nodes to find the equilibrium solutions for best balancing the number of interim hits with their chemical diversity. The model considers the heterogeneous environment with workload uncertainty, processing time uncertainty, and limited knowledge about the input dataset structure. We perform computational experiments and evaluate the performance of the developed approach considering organic molecules database GDB-9. The used set of molecules is rich enough to demonstrate the feasibility and practicability of proposed solutions. We compare the algorithm with two known heuristics used in practice and observe that game-based scheduling outperforms them by the hit discovery rate and chemical diversity at earlier steps. Based on these results, we use a social utility metric for assessing the efficiency of our equilibrium solutions and show that they reach greatest values.

Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings

ERIC Educational Resources Information Center

Ayantoye, Catherine Adekemi; Luckner, John L.

2015-01-01

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that…

Cultural considerations and child maltreatment: in search of universal principles.

PubMed

Kolhatkar, Gauri; Berkowitz, Carol

2014-10-01

Cultural diversity poses challenges within the health care setting, particularly regarding the question of how health professionals can resolve the tension between respecting cultural norms or child-rearing practices and the importance of determining what constitutes harm and child maltreatment. Cultural competency and respect for cultural diversity does not imply universal tolerance of all practices. The United Nations provides a standard of universal child rights, protecting them from harmful practices. Pediatric providers must respect cross-cultural differences while maintaining legal and ethical standards of safety and wellbeing for children, promoting evidence-based prevention of maltreatment, and advocating for child wellness across all cultures. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring Teaching Practices in Physical Education with Culturally Diverse Classes: A Cross-Cultural Study

ERIC Educational Resources Information Center

Dagkas, Symeon

2007-01-01

This is a cross-cultural comparative study that sets out to explore teachers' knowledge, understanding and practices of the teaching of Physical Education (PE) to students from different cultural backgrounds. More specifically, it explores key issues in the teaching of PE to Muslim students. Thirteen PE teachers, six from England and seven from…

Development of archetypes for non-ranking classification and comparison of European National Health Technology Assessment systems.

PubMed

Allen, Nicola; Pichler, Franz; Wang, Tina; Patel, Sundip; Salek, Sam

2013-12-01

European countries are increasingly utilising health technology assessment (HTA) to inform reimbursement decision-making. However, the current European HTA environment is very diverse, and projects are already underway to initiate a more efficient and aligned HTA practice within Europe. This study aims to identify a non-ranking method for classifying the diversity of European HTA agencies process and the organisational architecture of the national regulatory review to reimbursement systems. Using a previously developed mapping methodology, this research created process maps to describe national processes for regulatory review to reimbursement for 33 European jurisdictions. These process maps enabled the creation of 2 HTA taxonomic sets. The confluence of the two taxonomic sets was subsequently cross-referenced to identify 10 HTA archetype groups. HTA is a young, rapidly evolving field and it can be argued that optimal practices for performing HTA are yet to emerge. Therefore, a non-ranking classification approach could objectively characterise and compare the diversity observed in the current European HTA environment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Performance evaluation of receive-diversity free-space optical communications over correlated Gamma-Gamma fading channels.

PubMed

Yang, Guowei; Khalighi, Mohammad-Ali; Ghassemlooy, Zabih; Bourennane, Salah

2013-08-20

The efficacy of spatial diversity in practical free-space optical communication systems is impaired by the fading correlation among the underlying subchannels. We consider in this paper the generation of correlated Gamma-Gamma random variables in view of evaluating the system outage probability and bit-error-rate under the condition of correlated fading. Considering the case of receive-diversity systems with intensity modulation and direct detection, we propose a set of criteria for setting the correlation coefficients on the small- and large-scale fading components based on scintillation theory. We verify these criteria using wave-optics simulations and further show through Monte Carlo simulations that we can effectively neglect the correlation corresponding to the small-scale turbulence in most practical systems, irrespective of the specific turbulence conditions. This has not been clarified before, to the best of our knowledge. We then present some numerical results to illustrate the effect of fading correlation on the system performance. Our conclusions can be generalized to the cases of multiple-beam and multiple-beam multiple-aperture systems.

Building clinicians-researchers partnerships: lessons from diverse natural settings and practice-oriented initiatives.

PubMed

Castonguay, Louis G; Youn, Soo Jeong; Xiao, Henry; Muran, J Christopher; Barber, Jacques P

2015-01-01

In this concluding paper, we identify the type of studies conducted by 11 teams of contributors to a special issue on building clinicians-researchers partnerships. Those studies were conducted across a variety of clinical settings. We also integrate the lessons that have emerged from their collaborative initiatives in terms of obstacles faced, strategies adopted to address these challenges, benefits gained, and general recommendations offered to facilitate studies conducted with or by clinicians. The paper ends with the authors' thoughts about the future success of practice-oriented research in general.

Informal science education: lifelong, life-wide, life-deep.

PubMed

Sacco, Kalie; Falk, John H; Bell, James

2014-11-01

Informal Science Education: Lifelong, Life-Wide, Life-Deep Informal science education cultivates diverse opportunities for lifelong learning outside of formal K-16 classroom settings, from museums to online media, often with the help of practicing scientists.

Walking the talk: insights into dynamics of race and gender for nurses.

PubMed

Choiniere, Jacqueline A; MacDonnell, Judith; Shamonda, Hope

2010-11-01

This article explores how the dynamics of violence and support for nurses are influenced by the intersections of race, gender, and other social relations in various practice settings. Utilizing a qualitative study design, situated in the naturalistic and critical paradigms, this article is grounded in the experiences of key informants (KIs), each possessing significant expertise on issues of equity and violence, as well as insight into the current practice settings in Ontario, Canada. The individual KI interviews were analyzed using conventional qualitative content analysis, with its focus on capturing emerging insights. The findings reflect the everyday nature of gendered and racialized violence, the influence of setting and the effectiveness of existing resources. Professional, organizational, and broader policy implications are discussed to support diversely situated nurses within their various practice environments.

Influence of Traditional Management and Environmental Variables on Mediterranean Saproxylic Beetle Assemblages.

PubMed

Ramilo, P; Martínez-Falcón, A P; García-López, A; Brustel, H; Galante, E; Micó, E

2017-12-08

Mediterranean oak forests of the Iberian Peninsula host a great diversity of saproxylic beetles. For centuries, humans have carried out traditional management practices in this area, at both habitat and tree level, causing changes in forest structure. The aim of this study was to evaluate the anthropic effect of these traditional practices on saproxylic beetle diversity by measuring a set of environmental variables related to forest structure at both plot and tree level. Fauna was collected using window traps over a period of 12 mo. Multiple regression procedures showed which variables significantly affected the diversity of the studied assemblage. Our results demonstrated that the different metrics used to assess the diversity of assemblages responded variably depending on the management strategies applied and the level at which they were carried out. Certain management practices that disrupted the landscape from its natural state, such as the introduction of livestock or the local removal of particular trees, maximized species richness but, nevertheless, had a negative effect on the rest of diversity metrics analyzed. However, other practices such as pollarding, which involves the suppression of the main branch of the tree, had a positive effect on all diversity metrics evaluated as it promoted the formation of potential microhabitats for saproxylic fauna. We concluded that not all types and degrees of traditional forest management favor saproxylic beetle diversity and that different diversity metrics should be taken into consideration in future strategies for the protection and conservation of this fauna. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The diverse landscape of palliative care clinics.

PubMed

Smith, Alexander K; Thai, Julie N; Bakitas, Marie A; Meier, Diane E; Spragens, Lynn H; Temel, Jennifer S; Weissman, David E; Rabow, Michael W

2013-06-01

Many health care organizations are interested in instituting a palliative care clinic. However, there are insufficient published data regarding existing practices to inform the development of new programs. Our objective was to obtain in-depth information about palliative care clinics. We conducted a cross-sectional survey of 20 outpatient palliative care practices in diverse care settings. The survey included both closed- and open-ended questions regarding practice size, utilization of services, staffing, referrals, services offered, funding, impetus for starting, and challenges. Twenty of 21 (95%) practices responded. Practices self-identified as: hospital-based (n=7), within an oncology division/cancer center (n=5), part of an integrated health system (n=6), and hospice-based (n=2). The majority of referred patients had a cancer diagnosis. Additional common diagnoses included chronic obstructive pulmonary disease, neurologic disorders, and congestive heart failure. All practices ranked "pain management" and "determining goals of care" as the most common reasons for referrals. Twelve practices staffed fewer than 5 half-days of clinic per week, with 7 operating only one half-day per week. Practices were staffed by a mixture of physicians, advanced practice nurses or nurse practitioners, nurses, or social workers. Eighteen practices expected their practice to grow within the next year. Eleven practices noted a staffing shortage and 8 had a wait time of a week or more for a new patient appointment. Only 12 practices provide 24/7 coverage. Billing and institutional support were the most common funding sources. Most practices described starting because inpatient palliative providers perceived poor quality outpatient care in the outpatient setting. The most common challenges included: funding for staffing (11) and being overwhelmed with referrals (8). Once established, outpatient palliative care practices anticipate rapid growth. In this context, outpatient practices must plan for increased staffing and develop a sustainable financial model.

Parent and Staff Expectations for Continuity of Home Practices in the Child Care Setting for Families with Diverse Cultural Backgrounds

ERIC Educational Resources Information Center

De Gioia, Katey

2009-01-01

The use of childcare services for very young children (birth to three years) has increased dramatically in the past two decades (Department of Families, Community Services and Indigenous Affairs, 2004). This article investigates the expectations for cultural continuity of caregiving practices (with particular emphasis on sleep and feeding) between…

Scaffolding versus Routine Support for Latina/o Youth in an Urban School: Tensions in Building toward Disciplinary Literacy

ERIC Educational Resources Information Center

Athanases, Steven Z.; de Oliveira, Luciana C.

2014-01-01

Scaffolding is widely referenced in educational literature and practice, in literacy education in particular, but often in reductive ways. Scaffolding is key for diverse youth in high-need settings, but few studies examine complexities and tensions of scaffolding in practice. This study asked how, if at all, teachers at a California high school…

Becoming a Physicist: How Identities and Practices Shape Physics Trajectories

NASA Astrophysics Data System (ADS)

Quan, Gina M.

This dissertation studies the relationships and processes which shape students' participation within the discipline of physics. Studying this early disciplinary participation gives insight to how students are supported in or pushed out of physics, which is an important step in cultivating a diverse set of physics students. This research occurs within two learning environments that we co-developed: a physics camp for high school girls and a seminar for undergraduate physics majors to get started in physics research. Using situated learning theory, we conceptualized physics learning to be intertwined with participation in physics practices and identity development. This theoretical perspective draws our attention to relationships between students and the physics community. Specifically, we study how students come to engage in the practices of the community and who they are within the physics community. We find that students' interactions with faculty and peers impact the extent to which students engage in authentic physics practices. These interactions also impact the extent to which students develop identities as physicists. We present implications of these findings for the design of physics learning spaces. Understanding this process of how students become members of the physics community will provide valuable insights into fostering a diverse set of successful trajectories in physics.

Culture creates genetic structure in the Caucasus: Autosomal, mitochondrial, and Y-chromosomal variation in Daghestan

PubMed Central

Marchani, Elizabeth E; Watkins, W Scott; Bulayeva, Kazima; Harpending, Henry C; Jorde, Lynn B

2008-01-01

Background Near the junction of three major continents, the Caucasus region has been an important thoroughfare for human migration. While the Caucasus Mountains have diverted human traffic to the few lowland regions that provide a gateway from north to south between the Caspian and Black Seas, highland populations have been isolated by their remote geographic location and their practice of patrilocal endogamy. We investigate how these cultural and historical differences between highland and lowland populations have affected patterns of genetic diversity. We test 1) whether the highland practice of patrilocal endogamy has generated sex-specific population relationships, and 2) whether the history of migration and military conquest associated with the lowland populations has left Central Asian genes in the Caucasus, by comparing genetic diversity and pairwise population relationships between Daghestani populations and reference populations throughout Europe and Asia for autosomal, mitochondrial, and Y-chromosomal markers. Results We found that the highland Daghestani populations had contrasting histories for the mitochondrial DNA and Y-chromosome data sets. Y-chromosomal haplogroup diversity was reduced among highland Daghestani populations when compared to other populations and to highland Daghestani mitochondrial DNA haplogroup diversity. Lowland Daghestani populations showed Turkish and Central Asian affinities for both mitochondrial and Y-chromosomal data sets. Autosomal population histories are strongly correlated to the pattern observed for the mitochondrial DNA data set, while the correlation between the mitochondrial DNA and Y-chromosome distance matrices was weak and not significant. Conclusion The reduced Y-chromosomal diversity exhibited by highland Daghestani populations is consistent with genetic drift caused by patrilocal endogamy. Mitochondrial and Y-chromosomal phylogeographic comparisons indicate a common Near Eastern origin of highland populations. Lowland Daghestani populations show varying influence from Near Eastern and Central Asian populations. PMID:18637195

Pharmacogenomics in diverse practice settings: implementation beyond major metropolitan areas

PubMed Central

Dorfman, Elizabeth H; Trinidad, Susan Brown; Morales, Chelsea T; Howlett, Kevin; Burke, Wylie; Woodahl, Erica L

2015-01-01

Aim The limited formal study of the clinical feasibility of implementing pharmacogenomic tests has thus far focused on providers at large medical centers in urban areas. Our research focuses on small metropolitan, rural and tribal practice settings. Materials & methods We interviewed 17 healthcare providers in western Montana regarding pharmacogenomic testing. Results Participants were optimistic about the potential of pharmacogenomic tests, but noted unique barriers in small and rural settings including cost, adherence, patient acceptability and testing timeframe. Participants in tribal settings identified heightened sensitivity to genetics and need for community leadership approval as additional considerations. Conclusion Implementation differences in small metropolitan, rural and tribal communities may affect pharmacogenomic test adoption and utilization, potentially impacting many patients. PMID:25712186

Using an Action Learning Set (ALS) to Support the Nurse and Allied Health Professional Consultant Role

ERIC Educational Resources Information Center

Richardson, Janet; Ainsworth, Roberta; Allison, Rhoda; Billyard, Jo; Corley, Reine; Viner, Jane

2008-01-01

Advanced clinical practice roles are now an integral feature of many healthcare services and have been adopted in a diversity of areas. However, mentoring of these roles is not well documented in the literature and formal mechanisms of support are limited. An action learning set (ALS) was developed to provide support for consultants currently in…

Role of diversity in ICA and IVA: theory and applications

NASA Astrophysics Data System (ADS)

Adalı, Tülay

2016-05-01

Independent component analysis (ICA) has been the most popular approach for solving the blind source separation problem. Starting from a simple linear mixing model and the assumption of statistical independence, ICA can recover a set of linearly-mixed sources to within a scaling and permutation ambiguity. It has been successfully applied to numerous data analysis problems in areas as diverse as biomedicine, communications, finance, geo- physics, and remote sensing. ICA can be achieved using different types of diversity—statistical property—and, can be posed to simultaneously account for multiple types of diversity such as higher-order-statistics, sample dependence, non-circularity, and nonstationarity. A recent generalization of ICA, independent vector analysis (IVA), generalizes ICA to multiple data sets and adds the use of one more type of diversity, statistical dependence across the data sets, for jointly achieving independent decomposition of multiple data sets. With the addition of each new diversity type, identification of a broader class of signals become possible, and in the case of IVA, this includes sources that are independent and identically distributed Gaussians. We review the fundamentals and properties of ICA and IVA when multiple types of diversity are taken into account, and then ask the question whether diversity plays an important role in practical applications as well. Examples from various domains are presented to demonstrate that in many scenarios it might be worthwhile to jointly account for multiple statistical properties. This paper is submitted in conjunction with the talk delivered for the "Unsupervised Learning and ICA Pioneer Award" at the 2016 SPIE Conference on Sensing and Analysis Technologies for Biomedical and Cognitive Applications.

Waveform-Diverse Multiple-Input Multiple-Output Radar Imaging Measurements

NASA Astrophysics Data System (ADS)

Stewart, Kyle B.

Multiple-input multiple-output (MIMO) radar is an emerging set of technologies designed to extend the capabilities of multi-channel radar systems. While conventional radar architectures emphasize the use of antenna array beamforming to maximize real-time power on target, MIMO radar systems instead attempt to preserve some degree of independence between their received signals and to exploit this expanded matrix of target measurements in the signal-processing domain. Specifically the use of sparse “virtual” antenna arrays may allow MIMO radars to achieve gains over traditional multi-channel systems by post-processing diverse received signals to implement both transmit and receive beamforming at all points of interest within a given scene. MIMO architectures have been widely examined for use in radar target detection, but these systems may yet be ideally suited to real and synthetic aperture radar imaging applications where their proposed benefits include improved resolutions, expanded area coverage, novel modes of operation, and a reduction in hardware size, weight, and cost. While MIMO radar's theoretical benefits have been well established in the literature, its practical limitations have not received great attention thus far. The effective use of MIMO radar techniques requires a diversity of signals, and to date almost all MIMO system demonstrations have made use of time-staggered transmission to satisfy this requirement. Doing so is reliable but can be prohibitively slow. Waveform-diverse systems have been proposed as an alternative in which multiple, independent waveforms are broadcast simultaneously over a common bandwidth and separated on receive using signal processing. Operating in this way is much faster than its time-diverse equivalent, but finding a set of suitable waveforms for this technique has proven to be a difficult problem. In light of this, many have questioned the practicality of MIMO radar imaging and whether or not its theoretical benefits may be extended to real systems. Work in this writing focuses specifically on the practical aspects of MIMO radar imaging systems and provides performance data sourced from experimental measurements made using a four-channel software-defined MIMO radar platform. Demonstrations of waveform-diverse imaging data products are provided and compared directly against time-diverse equivalents in order to assess the performance of prospective MIMO waveforms. These are sourced from the pseudo-noise, short-term shift orthogonal, and orthogonal frequency multiplexing signal families while experimental results demonstrate waveform-diverse measurements of polarimetric radar cross section, top-down stationary target images, and finally volumetric MIMO synthetic aperture radar imagery. The data presented represents some of the first available concerning the overall practicality of waveform-diverse MIMO radar architectures, and results suggest that such configurations may achieve a reasonable degree of performance even in the presence of significant practical limitations.

Implementation of a health data-sharing infrastructure across diverse primary care organizations.

PubMed

Cole, Allison M; Stephens, Kari A; Keppel, Gina A; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks.

Implementation of a Health Data-Sharing Infrastructure Across Diverse Primary Care Organizations

PubMed Central

Cole, Allison M.; Stephens, Kari A.; Keppel, Gina A.; Lin, Ching-Ping; Baldwin, Laura-Mae

2014-01-01

Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks. PMID:24594564

Teaching Science in Diverse Settings: Marginalized Discourses and Classroom Practice. Counterpoints: Studies in the Postmodern Theory of Education.

ERIC Educational Resources Information Center

Barton, Angela Calabrese, Ed.; Osborne, Margery D., Ed.

The essays in this book draw from current debates concerning schooling and the need for liberatory education; the social construction of science and identity; and systems of race, class, and gender oppression and domination. These works aim to pose such questions as: (1) How can we shape practice and curriculum to address the needs of diverse…

Embryogenic callus proliferation and regeneration conditions for genetic transformation of diverse sugarcane cultivars.

PubMed

Basnayake, Shiromani W V; Moyle, Richard; Birch, Robert G

2011-03-01

Amenability to tissue culture stages required for gene transfer, selection and plant regeneration are the main determinants of genetic transformation efficiency via particle bombardment into sugarcane. The technique is moving from the experimental phase, where it is sufficient to work in a few amenable genotypes, to practical application in a diverse and changing set of elite cultivars. Therefore, we investigated the response to callus initiation, proliferation, regeneration and selection steps required for microprojectile-mediated transformation, in a diverse set of Australian sugarcane cultivars. 12 of 16 tested cultivars were sufficiently amenable to existing routine tissue-culture conditions for practical genetic transformation. Three cultivars required adjustments to 2,4-D levels during callus proliferation, geneticin concentration during selection, and/or light intensity during regeneration. One cultivar gave an extreme necrotic response in leaf spindle explants and produced no callus tissue under the tested culture conditions. It was helpful to obtain spindle explants for tissue culture from plants with good water supply for growth, especially for genotypes that were harder to culture. It was generally possible to obtain several independent transgenic plants per bombardment, with time in callus culture limited to 11-15 weeks. A caution with this efficient transformation system is that separate shoots arose from different primary transformed cells in more than half of tested calli after selection for geneticin resistance. The results across this diverse cultivar set are likely to be a useful guide to key variables for rapid optimisation of tissue culture conditions for efficient genetic transformation of other sugarcane cultivars.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

PubMed

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dreaming Stories: A Springboard for Learning. [Book and DVD]. Research in Practice Series. Volume 14, Number 2

ERIC Educational Resources Information Center

Connor, Jenni

2007-01-01

This special book and DVD set includes 13 of Aboriginal Nations' award-winning animated short films and a guide to using them in a diverse range of early childhood settings. Dreaming Stories are important parts of Aboriginal and Torres Strait Islander peoples' cultural heritage, and invaluable sources of knowledge and wisdom for everyone. In early…

Hill Girls, Consumption Practices, Power, and City Style: Raced and Classed Production of Femininities in a Higher Education Setting

ERIC Educational Resources Information Center

Esposito, Jennifer

2011-01-01

This study investigated the ways a diverse group of university women in the USA utilised racialised and classed discourses of femininity in the creation of subjectivities. Interview and focus group data were collected over a two-year time period and focused on how women navigated the higher education setting. Two forms of femininity, "Hill girl"…

Ethical dilemmas experienced by speech-language pathologists working in private practice.

PubMed

Flatley, Danielle R; Kenny, Belinda J; Lincoln, Michelle A

2014-06-01

Speech-language pathologists experience ethical dilemmas as they fulfil their professional roles and responsibilities. Previous research findings indicated that speech-language pathologists working in publicly funded settings identified ethical dilemmas when they managed complex clients, negotiated professional relationships, and addressed service delivery issues. However, little is known about ethical dilemmas experienced by speech-language pathologists working in private practice settings. The aim of this qualitative study was to describe the nature of ethical dilemmas experienced by speech-language pathologists working in private practice. Data were collected through semi-structured interviews with 10 speech-language pathologists employed in diverse private practice settings. Participants explained the nature of ethical dilemmas they experienced at work and identified their most challenging and frequently occurring ethical conflicts. Qualitative content analysis was used to analyse transcribed data and generate themes. Four themes reflected the nature of speech-language pathologists' ethical dilemmas; balancing benefit and harm, fidelity of business practices, distributing funds, and personal and professional integrity. Findings support the need for professional development activities that are specifically targeted towards facilitating ethical practice for speech-language pathologists in the private sector.

76 FR 10367 - Agency Information Collection Request; 60-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

.... Proposed Project: Research Evaluation and Impact Assessment of ARRA Comparative Effectiveness Research... under real-world conditions in diverse populations and clinical practice settings, that is, comparative... Coordinating Council on Comparative Effectiveness Research (FCCCER) to help coordinate and minimize duplicative...

Mental Health Promotion Education in Multicultural Settings.

ERIC Educational Resources Information Center

Khanlou, Nazilla

2003-01-01

A mental health promotion perspective provides a system-based understanding of relationships between culture and health. Educating nurses for multicultural practice should adopt an interdisciplinary approach that fosters critical awareness of diverse influences on mental health and their intersections. (Contains 38 references.) (SK)

The AAS Taskforce on Diversity and Inclusion in Graduate Education: a Proposed White Paper

NASA Astrophysics Data System (ADS)

Rudolph, Alexander L.

2018-06-01

At the January 2017 AAS meeting in Texas, the AAS Council approved the creation of a Graduate Education Taskforce focusing on Diversity and Inclusion. This task force is conducting a review of practices in recruiting, admissions, and retention in PhD programs in astronomy (including astronomy programs in departments of physics and astronomy). It is also engaging the broader astronomical community and selected outside experts in diversity in STEM in a discussion of best practices in these activities, with the goal of promoting diversity (race/ethnicity, gender, LGBTQ+, disability status, etc.) and inclusion in astronomy PhD programs. Building on the Nashville Recommendations from the Inclusive Astronomy 2015 meeting, the task force is developing a set of specific recommendations with the aim of endorsement by the AAS, in parallel with a campaign to get them adopted by astronomy departments. Finally, the task force will suggest and push adoption of a set of permanent measurements to be collected by the AAS to track progress on these goals. There is a separate special session at this meeting intended to report on the task force’s progress and to solicit community input on its draft recommendations to date.This presentation will give a brief overview of the task force's charge and activities and their plans to turn their final report into a White Paper for the Decadal Survey.

Rural nursing education: a photovoice perspective.

PubMed

Leipert, Beverly; Anderson, Emma

2012-01-01

For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status. Exemplar photos and reflections are provided. The photovoice research approach used in this rural education endeavour proved to be very useful in fostering students' exposure to, interest in, and understanding of rural settings and their influence on rural nursing practice. Photovoice is also recommended for use in rural courses other than nursing. Suggested strategies include group photovoice experience and the expansion of reflection to enhance rural health research.

Addressing mental health disparities through clinical competence not just cultural competence: the need for assessment of sociocultural issues in the delivery of evidence-based psychosocial rehabilitation services.

PubMed

Yamada, Ann-Marie; Brekke, John S

2008-12-01

Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness.

Second Language Teacher Education. International Perspectives

ERIC Educational Resources Information Center

Tedick, Diane J., Ed.

2005-01-01

The education of second language teachers takes place across diverse contexts, levels, settings, and geographic regions. By bringing together research, theory, and best practices from a variety of contexts (ESL/EFL, foreign language, bilingual and immersion education), this book contributes to building meaningful professional dialogue among…

New Perspectives on Translanguaging and Education

ERIC Educational Resources Information Center

Paulsrud, BethAnne, Ed.; Rosén, Jenny, Ed.; Straszer, Boglárka, Ed.; Wedin, Åsa, Ed.

2017-01-01

This edited collection explores the immense potential of translanguaging in educational settings and highlights teachers and students negotiating language ideologies in their everyday communicative practices. It makes a significant contribution to scholarship on translanguaging and considers the need for pedagogy to reflect and embrace diversity.…

Definitional ceremonies: narrative practices for psychologists to inform interdisciplinary teams' understanding of children's spirituality in pediatric settings.

PubMed

Moore, Kelsey; Talwar, Victoria; Moxley-Haegert, Linda

2015-03-01

In pediatric settings, parents and children often seek spiritual and religious support from their healthcare provider, as they try to find meaning in their illness. Narrative practices, such as definitional ceremonies, can provide a unique framework for psychologists to explore children's spirituality and its role in the midst of illness. In addition, definitional ceremonies can be used as a means for psychologists to inform interdisciplinary teams' understanding of children's spirituality and its relevance in pediatric treatment settings. In this article, our objectives are to (a) provide a brief overview of the literature on children's spirituality, (b) review some of the literature on childhood cancer patients' spirituality, (c) highlight the importance of whole-person care for diverse pediatric patients, and (d) introduce definitional ceremonies as appropriate narrative practices that psychologists can use to both guide their therapy and inform interdisciplinary teams' understanding of children's spirituality. © The Author(s) 2015.

Starting a nursing consultation practice.

PubMed

Schulmeister, L

1999-03-01

Because the clinical nurse specialist (CNS) role has been changed or eliminated in many hospital organizations, many CNSs in career transition are considering establishing collaborative or independent nursing consultation practices. Opportunities for consultants exist in diverse practice settings and specialties. Before starting a consultation practice, the CNS should carefully examine goals, identify resources, and begin contacting potential referral sources. He or she must also decide what form of business organization to establish and write a business plan to solidify ideas and prepare for the unexpected. Most CNS consultants rely on personal savings to cover initial business and personal expenses, and many continue working as a CNS until the consultation practice is established. Fees can be set based on community standards, what the market will bear, desired projected income, or a third-party payor's fee schedule. The consultation practice can be marketed by word of mouth, inexpensive advertising techniques such as distributing flyers and business cards, direct mall, and media advertising. In today's healthcare marketplace, opportunities abound for the CNS risk-taker interested in starting a nursing consultation practice.

Goal setting education and counseling practices of diabetes educators.

PubMed

Malemute, Charlene L; Shultz, Jill Armstrong; Ballejos, Miriam; Butkus, Sue; Early, Kathaleen Briggs

2011-01-01

The purpose of this study was to identify goal setting education practices used by diabetes educators working with type 2 diabetes patients. Data were collected by a mail questionnaire with 179 diabetes educators purposively selected from the 2008 American Association of Diabetes Educators membership listing. Many diabetes educators (52%) reported that more than 75% of their patients set goals for diabetes control. Independent factor patterns for the frequency of information collected from the patient for the first diabetes education session showed that educators either focused on patients' self-management practices (exercise and dietary practices, knowledge, and social impacts of diabetes) or issues with learning about self-management, such as understanding the patient's learning style and motivation for managing diabetes. Factor patterns overall showed diverse approaches to working with patients, including strategies used with patients struggling with dietary goals and the importance of tasks to complete during the first patient session. Although most educators reported practices that were largely patient centered as promoted by the American Diabetes Association (ADA) and models of chronic disease management, patterns of practice suggest that diabetes educators vary considerably in how they apply education practices, especially with dietary self-management education.

Robust estimation of microbial diversity in theory and in practice

PubMed Central

Haegeman, Bart; Hamelin, Jérôme; Moriarty, John; Neal, Peter; Dushoff, Jonathan; Weitz, Joshua S

2013-01-01

Quantifying diversity is of central importance for the study of structure, function and evolution of microbial communities. The estimation of microbial diversity has received renewed attention with the advent of large-scale metagenomic studies. Here, we consider what the diversity observed in a sample tells us about the diversity of the community being sampled. First, we argue that one cannot reliably estimate the absolute and relative number of microbial species present in a community without making unsupported assumptions about species abundance distributions. The reason for this is that sample data do not contain information about the number of rare species in the tail of species abundance distributions. We illustrate the difficulty in comparing species richness estimates by applying Chao's estimator of species richness to a set of in silico communities: they are ranked incorrectly in the presence of large numbers of rare species. Next, we extend our analysis to a general family of diversity metrics (‘Hill diversities'), and construct lower and upper estimates of diversity values consistent with the sample data. The theory generalizes Chao's estimator, which we retrieve as the lower estimate of species richness. We show that Shannon and Simpson diversity can be robustly estimated for the in silico communities. We analyze nine metagenomic data sets from a wide range of environments, and show that our findings are relevant for empirically-sampled communities. Hence, we recommend the use of Shannon and Simpson diversity rather than species richness in efforts to quantify and compare microbial diversity. PMID:23407313

Successful Students Who Are Deaf or Hard of Hearing and Culturally and/or Linguistically Diverse in Inclusive Settings.

PubMed

Ayantoye, Catherine Adekemi; Luckner, John L

2016-01-01

The population of students who are deaf or hard of hearing is becoming more culturally and/or linguistically diverse. However, there is a paucity of practitioner literature and research available to professionals and families to guide decision making about daily practices with these students and their families. The study identified factors that contribute to the success of students who are deaf or hard of hearing and from culturally and/or linguistically diverse backgrounds who receive the majority of their education in inclusive settings. Students were recruited from two schools in two school districts in a western state. Students, educators, interpreters, and parents participated in individual in-depth, semi-structured interviews. Observations of the students were also done. Analysis of the data included coding the transcribed interviews and the field notes to identify common themes. Seven themes emerged and are reported. Recommendations for future research are provided.

"Phronesis" on tour: cultural adaptability of Aristotelian ethical notions.

PubMed

Polansky, R

2000-12-01

How might bioethics take account of cultural diversity? Can practical wisdom of an Aristotelian sort be applied across cultures? After showing that practical wisdom involves both intellectual cleverness and moral virtue, it is argued that both these components have universality. Hence practical wisdom must be universal as well. Hellenic ethical thought neither depended on outdated theoretical notions nor limited itself to the Greek world, but was in fact developed with constant awareness of cultural differences, so it arguably works as well in other times and places when formulated. Even the eudaemonistic setting for practical wisdom is unproblematic.

Radical Education Reforms. The Series on Contemporary Educational Issues.

ERIC Educational Resources Information Center

Finn, Chester E., Jr., Ed.; Walberg, Herbert J., Ed.

This book presents a diverse set of unusual and significant departures from customary educational policies and practices. These "radical" ideas range from calling for national standards, to enacting statewide legislative initiatives, to implementing decentralized local initiatives such as charter schools, local school councils, and privatization.…

Adult Biliteracy in the United States. Language in Education: Theory and Practice 83.

ERIC Educational Resources Information Center

Spener, David, Ed.

This collection of articles by 15 leading researchers and teachers explores the social, cognitive, and pedagogical aspects of developing biliteracy--literacy in two languages. Chapters include the following: "Inheriting Sins While Seeking Absolution: Language Diversity and National Data Sets" (Reynaldo Macias); "Sociolinguistic…

STEM Studio: Where Innovation Generates Innovation

ERIC Educational Resources Information Center

Plonczak, Irene; Brooks, Jacqueline Grennon; Wilson, Gloria Lodato; Elijah, Rosebud; Caliendo, Julia

2014-01-01

STEM Studio at Hofstra University is a clinical practice site that brings together public school pupils and preservice teachers in settings with three features that lead to enhanced learning of all participants: classroom structures using multidisciplinary STEM tasks as platforms for learning; design challenge templates for diverse student…

Interprofessional E-Learning and Collaborative Work: Practices and Technologies

ERIC Educational Resources Information Center

Bromage, Adrian, Ed.; Clouder, Lynn, Ed.; Thistlethwaite, Jill, Ed.; Gordon, Frances, Ed.

2010-01-01

Interprofessionalism, an emerging model and philosophy of multi-disciplinary and multi-agency working, has in increasingly become an important means of cultivating joint endeavors across varied and diverse disciplinary and institutional settings. This book is therefore, an important source for understanding how interprofessionalism can be promoted…

How complexity science can inform scale-up and spread in health care: understanding the role of self-organization in variation across local contexts.

PubMed

Lanham, Holly Jordan; Leykum, Luci K; Taylor, Barbara S; McCannon, C Joseph; Lindberg, Curt; Lester, Richard T

2013-09-01

Health care systems struggle to scale-up and spread effective practices across diverse settings. Failures in scale-up and spread (SUS) are often attributed to a lack of consideration for variation in local contexts among different health care delivery settings. We argue that SUS occurs within complex systems and that self-organization plays an important role in the success, or failure, of SUS. Self-organization is a process whereby local interactions give rise to patterns of organizing. These patterns may be stable or unstable, and they evolve over time. Self-organization is a major contributor to local variations across health care delivery settings. Thus, better understanding of self-organization in the context of SUS is needed. We re-examine two cases of successful SUS: 1) the application of a mobile phone short message service intervention to improve adherence to medications during HIV treatment scale up in resource-limited settings, and 2) MRSA prevention in hospital inpatient settings in the United States. Based on insights from these cases, we discuss the role of interdependencies and sensemaking in leveraging self-organization in SUS initiatives. We argue that self-organization, while not completely controllable, can be influenced, and that improving interdependencies and sensemaking among SUS stakeholders is a strategy for facilitating self-organization processes that increase the probability of spreading effective practices across diverse settings. Published by Elsevier Ltd.

'I do the best I can': an in-depth exploration of the aphasia management pathway in the acute hospital setting.

PubMed

Foster, Abby M; Worrall, Linda E; Rose, Miranda L; O'Halloran, Robyn

2016-09-01

While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct, First contact with the profession, informed the entire management pathway. Five additional main categories were identified: Referral processes; Screening and assessment; Therapeutic intervention; Educational and affective counselling; and Advocacy. Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap. Implications for Rehabilitation Significant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting. Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required.

Practices around the use of masks and respirators among hospital health care workers in 3 diverse populations.

PubMed

Chughtai, Abrar Ahmad; MacIntyre, C Raina; Ashraf, Muhammad Orooj; Zheng, Yang; Yang, Peng; Wang, Quanyi; Dung, Tham Chi; Hien, Nguyen Tran; Seale, Holly

2015-10-01

A cross-sectional survey was conducted in 89 secondary- and tertiary-level hospitals in 3 countries, and samples of masks and respirators were also collected and examined. Results showed varied practices around the use of masks and respirators, which are probably influenced by the available resources and local recommendations. Nonstandardized practices are common in low-resource settings, which may be placing health care workers at risk. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Everyday drug diversions: a qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus.

PubMed

Vrecko, Scott

2015-04-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of 'drug diversion'--that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

Practical guide to understanding Comparative Effectiveness Research (CER).

PubMed

Neely, J Gail; Sharon, Jeffrey D; Graboyes, Evan M; Paniello, Randal C; Nussenbaum, Brian; Grindler, David J; Dassopoulos, Themistocles

2013-12-01

"Comparative effectiveness research" (CER) is not a new concept; however, recently it has been popularized as a method to develop scientifically sound actionable data by which patients, physicians, payers, and policymakers may make informed health care decisions. Fundamental to CER is that the comparative data are derived from large diverse populations of patients assembled from point-of-care general primary care practices and that measured outcomes include patient value judgments. The challenge is to obtain scientifically valid data to be acted upon by decision-making stakeholders with potentially quite diversely different agenda. The process requires very thoughtful research designs modulated by complex statistical and analytic methods. This article is composed of a guiding narrative with an extensive set of tables outlining many of the details required in performing and understanding CER. It ends with short discussions of three example papers, limitations of the method, and how a practicing physician may view such reports.

Statistical Diversions

ERIC Educational Resources Information Center

Petocz, Peter; Sowey, Eric

2012-01-01

The term "data snooping" refers to the practice of choosing which statistical analyses to apply to a set of data after having first looked at those data. Data snooping contradicts a fundamental precept of applied statistics, that the scheme of analysis is to be planned in advance. In this column, the authors shall elucidate the…

What Nurses Say They Do and Need: Implications for the Educational Preparation of Nurses.

ERIC Educational Resources Information Center

Cheek, Julianne; Jones, Jacqueline

2003-01-01

In-depth descriptions of practice of 38 Australian nurses in 17 settings were derived from interviews. Cross-case comparisons yielded themes with implications for nursing education: flexibility and adaptability, competence in interacting with diverse people, assessment abilities, communication and leadership skills, and coping with challenges…

Play and Literacy in Early Childhood: Research from Multiple Perspectives.

ERIC Educational Resources Information Center

Roskos, Kathleen A., Ed.; Christie, James F., Ed.

Noting that an examination of play from diverse perspectives deepens understanding and opens up new avenues for research and educational practice, this book brings together studies, research syntheses, and critical commentaries that examine play-literacy relationships from cognitive, ecological, and cultural perspectives. Each set of chapters is…

Social Work with Religious Volunteers: Activating and Sustaining Community Involvement

ERIC Educational Resources Information Center

Garland, Diana R.; Myers, Dennis M.; Wolfer, Terry A.

2008-01-01

Social workers in diverse community practice settings recruit and work with volunteers from religious congregations. This article reports findings from two surveys: 7,405 congregants in 35 Protestant congregations, including 2,570 who were actively volunteering, and a follow-up survey of 946 volunteers. It compares characteristics of congregation…

What Tension between Fidelity and Cultural Adaptation? A Reaction to Marsiglia and Booth

ERIC Educational Resources Information Center

Sampson, McClain; Torres, Luis R.

2015-01-01

This paper is a reaction to Marsiglia and Booths' paper, "Cultural Adaptation of Interventions in Real Practice Settings." In their paper, Marsiglia and Booth present the difficulty of implementing and replicating evidence-supported treatments, such as randomized clinical trials, among culturally diverse clients. Practitioners working in…

The Knowledge Café: A Unique Teaching Experience

ERIC Educational Resources Information Center

Baim, Susan A.

2016-01-01

Teaching adult learners in a community-based educational setting differs in many ways from applying typical campus-based or online instructional best practices. Adult learners show tremendous diversity in their backgrounds, approach learning in a myriad of different ways, and rely heavily on their past experiences to help guide their future…

76 FR 28987 - Agency Information Collection Request; 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... diverse populations and clinical practice settings, that is, comparative effectiveness research (CER). The American Reinvestment and Recovery Act of 2009 (ARRA) expanded Federal resources devoted to CER by... also called for a report to Congress and the Secretary of HHS on priority CER topics by the Institute...

Nurses collaborating with cross disciplinary networks: starting to integrate genomics into practice.

PubMed

Adegbola, Maxine

2010-07-01

Nurses and other health-care providers are poised to include genetic discoveries into practice settings and to translate such knowledge for consumer benefit within culturally appropriate contexts. Nurses must seek collaboration with multi-disciplinary networks both locally and internationally. They must also capitalize on the expertise of other seasoned researchers in order to gain national and international exposure, recognition, and funding. Scholarly tailgating is using network relationships to achieve one's professional goals, and capitalizing on expert knowledge from seasoned researchers, educators, and practitioners from diverse international groups. By using scholarly tailgating principles, nurses can become important agents of change for multi-disciplinary networks, and thereby assist in decreasing health disparities. The purpose of this document is to encourage and inspire nurses to seek collaborative multi-disciplinary networks to enable genomic integration into health-care practice and education. Strategies for integrating genomics into practice settings are discussed.

Managing the culturally diverse medical practice team: twenty-five strategies.

PubMed

Hills, Laura

2014-01-01

A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

Doctors' experience with handheld computers in clinical practice: qualitative study

PubMed Central

McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

2004-01-01

Objective To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Design Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Setting Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. Participants 54 doctors who did or did not use handheld computers. Results Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Conclusions Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care. PMID:15142920

Sex work and modes of self-employment in the informal economy: diverse business practices and constraints to effective working.

PubMed

Pitcher, Jane

2015-01-01

This article draws on research with adult sex workers in indoor settings in Great Britain to explore diverse forms of self-employment, employment relationships and small business development, set within the context of changes to the wider economy. It considers how external constraints such as the legal context, social stigma and dominant policy discourses can impact on sex workers' autonomy and actively work against their safety and wellbeing. The article argues that broad policy and legal approaches which fail to recognise the complexity of sex work constrain sex workers' opportunities for business development and improvement of their working circumstances. It suggests the need for recognition of sex work as legitimate labour, as a prerequisite for policy changes to support sex workers and pave the way for improved working conditions, not only in managed settings but also facilitating collective arrangements and independent lone working.

Addressing Mental Health Disparities through Clinical Competence Not Just Cultural Competence: The Need for Assessment of Sociocultural Issues in the Delivery of Evidence-Based Psychosocial Rehabilitation Services

PubMed Central

Yamada, Ann-Marie; Brekke, John S

2008-01-01

Recognition of ethnic/racial disparities in mental health services has not directly resulted in the development of culturally responsive psychosocial interventions. There remains a fundamental need for assessment of sociocultural issues that have been linked with the expectations, needs, and goals of culturally diverse consumers with severe and persistent mental illness. The authors posit that embedding the assessment of sociocultural issues into psychosocial rehabilitation practice is one step in designing culturally relevant empirically supported practices. It becomes a foundation on which practitioners can examine the relevance of their interventions to the diversity encountered in everyday practice. This paper provides an overview of the need for culturally and clinically relevant assessment practices and asserts that by improving the assessment of sociocultural issues the clinical competence of service providers is enhanced. The authors offer a conceptual framework for linking clinical assessment of sociocultural issues to consumer outcomes and introduce an assessment tool adapted to facilitate the process in psychosocial rehabilitation settings. Emphasizing competent clinical assessment skills will ultimately offer a strategy to address disparities in treatment outcomes for understudied populations of culturally diverse consumers with severe and persistent mental illness. PMID:18778881

Becoming Inclusive: A Code of Conduct for Inclusion and Diversity.

PubMed

Schmidt, Bonnie J; MacWilliams, Brent R; Neal-Boylan, Leslie

There are increasing concerns about exclusionary behaviors and lack of diversity in the nursing profession. Exclusionary behaviors, which may include incivility, bullying, and workplace violence, discriminate and isolate individuals and groups who are different, whereas inclusive behaviors encourage diversity. To address inclusion and diversity in nursing, this article offers a code of conduct. This code of conduct builds on existing nursing codes of ethics and applies to nursing students and nurses in both educational and practice settings. Inclusive behaviors that are demonstrated in nurses' relationships with patients, colleagues, the profession, and society are described. This code of conduct provides a basis for measureable change, empowerment, and unification of the profession. Recommendations, implications, and a pledge to action are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity.

PubMed

McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M

2015-08-01

The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

A National Long-term Outcomes Evaluation of U. S. Premedical Postbaccalaureate Programs Designed to Promote Healthcare Access and Workforce Diversity

PubMed Central

McDougle, Leon; Way, David P.; Lee, Winona K.; Morfin, Jose A.; Mavis, Brian E.; Wiggins, De’Andrea; Latham-Sadler, Brenda A.; Clinchot, Daniel M.

2016-01-01

The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of healthcare service to the poor and underserved and contribution to healthcare workforce diversity. Methods We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). Results The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. Conclusion The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for healthcare workforce diversity. PMID:26320900

Practice and Policy to Enhance Student Induction and Transition: A Case Study of Institution-Wide Change

ERIC Educational Resources Information Center

Alsford, Sally; Rose, Christine

2014-01-01

This case study gives an analytical account of institutional development in induction provision. Driven by student experience concerns, a London post-1992 University set up an "enhanced induction project" to provide a more integrated, personalised approach through more coordinated processes. In a large, diverse context, university-wide…

Telling Their Stories: Primary Care Practitioners' Experience Evaluating and Reporting Injuries Caused by Child Abuse

ERIC Educational Resources Information Center

Flaherty, Emalee G.; Jones, Rise; Sege, Robert

2004-01-01

Objective: To learn about primary care physicians' experiences in identifying and reporting injuries caused by physical abuse. Method: Two qualitative analysts facilitated a focus group of six Chicago area, primary care physicians. Physicians representing diverse practice settings were selected to participate in the discussion. The analysts…

Methodological Issues in Alcohol Screening and Brief Intervention Research

ERIC Educational Resources Information Center

Kypri, Kypros

2007-01-01

The research literature on screening and brief intervention (SBI) for unhealthy alcohol use is large and diverse. More than 50 clinical trials and 9 systematic reviews have been published on SBI in a range of healthcare settings, and via a variety of delivery approaches, in general practice, hospital wards, emergency departments, addiction…

Supporting Socio-Emotional Competence and Psychological Well-Being of School Psychologists through Mindfulness Practice

ERIC Educational Resources Information Center

Alahari, Uma

2017-01-01

The development of effective emotional regulation is critical to the success of educational professionals in a variety of settings. These skills are particularly important for school psychologists who must learn to interact successfully with diverse students, teachers, and parents on a daily basis. Research now suggests that mindfulness practice…

Inclusion in School: A Policy, Ideology or Lived Experience? Similar Findings in Diverse School Cultures

ERIC Educational Resources Information Center

Paliokosta, Paty; Blandford, Sonia

2010-01-01

This article summarises three case studies examining the implementation of inclusive practices, which evidence the exclusionary pressures acting in school settings that put the needs, rights and entitlements of vulnerable children and young people at risk. It examines how three very culturally different secondary schools in England interpreted…

Fostering Preservice Teachers' Development: Engagement in Practice and Learning

ERIC Educational Resources Information Center

McMahan, Sarah K.; Garza, Rubén

2017-01-01

Given the benefits associated with authentic field experiences (Edwards, 1996; McMahan et al., 2015; Siwatu, 2010), it is not uncommon to include early field experiences prior to student teaching as a way to engage university students with teaching diverse students in an authentic school setting. This study explored preservice teachers'…

Understanding a Monocultural, Student-Teaching Setting from Sociocultural Perspectives: A Video Analysis

ERIC Educational Resources Information Center

Chepyator-Thomson, Jepkorir Rose

2006-01-01

Sociocultural considerations play an important role in any teaching episode in our increasingly diverse society. This analysis focuses on a male European American preservice teacher, who is practicing teaching at a school with 3% African-American, 3% Asian, 91% European American, 1% Hispanic American, and 3% multiracial students. Examination of…

Beyond Participation: What We Learned from Hunter about Collaboration with Pasifika Children and Families

ERIC Educational Resources Information Center

Cooper, Maria; Hedges, Helen

2014-01-01

Increasing the participation rates of Pasifika children in early childhood settings is a policy target in Aotearoa-New Zealand. Yet, participation may not engender positive learning outcomes for children from diverse cultural backgrounds without attention to teacher knowledge and practice. The early childhood curriculum document, Te Whariki,…

Teaching and Learning Music Composition in Primary School Settings

ERIC Educational Resources Information Center

Saetre, Jon Helge

2011-01-01

The field of creative music education is described as complex, unpredictable and versatile. The aim of this article is to explore this complexity and diversity on the basis of the continental "didaktik" tradition and Robin Alexander's generic model of teaching. The educational practice and orientation of the teacher are investigated in relation to…

Effective Mental Health Interventions and Treatments for Young Children with Diverse Needs

ERIC Educational Resources Information Center

Osofsky, Joy; Wieder, Serena; Noroña, Carmen Rosa; Lowell, Darcy; Worthy, D'Lisa Ramsey

2018-01-01

Infant and early childhood mental health interventions and treatment take place in many different settings including clinics serving adults and children, primary care centers, pediatric clinics, private practice offices, homes, early intervention offices, and child care centers. In addition, the types of evaluations and services offered in these…

Systematic Quality Development Work in a Swedish Leisure-Time Centre

ERIC Educational Resources Information Center

Lager, Karin; Sheridan, Sonja; Gustafsson, Jan

2016-01-01

There is increasing activity in the area of quality issues in education in Europe. Diverse discourses of policy for quality are encountered in daily practice. This article explores systematic quality development work in a Swedish educational setting: the leisure-time centre. By following 2 teachers' enactments of policy in planning, organising,…

A Whole-System Approach to Understanding Agricultural Chemicals in the Environment

USGS Publications Warehouse

,

2009-01-01

The effects of the use of agricultural chemicals and other practices associated with agriculture on the quality of streams and groundwater is well known; however, less is known about how those effects may vary across different geographic regions of the Nation. Scientists at the U.S. Geological Survey (USGS) are conducting studies on the transport and fate of agricultural chemicals in diverse agricultural settings across the country using comparable and consistent methodology and study designs (fig. 1; Capel and others, 2004; Capel and others, 2008). Assessments in five study areas have been completed, and the results highlight how environmental processes and agricultural practices interact to affect the movement and transformation of agricultural chemicals in the environment. The studies address major environmental compartments, including surface water, groundwater, the unsaturated zone, the streambed, and the atmosphere, as well as the pathways that interconnect these compartments. The study areas represent major agricultural settings, such as irrigated diverse cropping in the West and corn and soybean row cropping in the Midwest and, therefore, findings are relevant throughout much of the Nation.

Aneurysm treatment practice patterns for newly appointed dual-trained cerebrovascular/endovascular neurosurgeons: Comparison of open surgical to neuroendovascular procedures in the first 2 years of academic practice.

PubMed

Jiang, Bowen; Bender, Matthew T; Hasjim, Bima; Hsu, Frank P K; Tamargo, Rafael J; Huang, Judy; Colby, Geoffrey P; Coon, Alexander L; Lin, Li-Mei

2017-01-01

The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon's practice. A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice. Of these aneurysms, 172 were treated with microsurgical clipping, 191 with coiling, and 170 with flow diversion. Treatment in the setting of acute subarachnoid hemorrhage (SAH) occurred in 23% (122/533) of the aneurysms. Majority of the clipped aneurysms (70%, 121/172) were anterior cerebral artery (ACA), anterior communicating artery (ACOM), or middle cerebral artery (MCA) in location. In comparison, only 23% (82/361) of aneurysms treated with coiling or flow diversion therapy were ACA, ACOM, or MCA in location ( P < 0.05). Additionally, majority of the flow diverted aneurysm (65%, 111/170) were cavernous or ophthalmic/paraophthalmic in location. During the second year of practice, there appeared to be a trend towards more aneurysms treated with neuroendovascular techniques (22% increase), particularly in flow diversion. Although the CVNV neurosurgeon treats cerebral aneurysms more commonly with neuroendovascular techniques, a third of the cerebral aneurysms are still selected for microsurgical clipping. Aneurysms located along the ACA/ACOM or MCA are the most frequent aneurysms reserved for microsurgical clipping. The CVNV neurosurgeon must be prepared to manage a high percentage of ACA/ACOM or MCA aneurysms microsurgically.

Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists.

PubMed

Pascoe, Michelle; Klop, Daleen; Mdlalo, Thandeka; Ndhambi, Mikateko

2018-02-01

Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.

Study protocol for a cluster randomized trial of the Community of Voices choir intervention to promote the health and well-being of diverse older adults.

PubMed

Johnson, Julene K; Nápoles, Anna M; Stewart, Anita L; Max, Wendy B; Santoyo-Olsson, Jasmine; Freyre, Rachel; Allison, Theresa A; Gregorich, Steven E

2015-10-13

Older adults are the fastest growing segment of the United States population. There is an immediate need to identify novel, cost-effective community-based approaches that promote health and well-being for older adults, particularly those from diverse racial/ethnic and socioeconomic backgrounds. Because choral singing is multi-modal (requires cognitive, physical, and psychosocial engagement), it has the potential to improve health outcomes across several dimensions to help older adults remain active and independent. The purpose of this study is to examine the effect of a community choir program (Community of Voices) on health and well-being and to examine its costs and cost-effectiveness in a large sample of diverse, community-dwelling older adults. In this cluster randomized controlled trial, diverse adults age 60 and older were enrolled at Administration on Aging-supported senior centers and completed baseline assessments. The senior centers were randomly assigned to either start the choir immediately (intervention group) or wait 6 months to start (control). Community of Voices is a culturally tailored choir program delivered at the senior centers by professional music conductors that reflects three components of engagement (cognitive, physical, and psychosocial). We describe the nature of the study including the cluster randomized trial study design, sampling frame, sample size calculation, methods of recruitment and assessment, and primary and secondary outcomes. The study involves conducting a randomized trial of an intervention as delivered in "real-world" settings. The choir program was designed using a novel translational approach that integrated evidence-based research on the benefits of singing for older adults, community best practices related to community choirs for older adults, and the perspective of the participating communities. The practicality and relatively low cost of the choir intervention means it can be incorporated into a variety of community settings and adapted to diverse cultures and languages. If successful, this program will be a practical and acceptable community-based approach for promoting health and well-being of older adults. ClinicalTrials.gov NCT01869179 registered 9 January 2013.

Global Bioethics and Culture in a Pluralistic World: How does Culture influence Bioethics in Africa?

PubMed Central

Chukwuneke, FN; Umeora, OUJ; Maduabuchi, JU; Egbunike, N

2014-01-01

Bioethics principles and practice can be influenced by different cultural background. This is because the four globally accepted bioethics principles are often based on basic ethical codes such as autonomy, beneficence, nonmaleficence and justice. Beneficence/nonmaleficence requires us to maximize possible benefits, while minimizing possible harms and consequently secure the well-being of others by refraining from harming them. Autonomy gives individuals the right to self-actualization and decision-making, while justice is concerned with the fair selection and distribution of the burdens and benefits of research among participants. Applications of these principles in cultural settings vary more often from one cultural perspective to the other because of the different understanding and practices of “what is good.” The proponents of global ethics may argue that these principles should be universally generalizable and acceptable, but this is not possible because of the existing cultural diversities. In the African set-up, despite the existence of major common cultural practices, there are other norms and practices, which differ from one society to the other within the communities. Therefore, the word “global” bioethics may not be applicable generally in practice except if it can account for the structural dynamics and cultural differences within the complex societies in which we live in. However, the extent to which cultural diversity should be permitted to influence bioethical judgments in Africa, which at present is burdened with many diseases, should be of concern to researchers, ethicist and medical experts taking into considerations the constantly transforming global society. This topic examines the cultural influence on principles and practice of bioethics in Africa. PMID:25328772

Advancing Educational Diversity: Antifragility, Standardization, Democracy, and a Multitude of Education Options

ERIC Educational Resources Information Center

Fortunato, Michael W. P.

2017-01-01

This essay is a response to a paper by Avery and Hains that raises questions about the often unintended effects of knowledge standardization in an educational setting. While many K-12 schools are implementing common core standards, and many institutions of higher education are implementing their own standardized educational practices, the question…

Culturally Responsive Wraparound Supports: Collaborating with Families to Promote Students' Behavior Regulation across Settings

ERIC Educational Resources Information Center

Fallon, Lindsay M.; Mueller, Marlana R.

2017-01-01

As public schools in the U.S. are becoming increasingly culturally and linguistically diverse (CLD), there has been an effort to generate empirical support for culturally responsive practices in schools to promote a variety of positive outcomes for children (e.g., behavioral health, mental health, academic achievement). School psychologists can…

Computer-based tools for decision support in agroforestry: Current state and future needs

Treesearch

E.A. Ellis; G. Bentrup; Michelle M. Schoeneberger

2004-01-01

Successful design of agroforestry practices hinges on the ability to pull together very diverse and sometimes large sets of information (i.e., biophysical, economic and social factors), and then implementing the synthesis of this information across several spatial scales from site to landscape. Agroforestry, by its very nature, creates complex systems with impacts...

Teaching Interprofessional Practice: An Exploratory Course Assignment in Social Work and Speech Language Pathology

ERIC Educational Resources Information Center

Edwards, Claire M.; Newell, Jason M.; Rich, Danielle Waldrep; Hitchcock, Laurel I.

2015-01-01

The professions of social work (SWK) and speech language pathology (SLP) often involve the provision of services to a diverse group of client populations in a variety of settings; this is particularly true when meeting the complex needs of children and their families. It is widely accepted that collaborative treatment approaches utilizing…

"I Never Hear It Talked About": Exploring Discourses of Whiteness in a Predominantly White Elementary School

ERIC Educational Resources Information Center

Heuschkel, Kimberly A.

2013-01-01

Much is known about the practices, beliefs, assumptions, and discourses of teachers as they look at issues of racial, ethnic, and cultural diversity but little has been done to understand how racial injustice is sustained in these school settings and how whiteness operates in predominantly white educational contexts. White elementary school…

Biogeographic, cultural, and historical setting of the Northern Rocky Mountains [Chapter 2

Treesearch

S. Karen Dante-Wood

2018-01-01

The Northern Rockies Adaptation Partnership (NRAP) includes diverse landscapes, ranging from high mountains to grasslands, from alpine glaciers to broad rivers (fig. 1.1). This region, once inhabited solely by Native Americans, has been altered by two centuries of settlement by Euro- Americans through extractive practices such as timber harvest, grazing, and mining,...

Critical Health Literacy: Shifting Textual-Social Practices in the Health Classroom

ERIC Educational Resources Information Center

Renwick, Kerry

2014-01-01

This paper will consider ways in which students are constructed as aliens in health classrooms. Creating the classroom as a setting for health promotion requires closer attention to those who make use of such space. If classrooms are places where diversity exists and is recognised, then health educators are challenged to consider how students are…

I Wish I Could Believe You: The Frustrating Unreliability of Some Assessment Research

ERIC Educational Resources Information Center

Hunt, Tim; Jordan, Sally

2016-01-01

Many practitioner researchers strive to understand which assessment practices have the best impact on learning, but in authentic educational settings, it can be difficult to determine whether one intervention, for example the introduction of an online quiz to a course studied by diverse students, is responsible for the observed effect. This paper…

The Entrepreneurial Domains of American Higher Education. ASHE Higher Education Report, Volume 34, Number 5

ERIC Educational Resources Information Center

Mars, Matthew M.; Metcalf, Amy Scott

2009-01-01

This volume draws on a diverse set of literatures to represent the various ways in which entrepreneurship is understood in and applied to higher education. It provides a platform for debate for those considering applications of entrepreneurial principles to academic research and practices. Using academic entrepreneurship in the United States as…

"Indigenising" or "Interculturalising" Universities in Mexico?: Towards an Ethnography of Diversity Discourses and Practices inside the "Universidad Veracruzana Intercultural"

ERIC Educational Resources Information Center

Dietz, Gunther; Cortes, Laura Mateos

2011-01-01

Multicultural discourse has reached Latin American higher education in the form of a set of policies targeting indigenous peoples. These policies are strongly influenced by the transfer of European notions of "interculturality", which, in the Mexican context, are understood as positive interactions between members of minority and…

Attitude of Students towards Peers with Disabilities: Relocating Students from an Education Support Centre to an Inclusive Middle School Setting

ERIC Educational Resources Information Center

McGregor, Steven J. R.; Forlin, Chris

2005-01-01

When establishing inclusive or whole schooling practices, the attitudes of students towards their peers with differing abilities to themselves is potentially a critical determinant in the success of schools to manage diverse student populations. This research investigates any potential changes in peer attitudes following the inclusion of…

Parenting Support: Policy and Practice in the Irish Context

ERIC Educational Resources Information Center

Connolly, Nuala; Devaney, Carmel

2018-01-01

Increasing government interest in parenting support has emerged in response to the increasingly diverse form of families, a growing emphasis on children's rights and a policy shift towards prevention and early intervention. This has contributed to a range of stakeholder activity in the area, with the notion that parenting is a set of skills that…

What Motives Are Important for Participation in Leisure-Time Activities at Swedish Youth Centres?

ERIC Educational Resources Information Center

Geidne, Susanna; Fredriksson, Ingela; Eriksson, Charli

2016-01-01

Objective: This study aimed to explore the motives of young people in multicultural suburbs for participating in youth-centre activities. Design and setting: The study employed practice-based research with a focus on collaboration and methodological diversity. Data on motives for participation were collected in spring 2013 at two non-governmental…

The Lure of Internationalization: Paradoxical Discourses of Transnational Student Mobility, Linguistic Diversity and Cross-Cultural Exchange

ERIC Educational Resources Information Center

Fabricius, Anne H.; Mortensen, Janus; Haberland, Hartmut

2017-01-01

This paper scrutinizes a set of paradoxes arising from a mismatch between contemporary discourses that praise and promote mobility in and internationalization of higher education, and the everyday effects of mobility and internationalization on university teaching and learning practice. We begin with a general characterization of the discourse of…

Gender and Linguistic Ideology: A Re-Examination of Directive Usage by Japanese Male Superiors in the Workplace

ERIC Educational Resources Information Center

Saito, Junko

2009-01-01

This study examines Japanese male superiors' linguistic practices in an institutional setting in Japan, in particular focusing on directive usage. It quantitatively and qualitatively elucidates how seven male superiors in a workplace, which is located in the Tokyo area, employ diverse linguistic resources in directive discourse so as to persuade…

Keep It R.E.A.L.!: Relevant, Engaging, and Affirming Literacy for Adolescent English Learners

ERIC Educational Resources Information Center

Stewart, Mary Amanda

2017-01-01

This book introduces a set of pedagogical practices designed to assist adolescent English learners in developing their English skills in a way that honors and leverages their native languages and cultures. Responding to the linguistic and educational diversity of adolescents, the R.E.A.L. (Relevant, Engaging, and Affirming Literacy) method offers…

Medical Teaching in Sioux Lookout: Primary Health Care in a Cross-Cultural Setting

PubMed Central

Hagen, Catherine; Casson, Ian; Wilson, Ruth

1989-01-01

When participating in health care in northern Native communities, physician-teachers are challenged to understand community development, treat diverse manifestations of illness and socio-cultural strain, and provide opportunities for students and residents to learn the skills, knowledge, and attitudes that will promote the health of Native people and that will develop the students' own education. The University of Toronto Sioux Lookout Program includes a teaching practice with the goals of service, teaching, and research that provides care and promotes health for 13 000 Ojibway- or Cree-speaking aboriginal Canadians in northwestern Ontario. Knowledge gained in this setting about broad determinants of health, communication skills, and clinical decision making can be generalized to other practices. PMID:21249082

Student perception of travel service learning experience in Morocco.

PubMed

Puri, Aditi; Kaddoura, Mahmoud; Dominick, Christine

2013-08-01

This study explores the perceptions of health profession students participating in academic service learning in Morocco with respect to adapting health care practices to cultural diversity. Authors utilized semi-structured, open-ended interviews to explore the perceptions of health profession students. Nine dental hygiene and nursing students who traveled to Morocco to provide oral and general health services were interviewed. After interviews were recorded, they were transcribed verbatim to ascertain descriptive validity and to generate inductive and deductive codes that constitute the major themes of the data analysis. Thereafter, NVIVO 8 was used to rapidly determine the frequency of applied codes. The authors compared the codes and themes to establish interpretive validity. Codes and themes were initially determined independently by co-authors and applied to the data subsequently. The authors compared the applied codes to establish intra-rater reliability. International service learning experiences led to perceptions of growth as a health care provider among students. The application of knowledge and skills learned in academic programs and service learning settings were found to help in bridging the theory-practice gap. The specific experience enabled students to gain an understanding of diverse health care and cultural practices in Morocco. Students perceived that the experience gained in international service learning can heighten awareness of diverse cultural and health care practices to foster professional growth of health professionals.

The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine-naloxone film.

PubMed

White, Nancy; Ali, Robert; Larance, Briony; Zador, Deborah; Mattick, Richard P; Degenhardt, Louisa

2016-01-01

Around 65% of people incarcerated in prisons in Australia, America and Europe have a history of drug dependence, sometimes treated with opioid substitution treatment (OST) medications. Studies report that those in treatment in prison do engage in some level of diversion to others, whether on a voluntary or coerced basis. We aimed to examine the use of prescribed and non-prescribed OST medications by those in prisons, especially buprenorphine-naloxone film (BNX-F); the extent of non-adherence and diversion and reasons for such practices; and the impact of the introduction of BNX-F into the prison system. Mixed methods study drawing on: (i) structured interviews with current OST clients (n = 60) who reported being incarcerated in the 12 months prior to being interviewed and (ii) qualitative interviews with key experts working in corrections and prison (or justice) health settings. The majority were prescribed OST medications in prison, with 25% removing all or part of their supervised dose on at least one occasion, and 44% reporting use of non-prescribed medications. Some reported intravenous use (14% injected). One-third of OST recipients reported selling/sharing OST medications with others in prison. The introduction of BNX-F into the prison system saw different diversion methods used and removal from dosing within prison. Despite prison being a highly regulated and controlled environment, some level of diversion and sharing of psychoactive medication occurs among prisoners. The buprenorphine formulations used in OST present particular challenges with respect to supervised dosing in this setting. [White N, Ali R, Larance B, Zador D, Mattick RP, Degenhardt L. The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine-naloxone film. Drug Alcohol Rev 2015;●●:●●-●●]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Survival, momentum, and things that make me "me": patients' perceptions of goal setting after stroke.

PubMed

Brown, Melanie; Levack, William; McPherson, Kathryn M; Dean, Sarah G; Reed, Kirk; Weatherall, Mark; Taylor, William J

2014-01-01

Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. Thematic analysis was used to analyse interview transcripts from 10 stroke survivors, recruited from 4 rehabilitation units as part of a pilot study investigating the effects of a structured means of eliciting patient-centred goals in post-acute stroke rehabilitation. Three key themes emerged: (1) "A Day by Day Momentum", comprising subordinate themes of "Unpredictability" and "Natural Progression" in which daily progress forwards was seen as an integral part of rehabilitation; (2) "Battle versus Alliance" in which issues of struggle versus support influenced participants' advancement; and (3) "The Special Things", consisting of subordinate themes of "What Makes Me 'Me'" and "Symbolic Achievements" concerning issues defining individuals and their rehabilitation experiences. Patients' discourse around goal setting can differ from the discourse conventionally used by clinicians when describing "best practice" in rehabilitation goal setting. Understanding patients' non-conventional views of goals may assist in supporting and motivating them, thus providing drive for their rehabilitation. Stroke patients think about goals very differently from health professionals. Individual patients have diverse ideas about goals within the context of the uncertainty of stroke, their life as a whole and recovery after formal rehabilitation is completed. To meet these diverse needs, health professionals need to communicate fully with patients to gain an understanding of their experiences of stroke and wider views on goals.

Aneurysm treatment practice patterns for newly appointed dual-trained cerebrovascular/endovascular neurosurgeons: Comparison of open surgical to neuroendovascular procedures in the first 2 years of academic practice

PubMed Central

Jiang, Bowen; Bender, Matthew T.; Hasjim, Bima; Hsu, Frank P. K.; Tamargo, Rafael J.; Huang, Judy; Colby, Geoffrey P.; Coon, Alexander L.; Lin, Li-Mei

2017-01-01

Background: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. Methods: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon’s practice. Results: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice. Of these aneurysms, 172 were treated with microsurgical clipping, 191 with coiling, and 170 with flow diversion. Treatment in the setting of acute subarachnoid hemorrhage (SAH) occurred in 23% (122/533) of the aneurysms. Majority of the clipped aneurysms (70%, 121/172) were anterior cerebral artery (ACA), anterior communicating artery (ACOM), or middle cerebral artery (MCA) in location. In comparison, only 23% (82/361) of aneurysms treated with coiling or flow diversion therapy were ACA, ACOM, or MCA in location (P < 0.05). Additionally, majority of the flow diverted aneurysm (65%, 111/170) were cavernous or ophthalmic/paraophthalmic in location. During the second year of practice, there appeared to be a trend towards more aneurysms treated with neuroendovascular techniques (22% increase), particularly in flow diversion. Conclusion: Although the CVNV neurosurgeon treats cerebral aneurysms more commonly with neuroendovascular techniques, a third of the cerebral aneurysms are still selected for microsurgical clipping. Aneurysms located along the ACA/ACOM or MCA are the most frequent aneurysms reserved for microsurgical clipping. The CVNV neurosurgeon must be prepared to manage a high percentage of ACA/ACOM or MCA aneurysms microsurgically. PMID:28808603

The views of medical education stakeholders on guidelines for cultural diversity teaching.

PubMed

Dogra, Nisha

2007-03-01

The General Medical Council set out the framework within which it expects medical education to develop. Educational guidelines have been developed across the world but their development is less clear in the UK. There has been little work regarding views about educational guidelines. The research objective was to establish the views of medical education stakeholders towards specific guidelines for teaching in cultural diversity to medical students. Sixty-one individuals were interviewed using a semi-structured interview. Thematic analysis was undertaken after the interviews were transcribed verbatim. In total, 51 respondents felt that guidelines would be useful; 17 of these explicitly stipulated that these would only be useful if they were not prescriptive and if they were applied flexibly and were practical. Four respondents, including two policy-makers holding senior positions with medical educational bodies, felt that new guidelines would not be useful, as they already existed in some form. Five respondents were unsure if guidelines would be helpful or not. Guidelines were considered to be potentially useful for several reasons including to: help clarify what should be taught regarding cultural diversity and how it should be taught, provide justification for teaching the subject, help those unfamiliar with the subject, support those assigned with responsibility for developing such teaching, provide course and curriculum designers with reassurance, increase the credibility of the subject, set standards that serve as a benchmark against which schools can compare themselves with one another and highlight good practice. The reservations expressed suggest that the guidelines need to be developed using a range of stakeholders and have some degree of consensus to ensure that they will be used. The literature relating to attitudes towards clinical practice guidelines has much to contribute to the development of educational guidelines.

Grain-dependent responses of mammalian diversity to land use and the implications for conservation set-aside.

PubMed

Wearn, Oliver R; Carbone, Chris; Rowcliffe, J Marcus; Bernard, Henry; Ewers, Robert M

2016-07-01

Diversity responses to land-use change are poorly understood at local scales, hindering our ability to make forecasts and management recommendations at scales which are of practical relevance. A key barrier in this has been the underappreciation of grain-dependent diversity responses and the role that β-diversity (variation in community composition across space) plays in this. Decisions about the most effective spatial arrangement of conservation set-aside, for example high conservation value areas, have also neglected β-diversity, despite its role in determining the complementarity of sites. We examined local-scale mammalian species richness and β-diversity across old-growth forest, logged forest, and oil palm plantations in Borneo, using intensive camera- and live-trapping. For the first time, we were able to investigate diversity responses, as well as β-diversity, at multiple spatial grains, and across the whole terrestrial mammal community (large and small mammals); β-diversity was quantified by comparing observed β-diversity with that obtained under a null model, in order to control for sampling effects, and we refer to this as the β-diversity signal. Community responses to land use were grain dependent, with large mammals showing reduced richness in logged forest compared to old-growth forest at the grain of individual sampling points, but no change at the overall land-use level. Responses varied with species group, however, with small mammals increasing in richness at all grains in logged forest compared to old-growth forest. Both species groups were significantly depauperate in oil palm. Large mammal communities in old-growth forest became more heterogeneous at coarser spatial grains and small mammal communities became more homogeneous, while this pattern was reversed in logged forest. Both groups, however, showed a significant β-diversity signal at the finest grain in logged forest, likely due to logging-induced environmental heterogeneity. The β-diversity signal in oil palm was weak, but heterogeneity at the coarsest spatial grain was still evident, likely due to variation in landscape forest cover. Our findings suggest that the most effective spatial arrangement of set-aside will involve trade-offs between conserving large and small mammals. Greater consideration in the conservation and management of tropical landscapes needs to be given to β-diversity at a range of spatial grains. © 2016 by the Ecological Society of America.

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario.

PubMed

Morris, Diane; Matthews, June

2014-12-01

Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an "Ideal Interprofessional Team". These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

In blind pursuit of racial equality?

PubMed

Apfelbaum, Evan P; Pauker, Kristin; Sommers, Samuel R; Ambady, Nalini

2010-11-01

Despite receiving little empirical assessment, the color-blind approach to managing diversity has become a leading institutional strategy for promoting racial equality, across domains and scales of practice. We gauged the utility of color blindness as a means to eliminating future racial inequity--its central objective--by assessing its impact on a sample of elementary-school students. Results demonstrated that students exposed to a color-blind mind-set, as opposed to a value-diversity mind-set, were actually less likely both to detect overt instances of racial discrimination and to describe such events in a manner that would prompt intervention by certified teachers. Institutional messages of color blindness may therefore artificially depress formal reporting of racial injustice. Color-blind messages may thus appear to function effectively on the surface even as they allow explicit forms of bias to persist.

How health professionals conceive and construct interprofessional practice in rural settings: a qualitative study.

PubMed

Parker, Vicki; McNeil, Karen; Higgins, Isabel; Mitchell, Rebecca; Paliadelis, Penelope; Giles, Michelle; Parmenter, Glenda

2013-12-01

Although interprofessional practice (IPP) offers the potential to enhance rural health services and provide support to rural clinicians, IPP may itself be problematic due to workforce limitations and service fragmentation. Differing socioeconomic and geographic characteristics of rural communities means that the way that IPP occurs in rural contexts will necessarily differ from that occurring in metropolitan contexts. The aim of this study was to investigate the factors contributing to effective IPP in rural contexts, to examine how IPP happens and to identify barriers and enablers. Using Realistic Evaluation as a framework, semi-structured interviews were conducted with health professionals in a range of rural healthcare contexts in NSW, Australia. Independent thematic analysis was undertaken by individual research team members, which was then integrated through consensus to achieve a qualitative description of rural IPP practice. There was clear evidence of diversity and complexity associated with IPP in the rural settings that was supported by descriptions of collaborative integrated practice. There were instances where IPP doesn't and could happen. There were a number of characteristics identified that significantly impacted on IPP including the presence of a shared philosophical position and valuing of IPP and recognition of the benefits, funding to support IPP, pivotal roles, proximity and workforce resources. The nature of IPP in rural contexts is diverse and determined by a number of critical factors. This study goes some of the way towards unravelling the complexity of IPP in rural contexts, highlighting the strong motivating factors that drive IPP. However, it has also identified significant structural and relational barriers related to workload, workforce, entrenched hierarchies and ways of working and service fragmentation. Further research is required to explicate the mechanisms that drive successful IPP across a range of diverse rural contexts in order to inform the implementation of robust flexible strategies that will support sustainable models of rural IPP.

How health professionals conceive and construct interprofessional practice in rural settings: a qualitative study

PubMed Central

2013-01-01

Background Although interprofessional practice (IPP) offers the potential to enhance rural health services and provide support to rural clinicians, IPP may itself be problematic due to workforce limitations and service fragmentation. Differing socioeconomic and geographic characteristics of rural communities means that the way that IPP occurs in rural contexts will necessarily differ from that occurring in metropolitan contexts. The aim of this study was to investigate the factors contributing to effective IPP in rural contexts, to examine how IPP happens and to identify barriers and enablers. Methods Using Realistic Evaluation as a framework, semi-structured interviews were conducted with health professionals in a range of rural healthcare contexts in NSW, Australia. Independent thematic analysis was undertaken by individual research team members, which was then integrated through consensus to achieve a qualitative description of rural IPP practice. Results There was clear evidence of diversity and complexity associated with IPP in the rural settings that was supported by descriptions of collaborative integrated practice. There were instances where IPP doesn’t and could happen. There were a number of characteristics identified that significantly impacted on IPP including the presence of a shared philosophical position and valuing of IPP and recognition of the benefits, funding to support IPP, pivotal roles, proximity and workforce resources. Conclusions The nature of IPP in rural contexts is diverse and determined by a number of critical factors. This study goes some of the way towards unravelling the complexity of IPP in rural contexts, highlighting the strong motivating factors that drive IPP. However, it has also identified significant structural and relational barriers related to workload, workforce, entrenched hierarchies and ways of working and service fragmentation. Further research is required to explicate the mechanisms that drive successful IPP across a range of diverse rural contexts in order to inform the implementation of robust flexible strategies that will support sustainable models of rural IPP. PMID:24289815

Everyday drug diversions: A qualitative study of the illicit exchange and non-medical use of prescription stimulants on a university campus

PubMed Central

Vrecko, Scott

2015-01-01

This article investigates everyday experiences and practises that are associated with processes of pharmaceuticalization and with practices of ‘drug diversion’—that is, the illicit exchange and non-medical use of prescription drugs. It reports results from a qualitative study that was designed to examine the everyday dimensions of non-medical prescription stimulant use among students on an American university campus, which involved 38 semi-structured interviews with individuals who used prescription stimulants as a means of improving academic performance. While discussions of drug diversion are often framed in terms of broad, population-level patterns and demographic trends, the present analysis provides a complementary sociocultural perspective that is attuned to the local and everyday phenomena. Results are reported in relation to the acquisition of supplies of medications intended for nonmedical use. An analysis is provided which identifies four different sources of diverted medications (friends; family members; black-market vendors; deceived clinicians), and describes particular sets of understandings, practices and experiences that arise in relation to each different source. Findings suggest that at the level of everyday experience and practice, the phenomenon of prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity. PMID:25455480

Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings.

PubMed

Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D

2017-12-01

Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.

A Practical and Reflexive Liberal-Humanist Approach to International Mindedness in International Schools: Case Studies from Malaysia and Brunei

ERIC Educational Resources Information Center

Tamatea, Laurence

2008-01-01

This article explores the response to cultural diversity and international mindedness at international schools in Malaysia and Brunei. It shows that the curriculum at these schools is set within a liberal-humanist framework, which some might suggest facilitates the project of "Westernization". It argues, however, that under the (local)…

Implications for Equity and Diversity of Increasing International Student Numbers in European Universities: Policies and Practice in Four National Contexts

ERIC Educational Resources Information Center

Haapakoski, Jani; Pashby, Karen

2017-01-01

This paper examines the main rationales for and possible implications of the policy of increasing international student numbers in higher education (HE). Drawing on critical discourse analysis, we map key themes emerging from two sets of data--university strategy documents and interviews with staff--collected at eight universities in four national…

Confucian Values and School Leadership in Vietnam: Exploring the Influence of Culture on Principal Decision Making

ERIC Educational Resources Information Center

Truong, Thang Dinh; Hallinger, Philip; Sanga, Kabini

2017-01-01

There is an emerging global consensus that the knowledge base in educational leadership and management must offer a deeper examination of leadership practice across a more diverse set of national contexts. Nonetheless, a recent review of the literature in this field concluded that this challenge has yet to be adequately addressed with respect to…

A Personalised Needs-Led Group Approach to Induction: Perceptions of Early Academics in a University School of Education

ERIC Educational Resources Information Center

Jarvis, Joy; Dickerson, Claire; Chivers, Leo; Collins, Chris; Lee, Libby; Levy, Roger; Solly, Dianne

2012-01-01

Members of staff joining a school of education often have extensive experience in practice but not in academia and the university setting may present a complex diversity of roles, ways of working, values and goals. Colleagues may face issues of understanding the organisational structure and culture, changing identities, and concerns about their…

A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States

Treesearch

Theresa B. Jain; Mike A. Battaglia; Han-Sup Han; Russell T. Graham; Christopher R. Keyes; Jeremy S. Fried; Jonathan E. Sandquist

2012-01-01

This guide describes the benefits, opportunities, and trade-offs concerning fuel treatments in the dry mixed conifer forests of northern California and the Klamath Mountains, Pacific Northwest Interior, northern and central Rocky Mountains, and Utah. Multiple interacting disturbances and diverse physical settings have created a forest mosaic with historically low- to...

Teaching about Race in a Multicultural Setting: Culturally Relevant Pedagogy and the U.S. History Classroom

ERIC Educational Resources Information Center

Martell, Christopher C.

2014-01-01

In this interpretative case study, the researcher examined the beliefs and practices of three social studies teachers related to their teaching of race in U.S. history at a racially and ethnically diverse urban high school. Using the theory of culturally relevant pedagogy as a lens, this study employed mixed methods, analyzing teacher interviews,…

Using Others' Words: Conversational Use of Reported Speech by Individuals with Aphasia and Their Communication Partners.

ERIC Educational Resources Information Center

Hengst, Julie A.; Frame, Simone R.; Neuman-Stritzel, Tiffany; Gannaway, Rachel

2005-01-01

Reported speech, wherein one quotes or paraphrases the speech of another, has been studied extensively as a set of linguistic and discourse practices. Researchers agree that reported speech is pervasive, found across languages, and used in diverse contexts. However, to date, there have been no studies of the use of reported speech among…

The Impact of Tier 1 Reading Instruction on Reading Outcomes for Students in Grades 4-12: A Meta-Analysis

ERIC Educational Resources Information Center

Swanson, Elizabeth; Stevens, Elizabeth A.; Scammacca, Nancy K.; Capin, Philip; Stewart, Alicia A.; Austin, Christy R.

2017-01-01

Understanding the efficacy of evidence-based reading practices delivered in the Tier 1 (i.e. general classroom) setting is critical to successful implementation of multi-tiered systems, meeting a diverse range of student learning needs, and providing high quality reading instruction across content areas. This meta-analysis presents evidence on the…

Understanding the ways in which health visitors manage anxiety in cross-cultural work: a qualitative study.

PubMed

Cuthill, Fiona

2014-10-01

This paper is a report of part of a study that explored the ways in which health visitors manage uncertainty and anxiety when working with clients across cultures. Internationally health care professionals are required to deliver a high standard of culturally appropriate care to increasingly diverse communities and yet problems persist. Research evidence informing cultural 'competence' is focused largely around student experience and consequently little is known about the day-to-day experiences of health professionals in diverse community settings. Anxiety and uncertainty are increasingly recognised as important emotions experienced by a variety of health care professionals when working across cultures and yet the ways in which anxiety and uncertainty is managed in practice is less well understood. Grounded theory methodology was used and 21 semi-structured interviews were conducted with participating health visitors in the North East of England between May 2008 and September 2009. All participants described themselves as white. This study identified three different positions adopted by the health visitors to manage uncertainty and anxiety in their work across cultures. Identified as, 'Fixing a culture', 'Reworking the equality agenda' and 'Asserting the professional self', these strategies identify the ways in which health visitors try to manage the uncertainty and anxiety they feel when working in diverse communities. All of these strategies attempt in different ways to negate cultural difference and to render culture as static and known. Given that health professionals report anxiety and uncertainty when working across diverse community settings, identification of the strategies used by health visitors to manage that anxiety is important for both policy and practice. New strategies need to be developed to help health professionals to manage uncertainty and anxiety in ways that promote both cultural safe care and health equity.

How to Break the Cycle of Low Workforce Diversity: A Model for Change.

PubMed

O'Brien, Katherine R; Scheffer, Marten; van Nes, Egbert H; van der Lee, Romy

2015-01-01

Social justice concerns but also perceived business advantage are behind a widespread drive to increase workplace diversity. However, dominance in terms of ethnicity, gender or other aspects of diversity has been resistant to change in many sectors. The different factors which contribute to low diversity are often hotly contested and difficult to untangle. We propose that many of the barriers to change arise from self-reinforcing feedbacks between low group diversity and inclusivity. Using a dynamic model, we demonstrate how bias in employee appointment and departure can trap organizations in a state with much lower diversity than the applicant pool: a workforce diversity "poverty trap". Our results also illustrate that if turnover rate is low, employee diversity takes a very long time to change, even in the absence of any bias. The predicted rate of change in workforce composition depends on the rate at which employees enter and leave the organization, and on three measures of inclusion: applicant diversity, appointment bias and departure bias. Quantifying these three inclusion measures is the basis of a new, practical framework to identify barriers and opportunities to increasing workforce diversity. Because we used a systems approach to investigate underlying feedback mechanisms rather than context-specific causes of low workforce diversity, our results are applicable across a wide range of settings.

Cross-Cultural Considerations in U.S. Research Ethics Education

PubMed Central

Heitman, Elizabeth

2014-01-01

Demand among graduate and postdoctoral trainees for international research experience brings together students and investigators from increasingly diverse cultural backgrounds around the world. Educators in research ethics and scientific integrity need to address the cultural aspects of both science and ethics to help all trainees learn ethical practices for effective collaboration with a diverse array of partners. NIH and NSF’s mandates for instruction in the responsible conduct of research do not specifically address the needs of international trainees or U.S. trainees who undertake research projects abroad. Nonetheless, research ethics educators’ typical focus on policy and professional standards can offer trainees and faculty investigators helpful insights into differing ethical values and priorities in research. Examination of linguistic differences can also reveal important conceptual frameworks that shape ethical practice. New resources for teaching research integrity in cross-cultural settings can be a valuable addition to the development of shared understanding of the goals of scientific research. PMID:25574262

Transcultural nursing: providing culturally congruent care to the Hausa of Northwest Africa.

PubMed

Chmielarczyk, V

1991-01-01

Research around the world is now beginning to validate the theory of Cultural Care as an important means to provide culturally congruent care to clients, families, and groups of diverse cultures. Knowledge of Leininger's Theory of Cultural Care Diversity and Universality can provide meaningful care to clients who have different traditional and current beliefs and values. The Leininger Sunrise Model can serve as a valuable guide to discover care meanings and practices related to the theory, and to provide practical and meaningful culture specific care decisions and actions by nurses. The three major modes of action, namely, cultural care maintenance or preservation, accommodation or negotiation, and repatterning or restructuring, are important differential means to provide culturally congruent care to clients within their own cultural setting. This article considers the application of such care for the Hausa of Northwest Africa.(ABSTRACT TRUNCATED AT 250 WORDS)

The Microbial Genomes Atlas (MiGA) webserver: taxonomic and gene diversity analysis of Archaea and Bacteria at the whole genome level.

PubMed

Rodriguez-R, Luis M; Gunturu, Santosh; Harvey, William T; Rosselló-Mora, Ramon; Tiedje, James M; Cole, James R; Konstantinidis, Konstantinos T

2018-06-14

The small subunit ribosomal RNA gene (16S rRNA) has been successfully used to catalogue and study the diversity of prokaryotic species and communities but it offers limited resolution at the species and finer levels, and cannot represent the whole-genome diversity and fluidity. To overcome these limitations, we introduced the Microbial Genomes Atlas (MiGA), a webserver that allows the classification of an unknown query genomic sequence, complete or partial, against all taxonomically classified taxa with available genome sequences, as well as comparisons to other related genomes including uncultivated ones, based on the genome-aggregate Average Nucleotide and Amino Acid Identity (ANI/AAI) concepts. MiGA integrates best practices in sequence quality trimming and assembly and allows input to be raw reads or assemblies from isolate genomes, single-cell sequences, and metagenome-assembled genomes (MAGs). Further, MiGA can take as input hundreds of closely related genomes of the same or closely related species (a so-called 'Clade Project') to assess their gene content diversity and evolutionary relationships, and calculate important clade properties such as the pangenome and core gene sets. Therefore, MiGA is expected to facilitate a range of genome-based taxonomic and diversity studies, and quality assessment across environmental and clinical settings. MiGA is available at http://microbial-genomes.org/.

Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings.

PubMed

Small, Jeff; Chan, Sing Mei; Drance, Elisabeth; Globerman, Judith; Hulko, Wendy; O'Connor, Deborah; Perry, JoAnn; Stern, Louise; Ho, Lorraine

2015-09-01

Linguistic and ethnocultural diversity in long-term residential care is a growing trend in many urban settings. When long-term care staff and residents do not share the same language or ethnocultural background, the quality of their communication and care are jeopardized. There is very little research addressing how staff and residents communicate when they experience a mismatch in their language and ethnocultural backgrounds. Thus, the goals of the present study were to 1) document the verbal and nonverbal behaviours used by staff and residents in diverse interactions, and 2) identify and account for behaviours that either promoted or detracted from positive communication by drawing on principles from 'Communication Accommodation Theory'. Two long-term care facilities in British Columbia Canada were selected due to the diverse linguistic and ethnocultural backgrounds of their staff and residents. Twenty-seven staff and 27 residents consented to being video-recorded during routine activities (e.g., mealtimes, recreational activities). The recorded observations were transcribed, translated, and coded using qualitative descriptive and interpretive analyses. A number of verbal and nonverbal behaviours were identified and interpreted in relation to whether they promoted or detracted from positive communication. The findings point to considering a variety of proactive strategies that staff and administrators could employ to effectively accommodate to language and ethnocultural diversity in long-term care practice.

From Blank Canvas to Masterwork: Creating a Professional Practice Model at a Magnet Hospital

PubMed Central

Tydings, Donna M.; Nickoley, Sue; Nichols, Lynn W.; Krenzer, Maureen E.

2016-01-01

Objective. The purpose of this study was to engage registered nurses (RNs) in the creation of a Professional Practice Model (PPM). Background. PPMs are essential as the philosophical underpinnings for nursing practice. The study institution created a new PPM utilizing the voice of their RNs. Methods. Qualitative inquiry with focus groups was conducted to explore RNs values and beliefs about their professional practice. Constant-comparative analysis was used to code data and identify domains. Results. The 92 RN participants represented diverse roles and practice settings. The four domains identified were caring, knowing, navigating, and leading. Conclusions. Nurse leaders face the challenge of assisting nurses in articulating their practice using a common voice. In this study, nurses described their identity, their roles, and how they envisioned nursing should be practiced. The results align with the ANCC Magnet® Model, ANA standards, and important foundational and organization specific documents. PMID:28097022

Diverse Pathways in Early Childhood Professional Development: An Exploration of Early Educators in Public Preschools, Private Preschools, and Family Child Care Homes

PubMed Central

Fuligni, Allison Sidle; Howes, Carollee; Lara-Cinisomo, Sandraluz; Karoly, Lynn

2009-01-01

This paper presents a naturalistic investigation of the patterns of formal education, early childhood education training, and mentoring of a diverse group of urban early childhood educators participating in the Los Angeles: Exploring Children's Early Learning Settings (LA ExCELS) study. A total of 103 preschool teachers and family child care providers serving primarily low-income 3- and 4-year-old children in Los Angeles County provided data on their education, training, and beliefs about teaching. This sample worked in public center based preschool programs including Head Start classrooms and State preschool classrooms (N=42), private non-profit preschools including community based organizations and faith-based preschools (N=42), and licensed family child care homes (N=19). This study uses a person-centered approach to explore patterns of teacher preparation, sources of support, supervision, and mentoring across these 3 types of education settings, and how these patterns are associated with early childhood educators' beliefs and practices. Findings suggest a set of linkages between type of early education setting, professional development, and supervision of teaching. Public preschools have the strongest mandates for formal professional development and typically less variation in levels of monitoring, whereas family child care providers on average have less formal education and more variability in their access to and use of other forms of training and mentorship. Four distinct patterns of formal education, child development training, and ongoing mentoring or support were identified among the educators in this study. Associations between professional development experiences and teachers' beliefs and practices suggested the importance of higher levels of formal training for enhancing the quality of teacher-child interactions. Implications of the findings for changing teacher behaviors are discussed with respect to considering the setting context. PMID:20072719

The future of anesthesiology: implications of the changing healthcare environment.

PubMed

Prielipp, Richard C; Cohen, Neal H

2016-04-01

Anesthesiology is at a crossroad, particularly in the USA. We explore the changing and future roles for anesthesiologists, including the implication of new models of care such as the perioperative surgical home, changes in payment methodology, and the impact other refinements in healthcare delivery will have on practice opportunities and training requirements for anesthesiologists. The advances in the practice of anesthesiology are having a significant impact on patient care, allowing a more diverse and complex patient population to benefit from the knowledge, skills and expertise of anesthesiologists. Expanded clinical opportunities, increased utilization of technology and expansion in telemedicine will provide the foundation to care for more patients in diverse settings and to better monitor patients remotely while ensuring immediate intervention as needed. Although the roles of anesthesiologists have been diverse, the scope of practice varies from one country to another. The changing healthcare needs in the USA in particular are creating new opportunities for American anesthesiologists to define expanded roles in healthcare delivery. To fulfill these evolving needs of patients and health systems, resident training, ongoing education and methods to ensure continued competency must incorporate new approaches of education and continued certification to ensure that each anesthesiologist has the full breadth and depth of clinical skills needed to support patient and health system needs. The scope of anesthesia practice has expanded globally, providing anesthesiologists, particularly those in the USA, with unique new opportunities to assume a broader role in perioperative care of surgical patients.

Intersectionality takes it to the streets: Mobilizing across diverse interests for the Women’s March

PubMed Central

Fisher, Dana R.; Dow, Dawn M.; Ray, Rashawn

2017-01-01

Can a diverse crowd of individuals whose interests focus on distinct issues related to racial identity, class, gender, and sexuality mobilize around a shared issue? If so, how does this process work in practice? To date, limited research has explored intersectionality as a mobilization tool for social movements. This paper unpacks how intersectionality influences the constituencies represented in one of the largest protests ever observed in the United States: the Women’s March on Washington in January 2017. Analyzing a data set collected from a random sample of participants, we explore how social identities influenced participation in the Women’s March. Our analysis demonstrates how individuals’ motivations to participate represented an intersectional set of issues and how coalitions of issues emerge. We conclude by discussing how these coalitions enable us to understand and predict the future of the anti-Trump resistance. PMID:28948230

Intersectionality takes it to the streets: Mobilizing across diverse interests for the Women's March.

PubMed

Fisher, Dana R; Dow, Dawn M; Ray, Rashawn

2017-09-01

Can a diverse crowd of individuals whose interests focus on distinct issues related to racial identity, class, gender, and sexuality mobilize around a shared issue? If so, how does this process work in practice? To date, limited research has explored intersectionality as a mobilization tool for social movements. This paper unpacks how intersectionality influences the constituencies represented in one of the largest protests ever observed in the United States: the Women's March on Washington in January 2017. Analyzing a data set collected from a random sample of participants, we explore how social identities influenced participation in the Women's March. Our analysis demonstrates how individuals' motivations to participate represented an intersectional set of issues and how coalitions of issues emerge. We conclude by discussing how these coalitions enable us to understand and predict the future of the anti-Trump resistance.

Contextual diversity facilitates learning new words in the classroom.

PubMed

Rosa, Eva; Tapia, José Luis; Perea, Manuel

2017-01-01

In the field of word recognition and reading, it is commonly assumed that frequently repeated words create more accessible memory traces than infrequently repeated words, thus capturing the word-frequency effect. Nevertheless, recent research has shown that a seemingly related factor, contextual diversity (defined as the number of different contexts [e.g., films] in which a word appears), is a better predictor than word-frequency in word recognition and sentence reading experiments. Recent research has shown that contextual diversity plays an important role when learning new words in a laboratory setting with adult readers. In the current experiment, we directly manipulated contextual diversity in a very ecological scenario: at school, when Grade 3 children were learning words in the classroom. The new words appeared in different contexts/topics (high-contextual diversity) or only in one of them (low-contextual diversity). Results showed that words encountered in different contexts were learned and remembered more effectively than those presented in redundant contexts. We discuss the practical (educational [e.g., curriculum design]) and theoretical (models of word recognition) implications of these findings.

Contextual diversity facilitates learning new words in the classroom

PubMed Central

Tapia, José Luis; Perea, Manuel

2017-01-01

In the field of word recognition and reading, it is commonly assumed that frequently repeated words create more accessible memory traces than infrequently repeated words, thus capturing the word-frequency effect. Nevertheless, recent research has shown that a seemingly related factor, contextual diversity (defined as the number of different contexts [e.g., films] in which a word appears), is a better predictor than word-frequency in word recognition and sentence reading experiments. Recent research has shown that contextual diversity plays an important role when learning new words in a laboratory setting with adult readers. In the current experiment, we directly manipulated contextual diversity in a very ecological scenario: at school, when Grade 3 children were learning words in the classroom. The new words appeared in different contexts/topics (high-contextual diversity) or only in one of them (low-contextual diversity). Results showed that words encountered in different contexts were learned and remembered more effectively than those presented in redundant contexts. We discuss the practical (educational [e.g., curriculum design]) and theoretical (models of word recognition) implications of these findings. PMID:28586354

Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU.

PubMed

Ewald, Dominik A; Huss, Gottfried; Auras, Silke; Caceres, Juan Ruiz-Canela; Hadjipanayis, Adamos; Geraedts, Max

2018-06-01

Paediatric ambulatory healthcare systems in Europe are, because of historical reasons, diverse and show strikingly different outcomes. All across Europe, the benchmarking of structures, processes and outcomes could reveal opportunities for improving Paediatric Primary Care (PPC). The aim of this study was to develop a set of Quality Indicators (QIs) to assess and monitor PPC in Europe. In a three-step process, we used the available external evidence and European expert consensus in a modified RAND/UCLA Appropriateness Method (RAM) to develop an indicator set. (1) A broad literature and online research of published QI and guidelines yielded an inventory of 1516 QI. (2) A collaborative panel of paediatric senior experts from the European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) from 15 European countries participated in a first consensus process to reduce the initial indicator inventory by eliminating not PPC-focused indicators and duplicates. (3) In a second consensus process, the panel rated the QI regarding validity and feasibility. The final QI set "COSI-PPC-EU" consists of 42 indicators in five categories of PPC: (A) health promotion/prevention/screening (13 QI), (B) acute care (9 QI), (C) chronic care (8 QI), (D) practice management (3 QI) and (E) patient safety (9 QI). COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi-country collaborative effort. The method combined a systematic literature review and a consensus process among European paediatric experts. • The quality indicator set can facilitate quality improvement of PPC. After studying the feasibility, providers can use COSI-PPC-EU to monitor, compare and improve performance of practices, regions and countries.

Secondary traumatic stress among domestic violence advocates: workplace risk and protective factors.

PubMed

Slattery, Suzanne M; Goodman, Lisa A

2009-11-01

This study identified workplace factors associated with secondary traumatic stress (STS) in a sample of 148 domestic violence advocates working in diverse settings. Findings indicate that coworker support and quality clinical supervision are critical to emotional well-being and that an environment in which there is shared power-that is, respect for diversity, mutuality, and consensual decision making-provides better protection for advocates than more traditional, hierarchical organizational models. Furthermore, shared power emerged as the only workplace variable to significantly predict STS above and beyond individual factors. The discussion includes implications for practice and policy as well as directions for future research.

Improving care transitions through meaningful use stage 2: continuity of care document.

PubMed

Murphy, Lyn Stankiewicz; Wilson, Marisa L; Newhouse, Robin P

2013-02-01

In this department, Drs Murphy, Wilson, and Newhouse highlight hot topics in nursing outcomes, research, and evidence-based practice relevant to the nurse administrator. The goal is to discuss the practical implications for nurse leaders in diverse healthcare settings. Content includes evidence-based projects and decision making, locating measurement tools for quality improvement and safety projects, using outcome measures to evaluate quality, practice implications of administrative research, and exemplars of projects that demon strate innovative approaches to organizational problems. In this article, the authors describe the elements of continuity of care documentation, how sharing information can improve the quality and safety of care transitions and the implications for nurse executives.

Questions of English: Ethics, Aesthetics, Rhetoric and the Formation of the Subject in England, Australia and the United States.

ERIC Educational Resources Information Center

Peel, Robin; Patterson, Annette; Gerlach, Jeanne

This book sets out to map the development of English as a subject and how it has come to encompass the diversity of ideas that currently characterize it. Drawing on a combination of historical analysis and recent research findings, it brings together and compares important new insights on curriculum development and teaching practices from England,…

Computer-Mediated Communication and Culture: A Comparison of "Confucian-Heritage" and "Western" Learner Attitudes to Asynchronous E-Discussions Undertaken in an Australian Higher Educational Setting

ERIC Educational Resources Information Center

Ramsay, Guy

2005-01-01

While the internationalisation of higher education has made learner diversity a key consideration in tertiary pedagogical practice, research into the application of computer-mediated technologies in this domain has rarely taken into account culture. This article responds to this gap in the research by comparing "Confucian-heritage" and…

Diverse Redundant Systems for Reliable Space Life Support

NASA Technical Reports Server (NTRS)

Jones, Harry W.

2015-01-01

Reliable life support systems are required for deep space missions. The probability of a fatal life support failure should be less than one in a thousand in a multi-year mission. It is far too expensive to develop a single system with such high reliability. Using three redundant units would require only that each have a failure probability of one in ten over the mission. Since the system development cost is inverse to the failure probability, this would cut cost by a factor of one hundred. Using replaceable subsystems instead of full systems would further cut cost. Using full sets of replaceable components improves reliability more than using complete systems as spares, since a set of components could repair many different failures instead of just one. Replaceable components would require more tools, space, and planning than full systems or replaceable subsystems. However, identical system redundancy cannot be relied on in practice. Common cause failures can disable all the identical redundant systems. Typical levels of common cause failures will defeat redundancy greater than two. Diverse redundant systems are required for reliable space life support. Three, four, or five diverse redundant systems could be needed for sufficient reliability. One system with lower level repair could be substituted for two diverse systems to save cost.

Backward Planning a Craniomaxillofacial Trauma Curriculum for the Surgical Workforce in Low-Resource Settings.

PubMed

Shaye, David A; Tollefson, Travis; Shah, Irfan; Krishnan, Gopal; Matic, Damir; Figari, Marcelo; Lim, Thiam Chye; Aniruth, Sunil; Schubert, Warren

2018-06-06

Trauma is a significant contributor to global disease, and low-income countries disproportionately shoulder this burden. Education and training are critical components in the effort to address the surgical workforce shortage. Educators can tailor training to a diverse background of health professionals in low-resource settings using competency-based curricula. We present a process for the development of a competency-based curriculum for low-resource settings in the context of craniomaxillofacial (CMF) trauma education. CMF trauma surgeons representing 7 low-, middle-, and high-income countries conducted a standardized educational curriculum development program. Patient problems related to facial injuries were identified and ranked from highest to lowest morbidity. Higher morbidity problems were categorized into 4 modules with agreed upon competencies. Methods of delivery (lectures, case discussions, and practical exercises) were selected to optimize learning of each competency. A facial injuries educational curriculum (1.5 days event) was tailored to health professionals with diverse training backgrounds who care for CMF trauma patients in low-resource settings. A backward planned, competency-based curriculum was organized into four modules titled: acute (emergent), eye (periorbital injuries and sight preserving measures), mouth (dental injuries and fracture care), and soft tissue injury treatments. Four courses have been completed with pre- and post-course assessments completed. Surgeons and educators from a diverse geographic background found the backward planning curriculum development method effective in creating a competency-based facial injuries (trauma) course for health professionals in low-resource settings, where contextual aspects of shortages of surgical capacity, equipment, and emergency transportation must be considered.

Clinical neuropsychology practice and training in Canada.

PubMed

Janzen, Laura A; Guger, Sharon

2016-11-01

This invited paper provides information about professional neuropsychology issues in Canada and is part of a special issue addressing international perspectives on education, training, and practice in clinical neuropsychology. Information was gathered from literature searches and personal communication with other neuropsychologists in Canada. Canada has a rich neuropsychological history. Neuropsychologists typically have doctoral-level education including relevant coursework and supervised practical experience. Licensure requirements vary across the 10 provinces and there are regional differences in salary. While training at the graduate and internship level mirrors that of our American colleagues, completion of a two-year postdoctoral fellowship in neuropsychology is not required to obtain employment in many settings and there are few postdoctoral training programs in this country. The majority of neuropsychologists are employed in institutional settings (e.g. hospitals, universities, rehabilitation facilities), with a growing number entering private practice or other settings. There are challenges in providing neuropsychological services to the diverse Canadian population and a need for assessment measures and normative data in multiple languages. Canadian neuropsychologists face important challenges in defining ourselves as distinct from other professions and other psychologists, in maintaining funding for high-quality training and research, in establishing neuropsychology-specific training and practice standards at the provincial or national level, and ensuring the clinical care that we provide is efficient and effective in meeting the needs of our patient populations and consumers, both within and outside of the publically funded health care system.

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

PubMed

Specker, Jona; Schermer, Maartje H N

2017-07-01

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

Narrative pedagogy with evolving case study--A transformative approach to gerontic nursing practice for undergraduate nursing students.

PubMed

Laver, Shaorn; Croxon, Lyn

2015-09-01

Engaging nursing students in the complexities of care across community, acute, rehabilitation and residential aged care settings is challenging. Equally challenging is conceptualising and promoting diverse and comprehensive health assessments across care settings that reflect clinical reality, inform clinical decision making, traverse theory and practice, and transform clinical practice knowledge. This article describes the use of narrative and evolving case study as a teaching-learning tool utilised by the authors in a third year undergraduate gerontic nursing subject in a pre-service nursing degree at a rural university. Principles of transformative learning and strengths based nursing were drawn upon in the development of the case study. The aim of the approach was to draw on embedded knowledge and the experiences of students and academics from assorted practice settings to facilitate understanding of the lived experiences of an older community dwelling couple. Using social learning strategies students were encouraged to analyse and think critically and creatively about the situations they were presented with. They identified possible solutions that would be acceptable to the couple. Building on the older couple's strengths, achievements and personal social capital, the aim was to develop a positive paradigm for health and the way older people are viewed by nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.

The supportive roles of religion and spirituality in end-of-life and palliative care of patients with cancer in a culturally diverse context: a literature review.

PubMed

López-Sierra, Héctor E; Rodríguez-Sánchez, Jesús

2015-03-01

This is a literature review of the supportive roles of religion and spirituality (R/S) in end-of-life (EoL) and palliative care of patients with cancer in a culturally diverse context. This review examines 26 noteworthy articles published between August 2013 and August 2014 from five well supported databases. Current evidence shows that R/S evokes in patients the sources to find the necessary inner strengths, which includes perspective thinking, rituals for transcending immediate physical condition and modalities of coping with their oncological illnesses. R/S are not a monolithically experience for they always manifest themselves in diverse cultural settings. As such, R/S provide the individual and their families with a practical context and social memory, which includes traditions and social family practices for maintaining meaning and well-being. Nonetheless, although various dimensions of R/S show a link between cancer risk factors and well being in cancer patients, more specific dimensions of R/S need to be studied taking into account the individuals' particular religious and cultural contexts, so that R/S variables within that context can provide a greater integrative structure for understanding and to move the field forward. Behavioral, cognitive and psychosocial scientists have taken a more in-depth look at the claims made in the past, suggesting that a relationship between R/S, cultural diversity and health exists. Case in point are the studies on EoL care, which have progressively considered the role of cultural, religion and spiritual diversity in the care of patients with oncological terminal illnesses. Beyond these facts, this review also shows that EoL supportive and palliative care providers could further enhance their practical interventions by being sensitive and supportive of cultural diversity. http://links.lww.com/COSPC/A10

The consultant nurse - expert practitioner and much more.

PubMed

Mitchell, Theresa; Butler-Williams, Carole; Easton, Karen; Ingledew, Ian; Parkin, Donna; Wade, Sharon; Warner, Richard

The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health - clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in an NHS trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of 'expert' or 'advanced' practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability.

The use of gaming strategies in a transcultural setting.

PubMed

Gary, R; Marrone, S; Boyles, C

1998-01-01

Saudi Arabia's vast economic resources have enabled the development of state-of-the-art hospitals. Nurses recruited from around the world staff these hospitals creating one of the most multicultural practice settings in the world. Ethnic, educational, and experiential diversity; language and communication barriers; and alternative ways of knowing and learning challenge nurse educators to be more creative and explore opportunities for greater participation and learning among various cultural groups. Gaming, as a teaching-learning strategy for multicultural participants, affords the necessary flexibility and nonthreatening atmosphere which facilitates positive interactions among different, and often competing, communication patterns and learning styles. This article explores how and why gaming is as an effective educational strategy in a transcultural setting.

Diverse Data Sets Can Yield Reliable Information through Mechanistic Modeling: Salicylic Acid Clearance.

PubMed

Raymond, G M; Bassingthwaighte, J B

This is a practical example of a powerful research strategy: putting together data from studies covering a diversity of conditions can yield a scientifically sound grasp of the phenomenon when the individual observations failed to provide definitive understanding. The rationale is that defining a realistic, quantitative, explanatory hypothesis for the whole set of studies, brings about a "consilience" of the often competing hypotheses considered for individual data sets. An internally consistent conjecture linking multiple data sets simultaneously provides stronger evidence on the characteristics of a system than does analysis of individual data sets limited to narrow ranges of conditions. Our example examines three very different data sets on the clearance of salicylic acid from humans: a high concentration set from aspirin overdoses; a set with medium concentrations from a research study on the influences of the route of administration and of sex on the clearance kinetics, and a set on low dose aspirin for cardiovascular health. Three models were tested: (1) a first order reaction, (2) a Michaelis-Menten (M-M) approach, and (3) an enzyme kinetic model with forward and backward reactions. The reaction rates found from model 1 were distinctly different for the three data sets, having no commonality. The M-M model 2 fitted each of the three data sets but gave a reliable estimates of the Michaelis constant only for the medium level data (K m = 24±5.4 mg/L); analyzing the three data sets together with model 2 gave K m = 18±2.6 mg/L. (Estimating parameters using larger numbers of data points in an optimization increases the degrees of freedom, constraining the range of the estimates). Using the enzyme kinetic model (3) increased the number of free parameters but nevertheless improved the goodness of fit to the combined data sets, giving tighter constraints, and a lower estimated K m = 14.6±2.9 mg/L, demonstrating that fitting diverse data sets with a single model improves confidence in the results. This modeling effort is also an example of reproducible science available at html://www.physiome.org/jsim/models/webmodel/NSR/SalicylicAcidClearance.

Creating more effective mentors: Mentoring the mentor

PubMed Central

Gandhi, Monica; Johnson, Mallory

2016-01-01

Introduction Given the diversity of those affected by HIV, increasing diversity in the HIV biomedical research workforce is imperative. A growing body of empirical and experimental evidence supports the importance of strong mentorship in the development and success of trainees and early career investigators in academic research settings, especially for mentees of diversity. Often missing from this discussion is the need for robust mentoring training programs to ensure that mentors are trained in best practices on the tools and techniques of mentoring. Recent experimental evidence shows improvement in mentor and mentee perceptions of mentor’s competency after structured and formalized training on best practices in mentoring. Methods We developed a 2-day “Mentoring the Mentors” workshop at UCSF to train mid-level and senior HIV researchers from around the country (recruited mainly from Centers for AIDS Research (CFARs)) on best practices, tools and techniques of effective mentoring. The workshop content was designed using principles of Social Cognitive Career Theory (SCCT) and included training specific to working with early career investigators from underrepresented groups, including training on unconscious bias, microaggressions, and diversity supplements. The workshop has been held 3 times (September 2012, October 2013 and May 2015) with plans for annual training. Mentoring competency was measured using a validated tool before and after each workshop. Results Mentoring competency skills in six domains of mentoring -specifically effective communication, aligning expectations, assessing understanding, fostering independence, addressing diversity and promoting development - all improved as assessed by a validated measurement tool for participants pre- and-post the “Mentoring the Mentors” training workshops. Qualitative assessments indicated a greater awareness of the micro-insults and unconscious bias experienced by mentees of diversity and a commitment to improve awareness and mitigate these effects via the mentor-mentee relationship. Discussion Our “Mentoring the Mentors” workshop for HIV researchers/mentors offers a formal and structured curriculum on best practices, tools and techniques of effective mentoring, and methods to mitigate unconscious bias in the mentoring relationship and at the institutional level with mentees of diversity. We found quantitative and qualitative improvements in mentoring skills as assessed by self-report by participants after each workshop and plan additional programs with longitudinal longer-term assessments focused on objective mentee outcomes (grants, papers, academic retention). Mentoring training can improve mentoring skills and are likely to improve outcomes for optimally-mentored mentees. PMID:27039092

Practice parameters and financial factors impacting developmental-behavioral pediatrics.

PubMed

Adair, Robin; Perrin, Ellen; Hubbard, Carol; Savageau, Judith A

2010-01-01

Little has been published about the professional activities of developmental-behavioral (DB) pediatricians. To better understand the settings in which DB pediatricians work, allocation of their professional time, and how financial considerations impact their practice, the Society for Developmental and Behavioral Pediatrics surveyed its membership. An extensive on-line three-part survey was conducted in 2006-2007 assessing sociodemographic characteristics, practice descriptors, coding and billing practices, productivity goals and perceived pressures among Society for Developmental and Behavioral Pediatric's 438 physician members. Of the pediatricians responding, representing all regions of the United States, 93% were DB pediatrics subspecialty board certified or eligible. The majority was practicing DB pediatrics full-time (73%); and 67% were exclusively in academic settings. All reported seeing patients, 84% reported teaching, 76% reported having administrative responsibilities, and 46% reported conducting research. Despite having non-clinical responsibilities, full-time equivalent positions included an average of 25 hours per week in direct patient care and 14.5 hours per week (37% of clinical time) in indirect patient care. Only 42% reported working with multidisciplinary teams. Salaries varied widely within and across regions. Deficits in billing/coding practices, awareness of personal clinical productivity, and familiarity with national productivity benchmarks were identified. DB pediatricians work in diverse settings nationwide. They provide considerable time in indirect patient care, which is poorly reimbursed in general and relative to direct patient care. The results of this survey offer opportunities for provider, institutional and payer education.

Challenges of Using Methadone in the Indian Pain and Palliative Care Practice.

PubMed

Viswanath, Vidya; Palat, Gayatri; Chary, Srini; Broderick, Ann

2018-01-01

Palliative care providers across India lobbied to gain access to methadone for pain relief and this has finally been achieved. Palliative care activists will count on the numerous strengths for introducing methadone in India, including the various national and state government initiatives that have been introduced recognizing the importance of palliative care as a specialty in addition to improving opioid accessibility and training. Adding to the support are the Non-Governmental Organizations (NGOs), the medical fraternity and the international interactive and innovative programs such as the Project Extension for Community Health Outcome. As compelling as the need for methadone is, many challenges await. This article outlines the challenges of procuring methadone and also discusses the challenges specific to methadone. Balancing the availability and diversion in a setting of opioid phobia, implementing the amended laws to improve availability and accessibility in a country with diverse health-care practices are the major challenges in implementing methadone for relief of pain. The unique pharmacology of the drug requires meticulous patient selection, vigilant monitoring, and excellent communication and collaboration with a multidisciplinary team and caregivers. The psychological acceptance of the patient, the professional training of the team and the place where care is provided are also challenges which need to be overcome. These challenges could well be the catalyst for a more diligent and vigilant approach to opioid prescribing practices. Start low, go slow could well be the way forward with caregiver education to prescribe methadone safely in the Indian palliative care setting.

Sustaining school-based asthma interventions through policy and practice change.

PubMed

Carpenter, Laurie M; Lachance, Laurie; Wilkin, Margaret; Clark, Noreen M

2013-12-01

Schools are an ideal setting for implementation of asthma interventions for children; however, sustaining school-based programs can be challenging. This study illustrates policy and practice changes brought about through the Childhood Asthma Linkages in Missouri (CALM) program to sustain such programs. Researchers analyzed caregiver-reported quantitative data regarding asthma-related outcomes in preintervention and postintervention surveys and qualitative data regarding sustainability efforts in schools reported by CALM grantees. A grounded theory approach was used to identify key concepts and themes that emerged. In 330 children, significant improvements were seen in asthma symptoms, rescue inhaler use, health care utilization, school absenteeism, and activity limitations. Overall, 27 school-based policy and practice changes supporting program sustainability were reported, with policy changes most often concerning the assessment and/or monitoring of children with asthma in the school setting, and practice changes most often regarding institution of regular asthma education programs for students and school personnel. Sustaining school-based asthma programs is challenging, but can be realized through the participation of diverse partners in enacting policy and practice changes that support the institutionalization of programs into the day-to-day processes of the schools. © 2013, American School Health Association.

The effectiveness of concept mapping and retrieval practice as learning strategies in an undergraduate physiology course.

PubMed

Burdo, Joseph; O'Dwyer, Laura

2015-12-01

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving information that was previously coded into memory. The relative benefits of these two methods have never been tested against each other in a classroom setting. Our study was designed to investigate whether or not concept mapping or retrieval practice produced a significant learning benefit in an undergraduate physiology course as measured by exam performance and, if so, was the benefit of one method significantly greater than the other. We found that there was a trend toward increased exam scores for the retrieval practice group compared with both the control group and concept mapping group, and that trend achieved statistical significance for one of the four module exams in the course. We also found that women performed statistically better than men on the module exam that contained a substantial amount of material relating to female reproductive physiology. Copyright © 2015 The American Physiological Society.

Practicing ethnography in migration-related detention centers: A reflexive account.

PubMed

Esposito, Francesca

2017-01-01

Feminist scholars, as well as community psychologists, have advocated the role of reflexive engagement in the research process in order to challenge power relations. Moreover, the liberating potential of storytelling, especially when working with issues of diversity and marginalization, has been stressed. The purpose of this article is to reflect on an ethnographic work underway in the Identification and Expulsion Center-CIE of Ponte Galeria, Rome. How the researcher's identities, values, and experiences, alongside power and privilege, have influenced her positioning in the research setting and the relationships formed with the different setting members is the subject of discussion. In sharing the story of this work, the final intent is to contribute to the joint effort to foster a reflexive community psychology practice incorporating feminist goals and a dialogue about ethnography in community psychology.

Improving Program Design and Assessment with Broadening Participation Resources

NASA Astrophysics Data System (ADS)

Siegfried, D.; Johnson, A.; Thomas, S. H.; Fauver, A.; Detrick, L.

2012-12-01

Many theoretical and research-based approaches suggest how to best use mentoring to enhance an undergraduate research program. The Institute for Broadening Participation's Pathways to Engineering and Pathways to Ocean Sciences projects synthesized a set of mentoring studies, theoretical sources, and other texts pertinent to undergraduate research program design into a suite of practical tools that includes an online mentoring manual, an online reference library of mentoring and diversity literature, and practical guides such as Using Social Media to Build Diversity in Your REU. The overall goal is to provide easy-to-access resources that can assist faculty and program directors in implementing or honing the mentoring elements in their research programs for undergraduates. IBP's Online Mentoring Manual addresses common themes, such as modeling, student self-efficacy, career development, retention and evaluation. The Online Diversity Reference Library provides a comprehensive, annotated selection of key policy documents, research studies, intervention studies, and other texts on broadening participation in science, technology, engineering and mathematics. IBP's suite of tools provides the theoretical underpinnings and research findings that can help leaders in education integrate site-appropriate mentoring elements into their educational programs. Program directors and faculty from a variety of program types and disciplines have benefitted from using the Manual and other resources. IBP continues the work of translating and synthesizing theory to practice and welcomes your participation and partnership in that effort.

Mind-set interventions are a scalable treatment for academic underachievement.

PubMed

Paunesku, David; Walton, Gregory M; Romero, Carissa; Smith, Eric N; Yeager, David S; Dweck, Carol S

2015-06-01

The efficacy of academic-mind-set interventions has been demonstrated by small-scale, proof-of-concept interventions, generally delivered in person in one school at a time. Whether this approach could be a practical way to raise school achievement on a large scale remains unknown. We therefore delivered brief growth-mind-set and sense-of-purpose interventions through online modules to 1,594 students in 13 geographically diverse high schools. Both interventions were intended to help students persist when they experienced academic difficulty; thus, both were predicted to be most beneficial for poorly performing students. This was the case. Among students at risk of dropping out of high school (one third of the sample), each intervention raised students' semester grade point averages in core academic courses and increased the rate at which students performed satisfactorily in core courses by 6.4 percentage points. We discuss implications for the pipeline from theory to practice and for education reform. © The Author(s) 2015.

Challenges to replicating evidence-based research in real-world settings: training African-American peers as patient navigators for colon cancer screening.

PubMed

Sly, Jamilia R; Jandorf, Lina; Dhulkifl, Rayhana; Hall, Diana; Edwards, Tiffany; Goodman, Adam J; Maysonet, Elithea; Azeez, Sulaiman

2012-12-01

Many cancer-prevention interventions have demonstrated effectiveness in diverse populations, but these evidenced-based findings slowly disseminate into practice. The current study describes the process of disseminating and replicating research (i.e., peer patient navigation for colonoscopy screening) in real-world settings. Two large metropolitan hospitals collaborated to replicate a peer patient navigation model within their existing navigation systems. Six African-American peer volunteers were recruited and trained to navigate patients through colonoscopy scheduling and completion. Major challenges included: (1) operating within multiple institutional settings; (2) operating within nonacademic/research infrastructures; (3) integrating into an established navigation system; (4) obtaining support of hospital staff without overburdening; and (5) competing priorities and time commitments. Bridging the gap between evidence-based research and practice is critical to eliminating many cancer health disparities; therefore, it is crucial that researchers and practitioners continue to work to achieve both diffusion and fusion of evidence-based findings. Recommendations for addressing these challenges are discussed.

SIB health psychology in Brazil: The challenges for working in public health settings.

PubMed

Spink, Mary-Jane P; Brigagão, Jacqueline M; Menegon, Vera M; Vicentin, Maria-Cristina G

2016-03-01

Considering the diversity of theoretical approaches and settings for psychological practice, this editorial provides a background for the articles that have been included in this special issue concerning health psychology in the context of the Brazilian Unified Health System (Sistema Unico de Saude). We addressed issues concerning the national curricular outline for undergraduate training in psychology and historical data on the social movements that led to the creation of the Sistema Unico de Saude and the Psychiatric Reform which created an important area for psychological work absorbing a considerable number of psychologists. © The Author(s) 2016.

Take the Reins on Model Quality with ModelCHECK and Gatekeeper

NASA Technical Reports Server (NTRS)

Jones, Corey

2012-01-01

Model quality and consistency has been an issue for us due to the diverse experience level and imaginative modeling techniques of our users. Fortunately, setting up ModelCHECK and Gatekeeper to enforce our best practices has helped greatly, but it wasn't easy. There were many challenges associated with setting up ModelCHECK and Gatekeeper including: limited documentation, restrictions within ModelCHECK, and resistance from end users. However, we consider ours a success story. In this presentation we will describe how we overcame these obstacles and present some of the details of how we configured them to work for us.

How to Break the Cycle of Low Workforce Diversity: A Model for Change

PubMed Central

O’Brien, Katherine R.; Scheffer, Marten; van Nes, Egbert H.; van der Lee, Romy

2015-01-01

Social justice concerns but also perceived business advantage are behind a widespread drive to increase workplace diversity. However, dominance in terms of ethnicity, gender or other aspects of diversity has been resistant to change in many sectors. The different factors which contribute to low diversity are often hotly contested and difficult to untangle. We propose that many of the barriers to change arise from self-reinforcing feedbacks between low group diversity and inclusivity. Using a dynamic model, we demonstrate how bias in employee appointment and departure can trap organizations in a state with much lower diversity than the applicant pool: a workforce diversity “poverty trap”. Our results also illustrate that if turnover rate is low, employee diversity takes a very long time to change, even in the absence of any bias. The predicted rate of change in workforce composition depends on the rate at which employees enter and leave the organization, and on three measures of inclusion: applicant diversity, appointment bias and departure bias. Quantifying these three inclusion measures is the basis of a new, practical framework to identify barriers and opportunities to increasing workforce diversity. Because we used a systems approach to investigate underlying feedback mechanisms rather than context-specific causes of low workforce diversity, our results are applicable across a wide range of settings. PMID:26217957

Organizational strategy and diversity management: diversity-sensitive orientation as a moderating influence.

PubMed

Dansky, Kathryn H; Weech-Maldonado, Robert; De Souza, Gita; Dreachslin, Janice L

2003-01-01

Empirical studies on diversity suggest that health care organizations have been slow to embrace diversity management. We propose that sensitivity to diversity, at the corporate level, moderates strategic decision making, which influences human resource management practices such as diversity initiatives. This study of 203 hospitals explored the relationships among organizational strategy, organizational sensitivity to diversity, and diversity management practices.

[Revisiting the chemical diversity in prostatic calculi: a SEM and FT-IR investigation].

PubMed

Dessombz, A; Méria, P; Bazin, D; Foy, E; Rouzière, S; Weil, R; Daudon, M

2011-12-01

Revisiting the chemical diversity of the crystalline phases of prostatic calculi by means of SEM and FT-IR analysis. A set of 32 prostatic calculi has been studied by FT-IR and SEM. FT-IR analysis has determined the chemical composition of each prostatic calculus and the SEM observation has described the morphology of the calculi surfaces and layers. Infrared analysis revealed that 90.7% of the stones were mainly composed of calcium phosphates. However, several mineral phases previously not reported in prostatic calculi were observed, as brushite or octocalcium phosphate pentahydrate. Prostatic calculi exhibited a diversity of crystalline composition and morphology. As previously reported for urinary calculi, relationships between composition and morphology of prostatic stones and étiopathogenic conditions could be of interest in clinical practice. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Best Practices for Managing Organizational Diversity

ERIC Educational Resources Information Center

Kreitz, Patricia A.

2008-01-01

Organizations with increasingly diverse workforces and customer populations face challenges in reaping diversity's benefits while managing its potentially disruptive effects. This article defines workplace diversity and identifies best practices supporting planned and positive diversity management. It explores how academic libraries can apply…

Association between household food security and infant feeding practices in urban informal settlements in Nairobi, Kenya.

PubMed

Macharia, T N; Ochola, S; Mutua, M K; Kimani-Murage, E W

2018-02-01

Studies in urban informal settlements show widespread inappropriate infant and young child feeding (IYCF) practices and high rates of food insecurity. This study assessed the association between household food security and IYCF practices in two urban informal settlements in Nairobi, Kenya. The study adopted a longitudinal design that involved a census sample of 1110 children less than 12 months of age and their mothers aged between 12 and 49 years. A questionnaire was used to collect information on: IYCF practices and household food security. Logistic regression was used to determine the association between food insecurity and IYFC practices. The findings showed high household food insecurity; only 19.5% of the households were food secure based on Household Insecurity Access Score. Infant feeding practices were inappropriate: 76% attained minimum meal frequency; 41% of the children attained a minimum dietary diversity; and 27% attained minimum acceptable diet. With the exception of the minimum meal frequency, infants living in food secure households were significantly more likely to achieve appropriate infant feeding practices than those in food insecure households: minimum meal frequency (adjusted odds ratio (AOR)=1.26, P=0.530); minimum dietary diversity (AOR=1.84, P=0.046) and minimum acceptable diet (AOR=2.35, P=0.008). The study adds to the existing body of knowledge by demonstrating an association between household food security and infant feeding practices in low-income settings. The findings imply that interventions aimed at improving infant feeding practices and ultimately nutritional status need to also focus on improving household food security.

From Lived Experiences to Game Creation: How Scaffolding Supports Elementary School Students Learning Computer Science Principles in an After School Setting

ERIC Educational Resources Information Center

Her Many Horses, Ian

2016-01-01

The world, and especially our own country, is in dire need of a larger and more diverse population of computer scientists. While many organizations have approached this problem of too few computer scientists in various ways, a promising, and I believe necessary, path is to expose elementary students to authentic practices of the discipline.…

Passport to ELL: Four Programs for Kindergarten through High School English Language Learners Help Teachers Fill Gaps Left by Often Out-of-Date Classroom Materials

ERIC Educational Resources Information Center

Schwartzman, Ana

2004-01-01

Teachers in English Language Learning classrooms have long faced the challenge of working with children who have diverse ethnic and cultural backgrounds and wide-ranging linguistic skill sets. A child from El Salvador, for example, will need to practice different pronunciation and stress patterns than a child from Vietnam. Technology can help…

Implementation of genetic conservation practices in a muskellunge propagation and stocking program

USGS Publications Warehouse

Jennings, Martin J.; Sloss, Brian L.; Hatzenbeler, Gene R.; Kampa, Jeffrey M.; Simonson, Timothy D.; Avelallemant, Steven P.; Lindenberger, Gary A.; Underwood, Bruce D.

2010-01-01

Conservation of genetic resources is a challenging issue for agencies managing popular sport fishes. To address the ongoing potential for genetic risks, we developed a comprehensive set of recommendations to conserve genetic diversity of muskellunge (Esox masquinongy) in Wisconsin, and evaluated the extent to which the recommendations can be implemented. Although some details are specific to Wisconsin's muskellunge propagation program, many of the practical issues affecting implementation are applicable to other species and production systems. We developed guidelines to restrict future broodstock collection operations to lakes with natural reproduction and to develop a set of brood lakes to use on a rotational basis within regional stock boundaries, but implementation will require considering lakes with variable stocking histories. Maintaining an effective population size sufficient to minimize the risk of losing alleles requires limiting broodstock collection to large lakes. Recommendations to better approximate the temporal distribution of spawning in hatchery operations and randomize selection of brood fish are feasible. Guidelines to modify rearing and distribution procedures face some logistic constraints. An evaluation of genetic diversity of hatchery-produced fish during 2008 demonstrated variable success representing genetic variation of the source population. Continued evaluation of hatchery operations will optimize operational efficiency while moving toward genetic conservation goals.

Implementation of genetic conservation practices in a muskellunge propagation and stocking program

USGS Publications Warehouse

Jennings, Martin J.; Sloss, Brian L.; Hatzenbeler, Gene R.; Kampa, Jeffrey M.; Simonson, Timothy D.; Avelallemant, Steven P.; Lindenberger, Gary A.; Underwood, Bruce D.

2010-01-01

Conservation of genetic resources is a challenging issue for agencies managing popular sport fishes. To address the ongoing potential for genetic risks, we developed a comprehensive set of recommendations to conserve genetic diversity of muskellunge (Esox masquinongy) in Wisconsin, and evaluated the extent to which the recommendations can be implemented. Although some details are specific to Wisconsin's muskellunge propagation program, many of the practical issues affecting implementation are applicable to other species and production systems. We developed guidelines to restrict future brood stock collection operations to lakes with natural reproduction and to develop a set of brood lakes to use on a rotational basis within regional stock boundaries, but implementation will require considering lakes with variable stocking histories. Maintaining an effective population size sufficient to minimize the risk of losing alleles requires limiting brood stock collection to large lakes. Recommendations to better approximate the temporal distribution of spawning in hatchery operations and randomize selection of brood fish are feasible. Guidelines to modify rearing and distribution procedures face some logistic constraints. An evaluation of genetic diversity of hatchery-produced fish during 2008 demonstrated variable success representing genetic variation of the source population. Continued evaluation of hatchery operations will optimize operational efficiency while moving toward genetic conservation goals.

Conflicting patterns of genetic structure produced by nuclear and mitochondrial markers in the Oregon Slender Salamander (Batrachoseps wrighti): implications for conservation efforts and species management

USGS Publications Warehouse

Miller, Mark; Haig, Susan M.; Wagner, R.S.

2005-01-01

Endemic to Oregon in the northwestern US, the Oregon slender salamander (Batrachoseps wrighti) is a terrestrial plethodontid found associated with late successional mesic forests. Consequently, forest management practices such as timber harvesting may impact their persistence. Therefore, to infer possible future effects of these practices on population structure and differentiation, we used mitochondrial DNA sequences (cytochrome b) and RAPD markers to analyze 22 populations across their range. Phylogenetic analyses of sequence data (774 bp) revealed two historical lineages corresponding to northern and southern-distributed populations. Relationships among haplotypes and haplotype diversity within lineages suggested that the northern region may have more recently been colonized compared to the southern region. In contrast to the mitochondrial data, analyses of 46 RAPD loci suggested an overall pattern of isolation-by-distance in the set of populations examined and no particularly strong clustering of populations based on genetic distances. We propose two non-exclusive hypotheses to account for discrepancies between mitochondrial and nuclear data sets. First, our data may reflect an overall ancestral pattern of isolation-by-distance that has subsequently been influenced by vicariance. Alternately, our analyses may suggest that male-mediated gene flow and female philopatry are important contributors to the pattern of genetic diversity. We discuss the importance of distinguishing between these two hypotheses for the purposes of identifying conservation units and note that, regardless of the relative contribution of each mechanism towards the observed pattern of diversity, protection of habitat will likely prove critical for the long-term persistence of this species.

The 2017 Diabetes Educator and the Diabetes Self-Management Education National Practice Survey.

PubMed

Rinker, Joanne; Dickinson, Jane K; Litchman, Michelle L; Williams, Ann S; Kolb, Leslie E; Cox, Carla; Lipman, Ruth D

2018-06-01

Purpose The American Association of Diabetes Educators conducts the National Practice Survey (NPS) biennially to document current practice in diabetes education in the United States. The purpose of the study is to obtain insight about factors influencing the work of the diabetes educator. Method The 2017 NPS was comprised of 100 questions covering diabetes educator demographics, profile populations of people with diabetes, practice information, program accreditation, program curriculum, staffing, education delivery methods, data collection, and reporting. The basic survey consisted of 22 questions using branch logic, from which respondents were then directed to questions tailored to their particular practice setting, enabling them to answer only a relevant subset of the remaining questions. The web-based survey was sent to approximately 32 000 individuals who were either members of the American Association of Diabetes Educators (AADE) or Certified Diabetes Educators (CDE) with the National Certification Board for Diabetes Educators (NCBDE) but not AADE members. Weekly reminder e-mails were sent to recipients who had not yet responded. The outreach efforts resulted in the survey being completed by 4696 individuals, a 17% response rate yielding 95% confidence that these responses are within ±5% accuracy. Results Diabetes Self-Management Education and Support (DSMES) continues to be a field dominated by women (95%). Diabetes educators represent a diverse health care profession, with educators indicating most commonly that their primary discipline is nursing (48%), nutrition (38%), and pharmacy (7%). When asked about credentials, 82.6% indicated that they held a CDE, 3.8% held the Board Certified-Advanced Diabetes Management (BC-ADM) credential, and 16.5% held neither the CDE nor the BC-ADM. Nearly 75% characterized their role as a diabetes educator as providing direct patient care. DSMES continued to be provided in a varied array of settings to educationally, socioeconomically, and racially diverse patient populations. DSMES was delivered using a number of different educational strategies. Diabetes educators have direct influence in care and services that people with diabetes receive. Conclusions The results of the 2017 NPS demonstrate that diabetes educators are meeting the needs of varied populations in various practice settings. They are working with individuals with type 1 and type 2 diabetes, those at risk for diabetes, and women with gestational diabetes and are involved in recommending, implementing, and providing key referrals and recommendations for diabetes care, including insulin initiation, titration, medication adjustments, recommendations on devices, and technology. Identified areas for improvement include needs for increased racial and ethnic diversity in the workforce, recruiting young professionals, drawing practice approaches from related disciplines (eg, mental health and disability rehabilitation), and encouraging tracking of more areas of outcomes data. Diabetes educators are playing an increasingly central role within multidisciplinary care teams with people at risk for diabetes, those who have diabetes, and those with other chronic conditions.

A practical implementation for a data dictionary in an environment of diverse data sets

USGS Publications Warehouse

Sprenger, Karla K.; Larsen, Dana M.

1993-01-01

The need for a data dictionary database at the U.S. Geological Survey's EROS Data Center (EDC) was reinforced with the Earth Observing System Data and Information System (EOSDIS) requirement for consistent field definitions of data sets residing at more than one archive center. The EDC requirement addresses the existence of multiple sets with identical field definitions using various naming conventions. The EDC is developing a data dictionary database to accomplish the following foals: to standardize field names for ease in software development; to facilitate querying and updating of the date; and to generate ad hoc reports. The structure of the EDC electronic data dictionary database supports different metadata systems as well as many different data sets. A series of reports is used to keep consistency among data sets and various metadata systems.

Current Evaluation Practices of Diversity Trainers in German-Speaking Countries

ERIC Educational Resources Information Center

Rohmann, Anette; Froncek, Benjamin; Mazziotta, Agostino; Piper, Verena

2017-01-01

Diversity training has been greatly expanded in recent years in order to help people deal with the challenges of increased social diversity. However, little is known about the systematic evaluation of diversity training. The present research surveyed 172 diversity trainers concerning their evaluation practices with regard to diversity training.…

Safer sex practices among newly diagnosed HIV-positive men who have sex with men in China: results from an ethnographic study

PubMed Central

Li, Haochu; Sankar, Andrea; Holroyd, Eleanor; Jiang, Baofa

2017-01-01

ABSTRACT The study reported here sought to understand the rationales of safer sex practices adopted by newly diagnosed HIV-positive men who have sex with men (MSM). Guided by a socio-ecological framework, an ethnography was conducted among newly diagnosed HIV-positive MSM. In-depth interviews and participant observation were employed to produce an account of the social and cultural settings that was faithful to the perspectives of participants. A total of 31 participants with diverse backgrounds were recruited in a southern city of China. Participant observation was conducted in local healthcare settings, MSM venues, and NGO offices. Most participants (24/31) reported stopping unprotected anal intercourse (UAI) immediately after being diagnosed as HIV-positive. Factors associated with safer sex practices were identified at both individual and environmental levels, including self-protection, establishment of self-esteem, dignity, altruism and reciprocity, disease experience as a source of personal growth, and organizational culture and values. Newly diagnosed HIV-positive MSM navigate their sexual practices within the context of multiple competing factors. Implications for sustained behaviour change enabling safer sex practices include stimulating survival instinct, facilitating safer sex decision making, motivating and facilitating personal growth, and encouraging volunteerism to promote intentional activities for safer sex practices. PMID:29284374

Safer sex practices among newly diagnosed HIV-positive men who have sex with men in China: results from an ethnographic study.

PubMed

Li, Haochu; Sankar, Andrea; Holroyd, Eleanor; Jiang, Baofa

2017-12-01

The study reported here sought to understand the rationales of safer sex practices adopted by newly diagnosed HIV-positive men who have sex with men (MSM). Guided by a socio-ecological framework, an ethnography was conducted among newly diagnosed HIV-positive MSM. In-depth interviews and participant observation were employed to produce an account of the social and cultural settings that was faithful to the perspectives of participants. A total of 31 participants with diverse backgrounds were recruited in a southern city of China. Participant observation was conducted in local healthcare settings, MSM venues, and NGO offices. Most participants (24/31) reported stopping unprotected anal intercourse (UAI) immediately after being diagnosed as HIV-positive. Factors associated with safer sex practices were identified at both individual and environmental levels, including self-protection, establishment of self-esteem, dignity, altruism and reciprocity, disease experience as a source of personal growth, and organizational culture and values. Newly diagnosed HIV-positive MSM navigate their sexual practices within the context of multiple competing factors. Implications for sustained behaviour change enabling safer sex practices include stimulating survival instinct, facilitating safer sex decision making, motivating and facilitating personal growth, and encouraging volunteerism to promote intentional activities for safer sex practices.

Thinking Outside of Outpatient: Underutilized Settings for Psychotherapy Education.

PubMed

Blumenshine, Philip; Lenet, Alison E; Havel, Lauren K; Arbuckle, Melissa R; Cabaniss, Deborah L

2017-02-01

Although psychiatry residents are expected to achieve competency in conducting psychotherapy during their training, it is unclear how psychotherapy teaching is integrated across diverse clinical settings. Between January and March 2015, 177 psychiatry residency training directors were sent a survey asking about psychotherapy training practices in their programs, as well as perceived barriers to psychotherapy teaching. Eighty-two training directors (44%) completed the survey. While 95% indicated that psychotherapy was a formal learning objective for outpatient clinic rotations, fifty percent or fewer noted psychotherapy was a learning objective in other settings. Most program directors would like to see psychotherapy training included (particularly supportive psychotherapy and cognitive behavioral therapy) on inpatient (82%) and consultation-liaison settings (57%). The most common barriers identified to teaching psychotherapy in these settings were time and perceived inadequate staff training and interest. Non-outpatient rotations appear to be an underutilized setting for psychotherapy teaching.

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation.

PubMed

Scobbie, Lesley; McLean, Donald; Dixon, Diane; Duncan, Edward; Wyke, Sally

2013-05-24

Goal setting is considered 'best practice' in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning & coping planning and appraisal & feedback. All stages are recorded in a patient-held record. In this study we examined the implementation, acceptability and perceived benefits of G-AP in one community rehabilitation team with people recovering from stroke. G-AP was implemented for 6 months with 23 stroke patients. In-depth interviews with 8 patients and 8 health professionals were analysed thematically to investigate views of its implementation, acceptability and perceived benefits. Case notes of interviewed patients were analysed descriptively to assess the fidelity of G-AP implementation. G-AP was mostly implemented according to protocol with deviations noted at the planning and appraisal and feedback stages. Each stage was felt to make a useful contribution to the overall process; however, in practice, goal negotiation and goal setting merged into one stage and the appraisal and feedback stage included an explicit decision making component. Only two issues were raised regarding G-APs acceptability: (i) health professionals were concerned about the impact of goal non-attainment on patient's well-being (patients did not share their concerns), and (ii) some patients and health professionals found the patient-held record unhelpful. G-AP was felt to have a positive impact on patient goal attainment and professional goal setting practice. Collaborative partnerships between health professionals and patients were apparent throughout the process. G-AP has been perceived as both beneficial and broadly acceptable in one community rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings.

Conserving genetic diversity in the honeybee: comments on Harpur et al. (2012).

PubMed

De la Rúa, Pilar; Jaffé, Rodolfo; Muñoz, Irene; Serrano, José; Moritz, Robin F A; Kraus, F Bernhard

2013-06-01

The article by Harpur et al. (2012) 'Management increases genetic diversity of honey bees via admixture' concludes that '…honey bees do not suffer from reduced genetic diversity caused by management and, consequently, that reduced genetic diversity is probably not contributing to declines of managed Apis mellifera populations'. In the light of current honeybee and beekeeping declines and their consequences for honeybee conservation and the pollination services they provide, we would like to express our concern about the conclusions drawn from the results of Harpur et al. (2012). While many honeybee management practices do not imply admixture, we are convinced that the large-scale genetic homogenization of admixed populations could drive the loss of valuable local adaptations. We also point out that the authors did not account for the extensive gene flow that occurs between managed and wild/feral honeybee populations and raise concerns about the data set used. Finally, we caution against underestimating the importance of genetic diversity for honeybee colonies and highlight the importance of promoting the use of endemic honeybee subspecies in apiculture. © 2013 John Wiley & Sons Ltd.

Diversity dynamics: The experience of male Robert Wood Johnson Foundation nurse faculty scholars.

PubMed

Brody, Abraham A; Farley, Jason E; Gillespie, Gordon L; Hickman, Ronald; Hodges, Eric A; Lyder, Courtney; Palazzo, Steven J; Ruppar, Todd; Schiavenato, Martin; Pesut, Daniel J

Managing diversity dynamics in academic or clinical settings for men in nursing has unique challenges resulting from their minority status within the profession. The purpose of this study was to share challenges and lessons learned identified by male scholars in the Robert Wood Johnson Foundation Nurse Faculty Scholars program and suggest strategies for creating positive organizations promoting inclusive excellence. Multiple strategies including informal mentored discussions and peer-to-peer dialogue throughout the program, formal online surveys of scholars and National Advisory Committee members, and review of scholar progress reports were analyzed as part of the comprehensive evaluation plan of the program. Diversity dynamic issues include concerns with negative stereotyping, microaggression, gender intelligence, and differences in communication and leadership styles. Male nurse faculty scholars report experiencing both opportunities and challenges residing in a predominately female profession. This article attempts to raise awareness and suggest strategies to manage diversity dynamics in service of promoting the development of a culture of health that values diversity and inclusive excellence for both men and women in academic, research, and practice contexts. Copyright © 2017 Elsevier Inc. All rights reserved.

In silico prediction of Tetrahymena pyriformis toxicity for diverse industrial chemicals with substructure pattern recognition and machine learning methods.

PubMed

Cheng, Feixiong; Shen, Jie; Yu, Yue; Li, Weihua; Liu, Guixia; Lee, Philip W; Tang, Yun

2011-03-01

There is an increasing need for the rapid safety assessment of chemicals by both industries and regulatory agencies throughout the world. In silico techniques are practical alternatives in the environmental hazard assessment. It is especially true to address the persistence, bioaccumulative and toxicity potentials of organic chemicals. Tetrahymena pyriformis toxicity is often used as a toxic endpoint. In this study, 1571 diverse unique chemicals were collected from the literature and composed of the largest diverse data set for T. pyriformis toxicity. Classification predictive models of T. pyriformis toxicity were developed by substructure pattern recognition and different machine learning methods, including support vector machine (SVM), C4.5 decision tree, k-nearest neighbors and random forest. The results of a 5-fold cross-validation showed that the SVM method performed better than other algorithms. The overall predictive accuracies of the SVM classification model with radial basis functions kernel was 92.2% for the 5-fold cross-validation and 92.6% for the external validation set, respectively. Furthermore, several representative substructure patterns for characterizing T. pyriformis toxicity were also identified via the information gain analysis methods. Copyright © 2010 Elsevier Ltd. All rights reserved.

Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study.

PubMed

Phillips, Cameron J; Marshall, Andrea P; Chaves, Nadia J; Jankelowitz, Stacey K; Lin, Ivan B; Loy, Clement T; Rees, Gwyneth; Sakzewski, Leanne; Thomas, Susie; To, The-Phung; Wilkinson, Shelley A; Michie, Susan

2015-01-01

The Theoretical Domains Framework (TDF) is an integrative framework developed from a synthesis of psychological theories as a vehicle to help apply theoretical approaches to interventions aimed at behavior change. This study explores experiences of TDF use by professionals from multiple disciplines across diverse clinical settings. Mixed methods were used to examine experiences, attitudes, and perspectives of health professionals in using the TDF in health care implementation projects. Individual interviews were conducted with ten health care professionals from six disciplines who used the TDF in implementation projects. Deductive content and thematic analysis were used. Three main themes and associated subthemes were identified including: 1) reasons for use of the TDF (increased confidence, broader perspective, and theoretical underpinnings); 2) challenges using the TDF (time and resources, operationalization of the TDF) and; 3) future use of the TDF. The TDF provided a useful, flexible framework for a diverse group of health professionals working across different clinical settings for the assessment of barriers and targeting resources to influence behavior change for implementation projects. The development of practical tools and training or support is likely to aid the utility of TDF.

Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study

PubMed Central

Phillips, Cameron J; Marshall, Andrea P; Chaves, Nadia J; Jankelowitz, Stacey K; Lin, Ivan B; Loy, Clement T; Rees, Gwyneth; Sakzewski, Leanne; Thomas, Susie; To, The-Phung; Wilkinson, Shelley A; Michie, Susan

2015-01-01

Background The Theoretical Domains Framework (TDF) is an integrative framework developed from a synthesis of psychological theories as a vehicle to help apply theoretical approaches to interventions aimed at behavior change. Purpose This study explores experiences of TDF use by professionals from multiple disciplines across diverse clinical settings. Methods Mixed methods were used to examine experiences, attitudes, and perspectives of health professionals in using the TDF in health care implementation projects. Individual interviews were conducted with ten health care professionals from six disciplines who used the TDF in implementation projects. Deductive content and thematic analysis were used. Results Three main themes and associated subthemes were identified including: 1) reasons for use of the TDF (increased confidence, broader perspective, and theoretical underpinnings); 2) challenges using the TDF (time and resources, operationalization of the TDF) and; 3) future use of the TDF. Conclusion The TDF provided a useful, flexible framework for a diverse group of health professionals working across different clinical settings for the assessment of barriers and targeting resources to influence behavior change for implementation projects. The development of practical tools and training or support is likely to aid the utility of TDF. PMID:25834455

The Divide between Diversity Training and Diversity Education: Integrating Best Practices

ERIC Educational Resources Information Center

King, Eden B.; Gulick, Lisa M. V.; Avery, Derek R.

2010-01-01

The fields of diversity training and diversity education have developed in a disconnected manner. This divide ensures that each field advances slowly and with narrow focus. The authors argue here that the divide should be bridged with attention to the best practices that diversity training and diversity education offer. By integrating the best…

Nurses' comfort level with spiritual assessment: a study among nurses working in diverse healthcare settings.

PubMed

Cone, Pamela H; Giske, Tove

2017-10-01

To gain knowledge about nurses' comfort level in assessing spiritual matters and to learn what questions nurses use in practice related to spiritual assessment. Spirituality is important in holistic nursing care; however, nurses report feeling uncomfortable and ill-prepared to address this domain with patients. Education is reported to impact nurses' ability to engage in spiritual care. This cross-sectional exploratory survey reports on a mixed-method study examining how comfortable nurses are with spiritual assessment. In 2014, a 21-item survey with 10 demographic variables and three open-ended questions were distributed to Norwegian nurses working in diverse care settings with 172 nurse responses (72 % response rate). SPSS was used to analyse quantitative data; thematic analysis examined the open-ended questions. Norwegian nurses reported a high level of comfort with most questions even though spirituality is seen as private. Nurses with some preparation or experience in spiritual care were most comfortable assessing spirituality. Statistically significant correlations were found between the nurses' comfort level with spiritual assessment and their preparedness and sense of the importance of spiritual assessment. How well-prepared nurses felt was related to years of experience, degree of spirituality and religiosity, and importance of spiritual assessment. Many nurses are poorly prepared for spiritual assessment and care among patients in diverse care settings; educational preparation increases their comfort level with facilitating such care. Nurses who feel well prepared with spirituality feel more comfortable with the spiritual domain. By fostering a culture where patients' spirituality is discussed and reflected upon in everyday practice and in continued education, nurses' sense of preparedness, and thus their level of comfort, can increase. Clinical supervision and interprofessional collaboration with hospital chaplains and/or other spiritual leaders can facilitate tailor spiritual assessment of patients based on patient concerns and view of life. © 2016 John Wiley & Sons Ltd.

Doctors' experience with handheld computers in clinical practice: qualitative study.

PubMed

McAlearney, Ann Scheck; Schweikhart, Sharon B; Medow, Mitchell A

2004-05-15

To examine doctors' perspectives about their experiences with handheld computers in clinical practice. Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. Six practice settings across the United States and two additional focus group sessions held at a national meeting of general internists. 54 doctors who did or did not use handheld computers. Doctors who used handheld computers in clinical practice seemed generally satisfied with them and reported diverse patterns of use. Users perceived that the devices helped them increase productivity and improve patient care. Barriers to use concerned the device itself and personal and perceptual constraints, with perceptual factors such as comfort with technology, preference for paper, and the impression that the devices are not easy to use somewhat difficult to overcome. Participants suggested that organisations can help promote handheld computers by providing advice on purchase, usage, training, and user support. Participants expressed concern about reliability and security of the device but were particularly concerned about dependency on the device and over-reliance as a substitute for clinical thinking. Doctors expect handheld computers to become more useful, and most seem interested in leveraging (getting the most value from) their use. Key opportunities with handheld computers included their use as a stepping stone to build doctors' comfort with other information technology and ehealth initiatives and providing point of care support that helps improve patient care.

Effects of Short-Term Set-Aside Management Practices on Soil Microorganism and Enzyme Activity in China.

PubMed

Li, Guangyu; Wu, Cifang

2017-08-14

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on soil microbial community and enzyme enzymes. We analyzed the bacterial structure, microbial biomass carbon/nitrogen and enzyme activity of farmland soil under different set-aside regimes in the Yellow River Delta of China. Bacterial alpha diversity was relatively lower under only irrigation, and farmyard manure applications showed clear advantages. Set-asides should consider their influence on soil organic carbon and nitrogen, which were correlated with microbial community structure. Nitrospira (0.47-1.67%), Acidobacteria Gp6 (8.26-15.91%) and unclassified Burkholderiales (1.50-2.81%) were significantly altered ( p < 0.01). Based on functions of these genera, some set-aside patterns led to a relative balance in nitrogen and carbon turnover. Partial treatments showed a deficiency in organic matter. In addition, farmyard manure may lead to the increased consumption of organic matter, with the exception of native plants set-asides. Conventional farming (control group) displayed a significant enzyme activity advantage. Set-aside management practices guided soil microbial communities to different states. Integrated soil microbiota and the content of carbon and nitrogen, native plants with farmyard manure showed an equilibrium state relatively, which would be helpful to improve land quality in the short-term.

A Framework of Working Across Disciplines in Early Design and R&D of Large Complex Engineered Systems

NASA Technical Reports Server (NTRS)

McGowan, Anna-Maria Rivas; Papalambros, Panos Y.; Baker, Wayne E.

2015-01-01

This paper examines four primary methods of working across disciplines during R&D and early design of large-scale complex engineered systems such as aerospace systems. A conceptualized framework, called the Combining System Elements framework, is presented to delineate several aspects of cross-discipline and system integration practice. The framework is derived from a theoretical and empirical analysis of current work practices in actual operational settings and is informed by theories from organization science and engineering. The explanatory framework may be used by teams to clarify assumptions and associated work practices, which may reduce ambiguity in understanding diverse approaches to early systems research, development and design. The framework also highlights that very different engineering results may be obtained depending on work practices, even when the goals for the engineered system are the same.

From Controlled Trial to Community Adoption: The Multisite Translational Community Trial

PubMed Central

Murimi, Mary; Gonzalez, Anjelica; Njike, Valentine; Green, Lawrence W.

2011-01-01

Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. PMID:21680935

EHR Safety: The Way Forward to Safe and Effective Systems

PubMed Central

Walker, James M.; Carayon, Pascale; Leveson, Nancy; Paulus, Ronald A.; Tooker, John; Chin, Homer; Bothe, Albert; Stewart, Walter F.

2008-01-01

Diverse stakeholders—clinicians, researchers, business leaders, policy makers, and the public—have good reason to believe that the effective use of electronic health care records (EHRs) is essential to meaningful advances in health care quality and patient safety. However, several reports have documented the potential of EHRs to contribute to health care system flaws and patient harm. As organizations (including small hospitals and physician practices) with limited resources for care-process transformation, human-factors engineering, software safety, and project management begin to use EHRs, the chance of EHR-associated harm may increase. The authors propose a coordinated set of steps to advance the practice and theory of safe EHR design, implementation, and continuous improvement. These include setting EHR implementation in the context of health care process improvement, building safety into the specification and design of EHRs, safety testing and reporting, and rapid communication of EHR-related safety flaws and incidents. PMID:18308981

Evolution of Functional Family Therapy as an Evidence-Based Practice for Adolescents with Disruptive Behavior Problems.

PubMed

Robbins, Michael S; Alexander, James F; Turner, Charles W; Hollimon, Amy

2016-09-01

This article summarizes the evolution of functional family therapy (FFT) based upon four decades of clinical practice and scientific scrutiny through research evidence. FFT research has evolved from an initial focus upon clinical process research, which examined sequential exchanges between therapists and family members. A key element of this research has been an examination of the way in which clinicians acquire, consolidate, and maintain the skills needed to implement FFT effectively with youth and families. Many randomized efficacy and effectiveness studies have evaluated the impact of FFT across diverse clinical populations. Subsequent research investigated factors that influence the effectiveness of implementation across more than 300 clinical settings in which more than 2,500 trained clinicians have provided service to nearly 400,000 families. Another important set of investigations concerned the cost-effectiveness of the interventions. © 2016 Family Process Institute.

Innovation and Transformation in California’s Safety-net Healthcare Settings: An Inside Perspective

PubMed Central

Lyles, Courtney R.; Aulakh, Veenu; Jameson, Wendy; Schillinger, Dean; Yee, Hal; Sarkar, Urmimala

2016-01-01

Background Health reform requires safety-net settings to transform care delivery, but how they will innovate in order to achieve this transformation is unknown. Methods We conducted two series of key informant interviews (N= 28) in 2012 with leadership from both California’s public hospital systems and community health centers. Interviews focused on how innovation was conceptualized and solicited examples of successful innovations. Results In contrast to disruptive innovation, interviewees often defined innovation as improving implementation, making incremental changes, and promoting integration. Many leaders gave examples of existing innovative practices such as patient-centered approaches to meeting their diverse patient needs. Participants expressed challenges to adapting quickly, but a desire to partner together. Conclusions Safety-net systems have already begun implementing innovative practices supporting their key priority areas. However, more support is needed, specifically to accelerate the change needed to succeed under health reform. PMID:24170938

Informal and Illicit Entrepreneurs: Fighting for a Place in the Neoliberal Economic Order

PubMed Central

Galemba, Rebecca B.

2013-01-01

A panel at the 2007 meetings of the American Anthropological Association examined the working lives of illicit and informal entrepreneurs living in “the gaps” or “shadows” of neoliberal globalization. Panelists challenged dichotomies such as informal/formal and legal/illegal by examining the everyday practices of workers in diverse settings. Emphasis was placed on entrepreneurs’ efforts to legitimate their activities and identities to themselves and others. PMID:24223472

Understanding healthcare practices in superdiverse neighbourhoods and developing the concept of welfare bricolage: Protocol of a cross-national mixed-methods study.

PubMed

Phillimore, Jenny; Bradby, Hannah; Knecht, Michi; Padilla, Beatriz; Brand, Tilman; Cheung, Sin Yi; Pemberton, Simon; Zeeb, Hajo

2015-06-28

Diversity in Europe has both increased and become more complex posing challenges to both national and local welfare state regimes. Evidence indicates specific barriers for migrant, faith and minority ethnic groups when accessing healthcare. However, previous studies of health in diverse cities in European countries have mainly adopted an ethno-national focus. Taking into account the new complexity of diversity within cities, a deeper and multi-faceted understanding of everyday health practices in superdiverse contexts is needed to support appropriate healthcare provision. This protocol describes a mixed method study investigating how residents in superdiverse neighbourhoods access healthcare. The study will include participant observation and qualitative interviewing as well as a standardised health survey and will be carried out in eight superdiverse neighbourhoods - with varying deprivations levels and trajectories of change - in four European countries (Germany, Portugal, Sweden and UK). In each neighbourhood, trained polylingual community researchers together with university researchers will map formal and informal provision and infrastructures supportive to health and healthcare. In-depth interviews with residents and healthcare providers in each country will investigate local health-supportive practices. Thematic analysis will be used to identify different types of help-seeking behaviours and support structures across neighbourhoods and countries. Using categories identified from analyses of interview material, a health survey will be set up investigating determinants of access to healthcare. Complex models, such as structural equation modelling, will be applied to analyse commonalities and differences between population groups, neighbourhoods and countries. This study offers the potential to contribute to a deeper understanding of how residents in superdiverse neighbourhoods deal with health and healthcare in everyday practices. The findings will inform governmental authorities, formal and informal healthcare providers how to further refine health services and how to achieve equitable access in diverse population groups.

Residential therapeutic communities in the mainstream: diversity and issues.

PubMed

De Leon, G

1995-01-01

Not all residential drug abuse treatment programs are therapeutic communities (TCs), not all TCs are in residential settings, and not all programs that call themselves TCs employ the same social and psychological models of treatment. The term "therapeutic community" is widely used to represent a distinct approach in almost any setting, including community residences, hospital wards, prisons, and homeless shelters. One effect of this labeling has been to cloud understanding of the TC as a drug abuse treatment approach, how well it works, where it works best, and for which clients it is most appropriate. This article attempts to further a general understanding of residential TCs. Distinctions are drawn between residential drug abuse treatment and residential TCs. The diversity of programs within the TC modality is described in terms of modifications of the model and applications to special populations; and the essential elements of the TC program model are briefly outlined. Finally, movement into the mainstream has surfaced issues for the TC in terms of policy and practice, several of which are highlighted.

Transcultural comparison of hospital and hospice as caring environments for dying patients.

PubMed

Gates, M F

1991-01-01

Leininger's nursing Theory of Cultural Care Diversity and Universality provided the framework for this comparative study of two environments for persons who are dying; namely a hospital oncology unit and a free-standing hospice unit. Analysis of data from ethnographic and ethnonursing research methods including unstructured interviews, observation-participation, and field journal materials yielded contrasts with two settings. The presence of a caring atmosphere/ambience was apparent in both the hospital and hospice. Universal patterns common to both were: caring beliefs and practices of staff; identification of each setting as "community" or "home"; and multiple symbolic uses of humor and food. Diversities included hierarchical organizational structure and cure orientation in the hospital; interdisciplinary collaboration and care orientation in hospice; more pronounced use of touch as a caring modality; and greater evidence of symbolism and ritual related to death and dying in hospice. Adoption of the cultural care modes of accommodation, repatterning, and maintenance are suggested in promoting a caring atmosphere wherever dying patients are served.

Creating More Effective Mentors: Mentoring the Mentor.

PubMed

Gandhi, Monica; Johnson, Mallory

2016-09-01

Given the diversity of those affected by HIV, increasing diversity in the HIV biomedical research workforce is imperative. A growing body of empirical and experimental evidence supports the importance of strong mentorship in the development and success of trainees and early career investigators in academic research settings, especially for mentees of diversity. Often missing from this discussion is the need for robust mentoring training programs to ensure that mentors are trained in best practices on the tools and techniques of mentoring. Recent experimental evidence shows improvement in mentor and mentee perceptions of mentor competency after structured and formalized training on best practices in mentoring. We developed a 2-day "Mentoring the Mentors" workshop at UCSF to train mid-level and senior HIV researchers from around the country [recruited mainly from Centers for AIDS Research (CFARs)] on best practices, tools and techniques of effective mentoring. The workshop content was designed using principles of Social Cognitive Career Theory (SCCT) and included training specifically geared towards working with early career investigators from underrepresented groups, including sessions on unconscious bias, microaggressions, and diversity supplements. The workshop has been held three times (September 2012, October 2013 and May 2015) with plans for annual training. Mentoring competency was measured using a validated tool before and after each workshop. Mentoring competency skills in six domains of mentoring-specifically effective communication, aligning expectations, assessing understanding, fostering independence, addressing diversity and promoting development-all improved as assessed by a validated measurement tool for participants pre- and -post the "Mentoring the Mentors" training workshops. Qualitative assessments indicated a greater awareness of the micro-insults and unconscious bias experienced by mentees of diversity and a commitment to improve awareness and mitigate these effects via the mentor-mentee relationship. Our "Mentoring the Mentors" workshop for HIV researchers/mentors offers a formal and structured curriculum on best practices, tools and techniques of effective mentoring, and methods to mitigate unconscious bias in the mentoring relationship. We found quantitative and qualitative improvements in mentoring skills as assessed by self-report by participants after each workshop and plan additional programs with longitudinal longer-term assessments focused on objective mentee outcomes (grants, papers, academic retention). Mentoring training can improve mentoring skills and is likely to improve outcomes for optimally-mentored mentees.

Improving the management and referral of patients with transient ischaemic attacks: a change strategy for a health community

PubMed Central

Wright, J; Harrison, S; McGeorge, M; Patterson, C; Russell, I; Russell, D; Small, N; Taylor, M; Walsh, M; Warren, E; Young, J

2006-01-01

Problem Rapid referral and management of patients with transient ischaemic attacks is a key component in the national strategy for stroke prevention. However, patients with transient ischaemic attacks are poorly identified and undertreated. Design and setting Before and after evaluation of quality improvement programme with controlled comparison in three primary care trusts reflecting diverse populations and organisational structures in an urban district in the North of England. Key measures for improvement The proportion of patients receiving antiplatelet drugs and safe driving advice on referral to a speciality clinic, and the numbers of referrals, adjusted for age, to the specialist clinic before and after the improvement programme. Strategies for change Interviews with patient and professionals to identify gaps and barriers to good practice; development of evidence based guidelines for the management of patients with transient ischaemic attacks; interactive multidisciplinary workshops for each primary care trust with feedback of individual audit results of referral practice; outreach visits to teams who were unable to attend the workshops; referral templates and desktop summaries to provide reminders of the guidelines to clinicians; incorporation of standards into professional contracts. Effects of change A significant improvement occurred in identification and referral of patients with transient ischaemic attacks to specialist clinics, with a 41% increase in referrals from trained practices compared with control practices. There were also significant improvements in the early treatment and safety advice provided to patients before referral. Lessons learnt A strategic approach to effective quality improvement across a diverse health community is feasible and achievable. Careful planning with patient and professional involvement to develop a tailored and multifaceted quality improvement programme to implement evidence based practice can work in very different primary care settings. Key components of the effectiveness of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication, and use of established networks and opinion leaders. PMID:16456203

Handbook of Research on Classroom Diversity and Inclusive Education Practice

ERIC Educational Resources Information Center

Curran, Christina M., Ed.; Petersen, Amy J., Ed.

2017-01-01

As classrooms are becoming more diverse, teachers are now faced with the responsibility of creating an inclusive classroom community. As such, researching classroom pedagogies and practices is an imperative step in curriculum planning. The "Handbook of Research on Classroom Diversity and Inclusive Education Practice" is an authoritative…

Teaching transcultural nursing in a transcultural setting.

PubMed

Baker, S S; Burkhalter, N C

1996-01-01

The application of Leininger's Theory of Culture Care Diversity and Universality to the dialogue between students and faculty regarding nursing education and practice provides the theoretical framework for evaluating a transcultural nursing curriculum in a transcultural, transnational setting on the Texas-Mexico border. In evaluating the first semester of this cultural encounter between the nurse-patient-community system and baccalaureate nursing education, faculty and students at Texas A&M International University School of Nursing in Laredo identified some particular challenges and assessed the effectiveness of approaches to meeting these challenges within the context of Leininger's Culture Care Theory and its three modes of action: culture care preservation, accommodation, and repatterning.

Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change.

PubMed

Tomoaia-Cotisel, Andrada; Scammon, Debra L; Waitzman, Norman J; Cronholm, Peter F; Halladay, Jacqueline R; Driscoll, David L; Solberg, Leif I; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C; Fetters, Michael D; Wise, Christopher G; Alexander, Jeffrey A; Hauser, Diane; McMullen, Carmit K; Scholle, Sarah Hudson; Tirodkar, Manasi A; Schmidt, Laura; Donahue, Katrina E; Parchman, Michael L; Stange, Kurt C

2013-01-01

We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research.

Level of Knowledge and Practice of Mothers on Minimum Dietary Diversity Practices and Associated Factors for 6–23-Month-Old Children in Adea Woreda, Oromia, Ethiopia

PubMed Central

Agize, Andualem; Dejenu, Getiye

2017-01-01

Background. Globally, undernutrition is responsible for at least 35% of deaths in children less than 5 years of age and estimated 6% of under-five deaths can be prevented by ensuring optimal complementary feeding especially the dietary diversity and meal frequency. In Ethiopia, 5% of children were fed according to minimum standards with respect to food diversity. Objective. To assess the level of knowledge and practice of mothers on dietary diversity practices and associated factors for children 6–23 months in Adea woreda. Methods. Community-based cross-sectional study was conducted. A sample of 730 mothers who have children in the age group of 6–23 months were selected using systematic sampling. Logistic regression model was fitted in order to identify factors associated with knowledge and practice of dietary diversity practice. Result. Of the total 700, 357 (51%) were knowledgeable on dietary diversity but 112 (16%) practiced appropriate dietary diversity practice for their 6–23-month-old children. Husbands' education (AOR = 2.79, 95% CI = (1.55, 5.00)), mothers' age, and marital status were significantly associated with knowledge of mothers. Mothers' age, husbands' education, marital status, and knowledge of mothers were significantly associated with mothers' dietary diversity for 6–23-month-old children. Conclusion. This study showed that approximately half of the mothers have good knowledge on minimum dietary diversity for children 6–23 months old and very low proportion of children 6–23 months old received diversified meal according to Infant and Young Child Feeding indicators. It was identified that different factors are responsible for this discrepancy. PMID:28497063

Using qualitative insights to change practice: exploring the culture of antibiotic prescribing and consumption for urinary tract infections

PubMed Central

Duane, Sinead; Domegan, Christine; Callan, Aoife; Galvin, Sandra; Cormican, Martin; Bennett, Kathleen; Murphy, Andrew W

2016-01-01

Objectives The aim of this paper is to explore the culture of antibiotic prescribing and consumption in the community for urinary tract infections (UTI) from the perspective of the general practitioners (GPs) and community member. Design Indepth interviews were conducted with GPs, and focus groups were held with community members. Setting General practice and community setting. Participants 15 GPs practising in rural and urban locations in Ireland participated in the indepth interviews. 6 focus groups (n=42) with participants who had direct or indirect experiences with UTI were also undertaken. Results The decision to prescribe or consume an antibiotic for a UTI is a set of complex processes including need recognition, information search and evaluation processes governed by the relationship and interactions between the GP and the patient. Different GP and patient decision-making profiles emerged emphasising the diversity and variety of general practice in real-life settings. The GP findings showed a requirement for more microbiological information on antibiotic resistance patterns to inform prescribing decisions. Focus group participants wanted a conversation with the GP about their illness and the treatment options available. Conclusions Collectively, this research identified the consultation as a priority intervention environment for stimulating change in relation to antibiotics. This paper demonstrates how qualitative research can identify the interacting processes which are instrumental to the decision to prescribe or consume an antibiotic for a suspected UTI. Qualitative research empowers researchers to investigate the what, how and why of interventions in real-life setting. Qualitative research can play a critical and instrumental role in designing behavioural change strategies with high impact on practice. The results of this research were used to design a complex intervention informed by social marketing. Trial registration number NCT01913860; Pre-results. PMID:26754175

Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

PubMed Central

Drolet, Marie-Josée; Williams-Jones, Bryn

2015-01-01

ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

Clinical education in nursing: rethinking learning in practice settings.

PubMed

Ironside, Pamela M; McNelis, Angela M; Ebright, Patricia

2014-01-01

Clinical education is a time- and resource-intensive aspect of contemporary nursing programs. Despite widespread agreement in the discipline about the centrality of clinical experiences to learning nursing, little is known about if and how current clinical experiences contribute to students' learning and readiness for practice. Before large-scale studies testing specific educational interventionals can be conducted, it is important to understand what currently occurs during clinical experiences. This study, funded by the National Council of State Boards of Nursing, examined the nature of contemporary clinical education by describing students' and faculty's experiences at three geographically diverse universities in the United States. Findings suggest that teachers' and students' focus on task completion persists and often overshadows the more complex aspects of learning nursing practice. Copyright © 2014 Elsevier Inc. All rights reserved.

The ab-initio density matrix renormalization group in practice.

PubMed

Olivares-Amaya, Roberto; Hu, Weifeng; Nakatani, Naoki; Sharma, Sandeep; Yang, Jun; Chan, Garnet Kin-Lic

2015-01-21

The ab-initio density matrix renormalization group (DMRG) is a tool that can be applied to a wide variety of interesting problems in quantum chemistry. Here, we examine the density matrix renormalization group from the vantage point of the quantum chemistry user. What kinds of problems is the DMRG well-suited to? What are the largest systems that can be treated at practical cost? What sort of accuracies can be obtained, and how do we reason about the computational difficulty in different molecules? By examining a diverse benchmark set of molecules: π-electron systems, benchmark main-group and transition metal dimers, and the Mn-oxo-salen and Fe-porphine organometallic compounds, we provide some answers to these questions, and show how the density matrix renormalization group is used in practice.

Working data together: the accountability and reflexivity of digital astronomical practice.

PubMed

Hoeppe, Götz

2014-04-01

Drawing on ethnomethodology, this article considers the sequential work of astronomers who combine observations from telescopes at two observatories in making a data set for scientific analyses. By witnessing the induction of a graduate student into this work, it aims at revealing the backgrounded assumptions that enter it. I find that these researchers achieved a consistent data set by engaging diverse evidential contexts as contexts of accountability. Employing graphs that visualize data in conventional representational formats of observational astronomy, experienced practitioners held each other accountable by using an 'implicit cosmology', a shared (but sometimes negotiable) characterization of 'what the universe looks like' through these formats. They oriented to data as malleable, that is, as containing artifacts of the observing situation which are unspecified initially but can be defined and subsequently removed. Alternating between reducing data and deducing astronomical phenomena, they ascribed artifacts to local observing conditions or computational procedures, thus maintaining previously stabilized phenomena reflexively. As researchers in data-intensive sciences are often removed from the instruments that generated the data they use, this example demonstrates how scientists can achieve agreement by engaging stable 'global' data sets and diverse contexts of accountability, allowing them to bypass troubling features and limitations of data generators.

Entomological Monitoring and Evaluation: Diverse Transmission Settings of ICEMR Projects Will Require Local and Regional Malaria Elimination Strategies

PubMed Central

Conn, Jan E.; Norris, Douglas E.; Donnelly, Martin J.; Beebe, Nigel W.; Burkot, Thomas R.; Coulibaly, Mamadou B.; Chery, Laura; Eapen, Alex; Keven, John B.; Kilama, Maxwell; Kumar, Ashwani; Lindsay, Steve W.; Moreno, Marta; Quinones, Martha; Reimer, Lisa J.; Russell, Tanya L.; Smith, David L.; Thomas, Matthew B.; Walker, Edward D.; Wilson, Mark L.; Yan, Guiyun

2015-01-01

The unprecedented global efforts for malaria elimination in the past decade have resulted in altered vectorial systems, vector behaviors, and bionomics. These changes combined with increasingly evident heterogeneities in malaria transmission require innovative vector control strategies in addition to the established practices of long-lasting insecticidal nets and indoor residual spraying. Integrated vector management will require focal and tailored vector control to achieve malaria elimination. This switch of emphasis from universal coverage to universal coverage plus additional interventions will be reliant on improved entomological monitoring and evaluation. In 2010, the National Institutes for Allergies and Infectious Diseases (NIAID) established a network of malaria research centers termed ICEMRs (International Centers for Excellence in Malaria Research) expressly to develop this evidence base in diverse malaria endemic settings. In this article, we contrast the differing ecology and transmission settings across the ICEMR study locations. In South America, Africa, and Asia, vector biologists are already dealing with many of the issues of pushing to elimination such as highly focal transmission, proportionate increase in the importance of outdoor and crepuscular biting, vector species complexity, and “sub patent” vector transmission. PMID:26259942

Entomological Monitoring and Evaluation: Diverse Transmission Settings of ICEMR Projects Will Require Local and Regional Malaria Elimination Strategies.

PubMed

Conn, Jan E; Norris, Douglas E; Donnelly, Martin J; Beebe, Nigel W; Burkot, Thomas R; Coulibaly, Mamadou B; Chery, Laura; Eapen, Alex; Keven, John B; Kilama, Maxwell; Kumar, Ashwani; Lindsay, Steve W; Moreno, Marta; Quinones, Martha; Reimer, Lisa J; Russell, Tanya L; Smith, David L; Thomas, Matthew B; Walker, Edward D; Wilson, Mark L; Yan, Guiyun

2015-09-01

The unprecedented global efforts for malaria elimination in the past decade have resulted in altered vectorial systems, vector behaviors, and bionomics. These changes combined with increasingly evident heterogeneities in malaria transmission require innovative vector control strategies in addition to the established practices of long-lasting insecticidal nets and indoor residual spraying. Integrated vector management will require focal and tailored vector control to achieve malaria elimination. This switch of emphasis from universal coverage to universal coverage plus additional interventions will be reliant on improved entomological monitoring and evaluation. In 2010, the National Institutes for Allergies and Infectious Diseases (NIAID) established a network of malaria research centers termed ICEMRs (International Centers for Excellence in Malaria Research) expressly to develop this evidence base in diverse malaria endemic settings. In this article, we contrast the differing ecology and transmission settings across the ICEMR study locations. In South America, Africa, and Asia, vector biologists are already dealing with many of the issues of pushing to elimination such as highly focal transmission, proportionate increase in the importance of outdoor and crepuscular biting, vector species complexity, and "sub patent" vector transmission. © The American Society of Tropical Medicine and Hygiene.

Inexplicable or Simply Unexplained? The Management of Maize Seed in Mexico

PubMed Central

Dyer, George A.; López-Feldman, Alejandro

2013-01-01

Farmer management of plant germplasm pre-dates crop domestication, but humans’ role in crop evolution and diversity remains largely undocumented and often contested. Seemingly inexplicable practices observed throughout agricultural history, such as exchanging or replacing seed, continue to structure crop populations across the developing world. Seed management practices can be construed as events in the life history of crops and management data used to model crop demography, but this requires suitable quantitative data. As a prerequisite to addressing the causes and implications of maize seed management, we describe its patterns of variation across Mexico by drawing from the literature and new analysis. We find that rates of seed replacement, introduction and diffusion differ significantly across regions and altitudinal zones, but interactions among explanatory factors can obscure patterns of variation. The type, source, geographic origin and ownership of seed help explain observed rates. Yet, controlling for the characteristics of germplasm barely reduces interregional differences vastly exceeding variation across elevations. With few exceptions, monotonic altitudinal trends are absent. Causal relationships between management practices and the physical environment could determine farmers’ wellbeing and crop conservation in the face of climate change. Scarce and inconsistent data on management nevertheless could prevent an understanding of these relationships. Current conceptions on the management and dynamics of maize diversity are founded on a patchwork of observations in surprisingly few and dissimilar environments. Our estimates of management practices should shed light on differences in maize population dynamics across Mexico. Consistency with previous studies spanning over a decade suggests that common sets of forces are present within large areas, but causal associations remain unknown. The next step in explaining crop diversity should address variation in seed management across space and time simultaneously while identifying farmers’ values and motivations as underlying forces. PMID:23840847

Inexplicable or simply unexplained? The management of maize seed in Mexico.

PubMed

Dyer, George A; López-Feldman, Alejandro

2013-01-01

Farmer management of plant germplasm pre-dates crop domestication, but humans' role in crop evolution and diversity remains largely undocumented and often contested. Seemingly inexplicable practices observed throughout agricultural history, such as exchanging or replacing seed, continue to structure crop populations across the developing world. Seed management practices can be construed as events in the life history of crops and management data used to model crop demography, but this requires suitable quantitative data. As a prerequisite to addressing the causes and implications of maize seed management, we describe its patterns of variation across Mexico by drawing from the literature and new analysis. We find that rates of seed replacement, introduction and diffusion differ significantly across regions and altitudinal zones, but interactions among explanatory factors can obscure patterns of variation. The type, source, geographic origin and ownership of seed help explain observed rates. Yet, controlling for the characteristics of germplasm barely reduces interregional differences vastly exceeding variation across elevations. With few exceptions, monotonic altitudinal trends are absent. Causal relationships between management practices and the physical environment could determine farmers' wellbeing and crop conservation in the face of climate change. Scarce and inconsistent data on management nevertheless could prevent an understanding of these relationships. Current conceptions on the management and dynamics of maize diversity are founded on a patchwork of observations in surprisingly few and dissimilar environments. Our estimates of management practices should shed light on differences in maize population dynamics across Mexico. Consistency with previous studies spanning over a decade suggests that common sets of forces are present within large areas, but causal associations remain unknown. The next step in explaining crop diversity should address variation in seed management across space and time simultaneously while identifying farmers' values and motivations as underlying forces.

Reporting on the Strategies Needed to Implement Proven Interventions: An Example From a "Real-World" Cross-Setting Implementation Study.

PubMed

Gold, Rachel; Bunce, Arwen E; Cohen, Deborah J; Hollombe, Celine; Nelson, Christine A; Proctor, Enola K; Pope, Jill A; DeVoe, Jennifer E

2016-08-01

The objective of this study was to empirically demonstrate the use of a new framework for describing the strategies used to implement quality improvement interventions and provide an example that others may follow. Implementation strategies are the specific approaches, methods, structures, and resources used to introduce and encourage uptake of a given intervention's components. Such strategies have not been regularly reported in descriptions of interventions' effectiveness, or in assessments of how proven interventions are implemented in new settings. This lack of reporting may hinder efforts to successfully translate effective interventions into "real-world" practice. A recently published framework was designed to standardize reporting on implementation strategies in the implementation science literature. We applied this framework to describe the strategies used to implement a single intervention in its original commercial care setting, and when implemented in community health centers from September 2010 through May 2015. Per this framework, the target (clinic staff) and outcome (prescribing rates) remained the same across settings; the actor, action, temporality, and dose were adapted to fit local context. The framework proved helpful in articulating which of the implementation strategies were kept constant and which were tailored to fit diverse settings, and simplified our reporting of their effects. Researchers should consider consistently reporting this information, which could be crucial to the success or failure of implementing proven interventions effectively across diverse care settings. clinicaltrials.gov Identifier: NCT02299791. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Toward Defining, Measuring, and Evaluating LGBT Cultural Competence for Psychologists

PubMed Central

Boroughs, Michael S.; Andres Bedoya, C.; O'Cleirigh, Conall; Safren, Steven A.

2015-01-01

A central part of providing evidence-based practice is appropriate cultural competence to facilitate psychological assessment and intervention with diverse clients. At a minimum, cultural competence with lesbian, gay, bisexual, and transgender (LGBT) people involves adequate scientific and supervised practical training, with increasing depth and complexity across training levels. In order to further this goal, we offer 28 recommendations of minimum standards moving toward ideal training for LGBT-specific cultural competence. We review and synthesize the relevant literature to achieve and assess competence across the various levels of training (doctoral, internship, post-doctoral, and beyond) in order to guide the field towards best practices. These recommendations are aligned with educational and practice guidelines set forth by the field and informed by other allied professions in order to provide a roadmap for programs, faculty, and trainees in improving the training of psychologists to work with LGBT individuals. PMID:26279609

Examining variability in parent feeding practices within a low-income, racially/ethnically diverse, and immigrant population using ecological momentary assessment.

PubMed

Berge, Jerica M; Tate, Allan; Trofholz, Amanda; Loth, Katie; Miner, Michael; Crow, Scott; Neumark-Sztainer, Dianne

2018-04-21

Current measures of parent feeding practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations in these behaviors across time and context. The current study uses ecological momentary assessment to examine variability of, and predictors of, parent feeding practices within a low-income, racially/ethnically diverse, and immigrant sample. Children ages 5-7 years old and their parents (n = 150 dyads) from six racial/ethnic groups (n = 25 from each; Black/African American, Hispanic, Hmong, Native American, Somali, White) were recruited for this mixed-methods study through primary care clinics. Among parents who used restriction (49%) and pressure-to-eat (69%) feeding practices, these feeding practices were utilized about every other day. Contextual factors at the meal associated with parent feeding practices included: number of people at the meal, who prepared the meal, types of food served at meals (e.g., pre-prepared, homemade, fast food), meal setting (e.g., kitchen table, front room), and meal emotional atmosphere (p < 0.05). Parents tended to restrict desserts, dairy, and vegetables and pressure children to eat fruits, vegetables, meat proteins, and refined grains (p < 0.05). There were some differences by race/ethnicity across findings (p < 0.01), with Hmong parents engaging in the highest levels of pressure-to-eat feeding practices. Parent feeding practices varied across the week, indicating feeding practices are more likely to be context-specific, or state-like than trait-like. There were some meal characteristics more strongly associated with engaging in restriction and pressure-to-eat feeding practices. Given that parent feeding practices appear to be state-like, future interventions and health care providers who work with parents and children may want to address contextual factors associated with parent feeding practices to decrease restriction and pressure-to-eat parent feeding practices. Copyright © 2018 Elsevier Ltd. All rights reserved.

National Collegiate Athletic Association Division I athletic trainers' concussion-management practice patterns.

PubMed

Kelly, Kassandra C; Jordan, Erin M; Joyner, A Barry; Burdette, G Trey; Buckley, Thomas A

2014-01-01

A cornerstone of the recent consensus statements on concussion is a multifaceted concussion-assessment program at baseline and postinjury and when tracking recovery. Earlier studies of athletic trainers' (ATs') practice patterns found limited use of multifaceted protocols; however, these authors typically grouped diverse athletic training settings together. To (1) describe the concussion-management practice patterns of National Collegiate Athletic Association (NCAA) Division I ATs, (2) compare these practice patterns to earlier studies, and (3) objectively characterize the clinical examination. Cross-sectional study. Online survey. A total of 610 ATs from NCAA Division I institutions, for a response rate of 34.4%. The survey had 3 subsections: demographic questions related to the participant's experiences, concussion-assessment practice patterns, and concussion-recovery and return-to-participation practice patterns. Specific practice-pattern questions addressed balance, cognitive and mental status, neuropsychological testing, and self-reported symptoms. Finally, specific components of the clinical examination were examined. We identified high rates of multifaceted assessments (i.e., assessments using at least 3 techniques) during testing at baseline (71.2%), acute concussion assessment (79.2%), and return to participation (66.9%). The specific techniques used are provided along with their adherence with evidence-based practice findings. Respondents endorsed a diverse array of clinical examination techniques that often overlapped objective concussion-assessment protocols or were likely used to rule out associated potential conditions. Respondents were cognizant of the Third International Consensus Statement, the National Athletic Trainers' Association position statement, and the revised NCAA Sports Medicine Handbook recommendations. Athletic trainers in NCAA Division I demonstrated widespread use of multifaceted concussion-assessment techniques and appeared compliant with recent consensus statements and the NCAA Sports Medicine Handbook.

Developing Strategies and Practices for Culturally Diverse Classrooms. The Bill Harp Professional Teachers Library Series.

ERIC Educational Resources Information Center

Gibson, Joyce Taylor

Designed to teach educators how to consciously develop strategies and practices for cultural groups that are at risk for education failure, this book defines and describes diversity; offers a unique process for developing strategies to serve diverse populations; and provides opportunities to practice the approach through questions, exercises, and…

Effectiveness of practices to reduce blood culture contamination: a Laboratory Medicine Best Practices systematic review and meta-analysis.

PubMed

Snyder, Susan R; Favoretto, Alessandra M; Baetz, Rich Ann; Derzon, James H; Madison, Bereneice M; Mass, Diana; Shaw, Colleen S; Layfield, Christopher D; Christenson, Robert H; Liebow, Edward B

2012-09-01

This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits. The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies' effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12). Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based "best practices" with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement. Copyright © 2012 The Canadian Society of Clinical Chemists. All rights reserved.

Giving hope, ticking boxes or securing services? A qualitative study of respiratory physiotherapists' views on goal-setting with people with chronic obstructive pulmonary disease.

PubMed

Summers, Rachael H; Ballinger, Claire; Nikoletou, Dimitra; Garrod, Rachel; Bruton, Anne; Leontowitsch, Miranda

2017-07-01

To explore respiratory physiotherapists' views and experiences of using goal-setting with people with chronic obstructive pulmonary disease in rehabilitation settings. A total of 17 respiratory physiotherapists with ⩾12 months current or previous experience of working with patients with chronic obstructive pulmonary disease in a non-acute setting. Participants were diverse in relation to age (25-49 years), sex (13 women), experience (Agenda for Change bands 6-8) and geographic location. Data were collected via face-to-face qualitative in-depth interviews (40-70 minutes) using a semi-structured interview guide. Interview locations were selected by participants (included participants' homes, public places and University). Interviews followed an interview guide, were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis; constant comparison was made within and between accounts, and negative case analysis was used. Three themes emerged through the process of analysis: (1) 'Explaining goal-setting'; (2) 'Working with goals'; and (3) 'Influences on collaborative goal-setting'. Goal-setting practices among respiratory physiotherapists varied considerably. Collaborative goal-setting was described as challenging and was sometimes driven by service need rather than patient values. Lack of training in collaborative goal-setting at both undergraduate and postgraduate level was also seen as an issue. Respiratory physiotherapists reflected uncertainties around the use of goal-setting in their practice, and conflict between patients' goals and organisational demands. This work highlights a need for wider discussion to clarify the purpose and implementation of goal-setting in respiratory rehabilitation.

Effects of Short-Term Set-Aside Management Practices on Soil Microorganism and Enzyme Activity in China

PubMed Central

Wu, Cifang

2017-01-01

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on soil microbial community and enzyme enzymes. We analyzed the bacterial structure, microbial biomass carbon/nitrogen and enzyme activity of farmland soil under different set-aside regimes in the Yellow River Delta of China. Bacterial alpha diversity was relatively lower under only irrigation, and farmyard manure applications showed clear advantages. Set-asides should consider their influence on soil organic carbon and nitrogen, which were correlated with microbial community structure. Nitrospira (0.47–1.67%), Acidobacteria Gp6 (8.26–15.91%) and unclassified Burkholderiales (1.50–2.81%) were significantly altered (p < 0.01). Based on functions of these genera, some set-aside patterns led to a relative balance in nitrogen and carbon turnover. Partial treatments showed a deficiency in organic matter. In addition, farmyard manure may lead to the increased consumption of organic matter, with the exception of native plants set-asides. Conventional farming (control group) displayed a significant enzyme activity advantage. Set-aside management practices guided soil microbial communities to different states. Integrated soil microbiota and the content of carbon and nitrogen, native plants with farmyard manure showed an equilibrium state relatively, which would be helpful to improve land quality in the short-term. PMID:28805737

'One size does not fit all': Perspectives on diversity in community aged care.

PubMed

Meyer, Claudia; Appannah, Arti; McMillan, Sally; Browning, Colette; Ogrin, Rajna

2018-05-13

Typically, older people are viewed via a single health condition, yet health outcomes are likely impacted by the intersection of many individual characteristics. Promoting inclusive health care is underpinned by reducing bias, respectful communication and supporting individual needs and preferences. This study explores perspectives of community aged care workers on diversity training and implementing training into practice. Ninety community aged care workers were telephone-interviewed three months after a one-day diversity training workshop. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Five themes emerged: 'raising awareness'; 'reserving judgement'; 'confidence and empowerment to embed diversity into practice'; 'communicating effectively'; and 'thinking about change … but'. Diversity concepts were positively received, but applying diversity principles into practice is more difficult. Recommendations to promote inclusive health care included raising awareness of bias, communicating with inclusive language and embedding diversity concepts into community aged care practice by addressing individual, organisational and wider system constraints. © 2018 AJA Inc.

Benchmarking density functional theory predictions of framework structures and properties in a chemically diverse test set of metal-organic frameworks

DOE PAGES

Nazarian, Dalar; Ganesh, P.; Sholl, David S.

2015-09-30

We compiled a test set of chemically and topologically diverse Metal–Organic Frameworks (MOFs) with high accuracy experimentally derived crystallographic structure data. The test set was used to benchmark the performance of Density Functional Theory (DFT) functionals (M06L, PBE, PW91, PBE-D2, PBE-D3, and vdW-DF2) for predicting lattice parameters, unit cell volume, bonded parameters and pore descriptors. On average PBE-D2, PBE-D3, and vdW-DF2 predict more accurate structures, but all functionals predicted pore diameters within 0.5 Å of the experimental diameter for every MOF in the test set. The test set was also used to assess the variance in performance of DFT functionalsmore » for elastic properties and atomic partial charges. The DFT predicted elastic properties such as minimum shear modulus and Young's modulus can differ by an average of 3 and 9 GPa for rigid MOFs such as those in the test set. Moreover, we calculated the partial charges by vdW-DF2 deviate the most from other functionals while there is no significant difference between the partial charges calculated by M06L, PBE, PW91, PBE-D2 and PBE-D3 for the MOFs in the test set. We find that while there are differences in the magnitude of the properties predicted by the various functionals, these discrepancies are small compared to the accuracy necessary for most practical applications.« less

National Association of Diversity Officers in Higher Education Standards of Professional Practice for Chief Diversity Officers

ERIC Educational Resources Information Center

Worthington, Roger L.; Stanley, Christine A.; Lewis, William T., Sr.

2014-01-01

The National Association of Diversity Officers in Higher Education (NADOHE) have developed and approved Standards of Professional Practice for Chief Diversity Officers (CDOs). The standards established in this document are a formative advancement toward the increased professionalization of the CDO in institutions of higher education. These…

Sharing What We Know about Living a Good Life: Indigenous Approaches to Knowledge Translation

PubMed Central

Smylie, Janet; Olding, Michelle; Ziegler, Carolyn

2015-01-01

Knowledge Translation (KT), a core priority in Canadian health research, policy, and practice for the past decade, has a long and rich tradition within Indigenous communities. In Indigenous knowledge systems the processes of “knowing” and “doing” are often intertwined and indistinguishable. However, dominant KT models in health science do not typically recognize Indigenous knowledge conceptualizations, sharing systems, or protocols and will likely fall short in Indigenous contexts. There is a need to move towards KT theory and practice that embraces diverse understandings of knowledge and that recognizes, respects, and builds on pre-existing knowledge systems. This will not only result in better processes and outcomes for Indigenous communities, it will also provide rich learning for mainstream KT scholarship and practice. As professionals deeply engaged in KT work, health librarians are uniquely positioned to support the development and implementation of Indigenous KT. This article provides information that will enhance the ability of readers from diverse backgrounds to promote and support Indigenous KT efforts, including an introduction to Indigenous knowledge conceptualizations and knowledge systems; key contextual issues to consider in planning, implementing, or evaluating KT in Indigenous settings; and contemporary examples of Indigenous KT in action. The authors pose critical reflection questions throughout the article that encourage readers to connect the content with their own practices and underlying knowledge assumptions. PMID:26793244

The Effects of a Warm or Chilly Climate Toward Socioeconomic Diversity on Academic Motivation and Self-Concept.

PubMed

Browman, Alexander S; Destin, Mesmin

2016-02-01

Persistent academic achievement gaps exist between university students from high and low socioeconomic status (SES) backgrounds. The current research proposes that the extent to which a university is perceived as actively supporting versus passively neglecting students from diverse socioeconomic backgrounds can influence low-SES students' academic motivation and self-concepts. In Experiments 1 and 2, low-SES students exposed to cues suggestive of an institution's warmth toward socioeconomic diversity demonstrated greater academic efficacy, expectations, and implicit associations with high academic achievement compared with those exposed to cues indicating institutional chilliness. Exploring the phenomenology underlying these effects, Experiment 3 demonstrated that warmth cues led low-SES students to perceive their socioeconomic background as a better match with the rest of the student body and to perceive the university as more socioeconomically diverse than did chilliness cues. Contributions to our understanding of low-SES students' psychological experiences in academic settings and practical implications for academic institutions are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.

Cross-cultural training of general practitioner registrars: how does it happen?

PubMed

Watt, Kelly; Abbott, Penny; Reath, Jenny

2016-01-01

An equitable multicultural society requires general practitioners (GPs) to be proficient in providing health care to patients from diverse backgrounds. GPs are required to have a certain attitudes, knowledge and skills known as cultural competence. Given its importance to registrar training, the aim of this study was to explore ways in which GP registrars are currently developing cultural competence. This study employed a survey design for GP registrars in Western Sydney. Training approaches to cultural competence that are relevant to the Australian General Practice setting include exposure to diversity, attitudes, knowledge and skills development. The 43 GP registrar respondents in Western Sydney are exposed to a culturally diverse patient load during training. Registrars report a variety of teachings related to cross-cultural training, but there is little consistency, with the most common approach entailing listening to patients' personal stories. Exposure to cultural diversity appears to be an important way in which cultural competency is developed. However, guidance and facilitation of skills development throughout this exposure is required and currently may occur opportunistically rather than consistently.

Lessons learned using a values-engaged approach to attend to culture, diversity, and equity in a STEM program evaluation.

PubMed

Boyce, Ayesha S

2017-10-01

Evaluation must attend meaningfully and respectfully to issues of culture, race, diversity, power, and equity. This attention is especially critical within the evaluation of science, technology, engineering, and mathematics (STEM) educational programming, which has an explicit agenda of broadening participation. The purpose of this article is to report lessons learned from the implementation of a values-engaged, educative (Greene et al., 2006) evaluation within a multi-year STEM education program setting. This meta-evaluation employed a case study design using data from evaluator weekly systematic reflections, review of evaluation and program artifacts, stakeholder interviews, and peer review and assessment. The main findings from this study are (a) explicit attention to culture, diversity, and equity was initially challenged by organizational culture and under-developed evaluator-stakeholder professional relationship and (b) evidence of successful engagement of culture, diversity, and equity emerged in formal evaluation criteria and documents, and informal dialogue and discussion with stakeholders. The paper concludes with lessons learned and implications for practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Conflicts of interest in divisions of general practice

PubMed Central

Palmer, N; Braunack‐Mayer, A; Rogers, W; Provis, C; Cullity, G

2006-01-01

Community‐based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed. PMID:17145912

Trying on and trying out: participatory action research as a tool for literacy and identity work in middle grades classrooms.

PubMed

Van Sluys, Katie

2010-09-01

This article explores the role of collaborative, ethnographic, participatory action research (PAR) with eighth grade students as a set of possible literacy practices for involving students with issues connected to their lives, resources, language(s), and communities. Findings are based on a year of fieldwork conducted as part of shared inquiry into one public school community's experiences with gentrification and meeting the complex needs of diverse learners. Findings bring to life the ways in which PAR facilitates the redefining of reading, writing, and research; the reconsideration of languages; the rethinking of literacy practices; and the repositioning of participants within and beyond given research endeavors.

Learner-centred teaching in a non-learner-centred world: An interpretive phenomenological study of the lived experience of clinical nursing faculty.

PubMed

Oyelana, Olabisi; Martin, Donna; Scanlan, Judith; Temple, Beverley

2018-08-01

With the growing complexities in the contemporary health care system, there is a challenge of preparing nurses for the practice demands. To this end, learner-centred teaching has emerged in many nursing curricula in Canada and evidence indicates its effectiveness in developing the essential practice skills in nursing students. It is important to examine the experience of the clinical faculty members who implement learner-centred teaching, as doing so would provide an insight to the factors that may hinder the implementation of learner-centred teaching in the practice settings. This phenomenological study aimed to address two research questions: what does learner-centred teaching mean to clinical nurse faculty? What is the lived experience of clinical nursing faculty who incorporate learner-centred teaching? Ten clinical nurse faculty members who had at least two years of clinical teaching experience volunteered to participate in the study. Data were collected using a semi-structured interview guide and audio recorder. Additional data sources included a demographic survey and a reflective journal. Multiple sub-themes emerged from this study from which three significant themes were consolidated: diversity of meanings, facilitators of LCT, and barriers to LCT. However, an overarching theme of "learner-centred teaching in a non-learner-centred world" was coined from participants' accounts of their experiences of barriers in incorporating LCT in the practice settings. A collaborative effort between faculty and the stakeholders is paramount to a successful implementation of learner-centred teaching in practice settings. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Findings: Sector-Leading and Innovative Practice in Advancing Equality and Diversity. Report to HEFCE by the Equality Challenge Unit

ERIC Educational Resources Information Center

Higher Education Funding Council for England, 2017

2017-01-01

Following our "Call for evidence of sector-leading and innovative practice in advancing equality and diversity" (HEFCE Circular letter 16/2016), HEFCE commissioned the Equality Challenge Unit (ECU) to report back on the range of equality and diversity practice undertaken across the higher education sector. Of 120 submissions received,…

Uterine artery embolization for treatment of leiomyomata: long-term outcomes from the FIBROID Registry.

PubMed

Goodwin, Scott C; Spies, James B; Worthington-Kirsch, Robert; Peterson, Eric; Pron, Gaylene; Li, Shuang; Myers, Evan R

2008-01-01

To assess long-term clinical outcomes of uterine artery embolization across a wide variety of practice settings in a large patient cohort. The Fibroid Registry for Outcomes Data (FIBROID) for Uterine Embolization was a 3-year, single-arm, prospective, multi-center longitudinal study of the short- and long-term outcomes of uterine artery embolization for leiomyomata. Two thousand one hundred twelve patients with symptomatic leiomyomata were eligible for long-term follow-up at 27 sites representing a geographically diverse set of practices, including academic centers, community hospitals, and closed-panel health maintenance organizations. At 36 months after treatment, 1,916 patients remained in the study, and of these, 1,278 patients completed the survey. The primary measures of outcome were the symptom and health-related quality-of-life scores from the Uterine Fibroid Symptom and Quality of Life questionnaire. Mean symptom scores improved 41.41 points (P<.001), and the quality of life scores improved 41.47 points (P<.001), both moving into the normal range for this questionnaire. The improvements were independent of practice setting. During the 3 years of the study, Kaplan-Meier estimates of hysterectomy, myomectomy, or repeat uterine artery embolization were 9.79%, 2.82%, and 1.83% of the patients, respectively. Uterine artery embolization results in a durable improvement in quality of life. These results are achievable when the procedure is performed in any experienced community or academic interventional radiology practice. III.

Primary health care as a philosophical and practical framework for nursing education: rhetoric or reality?

PubMed

Mackey, Sandra; Hatcher, Deborah; Happell, Brenda; Cleary, Michelle

2013-08-01

At least three decades after primary health care (PHC) took nursing by storm it is time to re-examine the philosophical shift to a PHC framework in pre-registration nursing curricula and overview factors which may hinder or promote full integration of PHC as a course philosophy and a contemporary approach to professional practice. Whilst nurse education has traditionally focused on preparing graduates for practice in the acute care setting, there is continuing emphasis on preparing nurses for community based primary health roles, with a focus on illness prevention and health promotion. This is driven by growing evidence that health systems are not responding adequately to the needs and challenges of diverse populations, as well as economic imperatives to reduce the burden of disease associated with the growth of chronic and complex diseases and to reduce the costs associated with the provision of health care. Nursing pre-registration programs in Australia and internationally have philosophically adopted PHC as a curriculum model for preparing graduates with the necessary competencies to function effectively across a range of settings. Anecdotal evidence, however, suggests that when adopted as a program philosophy PHC is not always well integrated across the curriculum. In order to develop a strong and resilient contemporary nursing workforce prepared for practice in both acute and community settings, pre-registration nursing programs need to comprehensively consider and address the factors impacting on the curricula integration of PHC philosophy.

Wide variations in blood product transfusion practices among providers who care for patients with acute leukemia in the United States.

PubMed

Pine, Alexander B; Lee, Eun-Ju; Sekeres, Mikkael; Steensma, David P; Zelterman, Daniel; Prebet, Thomas; DeZern, Amy; Komrokji, Rami; Litzow, Mark; Luger, Selina; Stone, Richard; Erba, Harry P; Garcia-Manero, Guillermo; Lee, Alfred I; Podoltsev, Nikolai A; Barbarotta, Lisa; Kasberg, Stephanie; Hendrickson, Jeanne E; Gore, Steven D; Zeidan, Amer M

2017-02-01

Transfusion of blood products is a key component of the supportive management in patients with acute leukemia (AL). However high-quality trial evidence and clinical outcome data to support specific transfusion goals for blood products for patients with AL remain limited leading to diverse transfusion practices. The primary objective of this study was to determine the spectrum of transfusion patterns in a variety of care settings among providers who treat AL patients. A 31-question survey queried providers caring for AL patients about the existence of institutional guidelines for transfusion of blood products, transfusion triggers for hemoglobin (Hb), platelets (PLTs), and fibrinogen in various settings including inpatient and outpatient and before procedures. We analyzed 130 responses and identified divergent transfusion Hb goals in hospitalized and ambulatory patients, fibrinogen goals for cryoprecipitate transfusions, and variation in practice for use of certain PLTs and red blood cell products. The least variable transfusion patterns were reported for PLT goals in thrombocytopenia and in the setting of invasive procedures such as bone marrow biopsy and lumbar punctures. This survey confirmed wide variations in blood product transfusion practices across several clinical scenarios in patients with AL. The findings emphasized the need for large prospective randomized trials to develop standardized evidence-based guidelines for blood product transfusions in patients with AL with the goal of limiting unnecessary transfusions without compromising outcomes. © 2016 AABB.

Cross-disciplinary research in cancer: an opportunity to narrow the knowledge-practice gap.

PubMed

Urquhart, R; Grunfeld, E; Jackson, L; Sargeant, J; Porter, G A

2013-12-01

Health services researchers have consistently identified a gap between what is identified as "best practice" and what actually happens in clinical care. Despite nearly two decades of a growing evidence-based practice movement, narrowing the knowledge-practice gap continues to be a slow, complex, and poorly understood process. Here, we contend that cross-disciplinary research is increasingly relevant and important to reducing that gap, particularly research that encompasses the notion of transdisciplinarity, wherein multiple academic disciplines and non-academic individuals and groups are integrated into the research process. The assimilation of diverse perspectives, research approaches, and types of knowledge is potentially effective in helping research teams tackle real-world patient care issues, create more practice-based evidence, and translate the results to clinical and community care settings. The goals of this paper are to present and discuss cross-disciplinary approaches to health research and to provide two examples of how engaging in such research may optimize the use of research in cancer care.

Effectiveness of practices to reduce blood culture contamination: A Laboratory Medicine Best Practices systematic review and meta-analysis☆

PubMed Central

Snyder, Susan R.; Favoretto, Alessandra M.; Baetz, Rich Ann; Derzon, James H.; Madison, Bereneice M.; Mass, Diana; Shaw, Colleen S.; Layfield, Christopher D.; Christenson, Robert H.; Liebow, Edward B.

2015-01-01

Objectives This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits. Design and methods The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used. Results Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies’ effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12). Conclusions Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based “best practices” with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement. PMID:22709932

Leading Multi-Ethnic Schools: Adjustments in Concepts and Practices for Engaging with Diversity

ERIC Educational Resources Information Center

Shah, Saeeda

2008-01-01

The student population across world is increasingly reflective of diverse cultures, religions and ethnicities. This rich diversity may become a challenge for educational leaders, teachers, and policy-makers in the absence of an understanding of diverse sources of knowledge people draw on for directing their beliefs and daily practices. This paper…

EQUIP Healthcare: An overview of a multi-component intervention to enhance equity-oriented care in primary health care settings.

PubMed

Browne, Annette J; Varcoe, Colleen; Ford-Gilboe, Marilyn; Wathen, C Nadine

2015-12-14

The primary health care (PHC) sector is increasingly relevant as a site for population health interventions, particularly in relation to marginalized groups, where the greatest gains in health status can be achieved. The purpose of this paper is to provide an overview of an innovative multi-component, organizational-level intervention designed to enhance the capacity of PHC clinics to provide equity-oriented care, particularly for marginalized populations. The intervention, known as EQUIP, is being implemented in Canada in four diverse PHC clinics serving populations who are impacted by structural inequities. These PHC clinics serve as case studies for the implementation and evaluation of the EQUIP intervention. We discuss the evidence and theory that provide the basis for the intervention, describe the intervention components, and discuss the methods used to evaluate the implementation and impact of the intervention in diverse contexts. Research and theory related to equity-oriented care, and complexity theory, are central to the design of the EQUIP intervention. The intervention aims to enhance capacity for equity-oriented care at the staff level, and at the organizational level (i.e., policy and operations) and is novel in its dual focus on: (a) Staff education: using standardized educational models and integration strategies to enhance staff knowledge, attitudes and practices related to equity-oriented care in general, and cultural safety, and trauma- and violence-informed care in particular, and; (b) Organizational integration and tailoring: using a participatory approach, practice facilitation, and catalyst grants to foster shifts in organizational structures, practices and policies to enhance the capacity to deliver equity-oriented care, improve processes of care, and shift key client outcomes. Using a mixed methods, multiple case-study design, we are examining the impact of the intervention in enhancing staff knowledge, attitudes and practices; improving processes of care; shifting organizational policies and structures; and improving selected client outcomes. The multiple case study design provides an ideal opportunity to study the contextual factors shaping the implementation, uptake and impact of our tailored intervention within diverse PHC settings. The EQUIP intervention illustrates the complexities involved in enhancing the PHC sector's capacity to provide equity-oriented care in real world clinical contexts.

Evidence-based practice curriculum in allied health professions for teaching-research-practice nexus.

PubMed

Asokan, G V

2012-11-01

Allied healthcare workers are from diverse professions and the key skill required is providing evidence-based care but this concept has not permeated enough for using it skillfully in their professions. A well structured curriculum in allied health professions is needed to strengthen concerted teaching, research, and practice to empower their professionals and make considerable differences in the lives of people by adopting evidence-based practice. Information sources for allied health professionals have relied on advice of their supervisors and colleagues, personal experiences, authoritative theory and texts for practice. Because of "research-practice" gap, often the use of evidence is not reflected in an individual day to day professional practice. Although allied health professionals work in resource and evidence challenged settings, there are certain barriers and facilitators, which need to be addressed. To implement practice-related research findings and uptake of evidence requires two essential components, namely, practical component and knowledge component. Research bench marking and research metrics for quality assurance and standardization through evidence-based practice will promote academic status and credibility of allied health profession. © 2012 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

A Qualitative Investigation of Parents’ Perspectives about Feeding Practices with Siblings among Racially/Ethnically and Socioeconomically Diverse Households

PubMed Central

Berge, Jerica M.; Trofholz, Amanda; Schulte, Anna; Conger, Katherine; Neumark-Sztainer, Dianne

2016-01-01

Objective Little is known about parent feeding practices with siblings. Because this is a new area of research, qualitative research is needed to understand parents’ perspectives about how they make decisions about feeding siblings and whether they adapt their feeding practices dependent on sibling characteristics such as weight status. The main objective of the current study was to describe parent feeding practices with siblings. Design Qualitative cross-sectional study with 88 parents with at least two siblings. Setting Parents were interviewed in their homes in Minneapolis/St. Paul Minnesota. Participants Parents were from racially/ethnically diverse (64% African American) and low-income households (77% earned < $35,000/yr.). Main Outcome Measure Parents’ perceptions of feeding practices with siblings. Analysis Qualitative interviews were coded using a hybrid deductive and inductive content analysis approach. Results Parents indicated that they used child food preferences, in-the-moment decisions, and planned meals when deciding how to feed siblings. Additionally, the majority of parents indicated that they managed picky eating by making one meal or giving some flexibility/leeway to siblings about having other food options. Furthermore, parents endorsed using different feeding practices (e.g., food restriction, portion control, pressure-to-eat, opportunities for healthful eating) with siblings dependent on child weight status or age/developmental stage. Conclusions and Implications Findings from the current study may inform future research regarding how to measure parent feeding practices with siblings in the home environment and the development of interventions tailored for families with multiple children in the home. Future quantitative research is needed to confirm these qualitative findings. PMID:27373864

Context Matters: The Experience of 14 Research Teams in Systematically Reporting Contextual Factors Important for Practice Change

PubMed Central

Tomoaia-Cotisel, Andrada; Scammon, Debra L.; Waitzman, Norman J.; Cronholm, Peter F.; Halladay, Jacqueline R.; Driscoll, David L.; Solberg, Leif I.; Hsu, Clarissa; Tai-Seale, Ming; Hiratsuka, Vanessa; Shih, Sarah C.; Fetters, Michael D.; Wise, Christopher G.; Alexander, Jeffrey A.; Hauser, Diane; McMullen, Carmit K.; Scholle, Sarah Hudson; Tirodkar, Manasi A.; Schmidt, Laura; Donahue, Katrina E.; Parchman, Michael L.; Stange, Kurt C.

2013-01-01

PURPOSE We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement. Team members identified the most important contextual factors for their studies. We grouped the findings thematically and developed recommendations for reporting context. RESULTS The most important contextual factors sorted into 5 domains: (1) the practice setting, (2) the larger organization, (3) the external environment, (4) implementation pathway, and (5) the motivation for implementation. To understand context, investigators recommend (1) engaging diverse perspectives and data sources, (2) considering multiple levels, (3) evaluating history and evolution over time, (4) looking at formal and informal systems and culture, and (5) assessing the (often nonlinear) interactions between contextual factors and both the process and outcome of studies. We include a template with tabular and interpretive elements to help study teams engage research participants in reporting relevant context. CONCLUSIONS These findings demonstrate the feasibility and potential utility of identifying and reporting contextual factors. Involving diverse stakeholders in assessing context at multiple stages of the research process, examining their association with outcomes, and consistently reporting critical contextual factors are important challenges for a field interested in improving the internal and external validity and impact of health care research. PMID:23690380

Promise and dismay: The state of strategic environmental assessment systems and practices in Canada

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

Noble, Bram F.

2009-01-15

Has strategic environmental assessment (SEA) finally reached a point of maturity in Canada? Or, is it still stumbling to find its place in the impact assessment family? Strategic environmental assessment has been ongoing in Canada for a number of years, both formally and informally, and under a variety of labels and institutional models. The result is a system of SEA that is diverse, founded on a range of principles and frameworks, and not well understood. This paper provides a critical review of Canadian SEA systems and practices. To accomplish this objective, a manageable and diverse set of past and recentmore » SEA and SEA-like frameworks and applications are described and critically analyzed based on a set of input, process, and output evaluation criteria. Results suggest considerable variability in SEA experience and value added. This is due in large part to the institutional and methodological pluralism of SEA, the boundaries of which are not well defined. Under the federal system, since the formalization of SEA, many applications have been disappointing in light of broader SEA good-practice principles and criteria. Indeed, some of the better examples of SEA have neither carried the SEA name tag nor occurred under formal SEA requirements. Further, many of the same challenges to project-based impact assessment also plague the development and value added of SEA. Of particular concern is the systematic separation of SEA from downstream decision inputs and assessment activities. As Canada commences review of its federal SEA Directive in preparation for the next generation of SEA, this paper reflects on what it has achieved in the prior.« less

Best Practices for Managing Organizational Diversity

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

Kreitz, Patricia A.; /SLAC

2007-05-18

In the twentieth century, ecologists and agriculturists developed an increasingly sophisticated understanding of the value of biological diversity, specifically the resilience and adaptability it brings to ecosystems. In the twenty-first century, the ecosystem model has been applied to human systems, particularly to understanding how organizations are structured and how they operate. Twenty-first century organizations are challenged by diversity in many arenas. Demographic changes in workforce composition and customer populations, combined with globalized markets and international competition are increasing the amount of diversity organizations must manage, both internally and externally. Many diversity specialists and business leaders argue that businesses and organizationsmore » interested in surviving and thriving in the twenty-first century need to take competitive advantage of a diverse workplace (Soutar, 2004; Yang, 2005). But to do so successfully, leaders and human resources (HR) managers must redefine management and leadership (Jones, 1989). Just as mono-cropping destroys biological diversity, and, in extreme cases, such as the Irish potato famine--human as well as natural ecosystems (Keohane, n.d.), so does mono-managing similarly destroy diversity within organizations. Leaders wanting to build strong, diverse organizations will not be successful if they rely on one approach or solution. Single-threaded diversity solutions, such as focusing only on recruitment or single-approach management techniques, such as requiring every employee to take diversity training, do not create lasting change (Kossek & Lobel, 1996; McMahon, 2006; Thomas, 1990). Bringing about the changes needed to build and sustain diversity requires commitment, strategy, communication, and concrete changes in organizational structure and processes. How, then, can managers and leaders develop diverse organizations and ensure that they are managed to take optimum advantage of diversity? What role should human resource specialists play in creating and managing diverse organizations? What are the best practices they should apply? The purpose of this review is to define workplace diversity, to identify best practices, and to identify how diversity management best practices can be applied in academic libraries. Finally, this review will provide a resource list for HR managers and leaders to learn more about those best practices with the goal of optimizing their organization's approach to diversity.« less

Working with Practicing Teachers in a High-Stakes Teaching Context to Rethink Their Pedagogical Practices with Children of Diverse Backgrounds

ERIC Educational Resources Information Center

Brown, Christopher P.; Weber, Natalie Babiak

2016-01-01

The public education system in the United States continues to struggle in educating children of diverse backgrounds. Many have addressed this issue by documenting how certain practices teach children particular types of knowledge and skills. This developmental focus on what should be happening to children of diverse backgrounds tends to ignore the…

Developing a Framework for Evaluating Ethical Outcomes of Good Participatory Practices in TB Clinical Drug Trials.

PubMed

MacQueen, Kathleen M; Eley, Natalie T; Frick, Mike; Mingote, Laia Ruiz; Chou, Alicia; Seidel, Stephanie S; Hannah, Stacey; Hamilton, Carol

2016-07-01

Good Participatory Practice Guidelines for TB Drug Trials (GPP-TB) were issued in 2012, based on similar guidelines for HIV prevention and reflecting growing acceptance of the importance of community engagement and participatory strategies in clinical research. Though the need for such strategies is clear, evaluation of the benefits and burdens are needed. Working with a diverse group of global TB stakeholders including advocates, scientists, and ethicists, we used a Theory of Change approach to develop an evaluation framework for GPP-TB that includes a clearly defined ethical goal, a set of powerful strategies derived from GPP-TB practices for achieving the goal, and outcomes connecting strategies to goal. The framework is a first step in systematically evaluating participatory research in clinical trials. © The Author(s) 2016.

The struggle for equality in healthcare continues.

PubMed

Rutledge, E O

2001-01-01

All healthcare providers, both institutional and individual, must make every effort to ensure that every person who seeks their medical care is offered competent, sincere, and equal treatment options. Unfortunately, this ideal scenario does not take into account the lack of diversity among care providers and the lack of culturally competent policies within healthcare delivery settings. As a result, many care providers continue to follow racially biased treatment practices and many organizations continue to ignore their public trust of providing fair treatment to everyone, regardless of skin color, gender, economic capabilities, etc. Although developing and implementing a diversity plan and culturally competent policies is very complex practically, politically, and programmatically for traditional institutional care providers, it must be done. The key ingredient to this effort is the absolute commitment and support of the organization's governing bodies and executive management. Institutions can certainly volunteer and begin to develop such programs that foster recruitment, selection, and retention of culturally competent care providers to ensure that equal healthcare is received by their patient populations. However, many institutions are already besieged by too many healthcare challenges to volunteer for such an effort. The Joint Commission on Accreditation of Healthcare Organizations and the National Council of Quality Assurance can certainly help jumpstart this effort by establishing an accreditation standard that requires all healthcare providers to establish and practice culturally competent care within their organizations. Providers must also embrace the diversity that is a part of our society and must not let race or ethnicity be a determining factor in offering treatment options.

CREATE Two-Year/Four-Year Faculty Workshops: A Focus on Practice, Reflection, and Novel Curricular Design Leads to Diverse Gains for Faculty at Two-Year and Four-Year Institutions †

PubMed Central

Hoskins, Sally G.; Gottesman, Alan J.; Kenyon, Kristy L.

2017-01-01

Improving STEM education through the propagation of highly effective teaching strategies is a major goal of national reform movements. CREATE (Consider, Read, Elucidate the hypotheses, Analyze and interpret the data, and Think of the next Experiment) is a transformative teaching and learning strategy grounded in evidence-based science pedagogy. CREATE courses promote both cognitive (e.g., critical thinking) and affective (e.g., attitudinal and epistemological) student gains in diverse settings. In this study, we look more deeply into the faculty development workshop used to disseminate CREATE pedagogy to instructors at two-year and four-year institutions. We hypothesized that an immersive experience would positively shift faculty participants’ views on teaching/learning, build their understanding of CREATE pedagogy and develop their confidence for course implementation. Internal and external assessments indicate that faculty participants did achieve gains within the timeframe of the CREATE workshop. We discuss the workshop training outcomes in the context of designing effective dissemination models for innovative practices. PMID:29854053

Visualization of diversity in large multivariate data sets.

PubMed

Pham, Tuan; Hess, Rob; Ju, Crystal; Zhang, Eugene; Metoyer, Ronald

2010-01-01

Understanding the diversity of a set of multivariate objects is an important problem in many domains, including ecology, college admissions, investing, machine learning, and others. However, to date, very little work has been done to help users achieve this kind of understanding. Visual representation is especially appealing for this task because it offers the potential to allow users to efficiently observe the objects of interest in a direct and holistic way. Thus, in this paper, we attempt to formalize the problem of visualizing the diversity of a large (more than 1000 objects), multivariate (more than 5 attributes) data set as one worth deeper investigation by the information visualization community. In doing so, we contribute a precise definition of diversity, a set of requirements for diversity visualizations based on this definition, and a formal user study design intended to evaluate the capacity of a visual representation for communicating diversity information. Our primary contribution, however, is a visual representation, called the Diversity Map, for visualizing diversity. An evaluation of the Diversity Map using our study design shows that users can judge elements of diversity consistently and as or more accurately than when using the only other representation specifically designed to visualize diversity.

Generally representative is representative of none: commentary on the pitfalls of IQ test standardization in multicultural settings.

PubMed

Shuttleworth-Edwards, A B

2016-10-01

The aim of this paper is to address the issue of IQ testing within the multicultural context, with a focus on the adequacy of nationwide population-based norms vs. demographically stratified within-group norms for valid assessment purposes. Burgeoning cultural diversity worldwide creates a pressing need to cultivate culturally fair psychological assessment practices. Commentary is provided to highlight sources of test-taking bias on tests of intellectual ability that may incur invalid placement and diagnostic decisions in multicultural settings. Methodological aspects of population vs. within-group norming solutions are delineated and the challenges of culturally relevant norm development are discussed. Illustrative South African within-group comparative data are supplied to support the review. A critical evaluation of the South African WAIS-III and the WAIS-IV standardizations further serves to exemplify the issues. A flaw in both South African standardizations is failure to differentiate between African first language individuals with a background of advantaged education vs. those from educationally disadvantaged settings. In addition, the standardizations merge the performance outcomes of distinct racial/ethnic groups that are characterized by differentially advantaged or disadvantaged backgrounds. Consequently, the conversion tables are without relevance for any one of the disparate South African cultural groups. It is proposed that the traditional notion of a countrywide unitary norming (also known as 'population-based norms') of an IQ test is an unsatisfactory model for valid assessment practices in diverse cultural contexts. The challenge is to develop new solutions incorporating data from finely stratified within-group norms that serve to reveal rather than obscure cross-cultural disparity in cognitive test performance.

Phys21:Preparing Physics Students for 21st Century Careers

NASA Astrophysics Data System (ADS)

McCormack, Elizabeth

2017-04-01

The Phys21: Preparing Physics Students for 21st Century Careersreport was commissioned by the APS and the AAPT and prepared by the Joint Task Force on Undergraduate Physics Programs (J-TUPP). It addresses the question: What skills and knowledge should the next generation of undergraduate physics majors possess to be well prepared for a diverse set of careers? J-TUPP members were particularly interested to understand better the needs of students who do not plan to pursue academic research careers. The major findings of the report and a summary of the guidelines that were developed for revising the undergraduate curriculum, addressing the needs of an increasingly diverse population of students, providing professional skills development, and enhancing student engagement through high impact teaching practices will be presented.

Behavioral Attitudes and Preferences in Cooking Practices with Traditional Open-Fire Stoves in Peru, Nepal, and Kenya: Implications for Improved Cookstove Interventions

PubMed Central

Rhodes, Evelyn L.; Dreibelbis, Robert; Klasen, Elizabeth; Naithani, Neha; Baliddawa, Joyce; Menya, Diana; Khatry, Subarna; Levy, Stephanie; Tielsch, James M.; Miranda, J. Jaime; Kennedy, Caitlin; Checkley, William

2014-01-01

Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20–49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a “one size fits all” improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves. PMID:25286166

Counteracting Educational Injustice with Applied Critical Leadership: Culturally Responsive Practices Promoting Sustainable Change

ERIC Educational Resources Information Center

Santamaría, Lorri J.; Santamaría, Andrés P.

2015-01-01

This contribution considers educational leadership practice to promote and sustain diversity. Comparative case studies are presented featuring educational leaders in the United States and New Zealand who counter injustice in their practice. The leaders' leadership practices responsive to the diversity presented in their schools offer…

Preparing the Future Dental Hygiene Workforce: Knowledge, Skills, and Reform.

PubMed

Fried, Jacquelyn L; Maxey, Hannah L; Battani, Kathryn; Gurenlian, JoAnn R; Byrd, Tammi O; Brunick, Ann

2017-09-01

With the health care delivery system in transition, the way in which oral health care services are delivered in 2040 will inevitably change. To achieve the aims of reduced cost, improved access, and higher quality and to advance population wellness, oral health care will likely become a more integrated part of medical care. An integrated primary care system would better meet the needs of an increasingly diverse and aging U.S. population with uneven access to health care services. By 2040, trends suggest that a smaller proportion of dental hygienists will work in traditional solo dental offices; many more will practice with multidisciplinary health care teams in large-group dental and medical practices and in a variety of non-traditional community settings. This integration will require changes in how dental hygienists are educated. To shape the skill sets, clinical judgment, and knowledge of future practitioners, current dental hygiene curricula must be reexamined, redirected, and enhanced. This article examines some of the factors that are likely to shape the future of dental hygiene practice, considers the strengths and weaknesses of current curricula, and proposes educational changes to prepare dental hygienists for practice in 2040. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Identifying educational priorities for occupational therapy students to prepare for mental health practice in Australia and New Zealand: Opinions of practising occupational therapists.

PubMed

Scanlan, Justin Newton; Pépin, Geneviève; Haracz, Kirsti; Ennals, Priscilla; Webster, Jayne S; Meredith, Pamela J; Batten, Rachel; Bowman, Siann; Bonassi, Marianne; Bruce, Rosie

2015-10-01

The effective preparation of occupational therapy students for mental health practice is critical to facilitate positive consumer outcomes, underpin optimal practice and support new graduates' professional identity. This project was established to determine a set of 'educational priorities' for occupational therapy students to prepare them for current (and future) entry-level practice in mental health, from the perspective of mental health occupational therapists in Australia and New Zealand. The study included two phases. In Phase One, participants identified what they considered to be important educational priorities for occupational therapy students to prepare them for practice in mental health. For Phase Two, an 'expert panel' was assembled to review and rank these using a Policy Delphi approach. Eighty-five participants provided educational priorities in Phase One. These were grouped into a total of 149 educational themes. In Phase Two, the expert panel (consisting of 37 occupational therapists from diverse locations and practice settings) prioritised these themes across three Delphi rounds. A final priority list was generated dividing educational themes into three prioritised categories: 29 'Essential', 25 'Important' and 44 'Optional' priorities. Highest-ranked priorities were: clinical reasoning, client-centred practice, therapeutic use of self, functional implications of mental illness, therapeutic use of occupation and mental health fieldwork experience. The priority list developed as part of this project provides additional information to support the review of occupational therapy curricula across Australia and New Zealand to ensure that new graduates are optimally prepared for mental health practice. © 2015 Occupational Therapy Australia.

Effective admissions practices to achieve greater student diversity in dental schools.

PubMed

Price, Shelia S; Grant-Mills, Donna

2010-10-01

In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.

Engagement with the TeenDrivingPlan and diversity of teens' supervised practice driving: lessons for internet-based learner driver interventions.

PubMed

Winston, Flaura K; Mirman, Jessica H; Curry, Allison E; Pfeiffer, Melissa R; Elliott, Michael R; Durbin, Dennis R

2015-02-01

Inexperienced, less-skilled driving characterises many newly licensed drivers and contributes to high crash rates. A randomised trial of TeenDrivingPlan (TDP), a new learner driver phase internet-based intervention, demonstrated effectiveness in improving safety relevant, on-road driving behaviour, primarily through greater driving practice diversity. To inform future learner driver interventions, this analysis examined TDP use and its association with practice diversity. Posthoc analysis of data from teen/parent dyads (n=107), enrolled early in learner phase and assigned to treatment arm in randomised trial. Inserted software beacons captured TDP use data. Electronic surveys completed by parents and teens assessed diversity of practice driving and TDP usability ratings at 24 weeks (end of study period). Most families (84%) used TDP early in the learner period; however, the number of TDP sessions in the first week was three times higher among dyads who achieved greater practice diversity than those with less. By week five many families still engaged with TDP, but differences in TDP use could not be detected between families with high versus low practice diversity. Usability was not a major issue for this sample based on largely positive user ratings. An engaging internet-based intervention, such as TDP, can support families in achieving high practice diversity. Future learner driver interventions should provide important information early in the learner period when engagement is greatest, encourage continued learning as part of logging practice drives, and incorporate monitoring software for further personalisation to meet family needs. NCT01498575. 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.

The Growing Genetic and Functional Diversity of Extended Spectrum Beta-Lactamases

PubMed Central

Ali, Tariq

2018-01-01

The β-lactams—a large class of diverse compounds—due to their excellent safety profile and broad antimicrobial spectrum are considered to be the most widely used therapeutic class of antibacterials prescribed in human and veterinary clinical practices. This, unfortunately, has also given rise to a continuous increased resistance globally in health care settings as well as in the community due to their permanent selective force driving diversification of the resistance mechanism. Resistance against β-lactams is increasing rapidly as novel β-lactamases, enzymes that degrade β-lactams, are being discovered each day such as recent emergence of extended spectrum β-lactamases (ESBL) that have the ability to inactivate most of the cephalosporins. The complexity and diversity of ESBL are increasing so rapidly that more than 170 variants have thus far been described for only a single genotype, the blaCTX-M-encoding ESBL. This review is to organize all the current updated literature describing genomic features, organization, and mechanism of resistance and mode of dissemination of all known ESBLs. PMID:29780833

Big data from small data: data-sharing in the ‘long tail’ of neuroscience

PubMed Central

Ferguson, Adam R; Nielson, Jessica L; Cragin, Melissa H; Bandrowski, Anita E; Martone, Maryann E

2016-01-01

The launch of the US BRAIN and European Human Brain Projects coincides with growing international efforts toward transparency and increased access to publicly funded research in the neurosciences. The need for data-sharing standards and neuroinformatics infrastructure is more pressing than ever. However, ‘big science’ efforts are not the only drivers of data-sharing needs, as neuroscientists across the full spectrum of research grapple with the overwhelming volume of data being generated daily and a scientific environment that is increasingly focused on collaboration. In this commentary, we consider the issue of sharing of the richly diverse and heterogeneous small data sets produced by individual neuroscientists, so-called long-tail data. We consider the utility of these data, the diversity of repositories and options available for sharing such data, and emerging best practices. We provide use cases in which aggregating and mining diverse long-tail data convert numerous small data sources into big data for improved knowledge about neuroscience-related disorders. PMID:25349910

On Defining and Developing Literacy across Communities

NASA Astrophysics Data System (ADS)

Bernardo, Allan B. I.

2000-09-01

The paper attempts to raise a few issues relating to the task of defining and operationalizing literacy and literacy development across communities with diverse socio-economic profiles. In particular, the following concerns are raised: (1) Can literacy development be assessed using one set of domains, given that the domains of literacy practices vary across cultures? (2) Does the acquisition of literacy skills mean the same thing to people across different communities? (3) Does illiteracy have the same consequences for people in different communities? (4) Is the process of literacy acquisition and development the same across diverse communities? The paper underscores the importance of considering the diverse socio-economic patterns in different communities in trying to determine present levels of literacy development and in proposing programs to increase levels of literacy skill. It also proposes using the level of community (in addition to the macro-level of nation-state and the micro-level of individual) in analyzing matters relating to literacy development.

The diversity of Iranian nursing students' clinical learning styles: a qualitative study.

PubMed

Baraz, Shahram; Memarian, Robabeh; Vanaki, Zohreh

2014-09-01

Numerous factors, including learning styles, affect the learning process of nursing students. Having insights about students' learning styles helps promoting the quality of education. The aim of this study was to explore the Iranian baccalaureate nursing students' learning styles in clinical settings. A qualitative design using a content analysis approach was used to collect and analyze data. Semi-structured interviews were conducted with fifteen Iranian baccalaureate nursing students selected using a purposive sample method. During data analysis, it was found that nursing students employed different clinical learning styles such as 'thoughtful observation,' 'learning by thinking,' and 'learning by doing'. Students adopt different learning strategies in clinical practice. Designing teaching strategies based on students' learning styles can promote students' learning and maximize their academic and clinical practice success. Nursing educators, curriculum designers, and students can use the findings of this study to improve the quality of nursing education in both the classroom and clinical settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Establishing a successful HIV counseling and testing service. A blueprint for preventing pediatric HIV infections and translating research into clinical practice.

PubMed

Rips, J

1997-12-01

The findings of ACTG 076 have already resulted in local, state, and federal legislative initiatives targeted at pregnant and post-partum women and their newborns. This article advises clinicians and administrations on setting up successful voluntary prenatal HIV counseling and testing programs for early detection of HIV infection, and complying with the burgeoning array of legislative directives. Over the past several years their have been attempts to optimize and evaluate testing programs--perinatal ZDV counseling and administration of ZDV--and to link HIV-infected women with care in academic, community, and municipal hospitals. The suggestions are, therefore, broad enough to be applicable to a full array of clinical practices, from a private single provider office to a large hospital-based prenatal clinic. It is hoped that the models presented in this article can be replicated in diverse settings, and that readers can avoid the pitfalls and barriers sometimes encountered.

Use of culture care theory with Anglo- and African American elders in a long-term care setting.

PubMed

McFarland, M R

1997-01-01

The purpose of this study was to discover the care expressions, practices, and patterns of elderly Anglo- and African American elders. The domain of inquiry was the cultural care of elderly residents within the environmental context of a long-term care institution. The ethnonursing qualitative research method was used to conduct the study which was conceptualized within Leininger's theory of culture care diversity and universality. Four major themes were discovered: (a) Residents expressed and lived generic care to maintain their preadmission lifeways; (b) The nursing staff provided aspects of professional care to support satisfying lifeways for residents; (c) Institutional care patterns and expressions were viewed as a continuing life experience but with major differences between the apartment section and nursing home units; and (d) An institutional culture of the retirement home was discovered which reflected unique lifeways and shared care and health expressions and practices. These themes substantiated the culture care theory and revealed new modes of care for the elderly in an institutional setting.

Best Practices for Wind Energy Development in the Great Lakes Region

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

Pebbles, Victoria; Hummer, John; Haven, Celia

2011-07-19

This report offers a menu of 18 different, yet complementary, preferred practices and policies. The best practices cover all phases of the wind energy development process - from the policies that allow for wind development, to the sustainable operation of a wind project, to the best practices for decommissioning a spent turbine - including applications for offshore wind. Each best practice describes the opportunities and challenges (pros and cons), and offers a case example that illustrates how that best practice is being utilized by a particular jurisdiction or wind project. The practices described in this publication were selected by amore » diverse group of interests from the Great Lakes Wind Collaborative that included environmental groups, industry, academia, and federal, state and local government regulators. The practices were identified through a year-long process that included a literature review, online survey and interviews with individuals from the public, private and non-profit sectors. Optimally, a suite of these best practices would be applied in an appropriate combination to fit the conditions of a particular wind project or a set of wind projects within a given locality or region.« less

Demographic faultlines: a meta-analysis of the literature.

PubMed

Thatcher, Sherry M B; Patel, Pankaj C

2011-11-01

We propose and test a theoretical model focusing on antecedents and consequences of demographic faultlines. We also posit contingencies that affect overall team dynamics in the context of demographic faultlines, such as the study setting and performance measurement. Using meta-analysis structural equation modeling with a final data set consisting of 311 data points (i.e., k [predictor-criterion relationships]), from 39 studies that were obtained from 36 papers with a total sample size of 24,388 individuals in 4,366 teams, we found that sex and racial diversity increased demographic faultline strength more than did diversity on the attributes of functional background, educational background, age, and tenure. Demographic faultline strength was found to increase task and relationship conflict as well as decrease team cohesion. Furthermore, although demographic faultline strength decreased both team satisfaction and team performance, there was a stronger decrease in team performance than in team satisfaction. The strength of these relationships increased when the study was conducted in the lab rather than in the field. We describe the theoretical and practical implications of these findings for advancing the study of faultlines. (c) 2011 APA, all rights reserved.

Discrete Fourier Transform-Based Multivariate Image Analysis: Application to Modeling of Aromatase Inhibitory Activity.

PubMed

Barigye, Stephen J; Freitas, Matheus P; Ausina, Priscila; Zancan, Patricia; Sola-Penna, Mauro; Castillo-Garit, Juan A

2018-02-12

We recently generalized the formerly alignment-dependent multivariate image analysis applied to quantitative structure-activity relationships (MIA-QSAR) method through the application of the discrete Fourier transform (DFT), allowing for its application to noncongruent and structurally diverse chemical compound data sets. Here we report the first practical application of this method in the screening of molecular entities of therapeutic interest, with human aromatase inhibitory activity as the case study. We developed an ensemble classification model based on the two-dimensional (2D) DFT MIA-QSAR descriptors, with which we screened the NCI Diversity Set V (1593 compounds) and obtained 34 chemical compounds with possible aromatase inhibitory activity. These compounds were docked into the aromatase active site, and the 10 most promising compounds were selected for in vitro experimental validation. Of these compounds, 7419 (nonsteroidal) and 89 201 (steroidal) demonstrated satisfactory antiproliferative and aromatase inhibitory activities. The obtained results suggest that the 2D-DFT MIA-QSAR method may be useful in ligand-based virtual screening of new molecular entities of therapeutic utility.

The intersection of culture, disability and assistive technology.

PubMed

Ripat, Jacquie; Woodgate, Roberta

2011-01-01

Although the use of assistive technology (AT) is by an individual, it occurs within a much larger socio-cultural environment. The purpose of this article is to describe and analyse current knowledge about the intersection of culture and disability in the context of the AT user. Literature review of theoretical and empirical study papers that discuss cultural aspects related to AT use or provision. Understanding how an individual's culturally defined identity is shaped as an AT user, and the meaning the AT holds to that person and family, is essential to providing culturally appropriate AT services. AT providers also belong to a culture framed by their professional experiences; needed are ways of addressing ethnocentricity within culturally diverse practice settings. Some AT users may identify with a disability culture, a culture formed by a shared set of beliefs, values and behaviours around the construct of disability. This review reveals there is a paucity of knowledge about the intersection of AT and culture, and that this intersection requires further research. Embarking on this investigation is mandatory if we seek to meet the needs of the culturally diverse individuals who use AT.

Global Mental Health: Five Areas for Value-Driven Training Innovation.

PubMed

Kohrt, Brandon A; Marienfeld, Carla B; Panter-Brick, Catherine; Tsai, Alexander C; Wainberg, Milton L

2016-08-01

In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. Priority values included humility, ethical awareness of power differentials, collaborative action, and "deep accountability" when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.

Global Mental Health: Five Areas for Value-Driven Training Innovation

PubMed Central

Kohrt, Brandon A.; Marienfeld, Carla B.; Panter-Brick, Catherine; Tsai, Alexander C.; Wainberg, Milton L.

2016-01-01

OBJECTIVE In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. METHODS Participants (n=48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. RESULTS Priority values included humility, ethical awareness of power differentials, collaborative action, and “deep accountability” when working in low-resource settings in both low- and middle-income countries (LMIC) and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors other than medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. CONCLUSIONS Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists. PMID:26983416

Evaluation of perceived collaborative behaviour amongst stakeholders and clinicians of a continuing education programme in arthritis care.

PubMed

Lundon, Katie; Kennedy, Carol; Rozmovits, Linda; Sinclair, Lynne; Shupak, Rachel; Warmington, Kelly; Passalent, Laura; Brooks, Sydney; Schneider, Rayfel; Soever, Leslie

2013-09-01

Successful implementation of new extended practice roles which transcend conventional boundaries of practice entails strong collaboration with other healthcare providers. This study describes interprofessional collaborative behaviour perceived by advanced clinician practitioner in arthritis care (ACPAC) graduates at 1 year beyond training, and relevant stakeholders, across urban, community and remote clinical settings in Canada. A mixed-method approach involved a quantitative (survey) and qualitative (focus group/interview) evaluation issued across a 4-month period. ACPAC graduates work across heterogeneous settings and are on teams of diverse size and composition. Seventy per cent perceived their team as actively working in an interprofessional care model. Mean scores on the Bruyère Clinical Team Self-Assessment on Interprofessional Practice subjective subscales were high (range: 3.66-4.26, scale: 1-5 = better perception of team's interprofessional practice), whereas the objective scale was lower (mean: 4.6, scale: 0-9 = more interprofessional team practices). Data from focus groups (ACPAC graduates) and interviews (stakeholders) provided further illumination of these results at individual, group and system levels. Issues relating to ACPAC graduate role recognition, as well as their deployment, integration and institutional support, including access to medical directives, limitation of scope of practice, remuneration conflicts and tenuous funding arrangements were barriers perceived to affect role implementation and interprofessional working. This study offers the opportunity to reflect on newly introduced roles for health professionals with expectations of collaboration that will challenge traditional healthcare delivery.

DIVERSITY: A new method for evaluating sensitivity of groundwater to contamination

NASA Astrophysics Data System (ADS)

Ray, J. A.; O'Dell, P. W.

1993-12-01

This study outlines an improved method, DIVERSITY, for delineating and rating groundwater sensitivity. It is an acronym for DIspersion/VElocity-Rated SensitivITY, which is based on an assessment of three aquifer characteristics: recharge potential, flow velocity, and flow directions. The primary objective of this method is to produce sensitivity maps at the county or state scale that illustrate intrinsic potential for contamination of the uppermost aquifer. Such maps can be used for recognition of aquifer sensitivity and for protection of groundwater quality. We suggest that overriding factors that strongly affect one or more of the three basic aquifer characteristics may systematically elevate or lower the sensitivity rating. The basic method employs a three-step procedure: (1) Hydrogeologic settings are delineated on the basis of geology and groundwater recharge/discharge position within a terrane. (2) A sensitivity envelope or model for each setting is outlined on a three-component rating graph. (3) Sensitivity ratings derived from the envelope are extrapolated to hydrogeologic setting polygons utilizing overriding and key factors, when appropriate. The three-component sensitivity rating graph employs two logarithmic scales and a relative area scale on which measured and estimated values may be plotted. The flow velocity scale ranging from 0.01 to more than 10,000 m/d is the keystone of the rating graph. Whenever possible, actual time-of-travel values are plotted on the velocity scale to bracket the position of a sensitivity envelope. The DIVERSITY method was developed and tested for statewide use in Kentucky, but we believe it is also practical and applicable for use in almost any other area.

Genetic Patterns of Common-Bean Seed Acquisition and Early-Stage Adoption Among Farmer Groups in Western Uganda

PubMed Central

Wilkus, Erin L.; Berny Mier y Teran, Jorge C.; Mukankusi, Clare M.; Gepts, Paul

2018-01-01

Widespread adoption of new varieties can be valuable, especially where improved agricultural production technologies are hard to access. However, as farmers adopt new varieties, in situ population structure and genetic diversity of their seed holdings can change drastically. Consequences of adoption are still poorly understood due to a lack of crop genetic diversity assessments and detailed surveys of farmers' seed management practices. Common bean (Phaseolus vulgaris) is an excellent model for these types of studies, as it has a long history of cultivation among smallholder farmers, exhibits eco-geographic patterns of diversity (e.g., Andean vs. Mesoamerican gene-pools), and has been subjected to post-Columbian dispersal and recent introduction of improved cultivars. The Hoima district of western Uganda additionally provides an excellent social setting for evaluating consequences of adoption because access to improved varieties has varied across farmer groups in this production region. This study establishes a baseline understanding of the common bean diversity found among household producers in Uganda and compares the crop population structure, diversity and consequences of adoption of household producers with different adoption practices. Molecular diversity analysis, based on 4,955 single nucleotide polymorphism (SNP) markers, evaluated a total of 1,156 seed samples that included 196 household samples collected from household producers in the Hoima district, 19 breeder-selected varieties used in participatory breeding activities that had taken place prior to the study in the region, and a global bean germplasm collection. Households that had participated in regional participatory breeding efforts were more likely to adopt new varieties and, consequently, diversify their seed stocks than those that had not participated. Of the three farmer groups that participated in breeding efforts, households from the farmer group with the longest history of bean production were more likely to conserve “Seed Engufu”, a local “Calima”-type variety of the Andean bean gene pool, and, at the same time, introduce rare Mesoamerican gene pool varieties into household seed stocks. PMID:29868053

Genetic Patterns of Common-Bean Seed Acquisition and Early-Stage Adoption Among Farmer Groups in Western Uganda.

PubMed

Wilkus, Erin L; Berny Mier Y Teran, Jorge C; Mukankusi, Clare M; Gepts, Paul

2018-01-01

Widespread adoption of new varieties can be valuable, especially where improved agricultural production technologies are hard to access. However, as farmers adopt new varieties, in situ population structure and genetic diversity of their seed holdings can change drastically. Consequences of adoption are still poorly understood due to a lack of crop genetic diversity assessments and detailed surveys of farmers' seed management practices. Common bean ( Phaseolus vulgaris ) is an excellent model for these types of studies, as it has a long history of cultivation among smallholder farmers, exhibits eco-geographic patterns of diversity (e.g., Andean vs. Mesoamerican gene-pools), and has been subjected to post-Columbian dispersal and recent introduction of improved cultivars. The Hoima district of western Uganda additionally provides an excellent social setting for evaluating consequences of adoption because access to improved varieties has varied across farmer groups in this production region. This study establishes a baseline understanding of the common bean diversity found among household producers in Uganda and compares the crop population structure, diversity and consequences of adoption of household producers with different adoption practices. Molecular diversity analysis, based on 4,955 single nucleotide polymorphism (SNP) markers, evaluated a total of 1,156 seed samples that included 196 household samples collected from household producers in the Hoima district, 19 breeder-selected varieties used in participatory breeding activities that had taken place prior to the study in the region, and a global bean germplasm collection. Households that had participated in regional participatory breeding efforts were more likely to adopt new varieties and, consequently, diversify their seed stocks than those that had not participated. Of the three farmer groups that participated in breeding efforts, households from the farmer group with the longest history of bean production were more likely to conserve "Seed Engufu", a local "Calima"-type variety of the Andean bean gene pool, and, at the same time, introduce rare Mesoamerican gene pool varieties into household seed stocks.

Influence of Ethnolinguistic Diversity on the Sorghum Genetic Patterns in Subsistence Farming Systems in Eastern Kenya

PubMed Central

Labeyrie, Vanesse; Deu, Monique; Barnaud, Adeline; Calatayud, Caroline; Buiron, Marylène; Wambugu, Peterson; Manel, Stéphanie; Glaszmann, Jean-Christophe; Leclerc, Christian

2014-01-01

Understanding the effects of actions undertaken by human societies on crop evolution processes is a major challenge for the conservation of genetic resources. This study investigated the mechanisms whereby social boundaries associated with patterns of ethnolinguistic diversity have influenced the on-farm distribution of sorghum diversity. Social boundaries limit the diffusion of planting material, practices and knowledge, thus shaping crop diversity in situ. To assess the effect of social boundaries, this study was conducted in the contact zone between the Chuka, Mbeere and Tharaka ethnolinguistic groups in eastern Kenya. Sorghum varieties were inventoried and samples collected in 130 households. In all, 297 individual plants derived from seeds collected under sixteen variety names were characterized using a set of 18 SSR molecular markers and 15 morphological descriptors. The genetic structure was investigated using both a Bayesian assignment method and distance-based clustering. Principal Coordinates Analysis was used to describe the structure of the morphological diversity of the panicles. The distribution of the varieties and the main genetic clusters across ethnolinguistic groups was described using a non-parametric MANOVA and pairwise Fisher tests. The spatial distribution of landrace names and the overall genetic spatial patterns were significantly correlated with ethnolinguistic partition. However, the genetic structure inferred from molecular makers did not discriminate the short-cycle landraces despite their morphological distinctness. The cases of two improved varieties highlighted possible fates of improved materials. The most recent one was often given the name of local landraces. The second one, that was introduced a dozen years ago, displays traces of admixture with local landraces with differential intensity among ethnic groups. The patterns of congruence or discordance between the nomenclature of farmers’ varieties and the structure of both genetic and morphological diversity highlight the effects of the social organization of communities on the diffusion of seed, practices, and variety nomenclature. PMID:24637745

Impact of race on the professional lives of physicians of African descent.

PubMed

Nunez-Smith, Marcella; Curry, Leslie A; Bigby, JudyAnn; Berg, David; Krumholz, Harlan M; Bradley, Elizabeth H

2007-01-02

Increasing the racial and ethnic diversity of the physician workforce is a national priority. However, insight into the professional experiences of minority physicians is limited. This knowledge is fundamental to developing effective strategies to recruit, retain, and support a diverse physician workforce. To characterize how physicians of African descent experience race in the workplace. Qualitative study based on in-person and in-depth racially concordant interviews using a standard discussion guide. The 6 New England states in the United States. 25 practicing physicians of African descent representing a diverse range of primary practice settings, specialties, and ages. Professional experiences of physicians of African descent. 1) Awareness of race permeates the experience of physicians of African descent in the health care workplace; 2) race-related experiences shape interpersonal interactions and define the institutional climate; 3) responses to perceived racism at work vary along a spectrum from minimization to confrontation; 4) the health care workplace is often silent on issues of race; and 5) collective race-related experiences can result in "racial fatigue," with personal and professional consequences for physicians. The study was restricted to New England and may not reflect the experiences of physicians in other geographic regions. The findings are meant to be hypothesis-generating and require additional follow-up studies. The issue of race remains a pervasive influence in the work lives of physicians of African descent. Without sufficient attention to the specific ways in which race shapes physicians' work experiences, health care organizations are unlikely to create environments that successfully foster and sustain a diverse physician workforce.

Twelve evidence-based principles for implementing self-management support in primary care.

PubMed

Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H

2010-12-01

Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

Training and experience of nurses in responding to alcohol misuse in rural communities.

PubMed

Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

2013-07-01

Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

The role of collaborative ontology development in the knowledge negotiation process

NASA Astrophysics Data System (ADS)

Rivera, Norma

Interdisciplinary research (IDR) collaboration can be defined as the process of integrating experts' knowledge, perspectives, and resources to advance scientific discovery. The flourishing of more complex research problems, together with the growth of scientific and technical knowledge has resulted in the need for researchers from diverse fields to provide different expertise and points of view to tackle these problems. These collaborations, however, introduce a new set of "culture" barriers as participating experts are trained to communicate in discipline-specific languages, theories, and research practices. We propose that building a common knowledge base for research using ontology development techniques can provide a starting point for interdisciplinary knowledge exchange, negotiation, and integration. The goal of this work is to extend ontology development techniques to support the knowledge negotiation process in IDR groups. Towards this goal, this work presents a methodology that extends previous work in collaborative ontology development and integrates learning strategies and tools to enhance interdisciplinary research practices. We evaluate the effectiveness of applying such methodology in three different scenarios that cover educational and research settings. The results of this evaluation confirm that integrating learning strategies can, in fact, be advantageous to overall collaborative practices in IDR groups.

Rel8: demonstrating the feasibility of delivering an 8-week social skills program in a public mental health setting.

PubMed

Wauchope, Bronwyn; Terlich, Alissa; Lee, Stuart

2016-06-01

As community mental health services integrate recovery-oriented practices, treatments that focus on skills development and social integration are desirable. This study aimed to examine the feasibility of implementing "Rel8", an 8-week social skills training group adapted to suit a public community mental health setting. A retrospective audit was conducted of quantitative and qualitative data from four groups run between 2011 and 2013. Pre- and post-group measures were collected, assessing self-rated friendships and confidence with social skills and clinician-rated social skill performance. Qualitative feedback about group participation was also collected through use of a developed questionnaire. Analysis revealed significant improvements in participants' confidence with their social skills following group participation, with a trend also found for improved social skill performance. "Rel8", an adapted 8-week social skills training group, is a feasible program in the context of community mental health services. The program added to the recovery-centred practice of the community mental health service while also adding to the diversity of clinician skills for psychosocial-oriented practice. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health

PubMed Central

Llamas, Ana; Mayhew, Susannah

2016-01-01

Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the ‘Vertical Birth’—a practical manifestation of an intercultural health policy aimed at increasing indigenous women’s access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings. Our results also show that Kingdon’s model was useful in explaining how the VB practice emerged but also that it needs modifications when applied to low and middle income countries. PMID:26758539

Whither Risk Assessment: New Challenges and Opportunities a Third of a Century After the Red Book.

PubMed

Greenberg, Michael; Goldstein, Bernard D; Anderson, Elizabeth; Dourson, Michael; Landis, Wayne; North, D Warner

2015-11-01

Six multi-decade-long members of SRA reflect on the 1983 Red Book in order to examine the evolving relationship between risk assessment and risk management; the diffusion of risk assessment practice to risk areas such as homeland security and transportation; the quality of chemical risk databases; challenges from other groups to elements at the core of risk assessment practice; and our collective efforts to communicate risk assessment to a diverse set of critical groups that do not understand risk, risk assessment, or many other risk-related issues. The authors reflect on the 10 recommendations in the Red Book and present several pressing challenges for risk assessment practitioners. © 2015 Society for Risk Analysis.

Supporting good practice in the provision of services to people with comorbid mental health and alcohol and other drug problems in Australia: describing key elements of good service models.

PubMed

Merkes, Monika; Lewis, Virginia; Canaway, Rachel

2010-12-03

The co-occurrence of mental illness and substance use problems (referred to as "comorbidity" in this paper) is common, and is often reported by service providers as the expectation rather than the exception. Despite this, many different treatment service models are being used in the alcohol and other drugs (AOD) and mental health (MH) sectors to treat this complex client group. While there is abundant literature in the area of comorbidity treatment, no agreed overarching framework to describe the range of service delivery models is apparent internationally or at the national level. The aims of the current research were to identify and describe elements of good practice in current service models of treatment of comorbidity in Australia. The focus of the research was on models of service delivery. The research did not aim to measure the client outcomes achieved by individual treatment services, but sought to identify elements of good practice in services. Australian treatment services were identified to take part in the study through a process of expert consultation. The intent was to look for similarities in the delivery models being implemented across a diverse set of services that were perceived to be providing good quality treatment for people with comorbidity problems. A survey was designed based on a concept map of service delivery devised from a literature review. Seventeen Australian treatment services participated in the survey, which explored the context in which services operate, inputs such as organisational philosophy and service structure, policies and procedures that guide the way in which treatment is delivered by the service, practices that reflect the way treatment is provided to clients, and client impacts. The treatment of people with comorbidity of mental health and substance use disorders presents complex problems that require strong but flexible service models. While the treatment services included in this study reflected the diversity of settings and approaches described in the literature, the research found that they shared a range of common characteristics. These referred to: service linkages; workforce; policies, procedures and practices; and treatment.

Bringing Cultural Diversity to Feminist Psychology. Theory, Research, and Practice.

ERIC Educational Resources Information Center

Landrine, Hope, Ed.

This book focuses on the theoretical, empirical and practice-based implications of recognizing cultural diversity in the psychology of women. Contributors to this volume share the common objective of keeping feminist psychology robust and useful. Chapters in the first section, "Cultural Diversity in Theory and Methodology in Feminist…

78 FR 77792 - Extension of Comment Period for Proposed Interagency Policy Statement Establishing Joint...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

... Statement Establishing Joint Standards for Assessing the Diversity Policies and Practices of Entities... establishing standards for assessing the diversity policies and practices of the entities they regulate.\\1\\ To... Diversity and Inclusion, at (202) 452-2883; or Katherine Wheatley, Associate General Counsel, Legal Division...

Latina/o Academics' Resilient Qualities in Their Linguistically Diverse Practices

ERIC Educational Resources Information Center

Cavazos, Alyssa G.

2016-01-01

Emphasis placed on academic writing in English may create challenges for multilingual academics as they negotiate diverse languages. Based on personal interviews with bilingual Latina/o academics in rhetoric and composition, this study reveals that their language practices reflect diverse resilient qualities at various stages in their academic…

State of the Diversity Practice in Independent Schools

ERIC Educational Resources Information Center

Torres, Amada

2015-01-01

During the spring of 2014, the National Association of Independent Schools (NAIS) commissioned Insightlink Communications, a market research firm, to conduct the second survey on the state of the diversity practice in independent schools. The goals of the study included defining the roles played by diversity practitioners, their functions, and…

Friendliness, functionality and freedom: Design characteristics that support midwifery practice in the hospital setting.

PubMed

Hammond, Athena; Homer, Caroline S E; Foureur, Maralyn

2017-07-01

to identify and describe the design characteristics of hospital birth rooms that support midwives and their practice. this study used a qualitative exploratory descriptive methodology underpinned by the theoretical approach of critical realism. Data was collected through 21 in-depth, face-to-face photo-elicitation interviews and a thematic analysis guided by study objectives and the aims of exploratory research was undertaken. the study was set at a recently renovated tertiary hospital in a large Australian city. participants were 16 registered midwives working in a tertiary hospital; seven in delivery suite and nine in birth centre settings. Experience as a midwife ranged from three to 39 years and the sample included midwives in diverse roles such as educator, student support and unit manager. three design characteristics were identified that supported midwifery practice. They were friendliness, functionality and freedom. Friendly rooms reduced stress and increased midwives' feelings of safety. Functional rooms enabled choice and provided options to better meet the needs of labouring women. And freedom allowed for flexible, spontaneous and responsive midwifery practice. hospital birth rooms that possess the characteristics of friendliness, functionality and freedom offer enhanced support for midwives and may therefore increase effective care provision. new and existing birth rooms can be designed or adapted to better support the wellbeing and effectiveness of midwives and may thereby enhance the quality of midwifery care delivered in the hospital. Quality midwifery care is associated with positive outcomes and experiences for labouring women. Further research is required to investigate the benefit that may be transmitted to women by implementing design intended to support and enhance midwifery practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Delivery and postpartum practices among new mothers in Laputta, Myanmar: intersecting traditional and modern practices and beliefs.

PubMed

Diamond-Smith, Nadia; Thet, May Me; Khaing, Ei Ei; Sudhinaraset, May

2016-09-01

Myanmar is witnessing increased access to modern maternity care, along with shifting norms and practices. Past research has documented low rates of facility-based deliveries in the country, along with adverse maternal and child health outcomes. Research has also documented diverse traditional practices in the postpartum period, related to maternity care and maternal food intake. Through 34 qualitative interviews with women who recently gave birth and their mothers-in-law in one township in Myanmar (Laputta), we explore factors influencing decision-making around postpartum care and the practices that women engage in. We find that women use both modern and traditional providers because different types of providers play particular roles in the delivery and postpartum period. Despite knowledge of about healthy foods to eat postpartum, many women restrict the intake of certain foods, and mothers-in-laws' beliefs in these practices are particularly strong. Findings suggest that women and their families are balancing two different sets of practices and beliefs, which at times come in conflict. Educational campaigns and programmes should address both modern and traditional beliefs and practices to help women be better able to access safe care and improve their own and their children's health.

Everyday politics, social practices and movement networks: daily life in Barcelona's social centres.

PubMed

Yates, Luke

2015-06-01

The relations between everyday life and political participation are of interest for much contemporary social science. Yet studies of social movement protest still pay disproportionate attention to moments of mobilization, and to movements with clear organizational boundaries, tactics and goals. Exceptions have explored collective identity, 'free spaces' and prefigurative politics, but such processes are framed as important only in accounting for movements in abeyance, or in explaining movement persistence. This article focuses on the social practices taking place in and around social movement spaces, showing that political meanings, knowledge and alternative forms of social organization are continually being developed and cultivated. Social centres in Barcelona, Spain, autonomous political spaces hosting cultural and educational events, protest campaigns and alternative living arrangements, are used as empirical case studies. Daily practices of food provisioning, distributing space and dividing labour are politicized and politicizing as they unfold and develop over time and through diverse networks around social centres. Following Melucci, such latent processes set the conditions for social movements and mobilization to occur. However, they not only underpin mobilization, but are themselves politically expressive and prefigurative, with multiple layers of latency and visibility identifiable in performances of practices. The variety of political forms - adversarial, expressive, theoretical, and routinized everyday practices, allow diverse identities, materialities and meanings to overlap in movement spaces, and help explain networks of mutual support between loosely knit networks of activists and non-activists. An approach which focuses on practices and networks rather than mobilization and collective actors, it is argued, helps show how everyday life and political protest are mutually constitutive. © London School of Economics and Political Science 2014.

TeenDrivingPlan effectiveness: the effect of quantity and diversity of supervised practice on teens' driving performance.

PubMed

Mirman, Jessica H; Albert, W Dustin; Curry, Allison E; Winston, Flaura K; Fisher Thiel, Megan C; Durbin, Dennis R

2014-11-01

The large contribution of inexperience to the high crash rate of newly licensed teens suggests that they enter licensure with insufficient skills. In a prior analysis, we found moderate support for a direct effect of a web-based intervention, the TeenDrivingPlan (TDP), on teens' driving performance. The purpose of the present study was to identify the mechanisms by which TDP may be effective and to extend our understanding of how teens learn to drive. A randomized controlled trial conducted with teen permit holders and parent supervisors (N = 151 dyads) was used to determine if the effect of TDP on driver performance operated through five hypothesized mediators: (1) parent-perceived social support; (2) teen-perceived social support; (3) parent engagement; (4) practice quantity; and (5) practice diversity. Certified driving evaluators, blinded to teens' treatment allocation, assessed teens' driving performance 24 weeks after enrollment. Mediator variables were assessed on self-report surveys administered periodically over the study period. Exposure to TDP increased teen-perceived social support, parent engagement, and practice diversity. Both greater practice quantity and diversity were associated with better driving performance, but only practice diversity mediated the relationship between TDP and driver performance. Practice diversity is feasible to change and increases teens' likelihood of completing a rigorous on-road driving assessment just before licensure. Future research should continue to identify mechanisms that diversify practice driving, explore complementary ways to help families optimize the time they spend on practice driving, and evaluate the long-term effectiveness of TDP. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Relaxed Observance of Traditional Marriage Rules Allows Social Connectivity without Loss of Genetic Diversity.

PubMed

Guillot, Elsa G; Hazelton, Martin L; Karafet, Tatiana M; Lansing, J Stephen; Sudoyo, Herawati; Cox, Murray P

2015-09-01

Marriage rules, the community prescriptions that dictate who an individual can or cannot marry, are extremely diverse and universally present in traditional societies. A major focus of research in the early decades of modern anthropology, marriage rules impose social and economic forces that help structure societies and forge connections between them. However, in those early anthropological studies, the biological benefits or disadvantages of marriage rules could not be determined. We revisit this question by applying a novel simulation framework and genome-wide data to explore the effects of Asymmetric Prescriptive Alliance, an elaborate set of marriage rules that has been a focus of research for many anthropologists. Simulations show that strict adherence to these marriage rules reduces genetic diversity on the autosomes, X chromosome and mitochondrial DNA, but relaxed compliance produces genetic diversity similar to random mating. Genome-wide data from the Indonesian community of Rindi, one of the early study populations for Asymmetric Prescriptive Alliance, are more consistent with relaxed compliance than strict adherence. We therefore suggest that, in practice, marriage rules are treated with sufficient flexibility to allow social connectivity without significant degradation of biological diversity. © The Author 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

The feeding practices and structure questionnaire: construction and initial validation in a sample of Australian first-time mothers and their 2-year olds.

PubMed

Jansen, Elena; Mallan, Kimberley M; Nicholson, Jan M; Daniels, Lynne A

2014-06-04

Early feeding practices lay the foundation for children's eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years). Data were from 462 mothers and children (age 21-27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight. Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach's α: 0.61-0.89). Four factors reflected non-responsive feeding practices: 'Distrust in Appetite', 'Reward for Behaviour', 'Reward for Eating', and 'Persuasive Feeding'. Five factors reflected structure of the meal environment and limits: 'Structured Meal Setting', 'Structured Meal Timing', 'Family Meal Setting', 'Overt Restriction' and 'Covert Restriction'. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight. The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required.

Prepared to practice? Perception of career preparation and guidance of recent medical graduates at two campuses of a transnational medical school: a cross-sectional study.

PubMed

Kassim, Sameer S; McGowan, Yvonne; McGee, Hannah; Whitford, David L

2016-02-09

Graduating medical students enter the workforce with substantial medical knowledge and experience, yet little is known about how well they are prepared for the transition to medical practice in diverse settings. We set out to compare perceptions of medical school graduates' career guidance with their perceptions of preparedness to practice as interns. We also set out to compare perceptions of preparedness for hospital practice between graduates from two transnational medical schools. This was a cross-sectional study. A Preparedness for Hospital Practice (PHPQ) survey and career guidance questionnaire was sent to recent medical graduates, incorporating additional free text responses on career preparation. Data was analyzed using descriptive statistics and tests of association including Chi-square, Mann-Whitney U and Kruskal-Wallis H tests. Forty three percent (240/555) of graduates responded to the survey: 39 % of respondents were domestic (Dublin, Ireland or Manama, Kingdom of Bahrain) and interning locally; 15 % were overseas students interning locally; 42 % were overseas students interning internationally and 4 % had not started internship. Two variables explained 13 % of the variation in preparedness for hospital practice score: having planned postgraduate education prior to entering medical school and having helpful career guidance in medical school. Overseas graduates interning internationally were more likely to have planned their postgraduate career path prior to entering medical school. Dublin graduates found their career guidance more helpful than Bahrain counterparts. The most cited shortcomings were lack of structured career advice and lack of advice on the Irish and Bahraini postgraduate systems. This study has demonstrated that early consideration of postgraduate career preparation and helpful medical school career guidance has a strong association with perceptions of preparedness of medical graduates for hospital practice. In an era of increasing globalization of medical education, these findings can direct ongoing efforts to ensure all medical students receive career guidance and preparation for internship appropriate to their destination.

Does Staff Diversity Imply Openness to Diversity?

ERIC Educational Resources Information Center

Lauring, Jakob; Selmer, Jan

2013-01-01

Purpose: Post-secondary educational organizations are currently some of the most diverse settings to be found. However, few educational studies have dealt with staff diversity and hardly any has looked outside the USA. The purpose of this paper is to present a study of members of international university departments in Denmark. The authors set out…

Race/ethnicity and workplace discrimination: results of a national survey of physicians.

PubMed

Nunez-Smith, Marcella; Pilgrim, Nanlesta; Wynia, Matthew; Desai, Mayur M; Jones, Beth A; Bright, Cedric; Krumholz, Harlan M; Bradley, Elizabeth H

2009-11-01

Promoting racial/ethnic diversity within the physician workforce is a national priority. However, the extent of racial/ethnic discrimination reported by physicians from diverse backgrounds in today's health-care workplace is unknown. To determine the prevalence of physician experiences of perceived racial/ethnic discrimination at work and to explore physician views about race and discussions regarding race/ethnicity in the workplace. Cross-sectional, national survey conducted in 2006-2007. Practicing physicians (total n = 529) from diverse racial/ethnic backgrounds in the United States. We examined physicians' experience of racial/ethnic discrimination over their career course, their experience of discrimination in their current work setting, and their views about race/ethnicity and discrimination at work. The proportion of physicians who reported that they had experienced racial/ethnic discrimination "sometimes, often, or very often" during their medical career was substantial among non-majority physicians (71% of black physicians, 45% of Asian physicians, 63% of "other" race physicians, and 27% of Hispanic/Latino(a) physicians, compared with 7% of white physicians, all p < 0.05). Similarly, the proportion of non-majority physicians who reported that they experienced discrimination in their current work setting was substantial (59% of black, 39% of Asian, 35% of "other" race, 24% of Hispanic/Latino(a) physicians, and 21% of white physicians). Physician views about the role of race/ethnicity at work varied significantly by respondent race/ethnicity. Many non-majority physicians report experiencing racial/ethnic discrimination in the workplace. Opportunities exist for health-care organizations and diverse physicians to work together to improve the climate of perceived discrimination where they work.

Second language learning in a family nurse practitioner and nurse midwifery diversity education project.

PubMed

Kelley, Frances J; Klopf, Maria Ignacia

2008-10-01

To describe the Clinical Communication Program developed to integrate second language learning (L2), multimedia, Web-based technologies, and the Internet in an advanced practice nursing education program. Electronic recording devices as well as audio, video editing, Web design, and programming software were used as tools for developing L2 scenarios for practice in clinical settings. The Clinical Communication Program offers opportunities to support both students and faculty members to develop their linguistic and cultural competence skills to serve better their patients, in general, and their students who speak a language other than English, in particular. The program provided 24 h on-demand access for using audio, video, and text exercises via the Internet. L2 education for healthcare providers includes linguistic (listening, speaking, reading, and writing) experiences as well as cultural competence and practices inside and outside the classroom environment as well as online and offline the Internet realm.

The Evolution of Gero-Oncology Nursing

PubMed Central

Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

2016-01-01

Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

Understanding Digital Note-Taking Practice for Visualization.

PubMed

Willett, Wesley; Goffin, Pascal; Isenberg, Petra

2015-05-13

We present results and design implications from a study of digital note-taking practice to examine how visualization can support revisitation, reflection, and collaboration around notes. As digital notebooks become common forms of external memory, keeping track of volumes of content is increasingly difficult. Information visualization tools can help give note-takers an overview of their content and allow them to explore diverse sets of notes, find and organize related content, and compare their notes with their collaborators. To ground the design of such tools, we conducted a detailed mixed-methods study of digital note-taking practice. We identify a variety of different editing, organization, and sharing methods used by digital note-takers, many of which result in notes becoming "lost in the pile''. These findings form the basis for our design considerations that examine how visualization can support the revisitation, organization, and sharing of digital notes.

Education, outreach, and inclusive engagement: Towards integrated indicators of successful program outcomes in participatory science.

PubMed

Haywood, Benjamin K; Besley, John C

2014-01-01

The use and utility of science in society is often influenced by the structure, legitimacy, and efficacy of the scientific research process. Public participation in scientific research (PPSR) is a growing field of practice aimed at enhancing both public knowledge and understanding of science (education outreach) and the efficacy and responsiveness of scientific research, practice, and policy (participatory engagement). However, PPSR objectives focused on "education outreach" and "participatory engagement" have each emerged from diverse theoretical traditions that maintain distinct indicators of success used for program development and evaluation. Although areas of intersection and overlap among these two traditions exist in theory and practice, a set of comprehensive standards has yet to coalesce that supports the key principles of both traditions in an assimilated fashion. To fill this void, a comprehensive indicators framework is proposed with the goal of promoting a more integrative and synergistic PPSR program development and assessment process.

Conclusion: Agency in the face of complexity and the future of assumption-aware evaluation practice.

PubMed

Morrow, Nathan; Nkwake, Apollo M

2016-12-01

This final chapter in the volume pulls together common themes from the diverse set of articles by a group of eight authors in this issue, and presents some reflections on the next steps for improving the ways in which evaluators work with assumptions. Collectively, the authors provide a broad overview of existing and emerging approaches to the articulation and use of assumptions in evaluation theory and practice. The authors reiterate the rationale and key terminology as a common basis for working with assumption in program design and evaluation. They highlight some useful concepts and categorizations to promote more rigorous treatment of assumptions in evaluation. A three-tier framework for fostering agency for assumption-aware evaluation practice is proposed-agency for themselves (evaluators); agency for others (stakeholders); and agency for standards and principles. Copyright © 2016 Elsevier Ltd. All rights reserved.

From idea to implementation: creation of an educational picture book for radiation therapy patients.

PubMed

Osmar, Kari; Webb, Deborah

2015-03-01

Patient education is an integral part of the cancer patient's journey. Radiation therapists strive to provide timely, effective, and evidence-based information on care processes, side effects, and side effect management treatment strategies. Patient satisfaction surveys in health-care settings can guide new interventions and strategies to provide the right education to patients at the right time. Courses offered in adult education and patient education to practicing health-care providers allow for a unique opportunity to look at the current provision of health-care education to patients. This paper explores the development and implementation of a new visual aid for radiation therapy patients in an acute health-care setting with a diversity of languages spoken using principles of adult education.

Promoting High-Quality Cancer Care and Equity Through Disciplinary Diversity in Team Composition.

PubMed

Parsons, Susan K; Fineberg, Iris C; Lin, Mingqian; Singer, Marybeth; Tang, May; Erban, John K

2016-11-01

Disciplinary diversity in team composition is a valuable vehicle for oncology care teams to provide high-quality, person-centered comprehensive care. Such diversity facilitates care that effectively addresses the complex needs (biologic, psychosocial, and spiritual) of the whole person. The concept of professional or disciplinary diversity centers on differences in function, education, and culture, reflecting variety and heterogeneity in the perspectives of team members contributing to care. Thorough understanding of the skills, knowledge, and education related to each team member's professional or lay expertise is critical for members to be able to optimize the team's potential. Furthermore, respect and appreciation for differences and similarities across disciplinary cultures allow team members to create a positive collaboration dynamic that maintains a focus on the care of the person with cancer. We present a case study of one oncology team's provision of care to the patient, a Chinese immigrant woman with breast cancer. The case illuminates the strengths and challenges of disciplinary diversity in team composition in assessing and addressing potential barriers to care. Coordinated sharing of information among the varied team members facilitated understanding and care planning focused on the patient's concerns, needs, and strengths. Importantly, collaboration across the disciplinarily diverse set of team members facilitated high-quality oncology care and promoted equity in access to the full range of care options, including enrollment on a National Cancer Institute-sponsored clinical trial. Further implications of disciplinary diversity in oncology care teams are considered for both clinical practice and research.

Helping Couples Fulfill the "Highest of Life's Goals": Mate Selection, Marriage Counselling, and Genetic Counseling in United States.

PubMed

Stillwell, Devon

2016-02-01

This article traces the history of modern genetic counseling to mate selection and marriage counselling practices of the early-20th century. Mate selection revolved around a belief that human heredity could be improved and genetic diseases eradicated through better breeding. Marriage counselling, though interested in reproduction, was also concerned with the emotional and psychological well-being of couples. These two practices coalesced most obviously in the work of well-known geneticist Sheldon Reed. Even as marriage and genetic counselling diverged in the post-WWII period, vestiges of these practices remain in contemporary counseling experiences with family planning and genetic screening programs. Emphasizing points of continuity between "positive" eugenic ideologies and modern genetic practices elaborates the diverse origins of genetic counseling. It also exposes how genetic counselors have become involved in genetic enterprises beyond standard clinical settings, and prods at key issues in the interaction between genetic science and social values.

Cross-disciplinary research in cancer: an opportunity to narrow the knowledge–practice gap

PubMed Central

Urquhart, R.; Grunfeld, E.; Jackson, L.; Sargeant, J.; Porter, G.A.

2013-01-01

Health services researchers have consistently identified a gap between what is identified as “best practice” and what actually happens in clinical care. Despite nearly two decades of a growing evidence-based practice movement, narrowing the knowledge–practice gap continues to be a slow, complex, and poorly understood process. Here, we contend that cross-disciplinary research is increasingly relevant and important to reducing that gap, particularly research that encompasses the notion of transdisciplinarity, wherein multiple academic disciplines and non-academic individuals and groups are integrated into the research process. The assimilation of diverse perspectives, research approaches, and types of knowledge is potentially effective in helping research teams tackle real-world patient care issues, create more practice-based evidence, and translate the results to clinical and community care settings. The goals of this paper are to present and discuss cross-disciplinary approaches to health research and to provide two examples of how engaging in such research may optimize the use of research in cancer care. PMID:24311951

The art and nature of health: a study of therapeutic practice in museums.

PubMed

Mangione, Gemma

2018-02-01

Drawing on ethnographic fieldwork and interviews at a major metropolitan art museum and botanic garden, this article considers the practical accomplishment of American museums' 'health turn' by tracing how museum staff develop therapeutic programmes for visitors with disabilities. In doing so, it considers one of medical sociology's fundamental theoretical questions - how ideologies of health order social life - in an unconventional empirical setting. Acknowledging contemporary arguments for both the relative merits and unintended consequences of this policy trend, I focus instead on the particular institutional arrangements, professional norms, and material cultures of art and nature that shape museums' therapeutic work, so as to reveal its effects. Data reveals ideological similarities, but practical differences, between museological and medical understandings of wellness. Extending a 'medical sociology of practice' to new contexts ultimately foregrounds the contingencies, and diversity, of therapeutic mechanisms and meanings, thereby broadening sociological research on healing and healthism. © 2018 Foundation for the Sociology of Health & Illness.

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy.

PubMed

D'Arrigo-Patrick, Justine; Hoff, Chris; Knudson-Martin, Carmen; Tuttle, Amy

2017-09-01

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach. © 2016 Family Process Institute.

The Synergies research-practice partnership project: a 2020 Vision case study

NASA Astrophysics Data System (ADS)

Falk, John H.; Dierking, Lynn D.; Staus, Nancy L.; Wyld, Jennifer N.; Bailey, Deborah L.; Penuel, William R.

2016-03-01

This paper, describes Synergies, an on-going longitudinal study and design effort, being conducted in a diverse, under-resourced community in Portland, Oregon, with the goal of measurably improving STEM learning, interest and participation by early adolescents, both in school and out of school. Authors examine how the work of this particular research-practice partnership is attempting to accommodate the six principles outlined in this issue: (1) to more accurately reflect learning as a lifelong process occurring across settings, situations and time frames; (2) to consider what STEM content is worth learning; (3) to examine learning as a cultural process, involving varied repertoires of practice across learners' everyday lives; (4) to directly involve practitioners (and learners) in the research process; (5) to document how existing and emerging technologies and new media are, and will continue, to shape and redefine the content and practice of STEM learning research; and, (6) to take into account the broader socio-cultural-political contexts of the needs and concerns of the larger global society.

Construction of Difference and Diversity within Policy and Practice in England

ERIC Educational Resources Information Center

Lawson, Hazel; Boyask, Ruth; Waite, Sue

2013-01-01

Policy and practice responses to diversity and difference in pupil populations continue to challenge education systems around the world. This paper considers how teachers' understandings of diversity and difference and their pedagogical responses at the local level are influenced by, and can be reconciled with, policy at the general level with its…

Professional Leadership Practices and Diversity Issues in the U.S. Higher Education System: A Research Synthesis

ERIC Educational Resources Information Center

Karkouti, Ibrahim Mohamad

2016-01-01

This paper examines the effects of negligence toward diversity issues on campus racial climate, describes how exclusionary practices affect minority students' (i.e., Asian American, Hispanic, Black, and Native American) educational experiences, and addresses faculty issues relevant to diversity. In addition, the paper identifies the factors that…

Preparing Culturally Responsive Teachers: Effective Practices in Teacher Education

ERIC Educational Resources Information Center

Ellerbrock, Cheryl R.; Cruz, Bárbara C.; Vásquez, Anete; Howes, Elaine V.

2016-01-01

Despite the growing diversity in our nation's schools, many teacher educators avoid discussions on diversity issues for myriad reasons. As a result, numerous preservice teachers lack quality learning opportunities to become well versed on issues of diversity in meaningful ways that can translate to P-12 practice. This article elaborates on…

The Treatment and Use of Best Practices for Diversity in Position Announcements for New Presidents

ERIC Educational Resources Information Center

Wilson, Jeffery L.; Meyer, Katrina A.

2013-01-01

This study investigated how well institutions were communicating their commitment to diversity within position announcements for presidential openings and whether or not this communication reflected best practices in forwarding the diversity agenda for institutions. The sample included 70 institutions that advertised for a new campus president in…

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

PubMed Central

2013-01-01

Background Goal setting is considered ‘best practice’ in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning & coping planning and appraisal & feedback. All stages are recorded in a patient-held record. In this study we examined the implementation, acceptability and perceived benefits of G-AP in one community rehabilitation team with people recovering from stroke. Methods G-AP was implemented for 6 months with 23 stroke patients. In-depth interviews with 8 patients and 8 health professionals were analysed thematically to investigate views of its implementation, acceptability and perceived benefits. Case notes of interviewed patients were analysed descriptively to assess the fidelity of G-AP implementation. Results G-AP was mostly implemented according to protocol with deviations noted at the planning and appraisal and feedback stages. Each stage was felt to make a useful contribution to the overall process; however, in practice, goal negotiation and goal setting merged into one stage and the appraisal and feedback stage included an explicit decision making component. Only two issues were raised regarding G-APs acceptability: (i) health professionals were concerned about the impact of goal non-attainment on patient’s well-being (patients did not share their concerns), and (ii) some patients and health professionals found the patient-held record unhelpful. G-AP was felt to have a positive impact on patient goal attainment and professional goal setting practice. Collaborative partnerships between health professionals and patients were apparent throughout the process. Conclusions G-AP has been perceived as both beneficial and broadly acceptable in one community rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings. PMID:23705824

Cardiovascular risk assessment of South Asian populations in religious and community settings: a qualitative study.

PubMed

Eastwood, Sophie V; Rait, Greta; Bhattacharyya, Mimi; Nair, Devaki R; Walters, Kate

2013-08-01

Cardiovascular disease (CVD) is a leading cause of mortality, and South Asian groups experience worse outcomes than the general population in the UK. Regular screening for CVD risk factors is recommended, but we do not know the best settings in which to deliver this for ethnically diverse populations. Health promotion in religious and community settings may reduce inequalities in access to cardiovascular preventative health care. To use stakeholders' and attendees' experiences to explore the feasibility and potential impact of cardiovascular risk assessment targeting South Asian groups at religious and community venues and how health checks in these settings might compare with general practice assessments. Qualitative semi-structured interviews were used. The settings were two Hindu temples, one mosque and one Bangladeshi community centre in central and north-west London. Twenty-four participants (12 stakeholders and 12 attendees) were purposively selected for interview. Interviews were recorded and transcribed verbatim. Themes from the data were generated using thematic framework analysis. All attendees reported positive experiences of the assessments. All reported making lifestyle changes after the check, particularly to diet and exercise. Barriers to lifestyle change, e.g. resistance to change from family members, were identified. Advantages of implementing assessments in religious and community settings compared with general practice included accessibility and community encouragement. Disadvantages included reduced privacy, organizational difficulties and lack of follow-up care. Cardiovascular risk assessment in religious and community settings has the potential to trigger lifestyle change in younger participants. These venues should be considered for future health promotional activities.

Linguistically and Culturally Diverse Students' Perceptions of Successful Classroom Practices in a UK Graduate Program

ERIC Educational Resources Information Center

Rich, Sarah

2005-01-01

In this paper, I present the findings of a longitudinal study into the perceptions of linguistically and culturally diverse practicing teachers in a graduate program in the United Kingdom (UK) with regard to pedagogic practices deemed successful in helping them negotiate access to an academic community of practice. It is argued that an approach…

Linguistically Diverse Students and Special Education: A Mixed Methods Study of Teachers' Attitudes, Coursework, and Practice

ERIC Educational Resources Information Center

Greenfield, Renee A.

2011-01-01

While the number of linguistically diverse students (LDS) grows steadily in the U.S., schools, research and practice to support their education lag behind (Lucas & Grinberg, 2008). Research that describes the attitudes and practices of teachers who serve LDS and how those attitudes and practice intersect with language and special education is…

The effect of physician practice organization on efficient utilization of hospital resources.

PubMed Central

Burns, L R; Chilingerian, J A; Wholey, D R

1994-01-01

OBJECTIVE. This study examines variations in the efficient use of hospital resources across individual physicians. DATA SOURCES AND SETTING. The study is conducted over a two-year period (1989-1990) in all short-term general hospitals with 50 or more beds in Arizona. We examine hospital discharge data for 43,625 women undergoing cesarean sections and vaginal deliveries without complications. These data include physician identifiers that permit us to link patient information with information on physicians provided by the state medical association. STUDY DESIGN. The study first measures the contribution of physician characteristics to the explanatory power of regression models that predict resource use. It then tests hypothesized effects on resource utilization exerted by two sets of physician level factors: physician background and physician practice organization. The latter includes effects of hospital practice volume, concentration of hospital practice, percent managed care patients in one's hospital practice, and diversity of patients treated. Efficiency (inefficiency) is measured as the degree of variation in patient charges and length of stay below (above) the average of treating all patients with the same condition in the same hospital in the same year with the same severity of illness, controlling for discharge status and the presence of complications. PRINCIPAL FINDINGS. After controlling for patient factors, physician characteristics explain a significant amount of the variability in hospital charges and length of stay in the two maternity conditions. Results also support hypotheses that efficiency is influenced by practice organization factors such as patient volume and managed care load. Physicians with larger practices and a higher share of managed care patients appear to be more efficient. CONCLUSIONS. The results suggest that health care reform efforts to develop physician-hospital networks and managed competition may promote greater parsimony in physicians' practice behavior. PMID:8002351

Practical Strategies for Integrating Interprofessional Education and Collaboration into the Curriculum.

PubMed

Prast, Jean; Herlache-Pretzer, Ellen; Frederick, Andrea; Gafni-Lachter, Liat

2016-01-01

Interprofessional collaboration is vital for the provision of quality patient care. Thoughtfully designed educational programs can help students of health professions develop interprofessional competencies and capacities, including values and ethics, roles and responsibilities, interprofessional communication, and teamwork (Interprofessional Education Collaborative Expert Panel, 2011). The authors were involved in developing Interprofessional Education (IPE) activities and simulations to be infused into the curriculums of the various health professions programs in their College. A review of the IPE experiences revealed students greatly benefited from involvement in a diverse set of IPE activities and simulations.

Impact of Stand Management Practices on Beetle Diversity

Treesearch

Stephen P. Cook

2004-01-01

Abstract - Insects are useful indicators of change within ecosystems because of their abundance, richness and functional importance. Stand management practices impact the insect community within a forest. Therefore, the objective of the project is to determine the impact of various stand management practices on the diversity of beetles within...

Educational Achievement and Effective Schools: Examples of Best Practice

ERIC Educational Resources Information Center

Suarez-Ortega, Magdalena; Ballesteros-Velazquez, Belen; Malik-Lievano, Beatriz

2012-01-01

In this article, we present key aspects of a research project entitled "Students' Cultural Diversity and School Efficacy: A Repertory of Best Practice in Compulsory Learning Centers." First, we present our concept of cultural diversity and a reflection regarding "best school practices" and the notion of "student…

Diversity Practice in Social Work: Examining Theory in Practice

ERIC Educational Resources Information Center

Davis, Tamara S.

2009-01-01

Individualized care in children's services requires practitioners to move beyond individual worldviews to gain a cultural context for service planning and delivery to an increasingly diversifying U.S. population. As such, research is needed to empirically support diversity practice models used to prepare practitioners for cross-cultural work. This…

Embracing "Soft Skill" Diversity in the Workplace (Invited)

NASA Astrophysics Data System (ADS)

Thomas, T.

2010-12-01

Embracing "Soft Skill" Diversity in the Workplace Terri Thomas, Sr. Director Global Customer Support ShoreTel INRODUCTION Truly successful diversity programs go beyond gender, age, ethnicity, race, sexual orientation and spiritual practice. They include diversity of thought, style, leadership and communication styles, the so called “soft skills”. The increasing need for global workforces is stronger than ever and high performance teams have fully embraced, successfully harnessed and put into practice robust diversity programs than include a “soft skill” focus. Managing diversity presents significant organizational challenges, and is not an easy task, particularly in organizations that are heavily weighted with highly technical professionals such as engineers, accountants etc.. The focus of this presentation is on leveraging the “Soft Skills” diversity in technical work environments to create high performance and highly productive teams. WHY DIVERSITY and WHY NOW? Due to increasing changes in the U.S. population, in order to stay competitive, companies need to focus on diversity and look for ways to become inclusive organizations because diversity has the potential of yielding greater productivity and competitive advantages . Managing and valuing diversity is a key component of effective people management, which can improve workplace productivity (Black Enterprise, 2001). Changing demographics, from organizational restructuring, women in the workplace, equal opportunity legislation and other legal issues, are forcing organizations to become more aggressive in implementing robust diversity practices. However, YOU do not need to wait for your organization to introduce a formal “Diversity” program. There are steps you can take to introduce diversity into your own workgroups. There is no “one single answer” to solve this issue, however this discussion will provide thought provoking ideas, examples of success and failure and a starting point for you to implement “soft skill” diversity practices in your work environment. Most workplaces are made up of many aspects of diversity already so why not embrace it and use it to your competitive advantage.

Diversity-based reasoning in children.

PubMed

Heit, E; Hahn, U

2001-12-01

One of the hallmarks of inductive reasoning by adults is the diversity effect, namely that people draw stronger inferences from a diverse set of evidence than from a more homogenous set of evidence. However, past developmental work has not found consistent diversity effects with children age 9 and younger. We report robust sensitivity to diversity in children as young as 5, using everyday stimuli such as pictures of objects with people. Experiment 1 showed the basic diversity effect in 5- to 9-year-olds. Experiment 2 showed that, like adults, children restrict their use of diversity information when making inferences about remote categories. Experiment 3 used other stimulus sets to overcome an alternate explanation in terms of sample size rather than diversity effects. Finally, Experiment 4 showed that children more readily draw on diversity when reasoning about objects and their relations with people than when reasoning about objects' internal, hidden properties, thus partially explaining the negative findings of previous work. Relations to cross-cultural work and models of induction are discussed. Copyright 2001 Academic Press.

Teaching diversity to medical undergraduates: Curriculum development, delivery and assessment. AMEE GUIDE No. 103.

PubMed

Dogra, Nisha; Bhatti, Farah; Ertubey, Candan; Kelly, Moira; Rowlands, Angela; Singh, Davinder; Turner, Margot

2016-01-01

The aim of this Guide is to support teacher with the responsibility of designing, delivering and/or assessing diversity education. Although, the focus is on medical education, the guidance is relevant to all healthcare professionals. The Guide begins by providing an overview of the definitions used and the principles that underpin the teaching of diversity as advocated by Diversity and Medicine in Health (DIMAH). Following an outline of these principles we highlight the difference between equality and diversity education. The Guide then covers diversity education throughout the educational process from the philosophical stance of educators and how this influences the approaches used through to curriculum development, delivery and assessment. Appendices contain practical examples from across the UK, covering lesson plans and specific exercises to deliver teaching. Although, diversity education remains variable and fragmented there is now some momentum to ensure that the principles of good educational practice are applied to diversity education. The nature of this topic means that there are a range of different professions and medical disciplines involved which leads to a great necessity for greater collaboration and sharing of effective practice.

Combined internal medicine-psychiatry and family medicine-psychiatry training programs, 1999-2000: program directors' perspectives.

PubMed

Doebbeling, C C; Pitkin, A K; Malis, R; Yates, W R

2001-12-01

Despite tremendous growth in the number of combined-training residency programs, little is known about their directorships, financing, recruitment, curricula, and attrition rates, and the practice patterns of graduates. The authors surveyed residency program directors from combined internal medicine-psychiatry (IM/PSY) and family medicine-psychiatry (FP/PSY) programs to provide initial descriptive information. Programs' directors were determined from the American Medical Association's Graduate Medical Education Directory and FREIDA online database. Three mailings of a pretested questionnaire were sent to the 40 identified combined IM/PSY and FP/PSY residency programs. A total of 32 directors from 29 programs responded. Most programs were under the dual directorship of representatives from both the psychiatry department and either the internal medicine or the family medicine program. Although most directors responded that the residency program was based in psychiatry, both departments shared in administrative, recruiting, and financial responsibilities. Curricula varied widely, with limited focus on combined training experiences. Graduates (n = 41) tended to practice in academic settings (37%), where both aspects of training could be used. Others practiced in either community mental health centers or traditional private practice settings. The estimated attrition rate from combined residencies was 11%. Combined-training programs are directed by a diverse group of individuals, including dual-boarded physicians. Curricula vary widely, but most programs are within recommended guidelines. Further prospective studies are warranted to determine predictors of attrition and future practice plans.

Individual sequences in large sets of gene sequences may be distinguished efficiently by combinations of shared sub-sequences

PubMed Central

Gibbs, Mark J; Armstrong, John S; Gibbs, Adrian J

2005-01-01

Background Most current DNA diagnostic tests for identifying organisms use specific oligonucleotide probes that are complementary in sequence to, and hence only hybridise with the DNA of one target species. By contrast, in traditional taxonomy, specimens are usually identified by 'dichotomous keys' that use combinations of characters shared by different members of the target set. Using one specific character for each target is the least efficient strategy for identification. Using combinations of shared bisectionally-distributed characters is much more efficient, and this strategy is most efficient when they separate the targets in a progressively binary way. Results We have developed a practical method for finding minimal sets of sub-sequences that identify individual sequences, and could be targeted by combinations of probes, so that the efficient strategy of traditional taxonomic identification could be used in DNA diagnosis. The sizes of minimal sub-sequence sets depended mostly on sequence diversity and sub-sequence length and interactions between these parameters. We found that 201 distinct cytochrome oxidase subunit-1 (CO1) genes from moths (Lepidoptera) were distinguished using only 15 sub-sequences 20 nucleotides long, whereas only 8–10 sub-sequences 6–10 nucleotides long were required to distinguish the CO1 genes of 92 species from the 9 largest orders of insects. Conclusion The presence/absence of sub-sequences in a set of gene sequences can be used like the questions in a traditional dichotomous taxonomic key; hybridisation probes complementary to such sub-sequences should provide a very efficient means for identifying individual species, subtypes or genotypes. Sequence diversity and sub-sequence length are the major factors that determine the numbers of distinguishing sub-sequences in any set of sequences. PMID:15817134

Toward a Pedagogy of Linguistic Diversity: Understanding African American Linguistic Practices and Programmatic Learning Goals

ERIC Educational Resources Information Center

Perryman-Clark, Staci M.

2012-01-01

The relationship between cultural diversity, linguistic diversity, and composition has been a topic that has received much attention in rhetoric and composition's disciplinary conversations, even if current pedagogical practices used to address these matters lag behind in progress. In this essay, the author focuses on how to address linguistic…

[Cooperation, Job Satisfaction and Burn Out - Sustainability in Outpatient Mental Health Care among Medical Specialists in Germany].

PubMed

Baumgardt, Johanna; Moock, Jörn; Rössler, Wulf; Kawohl, Wolfram

2017-04-01

Objective Cooperation, job satisfaction, and burn out risk are indicators of sustainability in mental health services. Thus they were assessed among registered medical specialists in outpatient mental health care in Germany. Method A postal survey consisting of three questionnaires about cooperation, job satisfaction, and burnout was carried out among all registered medical specialists in outpatient mental health care in Germany (n = 4,430). Results 14.1 % (n = 626) of the specialists responded to the survey. Quality and quantity of cooperation regarding mental health care services were rated diverse, job satisfaction was assessed medium to high, and burnout risk was low to medium. Higher job satisfaction correlated with good quality of cooperation, fewer years of practice, fewer patients' chronically ill, more patients who as well seek psychotherapy, and less time spent on cooperation. Low burn out risk correlated with good quality of cooperation, higher age, single practice setting and a higher amount of patients who as well seek psychotherapy. Conclusion Quality and quantity of cooperation in outpatient mental health care - especially regarding community mental health care institutions - should be fostered. Aspects to be considered to reinforce job satisfaction and minimize burn out risk are age, years of practice, quality and quantity of cooperation, practice setting, and the mixture of patients. © Georg Thieme Verlag KG Stuttgart · New York.

The integration of behavioral health interventions in children's health care: services, science, and suggestions.

PubMed

Kolko, David J; Perrin, Ellen

2014-01-01

Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This article examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices, and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers are provided to enhance the capacity of the practice to deliver behavioral health care. There is moderate empirical support for the feasibility, acceptability, and clinical utility of these interventions for treating internalizing and externalizing behavior problems. Practical strategies to extend this work and address methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Pediatric primary care has become an important venue for providing mental health services to children and adolescents due, in part, to its many desirable features (e.g., no stigma, local setting, familiar providers). Further adaptation of existing delivery models may promote the delivery of effective integrated interventions with primary care providers as partners designed to address mental health problems in pediatric healthcare.

Elaboration of the Gothenburg model of person-centred care.

PubMed

Britten, Nicky; Moore, Lucy; Lydahl, Doris; Naldemirci, Oncel; Elam, Mark; Wolf, Axel

2017-06-01

Person-centred care (PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person-Centred Care (GPCC) was set up in 2010 to develop and implement person-centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the partnership to achieve commonly agreed goals; and using documentation to safeguard the partnership and record the person's narrative and shared goals. In this paper, we aimed to explore professionals' understanding of PCC routines as they implement the GPCC model in a range of different settings. We conducted a qualitative study and interviewed 18 clinician-researchers from five health-care professions who were working in seven diverse GPCC projects. Interviewees' accounts of PCC emphasized the ways in which persons are seen as different from patients; the variable emphasis placed on the person's goals; and the role of the person's own resources in building partnerships. This study illustrates what is needed for health-care professionals to implement PCC in everyday practice: the recognition of the person is as important as the specific practical routines. Interviewees described the need to change the clinical mindset and to develop the ways of integrating people's narratives with clinical practice. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Practicing governance towards equity in health systems: LMIC perspectives and experience.

PubMed

Gilson, Lucy; Lehmann, Uta; Schneider, Helen

2017-09-15

The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.

Gender Diversity in Academic Radiology Departments: Barriers and Best Practices to Optimizing Inclusion and Developing Women Leaders.

PubMed

Sepulveda, Karla A; Paladin, Angelisa M; Rawson, James V

2018-05-01

Gender diversity remains a challenge for radiology. As we aspire to embrace Diversity 3.0 and the goal of making diversity core to our organizations' mission, there must be increasing awareness of the barriers to achieving inclusion and to best practices for making diversity integral to achieving excellence. This article reviews the literature on gender diversity in radiology and in academic radiology leadership and discusses lessons learned from non-health-care industry and from academic radiology departments that have been successful in developing and supporting female employees. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Pairwise diversity ranking of polychotomous features for ensemble physiological signal classifiers.

PubMed

Gupta, Lalit; Kota, Srinivas; Molfese, Dennis L; Vaidyanathan, Ravi

2013-06-01

It is well known that fusion classifiers for physiological signal classification with diverse components (classifiers or data sets) outperform those with less diverse components. Determining component diversity, therefore, is of the utmost importance in the design of fusion classifiers that are often employed in clinical diagnostic and numerous other pattern recognition problems. In this article, a new pairwise diversity-based ranking strategy is introduced to select a subset of ensemble components, which when combined will be more diverse than any other component subset of the same size. The strategy is unified in the sense that the components can be classifiers or data sets. Moreover, the classifiers and data sets can be polychotomous. Classifier-fusion and data-fusion systems are formulated based on the diversity-based selection strategy, and the application of the two fusion strategies are demonstrated through the classification of multichannel event-related potentials. It is observed that for both classifier and data fusion, the classification accuracy tends to increase/decrease when the diversity of the component ensemble increases/decreases. For the four sets of 14-channel event-related potentials considered, it is shown that data fusion outperforms classifier fusion. Furthermore, it is demonstrated that the combination of data components that yield the best performance, in a relative sense, can be determined through the diversity-based selection strategy.

Evidence of a transnational arts and health practice methodology? A contextual framing for comparative community-based participatory arts practice in the UK and Mexico

PubMed Central

Raw, Anni; Mantecón, Ana Rosas

2014-01-01

Background This paper draws on new research exploring community-based, participatory arts practice in Northern England and Mexico City to discuss contextual influences on artists’ practice, and whether a common practice model can be identified. The international comparison is used to interrogate whether such a practice model is transnational, displaying shared characteristics that transcend contextual differences. Methods The study used multi-site ethnography to investigate the participatory practice of more than 40 artists. Participant observation and extended individual and group dialogues provided data on practice in a diverse range of art forms and settings, analysed using open coding and grounded theory principles. Results Findings locate differences in practitioners’ motivations, and perceptions of the work’s function; however, key similarities emerge across both sites, in practitioners’ workshop methodologies and crucially in their creative strategies for catalysing change. A model is presented distilling the key elements of a common practice methodology, found across the study and across art forms. Conclusions The discussion notes where divergences echo nationalities of contributors, drawing inferences about the level of influence of national context in this work, and concludes with the implications of these findings for potential international collaboration, to face challenges within the community arts and health sector globally. PMID:25729411

Evaluation of Health Plan Interventions to Influence Chronic Opioid Therapy Prescribing

PubMed Central

Saunders, Kathleen; Shortreed, Susan; Thielke, Stephen; Turner, Judith A.; LeResche, Linda; Beck, Randi; Von Korff, Michael

2015-01-01

Objectives Evaluate health plan interventions targeting physician chronic opioid therapy (COT) prescribing. Methods In 2006, Group Health’s (GH) integrated group practice (IGP) initiated diverse interventions targeting COT prescriber norms and practices. In 2010, the IGP implemented a COT guideline, including a mandated online course for physicians managing COT. These interventions were not implemented in GH’s network practices. We compared trends in GH-IGP and network practices for 2006–12 in the percent of patients receiving COT and their opioid dose. We compared physician beliefs before versus after the mandated course and pre- to post-course changes in COT dosing for IGP physicians who took the course. Results From 2006 to 2012, mean (SE) daily opioid dose among IGP COT patients (intervention setting) declined from 74.1 (1.9) mg. morphine equivalent dose (MED) to 48.3 (1.0) mg. MED. Dose changes among GH network COT patients (control setting) were modest—88.2 (5.0) mg. MED in 2006 to 75.7 (2.3) mg. MED in 2012. Among physicians taking the mandated course in 2011, we observed pre- to post-course changes toward more conservative opioid prescribing beliefs. However, COT dosing trends did not change pre- to post-course. Discussion Following initiatives implemented to alter physician prescribing practices and norms, mean opioid dose prescribed to COT patients declined more in intervention than control practices. Physicians reported more conservative beliefs regarding opioid prescribing immediately after completing an online course in 2011, but the course was not associated with additional reductions in mean daily opioid dose prescribed by physicians completing the course. PMID:25621426

"Those who care much, understand much." Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh.

PubMed

Naila, Nurun; Nahar, Baitun; Lazarus, Monica; Ritter, Gaelen; Hossain, Muttaquina; Mahfuz, Mustafa; Ahmed, Tahmeed; Denno, Donna; Walson, Judd; Ickes, Scott

2018-01-01

Appetite in children is an important determinant of nutritional intake and growth. The information used by caregivers to understand children's appetite can help inform infant and young child feeding promotion and appetite assessment. We conducted a qualitative study to (a) explore maternal perceptions and responses to children's appetite and (b) to identify how these factors differ by type of caregiver, level of maternal experience, and urban versus rural context. We used purposive sampling to recruit mothers and alternate caregivers into 14 total focus group discussions (six to eight participants in each group; N = 95) in both urban and rural settings in Bangladesh. To understand children's appetite, caregivers monitor children's dietary patterns, emotional signs, and physical and verbal cues. Healthy appetite was observed by willingness to eat diverse foods, finish offered portions, and by acceptance of foods without excessive prompting. Child illness was cited for a cause of low appetite, which was manifested through fussiness, and avoiding commonly consumed foods. Mothers described a limited set of feeding practices (offering diverse foods, playing, and cheering children with videos) to encourage consumption when children lacked appetite. Mothers' stress related to work was noted as a barrier to identifying appetite cues. Urban mothers described a lower access to instrumental social support for child feeding but informational support than mothers in the rural setting. Understanding caregivers' perceptions of children's appetite may inform strategies to improve responsive feeding and tool development to assess changes in appetite as early indicators of change in health or nutrition status among high-risk children. © 2017 John Wiley & Sons Ltd.

Institutionalizing Sex Education in Diverse U.S. School Districts.

PubMed

Saul Butler, Rebekah; Sorace, Danene; Hentz Beach, Kathleen

2018-02-01

This paper describes the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs, and examines the degree to which WISE has been successful in increasing access to sex education, removing barriers, and highlighting best practices. The data for this study come from a set of performance indicators, guidance documents, and tools designed for the WISE Initiative to capture changes in sex education institutionalization at WISE school districts. The evaluation includes the analysis of 186 school districts across 12 states in the U.S. As a result of the WISE Initiative, 788,865 unique students received new or enhanced sex education in school classrooms and 88 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit-a practical guide to help schools implement sex education. Barriers to implementing sexuality education can be overcome with administrative support and focused technical assistance and training, resulting in significant student reach in diverse school districts nationwide. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Learning style preferences of Australian accelerated postgraduate pre-registration nursing students: A cross-sectional survey.

PubMed

McKenna, Lisa; Copnell, Beverley; Butler, Ashleigh E; Lau, Rosalind

2018-01-01

Graduate entry programs leading to registration are gaining momentum in nursing. These programs attract student cohorts with professional, cultural, gender and age diversity. As a consequence of this diversity, such accelerated programs challenge traditional pedagogical methods used in nursing and require different approaches. To date, however, there has been limited research on the learning styles of students undertaking these programs to inform academics involved in their delivery. Kolb's Experiential Learning model has been used widely in a variety of educational settings because it is based on the theory of experiential learning. More recently VARK (Visual, Aural, Read/write and Kinaesthetic) model has become popular. The aim of this study was to investigate the learning styles of two cohorts of graduate entry nursing students undertaking an accelerated masters-level program. This was a cross-sectional survey of two cohorts of Master of Nursing Practice students enrolled at a large Australian university. The students were more inclined toward converging (practical) and least toward concrete experience (experiencing) learning styles. The majority of students were more inclined toward kinaesthetic and least toward aural learning style. Findings have implications for academics engaged in teaching graduate entry nursing students. Copyright © 2017. Published by Elsevier Ltd.

Dry land tree management for improved household livelihoods: farmer managed natural regeneration in Niger.

PubMed

Haglund, Eric; Ndjeunga, Jupiter; Snook, Laura; Pasternak, Dov

2011-07-01

Farmer Managed Natural Regeneration (FMNR), a set of practices farmers use to foster the growth of indigenous trees on agricultural land, has drawn substantial attention as a contributing factor to a trend of increasing vegetation greenness in the Republic of Niger. This paper identifies drivers of FMNR adoption and assesses its impacts on rural households in the Region of Maradi, Niger, an area covering 42,000 square kilometers. The results show that 26% of households practice a form of FMNR involving both pruning and protecting woody vegetation. Adoption is strongly linked to soil type, market access, and the education level of the head of household. FMNR raises household income and increases crop diversity, household migration rates, and the density and diversity of trees on farmland. It is estimated that FMNR raises the annual gross income of the region by between 17 and 21 million USD and has contributed an additional 900,000 to 1,000,000 trees to the local environment. These findings support the value of continued promotion of FMNR as an inexpensive means of enhancing rural livelihoods and an attractive alternative to reforestation efforts relying on tree planting. Copyright © 2011 Elsevier Ltd. All rights reserved.

Who are the people in your neighborhood? A descriptive analysis of individuals on public sex offender registries.

PubMed

Ackerman, Alissa R; Harris, Andrew J; Levenson, Jill S; Zgoba, Kristen

2011-01-01

Despite growing focus on registration and notification systems as central elements of national sex offender management practice, there has been remarkably little systematic analysis of the content of these registries and the diversity of individuals contained within them. Specifically, little research attention has been paid to examining the heterogeneity of the population of registered sex offenders - a circumstance that may obscure important distinctions within the population and, in turn, may undermine the ostensible purpose of SORN to prevent sexual victimization. Addressing this significant gap in our current knowledge, this article sets forth a national profile of the registered sex offender (RSO) population, drawn from an analysis of data on 445,127 RSOs obtained from the public registries of 49 states, Washington, DC, Puerto Rico and Guam. In contrast with the homogenized perception about registered sex offenders that permeates much public discourse, the analysis illuminates the wide diversity of registrants across a range of demographic, offense-related, registry status, and risk-oriented variables. Policy and practice implications concerning risk, prevention, and the public safety utility of sex offender registries are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

The Pedagogical Practices of Québec High School Teachers Relative to Sexual Diversity

ERIC Educational Resources Information Center

Richard, Gabrielle

2015-01-01

This article explores the ways in which teachers describe their pedagogical and intervention practices relative to sexual diversity in Québec (Canada). Three variables closely associated with teachers who report inclusive practices emerge: experiential training (based on the experience of a lesbian, gay, or bisexual [LGB] teacher), contact…

Colorblind and Multicultural Ideologies Are Associated with Faculty Adoption of Inclusive Teaching Practices

ERIC Educational Resources Information Center

Aragón, Oriana R.; Dovidio, John F.; Graham, Mark J.

2017-01-01

Professional workshops aimed at increasing student diversity typically urge college-level science, technology, engineering, and math (STEM) educators to implement inclusive teaching practices. A model of the process by which educators adopt such practices, and the relationship between adoption and 2 ideologies of diversity is tested here. One…

Strategies to recruit a diverse low-income population to child weight management programs from primary care practices

USDA-ARS?s Scientific Manuscript database

Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to ...

Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings.

PubMed

Baumbusch, Jennifer L; Kirkham, Sheryl Reimer; Khan, Koushambhi Basu; McDonald, Heather; Semeniuk, Pat; Tan, Elsie; Anderson, Joan M

2008-04-01

There is an emerging discourse of knowledge translation that advocates a shift away from unidirectional research utilization and evidence-based practice models toward more interactive models of knowledge transfer. In this paper, we describe how our participatory approach to knowledge translation developed during an ongoing program of research concerning equitable care for diverse populations. At the core of our approach is a collaborative relationship between researchers and practitioners, which underpins the knowledge translation cycle, and occurs simultaneously with data collection/analysis/synthesis. We discuss lessons learned including: the complexities of translating knowledge within the political landscape of healthcare delivery, the need to negotiate the agendas of researchers and practitioners in a collaborative approach, and the kinds of resources needed to support this process.

Unheard Voices: The Need for HIV Research and Prevention Priorities for YMSM in the Global Context.

PubMed

Hall, Casey D; Murdock, Daniel; Nehl, Eric J; Wong, Frank Y

2016-06-01

This commentary considers the AIDS Education and Prevention special issue (volume 28, number 3) entitled "Behavioral HIV Prevention Interventions for Diverse Young Men Who Have Sex with Men (MSM)." The research presented in this special issue highlights the importance of addressing sub-populations of young MSM in order to better understand the unique realities and risk-factors affecting HIV epidemics and intervention needs. Here, we focus on several broad topics raised in this special issue and comment on their implications for HIV research and practice targeting young MSM in low- and middle-income countries. We consider issues relevant to reaching hidden populations, tailoring interventions, and integrating new communications and bio-medical technologies in research and practice in low-resource settings.

Promoting excellence in care.

PubMed

2004-07-01

Welcome to Nurse Researcher. This year's annual RCN International Nursing Research Conference was held recently in Cambridge, UK. The event, which attracted over 500 delegates from a range of diverse and academic settings across the world, brought together nurses and other healthcare professionals to promote and develop nursing knowledge. Over 200 papers and poster presentations covered a wide range of topics in nursing and healthcare research, including: issues in research methodology; education; theoretical perspectives; transcultural nursing; evidence-based practice; employment issues; and research governance. In addition to concurrent sessions and posters, many symposia, workshops and other fringe and networking events offered opportunities for sharing good practice and research collaboration. Next year's conference will be held in Belfast, Northern Ireland, UK from Tuesday 8 to Friday 11 March 2005. For more information visit: www.man.ac.uk/rcn/research2005.

Practical experience from the Office of Adolescent Health's large scale implementation of an evidence-based Teen Pregnancy Prevention Program.

PubMed

Margolis, Amy Lynn; Roper, Allison Yvonne

2014-03-01

After 3 years of experience overseeing the implementation and evaluation of evidence-based teen pregnancy prevention programs in a diversity of populations and settings across the country, the Office of Adolescent Health (OAH) has learned numerous lessons through practical application and new experiences. These lessons and experiences are applicable to those working to implement evidence-based programs on a large scale. The lessons described in this paper focus on what it means for a program to be implementation ready, the role of the program developer in replicating evidence-based programs, the importance of a planning period to ensure quality implementation, the need to define and measure fidelity, and the conditions necessary to support rigorous grantee-level evaluation. Published by Elsevier Inc.

Improving outcomes for patients with type 2 diabetes using general practice networks: a quality improvement project in east London.

PubMed

Hull, Sally; Chowdhury, Tahseen A; Mathur, Rohini; Robson, John

2014-02-01

Structured diabetes care can improve outcomes and reduce risk of complications, but improving care in a deprived, ethnically diverse area can prove challenging. This report evaluates a system change to enhance diabetes care delivery in a primary care setting. All 35 practices in one inner London Primary Care Trust were geographically grouped into eight networks of four to five practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary team developed a 'care package' for type 2 diabetes management, with financial incentives based on network achievement of targets. Monthly electronic performance dashboards enabled networks to track and improve performance. Network multidisciplinary team meetings including the diabetic specialist team supported case management and education. Key measures for improvement included the number of diabetes care plans completed, proportion of patients attending for digital retinal screen and proportions of patients achieving a number of biomedical indices (blood pressure, cholesterol, glycated haemoglobin). Between 2009 and 2012, completed care plans rose from 10% to 88%. The proportion of patients attending for digital retinal screen rose from 72% to 82.8%. The proportion of patients achieving a combination of blood pressure ≤ 140/80 mm Hg and cholesterol ≤ 4 mmol/L rose from 35.3% to 46.1%. Mean glycated haemoglobin dropped from 7.80% to 7.66% (62-60 mmol/mol). Investment of financial, organisational and education resources into primary care practice networks can achieve clinically important improvements in diabetes care in deprived, ethnically diverse communities. This success is predicated on collaborative working between practices, purposively designed high-quality information on network performance and engagement between primary and secondary care clinicians.

Impact of a Generalizable Reminder System on Colorectal Cancer Screening in Diverse Primary Care Practices

PubMed Central

Nease, Donald E.; Ruffin, Mack T.; Klinkman, Michael S.; Jimbo, Masahito; Braun, Thomas M.; Underwood, Jennifer M.

2015-01-01

Background Computerized reminder systems (CRS) show promise for increasing preventive services such as colorectal cancer (CRC) screening. However, prior research has not evaluated a generalizable CRS across diverse, community primary care practices. We evaluated whether a generalizable CRS, ClinfoTracker, could improve screening rates for CRC in diverse primary care practices. Methods The study was a prospective trial to evaluate ClinfoTracker using historical control data in 12 Great Lakes Research In Practice Network community-based, primary care practices distributed from Southeast to Upper Peninsula Michigan. Our outcome measures were pre- and post-study practice-level CRC screening rates among patients seen during the 9-month study period. Ability to maintain the CRS was measured by days of reminder printing. Field notes were used to examine each practice’s cohesion and technology capabilities. Results All but one practice increased their CRC screening rates, ranging from 3.3% to 16.8% improvement. t tests adjusted for within practice correlation showed improvement in screening rates across all 12 practices, from 41.7% to 50.9%, P = 0.002. Technology capabilities impacted printing days (74% for high technology vs. 45% for low technology practices, P = 0.01), and cohesion demonstrated an impact trend for screening (15.3% rate change for high cohesion vs. 7.9% for low cohesion practices). Conclusions Implementing a generalizable CRS in diverse primary care practices yielded significant improvements in CRC screening rates. Technology capabilities are important in maintaining the system, but practice cohesion may have a greater influence on screening rates. This work has important implications for practices implementing reminder systems. PMID:18725836

From Darwin to constructivism: the evolution of grounded theory.

PubMed

Hall, Helen; Griffiths, Debra; McKenna, Lisa

2013-01-01

To explore the evolution of grounded theory and equip the reader with a greater understanding of the diverse conceptual positioning that is evident in the methodology. Grounded theory was developed during the modernist phase of research to develop theories that are derived from data and explain human interaction. Its philosophical foundations derive from symbolic interactionism and were influenced by a range of scholars including Charles Darwin and George Mead. Rather than a rigid set of rules and procedures, grounded theory is a way of conceptualising data. Researchers demonstrate a range of perspectives and there is significant variation in the way the methodology is interpreted and executed. Some grounded theorists continue to align closely with the original post-positivist view, while others take a more constructivist approach. Although the diverse interpretations accommodate flexibility, they may also result in confusion. The grounded theory approach enables researchers to align to their own particular world view and use methods that are flexible and practical. With an appreciation of the diverse philosophical approaches to grounded theory, researchers are enabled to use and appraise the methodology more effectively.

Sexual trauma disclosure in clinical settings: addressing diversity.

PubMed

Roberts, Sushma T; Watlington, Christina G; Nett, Sara D; Batten, Sonja V

2010-01-01

Although sexual trauma is an experience with wide prevalence, it remains difficult for many individuals to discuss this trauma openly with others. Disclosure of a sexual trauma history to a receptive individual can lead to both emotional and instrumental support. However, a myriad of factors related not only to current circumstances but also to cultural and individual differences determine whether an individual will choose to share his or her trauma history with someone else. Mental health clinicians may be more likely than many other people to be the recipients of a disclosure of sexual trauma. Thus, ensuring that clinicians show sensitivity to the role that diverse demographic and cultural factors can play in the process of disclosure is important to facilitating a thoughtful and productive response to such an event. The current article reviews a segment of the literature on disclosure of sexual assault and focuses on selected diversity domains (i.e., nonheterosexual orientation, age, gender, and race) that may impact the disclosure of sexual assault. Practical suggestions are proposed to assist clinicians in assessing sexual trauma and facilitating disclosure in a culturally competent manner.

Preceptorship in the intergenerational context: an integrative review of the literature.

PubMed

Earle, Vicki; Myrick, Florence; Yonge, Olive

2011-01-01

Preceptorship is a teaching/learning method used in many undergraduate nursing programs whereby learners are individually assigned to expert practitioners in the clinical setting. The current reality in today's workplace setting encompasses four generations (Veterans, Baby Boomers, Generation X, and Millennials) working together and often these generations do not share the same work ethic or expectations. Given this generational diversity, increased knowledge and awareness of the intergenerational context of the preceptorship experience is both an important and timely topic for nursing education. The purpose of this paper is to discuss an integrative review of the literature using the methodology of Whittemore and Knafl (2005). The computerized databases of CINAHL, PubMed, ProQuest Education, ERIC, and EMBASE were used to generate relevant literature. The sample consisted of 98 articles; 18 being research and 80 theoretical. Given the large sample size, the authors focus on summarizing the research literature in this paper. This review calls attention to the need for further research into generational diversity and its influence on the preceptorship experience. It also highlights the limited research that currently exists on the topic of the intergenerational nursing workforce. Implications for nursing education and clinical practice are also discussed. 2010 Elsevier Ltd. All rights reserved.

Can Genetics and Genomics Nursing Competencies Be Successfully Taught in a Prenursing Microbiology Course?

PubMed Central

Shuster, Michèle

2011-01-01

In recognition of the entry into the era of personalized medicine, a new set of genetics and genomics competencies for nurses was introduced in 2006. Since then, there have been a number of reports about the critical importance of these competencies for nursing practices and about the challenges of addressing these competencies in the preservice (basic science) nursing curriculum. At least one suggestion has been made to infuse genetics and genomics throughout the basic science curriculum for prenursing students. Based on this call and a review of the competencies, this study sought to assess the impact of incorporation of genetics and genomics content into a prenursing microbiology course. Broadly, two areas that address the competencies were incorporated into the course: 1) the biological basis and implications of genetic diversity and 2) the technological aspects of assessing genetic diversity in bacteria and viruses. These areas address how genetics and genomics contribute to healthcare, including diagnostics and selection of treatment. Analysis of learning gains suggests that genetics and genomics content can be learned as effectively as microbiology content in this setting. Future studies are needed to explore the most effective ways to introduce genetics and genomics technology into the prenursing curriculum. PMID:21633070

Prioritization for conservation of northern European cattle breeds based on analysis of microsatellite data.

PubMed

Tapio, I; Värv, S; Bennewitz, J; Maleviciute, J; Fimland, E; Grislis, Z; Meuwissen, T H E; Miceikiene, I; Olsaker, I; Viinalass, H; Vilkki, J; Kantanen, J

2006-12-01

Northern European indigenous cattle breeds are currently endangered and at a risk of becoming extinct. We analyzed variation at 20 microsatellite loci in 23 indigenous, 3 old imported, and 9 modern commercial cattle breeds that are presently distributed in northern Europe. We measured the breeds' allelic richness and heterozygosity, and studied their genetic relationships with a neighbor-joining tree based on the Chord genetic distance matrix. We used the Weitzman approach and the core set diversity measure of Eding et al. (2002) to quantify the contribution of each breed to the maximum amount of genetic diversity and to identify breeds important for the conservation of genetic diversity. We defined 11 breeds as a "safe set" of breeds (not endangered) and estimated a reduction in genetic diversity if all nonsafe (endangered) breeds were lost. We then calculated the increase in genetic diversity by adding one by one each of the nonsafe breeds to the safe set (the safe-set-plus-one approach). The neighbor-joining tree grouped the northern European cattle breeds into Black-and-White type, Baltic Red, and Nordic cattle groups. Väne cattle, Bohus Poll, and Danish Jersey had the highest relative contribution to the maximum amount of genetic diversity when the diversity was quantified by the Weitzman diversity measure. These breeds not only showed phylogenetic distinctiveness but also low within-population variation. When the Eding et al. method was applied, Eastern Finncattle and Lithuanian White Backed cattle contributed most of the genetic variation. If the loss of the nonsafe set of breeds happens, the reduction in genetic diversity would be substantial (72%) based on the Weitzman approach, but relatively small (1.81%) based on the Eding et al. method. The safe set contained only 66% of the observed microsatellite alleles. The safe-set-plus-one approach indicated that Bohus Poll and Väne cattle contributed most to the Weitzman diversity, whereas the Eastern Finncattle contribution was the highest according to the Eding et al. method. Our results indicate that both methods of Weitzman and Eding et al. recognize the importance of local populations as a valuable resource of genetic variation.

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

PubMed

Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

[Who teaches queer: the prospect of queer theory analysis in the health education process].

PubMed

Motta, Jose Inácio Jardim; Ribeiro, Victória Maria Brant

2013-06-01

The scope of this essay is to reflect on the possibilities of inclusion of a queer analytical body to the processes of education in the health field. This is because the development of the Unified Health System, with its new set of health practices has revealed challenges that include broadening the knowledge set especially required for revitalization of the notion of subject. Queer theory is needed to understand how identities and in particular gender and sexuality are incorporated, in a social and cultural process, and how, in the micro-social spaces, it can determine educational practices with the power to reinforce the status of the so-called minority sexualities. Queer theory framed in so-called post-critical theories of education is analyzed from the categories of power, resistance, transgression in the context of standardization and subjectivity. It is assumed that processes of education in health, grounded in queer teaching, working in terms of difference and not diversity, proposing processes of deconstruction of binaries such as nature/culture, reason/passion, homosexual/heterosexual, working towards shaping more assertive cultural and social subjects.

Anopheles larval abundance and diversity in three rice agro-village complexes Mwea irrigation scheme, central Kenya.

PubMed

Mwangangi, Joseph M; Shililu, Josephat; Muturi, Ephantus J; Muriu, Simon; Jacob, Benjamin; Kabiru, Ephantus W; Mbogo, Charles M; Githure, John; Novak, Robert J

2010-08-09

The diversity and abundance of Anopheles larvae has significant influence on the resulting adult mosquito population and hence the dynamics of malaria transmission. Studies were conducted to examine larval habitat dynamics and ecological factors affecting survivorship of aquatic stages of malaria vectors in three agro-ecological settings in Mwea, Kenya. Three villages were selected based on rice husbandry and water management practices. Aquatic habitats in the 3 villages representing planned rice cultivation (Mbui Njeru), unplanned rice cultivation (Kiamachiri) and non-irrigated (Murinduko) agro-ecosystems were sampled every 2 weeks to generate stage-specific estimates of mosquito larval densities, relative abundance and diversity. Records of distance to the nearest homestead, vegetation coverage, surface debris, turbidity, habitat stability, habitat type, rice growth stage, number of rice tillers and percent Azolla cover were taken for each habitat. Captures of early, late instars and pupae accounted for 78.2%, 10.9% and 10.8% of the total Anopheles immatures sampled (n = 29,252), respectively. There were significant differences in larval abundance between 3 agro-ecosystems. The village with 'planned' rice cultivation had relatively lower Anopheles larval densities compared to the villages where 'unplanned' or non-irrigated. Similarly, species composition and richness was higher in the two villages with either 'unplanned' or limited rice cultivation, an indication of the importance of land use patterns on diversity of larval habitat types. Rice fields and associated canals were the most productive habitat types while water pools and puddles were important for short periods during the rainy season. Multiple logistic regression analysis showed that presence of other invertebrates, percentage Azolla cover, distance to nearest homestead, depth and water turbidity were the best predictors for Anopheles mosquito larval abundance. These results suggest that agricultural practices have significant influence on mosquito species diversity and abundance and that certain habitat characteristics favor production of malaria vectors. These factors should be considered when implementing larval control strategies which should be targeted based on habitat productivity and water management.

10 CFR 960.3-2-1 - Site screening for potentially acceptable sites.

Code of Federal Regulations, 2011 CFR

2011-01-01

... that contain rock formations of suitable depth, thickness, and lateral extent and have structural... require diversity of geohydrologic settings and rock types and consideration of regionality, as specified... provisions for diversity of geohydrologic settings, diversity of rock types, and regionality (§§ 960.3-1-1...

[Gender, socioeconomic status, and ethnicity in the context of health and migration].

PubMed

Binder-Fritz, C; Rieder, A

2014-09-01

This article deals with the significance of gender as a social determinant of health and questions the influence of gender roles in health-care services. In the context of worldwide migration, women and men of different ethnicity or social class meet with health-care providers in cross-cultural medical settings. This setting is a challenge for the European Region and in order to allow for diversity and gender sensitivity in health-care practice, interventions should address a range of factors. The concept of intersectionality goes beyond gender sensitivity and includes the consideration of other dimensions of difference, such as age, social class, education, and ethnicity. The interaction between these social dimensions of health shapes the health needs of patients and also influences doctor-patient communiation and social interaction.

Use of video-feedback, reflection, and interactive analysis to improve nurse leadership practices.

PubMed

Crenshaw, Jeannette T

2012-01-01

The chronic shortage of registered nurses (RNs) affects patient safety and health care quality. Many factors affect the RN shortage in the workforce, including negative work environments, exacerbated by ineffective leadership approaches. Improvements in the use of relationship-based leadership approaches lead to healthier work environments that foster RN satisfaction and reduce RN turnover and vacancy rates in acute care settings. In this article, an innovative approach to reduce nurse turnover and decrease vacancy rates in acute care settings is described. Video feedback with reflection and interactive analysis is an untapped resource for nurse leaders and aspiring nurse leaders in their development of effective leadership skills. This unique method may be an effective leadership strategy for addressing recruitment and retention issues in a diverse workforce.

How Much Do rRNA Gene Surveys Underestimate Extant Bacterial Diversity?

PubMed

Rodriguez-R, Luis M; Castro, Juan C; Kyrpides, Nikos C; Cole, James R; Tiedje, James M; Konstantinidis, Konstantinos T

2018-03-15

The most common practice in studying and cataloguing prokaryotic diversity involves the grouping of sequences into operational taxonomic units (OTUs) at the 97% 16S rRNA gene sequence identity level, often using partial gene sequences, such as PCR-generated amplicons. Due to the high sequence conservation of rRNA genes, organisms belonging to closely related yet distinct species may be grouped under the same OTU. However, it remains unclear how much diversity has been underestimated by this practice. To address this question, we compared the OTUs of genomes defined at the 97% or 98.5% 16S rRNA gene identity level against OTUs of the same genomes defined at the 95% whole-genome average nucleotide identity (ANI), which is a much more accurate proxy for species. Our results show that OTUs resulting from a 98.5% 16S rRNA gene identity cutoff are more accurate than 97% compared to 95% ANI (90.5% versus 89.9% accuracy) but indistinguishable from any other threshold in the 98.29 to 98.78% range. Even with the more stringent thresholds, however, the 16S rRNA gene-based approach commonly underestimates the number of OTUs by ∼12%, on average, compared to the ANI-based approach (∼14% underestimation when using the 97% identity threshold). More importantly, the degree of underestimation can become 50% or more for certain taxa, such as the genera Pseudomonas , Burkholderia , Escherichia , Campylobacter , and Citrobacter These results provide a quantitative view of the degree of underestimation of extant prokaryotic diversity by 16S rRNA gene-defined OTUs and suggest that genomic resolution is often necessary. IMPORTANCE Species diversity is one of the most fundamental pieces of information for community ecology and conservational biology. Therefore, employing accurate proxies for what a species or the unit of diversity is are cornerstones for a large set of microbial ecology and diversity studies. The most common proxies currently used rely on the clustering of 16S rRNA gene sequences at some threshold of nucleotide identity, typically 97% or 98.5%. Here, we explore how well this strategy reflects the more accurate whole-genome-based proxies and determine the frequency with which the high conservation of 16S rRNA sequences masks substantial species-level diversity. Copyright © 2018 American Society for Microbiology.

Zebra: a web server for bioinformatic analysis of diverse protein families.

PubMed

Suplatov, Dmitry; Kirilin, Evgeny; Takhaveev, Vakil; Svedas, Vytas

2014-01-01

During evolution of proteins from a common ancestor, one functional property can be preserved while others can vary leading to functional diversity. A systematic study of the corresponding adaptive mutations provides a key to one of the most challenging problems of modern structural biology - understanding the impact of amino acid substitutions on protein function. The subfamily-specific positions (SSPs) are conserved within functional subfamilies but are different between them and, therefore, seem to be responsible for functional diversity in protein superfamilies. Consequently, a corresponding method to perform the bioinformatic analysis of sequence and structural data has to be implemented in the common laboratory practice to study the structure-function relationship in proteins and develop novel protein engineering strategies. This paper describes Zebra web server - a powerful remote platform that implements a novel bioinformatic analysis algorithm to study diverse protein families. It is the first application that provides specificity determinants at different levels of functional classification, therefore addressing complex functional diversity of large superfamilies. Statistical analysis is implemented to automatically select a set of highly significant SSPs to be used as hotspots for directed evolution or rational design experiments and analyzed studying the structure-function relationship. Zebra results are provided in two ways - (1) as a single all-in-one parsable text file and (2) as PyMol sessions with structural representation of SSPs. Zebra web server is available at http://biokinet.belozersky.msu.ru/zebra .

Parent Management Training-Oregon Model: Adapting Intervention with Rigorous Research.

PubMed

Forgatch, Marion S; Kjøbli, John

2016-09-01

Parent Management Training-Oregon Model (PMTO(®) ) is a set of theory-based parenting programs with status as evidence-based treatments. PMTO has been rigorously tested in efficacy and effectiveness trials in different contexts, cultures, and formats. Parents, the presumed agents of change, learn core parenting practices, specifically skill encouragement, limit setting, monitoring/supervision, interpersonal problem solving, and positive involvement. The intervention effectively prevents and ameliorates children's behavior problems by replacing coercive interactions with positive parenting practices. Delivery format includes sessions with individual families in agencies or families' homes, parent groups, and web-based and telehealth communication. Mediational models have tested parenting practices as mechanisms of change for children's behavior and found support for the theory underlying PMTO programs. Moderating effects include children's age, maternal depression, and social disadvantage. The Norwegian PMTO implementation is presented as an example of how PMTO has been tailored to reach diverse populations as delivered by multiple systems of care throughout the nation. An implementation and research center in Oslo provides infrastructure and promotes collaboration between practitioners and researchers to conduct rigorous intervention research. Although evidence-based and tested within a wide array of contexts and populations, PMTO must continue to adapt to an ever-changing world. © 2016 Family Process Institute.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 2--the evaluation.

PubMed

Dawber, Chris

2013-06-01

This paper outlines an evaluation of reflective practice groups (RPG) involving nurses and midwives from three clinical nursing specialties at Redcliffe and Caboolture Hospitals, Queensland, Australia. The groups were facilitated by the consultation liaison psychiatry nurse and author using a process-focused, whole-of-group approach to explore clinical narrative in a supportive group setting. This was a preliminary evaluation utilizing a recently-developed tool, the Clinical Supervision Evaluation Questionnaire, along with externally-facilitated focus groups. Nurses and midwives responded favourably to RPG, reporting a positive impact on clinical practice, self-awareness, and resilience. The majority of participants considered RPG had positive implications for team functioning. The focus groups identified the importance of facilitation style and the need to address aspects of workplace culture to enable group development and enhance the capacity for reflection. Evaluation of the data indicates this style of RPG can improve reflective thinking, promote team cohesion, and provide support for nurses and midwives working in clinical settings. Following on from this study, a second phase of research has commenced, providing more detailed, longitudinal evaluation across a larger, more diverse group of nurses. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

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

PubMed

Levin, Nadine; Leonelli, Sabina

2017-03-01

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

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

PubMed Central

Levin, Nadine

2016-01-01

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

Sustaining and growing the rural nursing and midwifery workforce: understanding the issues and isolating directions for the future.

PubMed

Francis, Karen L; Mills, Jane E

2011-01-01

Nurses and midwives represent the largest group of health professionals in the Australian health care system. In rural environments nurses and midwives make up a greater proportion of the health workforce than in urban settings, which makes their role in service provision even more significant. The role and scope of these nurses and midwives' practice is by necessity more generalist than specialist, which results in disciplinary strengths and weaknesses. As generalist health professionals they work in diverse settings such as public hospitals, multi-purpose services, community health, aged care and in non-government and private for profit and no-profit organisations including general practices. Their scope of practice covers prevention, intervention and rehabilitation and is lifespan inclusive. Rural nurses and midwives are older than their metropolitan based counterparts, work part-time and traditionally have limited access to professional development often due to ineffective locum relief programs. Workplace inflexibility, access to acceptable housing and partner employment are factors cited as inhibitors to growing this workforces. The future of the rural nursing and midwifery workforce will only be secured if Government invests to a greater degree in both education and training and the development of a nationally agreed remuneration scale that allows for part-time work.

Developmentally Universal Practice: Visioning Innovative Early Childhood Pedagogy for Meeting the Needs of Diverse Learners

ERIC Educational Resources Information Center

Harris, Kathleen I.

2015-01-01

Although developmentally appropriate practice (DAP) has strong merits, there are considerations pertaining to its development and implementation which must be raised. In order for educators to include diverse voices of young children, the time has come for a new conversation to unfold introducing developmentally universal practice (DUP). With this…

Addressing the Challenge of Diversity in the Graduate Ranks: Good Practices Yield Good Outcomes

ERIC Educational Resources Information Center

Thompson, Nancy L.; Campbell, Andrew G.

2013-01-01

In this paper, we examine the impact of implementing three systemic practices on the diversity and institutional culture in biomedical and public health PhD training at Brown University. We hypothesized that these practices, designed as part of the National Institutes of Health-funded Initiative to Maximize Student Development (IMSD) program in…

Big Data Analytics for Genomic Medicine

PubMed Central

He, Karen Y.; Ge, Dongliang; He, Max M.

2017-01-01

Genomic medicine attempts to build individualized strategies for diagnostic or therapeutic decision-making by utilizing patients’ genomic information. Big Data analytics uncovers hidden patterns, unknown correlations, and other insights through examining large-scale various data sets. While integration and manipulation of diverse genomic data and comprehensive electronic health records (EHRs) on a Big Data infrastructure exhibit challenges, they also provide a feasible opportunity to develop an efficient and effective approach to identify clinically actionable genetic variants for individualized diagnosis and therapy. In this paper, we review the challenges of manipulating large-scale next-generation sequencing (NGS) data and diverse clinical data derived from the EHRs for genomic medicine. We introduce possible solutions for different challenges in manipulating, managing, and analyzing genomic and clinical data to implement genomic medicine. Additionally, we also present a practical Big Data toolset for identifying clinically actionable genetic variants using high-throughput NGS data and EHRs. PMID:28212287

Advancing educational diversity: antifragility, standardization, democracy, and a multitude of education options

NASA Astrophysics Data System (ADS)

Fortunato, Michael W. P.

2017-03-01

This essay is a response to a paper by Avery and Hains that raises questions about the often unintended effects of knowledge standardization in an educational setting. While many K-12 schools are implementing common core standards, and many institutions of higher education are implementing their own standardized educational practices, the question is raised about what is lost in this effort to ensure regularity and consistency in educational outcomes. One such casualty may be local knowledge, which in a rural context includes ancestral knowledge about land, society, and cultural meaning. This essay explores whether or not efforts to standardize crowd out such knowledge, and decrease the diversity of knowledge within our society's complex ecosystem—thus making the ecosystem weaker. Using antifragility as a useful idea for examining system complexity, the essay considers the impact of standardization on innovation, democracy, and the valuation of some forms of knowledge (and its bearers) above others.

Big Data Analytics for Genomic Medicine.

PubMed

He, Karen Y; Ge, Dongliang; He, Max M

2017-02-15

Genomic medicine attempts to build individualized strategies for diagnostic or therapeutic decision-making by utilizing patients' genomic information. Big Data analytics uncovers hidden patterns, unknown correlations, and other insights through examining large-scale various data sets. While integration and manipulation of diverse genomic data and comprehensive electronic health records (EHRs) on a Big Data infrastructure exhibit challenges, they also provide a feasible opportunity to develop an efficient and effective approach to identify clinically actionable genetic variants for individualized diagnosis and therapy. In this paper, we review the challenges of manipulating large-scale next-generation sequencing (NGS) data and diverse clinical data derived from the EHRs for genomic medicine. We introduce possible solutions for different challenges in manipulating, managing, and analyzing genomic and clinical data to implement genomic medicine. Additionally, we also present a practical Big Data toolset for identifying clinically actionable genetic variants using high-throughput NGS data and EHRs.

Long-term no-tillage and organic input management enhanced the diversity and stability of soil microbial community.

PubMed

Wang, Yi; Li, Chunyue; Tu, Cong; Hoyt, Greg D; DeForest, Jared L; Hu, Shuijin

2017-12-31

Intensive tillage and high inputs of chemicals are frequently used in conventional agriculture management, which critically depresses soil properties and causes soil erosion and nonpoint source pollution. Conservation practices, such as no-tillage and organic farming, have potential to enhance soil health. However, the long-term impact of no-tillage and organic practices on soil microbial diversity and community structure has not been fully understood, particularly in humid, warm climate regions such as the southeast USA. We hypothesized that organic inputs will lead to greater microbial diversity and a more stable microbial community, and that the combination of no-tillage and organic inputs will maximize soil microbial diversity. We conducted a long-term experiment in the southern Appalachian mountains of North Carolina, USA to test these hypotheses. The results showed that soil microbial diversity and community structure diverged under different management regimes after long term continuous treatments. Organic input dominated the effect of management practices on soil microbial properties, although no-tillage practice also exerted significant impacts. Both no-tillage and organic inputs significantly promoted soil microbial diversity and community stability. The combination of no-tillage and organic management increased soil microbial diversity over the conventional tillage and led to a microbial community structure more similar to the one in an adjacent grassland. These results indicate that effective management through reducing tillage and increasing organic C inputs can enhance soil microbial diversity and community stability. Copyright © 2017 Elsevier B.V. All rights reserved.

Arbuscular mycorrhizal fungi diversity influenced by different agricultural management practices in a semi-arid Mediterranean agro-ecosystem

NASA Astrophysics Data System (ADS)

de Mar Alguacil, Maria; Torrecillas, Emma; Garcia-Orenes, Fuensanta; Torres, Maria Pilar; Roldan, Antonio

2013-04-01

The arbuscular mycorrhizal fungi (AMF) are a key, integral component of the stability, sustainability and functioning of ecosystems. In this study a field experiment was performed at the El Teularet-Sierra de Enguera Experimental Station (eastern Spain) to assess the influence during a 6-yr period of different agricultural practices on the diversity of arbuscular mycorrhizal fungi (AMF). The management practices included residual herbicide use, ploughing, ploughing + oats, addition of oat straw mulch and a control (land abandonment). Adjacent soil under natural vegetation was used as a reference for local, high-quality soil and as a control for comparison with the agricultural soils under different management practices. The AM fungal small-subunit (SSU) rRNA genes were subjected to PCR, cloning, sequencing and phylogenetic analyses. Thirty-six different phylotypes were identified, which were grouped in four families: Glomeraceae, Paraglomeraceae, Ambisporaceae and Claroideoglomeraceae. The first results showed significant differences in the distribution of the AMF phylotypes as consequence of the difference between agricultural management practices. Thus, the lowest diversity was observed for the plot that was treated with herbicide. The management practices including ploughing and ploughing + oats had similar AMF diversity. Oat straw mulching yielded the highest number of different AMF sequence types and showed the highest diversity index. Thus, this treatment could be more suitable in sustainable soil use and therefore protection of biodiversity.

Determinants of career satisfaction among pediatric hospitalists: a qualitative exploration

PubMed Central

Leyenaar, JoAnna K.; Capra, Lisa A.; O'Brien, Emily R.; Leslie, Laurel K.; Mackie, Thomas I.

2014-01-01

Objectives To characterize determinants of career satisfaction among pediatric hospitalists working in diverse practice settings, and to develop a framework to conceptualize factors influencing career satisfaction. Methods Semi-structured interviews were conducted with community and tertiary care hospitalists, using purposeful sampling to attain maximum response diversity. We employed close- and open-ended questions to assess levels of career satisfaction and its determinants. Interviews were conducted by telephone, recorded, and transcribed verbatim. Emergent themes were identified and analyzed using an inductive approach to qualitative analysis. Results A total of 30 interviews were conducted with community and tertiary care hospitalists, representing 20 hospital medicine programs and 7 Northeastern states. Qualitative analysis yielded 657 excerpts which were coded and categorized into four domains and associated determinants of career satisfaction: (i) professional responsibilities; (ii) hospital medicine program administration; (iii) hospital and healthcare systems; and (iv) career development. While community and tertiary care hospitalists reported similar levels of career satisfaction, they expressed variation in perspectives across these four domains. While the role of hospital medicine program administration was consistently emphasized by all hospitalists, community hospitalists prioritized resource availability, work schedule and clinical responsibilities while tertiary care hospitalists prioritized diversity in non-clinical responsibilities and career development. Conclusions We illustrate how hospitalists in different organizational settings prioritize both consistent and unique determinants of career satisfaction. Given associations between physician satisfaction and healthcare quality, efforts to optimize modifiable factors within this framework, at both community and tertiary care hospitals, may have broad impacts. PMID:24976348

Nonpareil 3: Fast Estimation of Metagenomic Coverage and Sequence Diversity.

PubMed

Rodriguez-R, Luis M; Gunturu, Santosh; Tiedje, James M; Cole, James R; Konstantinidis, Konstantinos T

2018-01-01

Estimations of microbial community diversity based on metagenomic data sets are affected, often to an unknown degree, by biases derived from insufficient coverage and reference database-dependent estimations of diversity. For instance, the completeness of reference databases cannot be generally estimated since it depends on the extant diversity sampled to date, which, with the exception of a few habitats such as the human gut, remains severely undersampled. Further, estimation of the degree of coverage of a microbial community by a metagenomic data set is prohibitively time-consuming for large data sets, and coverage values may not be directly comparable between data sets obtained with different sequencing technologies. Here, we extend Nonpareil, a database-independent tool for the estimation of coverage in metagenomic data sets, to a high-performance computing implementation that scales up to hundreds of cores and includes, in addition, a k -mer-based estimation as sensitive as the original alignment-based version but about three hundred times as fast. Further, we propose a metric of sequence diversity ( N d ) derived directly from Nonpareil curves that correlates well with alpha diversity assessed by traditional metrics. We use this metric in different experiments demonstrating the correlation with the Shannon index estimated on 16S rRNA gene profiles and show that N d additionally reveals seasonal patterns in marine samples that are not captured by the Shannon index and more precise rankings of the magnitude of diversity of microbial communities in different habitats. Therefore, the new version of Nonpareil, called Nonpareil 3, advances the toolbox for metagenomic analyses of microbiomes. IMPORTANCE Estimation of the coverage provided by a metagenomic data set, i.e., what fraction of the microbial community was sampled by DNA sequencing, represents an essential first step of every culture-independent genomic study that aims to robustly assess the sequence diversity present in a sample. However, estimation of coverage remains elusive because of several technical limitations associated with high computational requirements and limiting statistical approaches to quantify diversity. Here we described Nonpareil 3, a new bioinformatics algorithm that circumvents several of these limitations and thus can facilitate culture-independent studies in clinical or environmental settings, independent of the sequencing platform employed. In addition, we present a new metric of sequence diversity based on rarefied coverage and demonstrate its use in communities from diverse ecosystems.

Nourishing networks: an interprofessional learning model and its application to the Australian rural health workforce.

PubMed

Little, F; Brown, L; Grotowski, M; Harris, D

2012-01-01

Access to continuing professional development for rural health clinicians requires strategies to overcome barriers associated with finances, travel and a lack of resources. Approaches to providing professional development need to transcend conventional educational methods and consider interprofessional educational opportunities to meet the diverse needs of the rural health workforce. Rural clinicians often work in professional isolation and frequently work collaboratively with clinicians from a range of other health disciplines. Interprofessional learning and practice is therefore important in a rural areas as clinicians working in these settings are often more reliant on each other and require an understanding of other's roles to provide effective health care. In addition, specialist services are limited in rural areas, with health professionals increasingly required to perform extended roles at an advanced-practice level. A model for interprofessional learning has been developed to attempt to address the barriers related to the delivery of interprofessional education in the rural health setting in Australia. This model demonstrates a flexible approach to interprofessional learning which meets different educational needs across a number of health disciplines, and is tailored to varying levels of expertise. It incorporates three learning approaches: traditional learning, flexible learning and advanced practice. Each of these components of the model are described and the Nourishing Networks program is provided as an example of the application of the model in a rural setting, utilising 'eating disorders' as the educational topic. Interprofessional learning can be delivered effectively in a rural setting by utilising technology to help bridge the isolation experienced in rural practice. Challenges in delivering the interprofessional learning program included: engaging rural general practitioners, utilising technology and maintaining participant engagement. The use of technology is essential to access a broad group of rural clinicians however, there are limitations in its use that must be acknowledged. The pilot of the Stepped Interprofessional Rural Learning Model and its application to eating disorders has scope for use in delivering education for other health topics.

RE-AIM in Clinical, Community, and Corporate Settings: Perspectives, Strategies, and Recommendations to Enhance Public Health Impact

PubMed Central

Harden, Samantha M.; Smith, Matthew Lee; Ory, Marcia G.; Smith-Ray, Renae L.; Estabrooks, Paul A.; Glasgow, Russell E.

2018-01-01

The RE-AIM Framework is a planning and evaluation model that has been used in a variety of settings to address various programmatic, environmental, and policy innovations for improving population health. In addition to the broad application and diverse use of the framework, there are lessons learned and recommendations for the future use of the framework across clinical, community, and corporate settings. The purposes of this article are to: (A) provide a brief overview of the RE-AIM Framework and its pragmatic use for planning and evaluation; (B) offer recommendations to facilitate the application of RE-AIM in clinical, community, and corporate settings; and (C) share perspectives and lessons learned about employing RE-AIM dimensions in the planning, implementation, and evaluation phases within these different settings. In this article, we demonstrate how the RE-AIM concepts and elements within each dimension can be applied by researchers and practitioners in diverse settings, among diverse populations and for diverse health topics. PMID:29623270

Bias-Free Chemically Diverse Test Sets from Machine Learning.

PubMed

Swann, Ellen T; Fernandez, Michael; Coote, Michelle L; Barnard, Amanda S

2017-08-14

Current benchmarking methods in quantum chemistry rely on databases that are built using a chemist's intuition. It is not fully understood how diverse or representative these databases truly are. Multivariate statistical techniques like archetypal analysis and K-means clustering have previously been used to summarize large sets of nanoparticles however molecules are more diverse and not as easily characterized by descriptors. In this work, we compare three sets of descriptors based on the one-, two-, and three-dimensional structure of a molecule. Using data from the NIST Computational Chemistry Comparison and Benchmark Database and machine learning techniques, we demonstrate the functional relationship between these structural descriptors and the electronic energy of molecules. Archetypes and prototypes found with topological or Coulomb matrix descriptors can be used to identify smaller, statistically significant test sets that better capture the diversity of chemical space. We apply this same method to find a diverse subset of organic molecules to demonstrate how the methods can easily be reapplied to individual research projects. Finally, we use our bias-free test sets to assess the performance of density functional theory and quantum Monte Carlo methods.

10 CFR 960.3-1-1 - Diversity of geohydrologic settings.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Diversity of geohydrologic settings. 960.3-1-1 Section 960.3-1-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-1 Diversity of geohydrologic...

10 CFR 960.3-1-1 - Diversity of geohydrologic settings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Diversity of geohydrologic settings. 960.3-1-1 Section 960.3-1-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-1 Diversity of geohydrologic...

10 CFR 960.3-1-1 - Diversity of geohydrologic settings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Diversity of geohydrologic settings. 960.3-1-1 Section 960.3-1-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-1 Diversity of geohydrologic...

10 CFR 960.3-1-1 - Diversity of geohydrologic settings.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Diversity of geohydrologic settings. 960.3-1-1 Section 960.3-1-1 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Implementation Guidelines § 960.3-1-1 Diversity of geohydrologic...

Pedagogy and Practice: Providing Opportunities for Students to Develop Criticality in an Undergraduate Black Studies Course

ERIC Educational Resources Information Center

Reid, Jacqueline M.

2012-01-01

A growing number of researchers claim that diverse students with potentially diverse literacies are unable to take up the necessary literate practices to be successful in the university and upon leaving they are unable to master these literate practices, specifically the need to address critical thinking, problem-solving, and writing and to…

A Tale of Two Women Leaders: Diversity Policies and Practices in Enterprise Universities

ERIC Educational Resources Information Center

Wilkinson, Jane

2009-01-01

This paper explores the ways in which senior female academics' leadership practices are informed and negotiated in relation to a multiplicity of fields. As part of the shift in the logics of practice underpinning the Australian academic terrain, there has been a movement from the implementation of equity policies to that of diversity in relation…

Educational Assessment in Khyber Pakhtunkhwa Pakistan's North-West Frontier Province: Practices, Issues, and Challenges for Educating Culturally Linguistically Diverse and Exceptional Children

ERIC Educational Resources Information Center

Gouleta, Eirini

2015-01-01

This article presents the case of Khyber Pakhtunkhwa (KP), Pakistan's former North-West Frontier Province, and its provincial educational assessment policies and practices. These policies and practices affect millions of Culturally Linguistically Diverse and Exceptional (CLDE) children who live in rural and remote areas, and areas afflicted by…

The Evidence-Based Principles of Negative Pressure Wound Therapy in Trauma & Orthopedics

PubMed Central

A, Novak; Khan, Wasim S; J, Palmer

2014-01-01

Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice. PMID:25067971

Careful Words: Nursing, Language, and Emotion in Papua New Guinea.

PubMed

Andersen, Barbara

2017-01-01

Papua New Guinean nurses work in a sociomedical system in which cultural and linguistic diversity are matters of pressing concern. Using data drawn from ethnographic research with PNG nursing students, I show how nursing education socializes nurses to take stances toward language and communication that impact their care practices. I argue that nurses' use of language is shaped by their ethical commitments as educated Christians and indigenous concerns about the links between language, emotion, and health. In a resource-poor setting where health workers risk blame for structural inequalities, this "ethical metapragmatics" is an important but neglected facet of care work.

Contemporary paradigms for research related to women's mental health.

PubMed

Doucet, Shelley Anne; Letourneau, Nicole Lyn; Stoppard, Janet M

2010-04-01

Mental health problems are serious health concerns that affect women across diverse settings internationally. Knowledge of this population historically has been informed by research using a positivist approach. This article is a critical examination of contemporary paradigms for research related to women's mental health. We begin the article with an introduction to women's mental health, followed by an overview of the postpositivist, critical theory, and constructivist paradigms. We then present a critical examination of the benefits and limitations of these paradigms in relation to the study of women's mental health. We conclude with implications for research and practice.

Diversion Alert: 1-Year Evaluation Across Northern New England, 2013–2014

PubMed Central

Desrosiers, Clare

2016-01-01

This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert’s impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients’ care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert. In combination with other state and federal programs, Diversion Alert may be an effective tool to help prevent the misuse of opioid medications. PMID:27880633

How Activism Features in the Career Lives of Four Generations of Canadian Nurses.

PubMed

MacDonnell, Judith A; Buck-McFadyen, Ellen

2016-11-01

Recent nursing research using a critical feminist lens challenges the prevailing view of political inertia in nursing. This comparative life history study using a critical feminist lens explores the relevance of activism with four generations of Canadian nurses. Purposeful sampling of Ontario nurses resulted in 40 participants who were diverse in terms of generation, practice setting, and activist practice. Interviews and focus groups were completed with the sample of Ontario registered nurses or undergraduate and graduate nursing students: 8 Generation X, 9 Generation Y (Millennials), 20 Boomers, and 3 Overboomers. Factors such as professional norms and personal and organizational supports shaped contradictory nursing activist identities, practices, and impacts. Gendered norms, organizational dynamics, and the political landscape influenced the meanings nurses attributed to critical incidents and influences that prompted activism inside and outside the workplace, shaping the transformative potential of nursing. Despite its limitations, the study has implications for creating professional and organizational supports for consideration of health politics and policy, and spaces for dialogue to support practice and research aligned with social justice goals.

Feeding practices, nutritional status and associated factors of lactating women in Samre Woreda, South Eastern Zone of Tigray, Ethiopia

PubMed Central

2013-01-01

Background Lactating mothers from low-income settings are considered as a nutritionally vulnerable group. Due to the nursing process, mothers are subjected to nutritional stresses. Frequent pregnancies followed by lactation increase the health risk of mothers resulting in a high maternal mortality. Objective To assess the feeding practices, nutritional status and associated factors of lactating women from Samre Woreda, South Eastern Tigray, Ethiopia. Design Community based cross-sectional survey Setting Four kebeles of Samre Woreda (2 urban & 2 rural kebeles) Methods Four hundred lactating mothers were recruited from 400 randomly selected households. Data on socio-demographic characteristics, maternal characteristics, feeding practices, frequency of foods eaten and dietary diversity was collected using a pre-tested and structured questionnaire. Anthropometric measurements were taken from each mother using calibrated equipments and standardized techniques. A one-day weighed food record was also collected from randomly selected sub sample (n=60) of mothers. The nutrient and energy content of foods consumed by the mothers was calculated by using ESHA Food Processor and the Ethiopian Food Composition Tables. To investigate the socio-economic and demographic factors affecting the nutritional status of the women, logistic regression was used. ANOVA and t-test were also used to see if there was a mean difference in nutritional status among the lactating mothers. Results Majority (71.2%) of the participants did not take additional meals during lactation. The median dietary diversity score of the study participants was 5 out of 14 food groups. The prevalence of underweight, chronic energy deficiency and stunting were 31%, 25% and 2.2% respectively. Using logistic regression model, factors significantly associated with the nutritional status of the study participants (as determined by BMI and MUAC) were size of farm land, length of years of marriage, maize cultivation, frequency of antenatal care visit and age of breastfeeding child. Conclusions The feeding practices, dietary intakes and nutritional status of the lactating women were short of the national and international recommendations. Therefore, sustained health and nutrition education is recommended to the women and their families and communities on increased food intake, proper dietary practices and dietary diversification during lactation in order to improve health and nutrition outcomes of lactating women. PMID:23452646

Challenges Confronting the Diversity Professor in Training Corporate America: A Matter of Theoretical or Practical Perspectives.

ERIC Educational Resources Information Center

Chung, Wendy V.

Diversity professionals who specialize in multiculturalism and organizational communication will embrace theories that yield a "managing diversity" approach to achieving organizational diversity. They know that the organization's culture holds the keys to the long-term success of diversity efforts. Diversity programs should be anchored…

Designing a valid randomized pragmatic primary care implementation trial: the my own health report (MOHR) project.

PubMed

Krist, Alex H; Glenn, Beth A; Glasgow, Russell E; Balasubramanian, Bijal A; Chambers, David A; Fernandez, Maria E; Heurtin-Roberts, Suzanne; Kessler, Rodger; Ory, Marcia G; Phillips, Siobhan M; Ritzwoller, Debra P; Roby, Dylan H; Rodriguez, Hector P; Sabo, Roy T; Sheinfeld Gorin, Sherri N; Stange, Kurt C

2013-06-25

There is a pressing need for greater attention to patient-centered health behavior and psychosocial issues in primary care, and for practical tools, study designs and results of clinical and policy relevance. Our goal is to design a scientifically rigorous and valid pragmatic trial to test whether primary care practices can systematically implement the collection of patient-reported information and provide patients needed advice, goal setting, and counseling in response. This manuscript reports on the iterative design of the My Own Health Report (MOHR) study, a cluster randomized delayed intervention trial. Nine pairs of diverse primary care practices will be randomized to early or delayed intervention four months later. The intervention consists of fielding the MOHR assessment--addresses 10 domains of health behaviors and psychosocial issues--and subsequent provision of needed counseling and support for patients presenting for wellness or chronic care. As a pragmatic participatory trial, stakeholder groups including practice partners and patients have been engaged throughout the study design to account for local resources and characteristics. Participatory tasks include identifying MOHR assessment content, refining the study design, providing input on outcomes measures, and designing the implementation workflow. Study outcomes include the intervention reach (percent of patients offered and completing the MOHR assessment), effectiveness (patients reporting being asked about topics, setting change goals, and receiving assistance in early versus delayed intervention practices), contextual factors influencing outcomes, and intervention costs. The MOHR study shows how a participatory design can be used to promote the consistent collection and use of patient-reported health behavior and psychosocial assessments in a broad range of primary care settings. While pragmatic in nature, the study design will allow valid comparisons to answer the posed research question, and findings will be broadly generalizable to a range of primary care settings. Per the pragmatic explanatory continuum indicator summary (PRECIS) framework, the study design is substantially more pragmatic than other published trials. The methods and findings should be of interest to researchers, practitioners, and policy makers attempting to make healthcare more patient-centered and relevant. Clinicaltrials.gov: NCT01825746.

Scholarly work products of the doctor of nursing practice: one approach to evaluating scholarship, rigour, impact and quality.

PubMed

Terhaar, Mary F; Sylvia, Martha

2016-01-01

The aim of this investigation was to evaluate, monitor and manage the quality of projects conducted and work produced as evidence of scholarship upon completion of Doctor of Nursing Practice education. The Doctor of Nursing Practice is a relatively new degree which prepares nurses for high impact careers in diverse practice settings around the globe. Considerable variation characterises curricula across schools preparing Doctors of Nursing Practice. Accreditation assures curricula are focused on attainment of the Doctor of Nursing Practice essentials, yet outcomes have not been reported to help educators engage in programme improvement. This work has implications for nursing globally because translating strong evidence into practice is key to improving outcomes in direct care, leadership, management and education. The Doctor of Nursing Practice student learns to accomplish translation through the conduct of projects. Evaluating the rigour and results of these projects is essential to improving the quality, safety and efficacy of translation, improvements in care and overall system performance. A descriptive study was conducted to evaluate the scholarly products of Doctor of Nursing Practice education in one programme across four graduating classes. A total of 80 projects, conducted across the USA and around the globe, are described using a modification of the Uncertainty, Pace, Complexity Model. The per cent of students considered to have produced high quality work in relation to target expectations as well as the per cent that conducted means testing increased over the four study years. Evaluation of scope, complexity and rigour of scholarly work products has driven improvements in the curriculum and informed the work of faculty and advisors. Methods, evaluation and outcomes conformed around a set of expectations for scholarship and rigour have resulted in measurable outcomes, and quality publications have increased over time. © 2015 John Wiley & Sons Ltd.

Powered mobility intervention: understanding the position of tool use learning as part of implementing the ALP tool.

PubMed

Nilsson, Lisbeth; Durkin, Josephine

2017-10-01

To explore the knowledge necessary for adoption and implementation of the Assessment of Learning Powered mobility use (ALP) tool in different practice settings for both adults and children. To consult with a diverse population of professionals working with adults and children, in different countries and various settings; who were learning about or using the ALP tool, as part of exploring and implementing research findings. Classical grounded theory with a rigorous comparative analysis of data from informants together with reflections on our own rich experiences of powered mobility practice and comparisons with the literature. A core category learning tool use and a new theory of cognizing tool use, with its interdependent properties: motivation, confidence, permissiveness, attentiveness and co-construction has emerged which explains in greater depth what enables the application of the ALP tool. The scientific knowledge base on tool use learning and the new theory conveys the information necessary for practitioner's cognizing how to apply the learning approach of the ALP tool in order to enable tool use learning through powered mobility practice as a therapeutic intervention in its own right. This opens up the possibility for more children and adults to have access to learning through powered mobility practice. Implications for rehabilitation Tool use learning through powered mobility practice is a therapeutic intervention in its own right. Powered mobility practice can be used as a rehabilitation tool with individuals who may not need to become powered wheelchair users. Motivation, confidence, permissiveness, attentiveness and co-construction are key properties for enabling the application of the learning approach of the ALP tool. Labelling and the use of language, together with honing observational skills through viewing video footage, are key to developing successful learning partnerships.

Celebrating Diversity in Early Care and Education Settings: Moving beyond the Margins

ERIC Educational Resources Information Center

Durand, Tina M.

2010-01-01

As the USA continues to live up to its historical reputation as a nation of immigrants, early childhood professionals are increasingly faced with the challenge of supporting children and families from diverse cultural milieu. However, to truly celebrate diversity in early childhood settings, early childhood teachers and caregivers must engage in a…

Tolerance: Woven into the Fabric of the School, or Not?

ERIC Educational Resources Information Center

Pumpian, Ian

2013-01-01

Tolerance must be conceptualized based on the diversity that exists in our world, our communities, and our schools. The author posits that dealing with diversity is a 21st-century skill set and that tolerance of difference is a rudimentary element of that set. The diversity of experiences and situations that confront middle school students and…

Young adults' experiences of neighbourhood smoking-related norms and practices: A qualitative study exploring place-based social inequalities in smoking.

PubMed

Glenn, Nicole M; Lapalme, Josée; McCready, Geneviève; Frohlich, Katherine L

2017-09-01

In this qualitative exploratory study we asked how smoking among young adults relates to the local neighbourhood context to better understand place-based social inequalities in smoking. We used data collected through focus groups with young adults from four economically diverse neighbourhoods in Montreal, Canada. Using the collective lifestyles framework to guide data analysis, we examined within and between neighbourhood social norms, practices, and agency. We found that some smoking-related social norms, practices and agency were particular to neighbourhoods of the same socio-economic status (SES). For example, permissive smoking-related social norms in low-SES neighbourhoods made it difficult to avoid smoking but also reduced local experiences of smoking-related stigma and isolation. In high-SES neighbourhoods, strong anti-smoking norms led to smoking in secret and/or amidst 'acceptable' social settings. Findings may inform future investigations and local-level interventions focused on this age group. Copyright © 2017 Elsevier Ltd. All rights reserved.

Regulation of solid waste management at Brazilian ports: analysis and proposals for Brazil in light of the European experience.

PubMed

Jaccoud, Cristiane; Magrini, Alessandra

2014-02-15

With a coastline of 8500 km, Brazil has 34 public ports and various private terminals, which together in 2012 handled 809 million tonnes of goods. The solid wastes produced (from port activities, ships and cargoes) pose a highly relevant problem, both due to the quantity and diversity, requiring a complex and integrated set of practices resulting from legal requirements and proactive initiatives. The main Brazilian law on solid waste management is recent (Law 12,305/2010) and the specific rules on solid waste in ports are badly in need of revision to meet the challenges caused by expansion of the sector and to harmonize them with the best global practices. This paper analyzes the current legal/regulatory framework for solid waste management at Brazilian ports and compares this structure with the practice in Europe. At the end, we suggest initiatives to improve the regulation of solid wastes at Brazilian ports. Copyright © 2014 Elsevier Ltd. All rights reserved.

Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

PubMed

Solomon, Dagmawit; Aderaw, Zewdie; Tegegne, Teketo Kassaw

2017-10-12

Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia. A health facility based cross sectional study was undertaken in the three sub-cities of Addis Ababa from 26th February to 28th April, 2016. A multi-stage sampling technique was used to sample the 352 study participants or mothers who had children aged 6-23 months. Data were collected by using a structured and pretested questionnaire, cleaned and entered into Epi info 7 and analyzed using SPSS 24 software. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to identify factors associated with minimum dietary diversity. In this study, the overall children with minimum dietary diversity score were found to be 59.9%. Mother's educational attainment and a higher household monthly income were positively associated with the minimum dietary diversity practice. Similarly, mothers' knowledge on dietary diversity and child feeding was positively associated with minimum dietary diversity child feeding practice, with an adjusted odds ratio of 1.98 (95% CI: 1.11-3.53). In this study, the consumption of minimum dietary diversity was found to be high. In spite of this, more efforts need to be done to achieve the recommended minimum dietary diversity intake for all children aged between 6 and 23 months.

The nature, development and contribution of social marketing to public health practice since 2004 in England.

PubMed

French, Jeff

2009-11-01

Social marketing is a highly systematic approach to health improvement that sets out unambiguous success criteria focused on behaviour change. This paper reviews the key concepts and principles of social marketing and its recent rapid development across government in England in the public health field. This paper outlines the role of the National Social Marketing Centre and concludes with a discussion of the probable future impact of social marketing on public health practice. The paper argues that there is a close ideological match between social marketing and liberal democratic imperatives. Social marketing's focus on outcome, return on investment and its emphasis on developing interventions that can respond to diverse needs, means it is probable that social marketing will increasingly be required by governments as a standard part of public health programmes.

NASA's Postdoctoral Fellowship Programs

NASA Astrophysics Data System (ADS)

Beichman, Charles A.; Gelino, D. M.; Allen, R. J.; Prestwich, A. H.

2013-01-01

The three named fellowships --- the Einstein, Hubble and Sagan programs --- are among the most prestigious postdoctoral positions in astronomy. Their policies are closely coordinated to ensure the highest scientific quality, the broadest possible access to a diverse community of recent PhD graduates, and flexibility in completing the 3 year appointments in light of individual personal circumstances. We will discuss practical details related to "family-friendly" best practices such as no-cost extensions and the ability to transfer the host institution in response to "two body problems." We note, however, that the terms of the NASA fellowships are such that fellows become employees of their host institutions which set specific policies on issues such as parental leave. We look forward to participating in the discussion at this special session and conveying to NASA any suggestions for improving the fellowship program.

An initial framework for the language of higher-order thinking mathematics practices

NASA Astrophysics Data System (ADS)

Staples, Megan E.; Truxaw, Mary P.

2012-09-01

This article presents an examination of the language demands of cognitively demanding tasks and proposes an initial framework for the language demands of higher-order mathematics thinking practices. We articulate four categories for this framework: language of generalisation, language of comparison, language of proportional reasoning, and language of analysing impact. These categories were developed out of our collaborative work to design and implement higher-order thinking tasks with a group of Grade 9 (14- and 15-year-olds) teachers teaching in a linguistically diverse setting; analyses of student work samples on these tasks; and our knowledge of the literature. We describe each type of language demand and then analyse student work in each category to reveal linguistic challenges facing students as they engage these mathematical tasks. Implications for teaching and professional development are discussed.

Medical students’ knowledge, attitude, and practice of complementary and alternative medicine: a pre-and post-exposure survey in Majmaah University, Saudi Arabia

PubMed Central

Al Mansour, Mohammed Abdullah; Al-Bedah, Abdullah MN; AlRukban, Mohammed Othman; Elsubai, Ibrahim S; Mohamed, Elsadiq Yousif; El Olemy, Ahmed Tawfik; Khalil, Asim AH; Khalil, Mohamed KM; Alqaed, Meshari Saleh; Almudaiheem, Abdullah; Mahmoud, Waqas Sami; Medani, Khalid Altohami; Qureshi, Naseem Akhtar

2015-01-01

Background Evidently, complementary and alternative medicine (CAM) is a recognized medical practice that efficiently uses multiple treatment therapies and techniques in the prevention and management of a variety of human disorders. Many medical schools have integrated CAM curriculum in medical education system worldwide. Research in knowledge, attitude, and practice (KAP) of diverse health professionals exposed to CAM courses is important from many perspectives including improvement in KAP and teaching skills of faculty, together with capacity building and curriculum development. Objective and setting This pre- and post-design cross-sectional study aimed to assess CAM-KAP of two intakes of medical students in Majmaah University, Saudi Arabia. Methods The second-year medical students of the first (year 2012–2013) and second (year 2013–2014) intake (n=26 and 39, respectively) were selected for this study. A reliable, 16-item self-administered questionnaire was distributed among all the students for answering before and after the 48-hour CAM course. The data were analyzed using appropriate statistical test of significance. Results Medical students’ knowledge and attitude toward CAM significantly improved across some subitems of CAM questionnaire with a positive trend in the rest of its items including their views on CAM practices. Conclusion CAM course tends to have a positive impact on KAP of medical students. The preliminary results of this study call for further research with a larger sample in academic settings across the nation. PMID:26082671

Addressing the challenge of diversity in the graduate ranks: good practices yield good outcomes.

PubMed

Thompson, Nancy L; Campbell, Andrew G

2013-01-01

In this paper, we examine the impact of implementing three systemic practices on the diversity and institutional culture in biomedical and public health PhD training at Brown University. We hypothesized that these practices, designed as part of the National Institutes of Health-funded Initiative to Maximize Student Development (IMSD) program in the Division of Biology and Medicine, would have a positive effect on underrepresented minority (URM) recruitment and retention and objective measures of student success. These practices include: 1) develop strategic partnerships with selected undergraduate institutions; 2) provide a personalized education program of student support and skill-based modules to supplement discipline-based course work; and 3) transform institutional culture by engaging faculty in supporting diversity-related goals and practices. Data comparing URM numbers and key academic milestones before and after implementation of IMSD practices support the initial hypothesis and effectiveness of these practices at Brown. Program components are broadly applicable as best practices for others seeking to improve URM recruitment and achievements of graduate students traditionally underrepresented in the sciences.

Addressing the Challenge of Diversity in the Graduate Ranks: Good Practices Yield Good Outcomes

PubMed Central

Thompson, Nancy L.; Campbell, Andrew G.

2013-01-01

In this paper, we examine the impact of implementing three systemic practices on the diversity and institutional culture in biomedical and public health PhD training at Brown University. We hypothesized that these practices, designed as part of the National Institutes of Health–funded Initiative to Maximize Student Development (IMSD) program in the Division of Biology and Medicine, would have a positive effect on underrepresented minority (URM) recruitment and retention and objective measures of student success. These practices include: 1) develop strategic partnerships with selected undergraduate institutions; 2) provide a personalized education program of student support and skill-based modules to supplement discipline-based course work; and 3) transform institutional culture by engaging faculty in supporting diversity-related goals and practices. Data comparing URM numbers and key academic milestones before and after implementation of IMSD practices support the initial hypothesis and effectiveness of these practices at Brown. Program components are broadly applicable as best practices for others seeking to improve URM recruitment and achievements of graduate students traditionally underrepresented in the sciences. PMID:23463225

Evaluator competencies in the context of diversity training: The practitioners' point of view.

PubMed

Froncek, Benjamin; Mazziotta, Agostino; Piper, Verena; Rohmann, Anette

2018-04-01

Evaluator competencies have been discussed since the beginnings of program evaluation literature. More recently, the Essential Competencies for Program Evaluators (Ghere et al., 2006; Stevahn, King, Ghere & Minnema, 2005a) have proven to be a useful taxonomy for learning and improving evaluation practice. Evaluation is critical to diversity training activities, and diversity training providers face the challenge of conducting evaluations of their training programs. We explored what competencies are viewed as instrumental to conducting useful evaluations in this specific field of evaluation practice. In an online survey, N = 172 diversity training providers were interviewed via an open answer format about their perceptions of evaluator competencies, with n = 95 diversity training providers contributing statements. The Essential Competencies for Program Evaluators were used to conduct a deductive qualitative content analysis of the statements. While systematic inquiry, reflective practice, and interpersonal competence were well represented, situational analysis and project management were not. Implications are discussed for evaluation capacity building among diversity training providers and for negotiating evaluation projects with evaluation professionals. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multiple Voices for Ethnically Diverse Exceptional Learners, 1995.

ERIC Educational Resources Information Center

Ford, Bridgie Alexis, Ed.

1995-01-01

This first serial issue addresses topics and issues impacting educational services for culturally and linguistically diverse (CLD) learners. The issue contains three research-into-practice articles, an interview section called "In the Oral Tradition," and three teacher-generated articles which delineate learner-enhancing practices for…

Best Practices in Hiring: Addressing Unconscious Bias

NASA Astrophysics Data System (ADS)

Simpson, Caroline E.

2012-01-01

Research has shown that implementing certain hiring practices will increase diversity in the workplace while enhancing academic quality. All of these practices rely on addressing the issue of 'unconscious bias.' A brief overview of unconscious bias--what it is, how it works, and simple measures to counter it--will be presented. Successful strategies, actions, and recommendations for implementing best recruiting and hiring practices, which have been proven to enhance academic excellence by ensuring a deep and diverse applicant pool, will also be presented.

A Survey of Adverse Event Reporting Practices Among US Healthcare Professionals.

PubMed

Stergiopoulos, Stella; Brown, Carrie A; Felix, Thomas; Grampp, Gustavo; Getz, Kenneth A

2016-11-01

The under-reporting of adverse drug events (ADEs) is an international health concern. A number of studies have assessed the root causes but, to our knowledge, little information exists relating under-reporting to practices and systems used for the recording and tracking of drug-related adverse event observations in ambulatory settings, institutional settings, and retail pharmacies. Our objective was to explore the process for reporting ADEs in US hospitals, ambulatory settings, and retail pharmacies; to explore gaps and inconsistencies in the reporting process; and to identify the causes of under-reporting ADEs in these settings. The Tufts Center for the Study of Drug Development (Tufts CSDD) interviewed 11 thought leaders and conducted a survey between May and August 2014 among US-based healthcare providers (HCPs) in diverse settings to assess their experiences with, and processes for, reporting ADEs. A total of 123 individuals completed the survey (42 % were pharmacists; 27 % were nurses; 15 % were physicians; and 16 % were classified as 'other'). HCPs indicated that the main reasons for under-reporting were difficulty in determining the cause of the ADE, given that most patients receive multiple therapies simultaneously (66 % of respondents); that HCPs lack sufficient time to report ADEs (63 % of respondents); poor integration of ADE-reporting systems (53 % of respondents); and uncertainty about reporting procedures (52 % of respondents). The results of this pilot study identify that key factors contributing to the under-reporting of ADEs relate to a lack of standardized process, a lack of training and education, and a lack of integrated health information technologies.

LGBTQ Inclusion in Educator Preparation: Getting Ready for Gender and Sexual Diversity in Secondary School Settings

NASA Astrophysics Data System (ADS)

Hoelscher, Mary Helen

While many lesbian, gay, bisexual, transgender, and queer (LGBTQ) students are able to resiliently navigate their public school education many others experience harsh school climates and negative health and educational outcomes. Harassment and bullying of LGBTQ students in school environments have been linked to numerous negative psychological and academic outcomes for students diverse in sexual orientation and/or gender identity. Preparing teacher candidates (TCs) to respond effectively to harassment and bullying of students and to create inclusive curriculum has been recommended to improve outcomes for students. Yet the development of these teaching practices has not been pursued broadly in educator preparation programs (EPPs) or specifically in science EPPs (SEPPs). This dissertation broadens the notion of diversity traditionally attended to in EPPs through three studies. The first study is a holistic single-case study of an LGBTQ-inclusive EPP. It focused on the following three research questions: What were the contextual features that surrounded the LGBTQ-inclusive EPP? What were the specific elements of LGBTQ inclusion in the EPP? And, what were the strengths and weaknesses of the LGBTQ-inclusive EPP? This study drew primarily from data collected from interviews with faculty and administrators in a large post-baccalaureate 5th year preparation for licensure program. Document analysis was used to triangulate and expand upon the data collected during the interviews. A framework for analyzing LGBTQ inclusion across the components of an EPP was developed as part of this study. This study has direct implications for the particular EPP, but also clarifies research needs around LGBTQ inclusion in secondary EPPs. While little has research exists about LGBTQ inclusion in EPPs, far less has been attempted and understood in the discipline of secondary life science. The second study thus narrows its focus from the particulars of LGBTQ inclusion in an EPP to the possibilities for LGBTQ inclusion in life science educator preparation. This study, thus, is theoretical as it sets about exploring possibilities for LGBTQ inclusion across life science education curriculum by drawing from the literature about the needs of LGBT and questioning students, the small amount of scholarly work related to science teacher education, and other scholarly work that relates to preparing teachers for gender and sexual diversity in secondary settings. The second study explored possibilities for LGBTQ inclusion in science teacher education. The third study, a holistic multiple-case study, explored science teacher candidates' adoption of LGBTQ inclusion in their praxis during a science EPP (SEPP). The research questions guiding this study were: what were science TCs' commitments to LGBTQ-inclusive praxis? What were science TCs' enactments of LGBTQ-inclusive praxis? And, what supports and barriers influenced TCs' commitment to and enactment of LGBTQ-inclusive praxis during the SEPP? Understanding these commitments, enactments, and the supports and barriers to them will benefit the particular SEPP and contribute to greater understanding of the capacities and needs of science TCs as they are challenged to fully welcome and educate the diversity of learners who enter their classrooms. The set of studies concludes with a discussion of implications for EPPs and future research that may lead to the realization of a vision of classroom practices that are inclusive of LGBTQ students for the benefit of schools and communities.

Is gerontology ready for anti-racist pedagogy? A survey of educators' practices and perspectives.

PubMed

Karasik, Rona J; Kishimoto, Kyoko

2018-01-01

The older population in the United States is becoming more diverse, bringing increasing attention to the ways in which diversity and multiculturalism are addressed in gerontological education. Although diversity and multiculturalism have long been recognized as important components of the aging experience, our approach to understanding their significance and impact continues to grow and change. Anti-racist pedagogy represents one catalyst to stimulate such change. To evaluate the potential for anti-racist pedagogy in gerontology, this study explored gerontological educators' (N = 121) current practices and perspectives regarding the inclusion of diversity content in their courses, as well as the extent to which they are familiar with and/or use anti-racist pedagogy in their classes. The findings suggest that greater attention to issues of race, ethnicity, and multicultural diversity throughout the gerontological curriculum is needed and wanted. Although respondents were generally unfamiliar with the name anti-racist pedagogy, many indicated that their current teaching practices employed select components of it. Overall, the findings point toward the need for continued exploration of how anti-racist pedagogy may be brought into the gerontological classroom, as well as its implications for future research, policy, and practice.

A RE-AIM evaluation of theory-based physical activity interventions.

PubMed

Antikainen, Iina; Ellis, Rebecca

2011-04-01

Although physical activity interventions have been shown to effectively modify behavior, little research has examined the potential of these interventions for adoption in real-world settings. The purpose of this literature review was to evaluate the external validity of 57 theory-based physical activity interventions using the RE-AIM framework. The physical activity interventions included were more likely to report on issues of internal, rather than external validity and on individual, rather than organizational components of the RE-AIM framework, making the translation of many interventions into practice difficult. Furthermore, most studies included motivated, healthy participants, thus reducing the generalizability of the interventions to real-world settings that provide services to more diverse populations. To determine if a given intervention is feasible and effective in translational research, more information should be reported about the factors that affect external validity.

Being, becoming and belonging: Some thoughts on academic disciplinary effects

NASA Astrophysics Data System (ADS)

Slay, Jill

2011-12-01

In this paper I reflect on perspectives presented by John Settlage as he examines the truth of the proposition that `many teacher educators harbour deficit perspectives about their pre-service teachers, presuming that their lack of exposure to economically, ethnically and linguistically diverse settings renders them deficient as future educators.' In the study presented in his paper, he `uncovered shifting identities that indicate that mainstream future teachers do not fit the ``damaged goods'' label that ardent multiculturalists might be tempted to impose.' One of his conclusions was that `the practices of essentializing education majors because of their perceived deficiencies born of privilege are inaccurate and unproductive.' My reflections focus on tertiary teacher-researchers in mathematics, information technology, environmental sciences and engineering, their students and racism, and broaden Settlage's context to teaching and research relationships in this setting.

Managing Diversity.

ERIC Educational Resources Information Center

Geber, Beverly

1990-01-01

Demographic trends imply that organizations must learn to manage a diverse work force. Ways to change organizational systems, structures, and practices to eliminate subtle barriers are awareness training, attitude change, and valuing diversity. (SK)

Split-Session Focus Group Interviews in the Naturalistic Setting of Family Medicine Offices

PubMed Central

Fetters, Michael D.; Guetterman, Timothy C.; Power, Debra; Nease, Donald E.

2016-01-01

PURPOSE When recruiting health care professionals to focus group interviews, investigators encounter challenges such as busy clinic schedules, recruitment, and a desire to get candid responses from diverse participants. We sought to overcome these challenges using an innovative, office-based, split-session focus group procedure in a project that elicited feedback from family medicine practices regarding a new preventive services model. This procedure entails allocating a portion of time to the entire group and the remaining time to individual subgroups. We discuss the methodologic procedure and the implications of using this approach for data collection. METHODS We conducted split-session focus groups with physicians and staff in 4 primary care practices. The procedure entailed 3 sessions, each lasting 30 minutes: the moderator interviewed physicians and staff together, physicians alone, and staff alone. As part of the focus group interview, we elicited and analyzed participant comments about the split-session format and collected observational field notes. RESULTS The split-session focus group interviews leveraged the naturalistic setting of the office for context-relevant discussion. We tested alternate formats that began in the morning and at lunchtime, to parallel each practice’s workflow. The split-session approach facilitated discussion of topics primarily relevant to staff among staff, topics primarily relevant to physicians among physicians, and topics common to all among all. Qualitative feedback on this approach was uniformly positive. CONCLUSION A split-session focus group interview provides an efficient, effective way to elicit candid qualitative information from all members of a primary care practice in the naturalistic setting where they work. PMID:26755786

A patient-centered pharmacy services model of HIV patient care in community pharmacy settings: a theoretical and empirical framework.

PubMed

Kibicho, Jennifer; Owczarzak, Jill

2012-01-01

Reflecting trends in health care delivery, pharmacy practice has shifted from a drug-specific to a patient-centered model of care, aimed at improving the quality of patient care and reducing health care costs. In this article, we outline a theoretical model of patient-centered pharmacy services (PCPS), based on in-depth, qualitative interviews with a purposive sample of 28 pharmacists providing care to HIV-infected patients in specialty, semispecialty, and nonspecialty pharmacy settings. Data analysis was an interactive process informed by pharmacists' interviews and a review of the general literature on patient centered care, including Medication Therapy Management (MTM) services. Our main finding was that the current models of pharmacy services, including MTM, do not capture the range of pharmacy services in excess of mandated drug dispensing services. In this article, we propose a theoretical PCPS model that reflects the actual services pharmacists provide. The model includes five elements: (1) addressing patients as whole, contextualized persons; (2) customizing interventions to unique patient circumstances; (3) empowering patients to take responsibility for their own health care; (4) collaborating with clinical and nonclinical providers to address patient needs; and (5) developing sustained relationships with patients. The overarching goal of PCPS is to empower patients' to take responsibility for their own health care and self-manage their HIV-infection. Our findings provide the foundation for future studies regarding how widespread these practices are in diverse community settings, the validity of the proposed PCPS model, the potential for standardizing pharmacist practices, and the feasibility of a PCPS framework to reimburse pharmacists services.

EURRECA: development of tools to improve the alignment of micronutrient recommendations.

PubMed

Matthys, C; Bucchini, L; Busstra, M C; Cavelaars, A E J M; Eleftheriou, P; Garcia-Alvarez, A; Fairweather-Tait, S; Gurinović, M; van Ommen, B; Contor, L

2010-11-01

Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned, http://www.eurreca.org) Network of Excellence is developing generic tools for systematically establishing and updating micronutrient reference values or recommendations. Different types of instruments (including best practice guidelines, interlinked web pages, online databases and decision trees) have been identified. The first set of instruments is for training purposes and includes mainly interactive digital learning materials. The second set of instruments comprises collection and interlinkage of diverse information sources that have widely varying contents and purposes. In general, these sources are collections of existing information. The purpose of the majority of these information sources is to provide guidance on best practice for use in a wider scientific community or for users and stakeholders of reference values. The third set of instruments includes decision trees and frameworks. The purpose of these tools is to guide non-scientists in decision making based on scientific evidence. This platform of instruments will, in particular in Central and Eastern European countries, contribute to future capacity-building development in nutrition. The use of these tools by the scientific community, the European Food Safety Authority, bodies responsible for setting national nutrient requirements and others should ultimately help to align nutrient-based recommendations across Europe. Therefore, EURRECA can contribute towards nutrition policy development and public health strategies.

Rogue taxa phenomenon: a biological companion to simulation analysis

PubMed Central

Westover, Kristi M.; Rusinko, Joseph P.; Hoin, Jon; Neal, Matthew

2013-01-01

To provide a baseline biological comparison to simulation study predictions about the frequency of rogue taxa effects, we evaluated the frequency of a rogue taxa effect using viral data sets which differed in diversity. Using a quartet-tree framework, we measured the frequency of a rogue taxa effect in three data sets of increasing genetic variability (within viral serotype, between viral serotype, and between viral family) to test whether the rogue taxa was correlated with the mean sequence diversity of the respective data sets. We found a slight increase in the percentage of rogues as nucleotide diversity increased. Even though the number of rogues increased with diversity, the distribution of the types of rogues (friendly, crazy, or evil) did not depend on the diversity and in the case of the order-level data set the net rogue effect was slightly positive. This study, assessing frequency of the rogue taxa effect using biological data, indicated that simulation studies may over-predict the prevalence of the rogue taxa effect. Further investigations are necessary to understand which types of data sets are susceptible to a negative rogue effect and thus merit the removal of taxa from large phylogenetic reconstructions. PMID:23707704

Rogue taxa phenomenon: a biological companion to simulation analysis.

PubMed

Westover, Kristi M; Rusinko, Joseph P; Hoin, Jon; Neal, Matthew

2013-10-01

To provide a baseline biological comparison to simulation study predictions about the frequency of rogue taxa effects, we evaluated the frequency of a rogue taxa effect using viral data sets which differed in diversity. Using a quartet-tree framework, we measured the frequency of a rogue taxa effect in three data sets of increasing genetic variability (within viral serotype, between viral serotype, and between viral family) to test whether the rogue taxa was correlated with the mean sequence diversity of the respective data sets. We found a slight increase in the percentage of rogues as nucleotide diversity increased. Even though the number of rogues increased with diversity, the distribution of the types of rogues (friendly, crazy, or evil) did not depend on the diversity and in the case of the order-level data set the net rogue effect was slightly positive. This study, assessing frequency of the rogue taxa effect using biological data, indicated that simulation studies may over-predict the prevalence of the rogue taxa effect. Further investigations are necessary to understand which types of data sets are susceptible to a negative rogue effect and thus merit the removal of taxa from large phylogenetic reconstructions. Copyright © 2013 Elsevier Inc. All rights reserved.

DD-PREF: a language for expressing preferences over sets

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri; desJardins, Marie

2005-01-01

We present a representation language, DD-PREF (for Diversity and Depth PREFrences), for specifying the desired diversity and depth of sets of objects where each object is represented as a vector of feature values.

Complete genome analysis of 33 ecologically and biologically diverse Rift Valley fever virus strains reveals widespread virus movement and low genetic diversity due to recent common ancestry.

PubMed

Bird, Brian H; Khristova, Marina L; Rollin, Pierre E; Ksiazek, Thomas G; Nichol, Stuart T

2007-03-01

Rift Valley fever (RVF) virus is a mosquito-borne RNA virus responsible for large explosive outbreaks of acute febrile disease in humans and livestock in Africa with significant mortality and economic impact. The successful high-throughput generation of the complete genome sequence was achieved for 33 diverse RVF virus strains collected from throughout Africa and Saudi Arabia from 1944 to 2000, including strains differing in pathogenicity in disease models. While several distinct virus genetic lineages were determined, which approximately correlate with geographic origin, multiple exceptions indicative of long-distance virus movement have been found. Virus strains isolated within an epidemic (e.g., Mauritania, 1987, or Egypt, 1977 to 1978) exhibit little diversity, while those in enzootic settings (e.g., 1970s Zimbabwe) can be highly diverse. In addition, the large Saudi Arabian RVF outbreak in 2000 appears to have involved virus introduction from East Africa, based on the close ancestral relationship of a 1998 East African virus. Virus genetic diversity was low (approximately 5%) and primarily involved accumulation of mutations at an average of 2.9 x 10(-4) substitutions/site/year, although some evidence of RNA segment reassortment was found. Bayesian analysis of current RVF virus genetic diversity places the most recent common ancestor of these viruses in the late 1800s, the colonial period in Africa, a time of dramatic changes in agricultural practices and introduction of nonindigenous livestock breeds. In addition to insights into the evolution and ecology of RVF virus, these genomic data also provide a foundation for the design of molecular detection assays and prototype vaccines useful in combating this important disease.

Educator Beliefs and Cultural Knowledge: Implications for School Improvement Efforts

ERIC Educational Resources Information Center

Nelson, Sarah W.; Guerra, Patricia L.

2014-01-01

Purpose: This qualitative study reports on beliefs practicing educators hold about diverse students and families. Specifically, this study examined educator beliefs related to culturally, linguistically, and economically diverse students and families along with participants' knowledge of culture and its application in practice. Research Design:…

Guidelines for Psychological Practice in Health Care Delivery Systems

ERIC Educational Resources Information Center

American Psychologist, 2013

2013-01-01

Psychologists practice in an increasingly diverse range of health care delivery systems. The following guidelines are intended to assist psychologists, other health care providers, administrators in health care delivery systems, and the public to conceptualize the roles and responsibilities of psychologists in these diverse contexts. These…

Binary classification of aqueous solubility using support vector machines with reduction and recombination feature selection.

PubMed

Cheng, Tiejun; Li, Qingliang; Wang, Yanli; Bryant, Stephen H

2011-02-28

Aqueous solubility is recognized as a critical parameter in both the early- and late-stage drug discovery. Therefore, in silico modeling of solubility has attracted extensive interests in recent years. Most previous studies have been limited in using relatively small data sets with limited diversity, which in turn limits the predictability of derived models. In this work, we present a support vector machines model for the binary classification of solubility by taking advantage of the largest known public data set that contains over 46 000 compounds with experimental solubility. Our model was optimized in combination with a reduction and recombination feature selection strategy. The best model demonstrated robust performance in both cross-validation and prediction of two independent test sets, indicating it could be a practical tool to select soluble compounds for screening, purchasing, and synthesizing. Moreover, our work may be used for comparative evaluation of solubility classification studies ascribe to the use of completely public resources.

Ecoinformatics (Big Data) for Agricultural Entomology: Pitfalls, Progress, and Promise.

PubMed

Rosenheim, Jay A; Gratton, Claudio

2017-01-31

Ecoinformatics, as defined in this review, is the use of preexisting data sets to address questions in ecology. We provide the first review of ecoinformatics methods in agricultural entomology. Ecoinformatics methods have been used to address the full range of questions studied by agricultural entomologists, enabled by the special opportunities associated with data sets, nearly all of which have been observational, that are larger and more diverse and that embrace larger spatial and temporal scales than most experimental studies do. We argue that ecoinformatics research methods and traditional, experimental research methods have strengths and weaknesses that are largely complementary. We address the important interpretational challenges associated with observational data sets, highlight common pitfalls, and propose some best practices for researchers using these methods. Ecoinformatics methods hold great promise as a vehicle for capitalizing on the explosion of data emanating from farmers, researchers, and the public, as novel sampling and sensing techniques are developed and digital data sharing becomes more widespread.

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Launching the dialogue: Safety and innovation as partners for success in advanced manufacturing.

PubMed

Geraci, C L; Tinkle, S S; Brenner, S A; Hodson, L L; Pomeroy-Carter, C A; Neu-Baker, N

2018-06-01

Emerging and novel technologies, materials, and information integrated into increasingly automated and networked manufacturing processes or into traditional manufacturing settings are enhancing the efficiency and productivity of manufacturing. Globally, there is a move toward a new era in manufacturing that is characterized by: (1) the ability to create and deliver more complex designs of products; (2) the creation and use of materials with new properties that meet a design need; (3) the employment of new technologies, such as additive and digital techniques that improve on conventional manufacturing processes; and (4) a compression of the time from initial design concept to the creation of a final product. Globally, this movement has many names, but "advanced manufacturing" has become the shorthand for this complex integration of material and technology elements that enable new ways to manufacture existing products, as well as new products emerging from new technologies and new design methods. As the breadth of activities associated with advanced manufacturing suggests, there is no single advanced manufacturing industry. Instead, aspects of advanced manufacturing can be identified across a diverse set of business sectors that use manufacturing technologies, ranging from the semiconductors and electronics to the automotive and pharmaceutical industries. The breadth and diversity of advanced manufacturing may change the occupational and environmental risk profile, challenge the basic elements of comprehensive health and safety (material, process, worker, environment, product, and general public health and safety), and provide an opportunity for development and dissemination of occupational and environmental health and safety (OEHS) guidance and best practices. It is unknown how much the risk profile of different elements of OEHS will change, thus requiring an evolution of health and safety practices. These changes may be accomplished most effectively through multi-disciplinary, multi-sector, public-private dialogue that identifies issues and offers solutions.

Improving Adolescent Health Risk Assessment: A Multi-method Pilot Study.

PubMed

Thompson, Lindsay A; Wegman, Martin; Muller, Keith; Eddleton, Katie Z; Muszynski, Michael; Rathore, Mobeen; De Leon, Jessica; Shenkman, Elizabeth A

2016-12-01

Objectives Given poor compliance by providers with adolescent health risk assessment (HRA) in primary care, we describe the development and feasibility of using a health information technology (HIT)-enhanced HRA to improve the frequency of HRAs in diverse clinical settings, asking adolescents' recall of quality of care as a primary outcome. Methods We conducted focus groups and surveys with key stakeholders (Phase I) , including adolescents, clinic staff and providers to design and implement an intervention in a practice-based research network delivering private, comprehensive HRAs via tablet (Phase II). Providers and adolescents received geo-coded community resources according to individualized risks. Following the point-of-care implementation , we collected patient-reported outcomes using post-visit quality surveys (Phase III). Patient-reported outcomes from intervention and comparison clinics were analyzed using a mixed-model, fitted separately for each survey domain. Results Stakeholders agreed upon an HIT-enhanced HRA (Phase I). Twenty-two academic and community practices in north-central Florida then recruited 609 diverse adolescents (14-18 years) during primary care visits over 6 months; (mean patients enrolled = 28; median = 20; range 1-116; Phase II). Adolescents receiving the intervention later reported higher receipt of confidential/private care and counseling related to emotions and relationships (adjusted scores 0.42 vs 0.08 out of 1.0, p < .01; 0.85 vs 0.57, p < .001, respectively, Phase III) than those receiving usual care. Both are important quality indicators for adolescent well-child visits. Conclusions Stakeholder input was critical to the acceptability of the HIT-enhanced HRA. Patient recruitment data indicate that the intervention was feasible in a variety of clinical settings and the pilot evaluation data indicate that the intervention may improve adolescents' perceptions of high quality care.

The Fukushima-137Cs deposition case study: properties of the multi-model ensemble.

PubMed

Solazzo, E; Galmarini, S

2015-01-01

In this paper we analyse the properties of an eighteen-member ensemble generated by the combination of five atmospheric dispersion modelling systems and six meteorological data sets. The models have been applied to the total deposition of (137)Cs, following the nuclear accident of the Fukushima power plant in March 2011. Analysis is carried out with the scope of determining whether the ensemble is reliable, sufficiently diverse and if its accuracy and precision can be improved. Although ensemble practice is becoming more and more popular in many geophysical applications, good practice guidelines are missing as to how models should be combined for the ensembles to offer an improvement over single model realisations. We show that the ensemble of models share large portions of bias and variance and make use of several techniques to further show that subsets of models can explain the same amount of variance as the full ensemble mean with the advantage of being poorly correlated, allowing to save computational resources and reduce noise (and thus improving accuracy). We further propose and discuss two methods for selecting subsets of skilful and diverse members, and prove that, in the contingency of the present analysis, their mean outscores the full ensemble mean in terms of both accuracy (error) and precision (variance). Copyright © 2014. Published by Elsevier Ltd.

Meeting needs of Muslim girls in school sport: case studies exploring cultural and religious diversity.

PubMed

Benn, Tansin; Pfister, Gertrud

2013-01-01

This paper contains a sociocultural analysis of school sport experiences of Muslim girls in two countries with different gender policies in physical education (PE) classes: England and Denmark. In Denmark, PE lessons take place in co-educative classes, in England schools are more diverse, with predominantly co-educational but also single-sex and faith schools offering different learning contexts. Two case studies from Denmark and England are used to explore the experiences of migrant Muslim girls in these different settings. A social constructionist approach to gender underpins the interpretation of stakeholders' voices on the inclusion of Muslim girls and the analysis of PE discourses in these countries. Findings illustrate similarities and differences at the interface of cultural diversity, political rhetoric of inclusion and realities of sport experiences for Muslim girls in both countries. Complex influences on PE experiences include gender stereotypes, cultural and religious orientations and practices, as well as actions and expectations of parents, communities and coaches/teachers. The studies provide insights into the ways participants managed their identities as Muslim girls in different sport environments to enable participation and retention of their cultural identities. Highlighted throughout the paper are the ways in which school sport policy and practice, providers and gatekeepers, can include or exclude groups, in this case Muslim girls. Too often coaches and teachers are unaware of crucial facts about their learners, not only in terms of their physical development and capabilities but also in terms of their cultural needs. Mistakes in creating conducive learning environments leave young people to negotiate a way to participate or refrain from participation.

Multicultural Teacher Education as a Community of Practice: M.Ed./PDS Graduates' Perceptions of Their Preparation to Work with Diverse Students

ERIC Educational Resources Information Center

Lee, Young Ah; Chen, Shwu-Meei; Chang, Chen-Ni; Yoneda, Fusako

2017-01-01

This study used qualitative case study methods to investigate how a particular community of practice located in a Midwest university influenced the M.Ed./PDS graduates' perceptions of working with diverse students. We use the term multicultural education to refer to the orientations and practices of the M.Ed. program and how the graduates thought…

Demographic diversity, value congruence, and workplace outcomes in acute care.

PubMed

Gates, Michael G; Mark, Barbara A

2012-06-01

Nursing scholars and healthcare administrators often assume that a more diverse nursing workforce will lead to better patient and nurse outcomes, but this assumption has not been subject to rigorous empirical testing. In a study of nursing units in acute care hospitals, the influence of age, gender, education, race/ethnicity, and perceived value diversity on nurse job satisfaction, nurse intent to stay, and patient satisfaction were examined. Support was found for a negative relationship between perceived value diversity and all outcomes and for a negative relationship between education diversity and intent to stay. Additionally, positive relationships were found between race/ethnicity diversity and nurse job satisfaction as well as between age diversity and intent to stay. From a practice perspective, the findings suggest that implementing retention, recruitment, and management practices that foster a strong shared value system among nurses may lead to better workplace outcomes. Copyright © 2012 Wiley Periodicals, Inc.

Demographic Diversity, Value Congruence, and Workplace Outcomes in Acute Care

PubMed Central

Gates, Michael G.; Mark, Barbara A.

2012-01-01

Nursing scholars and healthcare administrators often assume that a more diverse nursing workforce will lead to better patient and nurse outcomes, but this assumption has not been subject to rigorous empirical testing. In a study of nursing units in acute care hospitals, the influence of age, gender, education, race/ethnicity, and perceived value diversity on nurse job satisfaction, nurse intent to stay, and patient satisfaction were examined. Support was found for a negative relationship between perceived value diversity and all outcomes and for a negative relationship between education diversity and intent to stay. Additionally, positive relationships were found between race/ethnicity diversity and nurse job satisfaction as well as between age diversity and intent to stay. From a practice perspective, the findings suggest that implementing retention, recruitment, and management practices that foster a strong shared value system among nurses may lead to better workplace outcomes. PMID:22377771

Intravaginal practices and microbicide acceptability in Papua New Guinea: implications for HIV prevention in a moderate-prevalence setting

PubMed Central

2012-01-01

Background The acceptability of female-controlled biomedical prevention technologies has not been established in Papua New Guinea, the only country in the Pacific region experiencing a generalised, moderate-prevalence HIV epidemic. Socio-cultural factors likely to impact on future product uptake and effectiveness, such as women’s ability to negotiate safer sexual choices, and intravaginal hygiene and menstrual practices (IVP), remain unclear in this setting. Methods A mixed-method qualitative study was conducted among women and men attending a sexual health clinic in Port Moresby. During in-depth interviews, participants used copies of a hand-drawn template to indicate how they wash/clean the vulva and/or vagina. Interviewers pre-filled commercially available vaginal applicators with 2-3mL KY Jelly® to create a surrogate vaginal microbicide product, which was demonstrated to study participants. Results A total of 28 IDIs were conducted (women=16; men=12). A diverse range of IVP were reported. The majority of women described washing the vulva only with soap and water as part of their daily routine; in preparation for sex; and following sexual intercourse. Several women described cleaning inside the vagina using fingers and soap at these same times. Others reported cleaning inside the vagina using a hose connected to a tap; using vaginal inserts, such as crushed garlic; customary menstrual ‘steaming’ practices; and the use of material fragments, cloth and newspaper to absorb menstrual blood. Unprotected sex during menstruation was common. The majority of both women and men said that they would use a vaginal microbicide gel for HIV/STI protection, should a safe and effective product become available. Microbicide use was considered most appropriate in ‘high-risk’ situations, such as sex with non-regular, transactional or commercial partners. Most women felt confident that they would be able to negotiate vaginal microbicide use with male sexual partners but if necessary would be prepared to use product covertly. Conclusions Notional acceptability of a vaginal microbicide gel for HIV/STI prevention was high among both women and men. IVP were diverse in nature, socio-cultural dimensions and motivators. These factors are likely to impact on the future acceptability and uptake of vaginal microbicides and other biomedical HIV prevention technologies in this setting. PMID:23116431

Programming cells by multiplex genome engineering and accelerated evolution.

PubMed

Wang, Harris H; Isaacs, Farren J; Carr, Peter A; Sun, Zachary Z; Xu, George; Forest, Craig R; Church, George M

2009-08-13

The breadth of genomic diversity found among organisms in nature allows populations to adapt to diverse environments. However, genomic diversity is difficult to generate in the laboratory and new phenotypes do not easily arise on practical timescales. Although in vitro and directed evolution methods have created genetic variants with usefully altered phenotypes, these methods are limited to laborious and serial manipulation of single genes and are not used for parallel and continuous directed evolution of gene networks or genomes. Here, we describe multiplex automated genome engineering (MAGE) for large-scale programming and evolution of cells. MAGE simultaneously targets many locations on the chromosome for modification in a single cell or across a population of cells, thus producing combinatorial genomic diversity. Because the process is cyclical and scalable, we constructed prototype devices that automate the MAGE technology to facilitate rapid and continuous generation of a diverse set of genetic changes (mismatches, insertions, deletions). We applied MAGE to optimize the 1-deoxy-D-xylulose-5-phosphate (DXP) biosynthesis pathway in Escherichia coli to overproduce the industrially important isoprenoid lycopene. Twenty-four genetic components in the DXP pathway were modified simultaneously using a complex pool of synthetic DNA, creating over 4.3 billion combinatorial genomic variants per day. We isolated variants with more than fivefold increase in lycopene production within 3 days, a significant improvement over existing metabolic engineering techniques. Our multiplex approach embraces engineering in the context of evolution by expediting the design and evolution of organisms with new and improved properties.

Perinatal Practices & Traditions Among Asian Indian Women.

PubMed

Goyal, Deepika

2016-01-01

As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.

Teaching for Diversity in Teacher Education: Transformative Frameworks

ERIC Educational Resources Information Center

Ragoonaden, Karen O.; Sivia, Awneet; Baxan, Victorina

2015-01-01

This paper examines the practice and professional development of teacher educators engaged in diversity pedagogy in Canadian teacher education programs. Using a reflective inquiry combined with a self-study of teacher and teacher education practices (S-STEP), three educators discuss the complexity of their research and teaching experiences through…

Compendium: Writings on Effective Practices for Culturally and Linguistically Diverse Exceptional Learners.

ERIC Educational Resources Information Center

Ford, Bridgie Alexis, Ed.

Derived from two national multicultural symposia, this compendium focuses on an array of topics that combine research and educational practices for youth from culturally and linguistically diverse backgrounds with disabilities and/or gifts. Specific papers include: (1) "Parent-Involved Social Skill Instruction and the Perceptions of Children…

Teaching Diverse Learners: Principles for Best Practice

ERIC Educational Resources Information Center

Mazur, Amy J.; Doran, Patricia Rice

2010-01-01

Based on current research, legislation, and best practices for the classroom, this user-friendly guide offers a comprehensive overview of everything teachers need to know to differentiate instruction for students who are culturally and linguistically diverse, as well as those who have or might have special education needs. Amy G. Mazur and…

Long-term productivity in traditional, organic and low-input management systems of the Upper Midwest

USDA-ARS?s Scientific Manuscript database

Traditional cropping practices in the Upper Midwest are marked by low-diversity and high tillage disturbance. Eight years of production were evaluated to determine potential benefits of adopting low-input and organic management practices on system productivity. Increased crop rotation diversity, red...

An Evaluation of Culturally Responsive Practices in Special Education Program for Preservice Educators

ERIC Educational Resources Information Center

Scott, LaRon A.; Alexander, Quentin; Fritton, Sandra; Thoma, Colleen

2017-01-01

Meeting the needs of students from culturally and linguistically diverse backgrounds is a serious concern that schools are facing. This article describes an evaluation of embedding culturally and linguistically diverse evidence-based practices in a master's program for teacher candidates seeking endorsement in special education. A…

Preservation of the genetic diversity of a local common carp in the agricultural heritage rice–fish system

PubMed Central

Ren, Weizheng; Hu, Liangliang; Guo, Liang; Zhang, Jian; Tang, Lu; Zhang, Entao; Zhang, Jiaen; Luo, Shiming; Tang, Jianjun; Chen, Xin

2018-01-01

We examined how traditional farmers preserve the genetic diversity of a local common carp (Cyprinus carpio), which is locally referred to as “paddy field carp” (PF-carp), in a “globally important agricultural heritage system” (GIAHS), i.e., the 1,200-y-old rice–fish coculture system in Zhejiang Province, China. Our molecular and morphological analysis showed that the PF-carp has changed into a distinct local population with higher genetic diversity and diverse color types. Within this GIAHS region, PF-carps exist as a continuous metapopulation, although three genetic groups could be identified by microsatellite markers. Thousands of small farmer households interdependently obtained fry and parental carps for their own rice–fish production, resulting in a high gene flow and large numbers of parent carps distributing in a mosaic pattern in the region. Landscape genetic analysis indicated that farmers’ connectivity was one of the major factors that shaped this genetic pattern. Population viability analysis further revealed that the numbers of these interconnected small farmer households and their connection intensity affect the carps’ inherent genetic diversity. The practice of mixed culturing of carps with diverse color types helped to preserve a wide range of genetic resources in the paddy field. This widespread traditional practice increases fish yield and resource use, which, in return, encourages famers to continue their practice of selecting and conserving diverse color types of PF-carp. Our results suggested that traditional farmers secure the genetic diversity of PF-carp and its viability over generations in this region through interdependently incubating and mixed-culturing practices within the rice−fish system. PMID:29295926

Implementation of Biotic Integrity Metrics to Identify the Effects of Land Use on the Diversity of Wetlands

NASA Astrophysics Data System (ADS)

Mills, L. D.; Hamilton, S. W.; Schiller, J. R.

2005-05-01

To identify critical biological measures of wetland health, we studied twelve wetlands in north-central Tennessee and south-central Kentucky, six impacted by row crop agriculture and six unimpacted. Aquatic macroinvertebrate were collected using 10.2 cm clear PVC pipe funnel traps and wire minnow traps. Seven samples were collected from each site between May 19 and August 8, 2004. Qualitative samples (one person-hour) were collected with dip nets from each wetland to correspond with the early July trap samples. Water quality parameters measured included dissolved oxygen, pH, temperature, specific conductance, and turbidity with multiparameter aquatic probe and nephlometer. Macroinvertebrates from three sets of samples for each site were identified, when possible, to genus. The number of organism collected per trap-period per site ranged from 43 to 2224. Fifty-six taxa were identified. Generally, natural areas showed greater species richness, diversity and evenness than agricultural sites. Dipterans, primarily chironomids, were the most dominant assemblages. The three most abundant predatory orders, Coleoptera, Odonata and Hemiptera, showed alternating patterns of dominance. Habitat stability and greater vegetative complexity, which are impacted by surrounding agricultural practices, appear to be strongly related to higher species diversity.

Cultural challenges to oral healthcare implementation in elders.

PubMed

Lo, Edward C M; Tan, Hai P

2014-02-01

For successful implementation of oral healthcare services for elders, there is a need to understand and respond to their oral health beliefs, perceived needs and preferred type of care services, all of which are shaped by their cultural beliefs and values. This poses challenges to oral healthcare providers, especially when serving a diverse elderly population with people coming from different cultural backgrounds. The general principles of oral healthcare provision and their adaptation to serve culturally diverse elderly populations are discussed. The oral health beliefs and behaviours of Chinese, an ethnic group that can be found in many countries across the world, are highlighted and used as examples. Chinese elders generally attach a higher value to the physical functions than to the appearance of their dentition and prefer to use traditional self-care methods to deal with their oral health problems rather than to seek professional services. There is need to incorporate into the training of oral healthcare providers the competence to adapt their services to the beliefs and practices of culturally diverse elderly population groups in different settings. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

Fluidized muds: a novel setting for the generation of biosphere diversity through geologic time.

PubMed

Aller, J Y; Aller, R C; Kemp, P F; Chistoserdov, A Y; Madrid, V M

2010-06-01

Reworked and fluidized fine-grained deposits in energetic settings are a major modern-day feature of river deltas and estuaries. Similar environments were probably settings for microbial evolution on the early Earth. These sedimentary systems act as efficient biogeochemical reactors with high bacterial phylogenetic diversity and functional redundancy. They are temporally rather than spatially structured, with repeated cycling of redox conditions and successive stages of microbial metabolic processes. Intense reworking of the fluidized bed entrains bacteria from varied habitats providing new, diverse genetic materials to contribute to horizontal gene transfer events and the creation of new bacterial ecotypes. These vast mud environments may act as exporters and promoters of biosphere diversity and novel adaptations, potentially on a globally important scale.

[Temporary disability and its legal implications].

PubMed

Martin-Fumadó, Carles; Martí Amengual, Gabriel; Puig Bausili, Lluïsa; Arimany-Manso, Josep

2014-03-01

Temporary disability is the condition that workers face when, as the result of illness (common or professional) or accident (work-related or not), they are temporarily prevented from performing their work and require health care. The management of temporary disability is a medical act that involves (in addition to a complex clinical assessment) obvious social, occupational and financial connotations and requires continuing medical follow-up from doctors, as well as responses to medical-legal conflicts. The regulatory framework on the subject is extensive in the Spanish setting and highly diverse in the European setting. Beyond the regulatory framework, the repercussions of temporary disability are self-evident at all levels. Although determining temporary disability is a common medical act for practicing physicians, it is not exempt from risks or difficulties arising from the assessment itself and the characteristics of practicing medical care. Established medical-legal conflicts include the processing of health data and the requirements for transferring information related to workers' temporary disability to their company's medical services. The interest and usefulness demonstrated by the data obtained from forensic medicine for public health require the incorporation of these data into general healthcare information, as it could be essential to the surveillance of worker health. The recommendations established by medical societies, as good practice guidelines, are especially useful in this type of conflict. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Early Detection of Heart Failure Using Electronic Health Records: Practical Implications for Time Before Diagnosis, Data Diversity, Data Quantity, and Data Density.

PubMed

Ng, Kenney; Steinhubl, Steven R; deFilippi, Christopher; Dey, Sanjoy; Stewart, Walter F

2016-11-01

Using electronic health records data to predict events and onset of diseases is increasingly common. Relatively little is known, although, about the tradeoffs between data requirements and model utility. We examined the performance of machine learning models trained to detect prediagnostic heart failure in primary care patients using longitudinal electronic health records data. Model performance was assessed in relation to data requirements defined by the prediction window length (time before clinical diagnosis), the observation window length (duration of observation before prediction window), the number of different data domains (data diversity), the number of patient records in the training data set (data quantity), and the density of patient encounters (data density). A total of 1684 incident heart failure cases and 13 525 sex, age-category, and clinic matched controls were used for modeling. Model performance improved as (1) the prediction window length decreases, especially when <2 years; (2) the observation window length increases but then levels off after 2 years; (3) the training data set size increases but then levels off after 4000 patients; (4) more diverse data types are used, but, in order, the combination of diagnosis, medication order, and hospitalization data was most important; and (5) data were confined to patients who had ≥10 phone or face-to-face encounters in 2 years. These empirical findings suggest possible guidelines for the minimum amount and type of data needed to train effective disease onset predictive models using longitudinal electronic health records data. © 2016 American Heart Association, Inc.

Strategic plan modelling by hospital senior administration to integrate diversity management.

PubMed

Newhouse, John J

2010-11-01

Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.

An improved method to set significance thresholds for β diversity testing in microbial community comparisons.

PubMed

Gülay, Arda; Smets, Barth F

2015-09-01

Exploring the variation in microbial community diversity between locations (β diversity) is a central topic in microbial ecology. Currently, there is no consensus on how to set the significance threshold for β diversity. Here, we describe and quantify the technical components of β diversity, including those associated with the process of subsampling. These components exist for any proposed β diversity measurement procedure. Further, we introduce a strategy to set significance thresholds for β diversity of any group of microbial samples using rarefaction, invoking the notion of a meta-community. The proposed technique was applied to several in silico generated operational taxonomic unit (OTU) libraries and experimental 16S rRNA pyrosequencing libraries. The latter represented microbial communities from different biological rapid sand filters at a full-scale waterworks. We observe that β diversity, after subsampling, is inflated by intra-sample differences; this inflation is avoided in the proposed method. In addition, microbial community evenness (Gini > 0.08) strongly affects all β diversity estimations due to bias associated with rarefaction. Where published methods to test β significance often fail, the proposed meta-community-based estimator is more successful at rejecting insignificant β diversity values. Applying our approach, we reveal the heterogeneous microbial structure of biological rapid sand filters both within and across filters. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Solo and Small Practices: A Vital, Diverse Part of Primary Care.

PubMed

Liaw, Winston R; Jetty, Anuradha; Petterson, Stephen M; Peterson, Lars E; Bazemore, Andrew W

2016-01-01

Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. © 2016 Annals of Family Medicine, Inc.

Solo and Small Practices: A Vital, Diverse Part of Primary Care

PubMed Central

Liaw, Winston R.; Jetty, Anuradha; Petterson, Stephen M.; Peterson, Lars E.; Bazemore, Andrew W.

2016-01-01

PURPOSE Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. METHODS A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. RESULTS More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. CONCLUSIONS Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. PMID:26755778

Comparison of genetic diversity between Canadian adapted genotypes and exotic germplasm of soybean.

PubMed

Iquira, Elmer; Gagnon, Eric; Belzile, François

2010-05-01

Soybean (Glycine max (L.) Merr.) was domesticated in China and the greatest genetic diversity for this species is found in Asia. In contrast, in North America, soybean cultivars trace back to a small number of plant introductions from Asia and genetic diversity is typically quite limited. The purpose of this work was to measure and compare the genetic diversity in two sets of soybean lines. The first set (termed "local") was composed of 100 lines used in a private breeding program in Quebec. The second set (termed "exotic") was composed of 200 lines from elsewhere in the world (but mostly from Asia) and included a few lines of Glycine soja, the wild progenitor of cultivated soybean. Almost all the genotypes belonged to maturity groups between 000 and II. A total of 39 microsatellites (SSRs) were used to genotype the two collections. The number of alleles per locus was almost twice as great in the exotic set compared with the local set. Also, the number of "unique" alleles, i.e., those uniquely present in one set and absent in the other, was almost fivefold greater (191 vs. 37) in a subset of 108 exotic lines with good adaptation than among the local set. A genetic distance matrix, a UPGMA cluster analysis, and a principal coordinate analysis were conducted based on the SSR data. These analyses all indicated that the exotic set was much more diverse and formed a clearly distinct group from the local set. Interestingly, some of the lines showing the best adaptation to local conditions were quite distinctive in terms of their genotype and could potentially contribute useful novel genetic variation within the breeding program.

"Meaningful use" of EHR in dental school clinics: how to benefit from the U.S. HITECH Act's financial and quality improvement incentives.

PubMed

Kalenderian, Elsbeth; Walji, Muhammad; Ramoni, Rachel B

2013-04-01

Through the 2009 HITECH (Health Information Technology for Economic and Clinical Health) Act, the U.S. government committed $27 billion to incentivize the adoption and "meaningful use" of certified electronic health records (EHRs) by providers, including dentists. Given their patient profiles, dental school clinics are in a position to benefit from this time-delimited commitment to support the adoption and use of certified EHR technology under the Medicaid-based incentive. The benefits are not merely financial: rather, the meaningful use objectives and clinical quality measures can drive quality improvement initiatives within dental practices and help develop a community of medical and dental professionals focused on quality. This article describes how dentists can qualify as eligible providers and the set of activities that must be undertaken and attested to in order to obtain this incentive. Two case studies describe the approaches that can be used to meet the Medicaid threshold necessary to be eligible for the incentive. Dentists can and have successfully applied for meaningful use incentive payments. Given the diverse set of patients who are treated at dental schools, these dental practices are among those most likely to benefit from the incentive programs.

The interaction between research and practice: a pan-European approach to managing H.pylori infection in primary care.

PubMed

Hungin, A P

2000-08-01

The transposition of evidence into clinical care presents many challenges. New knowledge may be immediately translatable to the practice setting, with barriers to be overcome before implementation. The early guidelines on Helicobacter pylori management presented an overview but were not able to take into account local factors and health care traditions, such as the non-availability of tests and established primary-secondary care relationships. Primary care is a specific specialty across most of Europe, existing within different health care systems and clinical traditions. The creation of H. pylori management guidelines, aimed at European primary care but adaptable to local national circumstances, presented a challenge in methodology and formulation. The process exposed similarities but also tensions between differing health care systems, as well as variations in the conditions in which GPs practise. Clinical differences, such as varying ulcer prevalence and drug resistance rates, highlighted the importance of guidelines being adaptable. This paper analyses the European Society for Primary Care Gastroenterology process of pan-European primary care agreement towards H.pylori management and how diverse views, traditions and national settings were reconciled through an evidence-based approach.

Diversifying mechanisms in the on-farm evolution of crop mixtures.

PubMed

Thomas, Mathieu; Thépot, Stéphanie; Galic, Nathalie; Jouanne-Pin, Sophie; Remoué, Carine; Goldringer, Isabelle

2015-06-01

While modern agriculture relies on genetic homogeneity, diversifying practices associated with seed exchange and seed recycling may allow crops to adapt to their environment. This socio-genetic model is an original experimental evolution design referred to as on-farm dynamic management of crop diversity. Investigating such model can help in understanding how evolutionary mechanisms shape crop diversity submitted to diverse agro-environments. We studied a French farmer-led initiative where a mixture of four wheat landraces called 'Mélange de Touselles' (MDT) was created and circulated within a farmers' network. The 15 sampled MDT subpopulations were simultaneously submitted to diverse environments (e.g. altitude, rainfall) and diverse farmers' practices (e.g. field size, sowing and harvesting date). Twenty-one space-time samples of 80 individuals each were genotyped using 17 microsatellite markers and characterized for their heading date in a 'common-garden' experiment. Gene polymorphism was studied using four markers located in earliness genes. An original network-based approach was developed to depict the particular and complex genetic structure of the landraces composing the mixture. Rapid differentiation among populations within the mixture was detected, larger at the phenotypic and gene levels than at the neutral genetic level, indicating potential divergent selection. We identified two interacting selection processes: variation in the mixture component frequencies, and evolution of within-variety diversity, that shaped the standing variability available within the mixture. These results confirmed that diversifying practices and environments maintain genetic diversity and allow for crop evolution in the context of global change. Including concrete measurements of farmers' practices is critical to disentangle crop evolution processes. © 2015 John Wiley & Sons Ltd.

How diversity gets lost: Age and gender in design practices of information and communication technologies.

PubMed

Oudshoorn, Nelly; Neven, Louis; Stienstra, Marcelle

2016-01-01

This article adopts an intersectional approach to investigate how age, gender, and diversity are represented, silenced, or prioritized in design. Based on a comparative study of design practices of information and communication technologies (ICTs) for young girls and older people, this article describes differences and similarities in the ways in which designers tried to cope with diversity. Ultimately diversity was neglected, and the developers relied on hegemonic views of gender and age, constructed older people and young girls as an "other," and consequently their input was neglected. These views were thus materialized in design and reinforce such views in powerful yet unobtrusive ways.

Predicting Acceptance of Diversity in Pre-Kindergarten Classrooms

ERIC Educational Resources Information Center

Sanders, Kay; Downer, Jason

2012-01-01

This study examined classroom-level contributors to an acceptance of diversity in publicly supported pre-kindergarten classrooms across 11 states. Classroom composition, process quality, and teacher characteristics were examined as predictors of diversity-promoting practices as measured by the ECERS-R, acceptance of diversity construct. Findings…

Multilevel and Diverse Classrooms

ERIC Educational Resources Information Center

Baurain, Bradley, Ed.; Ha, Phan Le, Ed.

2010-01-01

The benefits and advantages of classroom practices incorporating unity-in-diversity and diversity-in-unity are what "Multilevel and Diverse Classrooms" is all about. Multilevel classrooms--also known as mixed-ability or heterogeneous classrooms--are a fact of life in ESOL programs around the world. These classrooms are often not only…

Implementation of Audio Computer-Assisted Interviewing Software in HIV/AIDS Research

PubMed Central

Pluhar, Erika; Yeager, Katherine A.; Corkran, Carol; McCarty, Frances; Holstad, Marcia McDonnell; Denzmore-Nwagbara, Pamela; Fielder, Bridget; DiIorio, Colleen

2007-01-01

Computer assisted interviewing (CAI) has begun to play a more prominent role in HIV/AIDS prevention research. Despite the increased popularity of CAI, particularly audio computer assisted self-interviewing (ACASI), some research teams are still reluctant to implement ACASI technology due to lack of familiarity with the practical issues related to using these software packages. The purpose of this paper is to describe the implementation of one particular ACASI software package, the Questionnaire Development System™ (QDS™), in several nursing and HIV/AIDS prevention research settings. We present acceptability and satisfaction data from two large-scale public health studies in which we have used QDS with diverse populations. We also address issues related to developing and programming a questionnaire, discuss practical strategies related to planning for and implementing ACASI in the field, including selecting equipment, training staff, and collecting and transferring data, and summarize advantages and disadvantages of computer assisted research methods. PMID:17662924

13C-based metabolic flux analysis: fundamentals and practice.

PubMed

Yang, Tae Hoon

2013-01-01

Isotope-based metabolic flux analysis is one of the emerging technologies applied to system level metabolic phenotype characterization in metabolic engineering. Among the developed approaches, (13)C-based metabolic flux analysis has been established as a standard tool and has been widely applied to quantitative pathway characterization of diverse biological systems. To implement (13)C-based metabolic flux analysis in practice, comprehending the underlying mathematical and computational modeling fundamentals is of importance along with carefully conducted experiments and analytical measurements. Such knowledge is also crucial when designing (13)C-labeling experiments and properly acquiring key data sets essential for in vivo flux analysis implementation. In this regard, the modeling fundamentals of (13)C-labeling systems and analytical data processing are the main topics we will deal with in this chapter. Along with this, the relevant numerical optimization techniques are addressed to help implementation of the entire computational procedures aiming at (13)C-based metabolic flux analysis in vivo.

Genomic view on the peopling of India

PubMed Central

2012-01-01

India is known for its vast human diversity, consisting of more than four and a half thousand anthropologically well-defined populations. Each population differs in terms of language, culture, physical features and, most importantly, genetic architecture. The size of populations varies from a few hundred to millions. Based on the social structure, Indians are classified into various caste, tribe and religious groups. These social classifications are very rigid and have remained undisturbed by emerging urbanisation and cultural changes. The variable social customs, strict endogamy marriage practices, long-term isolation and evolutionary forces have added immensely to the diversification of the Indian populations. These factors have also led to these populations acquiring a set of Indian-specific genetic variations responsible for various diseases in India. Interestingly, most of these variations are absent outside the Indian subcontinent. Thus, this review is focused on the peopling of India, the caste system, marriage practice and the resulting health and forensic implications. PMID:23020857

Genomic view on the peopling of India.

PubMed

Tamang, Rakesh; Thangaraj, Kumarasamy

2012-10-01

India is known for its vast human diversity, consisting of more than four and a half thousand anthropologically well-defined populations. Each population differs in terms of language, culture, physical features and, most importantly, genetic architecture. The size of populations varies from a few hundred to millions. Based on the social structure, Indians are classified into various caste, tribe and religious groups. These social classifications are very rigid and have remained undisturbed by emerging urbanisation and cultural changes. The variable social customs, strict endogamy marriage practices, long-term isolation and evolutionary forces have added immensely to the diversification of the Indian populations. These factors have also led to these populations acquiring a set of Indian-specific genetic variations responsible for various diseases in India. Interestingly, most of these variations are absent outside the Indian subcontinent. Thus, this review is focused on the peopling of India, the caste system, marriage practice and the resulting health and forensic implications.

Pastoral care of mental illness and the accommodation of African Christian beliefs and practices by UK clergy.

PubMed

Leavey, Gerard; Loewenthal, Kate; King, Michael

2017-02-01

Faith-based organisations, especially those related to specific ethnic or migrant groups, are increasingly viewed by secular Western government agencies as potential collaborators in community health and welfare programmes. Although clergy are often called upon to provide mental health pastoral care, their response to such problems remains relatively unexamined. This paper examines how clergy working in multiethnic settings do not always have the answers that people want, or perhaps need, to problems of misfortune and suffering. In the UK these barriers can be attributed, generally, to a lack of training on mental health problems and minimal collaboration with health services. The current paper attempts to highlight the dilemmas of the established churches' involvement in mental health care in the context of diversity. We explore the inability of established churches to accommodate African and other spiritual beliefs and practices related to the etiology and treatment of mental health problems.

GEROM – Developing a Contemporary On-line Master’s Degree Curriculum in Gerontology

PubMed Central

Kokol, Peter; Blažun, Helena

2012-01-01

Demographic changes have profoundly influenced the structure of present and future populations in terms of the number of older people requiring nursing care, the nature and settings of the nursing care provided, and finally, each individual, e. g., nursing care providers. The aim of the paper is to present the results of the EU Erasmus project GEROM, which, among other things, resulted in an on-line gerontological master’s degree curriculum which is globally focused, flexible, innovative, diverse, contemporary and ICT-based. It focuses on meeting the needs of older people and their carers. An innovative aspect in the curriculum implementation is a virtual environment for clinical practice, enabling students to practice clinical and nursing interventions and diagnosing on-line, based on an adaptive, individualized and personalized blended-learning approach. During the pilot implementation of three randomly selected subjects, the students evaluated the program and were satisfied with both content and implementation. PMID:24199089

The Evolution of Gero-Oncology Nursing.

PubMed

Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

2016-02-01

This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.