Work vehicle warning lights : color options and effectiveness.

DOT National Transportation Integrated Search

2015-09-01

KTC reviewed existing regulations, guidance, and practices to assess the Kentucky Transportation Cabinets warning : lights program on highway work vehicles. The Kentucky Revised Statutes categorizes KYTC vehicles as public safety : vehicles ...

Collaborative Benchmarking: Discovering and Implementing Best Practices to Strengthen SEAs

ERIC Educational Resources Information Center

Building State Capacity and Productivity Center, 2013

2013-01-01

To help state educational agencies (SEAs) learn about and adapt best practices that exist in other SEAs and other organizations, the Building State Capacity and Productivity Center (BSCP Center) working closely with the Regional Comprehensive Centers will create multi-state groups, through a "Collaborative Benchmarking Best Practices Process" that…

Development Engineers' Work and Learning as Shared Practice

ERIC Educational Resources Information Center

Collin, Kaija

2008-01-01

The field of workplace learning lacks empirical studies that view workplace practices as places for learning and see these practices in a critical light. Accordingly, the aim of this study is, first, to describe examples of everyday shared practice and consider what kinds of various conflicting aims and demands exist in it. Second, the purpose is…

The Psychosomatic Disorders Pertaining to Dental Practice with Revised Working Type Classification

PubMed Central

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice". PMID:24478896

The psychosomatic disorders pertaining to dental practice with revised working type classification.

PubMed

Shamim, Thorakkal

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice".

Characteristics of nurses and hospital work environments that foster satisfaction and clinical expertise.

PubMed

Foley, Barbara Jo; Kee, Carolyn C; Minick, Ptlene; Harvey, Susan S; Jennings, Bonnie M

2002-05-01

The purpose of this aspect of a larger study was to describe characteristics of nurses and their work environment at two military hospitals. Few studies have explored characteristics among nurses who practice in military hospitals. There is reason to believe that differences exist between nurses who work in military and civilian hospitals, some of which are required educational level, leadership experience, officer status, and career development opportunities. A descriptive design was used to address how military and civilian nurses who work in military hospitals describe their autonomy, control over practice, nurse-physician collaboration, and clinical expertise and what relationships exist among these variables. Scores on autonomy, control over practice, and nurse-physician relationships all were above midpoint for all respondents as a group, indicating positive work environments in both of the military hospitals studied. Scores from the clinical expertise instrument were well above midpoint, indicating a desirable level of clinical expertise. These findings all reflect favorably on the military hospital work environment. This information will help to make a case for instituting or preserving those nursing processes that are effective and for identifying and working to change nursing processes that are not effective. Nurses will benefit by having a more collaborative work environment.

Developing a general practice library: a collaborative project between a GP and librarian.

PubMed

Pearson, D; Rossall, H

2001-12-01

The authors report on a self-completed questionnaire study from a North Yorkshire based general practice regarding the information needs of its clinicians. The work was carried out with a particular focus on the practice library, and the findings identified that a new approach to maintaining and developing the library was needed. The literature regarding the information needs of primary care clinicians and the role of practice libraries is considered, and compared to those of the clinicians at the practice. Discussion follows on how a collaborative project was set up between the practice and a librarian based at the local NHS Trust library in order to improve the existing practice library. Difficulties encountered and issues unique to the project are explored, including training implications presented by the implementation of electronic resources. Marketing activities implemented are discussed, how the library will operate in its new capacity, and how ongoing support and maintenance of the library will be carried out. It is concluded that although scepticism still exists regarding librarian involvement in practice libraries, collaboration between clinicians and librarians is an effective approach to the successful development and maintenance of a practice library, and recommendations are therefore made for similar collaborative work.

The relationship between organizational policies and practices and work limitations among hospital patient care workers.

PubMed

Sparer, Emily H; Boden, Leslie I; Sorensen, Glorian; Dennerlein, Jack T; Stoddard, Anne; Wagner, Gregory R; Nagler, Eve M; Hashimoto, Dean M; Hopcia, Karen; Sabbath, Erika L

2018-05-29

We examined relationships between organizational policies and practices (OPPs) (safety practices, ergonomic practices, and people-oriented culture) and work limitations in a sample of hospital workers. We used the 6-item Work Limitations Questionnaire (WLQ) to assess workers' perceptions of health-related work limitations. Self-reported OPPs and the WLQ were collected from workers in Boston, Massachusetts (n = 1277). We conducted random-intercept multi-level logistic regression models for each OPP using stepwise selection of covariates. As the unit-average ergonomic practice score increased by one, the odds of a worker reporting work limitations decreased by approximately 39% (P-value = 0.018), adjusted for job title, age, and body mass index. A similar relationship existed for people-oriented culture (P-value = 0.038). The association between safety practices and work limitations was similar, but not statistically significant. This study demonstrated the importance of workplace OPPs. OPPs that promote positive and supportive environments and that foster improvements in ergonomics may help reduce work limitations. © 2018 Wiley Periodicals, Inc.

Attitudes toward working mothers: accommodating the needs of mothers in the work force.

PubMed

Albright, A

1992-10-01

More women, including mothers, are part of the work force than ever before. In the workplace, barriers often exist that restrict promotion and advancement of mothers. Mothers often are penalized in attempting to meet the demands of parent and worker roles. Parenting practices have been considered primarily the domain of mothers. However, nurturing may be done effectively by fathers or other motivated adults. Policies of employers must change to accommodate needs of families. Examples of supportive practices may include flexible working hours, parental leave, and on-site child care.

The role of relationships in connecting social work research and evidence-based practice.

PubMed

Jones, Johnny M; Sherr, Michael E

2014-01-01

Critics of evidence-based practice (EBP) often challenge the efficacy of applying social work research in practice. Such skepticism underscores the historic chasm that still exists between social work researchers and practitioners. If taught and implemented consistently, the EBP model can mend the connection between researchers and practitioners by merging their roles. Merging their roles, however, requires a renewed emphasis on relationships in the research process. This article explores the role of relationships in social work research. Using a researcher/practitioner continuum, we assess the types of interactions faculty have with stakeholders. We then offer strategies for cultivating relationships with stakeholders that lead to community-derived and implemented research that is critical to advancing the widespread use of EBP in social work.

Work engagement in nursing practice: a relational ethics perspective.

PubMed

Keyko, Kacey

2014-12-01

The concept of work engagement has existed in business and psychology literature for some time. There is a significant body of research that positively correlates work engagement with organizational outcomes. To date, the interest in the work engagement of nurses has primarily been related to these organizational outcomes. However, the value of work engagement in nursing practice is not only an issue of organizational interest, but of ethical interest. The dialogue on work engagement in nursing must expand to include the ethical importance of engagement. The relational nature of work engagement and the multiple levels of influence on nurses' work engagement make a relational ethics approach to work engagement in nursing appropriate and necessary. Within a relational ethics perspective, it is evident that work engagement enables nurses to have meaningful relationships in their work and subsequently deliver ethical care. In this article, I argue that work engagement is essential for ethical nursing practice. If engagement is essential for ethical nursing practice, the environmental and organizational factors that influence work engagement must be closely examined to pursue the creation of moral communities within healthcare environments. © The Author(s) 2014.

Adjuncts in Social Work Programs: Good Practice or Unethical?

ERIC Educational Resources Information Center

Pearlman, Catherine A.

2013-01-01

Social work education programs rely heavily on adjunct instructors, as do most academic institutions. This article adds to existing literature on adjuncts by focusing on the unique issues in social work education, using social work values and ethics as a focus. The benefits and detriments for adjuncts, programs, and students in schools of social…

Between worst and best: developing criteria to identify promising practices in health promotion and disease prevention for the Canadian Best Practices Portal.

PubMed

Fazal, Nadia; Jackson, Suzanne F; Wong, Katy; Yessis, Jennifer; Jetha, Nina

2017-11-01

In health promotion and chronic disease prevention, both best and promising practices can provide critical insights into what works for enhancing the healthrelated outcomes of individuals and communities, and how/why these practices work in different situations and contexts. The promising practices criteria were developed using the Public Health Agency of Canada's (PHAC's) existing best practices criteria as the foundation. They were modified and pilot tested (three rounds) using published interventions. Theoretical and methodological issues and challenges were resolved via consultation and in-depth discussions with a working group. The team established a set of promising practices criteria, which differentiated from the best practices criteria via six specific measures. While a number of complex challenges emerged in the development of these criteria, they were thoroughly discussed, debated and resolved. The Canadian Best Practices Portal's screening criteria allow one to screen for both best and promising practices in the fields of public health, health promotion, chronic disease prevention, and potentially beyond.

SCHOOL SOCIAL WORK IN WISCONSIN, A DESCRIPTION OF SCHOOL SOCIAL WORK, GUIDELINES FOR A SCHOOL SOCIAL WORK PROGRAM. SOCIAL WORK IN OUR SCHOOLS.

ERIC Educational Resources Information Center

STAPLES, RICHARD M., COMP.

THIS ARTICLE DISCUSSES SCHOOL SOCIAL WORK DEVELOPMENT, PRACTICE, AND BASIC PRINCIPLES, THE ORGANIZATION OF SCHOOL SOCIAL WORK PROGRAMS IS DISCUSSED IN TERMS OF--(1) THE DEVELOPMENT OF NEW SCHOOL SOCIAL WORK PROGRAMS, (2) ADMINISTRATIVE ASPECTS, AND (3) EXISTING SCHOOL PROGRAMS. REFERRAL POLICIES AND PROCEDURES ARE COVERED. THE MANY ROLES OF THE…

Indoor Air Quality in Chemistry Laboratories.

ERIC Educational Resources Information Center

Hays, Steve M.

This paper presents air quality and ventilation data from an existing chemical laboratory facility and discusses the work practice changes implemented in response to deficiencies in ventilation. General methods for improving air quality in existing laboratories are presented and investigation techniques for characterizing air quality are…

Ideas of and Attitudes towards Projects and Changing Practices: Voices of Four Teachers

ERIC Educational Resources Information Center

Shome, Saurav; Natarajan, Chitra

2013-01-01

The paper reports a study of the project practices of four Indian middle school teachers, elicited through semi-structured interviews of individual teachers. The teachers also responded to a proposal to modify four aspects of existing project practices, viz. subject integration, assessment, group work, and management of resources. The aspects were…

Research-Practice Partnerships: Building Engagement to Benefit Children and Youth. Social Policy Report Brief. Volume 30, Issue 4

ERIC Educational Resources Information Center

Bridgman, Anne

2017-01-01

Gaps exist between research and practice, with some researchers expressing frustration that practitioners do not use or misuse research findings, and some practitioners saying research is not relevant to their work or not easily accessible or understood. In research-practice partnerships, which have proliferated recently, researchers and…

Disturbing Practices: Training Workers to Be Lean

ERIC Educational Resources Information Center

Yasukawa, Keiko; Brown, Tony; Black, Stephen

2014-01-01

Purpose: The purpose of this paper is to explore the possibilities for expansive learning during organisational change. It considers the introduction of "lean production" as a disturbance to the existing work practices. Design/methodology/approach: The paper considers two case studies of "lean production" training with…

Practice Patterns and Job Satisfaction of Mohs Surgeons.

PubMed

Kohli, Nita; Golda, Nicholas

2018-01-01

There is a paucity of data on Mohs surgery workforce patterns. To identify if gender differences exist in practice patterns of Mohs surgeons, factors that influence these differences, and factors influencing job satisfaction among Mohs surgeons. An electronic survey was distributed to dermatology organizations targeting members of the American College of Mohs Surgery (ACMS), from October 2015 to April 2016. Two hundred twenty-seven ACMS members responded; 37% were women. Twenty-five percent of women and 19% of men work part time. Thirty-seven percent of women practice in academia versus 22% of men. Forty-three percent of women and 23% of men identified children as a factor affecting their ability to work full time. Gender comparisons for current job satisfaction show 57% of men and 35% of women being very satisfied. Supervision/feedback/recognition adds to satisfaction at a higher rate for women (53%) than for men (29%). For both genders combined, work content, patient base, and autonomy had the highest average job satisfaction ratings. Gender differences exist in practice patterns and job satisfaction of Mohs surgeons. This study demonstrates factors that could influence job satisfaction among female Mohs surgeons-knowledge that is important to individuals who lead, mentor, or supervise female Mohs surgeons.

General practice and specialist palliative care teams: an exploration of their working relationship from the perspective of clinical staff working in New Zealand.

PubMed

Keane, Barry; Bellamy, Gary; Gott, Merryn

2017-01-01

With the future focus on palliative and end-of-life care provision in the community, the role of the general practice team and their relationship with specialist palliative care providers is key to responding effectively to the projected increase in palliative care need. Studies have highlighted the potential to improve co-ordination and minimise fragmentation of care for people living with palliative care need through a partnership between generalist services and specialist palliative care. However, to date, the exact nature of this partnership approach has not been well defined and debate exists about how to make such partnerships work successfully. The aim of this study was to explore how general practice and specialist palliative care team (SPCT) members view their relationship in terms of partnership working. Five focus group discussions with general practices and SPCT members (n = 35) were conducted in 2012 in two different regions of New Zealand and analysed using a general inductive approach. The findings indicate that participants' understanding of partnership working was informed by their identity as a generalist or specialist, their existing rules of engagement and the approach they took towards sustaining the partnership. Considerable commitment to partnership working was shown by all participating teams. However, their working relationship was based primarily on trust and personal liaison, with limited formal systems in place to enable partnership working. Tensions between the cultures of 'generalism' and 'specialism' also provided challenges for those endeavouring to meet palliative care need collaboratively in the community. Further research is required to better understand the factors associated with successful partnership working between general practices and specialist palliative care in order to develop robust strategies to support a more sustainable model of community palliative care. © 2015 John Wiley & Sons Ltd.

40 CFR Table 9 to Subpart Wwww of... - Initial Compliance With Work Practice Standards

Code of Federal Regulations, 2010 CFR

2010-07-01

... have demonstrated initial compliance if . . . 1. a new or existing closed molding operation using... adding materials, and materials are recovered after slitting. 2. a new or existing cleaning operation not...-containing materials storage operation keep containers that store HAP-containing materials closed or covered...

Provision of Adaptive Instruction: Implementation and Effects.

ERIC Educational Resources Information Center

Wang, Margaret C.

Despite increased interest in and acceptance of the concept and mandate of providing adaptive instruction to ensure schooling success for each student, a sizable gap exists between identification of specific educational practices and application of such practices in schools. The work described in this paper is aimed at examining the feasibility…

Gender, Parenthood, and Work Hours of Physicians.

ERIC Educational Resources Information Center

Grant, Linda; And Others

1990-01-01

Data from 204 young physicians (147 men, 57 women) revealed that parenthood significantly reduced women's, but not men's, practice hours. No significant gender differences existed for nonparents. Gaps between ideal and actual practice hours were smaller for mothers than for other groups, suggesting that mothers were more satisfied than other…

Suburban District Leaders' Perception of Their Practices

ERIC Educational Resources Information Center

Garcia France, Roxanne

2013-01-01

In the field of district leadership, most studies focus only on the context and conditions existing in large urban districts in need of reform. This study examined whether district leadership practices have applicability to district leaders working within the suburban context. In addition, it determined whether district conditions (i.e., district…

Assessing and changing medical practice culture.

PubMed

Hills, Laura

2011-01-01

Your medical practice has an existing culture that manifests itself daily in literally hundreds of ways. Some aspects of your culture likely support your practice's growth; others may be impeding your progress. This article describes the characteristics of medical practice culture and provides numerous examples of how culture influences behavior. It describes how culture is expressed in a medical practice through objects and artifacts, language, emotions, interactions, practice management systems, and daily work habits. It offers three techniques for assessing an existing medical practice culture and a checklist for conducting culture observations. This article also provides guidelines for identifying a desired medical practice culture and explores why changing culture is so difficult. It describes five reasons employees are likely to resist culture change and provides 12 fundamental changes that will enable a practice to improve its culture. Finally, this article explores how medical practice cultures are formed and perpetuated and provides more than a dozen questions to ask employees in a culture survey.

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.

Burnout and Work Engagement Among Dental Practitioners in Bangalore City: A Cross-Sectional Study

PubMed Central

Mallaiah, Pramila; Krishnamurthy, Archana; Sangha, Ranganath

2016-01-01

Introduction Burnout is a job-related stress reaction; a potential hazard for personal, professional lives of dentists. Work Engagement (WE) is the antithesis of Burnout and they can co-exist. Aim This study was taken up to know the prevalence of Burnout and WE among dentists in Bangalore, India. Matreials and Methods In a cross-sectional study, all (n=116) dentists practicing in Bangalore East Zone were randomly selected. A structured, self-administered questionnaire revealing dentists’ demographics, practice characteristics, Burnout level [6-item from Maslach Burnout Inventory] and WE [4-item from Utrecht Work Engagement Scale] was used. Ethical clearance and informed consent was obtained. The data was analyzed using SPSS version 15.0. Results With a response rate of 58.6%, high burnout was seen in 5.15% dentists. Personal Accomplishment was significantly associated with dentists in older age-group (p=0.002), married (p=0.014), MDS qualified (p=0.038), having long working hours (p=0.009) with assistants (p=0.024), more years into practice (0.007), travelling more distance from residence (p=0.021). Significance was also seen for dedication among dentists with assistants (p=0.006), emotional exhaustion among dentist with long working hours (p=0.009), and driving own vehicle (p=0.028). Finally absorption was found significant in dentists practicing solo. Conclusion Higher WE were found but still burnout persisted. Thus, burnout and WE were found to co-exist. PMID:27042589

Bioethics consultation practices and procedures: a survey of a large Canadian community of practice.

PubMed

Greenberg, R A; Anstey, K W; Macri, R; Heesters, A; Bean, S; Zlotnik Shaul, R

2014-06-01

The literature fails to reflect general agreement over the nature of the services and procedures provided by bioethicists, and the training and core competencies this work requires. If bioethicists are to define their activities in a consistent way, it makes sense to look for common ground in shared communities of practice. We report results of a survey of the services and procedures among bioethicists affiliated with the University of Toronto Joint Centre for Bioethics (JCB). This is the largest group of bioethicists working in healthcare organizations in Canada. The results suggest there are many common services and procedures of JCB bioethicists. This survey can serve as a baseline for further exploration of the work of JCB bioethicists. Common practices exist with respect to the domains of practice, individual reporting relationships, service availability within business hours and the education and training of the bioethicist.

Gallery Educators as Adult Learners: The Active Application of Adult Learning Theory

ERIC Educational Resources Information Center

McCray, Kimberly H.

2016-01-01

In order to better understand the importance of adult learning theory to museum educators' work, and that of their profession at large, museum professionals must address the need for more adult learning research and practice in museums--particularly work informed by existing theory and work seeking to generate new theory. Adult learning theory…

Implementation of cardiovascular disease prevention in primary health care: enhancing understanding using normalisation process theory.

PubMed

Volker, Nerida; Williams, Lauren T; Davey, Rachel C; Cochrane, Thomas; Clancy, Tanya

2017-02-24

The reorientation of primary health care towards prevention is fundamental to addressing the rising burden of chronic disease. However, in Australia, cardiovascular disease prevention practice in primary health care is not generally consistent with existing guidelines. The Model for Prevention study was a whole-of-system cardiovascular disease prevention intervention, with one component being enhanced lifestyle modification support and addition of a health coaching service in the general practice setting. To determine the feasibility of translating intervention outcomes into real world practice, implementation work done by stakeholders was examined using Normalisation Process Theory as a framework. Data was collected through interviews with 40 intervention participants and included general practitioners, practice nurses, practice managers, lifestyle advisors and participants. Data analysis was informed by normalisation process theory constructs. Stakeholders were in agreement that, while prevention is a key function of general practice, it was not their usual work. There were varying levels of engagement with the intervention by practice staff due to staff interest, capacity and turnover, but most staff reconfigured their work for required activities. The Lifestyle Advisors believed staff had varied levels of interest in and understanding of, their service, but most staff felt their role was useful. Patients expanded their existing relationships with their general practice, and most achieved their lifestyle modification goals. While the study highlighted the complex nature of the change required, many of the new or enhanced processes implemented as part of the intervention could be scaled up to improve the systems approach to prevention. Overcoming the barriers to change, such as the perception of CVD prevention as a 'hard sell', is going to rely on improving the value proposition for all stakeholders. The study provided a detailed understanding of the work required to implement a complex cardiovascular disease prevention intervention within general practice. The findings highlighted the need for multiple strategies that engage all stakeholders. Normalisation process theory was a useful framework for guiding change implementation.

Benefits from retrieval practice are greater for students with lower working memory capacity.

PubMed

Agarwal, Pooja K; Finley, Jason R; Rose, Nathan S; Roediger, Henry L

2017-07-01

We examined the effects of retrieval practice for students who varied in working memory capacity as a function of the lag between study of material and its initial test, whether or not feedback was given after the test, and the retention interval of the final test. We sought to determine whether a blend of these conditions exists that maximises benefits from retrieval practice for lower and higher working memory capacity students. College students learned general knowledge facts and then restudied the facts or were tested on them (with or without feedback) at lags of 0-9 intervening items. Final cued recall performance was better for tested items than for restudied items after both 10 minutes and 2 days, particularly for longer study-test lags. Furthermore, on the 2-day delayed test the benefits from retrieval practice with feedback were significantly greater for students with lower working memory capacity than for students with higher working memory capacity (r = -.42). Retrieval practice may be an especially effective learning strategy for lower ability students.

English as Rhetoric?--Once More, with Feeling...

ERIC Educational Resources Information Center

Green, Bill

2017-01-01

The installation of the new Australian Curriculum offers rich possibilities for rethinking English in Australia, and beyond. This paper proposes that rhetoric is usefully drawn into this work of reconceptualisation, as strategically an organising principle for English curriculum theory and practice. It reviews existing work on rhetoric and…

Linking College and Work: Exemplary Policies and Practices of Two-Year College Work-Based Learning Programs.

ERIC Educational Resources Information Center

Bragg, Debra D.; Hamm, Russell E.

Based on an initial phase of a study conducted in 1993 that surveyed 1,200 two-year colleges to describe the scope and character of work-based learning programs already in existence, phase 2 sought a more in-depth understanding of selected exemplary work-based learning programs. Ten programs in eight two-year colleges were identified for further…

Management of climatic heat stress risk in construction: a review of practices, methodologies, and future research.

PubMed

Rowlinson, Steve; Yunyanjia, Andrea; Li, Baizhan; Chuanjingju, Carrie

2014-05-01

Climatic heat stress leads to accidents on construction sites brought about by a range of human factors emanating from heat induced illness, and fatigue leading to impaired capability, physical and mental. It is an occupational characteristic of construction work in many climates and the authors take the approach of re-engineering the whole safety management system rather than focusing on incremental improvement, which is current management practice in the construction industry. From a scientific viewpoint, climatic heat stress is determined by six key factors: (1) air temperature, (2) humidity, (3) radiant heat, and (4) wind speed indicating the environment, (5) metabolic heat generated by physical activities, and (6) "clothing effect" that moderates the heat exchange between the body and the environment. By making use of existing heat stress indices and heat stress management processes, heat stress risk on construction sites can be managed in three ways: (1) control of environmental heat stress exposure through use of an action-triggering threshold system, (2) control of continuous work time (CWT, referred by maximum allowable exposure duration) with mandatory work-rest regimens, and (3) enabling self-paced working through empowerment of employees. Existing heat stress practices and methodologies are critically reviewed and the authors propose a three-level methodology for an action-triggering, localized, simplified threshold system to facilitate effective decisions by frontline supervisors. The authors point out the need for "regional based" heat stress management practices that reflect unique climatic conditions, working practices and acclimatization propensity by local workers indifferent geographic regions. The authors set out the case for regional, rather than international, standards that account for this uniqueness and which are derived from site-based rather than laboratory-based research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Read, Talk, Play, Watch: How HRD Practitioners Like to Learn

ERIC Educational Resources Information Center

Tyler, Jo A.

2008-01-01

While an aim of research is to inform practice, there exists a tension between scholars who undertake research and practitioners whom it might benefit. Scholars work diligently inside a system that values print for dissemination, but practitioners opine that the practicalities are embedded within ponderous articles rife with academic language and…

Best Practices for Teaching Those Afraid in Water

ERIC Educational Resources Information Center

Stillwell, Belinda E.

2011-01-01

The primary purpose of this study is to share what has been found to work well in professional practice based on a series of exploratory scholarly studies as well as information gathered informally from students and through specialized aquatic workshops, conferences and seminars. Research has shown that there is an existing population of at-risk…

How to Transform Teaching with Tablets

ERIC Educational Resources Information Center

Daccord, Tom; Reich, Justin

2015-01-01

Without a change in our technology integration strategies, there's no reason to expect that a new device will magically create new teaching practices. In some iPad classrooms, students are engaged in truly innovative work. On the whole, however, tablets are most often used to reproduce existing practices. To make the most of their investment in…

[Alcoholism and the aesthetics of existence: Jack London and the white logic of John Barleycorn].

PubMed

Arantes, Marco Antonio

2015-12-01

Employing this theme as a guideline, this article examines how his prose amounts to self-practice in the construction of subjectivity and the organization of existence. It investigates how this work is related to the theme of self-care, analyzed by Michel Foucault in volumes 2 and 3 of the History of sexuality, as regards the aesthetics of existence and the art of living which existed in the Greco-Roman and Hellenistic worlds.

Air Quality Benefits of Nighttime Construction in Texas Non-Attainment Counties--Technical Report.

DOT National Transportation Integrated Search

2017-12-15

The practice of performing some work zone activities at night has existed in the United States since at least the 1960s. Night work is most commonly initiated where it is impractical to close traffic lanes on certain high-volume roadways during norma...

Combining Education and Work; Experiences in Asia and Oceania: Bangladesh.

ERIC Educational Resources Information Center

Dacca Univ., Bangladesh. Inst. of Education and Research.

Bangladesh stresses the importance of education responsive to the country's development needs and capable of producing, through formal or non-formal methods, skilled, employable manpower. Although no pre-vocational training exists, new curricula have introduced practical work experience in the primary schools and have integrated agriculture,…

Community-Based Participatory Study Abroad: A Proposed Model for Social Work Education

ERIC Educational Resources Information Center

Fisher, Colleen M.; Grettenberger, Susan E.

2015-01-01

Study abroad experiences offer important benefits for social work students and faculty, including global awareness, practice skill development, and enhanced multicultural competence. Short-term study abroad programs are most feasible but typically lack depth of engagement with host communities and may perpetuate existing systems of power and…

Factors affecting food handling Practices among food handlers of Dangila town food and drink establishments, North West Ethiopia

PubMed Central

2014-01-01

Background Food borne diseases are major health problems in developed and developing countries including Ethiopia. The problem is more noticeable in developing countries due to prevailing poor food handling and sanitation practices, inadequate food safety laws, weak regulatory systems, lack of financial resources to invest on safer equipments, and lack of education for food handlers. Methods The objective of this study was to assess food handling practice and associated factors among food handlers working in food and drinking establishments of Dangila town, North West Ethiopia. Cross-sectional quantitative study design was conducted among 406 food handlers working in 105 food and drink establishments from July to August 2013 in Dangila town. Data were collected using face to face interview with pretested structured questionnaire and physical observation. Result The mean age of the respondents was 22.7 ± 4.2 years of which 62.8% of the food handlers were females. Two hundred thirteen (52.5%) of food handlers had good food handling practices. Marital status (AOR = 7.52, 95% CI, 1.45-38.97), monthly income (AOR = 0.395, 95% CI, 0.25-0.62), knowledge about food handling (AOR = 1.69, 95% CI, 1.05-2.73), existence of shower facility (AOR = 1.89, 95% CI, 1.12-3.21) and separate dressing room (AOR = 1.97, 95% CI, 1.11-3.49) were found to be significantly associated with good food handling Practices. Conclusion Above half of food handlers had good food handling practices. Marital status, monthly income, knowledge status, existence of shower facility, existence of separate dressing room and presence of insect and rodent were factors associated with food handling Practices. PMID:24908104

Portrait of the College Employee: Work "Em" to Death, or Just Leave "Em" Alone

ERIC Educational Resources Information Center

Simplicio, Joseph

2010-01-01

This article discusses work inequalities that currently exist within many of the nation's colleges. It does so by identifying two distinct groups of individuals who possess unique qualities that make them stand apart from one another. Each practice a special type of work ethic philosophy that helps define it as employees and as people. Through the…

The Way We Ask for Money… The Emergence and Institutionalization of Grant Writing Practices in Academia

ERIC Educational Resources Information Center

Serrano Velarde, Kathia

2018-01-01

Although existing scholarship offers critical insights into the working mechanisms of project-based research funding, little is known about the actual practice of writing grant proposals. Our study seeks to add a longitudinal dimension to the ongoing debate on the implications of competitive research funding by focusing on the incremental…

Inter- and Transdisciplinary Work: Connecting Research on Hormones with Problems of Educational Practice

ERIC Educational Resources Information Center

Rappolt-Schlichtmann, Gabrielle; Watamura, Sarah E.

2010-01-01

More than ever before, leaders within the field of education are looking to research on basic processes to inform and improve educational practices. Success requires building a reciprocal relationship between the field of education and research on learning and development, similar to what exists between biology and medicine. Key to this effort is…

Progressive Educational Practices and Environments in Sweden: Preparing Students to Live and Work in the Global Age

ERIC Educational Resources Information Center

Nordgren, R. D.

2006-01-01

A multi-site case study of three Swedish schools examined the dimensions of trust, responsibility, shared power (democracy), and global workforce competence as required by a decade-old national education reforms. A key finding was the existence of progressive educational practices including constructivist epistemology, evidenced by the schools'…

The Key to Employability Developing a Practical Model of Graduate Employability

ERIC Educational Resources Information Center

Pool, Lorraine Dacre; Sewell, Peter

2007-01-01

Purpose: The purpose of this paper is to introduce a straightforward, practical model of employability that will allow the concept to be explained easily and that can be used as a framework for working with students to develop their employability. Design/methodology/approach: The model was developed from existing research into employability issues…

Does Thoughtfully Adaptive Teaching Actually Exist? A Challenge to Teacher Educators

ERIC Educational Resources Information Center

Hoffman, James V.; Duffy, Gerald G.

2016-01-01

In this article, we explore the roots of thoughtfully adaptive teaching in reflection. Drawing on the conceptual work of Dewey and Schon, we examine reflective practice in teaching as a tool for resistance against institutional pressures to standardize teaching practices. We describe 2 programs of research related to this topic. One program of…

Separating "Inquiry Questions" and "Techniques" to Help Learners Move between the How and the Why of Biology Practical Work

ERIC Educational Resources Information Center

Philip, Judith M. D.; Taber, Keith S.

2016-01-01

School science practical activities have been criticised for exposing learners to a series of phenomena disconnected from the conceptual frameworks needed to understand them. Such activities are successful in the "domain of observables" but not the "domain of ideas". Few resources exist for classroom teachers wishing to improve…

From Quality Assurance to Quality Practices: An Investigation of Strong Microcultures in Teaching and Learning

ERIC Educational Resources Information Center

Mårtensson, Katarina; Roxå, Torgny; Stensaker, Bjørn

2014-01-01

One of the main beliefs in quality assurance is that this activity--indirectly--will stimulate change in the work practices associated with teaching and learning in higher education. However, few studies have provided empirical evidence of the existence of such a link. Instead, quality assurance has created an unfortunate divide between formal…

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems.

PubMed

Knowles, Sarah E; Chew-Graham, Carolyn; Coupe, Nia; Adeyemi, Isabel; Keyworth, Chris; Thampy, Harish; Coventry, Peter A

2013-09-20

Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about whether greater inter-professional working enhances experiences of care. The study demonstrates that research into implementation of novel treatments must consider how the introduction of innovation can be balanced with the need for integration into existing practice.

Better together? a naturalistic qualitative study of inter-professional working in collaborative care for co-morbid depression and physical health problems

PubMed Central

2013-01-01

Background Mental-physical multi-morbidities pose challenges for primary care services that traditionally focus on single diseases. Collaborative care models encourage inter-professional working to deliver better care for patients with multiple chronic conditions, such as depression and long-term physical health problems. Successive trials from the United States have shown that collaborative care effectively improves depression outcomes, even in people with long-term conditions (LTCs), but little is known about how to implement collaborative care in the United Kingdom. The aim of the study was to explore the extent to which collaborative care was implemented in a naturalistic National Health Service setting. Methods A naturalistic pilot study of collaborative care was undertaken in North West England. Primary care mental health professionals from IAPT (Increasing Access to Psychological Therapies) services and general practice nurses were trained to collaboratively identify and manage patients with co-morbid depression and long-term conditions. Qualitative interviews were performed with health professionals at the beginning and end of the pilot phase. Normalization Process Theory guided analysis. Results Health professionals adopted limited elements of the collaborative care model in practice. Although benefits of co-location in primary care practices were reported, including reduced stigma of accessing mental health treatment and greater ease of disposal for identified patients, existing norms around the division of mental and physical health work in primary care were maintained, limiting integration of the mental health practitioners into the practice setting. Neither the mental health practitioners nor the practice nurses perceived benefits to joint management of patients. Conclusions Established divisions between mental and physical health may pose particular challenges for multi-morbidity service delivery models such as collaborative care. Future work should explore patient perspectives about whether greater inter-professional working enhances experiences of care. The study demonstrates that research into implementation of novel treatments must consider how the introduction of innovation can be balanced with the need for integration into existing practice. PMID:24053257

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

PubMed

Hoff, Timothy

2013-12-01

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

Preparing Rural Students for an Urban Work Environment: A Handbook for Educators.

ERIC Educational Resources Information Center

Vaughn, D. Lanette; Vaughn, Paul R.

Written for rural educators, this handbook provides practical guidelines for working with rural youth who will be seeking jobs in urban areas. The suggested learning activities can be used for an independent course, integrated into existing programs, or applied in counseling. The introduction discusses needs of rural students and relates positive…

Collaborative Online Learning in Non-Formal Education Settings in the Developing World: A Best Practice Framework

ERIC Educational Resources Information Center

Asunka, Stephen

2011-01-01

In the present knowledge economy, individuals, particularly working adults, need to continuously acquire purposeful knowledge and skills so they can better contribute towards addressing society's ever-changing developmental challenges. In the developing world however, few opportunities exist for working adults to acquire such new learning…

Perceived Communication Skill Needs for Small Work Groups.

ERIC Educational Resources Information Center

Hawkins, Katherine; Fillion, Bryant

A study examined communication skills essential for small work groups and whether the quality of small group teaching and research is in decline. The study reviewed small group research done previously by others and the problem of existing pedagogy and research in small group communication which does not provide practical solutions to real life…

Public Welfare and Work Incentives: Theory and Practice. Studies in Public Welfare. Paper No. 14.

ERIC Educational Resources Information Center

Burke, Vee; Townsend, Alair A.

This chart book summarizes two volumes in the subcommittee's series, "Studies in Public Welfare." Paper No. 4 (Dec. 22, 1972) explored work incentive and disincentive features in existing and proposed public welfare programs (cash welfare, unemployment insurance, social security, veterans' benefits, food stamps, public housing, and medicaid).…

Negotiating markets for health: an exploration of physicians' engagement in dual practice in three African capital cities.

PubMed

Russo, Giuliano; McPake, Barbara; Fronteira, Inês; Ferrinho, Paulo

2014-09-01

Scarce evidence exists on the features, determinants and implications of physicians' dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local determinants on the practice. Forty-eight semi-structured qualitative interviews were conducted in the three cities to understand features of the practice and the respective markets. A survey was carried out in a sample of 331 physicians to explore their characteristics and decisions to work in public and private sectors. Descriptive analysis and inferential statistics were employed to explore differences in physicians' engagement in dual practice across the three locations. Different forms of dual practice were found to exist in the three cities, with public physicians engaging in private practice outside but also inside public facilities, in regulated as well as unregulated ways. Thirty-four per cent of the respondents indicated that they worked in public practice only, and 11% that they engaged exclusively in private practice. The remaining 55% indicated that they engaged in some form of dual practice, 31% 'outside' public facilities, 8% 'inside' and 16% both 'outside' and 'inside'. Local health system governance and the structure of the markets for physician services were linked to the forms of dual practice found in each location, and to their prevalence. Our analysis suggests that physicians' decisions to engage in dual practice are influenced by supply and demand factors, but also by how clearly separated public and private markets are. Where it is possible to provide little-regulated services within public infrastructure, less incentive seems to exist to engage in the formal private sector, with equity and efficiency implications for service provision. The study shows the value of analysing health markets to understand physicians' engagement in professional activities, and contributes to an evidence base for its regulation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013.

Understanding skill acquisition among registered nurses: the 'perpetual novice' phenomenon.

PubMed

Wilson, Barbara; Harwood, Lori; Oudshoorn, Abe

2015-12-01

To determine whether the perpetual novice phenomenon exists beyond nephrology nursing where it was first described. The perpetual novice is a state in which nurses are unable to progress from a novice to an expert in one or more essential clinical skills which are used in their practice area. Maintaining clinical competence is essential to quality patient care outcomes. An exploratory, sequential, mixed methods design was used, comprised of a quantitative component followed by in-depth interviews. Registered nurses employed in one of four roles were recruited from two university-affiliated hospitals in London, Ontario, Canada: Clinical Educator, Clinical Nurse Specialist, Advanced Practice Nurse and Nurse Practitioner. Participants were first asked to complete and return a survey and demographic questionnaire. Following the return of the completed surveys, ten participants were interviewed to enhance the results of the surveys. The results of the surveys confirmed that the perpetual novice phenomenon exists across multiple nursing care areas. Four contributing factors, both personal and structural in nature, emerged from the interviews: (1) opportunities for education, (2) the context of learning, (3) personal motivation and initiative to learn and (4) the culture of the units where nurses worked. The perpetual novice phenomenon exists due to a combination of both personal factors as well as contextual factors in the work environment. The results assist in directing future educational interventions and provide nursing leaders with the information necessary to create work environments that best enable practicing nurses to acquire and maintain clinical competence. © 2015 John Wiley & Sons Ltd.

Debating the use of work-based learning and interprofessional education in promoting collaborative practice in primary care: a discussion paper.

PubMed

Cameron, Shona; Rutherford, Ishbel; Mountain, Kristina

2012-01-01

The context of primary care in the UK is changing rapidly, underpinned by continuing policy drivers to ensure person-centred safe and effective practice. Undergraduate and postgraduate programmes for healthcare practitioners are increasingly using interprofessional education (IPE) as one route to engender greater understanding of others' roles and contributions to health care, with the suggestion that IPE leads to better integration and teamwork, and thus stronger collaborative practice. Access to education and professional development for those working in primary care is difficult, and individuals need the focus of learning to be clearly relevant to their practice. To review and debate the evidence on the role of work-based learning and IPE in enhancing collaborative practice in primary care. Literature search and critique of key papers relevant to primary care practice. The three themes emerged of IPE, workbased learning (WBL) and collaborative practice. There is a growing body of literature to support the positive outcomes of IPE and the utilisation of WBL in developing practice. A range of practitioners in a variety of work settings have used WBL approaches in the implementation of innovations and the development of communities of practice. However, little evidence exists to support these approaches in primary care. The application of WBL across primary care teams can support a positive and collaborative learning culture, resulting in changes to professional practice.

Does an activity based remuneration system attract young doctors to general practice?

PubMed Central

2012-01-01

Background The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority). The objective of this paper was to study which preferences that young doctors (women in majority), who are the potential entrants to general practice have for activity based vs. salary based payment systems. Methods In November-December 2010 all last year medical students and all interns in Norway (n = 1.562) were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. Results A total of 831 (53%) responded. Nearly half the sample (47%) did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix). Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those happy with a high work pace. Conclusions Given a concern about low recruitment to general practice in Norway, and the fact that an increasing share of medical students is women, we were interested in the extent to which the current Norwegian remuneration system correspond with the preferences of potential GPs. This study suggests that an existing remuneration mechanism has a selection effect on who would like to become a GP. Those most attracted are income motivated men. Those deterred are risk averse, and less happy with a high work pace. More research is needed on the extent to which experienced GPs differ along the questions we asked potential GPs, as well as studying the relative importance of other attributes than payment schemes. PMID:22433750

Risk assessment with victims of intimate partner violence: investigating the gap between research and practice.

PubMed

Cattaneo, Lauren Bennett; Chapman, Aliya R

2011-10-01

In intimate partner violence (IPV) risk assessment, there is consensus that a large gap exists between research and practice. This exploratory study interviewed 13 practitioners working with IPV victims to generate ideas about the nature of this gap, and found that only two conducted standardized risk assessment. Others felt imposing structure might detract from the quality of their work. Results support the need for different techniques in different contexts; some adjust only speed of services according to their risk perception, whereas others use in-depth information to customize services. Perspectives appear particularly disparate regarding victim minimization of risk. Implications for future work are discussed.

Clinging to the Past: The Air Force’s War on Dual-Career Families

DTIC Science & Technology

2014-06-01

combines existing research on stress and work-family conflict with new primary research on current USAF dual-career families in the form of a case...incompatibilities between the Air Force family schema (conceptions of, and practices relating to, USAF families). The study combines existing research on stress ... Stress Pathways ..................................................... 74 Figure 5, Civilian Dual-Career Stress Pathways

Making a business case for small medical practices to maintain quality while addressing racial healthcare disparities.

PubMed

Dunston, Frances J; Eisenberg, Andrew C; Lewis, Evelyn L; Montgomery, John M; Ramos, Diana; Elster, Arthur

2008-11-01

Various reports have documented variations in quality of care that occur among racial and ethnic populations, even after accounting for socioeconomic factors and health insurance status. Although quality improvement initiatives are often touted as the answer to healthcare disparities, researchers have questioned whether a business case exists that supports this notion. We assess various barriers and incentives for using quality improvement to address racial and ethnic healthcare disparities in small-to-medium-sized practices. We believe that although both indirect and direct cost incentives may exist, a favorable business case for small private practices cannot be made unless there are additional financial incentives. The business community can work with health plans to provide these incentives.

‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services

PubMed Central

2013-01-01

Background Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential. Methods The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England. Results A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working, shared clinics and joint meetings. Conclusions Cultural factors embodied in mutual misperceptions, attitudes, beliefs exist between CAMHS and AMHS. Working practices can exert either positive or negative effects on transition and continuity of care. Implementation of shared education and training, standardised approaches to record keeping and information transfer, supported by compatible IT resources are recommended, alongside management strategies which evaluate the achievement of outcomes related to transition and continuity of care. PMID:23822089

'Talking a different language': an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services.

PubMed

McLaren, Susan; Belling, Ruth; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P

2013-07-03

Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential. The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England. A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working, shared clinics and joint meetings. Cultural factors embodied in mutual misperceptions, attitudes, beliefs exist between CAMHS and AMHS. Working practices can exert either positive or negative effects on transition and continuity of care. Implementation of shared education and training, standardised approaches to record keeping and information transfer, supported by compatible IT resources are recommended, alongside management strategies which evaluate the achievement of outcomes related to transition and continuity of care.

Teacher Perception of Principal Leadership Practices: Impacting Teachers' Sense of Self-Efficacy in Rural Appalachia Kentucky

ERIC Educational Resources Information Center

Hibbard, Brandon Lee

2016-01-01

The purpose of this study was to determine if a significant relationship existed between principal leadership practices, as perceived by teachers, and teacher's sense of self-efficacy. The target population was rural Appalachian teachers that worked for a principal that had been in administration for at least three consecutive years. This study…

Current Approaches to the Assessment of Graphic Design in a Higher Education Context

ERIC Educational Resources Information Center

Giloi, Susan; du Toit, Pieter

2013-01-01

This article provides an overview of the current trends in assessment practice within the field of graphic design. The demands placed on educators to apply sound assessment practice for Higher Education subjects is as intense in the field of graphic design as in any other. Forcing the assessment of creative visual work into existing assessment…

Transforming Barriers into Bridges: The Benefits of a Student-Driven Accessibility Planning Committee. Practice Brief

ERIC Educational Resources Information Center

Cragg, Stephanie J.; Carter, Irene; Nikolova, Kristina

2013-01-01

The School of Social Work and Disability Studies Accessibility Planning Committee (APC) is a student-driven initiative that has been in existence for over 10 years. This practice brief looked at the committee through interviews with faculty and student members. The investigation aimed to determine whether the benefits of having a student-driven…

New Jersey interagency emergency management plan.

DOT National Transportation Integrated Search

2005-09-01

This report outlines the research and work performed to lay the foundation for the : development of a New Jersey Interagency Emergency Management Plan. The : research into existing practices within the four state level transportation agencies : revea...

Conditions for research in general practice. Can the Dutch and British experiences be applied to other countries, for example Spain?

PubMed

van der Zee, Jouke; Kroneman, Madelon; Bolíbar, Bonaventura

2003-06-01

The aim of this study is to identify conditions for research as part of professional development in general practice. Based on the work of Andrew Abbott, who studied the dynamics of professional development, five conditions were identified. These are: the creation of associations among professionals; control of work; the establishment of specialised education; the development of professional knowledge; and the creation of organised structures for professional work. Two countries with a well-established research tradition in general practice (the UK and the Netherlands) and one country where GP research development is still limited (Spain) were evaluated on the basis of these conditions. The conditions identified as favourable were as follows: the existence of a scientific association; a peer-reviewed journal; a defined population resulting in a population denominator for practices; a gatekeeping system; chairs and departments of general practice at universities; the integration of education centres and research centres; GPs working in group practices or health centres; a certain degree of independence from the Ministry of Health; and financial support for practicing GPs to conduct research activities. We showed that most conditions for the successful scientific progress of general practice in Spain are present. However there is still a gap between academia and general practice and a lack of research organisation and support.

Impact of long farm working hours on child safety practices in agricultural settings.

PubMed

Marlenga, Barbara; Pahwa, Punam; Hagel, Louise; Dosman, James; Pickett, William; Brison, Robert J; Crowe, Trever; Koehncke, Niels; Snodgrass, Phyllis; Day, Lesley; Voaklander, Donald

2010-01-01

To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants. Owner-operators reported a median of 60 to 70 hours of farm work per week during warm weather months, with declines in hours over the winter. Spouses reported similar seasonal patterns, although their median reported hours were much lower. Longer farm working hours by owner-operators were marginally associated with increased exposure of teenagers to farm work hazards. Exposures of young children to worksite hazards rose in association with longer farm working hours by spouses. Exposures of children to farm worksite hazards and demands may be consequences of adult long working hours. © 2010 National Rural Health Association.

Designing for privacy management in hospitals: Understanding the gap between user activities and IT staff's understandings.

PubMed

Eikey, Elizabeth V; Murphy, Alison R; Reddy, Madhu C; Xu, Heng

2015-12-01

We examined the role of privacy in collaborative clinical work and how it is understood by hospital IT staff. The purpose of our study was to identify the gaps between hospital IT staff members' perceptions of how electronic health record (EHR) users' protect the privacy of patient information and how users actually protect patients' private information in their daily collaborative activities. Since the IT staff play an important role in implementing and maintaining the EHR, any gaps that exist between the IT staff's perceptions of user work practices and the users' actual work practices can result in a number of problems in the configuration, implementation, or customization of the EHR, which can lead to collaboration challenges, interrupted workflow, and privacy breaches. We used qualitative data collection methods for this study. We conducted semi-structured interviews with 20 hospital IT staff members. We also conducted observations of EHR users in the in-patient units of the same hospital. We identified gaps in IT staff's understandings of users' work activities, especially in regards to privacy-compromising workarounds that are used by users and why they are used. We discuss the reasons why this gap may exist between IT staff and users and ways to improve IT staff's understanding of why users perform certain privacy-compromising workarounds. A hospital's IT staff face a daunting task in ensuring users' collaborative work practices are supported by the system while providing effective privacy mechanisms. In order to achieve both goals, the IT staff must have a clear understanding of their users' practices. However, as this study highlights, there may be a mismatch between the IT staff's understandings of how users protect patient privacy and how users actually protect privacy. Copyright © 2015. Published by Elsevier Ireland Ltd.

Critical Thinking as Integral to Social Work Practice

ERIC Educational Resources Information Center

Gibbons, Jill; Gray, Mel

2004-01-01

The paper examines the role of critical thinking in an experience-based model of social work education. Within this model, the development of a critical approach to our own understanding of, as well as to existing knowledge about, the world is fundamental for students and educators alike. Critical thinking is defined as more than a rational,…

Alternative validation practice of an automated faulting measurement method.

DOT National Transportation Integrated Search

2010-03-08

A number of states have adopted profiler based systems to automatically measure faulting, : in jointed concrete pavements. However, little published work exists which documents the : validation process used for such automated faulting systems. This p...

"To rid oneself of the uninvited guest": Robert Koch, Sergei Winogradsky and competing styles of practice in medical microbiology.

PubMed

Attenborough, Frederick Thomas

2012-01-01

Does an infectious disease have one, singular pathogenic cause, or many interacting causes? In the discipline of medical microbiology, there is no definitive theoretical answer to this question: there, the conditions of aetiological possibility exist in a curious tension. Ever since the late 19th century, the “germ theory of disease”–“one disease, one cause”– has co-existed with a much less well known theory of “multifactorality”–“one disease, many interacting causes”. And yet, in practice, it is always a singular and never a multifactorial aetiology that emerges once the pathogenic world is brought into the field of medical perception. This paper seeks to understand why. Performing a detailed, genealogical reading of the 2003 severe acute respiratory syndrome (SARS) outbreak, it foregrounds a set of links that connect the practical diagnostic tools at work within contemporary, 21st century laboratories to the philosophical assumptions at work within late-19th century understandings of the “germ theory of disease”.

Probabilistic framework for product design optimization and risk management

NASA Astrophysics Data System (ADS)

Keski-Rahkonen, J. K.

2018-05-01

Probabilistic methods have gradually gained ground within engineering practices but currently it is still the industry standard to use deterministic safety margin approaches to dimensioning components and qualitative methods to manage product risks. These methods are suitable for baseline design work but quantitative risk management and product reliability optimization require more advanced predictive approaches. Ample research has been published on how to predict failure probabilities for mechanical components and furthermore to optimize reliability through life cycle cost analysis. This paper reviews the literature for existing methods and tries to harness their best features and simplify the process to be applicable in practical engineering work. Recommended process applies Monte Carlo method on top of load-resistance models to estimate failure probabilities. Furthermore, it adds on existing literature by introducing a practical framework to use probabilistic models in quantitative risk management and product life cycle costs optimization. The main focus is on mechanical failure modes due to the well-developed methods used to predict these types of failures. However, the same framework can be applied on any type of failure mode as long as predictive models can be developed.

Development of roles for occupational therapists and physiotherapists in work related practice: An Australian perspective.

PubMed

Adam, Kerry; Gibson, Elizabeth; Lyle, Alexandra; Strong, Jenny

2010-01-01

This paper will explore the development of occupational therapists' and physiotherapists' roles in work related practice from an early focus on rehabilitation of injured workers, to one including prevention and health promotion. A review of international evidence identified the roles, tasks and employment paths for occupational therapists and physiotherapists in work related practice. The relationship between government regulation and therapists' access to the workplace was also examined. Occupational therapists and physiotherapists hold valued positions in work related professional practice. Whilst initially their roles were based on injury management through occupational rehabilitation, both professions have demonstrated a clear vision of the importance of prevention of work related injury and disease. Social and workplace changes in the late 1970s in a number of western countries, commencing with the Robens' reforms in the United Kingdom, led to improved legislation and regulation for managing occupational health and safety. The approach of both disciplines to practice in this field reflects their individual professional education. However, some role overlaps exists in consultancy activities in the industrial environment. Implementation of modern OHS regulatory programs in other western countries, including Australia, has increased and broadened the opportunities for therapists, as governments, employers and insurers support early intervention to minimise the impact of workplace injuries and diseases.

Relationships between dental hygienists' career attitudes and their retention of practice. Part II. From the results of the Ohio Dentist and Dental Hygiene Surveys.

PubMed

Cox, S S; Langhout, K J; Scheid, R C

1993-01-01

This article utilizes findings from the Ohio Dental Hygiene Survey and Ohio Dentist Survey to uncover what specific dental hygiene attitudes exist relative to employment and what factors have led to job termination and to re-entry. Ohio dental hygiene employees are most satisfied with patient relationships, co-worker relationships, and flexible working hours. The dental hygienists are least satisfied with fringe benefits, financial growth, and career creativity. Salary, benefits, nor career longevity were significant factors in determining satisfaction. Dental hygienists who were not working when surveyed, said they would consider returning to practice if a better salary were available, if they could find part-time work, if there were a good wage scale with benefits, or if their own financial need changed. Thirty-six percent of the non-practitioners said they would not ever consider returning to practice due to working conditions, establishment of a new career, or inadequate compensation. Dentist employers stated that they were satisfied or very satisfied with their dental hygienists' patient care and contribution to the practice.

Profession of neuropsychology in Latin America.

PubMed

Arango-Lasprilla, Juan Carlos; Stevens, Lillian; Morlett Paredes, Alejandra; Ardila, Alfredo; Rivera, Diego

2017-01-01

The purpose of this study was to analyze characteristics of individuals working in the profession of neuropsychology in Latin America in order to understand their background, professional training, current work situation, assessment and diagnostic procedures used, rehabilitation techniques employed, population targeted, teaching responsibilities, and research activities. A total of 808 professionals working in neuropsychology from 17 countries in Latin America completed an online survey between July 2013 and January 2014. The majority of participants were female and the mean age was 36.76 years (range 21-74 years). The majority of professionals working in neuropsychology in Latin America have a background in psychology, with some additional specialized training and supervised clinical practice. Over half work in private practice, universities, or private clinics and are quite satisfied with their work. Those who identify themselves as clinicians primarily work with individuals with learning problems, ADHD, mental retardation, TBI, dementia, and stroke. The majority respondents cite the top barrier in the use of neuropsychological instruments to be the lack of normative data for their countries. The top perceived barriers to the field include: lack of academic training programs, lack of clinical training opportunities, lack of willingness to collaborate between professionals, and lack of access to neuropsychological instruments. There is a need in Latin America to increase regulation, improve graduate curriculums, enhance existing clinical training, develop professional certification programs, validate existing neuropsychological tests, and create new, culturally-relevant instruments.

3 CFR - Establishing a Working Group on the Intersection of HIV/AIDS, Violence Against Women and Girls...

Code of Federal Regulations, 2013 CFR

2013-01-01

... prevention activities that engage men and boys and highlight their role in the prevention of violence against... research (disaggregated by sex, gender, and gender identity, where practicable); and (v) existing...

Practices of Return-to-Work Coordinators Working in Large Organizations.

PubMed

Durand, Marie-José; Nastasia, Iuliana; Coutu, Marie-France; Bernier, Michael

2017-03-01

Purpose Although the role of return-to-work coordinators (RTW coordinators) is associated with reducing long-term disabilities, little has been written about their practices. The objective of this study was to clearly identify their tasks and activities and the stakeholders with whom they collaborate. Methods A cross-sectional survey was conducted using a web-based self-administered questionnaire. Participant inclusion criteria were as follows: (1) working for a large organization with 500 or more employees; (2) being responsible for managing disabilities and coordinating the return-to-work process; and (3) having been involved in coordinating the return to work of at least one person in the past year. Results 195 RTW coordinators completed the questionnaire. The three tasks or activities rated as most important were applying laws, policies, and regulations related to work absences and return to work; contacting the absent worker; and planning the return to work. A nursing or occupational health and safety training background significantly influenced the RTW coordinators' practices. In addition, RTW coordinators collaborated mainly with workers and their supervisors. Conclusion Despite a wide variety of contexts and diverging definitions of competencies, a set of common RTW coordination practices appears to exist across industrialized countries. RTW coordinators with a training background in the health field seem better able to assimilate the various dimensions of work disability. Moreover, concerted action was found to be minimal and a far cry from recommendations. The practices defined could serve as a benchmark for describing RTW coordinators' responsibilities in greater detail and allow for cross-organization and cross-country comparisons.

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

PubMed Central

Hoff, Timothy

2013-01-01

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

Puzzling practice: a strategy for working with clinical practice issues.

PubMed

Walsh, Kenneth; Moss, Cheryle; Lawless, Jane; McKelvie, Rhonda; Duncan, Lindsay

2008-04-01

In this paper we aim to share the evolution of innovative ways to explore, 'unpack' and reframe clinical issues that exist in everyday practice. The elements of these processes, which we call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the four authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which we draw on and use in our practice development work and in our research practice. This paper pays attention to a particular form of puzzling practice that we have found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. The paper uses a semi-fictitious example of 'Puzzling Practice' gleaned from our experience as practice development facilitators. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle exploring the heart of out practice; formulating the puzzle question; visualizing the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.

Causal Impact of Employee Work Perceptions on the Bottom Line of Organizations.

PubMed

Harter, James K; Schmidt, Frank L; Asplund, James W; Killham, Emily A; Agrawal, Sangeeta

2010-07-01

Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results. © The Author(s) 2010.

Supporting practice teachers to identify failing students.

PubMed

Skingley, Ann; Arnott, J; Greaves, J; Nabb, J

2007-01-01

The subject of identifying and supporting failing students in community nursing education programmes has been largely overlooked in the literature, yet is of great concern to practice teachers. This article discusses the views on the topic of a group of practice teachers in the light of existing, related research and proposes a number of indicators for good practice. It is suggested that of central importance is the need for higher education institutions and practice teachers to work together in identifying students causing concern at an early stage in their studies, based on both objective and subjective observations, and to have in place documented procedures to be followed when such situations arise.

Overview of Vertical Axis Wind Turbine (VAWT)

NASA Technical Reports Server (NTRS)

Sullivan, W. N.

1979-01-01

A survey is presented of the practices which were applied for designing VAWT blades. An attempt is made to discuss strengths and weaknesses of the existing procedures. Discussion is provided on planned or suggested future work in developing improved design tools.

How high-performance work systems drive health care value: an examination of leading process improvement strategies.

PubMed

Robbins, Julie; Garman, Andrew N; Song, Paula H; McAlearney, Ann Scheck

2012-01-01

As hospitals focus on increasing health care value, process improvement strategies have proliferated, seemingly faster than the evidence base supporting them. Yet, most process improvement strategies are associated with work practices for which solid evidence does exist. Evaluating improvement strategies in the context of evidence-based work practices can provide guidance about which strategies would work best for a given health care organization. We combined a literature review with analysis of key informant interview data collected from 5 case studies of high-performance work practices (HPWPs) in health care organizations. We explored the link between an evidence-based framework for HPWP use and 3 process improvement strategies: Hardwiring Excellence, Lean/Six Sigma, and Baldrige. We found that each of these process improvement strategies has not only strengths but also important gaps with respect to incorporating HPWPs involving engaging staff, aligning leaders, acquiring and developing talent, and empowering the front line. Given differences among these strategies, our analyses suggest that some may work better than others for individual health care organizations, depending on the organizations' current management systems. In practice, most organizations implementing improvement strategies would benefit from including evidence-based HPWPs to maximize the potential for process improvement strategies to increase value in health care.

The prevalence of work-related musculoskeletal disorders among sonographers.

PubMed

Al-Rammah, Tamader Y; Aloufi, Areej S; Algaeed, Saffana K; Alogail, Noura S

2017-01-01

Work-related musculoskeletal disorders (WRMSDs) have a significant effect on the psychological and physical function of the sonographer. This study is concerned about finding the prevalence of WRMSDs among sonographers in the Kingdom of Saudi Arabia and assessing how to improve future practices and develop guidelines for safe, pain-free ultrasound departments. A survey was distributed to sonographers working in major hospitals in Riyadh, Saudi Arabia (n = 100, 83% response rate). The questionnaire focused on workload and ergonomics, pain existence and history, and the level of the sonographers' awareness of prevention measures and best practices. Ethical approval was obtained from a local Institutional Review Board. Eighty-four percent of respondents suffer from pain they associated with their ultrasound practice. The shoulder, back, neck and right hand were the main symptomatic body areas. Low levels of awareness about best practices and safety measures were revealed. There was a strong correlation between the degree of pain suffered and the years of practice, the number of patients scanned per day, and movements during the exam. Implementing standards and guidelines for best ultrasound practices is needed to develop better and safer ultrasound departments in Saudi hospitals for every practitioner.

A study examining the impact of 12-hour shifts on critical care staff.

PubMed

Richardson, Annette; Turnock, Christopher; Harris, Liz; Finley, Alison; Carson, Sarah

2007-11-01

Twelve-hour shifts contribute to flexible patterns of work, but the effects on delivery of direct care and staff fatigue are important topics for deeper examination. To examine the impact and implications of 12-hour shifts on critical care staff. A staged dual approach using two focus groups (n = 16) and questionnaires (n = 147) with critical care staff from three critical care units. Positive effects were found with planning and prioritizing care, improved relationships with patients/relatives, good-quality time off work and ease of travelling to work. Less favourable effects were with caring for patients in isolation cubicles and the impact on staff motivation and tiredness. Acceptable patterns of work were suggested for 'numbers of consecutive shifts' and 'rest periods between shifts'. Most participants believed 12-hour shifts should continue. The challenge is to ensure existing systems and practices develop to improve on the less positive effects of working 12-hour shifts. This study provides nurse managers with important and relevant staff views on the impact of working 12-hour shifts. In particular to those working within a critical care environment and suggests the challenge is to ensure existing systems and practices develop to improve on the less encouraging effects of working 12-hour shifts. It adds an understanding of the senior nurse's view on the positive and negative effects of managing and organizing staff off duty to safely run a department with 12-hour shifts.

Studying work practices: a key factor in understanding accidents on the level triggered by a balance disturbance.

PubMed

Derosier, C; Leclercq, S; Rabardel, P; Langa, P

2008-12-01

Accidents on the level (AOL) rank second amongst the most numerous and serious occupational accidents with days lost in France and are a major health and safety problem in every sector of activity. The case study described in this paper was conducted at a metallurgical company with 300 employees. The aims of this work were dual: 1) to extend the general knowledge required for preventing these accidents; 2) to propose prevention measures to this company. Existing data on company occupational accidents were gathered and analysed to identify a work situation that appeared likely to cause AOL. This work situation was analysed in detail. Several risk factors were identified within this work situation, by way of interviews with 12 operators. These risk factors concerned various dimensions of the work situation, particularly its physical dimension (e.g. templates structure) and organisational dimension (e.g. parts availability). Interviews were conducted, focusing on risk factors perceived by operators and involving allo-confrontations based on accounts of four AOL occurring in this situation. Allo-confrontations were interviews confronting operators with a risk occupational situation that was accidental for one of their colleagues, the latter being absent from the interview. Results highlighted the fact that the work practices implemented are key factors in understanding these accidents. This study underlines the role of work practices in AOL causality and prevention. It also provides explanations associated with various work situation dimensions involving adoption of more or less safe work practices. AOL are serious and frequent in occupational situations. Injury claims analysis and interviews in an industrial company emphasise the specific characteristics of an occupational situation and of prevention actions forming the basis of an intervention. The need for a better understanding of factors affecting work practice is highlighted in relation to research.

Changing Teachers, Changing Times. Teachers' Work and Culture in the Postmodern Age. Professional Development and Practice Series.

ERIC Educational Resources Information Center

Hargreaves, Andy

This book examines the personal, moral, cultural, and political dimensions of teaching in the context of rapid and far-reaching change within teachers' work and in the world beyond it. The chapters in Part One examine the powerful forces for change in society and how those forces are exerting pressure on existing institutions. Issues such as the…

Beyond bureaucracy: emerging trends in social care informatics.

PubMed

Wastell, David; White, Sue

2014-09-01

Existing information technology systems in much of UK social care have been designed to serve the interests of the bureaucracy rather than supporting professional practice or improving services to the public. The ill-starred Integrated Children's System in statutory children's services is typical. The Integrated Children's System is a system for form-filling, micro-managing professional practice through an enforced regime of standard processes and time scales. In this article, we argue against this dominant design. We provide several examples where technology has enabled alternative modes of support for professional work, based on socio-technical principles. One such system is Patchwork, which describes itself as a 'Facebook for Social Work'; its aim is to support multi-professional teams working with vulnerable families. © The Author(s) 2013.

When Sex Work Becomes Your Everything: The Complex Linkages Between Economy and Affection Among Male Sex Workers in Peru.

PubMed

Bayer, Angela M; Garvich, Mijail; Díaz, David A; Sánchez, Hugo; García, Patricia J; Coates, Thomas J

2014-09-01

In Peru, there are few studies on male sex workers (MSWs), and existing studies explore limited subgroups or offer limited information about MSWs' perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives, and HIV/STI (sexually transmitted infection) risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs' perceived HIV/STI risks, vulnerabilities, and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health, and well-being. © The Author(s) 2013.

When sex work becomes your everything: The complex linkages between economy and affection among male sex workers in Peru

PubMed Central

Bayer, Angela M.; Garvich, Mijail; Díaz, David A.; Sánchez, Hugo; García, Patricia J.; Coates, Thomas J.

2014-01-01

In Peru, there are few studies on male sex workers (MSWs) and existing studies explore limited sub-groups or offer limited information about MSWs’ perspectives. This study provides in-depth perspectives from 40 MSWs who work in downtown Lima (Cercado) and in surrounding urban neighborhoods (non-Cercado) through interviews on their identities, lives and HIV/STI risks and vulnerabilities. Findings are that entry into sex work links economy and affection, particularly among Cercado MSWs. Continued sex work cements this link, making it difficult to exit sex work and establish goals. Ties between economics and affections influence MSWs’ perceived HIV/STI risks, vulnerabilities and prevention practices. Although Cercado MSWs report higher HIV/STI risks and vulnerabilities than non-Cercado peers, they report fewer prevention practices given inability to buy condoms and acceptance of client offers of higher payment, especially clients they feel affection for. MSWs need support to strengthen their self-perceptions and define and pursue their goals in order to improve their HIV/STI prevention practices, health and well-being. PMID:24368712

The nature of expertise in fingerprint examiners.

PubMed

Busey, Thomas A; Parada, Francisco J

2010-04-01

Latent print examinations involve a complex set of psychological and cognitive processes. This article summarizes existing work that has addressed how training and experience creates changes in latent print examiners. Experience appears to improve overall accuracy, increase visual working memory, and lead to configural processing of upright fingerprints. Experts also demonstrate a narrower visual filter and, as a group, tend to show greater consistency when viewing ink prints. These findings address recent criticisms of latent print evidence, but many open questions still exist. Cognitive scientists are well positioned to conduct studies that will improve the training and practices of latent print examiners, and suggestions for becoming involved in fingerprint research are provided.

Employer Expectations for Newly Trained Pathologists: Report of a Survey From the Graduate Medical Education Committee of the College of American Pathologists.

PubMed

Post, Miriam D; Johnson, Kristen; Brissette, Mark D; Conran, Richard Michael; Domen, Ronald E; Hoffman, Robert D; McCloskey, Cindy B; Raciti, Patricia M; Roberts, Cory Anthony; Rojiani, Amyn M; Tucker, J Allan; Powell, Suzanne Z

2017-02-01

-Multiple sources have identified challenges that training programs face in preparing graduates for the "real world" practice of pathology, and many training programs have sought to decrease the gap between skills acquired during training and those required in practice. However, there exists the possibility that some of the difficulty experienced by newly trained pathologists and employers might arise from differences between employer expectations of new hires and what applicants expect from their first job. -To define the constellation of skills and attributes employers prioritize when hiring newly trained pathologists. -A survey of fellows of the College of American Pathologists in practice for 5 or more years in the United States was administered and the results were analyzed. -A total of 630 pathologists who were responsible for hiring a new-in-practice pathologist completed the survey. Regardless of practice setting, certain skills and attributes were rated critically important in new hires, including ethics/integrity, work ethic, and professionalism. Seventy-one percent reported having some difficulty hiring entry-level pathologists and cited inadequate training/experience during residency, and applicants having unrealistic expectations regarding work load/hours as the most common reasons. -Prospective employers not only expect well-developed diagnostic skills in their job applicants, but also require evidence of a strong work ethic and outstanding professionalism. Successful applicants must display willingness to assume responsibilities and flexibility regarding existing and new responsibilities. A secondary but important finding of this survey was that most jobs are garnered through word-of-mouth recommendations; therefore, it is crucial for pathologists-in-training to hone their networking skills.

Relationship between nurses' practice environments and nursing outcomes in Turkey.

PubMed

Topçu, I; Türkmen, E; Badır, A; Göktepe, N; Miral, M; Albayrak, S; Kebapçı, A; Serbest, Ş; Özcan, D

2016-06-01

This study aimed to understand nursing practice environment characteristics in Istanbul-area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. A well-known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. This cross-sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Almost half of nurses suffered from high-level burnout related to emotional exhaustion and personal accomplishment, and one-third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. There was a relationship between poor practice environments and nursing outcomes in Turkey. The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Poor practice environments, high-level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. © 2016 International Council of Nurses.

The Energy Forum of Sri Lanka: Working toward appropriate expertise

NASA Astrophysics Data System (ADS)

Nieusma, Dean

Taking my cue from the knowledge base and practices comprising appropriate technology development, and building on politics of expertise scholarship, this dissertation develops the concept of appropriate expertise: the combination of social and technical competences required to address marginalization through technological interventions. The dissertation asks what appropriate expertise looks like "on the ground" in the context of development as practiced by an exceptional group of technology designers from the Energy Forum of Sri Lanka: What design goals did they strive toward? What challenges did they face? What strategies did they employ? In an effort to answer these questions, the dissertation looks at how these designers interacted across a range of contexts with a broad spectrum of people and institutions, each with its own expertise to draw upon. In particular, it looks at how they situated their work in a highly contoured field of social power, where different types of expertise were used as resources for reinforcing or resisting existing power relations. I use the concept relations of expertise to denote the structure of expert interactions across multiple contexts of activity. Although this concept links to broad political-economic conditions that order varied expert practices, my analytic focus is at a different level: the situated experiences of expert practitioners. By starting with ground-level practices and understandings, I argue that creating new relations of expertise---that is, changing the nature of the interactions among experts and between experts and those they work with---is the key way my informants worked to legitimate marginalized perspectives and thereby empower marginalized social groups around technology-development practices. Appropriate expertise enables the creation of appropriate technologies, but it does more. It enables the creation of new relations of expertise, both through inspiring new forms of interpersonal interaction surrounding technology development and through incremental modification of existing decision-making structures to allow a more diverse group stakeholders to come together around technology decision making in the context of development.

Pierre Bourdieu: Expanding the scope of nursing research and practice.

PubMed

Nairn, Stuart; Pinnock, David

2017-10-01

Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure. © 2017 John Wiley & Sons Ltd.

Former Hawaii Restoration Ecologist Now Favors 'Tinkering' Over Rigor. Review of Cabin, Robert J. 2011. Intelligent tinkering: bridging the gap between science and practice.

Treesearch

Susan Cordell

2012-01-01

In his new book, Bob Cabin uses his personal involvement in the restoration of Hawai'i dry forests to illustrate the tensions that he feels exists between the science and practice of ecological restoration. It is a journey that starts out among the multidisciplinary, multi-interest perspectives associated with a grass-roots communitybased working group (Part 1,...

Identifying knowledge gaps between practice and research for implementation components of sustainable interventions to improve the working environment - A rapid review.

PubMed

Rasmussen, Charlotte Diana Nørregaard; Højberg, Helene; Bengtsen, Elizabeth; Jørgensen, Marie Birk

2018-02-01

In a recent study, we involved all relevant stakeholders to identify practice-based implementation components for successful implementation and sustainability in work environment interventions. To understand possible knowledge gaps between evidence and practice, the aim of this paper is to investigate if effectiveness studies of the 11 practice-based implementation components can be identified in existing scientific literature. PubMed/MEDLINE, PsycINFO, and Web of Science were searched for relevant studies. After screening, 38 articles met the inclusion criteria. Since some of the studies describe more than one practice-based implementation concept a total of 125 quality criteria assessments were made. The overall result is that 10 of the 11 practice-based implementation components can be found in the scientific literature, but the evaluation of them is poor. From this review it is clear that there are knowledge gaps between evidence and practice with respect to the effectiveness of implementation concepts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

15 CFR 996.11 - Development of standards for a hydrographic product or class.

Code of Federal Regulations, 2012 CFR

2012-01-01

... COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The Quality... class. (a) NOAA shall work, to the extent practicable, through existing, recognized, standards bodies in...

15 CFR 996.11 - Development of standards for a hydrographic product or class.

Code of Federal Regulations, 2013 CFR

2013-01-01

... COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The Quality... class. (a) NOAA shall work, to the extent practicable, through existing, recognized, standards bodies in...

15 CFR 996.11 - Development of standards for a hydrographic product or class.

Code of Federal Regulations, 2011 CFR

2011-01-01

... COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The Quality... class. (a) NOAA shall work, to the extent practicable, through existing, recognized, standards bodies in...

15 CFR 996.11 - Development of standards for a hydrographic product or class.

Code of Federal Regulations, 2014 CFR

2014-01-01

... COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The Quality... class. (a) NOAA shall work, to the extent practicable, through existing, recognized, standards bodies in...

Case Studies of Two High-Poverty High-Performing Schools

ERIC Educational Resources Information Center

Gehrke, Lori R.

2010-01-01

The existing literature on learning organizations emphasize that leadership and strong organizational culture are central to their successful development. Whereas schools continue to face government control, accountability, and financial restraints, they are also working diligently to engage in ongoing school improvement practices to provide…

The public health nutrition intervention management bi-cycle: a model for training and practice improvement.

PubMed

Hughes, Roger; Margetts, Barrie

2012-11-01

The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. Education and practice settings. This model will have applications for educators and practitioners. Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.

Designing Clinical Space for the Delivery of Integrated Behavioral Health and Primary Care.

PubMed

Gunn, Rose; Davis, Melinda M; Hall, Jennifer; Heintzman, John; Muench, John; Smeds, Brianna; Miller, Benjamin F; Miller, William L; Gilchrist, Emma; Brown Levey, Shandra; Brown, Jacqueline; Wise Romero, Pam; Cohen, Deborah J

2015-01-01

This study sought to describe features of the physical space in which practices integrating primary care and behavioral health care work and to identify the arrangements that enable integration of care. We conducted an observational study of 19 diverse practices located across the United States. Practice-level data included field notes from 2-4-day site visits, transcripts from semistructured interviews with clinicians and clinical staff, online implementation diary posts, and facility photographs. A multidisciplinary team used a 4-stage, systematic approach to analyze data and identify how physical layout enabled the work of integrated care teams. Two dominant spatial layouts emerged across practices: type-1 layouts were characterized by having primary care clinicians (PCCs) and behavioral health clinicians (BHCs) located in separate work areas, and type-2 layouts had BHCs and PCCs sharing work space. We describe these layouts and the influence they have on situational awareness, interprofessional "bumpability," and opportunities for on-the-fly communication. We observed BHCs and PCCs engaging in more face-to-face methods for coordinating integrated care for patients in type 2 layouts (41.5% of observed encounters vs 11.7%; P < .05). We show that practices needed to strike a balance between professional proximity and private work areas to accomplish job tasks. Private workspace was needed for focused work, to see patients, and for consults between clinicians and clinical staff. We describe the ways practices modified and built new space and provide 2 recommended layouts for practices integrating care based on study findings. Physical layout and positioning of professionals' workspace is an important consideration in practices implementing integrated care. Clinicians, researchers, and health-care administrators are encouraged to consider the role of professional proximity and private working space when creating new facilities or redesigning existing space to foster delivery of integrated behavioral health and primary care. © Copyright 2015 by the American Board of Family Medicine.

Professional knowledge, midwifery and the role of the external examiner.

PubMed

Walker, M; Sibson, J

1998-01-01

Following the move of midwifery education into institutions of higher education (IHE), professional sources have voiced some concern over the apparent 'cultural conflict' between IHE and the midwives. In order to investigate this, a 1-day conference was convened for midwife teachers and external examiners in the south of England, during which data were collected from recorded discussions and interviews. The findings confirm the existence of conflict which polarized around two issues: first, the centrality of practice for midwives and the perceived undermining of that practice by the academically orientated IHE; and second, the somewhat ambiguous role of the external examiner. These findings are explained in terms of recent work on professionalization which suggests that professional knowledge can be legitimized where the emphasis is placed on the indeterminate elements of the work and where knowledge originates from abstractions and conceptualizations derived from working practice. Such a knowledge base would be rather more resistant to undermining by the deductive, rationalist approach employed by IHE academics. It is suggested that external examiners are best placed to represent practice based knowledge to IHE examiners.

Practice assistants in primary care in Germany - associations with organizational attributes on job satisfaction.

PubMed

Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim; Miksch, Antje; Ose, Dominik; Campbell, Stephen M; Goetz, Katja

2013-08-05

Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations. This observational study was based on a job satisfaction survey and measurement of organizational attributes in general practices in the German federal state of Baden-Wuerttemberg. Job satisfaction was measured with the 10-item 'Warr-Cook-Wall job satisfaction scale'. Organizational attributes were evaluated with the 21-items 'survey of organizational attributes for primary care' (SOAPC). Linear regression analyses were performed in which each of SOAPC scales and the overall score of SOAPC was treated as outcome variables. 586 practice assistants out of 794 respondents (73.8%) from 234 general practices completed the questionnaire. Practice assistants were mostly satisfied with their colleagues and least of all satisfied with their income and recognition for their work. The regression analysis showed that 'freedom of working method' and 'recognition of work', the employment status of practice assistants and the mode of practice were almost always significantly associated with each subscale and overall score of SOAPC. Job satisfaction is highly associated with different aspects of organizational attributes for primary care ('communication', 'decision-making' and 'stress'). Consequently, improved job satisfaction could lead to a better-organized primary care team. This implication should be investigated directly in further intervention studies with a special focus on improving the recognition for work and income.

48 CFR 970.5203-2 - Performance improvement and collaboration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... in the communication of the success of improvements to other management and operating contractors in... management and operation of the contract. This may entail the alteration of existing practices or the... approaches consistent with the statement of work and performance measures of this contract. (b) The...

48 CFR 970.5203-2 - Performance improvement and collaboration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... in the communication of the success of improvements to other management and operating contractors in... management and operation of the contract. This may entail the alteration of existing practices or the... approaches consistent with the statement of work and performance measures of this contract. (b) The...

40 CFR 63.52 - Approval process for new and existing affected sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... affected sources. 63.52 Section 63.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... CATEGORIES Requirements for Control Technology Determinations for Major Sources in Accordance With Clean Air... emission reductions that can be achieved if the control technologies or work practices are installed...

Virtual reality interventions for rehabilitation: considerations for developing protocols.

PubMed

Boechler, Patricia; Krol, Andrea; Raso, Jim; Blois, Terry

2009-01-01

This paper is a preliminary report on a work in progress that explores the existence of practice effects in early use of virtual reality environments for rehabilitation purposes and the effects of increases in level of difficulty as defined by rate of on-screen objects.

Old, down and out? Appearance, body work and positive ageing among elderly South Korean women.

PubMed

Elfving-Hwang, Joanna

2016-08-01

This article offers an as yet unexplored dimension of our current understanding of the ageing body in the context of contemporary South Korea. Drawing on interviews with twenty elderly women living in the greater Seoul metropolitan area, this article explores the role of appearance, body work, and the presentation of self in the women's everyday lived experiences. Existing research on the ageing female body in South Korea has primarily focused on the so-called noin munjae ('the elderly issue') discourse, within which the ageing body is framed as passive, undesirable, or out-of-control. Contrary to this, the elderly women's own narratives of everyday beauty practices suggest that the act of sustaining well-ordered appearance in later life allows for the enforcing of positive selves in the context of personal beauty and body work. Maintaining a positive appearance was shown to play an important part of their everyday lives, and functioned as a ritual of not only presenting an appearance that signified control over the ageing body, but to continue to enjoy it. The carefully calculated engagement with various non-surgical and surgical beauty practices also emerged as an embodied practice of mediating intersubjective social encounters through which self-esteem was engendered by evidencing the self's efforts to show respect to others. The findings of this study challenge dominant discourses in the west which present body work on the ageing female body as primarily self-indulgent, or driven by anxiety about the body's inability to fit within existing youthful beauty ideals. Copyright © 2016 Elsevier Inc. All rights reserved.

Interprofessional primary care in academic family medicine clinics: implications for education and training.

PubMed

Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

2012-08-01

To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Focus group interviews using a purposive sampling procedure. Four academic family medicine clinics in Alberta. Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.

What Works? Common Practices in High Functioning Afterschool Programs across the Nation in Math, Reading, Science, Arts, Technology, and Homework--A Study by the National Partnership. The Afterschool Program Assessment Guide. CRESST Report 768

ERIC Educational Resources Information Center

Huang, Denise; Cho, Jamie; Mostafavi, Sima; Nam, Hannah H.; Oh, Christine; Harven, Aletha; Leon, Seth

2010-01-01

In an effort to identify and incorporate exemplary practices into existing and future afterschool programs, the U.S. Department of Education commissioned a large-scale evaluation of the 21st Century Community Learning Center (CCLC) program. The purpose of this evaluation project was to develop resources and professional development that addresses…

Evaluation of an Organisational Intervention to Promote Integrated Working between Health Services and Care Homes in the Delivery of End-of-Life Care for People with Dementia: Understanding the Change Process Using a Social Identity Approach

PubMed Central

Amador, Sarah; Mathie, Elspeth; Nicholson, Caroline

2016-01-01

In the United Kingdom, approximately a third of people with dementia live in long-term care facilities for adults, the majority of whom are in the last years of life. Working arrangements between health services and care homes in England are largely ad hoc and often inequitable, yet quality end-of-life care for people with dementia in these settings requires a partnership approach to care that builds on existing practice. This paper reports on the qualitative component of a mixed method study aimed at evaluating an organisational intervention shaped by Appreciative Inquiry to promote integrated working between visiting health care practitioners (i.e. General Practitioners and District Nurses) and care home staff. The evaluation uses a social identity approach to elucidate the mechanisms of action that underlie the intervention, and understand how organisational change can be achieved. We uncovered evidence of both (i) identity mobilisation and (ii) context change, defined in theory as mechanisms to overcome divisions in healthcare. Specifically, the intervention supported integrated working across health and social care settings by (i) the development of a common group identity built on shared views and goals, but also recognition of knowledge and expertise specific to each service group which served common goals in the delivery of end-of-life care, and (ii) development of context specific practice innovations and the introduction of existing end-of-life care tools and frameworks, which could consequently be implemented as part of a meaningful bottom-up rather than top-down process. Interventions structured around a Social Identity Approach can be used to gauge the congruence of values and goals between service groups without which efforts to achieve greater integration between different health services may prove ineffectual. The strength of the approach is its ability to accommodate the diversity of service groups involved in a given area of care, by valuing their respective contributions and building on existing ways of working within which practice changes can be meaningfully integrated. PMID:27616969

Evaluation of an Organisational Intervention to Promote Integrated Working between Health Services and Care Homes in the Delivery of End-of-Life Care for People with Dementia: Understanding the Change Process Using a Social Identity Approach.

PubMed

Amador, Sarah; Goodman, Claire; Mathie, Elspeth; Nicholson, Caroline

2016-06-03

In the United Kingdom, approximately a third of people with dementia live in long-term care facilities for adults, the majority of whom are in the last years of life. Working arrangements between health services and care homes in England are largely ad hoc and often inequitable, yet quality end-of-life care for people with dementia in these settings requires a partnership approach to care that builds on existing practice. This paper reports on the qualitative component of a mixed method study aimed at evaluating an organisational intervention shaped by Appreciative Inquiry to promote integrated working between visiting health care practitioners (i.e. General Practitioners and District Nurses) and care home staff. The evaluation uses a social identity approach to elucidate the mechanisms of action that underlie the intervention, and understand how organisational change can be achieved. We uncovered evidence of both (i) identity mobilisation and (ii) context change, defined in theory as mechanisms to overcome divisions in healthcare. Specifically, the intervention supported integrated working across health and social care settings by (i) the development of a common group identity built on shared views and goals, but also recognition of knowledge and expertise specific to each service group which served common goals in the delivery of end-of-life care, and (ii) development of context specific practice innovations and the introduction of existing end-of-life care tools and frameworks, which could consequently be implemented as part of a meaningful bottom-up rather than top-down process. Interventions structured around a Social Identity Approach can be used to gauge the congruence of values and goals between service groups without which efforts to achieve greater integration between different health services may prove ineffectual. The strength of the approach is its ability to accommodate the diversity of service groups involved in a given area of care, by valuing their respective contributions and building on existing ways of working within which practice changes can be meaningfully integrated.

Traditional healing practices among American Muslims: perceptions of community leaders in southeast Michigan.

PubMed

Alrawi, Sara; Fetters, Michael D; Killawi, Amal; Hammad, Adnan; Padela, Aasim

2012-06-01

Despite growing numbers of American Muslims, little empirical work exists on their use of traditional healing practices. We explored the types of traditional healing practices used by American Muslims in southeast Michigan. Twelve semi-structured interviews with American Muslim community leaders identified through a community-academic steering committee were conducted. Using a framework coding structure, a multidisciplinary investigative team identified themes describing traditional healing practices. Traditional healing practices can be categorized into three domains: Islamic religious text based practices, Islamic worship practices, and folk healing practices. Each domain may further contain therapies such as spiritual healing, medicinal herbs, mind body therapy, and dietary prescriptions. Traditional healing practices are utilized in three capacities of care: primary, secondary, and integrative. Our findings demonstrate that American Muslims actively utilize traditional healing practices. Healthcare practitioners caring for this population should be aware of the potential influence of these practices on health behaviors.

Relationships among factors affecting advanced practice registered nurses' job satisfaction and intent to leave: A systematic review.

PubMed

Han, Robin M; Carter, Patricia; Champion, Jane Dimmitt

2018-02-01

This systematic review explores relationships between advanced practice registered nurses' (APRN) job satisfaction and intent to leave. There exists a dearth of APRN providers compared with the ever-growing need for their services. Furthermore, the organizational costs associated with the APRN turnover are extremely high. It, therefore, behooves practice administrators to understand what factors most contribute to APRN job satisfaction and retention. A search of research databases CINAHL, PubMed, and PsycINFO, using keywords "Advanced Practice Registered Nurse," "job satisfaction," "intent to leave," "anticipated turnover," and "Nurse Practitioner" to yield articles included in this review. The strength of existing evidence for this topic is weak. Studies have found that extrinsic factors, such as administrative support and salary, significantly contribute to job dissatisfaction, whereas intrinsic factors, such as autonomy and finding work meaningful, most significantly contribute to job satisfaction. Additional research is needed to better understand the factors relating to APRN job satisfaction and dissatisfaction, and how those factors influence practitioners' intent to leave. Efforts to improve APRN job satisfaction will have positive implications for provider retention, practices, and patients. Administrators should consider the job satisfaction factors identified herein when implementing practice improvement and retention efforts.

Abandoning wells working group

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

NONE

The primary objective of this working group is to identify major technical, regulatory, and environmental issues that are relevant to the abandonment of offshore wellbores. Once the issues have been identified, the working group also has the objective of making recommendations or providing potential solutions for consideration. Areas for process improvement will be identified and {open_quotes}best practices{close_quotes} will be discussed and compared to {open_quotes}minimum standards.{close_quotes} The working group will primarily focus on wellbore abandonment in the Gulf of Mexico. However, workshop participants are encouraged to discuss international issues which may be relevant to wellbore abandonment practices in the Gulf ofmore » Mexico. The Abandoning Wells Group has identified several major areas for discussion that have concerns related to both operators and service companies performing wellbore abandonments in the Gulf of Mexico. The following broad topics were selected for the agenda: (1) MMS minimum requirements and state regulations. (2) Co-existence of best practices, new technology, and P & A economics. (3) Liability and environmental issues relating to wellbore abandonment.« less

Understanding partnership practice in primary health as pedagogic work: what can Vygotsky's theory of learning offer?

PubMed

Hopwood, Nick

2015-01-01

Primary health policy in Australia has followed international trends in promoting models of care based on partnership between professionals and health service users. This reform agenda has significant practice implications, and has been widely adopted in areas of primary health that involve supporting families with children. Existing research shows that achieving partnership in practice is associated with three specific challenges: uncertainty regarding the role of professional expertise, tension between immediate needs and longer-term capacity development in families, and the need for challenge while maintaining relationships based on trust. Recently, pedagogic or learning-focussed elements of partnership practice have been identified, but there have been no systematic attempts to link theories of learning with the practices and challenges of primary health-care professionals working with families in a pedagogic role. This paper explores key concepts of Vygotsky's theory of learning (including mediation, the zone of proximal development, internalisation, and double stimulation), showing how pedagogic concepts can provide a bridge between the policy rhetoric of partnership and primary health practice. The use of this theory to address the three key challenges is explicitly discussed.

A practical implementation of physics quality assurance for photon adaptive radiotherapy.

PubMed

Cai, Bin; Green, Olga L; Kashani, Rojano; Rodriguez, Vivian L; Mutic, Sasa; Yang, Deshan

2018-03-14

The fast evolution of technology in radiotherapy (RT) enabled the realization of adaptive radiotherapy (ART). However, the new characteristics of ART pose unique challenges for efficiencies and effectiveness of quality assurance (QA) strategies. In this paper, we discuss the necessary QAs for ART and introduce a practical implementation. A previously published work on failure modes and effects analysis (FMEA) of ART is introduced first to explain the risks associated with ART sub-processes. After a brief discussion of QA challenges, we review the existing QA strategies and tools that might be suitable for each ART step. By introducing the MR-guided online ART QA processes developed at our institute, we demonstrate a practical implementation. The limitations and future works to develop more robust and efficient QA strategies are discussed at the end. Copyright © 2018. Published by Elsevier GmbH.

The Eyesight of School Children: Defective Vision as Related to School Environment, and Methods of Prevention and Correction. Bulletin, 1919, No. 65

ERIC Educational Resources Information Center

Berkowitz, J. H.

1920-01-01

Competent authorities seem to agree as to the causes of eye strain in school children other than congenital defects. Standard works on diseases of the eye are practically unanimous in declaring that myopia results from the protracted and unhygienic use of the eyes in near work. Most of the factors tending to cause eye strain exist in the schools.…

40 CFR Table 4 to Subpart Eeee of... - Work Practice Standards

Code of Federal Regulations, 2010 CFR

2010-07-01

... Standards for Hazardous Air Pollutants: Organic Liquids Distribution (Non-Gasoline) Pt. 63, Subpt. EEEE... at an existing, reconstructed, or new affected source meeting any set of tank capacity and organic..., reconstructed, or new affected source meeting any set of tank capacity and organic HAP vapor pressure criteria...

15 CFR 996.12 - Development of standards compliance tests for a hydrographic product or class.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The... a hydrographic product or class. (a) NOAA shall work, to the extent practicable, through existing...

15 CFR 996.12 - Development of standards compliance tests for a hydrographic product or class.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., DEPARTMENT OF COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The... a hydrographic product or class. (a) NOAA shall work, to the extent practicable, through existing...

15 CFR 996.12 - Development of standards compliance tests for a hydrographic product or class.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., DEPARTMENT OF COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The... a hydrographic product or class. (a) NOAA shall work, to the extent practicable, through existing...

15 CFR 996.12 - Development of standards compliance tests for a hydrographic product or class.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., DEPARTMENT OF COMMERCE QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES The... a hydrographic product or class. (a) NOAA shall work, to the extent practicable, through existing...

Bringing Culture in: Community Responses to Apology, Reconciliation, and Reparations

ERIC Educational Resources Information Center

Miller, Bruce Granville

2006-01-01

In this paper, the author describes historic Coast Salish ritual practices and the concepts regarding wrongdoing and redemption that underlie them. He draws out the implications, particularly the associated dangers, derived from these existing rituals for ritual work conducted by outsiders engaging Coast Salish peoples. Finally, he considers the…

Advisory Boards: Academic Partnerships That Work.

ERIC Educational Resources Information Center

Silver, Gerald

An academic advisory board of volunteers drawn from college alumni and the general community can serve institutions of higher education at the college, school and even departmental level. Board members link the academic community to the external community by sharing expertise gained through practical experience. Such a board exists solely to give…

Where Local and National Evaluators Meet: Unintended Threats to Ethical Evaluation Practice

ERIC Educational Resources Information Center

Rodi, Michael S.; Paget, Kathleen D.

2007-01-01

The ethical work of program evaluators is based on a covenant of honesty and transparency among stakeholders. Yet even under the most favorable evaluation conditions, threats to ethical standards exist and muddle that covenant. Unfortunately, ethical issues associated with different evaluation structures and contracting arrangements have received…

Faith Lessons from Colleagues and Patients.

PubMed

Haines, Don

Although nurses' backgrounds are widely diverse, commonalities exist in faith and belief that can promote unity. Seeking to find shared ideals or beliefs promotes appreciation for team members' contributions, stronger working relationships, and benefit to patients. Vignettes of colleagues and patients illustrate the author's deepened understanding of this facet of nursing practice.

Barriers to Research Utilization by Certified Registered Nurse Anesthetists

ERIC Educational Resources Information Center

Palmer, Timothy J.

2013-01-01

At present, no documentation pertaining to the factors influencing utilization of research into clinical practice by Certified Registered Nurse Anesthetists (CRNAs) exists. An investigation was undertaken to determine perceptions of CRNAs regarding factors within the context of the work setting, which may serve to influence their utilization of…

Teaching and Learning Distillation in Chemistry Laboratory Courses.

ERIC Educational Resources Information Center

van Keulen, Hanno; And Others

Distillation in the chemistry laboratory is an essential part of a practicing chemists' and a chemistry educators' work. Nevertheless, regardless of the degree of importance in each of the aforementioned professions, few educational studies on teaching and learning distillation exist. In an effort to rectify this oversight, the Department of…

Book-Length Scholarly Essays as a Hybrid Genre in Science

ERIC Educational Resources Information Center

Varghese, Susheela Abraham; Abraham, Sunita Anne

2004-01-01

Drawing on existing work on popularizations, this investigation of book-length scholarly essays by practicing scientists across three disciplines reveals a hybrid genre that is neither popularization nor research report. The study utilizes both textual analysis and personal commentary from the writer-researchers to achieve a three-way comparison…

Mobile Phone Mood Charting for Adolescents

ERIC Educational Resources Information Center

Matthews, Mark; Doherty, Gavin; Sharry, John; Fitzpatrick, Carol

2008-01-01

Mobile phones may provide a useful and engaging platform for supporting therapeutic services working with adolescents. This paper examines the potential benefits of the mobile phone for self-charting moods in comparison to existing methods in current practice. The paper describes a mobile phone application designed by the authors which allows…

Fundamental science behind today's important medicines.

PubMed

Spector, Jonathan M; Harrison, Rosemary S; Fishman, Mark C

2018-04-25

Today's most transformative medicines exist because of fundamental discoveries that were made without regard to practical outcome and with their relevance to therapeutics only appearing decades later. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Making Knowledge Services Work in Higher Education

ERIC Educational Resources Information Center

Norris, Donald M.; Lefrere, Paul; Mason, Jon

2006-01-01

Over the past three years, knowledge-based practices in higher education have advanced, driving the development of low/no-cost, mass-market tools for knowledge sharing and reducing some barriers to change. New investors in higher education are developing strategies to exploit the knowledge-driven value propositions. Existing institutions, anxious…

The BGR Contingency Model for Leading Change

ERIC Educational Resources Information Center

Brown, Derek R.; Gordon, Raymond; Rose, Dennis Michael

2012-01-01

The continuing failure rates of change initiatives, combined with an increasingly complex business environment, have created significant challenges for the practice of change management. High failure rates suggest that existing change models are not working, or are being incorrectly used. A different mindset to change is required. The BGR…

Management Training in Business and Industry: A Multimodal Approach to Supervision.

ERIC Educational Resources Information Center

O'Keefe, Edward J.

Historically, a close working relationship has existed between psychology and management. The holistic approach emerging in psychology from Lazarus' multimodal model will have a major impact on management practices, ultimately leading to the development of multidmodal management. The scientific psychology most managers are familiar with was based…

A Learning Progressions Approach to Early Algebra Research and Practice

ERIC Educational Resources Information Center

Fonger, Nicole L.; Stephens, Ana; Blanton, Maria; Knuth, Eric

2015-01-01

We detail a learning progressions approach to early algebra research and how existing work around learning progressions and trajectories in mathematics and science education has informed our development of a four-component theoretical framework consisting of: a curricular progression of learning goals across big algebraic ideas; an instructional…

"A Powerful Tool": A Phenomenological Study of School Counselors' Experiences with Social Stories

ERIC Educational Resources Information Center

Goodman-Scott, Emily; Carlisle, Robert; Clark, Madeline; Burgess, Melanie

2017-01-01

Social stories are an evidence-based practice used to address students' social skills. Current literature primarily addresses special education teachers' use of social stories when working with youth with autism spectrum disorder. Although school counselors meet students' social/emotional needs, little research exists documenting their experiences…

48 CFR 52.227-18 - Rights in Data-Existing Works.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52... practicable of any claim or suit, affords the Contractor an opportunity under applicable laws, rules, or regulations to participate in the defense of the claim or suit, and obtains the Contractor's consent to the...

48 CFR 52.227-18 - Rights in Data-Existing Works.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52... practicable of any claim or suit, affords the Contractor an opportunity under applicable laws, rules, or regulations to participate in the defense of the claim or suit, and obtains the Contractor's consent to the...

48 CFR 52.227-18 - Rights in Data-Existing Works.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52... practicable of any claim or suit, affords the Contractor an opportunity under applicable laws, rules, or regulations to participate in the defense of the claim or suit, and obtains the Contractor's consent to the...

48 CFR 52.227-18 - Rights in Data-Existing Works.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 52... practicable of any claim or suit, affords the Contractor an opportunity under applicable laws, rules, or regulations to participate in the defense of the claim or suit, and obtains the Contractor's consent to the...

Cumulative complexity: a functional, patient-centered model of patient complexity can improve research and practice.

PubMed

Shippee, Nathan D; Shah, Nilay D; May, Carl R; Mair, Frances S; Montori, Victor M

2012-10-01

To design a functional, patient-centered model of patient complexity with practical applicability to analytic design and clinical practice. Existing literature on patient complexity has mainly identified its components descriptively and in isolation, lacking clarity as to their combined functions in disrupting care or to how complexity changes over time. The authors developed a cumulative complexity model, which integrates existing literature and emphasizes how clinical and social factors accumulate and interact to complicate patient care. A narrative literature review is used to explicate the model. The model emphasizes a core, patient-level mechanism whereby complicating factors impact care and outcomes: the balance between patient workload of demands and patient capacity to address demands. Workload encompasses the demands on the patient's time and energy, including demands of treatment, self-care, and life in general. Capacity concerns ability to handle work (e.g., functional morbidity, financial/social resources, literacy). Workload-capacity imbalances comprise the mechanism driving patient complexity. Treatment and illness burdens serve as feedback loops, linking negative outcomes to further imbalances, such that complexity may accumulate over time. With its components largely supported by existing literature, the model has implications for analytic design, clinical epidemiology, and clinical practice. Copyright © 2012 Elsevier Inc. All rights reserved.

Research in action: using positive deviance to improve quality of health care

PubMed Central

Bradley, Elizabeth H; Curry, Leslie A; Ramanadhan, Shoba; Rowe, Laura; Nembhard, Ingrid M; Krumholz, Harlan M

2009-01-01

Background Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed and incomplete. In this paper, we build on the established principle of 'positive deviance' to propose an approach to identifying practices that improve health care quality. Methods We synthesize existing literature on positive deviance, describe major alternative approaches, propose benefits and limitations of a positive deviance approach for research directed toward improving quality of health care, and describe an application of this approach in improving hospital care for patients with acute myocardial infarction. Results The positive deviance approach, as adapted for use in health care, presumes that the knowledge about 'what works' is available in existing organizations that demonstrate consistently exceptional performance. Steps in this approach: identify 'positive deviants,' i.e., organizations that consistently demonstrate exceptionally high performance in the area of interest (e.g., proper medication use, timeliness of care); study the organizations in-depth using qualitative methods to generate hypotheses about practices that allow organizations to achieve top performance; test hypotheses statistically in larger, representative samples of organizations; and work in partnership with key stakeholders, including potential adopters, to disseminate the evidence about newly characterized best practices. The approach is particularly appropriate in situations where organizations can be ranked reliably based on valid performance measures, where there is substantial natural variation in performance within an industry, when openness about practices to achieve exceptional performance exists, and where there is an engaged constituency to promote uptake of discovered practices. Conclusion The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. PMID:19426507

Using Web 2.0 for health promotion and social marketing efforts: lessons learned from Web 2.0 experts.

PubMed

Dooley, Jennifer Allyson; Jones, Sandra C; Iverson, Don

2014-01-01

Web 2.0 experts working in social marketing participated in qualitative in-depth interviews. The research aimed to document the current state of Web 2.0 practice. Perceived strengths (such as the viral nature of Web 2.0) and weaknesses (such as the time consuming effort it took to learn new Web 2.0 platforms) existed when using Web 2.0 platforms for campaigns. Lessons learned were identified--namely, suggestions for engaging in specific types of content creation strategies (such as plain language and transparent communication practices). Findings present originality and value to practitioners working in social marketing who want to effectively use Web 2.0.

Prisoner reentry: a public health or public safety issue for social work practice?

PubMed

Patterson, George T

2013-01-01

A significant literature identifies the policy, economic, health, and social challenges that confront released prisoners. This literature also describes the public health and public safety risks associated with prisoner reentry, provides recommendations for improving the reentry process, and describes the effectiveness of prison-based programs on recidivism rates. Public health and public safety risks are particularly significant in communities where large numbers of prisoners are released and few evidence-based services exist. The purpose of this article is to describe the public health and public safety risks that released prisoners experience when they reenter communities, and to discuss the social justice issues relevant for social work practice.

Reconfiguring diagnostic work in Danish general practice; regulation, triage and the secretaries as diagnostician.

PubMed

Andersen, Rikke Sand; Aarhus, Rikke

2017-07-31

Health care systems as well as bodies of medical knowledge are dynamic and change as the result of political and social transformations. In recent decades, health care systems have been subjected to a whole assemblage of regulatory practices. The local changes undertaken in Denmark that are being explored here are indicative of a long-term shift that has occurred in many welfare states intended to make public services in the Global North more efficient and transparent. Departing in prolonged field work in Danish general practice and the anthropological literature on audit culture, this paper suggests that the introduction of regulatory practices has enhanced the need for triage as a key organising principle. The term triage literally means separating out and refers to the process of sorting and placing patients in time and space. The paper suggests that an increasing introduction of triage feeds into a reconfiguration of diagnostic work, where the clinical setting is gradually becoming more intertwined with the governing domains of policy, and the work of the secretary is gradually becoming more intertwined with that of the doctor. Finally, the paper argues that an increasing regulation of general practice poses an ethically charged challenge to existing welfare politics of responsibility between the state and the public, as it makes it increasingly difficult to negotiate access to care.

Return-to-Work Strategies for Employees With Mental Health Conditions.

PubMed

Pomaki, Georgia

2017-01-01

There's no question that employers can no longer ignore mental health issues. Compassion and support for employees aside, it is simply good business to protect the mental health and productivity of employees. This article describes existing challenges surrounding employees with mental disorders: the link between mental disorders, disability and an employee's ability to return to work; best practices for employers, employees and health care providers; and the role of the insurance company. Together, using proven strategies, everyone contributes to the optimal solution of helping employees with mental disorders return to work.

Surveys on minimum practical abilities required by nonspecialist occupational physicians in Japan

PubMed Central

Nagata, Masako; Mori, Koji; Ishikawa, Asako; Nagata, Tomohisa

2016-01-01

Objectives: This study aimed to identify the practical abilities required by nonspecialist occupational physicians and specify the priorities for training programs. Methods: A practical abilities list was developed through a focus group meeting of specialists. We created a survey questionnaire and asked three groups, namely, occupational physicians, occupational health nurses, and health officers, to rate the importance of each practical ability. Results: The mean scores for all 45 items were greater than 4, i.e., in the middle of the 7-point Likert scale, for all the three groups. The occupational physicians' responses had a correlation with the other groups' responses. However, there were differences with regard to some practical abilities between the three groups. Five practical abilities from the top quartile were marked "A" by all the three groups: "Submit opinions on fitness for duty and work accommodation on the basis of data from health examination," "Respect employee privacy," "Submit opinion on fitness for duty and work accommodation on the basis of data from face-to-face interviews with employees," "Submit opinions on fitness for duty and work accommodation on the basis of data from health surveillance," and "Implement face-to-face interviews for employees who have worked overtime and evaluate the subjects' conditions including mental and physical health status, degree of accumulated fatigue, and depression." Conclusions: This study resulted in a rank-ordered list of 45 practical abilities that are required by nonspecialist occupational physicians. This result may be useful to review and redesign the existing training program for nonspecialist occupational physicians. PMID:27108644

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing

PubMed Central

Dreischulte, Tobias; Guthrie, Bruce

2017-01-01

Objective To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Design Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Setting Ten (30%) primary care practices participating in the trial from Scotland, UK. Results Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. Trial registration number NCT01425502. PMID:28283493

Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing.

PubMed

Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce

2017-03-10

To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time. Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices. Ten (30%) primary care practices participating in the trial from Scotland, UK. Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability. Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation. NCT01425502. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care.

PubMed

Wang-Romjue, Pauline

2018-04-01

Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments. © 2017 Wiley Periodicals, Inc.

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

Factors Associated With Interest in Working With Older Adults: Implications for Educational Practices.

PubMed

Chippendale, Tracy

2015-09-01

The aging population has created a pressing need for specialists in geriatrics. The purpose of this pilot study was to examine the predictors of interest in working with older adults among students enrolled in or planning to enroll in a health science program, using an existing data set. The study was guided by Super's theory of vocational development. Multiple regression, with a significance level of p < 0.05, was used for the analysis. Positive images of older adults and the participants' current amount of contact were significant predictors of interest in working with older adults, whereas negative images and prior amount of contact with older adults were not. Results suggest implications for curriculum design and educational programs to increase the workforce in geriatrics practice, which are discussed. Copyright 2015, SLACK Incorporated.

Indigenous HIV Prevention Beliefs and Practices Among Low-Earning Chinese Sex Workers as Context for Introducing Female Condoms and Other Novel Prevention Options.

PubMed

Dunn, Jennifer; Zhang, Qingning; Weeks, Margaret R; Li, Jianghong; Liao, Susu; Li, Fei

2017-07-01

New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.

[Characterization of the training and practice of human talent working in environmental health in Colombia].

PubMed

Agudelo-Calderón, Carlos A; García-Ubaque, Juan C; Robledo-Martínez, Rocío; García-Ubaque, Cesar A; Vaca, Martha L

2015-07-01

Objectives To characterize the peculiarities in the training, exercise, and performance of human talent working in environmental health in Colombia. Method Documentary and database reviews. Surveys and semi-structured interviews. Results Approximately 70 % of professionals in the area of environmental health work in health management, food engineering, environmental engineering, sanitary engineering, veterinary medicine, and pharmaceutical chemistry. 63 % of technologists belong to the field of sanitation technology. Only 20 % of surveyed educational institutions apply the competence approach to training to their students and the identification of occupational characteristics in the labor market is only used at the undergraduate level as a criterion of academic analysis and design. Only 20 % of educational institutions identify educational trends in Colombian and or international environmental health as a contribution to their programs. In prospective practices, the following topics to be strengthened were identified: risk factor identfication, measurement, and control; design and implementation of mechanisms for controlling environmental risks; forms of interdisciplinary work between the natural, social and health sciences; preventative and environmental protection measures and the concept of environment (natural, social, and cultural). Conclusion The human talent currently working in environmental health in the country is concentrated in primary care activities (inspection, monitoring and control) and a large spread exists in mission processes and competences, both professionally and technologically. A lack of coordination between the environmental sector and the education sector can be observed. A great diversity exists among the profiles offered by the different educational programs related to environmental health.

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

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

None

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

Mild cognitive impairment and prospective memory: translating the evidence into neuropsychological practice.

PubMed

Kinsella, Glynda J; Pike, Kerryn E; Cavuoto, Marina G; Lee, Stephen D

2018-04-30

There has been a recent rapid development of research characterizing prospective memory performance in mild cognitive impairment (MCI) in older age. However, this body of literature remains largely separated from routine clinical practice in neuropsychology. Furthermore, there is emerging evidence of effective interventions to improve prospective memory performance. Therefore, our objective in this article was to offer a clinical neuropsychological perspective on the existing research in order to facilitate the translation of the evidence-base into clinical practice. By conducting a critical review of the existing research related to prospective memory and MCI, we highlight how this data can be introduced into clinical practice, either within diagnostic assessment or clinical management. Prospective memory is impaired in older adults with MCI, with a pattern of performance that helps with differential diagnosis from healthy aging. Clinical neuropsychologists are encouraged to add prospective memory assessment to their toolbox for diagnostic evaluation of clients with MCI. Preliminary findings of prospective memory interventions in MCI are promising, but more work is required to determine how different approaches translate to increasing independence in everyday life.

An Experimental Study on Strengthening of Reinforced Concrete Flexural Members using Steel Wire Mesh

NASA Astrophysics Data System (ADS)

Al Saadi, Hamza Salim Mohammed; Mohandas, Hoby P.; Namasivayam, Aravind

2017-01-01

One of the major challenges and contemporary research in the field of structural engineering is strengthening of existing structural elements using readily available materials in the market. Several investigations were conducted on strengthening of various structural components using traditional and advanced materials. Many researchers tried to enhance the reinforced concrete (RC) beams strength using steel plate, Glass and Carbon Fibre Reinforced Polymers (GFRP & CFRP). For the reason that high weight to the strength ratio and compatibility in strength between FRP composites and steel bars, steel plates and GFRP and CFRP composites are not used for strengthening works practically. Hence, in this present work the suitability of using wire mesh for the purpose of strengthening the RC flexural members is studied by conducting experimental works. New technique of strengthening system using wire mesh with a view to improve sectional properties and subsequently flexural strength of RC beams is adopted in this work. The results for experimental and theoretical analysis were compared and found that good correlation exists between them. The experimental results indicate that RC beams strengthened with steel wire mesh are easy technique for strengthening of existing flexural members.

Interprofessional primary care in academic family medicine clinics

PubMed Central

Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

2012-01-01

Abstract Objective To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Design Focus group interviews using a purposive sampling procedure. Setting Four academic family medicine clinics in Alberta. Participants Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Methods Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Main findings Our data supported the D’Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model’s main “factors” (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent “elements.” It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. Conclusion The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care. PMID:22893347

40 CFR 63.1563 - When do I have to comply with this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... National Emission Standards for Hazardous Air Pollutants for Petroleum Refineries: Catalytic Cracking Units... for an existing catalytic cracking unit allowing additional time to meet the emission limitations and work practice standards for catalytic cracking units in §§ 63.1564 and 63.1565 if you commit to...

40 CFR 63.1563 - When do I have to comply with this subpart?

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Emission Standards for Hazardous Air Pollutants for Petroleum Refineries: Catalytic Cracking Units... for an existing catalytic cracking unit allowing additional time to meet the emission limitations and work practice standards for catalytic cracking units in §§ 63.1564 and 63.1565 if you commit to...

Children of La Frontera: Binational Efforts To Serve Mexican Migrant and Immigrant Students.

ERIC Educational Resources Information Center

Flores, Judith LeBlanc, Ed.

This book includes 20 chapters that provide background on the historical and current context of U.S.-Mexico relations and education in Mexico, examine existing binational educational and health programs, and describe effective practices for teaching Mexican migrant and immigrant students and working with families from Mexico. Following a foreword…

A walkthrough solution to the boundary overlap problem

Treesearch

Mark J. Ducey; Jeffrey H. Gove; Harry T. Valentine

2004-01-01

Existing methods for eliminating bias due to boundary overlap suffer some disadvantages in practical use, including the need to work outside the tract, restrictions on the kinds of boundaries to which they are applicable, and the possibility of significantly increased variance as a price for unbiasedness. We propose a new walkthrough method for reducing boundary...

Legal and Ethical Implications of Working with Minors in Alabama: Consent and Confidentiality

ERIC Educational Resources Information Center

Keim, Michael A.; Cobia, Debra

2010-01-01

Until recently, there has been little guidance in the professional literature with respect to counseling minors outside of the school setting. Although most authors suggest referring to state statutes for legal limits of counseling practice, little research exists describing these requirements in Alabama. The purpose of this literature and…

Data Sharing in Interpretive Engineering Education Research: Challenges and Opportunities from a Research Quality Perspective

ERIC Educational Resources Information Center

Walther, Joachim; Sochacka, Nicola W.; Pawley, Alice L.

2016-01-01

This article explores challenges and opportunities associated with sharing qualitative data in engineering education research. This exploration is theoretically informed by an existing framework of interpretive research quality with a focus on the concept of Communicative Validation. Drawing on practice anecdotes from the authors' work, the…

40 CFR 63.7294 - What work practice standard must I meet for soaking?

Code of Federal Regulations, 2013 CFR

2013-07-01

... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Coke Ovens: Pushing... standard must I meet for soaking? (a) For each new and existing by-product coke oven battery, you must... from raw coke oven gas leaking from the collecting main through the damper, and emissions that result...

Rural Revisited: A Decade and a Half of Practice

ERIC Educational Resources Information Center

Harris, Deborah

2006-01-01

No standard definition of rural areas exists for use in developing health care policy, research, and planning, or for purposes of federal program administration or distribution of funds. Families in rural areas define themselves in terms of values--typically a solid work ethic; traditional morals and values; hardiness; determination; a general…

The Fateful Rift: The San Andreas Fault in the Modern Mind.

ERIC Educational Resources Information Center

Percy, Walker

1990-01-01

Claims that modern science is radically incoherent and that this incoherence lies within the practice of science. Details the work of the scientist and philosopher Charles Sanders Pierce, expounding on the difference between Rene Descartes' dualistic philosophy and Pierce's triadic view. Concludes with a brief description of the human existence.…

Looking for America: The Disassociation of Urban Youth

ERIC Educational Resources Information Center

Sanchez, Heliodoro T., Jr.

2005-01-01

Many educational initiatives have been and continue to be based on a macro-social system understanding of communal roles, values, norms, interactions, perceptions, and realities. This practice neglects the unique impediments and social norms that exist within the myriad of micro-social systems in the United States. This work draws attention to the…

Prevention of sexual harassment in the workplace and educational settings.

PubMed

Pletcher, Beth A

2006-10-01

The American Academy of Pediatrics is committed to working to ensure that workplaces and educational settings in which pediatricians spend time are free of sexual harassment. The purpose of this statement is to heighten awareness and sensitivity to this important issue, recognizing that institutions, clinics, and office-based practices may have existing policies.

Functional Requirements for Bibliographic Records: An Investigation of Two Prototypes

ERIC Educational Resources Information Center

Pisanski, Jan; Zumer, Maja

2007-01-01

Purpose: This paper aims to establish how the Functional Requirements for Bibliographic Records (FRBR) conceptual model, which holds a lot of potential in theory, works in practice. It also aims to identify, and if possible, give solutions to problems found in two of the existing prototypes. Design/methodology/approach: An independent evaluation…

Instructional Leadership Structure in Singapore: A Co-Existence of Hierarchy and Heterarchy

ERIC Educational Resources Information Center

Nguyen, Dong Thanh; Ng, David; Yap, Pui San

2017-01-01

Purpose: The purpose of this paper is to explore the instructional leadership practices and structure in Singapore primary schools. Design/methodology/approach: The study employs a qualitative approach. Data were collected from interviews of 30 Singapore primary school principals and 25 working-day observations of five principals. A grounded…

Increasing Career Self-Efficacy through Group Work with Culturally and Linguistically Diverse Students

ERIC Educational Resources Information Center

Mitcham, Michelle; Greenidge, Wendy-lou; Bradham-Cousar, Michelle; Figliozzi, Jennifer; Thompson, Mary Ann

2012-01-01

Group counseling is a practical way for school counselors to deliver career services. School counselors face competing demands on their time coupled with the problematic student to counselor ratios that often exist in schools, group counseling thereby offers a pragmatic solution. This article provides implications for implementing group counseling…

Expanding horizons. Integrating environmental health in occupational health nursing.

PubMed

Rogers, B; Cox, A R

1998-01-01

1. Environmental hazards are ubiquitous. Many exist in the workplace or occur as a result of work process exposures. 2. Environmental health is a natural component of the expanding practice of occupational health nursing. 3. AAOHN's vision for occupational and environmental health will continue to set the standard and provide leadership in the specialty.

Teaching Bodies at Work

ERIC Educational Resources Information Center

Estola, Eila; Elbaz-Luwisch, Freema

2003-01-01

In this article we take a close look at teachers' narratives in order to describe the practice of teaching as an embodied activity. Based on the phenomenological understanding of the body as an active and intentional reaching out from its physical existence, we listened to what Finnish and Israeli teachers' narratives tell us about the voices of…

Evaluator and Program Manager Perceptions of Evaluation Capacity and Evaluation Practice

ERIC Educational Resources Information Center

Fierro, Leslie A.; Christie, Christina A.

2017-01-01

The evaluation community has demonstrated an increased emphasis and interest in evaluation capacity building in recent years. A need currently exists to better understand how to measure evaluation capacity and its potential outcomes. In this study, we distributed an online questionnaire to managers and evaluation points of contact working in…

Research Mediation in Education: A Typology of Research Brokering Organizations that Exist across Canada

ERIC Educational Resources Information Center

Cooper, Amanda Mae

2013-01-01

This paper explores the increasingly prominent role of research brokering organizations (RBOs) in strengthening connections between education research, policy and practice across Canada. This paper is organized in three sections. First, it provides a literature review of research mediation--exploring terminology, models and empirical work (albeit…

Measuring the Value Added by Technical Documentation: A Review of Research and Practice.

ERIC Educational Resources Information Center

Mead, Jay

1998-01-01

Reviews existing work on establishing value of technical documentation to determine its principles. States that value can be returned by reducing internal investment, increasing sales, and reducing after-sales costs. Argues that further research will improve the understanding of information as the product itself, rather than simply a supporting…

Navigating Your Way through the Research Jungle

ERIC Educational Resources Information Center

Bauer, Scott; Brazer, David

2012-01-01

These days, information overload seems to be the normal state of existence. School leaders are inundated with descriptions of best practices and programs that work. They are exhorted to use evidence in all facets of decision-making and to employ research-based strategies to improve schools. Of course, research findings are seldom definitive, and…

Exploring a pedagogical approach to integrating research, practice and teaching.

PubMed

Newton, Jennifer M; McKenna, Lisa G; Gilmour, Carole; Fawcett, Jacqueline

2010-01-01

Application of evidence is accepted as an important component of clinical practice. Teaching research to undergraduate students has been reported internationally as a challenge, particularly for nurse educators. In this paper, reported is a strategy designed to enhance research learning for undergraduate midwifery students at one university, which formed part of a larger, international investigation into women's responses to caesarean birth. Following theory classes and briefings, students worked with their clinical educators in practice to interview women using existing tools, and were engaged in qualitative data analysis. A number of challenges were encountered throughout the process, both for the educators and students. However, the teaching approach provided benefits for students in learning about midwifery research. Recommended as essential is for continued development of pedagogical approaches that make research tangible for students. Furthermore, provision of support for clinical staff working with students is important for success of such approaches.

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.

Insights from industry: a quantitative analysis of engineers' perceptions of empathy and care within their practice

NASA Astrophysics Data System (ADS)

Hess, Justin L.; Strobel, Johannes; Pan, Rui Celia; Wachter Morris, Carrie A.

2017-11-01

This study focuses on two seldom-investigated skills or dispositions aligned with engineering habits of mind - empathy and care. In order to conduct quantitative research, we designed, explored the underlying structure of, validated, and tested the reliability of the Empathy and Care Questionnaire (ECQ), a new psychometric instrument. In the second part, we used the ECQ to explore the perceptions of empathy and care of alumni/ae of an internationally ranked US institution, along with how perceptions differed by work experience and gender. Results show that participants perceived empathy and care to be important in multiple respects, most notably in relational aspects of engineering practice. Engineers with more engineering experience were more likely to perceive empathy and care as existing in engineering practice and as important to their work. While these phenomena are sometimes depicted as feminine qualities, we found no gender differences among our respondents.

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

PubMed

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Exploring the contexts of urban science classrooms. Part 2: The emergence of rituals in the learning of science

NASA Astrophysics Data System (ADS)

Emdin, Christopher

2007-04-01

In Part 1 of this paper, I described the corporate and communal nature of research, teaching, and learning in urban science classrooms as both a theoretical approach to understanding, and way of viewing practices within these fields. By providing a new approach to theorizing the cultural misalignments that are prevalent in urban schools, I look to provide an informative tool for investigating under-discussed dynamics that impact science teaching and learning. In this body of work, I further expose the nature of the corporate|communal by describing practices that define communal practice. I do so conversant of the fact that synthesizing my previous work on corporate and communal practices necessarily pushes science education researchers and teachers to look for somewhat tactile explications of communal practices. That is to say, if communal practices do exist within the corporate structures of science classrooms, how do they present themselves and how can they be targeted? This paper begins a journey into such a study and focuses on student transactions, fundamental interactions and rituals as a key to redefining and attaining success in urban science classrooms.

Distraction: an assessment of smartphone usage in health care work settings

PubMed Central

Gill, Preetinder S; Kamath, Ashwini; Gill, Tejkaran S

2012-01-01

Smartphone use in health care work settings presents both opportunities and challenges. The benefits could be severely undermined if abuse and overuse are not kept in check. This practice-focused research paper examines the current panorama of health software applications. Findings from existing research are consolidated to elucidate the level and effects of distraction in health care work settings due to smartphone use. A conceptual framework for crafting guidelines to regulate the use of smartphones in health care work settings is then presented. Finally, specific guidelines are delineated to assist in creating policies for the use of smartphones in a health care workplace. PMID:22969308

Radiological Worker II Training, Course 20301 (Live), Course 12909 (Test)

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

Harris, Jimmy D.

Radiological worker training is the basic building block for any additional radiological training you may receive. Upon completing radiological worker training, you will have the basic knowledge needed to work safely, using proper radiological practices, in areas where radiological hazards exist. You will also have a better understanding of the hazards and responsibilities associated with radiological work to help prevent the carelessness that can occur when working continually with or around radioactive material. This course does not qualify you for any specific radiological work. You may be required to take additional training at individual facilities to address facility- and job-specificmore » hazards and procedures.« less

Facilitators of transforming primary care: a look under the hood at practice leadership.

PubMed

Donahue, Katrina E; Halladay, Jacqueline R; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat

2013-01-01

This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41-4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08-1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement.

Facilitators of Transforming Primary Care: A Look Under the Hood at Practice Leadership

PubMed Central

Donahue, Katrina E.; Halladay, Jacqueline R.; Wise, Alison; Reiter, Kristin; Lee, Shoou-Yih Daniel; Ward, Kimberly; Mitchell, Madeline; Qaqish, Bahjat

2013-01-01

PURPOSE This study examined how characteristics of practice leadership affect the change process in a statewide initiative to improve the quality of diabetes and asthma care. METHODS We used a mixed methods approach, involving analyses of existing quality improvement data on 76 practices with at least 1 year of participation and focus groups with clinicians and staff in a 12-practice subsample. Existing data included monthly diabetes or asthma measures (clinical measures) and monthly practice implementation, leadership, and practice engagement scores rated by an external practice coach. RESULTS Of the 76 practices, 51 focused on diabetes and 25 on asthma. In aggregate, 50% to 78% made improvements within in each clinical measure in the first year. The odds of making practice changes were greater for practices with higher leadership scores (odds ratios = 2.41–4.20). Among practices focused on diabetes, those with higher leadership scores had higher odds of performing nephropathy screening (odds ratio = 1.37, 95% CI, 1.08–1.74); no significant associations were seen for the intermediate outcome measures of hemoglobin A1c, blood pressure, and cholesterol. Focus groups revealed the importance of a leader, typically a physician, who believed in the transformation work (ie, a visionary leader) and promoted practice engagement through education and cross-training. Practices with greater change implementation also mentioned the importance of a midlevel operational leader who helped to create and sustain practice changes. This person communicated and interacted well with, and was respected by both clinicians and staff. CONCLUSIONS In the presence of a vision for transformation, operational leaders within practices can facilitate practice changes that are associated with clinical improvement. PMID:23690383

Evaluating Practice-Based Learning.

PubMed

Logue, Nancy C

2017-03-01

Practice-based learning is an essential aspect of nursing education, and evaluating this form of learning is vital in determining whether students have the competence required to enter nursing practice. However, limited knowledge exists about the influences that shape how competence development is recognized in nursing programs. The purpose of this study was to explore the evaluation of practice-based learning from the students' standpoint. A qualitative design based on institutional ethnography was used to investigate evaluation of practice-based learning with students, preceptors, and faculty in a preceptorship practicum. The findings revealed how work associated with evaluation was organized by coexisting and often disparate influences within a nursing program and the workplaces where learning took place. The implications and recommendations of the inquiry are intended to encourage dialogue and action among stakeholders from education and practice to improve evaluation practices in preparing new members of the nursing profession. [J Nurs Educ. 2017;56(3):131-138.]. Copyright 2017, SLACK Incorporated.

The influences of nursing education on the socialization and professional working relationships of Canadian practical and degree nursing students: A critical analysis.

PubMed

Limoges, Jacqueline; Jagos, Kim

2015-10-01

Little evidence exists about how education influences the ways that registered nurses (RN) and registered practical nurses (RPN) negotiate their professional work relationships. This qualitative study used interviews and reflective writing from 250 Bachelor of Science in Nursing (BScN) and Practical Nursing (PN) students to explore how education constructs intraprofessional relations. The data were collected after two joint BScN/PN education events - one held in the first semester and one in the fourth semester. The findings reveal how education conveys and establishes dominant discourses about the tiers in nursing and the boundary work and professional closure strategies used by the two groups. In addition, although the two education programs are largely segregated and education about how to work with each other is rarely discussed, PN and BScN students strive to understand the differences and perceived inequities between the two designations of nurse. The data show how students attempt to reconcile the tensions and disjunctures they experience from the power relations by activating socially constructed and hegemonic positions that have been problematic for nursing. Findings will assist nurse educators to understand how education can be used to negotiate professional boundaries and working relationships that foster equity and social inclusion. Copyright © 2015 Elsevier Ltd. All rights reserved.

Role stressors and coping strategies among nurse managers.

PubMed

Udod, Sonia; Cummings, Greta G; Care, W Dean; Jenkins, Megan

2017-02-06

Purpose The purpose of this paper is to share preliminary evidence about nurse managers' (NMs) role stressors and coping strategies in acute health-care facilities in Western Canada. Design/methodology/approach A qualitative exploratory inquiry provides deeper insight into NMs' perceptions of their role stressors, coping strategies and factors and practices in the organizational context that facilitate and hinder their work. A purposeful sample of 17 NMs participated in this study. Data were collected through individual interviews and a focus group interview. Braun and Clarke's (2006) six phase approach to thematic analysis guided data analysis. Findings Evidence demonstrates that individual factors, organizational practices and structures affect NMs stress creating an evolving role with unrealistic expectations, responding to continuous organizational change, a fragmented ability to effectively process decisions because of work overload, shifting organizational priorities and being at risk for stress-related ill health. Practical implications These findings have implications for organizational support, intervention programs that enhance leadership approaches, address individual factors and work processes and redesigning the role in consideration of the role stress and work complexity affecting NMs health. Originality/value It is anticipated that health-care leaders would find these results concerning and inspire them to take action to support NMs to do meaningful work as a way to retain existing managers and attract front line nurses to positions of leadership.

Scientific Software - the role of best practices and recommendations

NASA Astrophysics Data System (ADS)

Fritzsch, Bernadette; Bernstein, Erik; Castell, Wolfgang zu; Diesmann, Markus; Haas, Holger; Hammitzsch, Martin; Konrad, Uwe; Lähnemann, David; McHardy, Alice; Pampel, Heinz; Scheliga, Kaja; Schreiber, Andreas; Steglich, Dirk

2017-04-01

In Geosciences - like in most other communities - scientific work strongly depends on software. For big data analysis, existing (closed or open source) program packages are often mixed with newly developed codes. Different versions of software components and varying configurations can influence the result of data analysis. This often makes reproducibility of results and reuse of codes very difficult. Policies for publication and documentation of used and newly developed software, along with best practices, can help tackle this problem. Within the Helmholtz Association a Task Group "Access to and Re-use of scientific software" was implemented by the Open Science Working Group in 2016. The aim of the Task Group is to foster the discussion about scientific software in the Open Science context and to formulate recommendations for the production and publication of scientific software, ensuring open access to it. As a first step, a workshop gathered interested scientists from institutions across Germany. The workshop brought together various existing initiatives from different scientific communities to analyse current problems, share established best practices and come up with possible solutions. The subjects in the working groups covered a broad range of themes, including technical infrastructures, standards and quality assurance, citation of software and reproducibility. Initial recommendations are presented and discussed in the talk. They are the foundation for further discussions in the Helmholtz Association and the Priority Initiative "Digital Information" of the Alliance of Science Organisations in Germany. The talk aims to inform about the activities and to link with other initiatives on the national or international level.

Beating the photon-number-splitting attack in practical quantum cryptography.

PubMed

Wang, Xiang-Bin

2005-06-17

We propose an efficient method to verify the upper bound of the fraction of counts caused by multiphoton pulses in practical quantum key distribution using weak coherent light, given whatever type of Eve's action. The protocol simply uses two coherent states for the signal pulses and vacuum for the decoy pulse. Our verified upper bound is sufficiently tight for quantum key distribution with a very lossy channel, in both the asymptotic and nonasymptotic case. So far our protocol is the only decoy-state protocol that works efficiently for currently existing setups.

Guide to thoracic imaging.

PubMed

Skinner, Sarah

2015-08-01

Thoracic imaging is commonly ordered in general practice. Guidelines exist for ordering thoracic imaging but few are specific for general practice. This article summarises current indications for imaging the thorax with chest X-ray and computed tomography. A simple frame-work for interpretation of the chest X-ray, suitable for trainees and practitioners providing primary care imaging in rural and remote locations, is presented. Interpretation of thoracic imaging is best done using a systematic approach. Radiological investigation is not warranted in un-complicated upper respiratory tract infections or asthma, minor trauma or acute-on-chronic chest pain.

Turning the UNCRC Upside Down: A Bottom-Up Perspective on Children's Rights

ERIC Educational Resources Information Center

Harcourt, Deborah; Hägglund, Solveig

2013-01-01

Children's rights have been studied from several perspectives. The implementation of children's rights has been argued in a corpus of seminal works seeking to problematise ways in which rights may be integrated and visible, with a particular focus on children's participation. Research also exists in the areas of policy, democratic practice and…

Critical Studies in Art and Design Education.

ERIC Educational Resources Information Center

Thistlewood, David, Ed.

This book brings together British and U.S. contributions to the debate of a critical studies approach to art and design education. The approach links practice and appreciation. But critical differences exist in definitions of the term design, with the U.S. recognition of design as the use of principles and elements of art in works and a British…

The Roots of Technical Learning and Thinking: Situating TLT in Schools

ERIC Educational Resources Information Center

Hansen, Ron

2008-01-01

Technical thinking is defined as an aptitude, ingenuity, and affliction for solving practical problems through experience. From the beginning of civilization such thinking has been a significant part of human existence. Learning associated with it is a natural instinct for most people, young and old, who work in a technical field, pursue a…

Curriculum Documents and Practice in the NZ Polytechnic Sector: Consensus and Dissensus

ERIC Educational Resources Information Center

Melles, Gavin

2008-01-01

In New Zealand the polytechnic sector embraces a range of post-compulsory education fields. Fields as diverse as nursing, business, social work and English as a Second Language (ESL) may co-exist on polytechnic campuses and are subject to similar curriculum documentation processes. The common competency-based framework and discourse of such…

The University and Race Relations.

ERIC Educational Resources Information Center

Hinderaker, Ivan

The most critical issue that the US must face is whether people of all races can work together and create a society in which equal opportunity genuinely exists for all. The racism practiced throughout the US has produced potentially destructive forces that could lead to a second civil war between outraged minority groups and the rest of society.…

"Explain to Your Partner": Teachers' Instructional Practices and Students' Dialogue in Small Groups

ERIC Educational Resources Information Center

Webb, Noreen M.; Franke, Megan L.; De, Tondra; Chan, Angela G.; Freund, Deanna; Shein, Pat; Melkonian, Doris K.

2009-01-01

Collaborative group work has great potential to promote student learning, and increasing evidence exists about the kinds of interaction among students that are necessary to achieve this potential. Less often studied is the role of the teacher in promoting effective group collaboration. This article investigates the extent to which teachers'…

Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures

ERIC Educational Resources Information Center

Campbell, Alistair; Hemsley, Samantha

2009-01-01

The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

Positioning and Repositioning: Linguistic Practices and Identity Negotiation of Overseas Returning Bilinguals in Hong Kong

ERIC Educational Resources Information Center

Chen, Katherine Hoi Ying

2008-01-01

Li Wei (1995) notes that relatively little sociolinguistic work on bilingualism has attempted to analyze and compare the complex relationships between aspects of language choice and code-switching among subgroups of the same community. This study aims to investigate the co-existence of two structurally different Cantonese-English code-switching…

The Group as Teacher: The Gestalt Peer-Learning Community as a Vehicle for Organisational Healing.

ERIC Educational Resources Information Center

Barber, Paul

The possibility of using a Gestalt-informed peer learning community to facilitate reflective learning and organizational change was explored. A peer learning community model exists that is based on two approaches to working with mental illness--therapeutic community practice (which is based on treating the community group rather than individuals…

Developing a Diagnosis System of Work-Related Capabilities for Students: A Computer-Assisted Assessment

ERIC Educational Resources Information Center

Liao, C. H.; Yang, M. H.; Yang, B. C.

2013-01-01

A gap exists between students' employment needs and higher education offerings. Thus, developing the capability to meet the learning needs of students in supporting their future aspirations should be facilitated. To bridge this gap in practice, this study uses multiple methods (i.e., nominal group technique and instructional systems development)…

Finding the Sweet Spot: Network Structures and Processes for Increased Knowledge Mobilization

ERIC Educational Resources Information Center

Briscoe, Patricia; Pollock, Katina; Campbell, Carol; Carr-Harris, Shasta

2015-01-01

The use of networks in public education is one of many knowledge mobilization (KMb) strategies utilized to promote evidence-based research into practice. However, challenges exist in the ability to mobilize knowledge through networks. The purpose of this paper is to explore how networks work. Data were collected from virtual discussions for an…

Feeling as a Way of Knowing: A Practical Guide for Working with Emotional Experience.

ERIC Educational Resources Information Center

Artz, Sibylle

Feeling, emotion, and passion are the "stuff" of everyday experience. This guidebook helps the reader understand emotions in a two-step approach. First, common assumptions about emotion are examined in order to arrive at a deeper understanding of current approaches to emotion, especially as these exist in the fields of psychology and…

Reading Interventions for Adolescent English Language Learners with Reading Difficulties: A Synthesis of the Evidence

ERIC Educational Resources Information Center

Huddle, Sally; Hosp, John; Watt, Sarah

2017-01-01

In this systematic review of the literature, reading interventions for adolescent English language learners (ELLs) were evaluated to determine the state of the existing research, identify promising practices, and to guide future research. Eight studies met the inclusion criteria and were assessed to determine if they met What Works Clearinghouse…

Assessment of Learning Outcomes in Higher Education: A Comparative Review of Selected Practices. OECD Education Working Papers, No. 15

ERIC Educational Resources Information Center

Nusche, Deborah

2008-01-01

Higher education institutions (HEIs) have experienced increasing pressures to provide accountability data and consumer information on the quality of teaching and learning. Existing ratings and rankings of HEIs tend to neglect information on student learning outcomes. Instead, they focus on inputs, activities and research outputs, such as resources…

Safety on the Job. Some Guidelines for Working Safely. Instructor's Edition.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This teacher's guide was developed to help teachers (especially in Oklahoma) promote safe practices on the job. As a supplement to existing programs in the requirements for job safety, this book can also promote same basic safety attitudes and help support basic safety concepts, with an emphasis on accident prevention. The guide contains eight…

Envisaging the Adoption Process to Strengthen Gay- and Lesbian-Headed Families: Recommendations for Adoption Professionals

ERIC Educational Resources Information Center

Matthews, John D.; Cramer, Elizabeth P.

2006-01-01

Although a growing number of child placement agencies are serving lesbians and gay men, a dearth of literature exists for adoption agency policies and practices related to working with this population. This article explores the unique characteristics and strengths of prospective gay and lesbian adoptive parents throughout each of the three phases…

Records of Practice and the Development of Collective Professional Knowledge

ERIC Educational Resources Information Center

Ball, Deborah Loewenberg; Ben-Peretz, Miriam; Cohen, Rhonda B.

2014-01-01

Although recent years have seen an increase in professional learning communities, use of video and lesson study groups, most teachers still work and learn in isolation. What they know is personal and remains private; little opportunity exists for most teachers to develop shared knowledge or language. The scale of the teaching force, and the rapid…

The Use of ePortfolios to Support Metacognitive Practice in a First-Year Writing Program

ERIC Educational Resources Information Center

Bowman, Jim; Lowe, Barbara J.; Sabourin, Katie; Sweet, Catherine Salomon

2016-01-01

Recognizing the importance of meaningful reflective writing as an integral component to the portfolios used in the first-year program (FYP), faculty questioned whether a newly developed electronic portfolio offered any pedagogical benefits over the existing traditional paper portfolio. Of particular interest for this work was whether the use of…

Supporting the Development of Assessment Literacy of Staff through Institutional Process Change

ERIC Educational Resources Information Center

Forsyth, Rachel; Cullen, Rod; Ringan, Neil; Stubbs, Mark

2015-01-01

This paper reflects on the work done at a large UK university to redesign assessment procedures in a way that was intended to contribute to an improvement in assessment literacy for staff. Existing practice was reviewed and showed that changes in assessment processes were needed to make the organization of assessment more consistent and more…

Governing in Whose Interests? Enacting School Leadership for Whom?

ERIC Educational Resources Information Center

Busher, Hugh; McKeown, Penny

2005-01-01

Leaders at all levels in schools try to implement particular policies and practices. These arise in response to pressures in the policy, social and economic contexts in which they work and from their own social and educational values. As part of the process of implementation, leaders try to modify existing organisational cultures to bind their…

Skepticism to Success: Meeting Critical Workforce Needs through Innovation and Collaboration

ERIC Educational Resources Information Center

Anderson, Margaret; Maier, Linda; Shepard, Michael

2010-01-01

To meet workforce demand and the needs of working or place-bound students, Whatcom Community College developed an online version of its existing face-to-face Physical Therapist Assistant program which became a model for other lab-based health science degrees. This article describes research studies that support the program's practices and includes…

Tasks, Ensembles, and Activity: Linkages between Text Production and Situation of Use in the Workplace

ERIC Educational Resources Information Center

Bracewell, Robert J.; Witte, Stephen P.

2003-01-01

This article is concerned with characterizing literacy activity as it is practiced in professional workplaces. Its starting point is activity theory, which grew out of the work of Vygotsky and has been subsequently elaborated in Russia and elsewhere. First, the authors propose that existing versions of activity theory are unable to account…

Undergraduate Research as a Fate Accompli: Innovation and Evolution of a Student Conference in Business

ERIC Educational Resources Information Center

Buff, Cheryl L.; Devasagayam, Raj

2016-01-01

The benefits of undergraduate research continue to receive academic attention and it is becoming an engaged learning practice present on many college campuses today. As research participation grows, an opportunity exists to showcase the work being accomplished and to use this public presentation to foster a culture of undergraduate research on…

In Their Own Voices: Faculty Developers' Perceptions of Their Professional Identity and Knowledge Acquisition Strategies

ERIC Educational Resources Information Center

Shaffer, Christine E.

2011-01-01

As colleges and universities increase the focus on student learning, faculty development has taken a more prominent role in higher education (Barr & Tagg, 1995; Fink, 2003; Lieberman & Guskin, 2002). While a significant body of work on the practice of faculty development exists, research on faculty developers as professionals is limited. Several…

Flexible but boring: medical students' perceptions of a career in general practice.

PubMed

Koehler, Nicole; McMenamin, Christine

2016-07-01

Australia will continue to face a general practitioner (GP) shortage unless a significant number of medical students make general practice their chosen career. Perceptions regarding general practice may influence career choices. Thus this study investigated what Australian medical students perceived to be the advantages and disadvantages of pursuing a career in general practice via an anonymous online survey. Fifty-one students indicated general practice to be their first ranked career preference, 200 indicated a career other than general practice, and 106 were undecided. Two-hundred and two students reported having been on a GP placement, whereas 88 students had not. Flexibility, continuity of patient care and work-life balance were the three most common stated advantages to pursuing a career in general practice whereas general practice being boring, poorly paid, and of low prestige were the three most common disadvantages stated. Some disadvantages stated by those with a non-GP preference were not stated by those with a GP preference (e.g. lack of procedural skills, lack of career advancement opportunities). Students with more than 80 h of GP placement experience were more likely to list the advantages of work-life balance and a diversity of problems/illnesses/patients than those with no placement experience but were also more likely to list the disadvantage of low prestige. Negative stereotypes regarding general practice continue to exist which may influence students' career choices.

Guideline harmonization and implementation plan for the BETTER trial: Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice

PubMed Central

Rogers, Jess; Manca, Donna; Lang-Robertson, Kelly; Bell, Stephanie; Salvalaggio, Ginetta; Greiver, Michelle; Korownyk, Christina; Klein, Doug; Carroll, June C.; Kahan, Mel; Meuser, Jamie; Buchman, Sandy; Barrett, Rebekah M.; Grunfeld, Eva

2014-01-01

Background The aim of the Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Family Practice (BETTER) randomized controlled trial is to improve the primary prevention of and screening for multiple conditions (diabetes, cardiovascular disease, cancer) and some of the associated lifestyle factors (tobacco use, alcohol overuse, poor nutrition, physical inactivity). In this article, we describe how we harmonized the evidence-based clinical practice guideline recommendations and patient tools to determine the content for the BETTER trial. Methods We identified clinical practice guidelines and tools through a structured literature search; we included both indexed and grey literature. From these guidelines, recommendations were extracted and integrated into knowledge products and outcome measures for use in the BETTER trial. End-users (family physicians, nurse practitioners, nurses and dieticians) were engaged in reviewing the recommendations and tools, as well as tailoring the content to the needs of the BETTER trial and family practice. Results In total, 3–5 high-quality guidelines were identified for each condition; from these, we identified high-grade recommendations for the prevention of and screening for chronic disease. The guideline recommendations were limited by conflicting recommendations, vague wording and different taxonomies for strength of recommendation. There was a lack of quality evidence for manoeuvres to improve the uptake of guidelines among patients with depression. We developed the BETTER clinical algorithms for the implementation plan. Although it was difficult to identify high-quality tools, 180 tools of interest were identified. Interpretation The intervention for the BETTER trial was built by integrating existing guidelines and tools, and working with end-users throughout the process to increase the intervention’s utility for practice. Trial registration: ISRCTN07170460 PMID:25077119

The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

PubMed

Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

2009-03-01

The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

Adaptation of the Practice Environment Scale for military nurses: a psychometric analysis.

PubMed

Swiger, Pauline A; Raju, Dheeraj; Breckenridge-Sproat, Sara; Patrician, Patricia A

2017-09-01

The aim of this study was to confirm the psychometric properties of Practice Environment Scale of the Nursing Work Index in a military population. This study also demonstrates association rule analysis, a contemporary exploratory technique. One of the instruments most commonly used to evaluate the nursing practice environment is the Practice Environment Scale of the Nursing Work Index. Although the instrument has been widely used, the reliability, validity and individual item function are not commonly evaluated. Gaps exist with regard to confirmatory evaluation of the subscale factors, individual item analysis and evaluation in the outpatient setting and with non-registered nursing staff. This was a secondary data analysis of existing survey data. Multiple psychometric methods were used for this analysis using survey data collected in 2014. First, descriptive analyses were conducted, including exploration using association rules. Next, internal consistency was tested and confirmatory factor analysis was performed to test the factor structure. The specified factor structure did not hold; therefore, exploratory factor analysis was performed. Finally, item analysis was executed using item response theory. The differential item functioning technique allowed the comparison of responses by care setting and nurse type. The results of this study indicate that responses differ between groups and that several individual items could be removed without altering the psychometric properties of the instrument. The instrument functions moderately well in a military population; however, researchers may want to consider nurse type and care setting during analysis to identify any meaningful variation in responses. © 2017 John Wiley & Sons Ltd.

To Be or Not to Be (Stressed): The Critical Role of a Psychologically Healthy Workplace in Effective Stress Management.

PubMed

Grawitch, Matthew J; Ballard, David W; Erb, Kaitlyn R

2015-10-01

This article explains how key practices pertaining to the psychologically healthy workplace can be used to develop a comprehensive approach to stress management in contemporary organizations. Specifically, we demonstrate the ways in which employee involvement, recognition, work-life balance, health and safety, and growth and development practices can be used to assist in the reduction of work stress and the proactive management of strain. Although many organizations strive to establish a positive environment conducive to work and well-being, identifying where to begin can often seem like a daunting task. Currently, many stress management efforts emphasize individual-level interventions that are simply implemented alongside existing organizational practices. We propose that a broader perspective allows for a better understanding of the stress process, resulting in the ability to consider a wider range of changes to organizational processes. Combining knowledge regarding psychologically healthy workplace practices, stress management intervention levels and the personal resource allocation framework, we present a comprehensive framework for approaching workplace stress management, which can be tailored to the unique needs of various organizations, departments and employees. By adopting this broader perspective, we believe organizations can more strategically address employee stress, resulting in more effective stress management and a profound impact on stress-related outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

The diverging perception among physiotherapists of how to work with the concept of evidence: a phenomenographic analysis.

PubMed

Snöljung, Åsa; Mattsson, Karin; Gustafsson, Lena-Karin

2014-12-01

Changes in Sweden's municipal care have impacted the situation of physiotherapists by the adoption of practice based on research evidence. Even if physiotherapists appear to be in favour of the idea of evidence-based practice, barriers still exist that prevent many from keeping up with current research. The aim of this study was to identify and describe the different ways in which physiotherapists in municipal care perceive the concept of evidence in rehabilitation. A phenomenographic design with semi-structured interviews was carried out with physiotherapists working with frail older people in three municipal care units in two neighbouring municipalities in Sweden. The physiotherapists' perceptions of evidence were explored in 12 interviews. Distinct perceptions of the concept of evidence are identified in three categories: 'Confidence with the concept of evidence in relation to measurement instruments'; 'Perception of evidence-based practice as a duty, condition and demand of the profession'; and 'Evidence-based work as a separate rather than directly patient-oriented activity'. Physiotherapists take full responsibility to comply with what they perceive to be the demands of their profession. However, what evidence actually meant, and therefore what the practical element of this responsibility consisted of, was not as clear. © 2014 John Wiley & Sons, Ltd.

Effect of experience on clinical decision making by cardiorespiratory physiotherapists in acute care settings.

PubMed

Smith, Megan; Higgs, Joy; Ellis, Elizabeth

2010-02-01

This article investigates clinical decision making in acute care hospitals by cardiorespiratory physiotherapists with differing degrees of clinical experience. Participants were observed as they engaged in their everyday practice and were interviewed about their decision making. Texts of the data were interpreted by using a hermeneutic approach that involved repeated reading and analysis of fieldnotes and interview transcripts to develop an understanding of the effect of experience on clinical decision making. Participants were classified into categories of cardiorespiratory physiotherapy experience: less experienced (<2 years), intermediate experience (2.5-4 years), and more experienced (>7 years). Four dimensions characteristic of increasing experience in cardiorespiratory physiotherapy clinical decision making were identified: 1) an individual practice model, 2) refined approaches to clinical decision making, 3) working in context, and 4) social and emotional capability. Underpinning these dimensions was evidence of reflection on practice, motivation to achieve best practice, critique of new knowledge, increasing confidence, and relationships with knowledgeable colleagues. These findings reflect characteristics of physiotherapy expertise that have been described in the literature. This study adds knowledge about the field of cardiorespiratory physiotherapy to the existing body of research on clinical decision making and broadens the existing understanding of characteristics of physiotherapy expertise.

Developing and Sustaining Recovery-Orientation in Mental Health Practice: Experiences of Occupational Therapists.

PubMed

Nugent, Alexandra; Hancock, Nicola; Honey, Anne

2017-01-01

Internationally, mental health policy requires clinicians to shift from a medical to a recovery-oriented approach. However, there is a significant lag in the translation of policy into practice. Occupational therapists have been identified as ideally situated to be recovery-oriented yet limited research exploring how they do this exists. This study aimed to explore Australian occupational therapists' experiences of developing and sustaining recovery-orientation in mental health practice. Semistructured, in-depth interviews were conducted with twelve occupational therapists working across different mental health service types. Participants identified themselves as being recovery-oriented. Data were analysed using constant comparative analysis. Occupational therapists described recovery-oriented practice as an active, ongoing, and intentional process of seeking out knowledge, finding fit between understandings of recovery-oriented practice and their professional identity, holding hope, and developing confidence through clinical reasoning. Human and systemic aspects of therapists' workplace environment influenced this process. Being a recovery-oriented occupational therapist requires more than merely accepting a specific framework. It requires commitment and ongoing work to develop and sustain recovery-orientation. Occupational therapists are called to extend current leadership activity beyond their workplace and to advocate for broader systemic change.

Evaluation of Existing Structure and Civil Protection Management Framework in Greek Local Authorities: A Questionnaire Survey Demonstrates Why Prevention Fails

NASA Astrophysics Data System (ADS)

Papanikolaou, Dimitrios; Papanikolaou, Ioannis; Diakakis, Michalis; Deligiannakis, Georgios

2013-04-01

In the face of a growing number of natural disasters and the increasing costs associated with them, Europe and Greece in particular, have devoted significant efforts and resources in natural hazards mitigation during the last decades. Despite the significant legislative efforts (e.g. 1998/22/EC, 2001/792/EC, 2007/60/EC Directives, 3013/2002 Act) and even though a number of steps has been taken towards improving civil protection, recent catastrophic events have illustrated the weaknesses of current approaches. In particular, in Greece, events such as the 1999 Athens earthquake, the 2007 and 2009 wildfires have shown the inadequacy of prevention and mitigation practices. Given the enhanced civil protection responsibilities, given by the Greek national law (Acts 3013/2002, 3852/2010) to local authorities in Greece, this work analyses and evaluates the existing structure and current management framework under which local authorities function and examines their risk mitigation practices. We conducted the largest questionnaire survey regarding Civil Protections issues, among the municipalities of Greece. To this aim, this work used a innovative online tool to assess current framework. Therefore, a network connecting civil protection departments of municipalities was developed, based on an Internet platform that acted also as a communication tool. Overall, we had feedback either online or offline from 125 municipalities across the country (representing more than one/third of the total municipalities of Greece). Through this network, municipal civil protection officials completed surveys designed to obtain and quantify information on several aspects of civil protection practices and infrastructure. In particular, the examined factors included: (i) personnel and equipment, (ii) inter-agency cooperation, (iii) training, (iv) compliance with existing regulations and (v) persistent problems encountered by civil protection departments, that prevent the effectiveness of current practices. Responses showed that civil protection personnel lack adequate training and expertise, many are overstretched with several duties, while several prevention actions are carried out by seasonal or voluntary staff. Approximately half of the heads of civil protection offices do not hold a university degree, only 27% have a relevant scientific background (geoscientists or engineers) and more than half of them are elected members and not permanent staff, implying that no continuity is secured. Inter-agency cooperation is shown to be poor and organizational learning from international practices not adequate. Half of the municipalities report that the authorization processes are too slow so that prevention actions particularly regarding forest fires are severely delayed. Existing regulations are not followed by a significant portion of municipalities since 19% have not established a civil protection office and 23% have not compiled an action plan yet. Existing action plans lack important information, present no spatial data and are predominantly catalogues and tables of information regarding authorised personnel and equipment. Overall, underfunding, poor coordination of the different actors involved, lack of training and understaffing, lack of proper equipment and several other issues are held responsible by officials for preventing effectiveness of current practices. Finally, the EU emergency number 112 is widely unknown (87%). This work was held under the LIFE+ project "Local Authorities Alliance for Forest Fire Prevention - LIFE08/ENV/GR/000553" which is implemented with the contribution of the LIFE financial instrument of the European Community.

Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence.

PubMed

Loisel, Patrick; Buchbinder, Rachelle; Hazard, Rowland; Keller, Robert; Scheel, Inger; van Tulder, Maurits; Webster, Barbara

2005-12-01

The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. One reason for limited dissemination of evidence is the complexity of the problem, as it is subject to multiple legal, administrative, social, political, and cultural challenges. A literature review and collection of experts' opinion is presented, on the current evidence for work disability prevention, and barriers to evidence implementation. Recommendations are presented for enhancing implementation of research results. The current evidence regarding work disability prevention shows that some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. Future studies should involve all relevant stakeholders and aim at developing new strategies that are effective, efficient, and have a potential for successful implementation. These studies should be based upon a clearer conceptualization of the broader context and inter-relationships that determine return to work outcomes.

Reimbursement for critical care services in India

PubMed Central

Jayaram, Raja; Ramakrishnan, Nagarajan

2013-01-01

There are significant variations in critical care practices, costs, and reimbursements in various countries. Of note, there is a paucity of reliable information on remuneration and reimbursement models for intensivists in India. This review article aims to analyze the existing reimbursement models in United States and United Kingdom and propose a frame-work model that may be applicable in India. PMID:23833469

Too Many Problems and Not Enough Help: Exploring the Need for School Social Workers in the Hashemite Kingdom of Jordan

ERIC Educational Resources Information Center

Alhajjaj, Huda A.

2017-01-01

Social work encompasses many different fields of practice. School social workers provide services to students encountering a wide spectrum of psychosocial and behavioral challenges at school, home, and society. While school social workers exist in many countries across the globe, many countries such as Jordan remain without school social workers.…

40 CFR Table 1 to Subpart Uuuu of... - Emission Limits and Work Practice Standards

Code of Federal Regulations, 2014 CFR

2014-07-01

... least once per month as specified in § 63.148(f)(2)). 12. heat exchanger system that cools process equipment or materials in the process unit each existing or new affected source monitor and repair the heat exchanger system according to § 63.104(a) through (e), except that references to “chemical manufacturing...

40 CFR Table 1 to Subpart Uuuu of... - Emission Limits and Work Practice Standards

Code of Federal Regulations, 2012 CFR

2012-07-01

... least once per month as specified in § 63.148(f)(2)). 12. heat exchanger system that cools process equipment or materials in the process unit each existing or new affected source monitor and repair the heat exchanger system according to § 63.104(a) through (e), except that references to “chemical manufacturing...

40 CFR Table 1 to Subpart Uuuu of... - Emission Limits and Work Practice Standards

Code of Federal Regulations, 2013 CFR

2013-07-01

... least once per month as specified in § 63.148(f)(2)). 12. heat exchanger system that cools process equipment or materials in the process unit each existing or new affected source monitor and repair the heat exchanger system according to § 63.104(a) through (e), except that references to “chemical manufacturing...

School Evaluation: Current Practices in OECD Countries and a Literature Review. OECD Education Working Papers, No. 42

ERIC Educational Resources Information Center

Faubert, Violaine

2009-01-01

This paper examines the current academic and policy literatures concerning school evaluation in primary and secondary education within the OECD countries. First, it provides a typology of the existing systems of school evaluation across the OECD. It encompasses the diverse criteria and instruments commonly used to carry out schools evaluation, as…

Introduction to the theory of infinite systems. Theory and practices

NASA Astrophysics Data System (ADS)

Fedorov, Foma M.

2017-11-01

A review of the author's work is given, which formed the basis for a new theory of general infinite systems. The Gaussian elimination and Cramer's rule have been extended to infinite systems. A special particular solution is obtained, it is called a strictly particular solution. Necessary and sufficient conditions for existence of the nontrivial solutions of homogeneous systems are given.

A Product Analysis Method and Its Staging to Develop Redesign Competences

ERIC Educational Resources Information Center

Hansen, Claus Thorp; Lenau, Torben Anker

2013-01-01

Most product development work in industrial practice is incremental, i.e., the company has had a product in production and on the market for some time, and now time has come to design an upgraded variant. This type of redesign project requires that the engineering designers have competences to carry through an analysis of the existing product…

The Welcome Workbook: A Self Review Framework for Expanding Inclusive Provision in Your Local Authority

ERIC Educational Resources Information Center

Centre for Studies on Inclusive Education, 2009

2009-01-01

The Welcome Workbook is a practical resource for people working in local authorities who want to see an increase in the number of children fulfilling their right to mainstream education. By providing a clear self-review framework, The Welcome Workbook enables local authorities to audit their existing processes and map a route towards more…

Racial/Ethnic Socialization and Identity Development in Black Families: The Role of Parent and Youth Reports

ERIC Educational Resources Information Center

Peck, Stephen C.; Brodish, Amanda B.; Malanchuk, Oksana; Banerjee, Meeta; Eccles, Jacquelynne S.

2014-01-01

Racial/ethnic (R/E) socialization is widely practiced in R/E minority families. However, only recently have models been developed to understand how parents' R/E socialization messages influence adolescent development. The primary goal of the present study was to clarify and extend existing work on R/E socialization in African American (Black)…

(Re)Telling Lived Experiences in Different Tales: A Potential Pathway in Working towards an Inclusive PE

ERIC Educational Resources Information Center

Berg Svendby, Ellen

2016-01-01

Existing research reveals that there are large discrepancies between the rhetoric of inclusive practice and what actually takes place in physical education (PE) lessons. PE appears to be a conservative subject, where little has changed over the years, despite increased diversity in schools and new modes of movement in society at large. In this…

Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

ERIC Educational Resources Information Center

Hutchison, Andrew; Kroese, Biza Stenfert

2016-01-01

Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

Reframing the School-to-Prison Pipeline: The Experiences of Latina/o Youth and Families

ERIC Educational Resources Information Center

Pantoja, Alicia

2013-01-01

In this paper, I argue that school-to-prison pipeline (SPP) research on Latina/os shows the existence of an interconnected system of policies and social practices, in and out of schools, punitive and non-punitive in nature, which together work to criminalize Latina/o students and their families. This intersection (Crenshaw, 1991) and multiplicity…

A Protocol for Rapid, Measurable Plant Tissue Culture Using Stem Disc Meristem Micropropagation of Garlic ("Allium Sativum L.")

ERIC Educational Resources Information Center

Peat, Gerry; Jones, Meriel

2012-01-01

Plant tissue culture is becoming an important technique for the mass propagation of plants. Problems with existing techniques, such as slow growth and contamination, have restricted the practical work in plant tissue culture carried out in schools. The new protocol using garlic meristematic stem discs explained in this article addresses many of…

Defense Cybersecurity: Opportunities Exist for DOD to Share Cybersecurity Resources with Small Businesses

DTIC Science & Technology

2015-09-01

risk self- Communications identified by small businesses . The guidance Commission includes links to addit ional cybersecurity resources...Working Group 4: Final Report. The report’s appendix provides cybersecurity risk management and best practice recommendations for small and medium...including small businesses . Cybersecurity education for risk assessment and planning. These programs provide education and training that small

40 CFR Table 1 to Subpart Uuuu of... - Emission Limits and Work Practice Standards

Code of Federal Regulations, 2011 CFR

2011-07-01

... least once per month as specified in § 63.148(f)(2)). 12. heat exchanger system that cools process equipment or materials in the process unit each existing or new affected source monitor and repair the heat exchanger system according to § 63.104(a) through (e), except that references to “chemical manufacturing...

Professional values and competencies as explanatory factors for the use of evidence-based practice in nursing.

PubMed

Skela-Savič, Brigita; Hvalič-Touzery, Simona; Pesjak, Katja

2017-08-01

To establish the connection between values, competencies, selected job characteristics and evidence-based practice use. Nurses rarely apply evidence-based practice in everyday work. A recent body of research has looked at various variables explaining the use of evidence-based practice, but not values and competencies. A cross-sectional, non-experimental quantitative explorative research design. Standardized instruments were used (Nurse Professional Values Scale-R, Nurse Competence Scale, Evidence-Based Practice Beliefs and Implementation Scale). The sample included 780 nurses from 20 Slovenian hospitals. The data were collected in 2015. The study identifies two new variables contributing to a better understanding of beliefs on and implementation of evidence-based practice, thus broadening the existing research evidence. These are the values of activism and professionalism and competencies aimed at the development and professionalization of nursing. Values of caring, trust and justice and competencies expected in everyday practice do not influence the beliefs and implementation of evidence-based practice. Respondents ascribed less importance to values connected with activism and professionalism and competencies connected with the development of professionalism. Nurses agree that evidence-based practice is useful in their clinical work, but they lack the knowledge to implement it in practice. Evidence-based practice implementation in nursing practice is low. Study results stress the importance of increasing the knowledge and skills on professional values of activism and professionalism and competencies connected to nursing development. The study expands the current understanding of evidence-based practice use and provides invaluable insight for nursing managers, higher education managers and the national nursing association. © 2017 John Wiley & Sons Ltd.

Strengthening health promotion in Australian workplaces.

PubMed

Fisher, K J; Deeds, S; Siebel, R; Allen, J

1997-01-01

The Australian workplace has emerged as an important venue for influencing the health of employees through regulations and behaviour change programs. Recent surveys have highlighted a growth in this activity but the effectiveness of these programs in changing unhealthy work practices and policies is questionable. The need for strengthening programs by stronger designs and evaluation, and addressing organisational factors and employee participation in planning and implementation processes is documented. Efforts in that direction in Queensland are cited, Building on these existing foundations, redirecting existing resources, and building intersectoral cooperation in public-private partnerships hold a creative, exemplary vision of the future for Australian workplace programming.

Realistic nurse-led policy implementation, optimization and evaluation: novel methodological exemplar.

PubMed

Noyes, Jane; Lewis, Mary; Bennett, Virginia; Widdas, David; Brombley, Karen

2014-01-01

To report the first large-scale realistic nurse-led implementation, optimization and evaluation of a complex children's continuing-care policy. Health policies are increasingly complex, involve multiple Government departments and frequently fail to translate into better patient outcomes. Realist methods have not yet been adapted for policy implementation. Research methodology - Evaluation using theory-based realist methods for policy implementation. An expert group developed the policy and supporting tools. Implementation and evaluation design integrated diffusion of innovation theory with multiple case study and adapted realist principles. Practitioners in 12 English sites worked with Consultant Nurse implementers to manipulate the programme theory and logic of new decision-support tools and care pathway to optimize local implementation. Methods included key-stakeholder interviews, developing practical diffusion of innovation processes using key-opinion leaders and active facilitation strategies and a mini-community of practice. New and existing processes and outcomes were compared for 137 children during 2007-2008. Realist principles were successfully adapted to a shorter policy implementation and evaluation time frame. Important new implementation success factors included facilitated implementation that enabled 'real-time' manipulation of programme logic and local context to best-fit evolving theories of what worked; using local experiential opinion to change supporting tools to more realistically align with local context and what worked; and having sufficient existing local infrastructure to support implementation. Ten mechanisms explained implementation success and differences in outcomes between new and existing processes. Realistic policy implementation methods have advantages over top-down approaches, especially where clinical expertise is low and unlikely to diffuse innovations 'naturally' without facilitated implementation and local optimization. © 2013 John Wiley & Sons Ltd.

Factors influencing evidence-based practice in prosthetics and orthotics.

PubMed

Andrysek, Jan; Christensen, James; Dupuis, Annie

2011-03-01

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

Extravehicular Crewman Work System (ECWS) study program. Volume 3: Satellite service

NASA Technical Reports Server (NTRS)

Wilde, R. C.

1980-01-01

The satellite service portion of the Extravehicular Crewman Work System Study defines requirements and service equipment concepts for performing satellite service from the space shuttle orbiter. Both normal and contingency orbital satellite service is required. Service oriented satellite design practices are required to provide on orbit satellite service capability for the wide variety of satellites at the subsystem level. Development of additional satellite service equipment is required. The existing space transportation system provides a limited capability for performing satellite service tasks in the shuttle payload bay area.

DEFENSE MANAGEMENT. Industry Practices Can Help Military Exchanges Better Assure That Their Goods Are Not Made by Child or Forced Labor

DTIC Science & Technology

2002-01-01

eliminating sweatshops in the United States. However, we reported on the widespread existence of sweatshops within the United States in the 1980s and 1990s.6...Monte, California, and found sweatshop working conditions-workers were confined behind razor wire fences and forced to work 20 hours a day for 70 cents...association, the El Monte raid provoked a public outcry and galvanized the U.S. government’s efforts against sweatshops . Concern in the United States about

An XML-based system for the flexible classification and retrieval of clinical practice guidelines.

PubMed Central

Ganslandt, T.; Mueller, M. L.; Krieglstein, C. F.; Senninger, N.; Prokosch, H. U.

2002-01-01

Beneficial effects of clinical practice guidelines (CPGs) have not yet reached expectations due to limited routine adoption. Electronic distribution and reminder systems have the potential to overcome implementation barriers. Existing electronic CPG repositories like the National Guideline Clearinghouse (NGC) provide individual access but lack standardized computer-readable interfaces necessary for automated guideline retrieval. The aim of this paper was to facilitate automated context-based selection and presentation of CPGs. Using attributes from the NGC classification scheme, an XML-based metadata repository was successfully implemented, providing document storage, classification and retrieval functionality. Semi-automated extraction of attributes was implemented for the import of XML guideline documents using XPath. A hospital information system interface was exemplarily implemented for diagnosis-based guideline invocation. Limitations of the implemented system are discussed and possible future work is outlined. Integration of standardized computer-readable search interfaces into existing CPG repositories is proposed. PMID:12463831

Reflective teaching practices: an approach to teaching communication skills in a small-group setting.

PubMed

Fryer-Edwards, Kelly; Arnold, Robert M; Baile, Walter; Tulsky, James A; Petracca, Frances; Back, Anthony

2006-07-01

Small-group teaching is particularly suited for complex skills such as communication. Existing work has identified the basic elements of small-group teaching, but few descriptions of higher-order teaching practices exist in the medical literature. Thus the authors developed an empirically driven and theoretically grounded model for small-group communication-skills teaching. Between 2002 and 2005, teaching observations were collected over 100 hours of direct contact time between four expert facilitators and 120 medical oncology fellows participating in Oncotalk, a semiannual, four-day retreat focused on end-of-life communication skills. The authors conducted small-group teaching observations, semistructured interviews with faculty participants, video or audio recording with transcript review, and evaluation of results by faculty participants. Teaching skills observed during the retreats included a linked set of reflective, process-oriented teaching practices: identifying a learning edge, proposing and testing hypotheses, and calibrating learner self-assessments. Based on observations and debriefings with facilitators, the authors developed a conceptual model of teaching that illustrates an iterative loop of teaching practices aimed at enhancing learners' engagement and self-efficacy. Through longitudinal, empirical observations, this project identified a set of specific teaching skills for small-group settings with applicability to other clinical teaching settings. This study extends current theory and teaching practice prescriptions by describing specific teaching practices required for effective teaching. These reflective teaching practices, while developed for communication skills training, may be useful for teaching other challenging topics such as ethics and professionalism.

Non-invasive diagnostic platforms in management of non-small cell lung cancer: opportunities and challenges

PubMed Central

Pennell, Nathan A.

2017-01-01

Several non-invasive diagnostic platforms are already being incorporated in routine clinical practice in the work up and monitoring of patients with lung cancer. These approaches have great potential to improve patient selection and monitor patients while on therapy, however several challenges exist in clinical validation and standardization of such platforms. In this review, we summarize the current technologies available for non-invasive diagnostic evaluation from the blood of patients with non-small cell lung cancer (NSCLC), and discuss the technical and logistical challenges associated incorporating such testing in clinical practice. PMID:29057238

Constructing America from the Sea: Maritime Archaeology Research, International Cooperation and Best Practices in the Underwater Cultural Heritage of Latin America

NASA Astrophysics Data System (ADS)

Rey da Silva, Arturo; Herrera Tovar, Jorge M.

2017-12-01

This article introduces this special issue of the Journal of Maritime Archaeology by giving a brief introduction to the current situation of the practice of maritime archaeology in Latin America, as well as reviewing the main challenges that the discipline faces here. An assessment of existing regional cooperation, the presence of maritime archaeology within the international community and its importance to develop new theoretical and methodological perspectives that advance access to knowledge is made. Finally, the article focuses on some of the current work carried out in Latin America.

The physics of MRI safety.

PubMed

Panych, Lawrence P; Madore, Bruno

2018-01-01

The main risks associated with magnetic resonance imaging (MRI) have been extensively reported and studied; for example, everyday objects may turn into projectiles, energy deposition can cause burns, varying fields can induce nerve stimulation, and loud noises can lead to auditory loss. The present review article is geared toward providing intuition about the physical mechanisms that give rise to these risks. On the one hand, excellent literature already exists on the practical aspect of risk management, with clinical workflow and recommendations. On the other hand, excellent technical articles also exist that explain these risks from basic principles of electromagnetism. We felt that an underserved niche might be found between the two, ie, somewhere between basic science and practical advice, to help develop intuition about electromagnetism that might prove of practical value when working around MR scanners. Following a wide-ranging introduction, risks originating from the main magnetic field, the excitation RF electromagnetic field, and switching of the imaging gradients will be presented in turn. 5 Technical Efficacy: 1 J. Magn. Reson. Imaging 2018;47:28-43. © 2017 International Society for Magnetic Resonance in Medicine.

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

PubMed

Nauta, Margaret M

2010-01-01

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

Differences in practice and personal profiles between male and female ophthalmologists.

PubMed

Danesh-Meyer, Helen V; Deva, Narme C; Ku, Judy Y F; Carroll, Stuart C; Tan, Yu Wee; Gamble, Greg

2007-01-01

To assess practice profiles and attitudes towards career and family among ophthalmologists in Australia and New Zealand, with an emphasis on identifying gender differences. A 43-part confidential survey addressing professional and personal issues was sent to all female ophthalmologists and to randomly selected age-matched male ophthalmologists, registered with the Royal Australian and New Zealand College of Ophthalmologists in 2005. A total of 254 (75%) of the surveys were returned, with no significant difference in response rate between genders. Differences in practice profiles were identified: females preferentially practise in the city (89.6% vs. 76.1%, P<0.001), work fewer hours (70% of males working 40 hours per week, compared with 41% of females, P<0.0001) and work part time (57.5% vs. 13.6%, P<0.0001). Female ophthalmologists earn less (average income being NZ/Aus$37,913 [95% confidence interval 25,600-50,226] less, P<0.0001); the difference remained significant (P<0.0001) even when adjusted for hours worked. Up to 93.3% of male ophthalmologists are married or in a stable relationship, compared with 75.6% of females (P=0.0003), and males are more likely to have children (P=0.0007). There was no significant difference in overall career satisfaction between male and female ophthalmologists; however, females expressed greater frustration with managing professional and family commitments, and unequal career advancement opportunities. Significant differences exist in practice profiles and personal circumstances between male and female ophthalmologists. Females appear to balance work and personal responsibilities by working fewer hours, and for lower income. Despite this, they are less likely to be in a stable relationship, or to have children. However, there is no difference between the two groups in overall career satisfaction.

A comparison of the nursing practice environment in mental health and medical-surgical settings.

PubMed

Roche, Michael A; Duffield, Christine M

2010-06-01

To examine the differences between characteristics of the work environment of nurses working in mental health and general acute inpatient nursing settings. Secondary analysis of data collected on 96 randomly selected medical and surgical (general) wards and six mental health wards in 24 public acute general hospitals across two Australian states between 2004 and 2006. All nurses on the participating wards were asked to complete a survey that included the Practice Environment Scale of the Nursing Work Index (NWI-PES). Responses were received from 2,556 nurses (76.3% response rate). Using the five-domain structure, comparisons were made between mental health and general nurses. Across the entire sample of nurses, those working in mental health settings scored more highly in regard to nurse-doctor relationships and staffing adequacy. Nurses in general wards reported more participation in hospital affairs, stronger leadership, and the presence of more of the foundations of nursing quality care such as access to continued education. Differences between the groups on each of the domains was statistically significant at p=.05 or greater, but not for the composite practice environment scale. A wide range of responses was seen when data were aggregated to the ward level. The work environment of mental health nurses is different from that of their colleagues working in general settings. Specific areas of the mental health environment, such as participation in the hospital, leadership, and the foundations of quality, may be enhanced to improve nurses' job satisfaction and, potentially, other nurse and patient outcomes. Factors in the medical and surgical nursing practice environment have been established as significant influences on nurse and patient outcomes. It is important to understand the existence and potential impact of these factors in mental health inpatient settings.

Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

PubMed

Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

2009-11-08

Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider explorations of ICT's potential benefits, yet firm evidence of the effects of role changes on health service outcomes is limited. This project will provide important evidence about the role of ICT in supporting new models of care delivery across multiple healthcare organizations and about the ways in which innovative work practice change is diffused.

Influence of indoor work environments on health, safety, and human rights among migrant sex workers at the Guatemala-Mexico Border: a call for occupational health and safety interventions.

PubMed

Goldenberg, Shira M; Rocha Jiménez, Teresita; Brouwer, Kimberly C; Morales Miranda, Sonia; Silverman, Jay G

2018-02-02

Migrant women are over-represented in the sex industry, and migrant sex workers experience disproportionate health inequities, including those related to health access, HIV and sexually transmitted infections (STIs), and violence. Despite calls for occupational sex work interventions situated in labour rights frameworks, there remains a paucity of evidence pertaining to migrant sex workers' needs and realities, particularly within Mexico and Central America. This study investigated migrant sex workers' narratives regarding the ways in which structural features of work environments shape vulnerability and agency related to HIV/STI prevention and violence at the Guatemala-Mexico border. Drawing on theoretical perspectives on risk environments and structural determinants of HIV in sex work, we analyzed in-depth interviews, focus groups, and ethnographic fieldwork conducted with 39 migrant sex workers in indoor work environments between 2012 and 2015 in Tecún Umán, Guatemala. Participant narratives revealed the following intersecting themes to be most closely linked to safety and agency to engage in HIV/STI prevention: physical features of indoor work environments (e.g., physical layout of venue, proximity to peers and third parties); social norms and practices for alcohol use within the workplace; the existence and nature of management practices and policies on health and safety practices; and economic influences relating to control over earnings and clients. Across work environments, health and safety were greatly shaped by human rights concerns stemming from workplace interactions with police, immigration authorities, and health authorities. Physical isolation, establishment norms promoting alcohol use, restricted economic agency, and human rights violations related to sex work policies and immigration enforcement were found to exacerbate risks. However, some establishment policies and practices promoted 'enabling environments' for health and safety, supporting HIV/STI prevention, economic agency, and protection from violence and exploitation; these practices and policies were especially crucial for recent migrants. Policy reforms and structural workplace interventions tailored to migrant sex workers' needs are recommended to promote improved working conditions and migrant sex workers' health, safety, and human rights.

Preliminary study on enhancing waste management best practice model in Malaysia construction industry

NASA Astrophysics Data System (ADS)

Jamaludin, Amril Hadri; Karim, Nurulzatushima Abdul; Noor, Raja Nor Husna Raja Mohd; Othman, Nurulhidayah; Malik, Sulaiman Abdul

2017-08-01

Construction waste management (CWM) is the practice of minimizing and diverting construction waste, demolition debris, and land-clearing debris from disposal and redirecting recyclable resources back into the construction process. Best practice model means best choice from the collection of other practices that was built for purpose of construction waste management. The practice model can help the contractors in minimizing waste before the construction activities will be started. The importance of minimizing wastage will have direct impact on time, cost and quality of a construction project. This paper is focusing on the preliminary study to determine the factors of waste generation in the construction sites and identify the effectiveness of existing construction waste management practice conducted in Malaysia. The paper will also include the preliminary works of planned research location, data collection method, and analysis to be done by using the Analytical Hierarchy Process (AHP) to help in developing suitable waste management best practice model that can be used in the country.

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.

Exploring the attributes of critical thinking: a conceptual basis.

PubMed

Forneris, Susan G

2004-01-01

Many teaching methods used in nursing education to enhance critical thinking focus on teaching students how to directly apply knowledge; a technically rational approach. While seemingly effective at enhancing students' critical thinking abilities in structured learning situations, these methods don't prepare students to operationalize critical thinking to manage the complexities that actually exist in practice. The work of contemporary educational theorists Paulo Freire, Donald Schon, Chris Argyris, Jack Mezirow, Stephen Brookfield, and Robert Tennyson all share similar perspectives on thinking in practice and the use of reflection to achieve a coherence of understanding. Their perspectives provide insight on how educators can shift from a means-end approach to operationalizing thinking in practice. The author identifies four attributes of critical thinking in practice evidenced in these views, followed by a discussion of specific educational strategies that reflect these attributes, and operationalize a critical thinking process in nursing practice to achieve a coherence of understanding.

Job satisfaction among primary care physicians: results of a survey.

PubMed

Behmann, Mareike; Schmiemann, Guido; Lingner, Heidrun; Kühne, Franziska; Hummers-Pradier, Eva; Schneider, Nils

2012-03-01

A shortage of primary care physicians (PCPs) seems likely in Germany in the near future and already exists in some parts of the country. Many currently practicing PCPs will soon reach retirement age, and recruiting young physicians for family practice is difficult. The attractiveness of primary care for young physicians depends on the job satisfaction of currently practicing PCPs. We studied job satisfaction among PCPs in Lower Saxony, a large federal state in Germany. In 2009, we sent a standardized written questionnaire on overall job satisfaction and on particular aspects of medical practice to 3296 randomly chosen PCPs and internists in family practice in Lower Saxony (50% of the entire target population). 1106 physicians (34%) responded; their mean age was 52, and 69% were men. 64% said they were satisfied or very satisfied with their job overall. There were particularly high rates of satisfaction with patient contact (91%) and working atmosphere (87% satisfied or very satisfied). In contrast, there were high rates of dissatisfaction with administrative tasks (75% dissatisfied or not at all satisfied). The results were more indifferent concerning payment and work life balance. Overall, younger PCPs and physicians just entering practice were more satisfied than their older colleagues who had been in practice longer. PCPs are satisfied with their job overall. However, there is significant dissatisfaction with administrative tasks. Improvements in this area may contribute to making primary care more attractive to young physicians.

Bridging the gap between research-supported interventions and everyday social work practice: a new approach.

PubMed

Rubin, Allen

2014-07-01

This article describes a rationale for a focus on case studies that would provide a database of single-group pre-post mean effect sizes that could be analyzed to identify which service provision characteristics are associated with more desirable outcomes when interventions supported by randomized clinical trials are adapted in everyday practice settings. In addition, meta-analyses are proposed that would provide benchmarks that agency practitioners could compare with their mean effect size to inform their decisions about whether to continue, modify, or replace existing efforts to adopt or adapt a specific research-supported treatment. Social workers should be at the forefront of the recommended studies in light of the profession's emphasis on applied research in real-world settings and the prominence of social work practitioners in such settings.

A review of competencies needed for health librarians--a comparison of Irish and international practice.

PubMed

Lawton, Aoife; Burns, Jane

2015-06-01

The purpose of this review was to uncover areas of competence which may lead to a baseline of skills for health librarians. A baseline could inform personal development plans for health librarians, criteria for job descriptions and curriculum for library and information science (LIS) courses. This research outlines existing competencies for librarians working in health care as defined by library associations, recent job descriptions and a mapping review of the library and information science literature. This is performed in the context of librarians working in the Irish health system with examples of practice drawn from the Irish experience. Ten areas of competence were found to be common to three of five library associations, which were also common to recent job descriptions. The literature reveals an ever changing working environment for librarians working in health with opportunities for new and evolving roles. The challenge for librarians moving into these roles will be to stay relevant and to keep skills updated in a rapidly moving health and information environment. © 2014 Health Libraries Group.

The 10 Building Blocks of High-Performing Primary Care

PubMed Central

Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

2014-01-01

Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements—engaged leadership, data-driven improvement, empanelment, and team-based care—that assist the implementation of the other 6 building blocks—patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement. PMID:24615313

The 10 building blocks of high-performing primary care.

PubMed

Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

2014-01-01

Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements-engaged leadership, data-driven improvement, empanelment, and team-based care-that assist the implementation of the other 6 building blocks-patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement.

Trust into Mistrust: The Uncertain Marriage between Public and Private Sector Practice for Middle Managers in Education

ERIC Educational Resources Information Center

Thompson, Carol; Wolstencroft, Peter

2018-01-01

The role of the middle manager has proved to be a difficult one to define due to the fluid nature of the tasks performed and the heterogeneity of understanding that exists for the term. This is further complicated by the differences associated with the context in which individual manager's work. This research, which explores the drive towards…

Unconscious and Unnoticed Professional Practice within an Outstanding School for Children and Young People with Complex Learning Difficulties and Disabilities

ERIC Educational Resources Information Center

Crombie, Richard; Sullivan, Lesley; Walker, Kate; Warnock, Rebecca

2014-01-01

This article describes a three-year project undertaken at Pear Tree School for children and young people with severe and multiple and profound learning difficulties. Lesley Sullivan, the school's head teacher, believed that much of the value within the work of this outstanding school went unidentified by existing approaches to planning, monitoring…

How Engineers Really Think About Risk: A Study of JPL Engineers

NASA Technical Reports Server (NTRS)

Hihn, Jairus; Chattopadhyay, Deb; Valerdi, Ricardo

2011-01-01

The objectives of this work are: To improve risk assessment practices as used during the mission design process by JPL's concurrent engineering teams. (1) Developing effective ways to identify and assess mission risks (2) Providing a process for more effective dialog between stakeholders about the existence and severity of mission risks (3) Enabling the analysis of interactions of risks across concurrent engineering roles.

Human Capital Formation and Foreign Direct Investment in Developing Countries. OECD Development Centre Working Paper No. 211 (Formerly Technical Paper No. 211)

ERIC Educational Resources Information Center

Miyamoto, Koji

2003-01-01

This paper synthesises the existing literature on human capital formation and foreign direct investment (FDI) in developing countries. The aim is to take a bird's eye view of the complex linkages between the activities of multinational enterprises (MNEs) and policies of host developing countries. In doing so, general trends, best practices and…

State Policy Leadership for Higher Education: A Brief Summary of the Origins and Continuing Evolution of a Profession

ERIC Educational Resources Information Center

Lingenfelter, Paul E.

2012-01-01

While state policy leadership for higher education is not universally recognized as a profession, either within states or within higher education, the profession has existed in the United States for more than half a century. Moreover, its essential work is now practiced in other countries all over the world. This essay will briefly consider how…

Teacher as the Instrument of Evaluation: A Descriptive Case Study of Connoisseurship and Educational Criticism's Role in Project-Based Learning, Technology Arts Classroom

ERIC Educational Resources Information Center

Castro, Edward Anthony

2010-01-01

Purpose: The study's purpose was to determine the degree to which connoisseurship and educational criticism exists in student work evaluation; to identify master teachers' methods utilizing verbal feedback; and to determine the degree that project-based learning (PBL) principles serve as a "model of practice" for selected PBL technology…

Topics to ponder: Part-time practice and pay parity.

PubMed

Tracy, Erin E; Wiler, Jennifer L; Holschen, Jolie C; Patel, Soha Sumanchandra; Ligda, Kristin Ondecko

2010-08-01

The medical profession has undergone a significant demographic change, with a dramatic increase in the number of women applying to medical school and practicing medicine. In recognition of the changing demographics in the medical profession, the American Medical Association's Women Physicians Congress (AMA-WPC) conducted a members' survey to identify the issues affecting women physicians and to ascertain certain practice characteristics. In 2008, an e-mail survey link was sent to a randomly selected nationwide sample of 4992 WPC members, and a second, identical survey was sent to 596 female AMA members, utilizing the Epocrates database (Epocrates, Inc., San Mateo, California). Two e-mail reminders were sent for the first survey, which had a 15% response rate. A quota of 148 physicians was received within 4 days and was utilized to interpret results from the second survey. Achieving work-life balance was a significant concern for 91% of the respondents (n = 884). Half of the respondents believed that pay is gender neutral, and 28% indicated that they were "somewhat or very concerned about sexual harassment". When queried regarding practice patterns, 29% of respondents indicated that they had worked part-time at some point during their careers. In this survey, women physicians indicated that gender pay disparity and sexual harassment remain important issues in the medical profession. Less than a third of respondents had ever worked part-time, which should be a consideration for physician workforce studies. Barriers to part-time practice may exist. Copyright © 2010 Excerpta Medica Inc. All rights reserved.

Recommendations for age-appropriate education of children and adolescents with diabetes and their parents in the European Union.

PubMed

Martin, Delphine; Lange, Karin; Sima, Alexandra; Kownatka, Dagmar; Skovlund, Søren; Danne, Thomas; Robert, Jean-Jacques

2012-09-01

Education is the keystone of diabetes care, and structured self-management education is the key to a successful outcome. Existing guidelines provide comprehensive guidance on the various aspects of education and offer general and organizational principles of education, detailed curricula at different ages and stages of diabetes, and recommendations on models, methods, and tools to attain educative objectives. The International Society for Pediatric and Adolescent Diabetes guidelines give the most elaborate and detailed descriptions and recommendations on the practice of education, which other national guidelines address on specific aspects of education and care. The aim of the work package on education developed by Better Control in Paediatric and Adolescent Diabetes in the European Union: Working to Create Centers of Reference (SWEET) project was not to generate new guidelines but to evaluate how the existing guidelines were implemented in some pediatric diabetes reference centers. The SWEET members have completed a questionnaire that elaborates on the many aspects of delivery of education. This survey highlights a profound diversity of practices across centers in Europe, in terms of organization as well as the practices and the content of initial and continuing education. A toolbox is being developed within SWEET to facilitate exchanges on all aspects of education and to establish a process of validation of materials, tools, written structured age-adjusted programs, and evaluation procedures for the education of children and adolescents with diabetes. © 2012 John Wiley & Sons A/S.

A worldview of the professional experiences and training needs of pediatric psycho-oncologists

PubMed Central

Oppenheim, Daniel; Breyer, Joanna; Battles, Haven; Zadeh, Sima; Patenaude, Andrea Farkas

2012-01-01

BACKGROUND Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families. METHOD A survey was designed to assess training, work environment, theoretical orientation, services provided, sub-specialty areas or areas of special interest, satisfactions, challenges and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey. RESULTS 786 professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%) and siblings (25%). Therapies provided include CBT (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds report having appropriate supervision; 37% conduct research; only half feel their salary is appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research and ethics. CONCLUSIONS An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision and needs for additional, specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation. PMID:22461180

Joyce Clifford the Scholar: In Her Own Words.

PubMed

Fulmer, Terry; Gibbons, M Patricia

2015-01-01

Dr Joyce H. Clifford was world renowned for her excellence in nursing administration and leadership. The purpose of this article is to examine her complete body of published scholarship and analyze her papers as a method of understanding her intellectual progression as a leader in the discipline, as well as to document how her conceptualization of professional practice and the practice environment advanced nursing practice and patient and family care. Using the qualitative method of narrative inquiry, a systematic analysis of her papers was conducted to describe the evolution of her scholarship and her impact on the discipline and patient care. We reviewed all known existing papers, categorized them into 3 stages, and discuss them here. Using quotes from her work, we have added her voice to the compelling professional practice issues she addressed in her lifetime.

The Evolving Politics of Race and Social Work Activism: A Call across Borders.

PubMed

Jeyapal, Daphne

2017-01-01

Social work has engaged with and led the revolutionary social movements of the past century. Yet today, as activism by and for racial others unfolds across the United States and Canada, our discipline remains largely silent. This article considers new ways for social workers to conceptualize social work activism, challenge the existing erasures within the profession, and construct innovative strategies to locate social work within the critical social movements of our time. Recognizing the continuity of histories of colonialism, slavery, and genocide, the author argues that social workers must engage with racialized communities' resistance through their legacy of exclusion and displacement. The author demonstrates the significance of an evolving politics of race and social justice for social work practice. © 2016 National Association of Social Workers.

Working conditions, work style, and job satisfaction among Albanian teachers

NASA Astrophysics Data System (ADS)

Kloep, Marion; Tarifa, Fatos

1994-03-01

For the first time in Albania, a large-scale study investigating teachers' working conditions was conducted. 349 teachers from many parts of the country and from all school levels answered an extensive questionnaire, providing a comprehensive description of their working situation. As data for parts of the study exist from the USA, Germany, Singapore, England, and Poland, results could be discussed in comparison to the conditions in these countries, showing that self-reported job satisfaction and engagement in effective classroom practices is relatively high among Albanian teachers, while the economic and physical conditions are bad. Stepwise regression analyses reveal that the items measuring professional autonomy account for a considerable part of the variance of the job satisfaction measure; while work efficiency is mainly predicted by items measuring social support and, again, professional autonomy.

Validation of the Nurses' Perception of Patient Rounding Scale: An Exploratory Study of the Influence of Shift Work on Nurses' Perception of Patient Rounding.

PubMed

Neville, Kathleen; DiBona, Courtney; Mahler, Maureen

2016-01-01

Hourly rounds have re-emerged as standard practice among nurses in acute care settings, and there is the need to identify nurses' perceptions regarding this practice. Further use of the Nurses' Perception of Patient Rounding Scale (NPPRS) is needed to further validate this new instrument. In addition, there exists a dearth of literature that examines the impact of hours worked and shift on nurses' perceptions of patient rounding. The purpose of this descriptive study was to explore nurses' perception of the required practice of patient rounding, to examine the influence of nurses' shift on nurses' perception of rounding practice, and to provide additional psychometric support for the NPPRS. The NPPRS, a 42-item scale in 5-point Likert format, and a demographic information sheet were used in the study. The NPPRS yields three subscales: communication, patient benefits, and nurse benefits. Using a convenience sample of anonymous nurse participants, 76 nurses from five medical-surgical units at a medical center in the northeast corridor of the United States participated in the study. Further psychometric support for the NPPRS was demonstrated. Excellent reliability coefficients via Cronbach's alpha for the total scale (0.91) and each of the subscales were obtained. A statistically significant difference was noted among nurses working 8 hours versus 12 hours or combined 8- and 12-hour workloads. Perceptions of nurse benefits were statistically significantly higher for nurses working 8 hours. In addition, results indicated that nurses perceived rounding to be more beneficial to their own practice than to patients. Analyses revealed that leadership support was instrumental in successful rounding practice. Further support for the NPPRS was obtained through this study. Strong nursing leadership, supportive of rounding, is essential for successful rounding. Further research should examine the efficacy of nurse rounding-developed protocols specific to the shift and unit of nursing practice.

Professional efficiencies for diagnostic imaging services rendered by different physicians: analysis of recent medicare multiple procedure payment reduction policy.

PubMed

Duszak, Richard; Silva, Ezequiel; Kim, Angela J; Barr, Robert M; Donovan, William D; Kassing, Pamela; McGinty, Geraldine; Allen, Bibb

2013-09-01

The aim of this study was to quantify potential physician work efficiencies and appropriate multiple procedure payment reductions for different same-session diagnostic imaging studies interpreted by different physicians in the same group practice. Medicare Resource-Based Relative Value Scale data were analyzed to determine the relative contributions of various preservice, intraservice, and postservice physician diagnostic imaging work activities. An expert panel quantified potential duplications in professional work activities when separate examinations were performed during the same session by different physicians within the same group practice. Maximum potential work duplications for various imaging modalities were calculated and compared with those used as the basis of CMS payment policy. No potential intraservice work duplication was identified when different examination interpretations were rendered by different physicians in the same group practice. When multiple interpretations within the same modality were rendered by different physicians, maximum potential duplicated preservice and postservice activities ranged from 5% (radiography, fluoroscopy, and nuclear medicine) to 13.6% (CT). Maximum mean potential duplicated work relative value units ranged from 0.0049 (radiography and fluoroscopy) to 0.0413 (CT). This equates to overall potential total work reductions ranging from 1.39% (nuclear medicine) to 2.73% (CT). Across all modalities, this corresponds to maximum Medicare professional component physician fee reductions of 1.23 ± 0.38% (range, 0.95%-1.87%) for services within the same modality, much less than an order of magnitude smaller than those implemented by CMS. For services from different modalities, potential duplications were too small to quantify. Although potential efficiencies exist in physician preservice and postservice work when same-session, same-modality imaging services are rendered by different physicians in the same group practice, these are relatively minuscule and have been grossly overestimated by current CMS payment policy. Greater transparency and methodologic rigor in government payment policy development are warranted. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A comparison of the workload of rural and urban primary care physicians in Germany: analysis of a questionnaire survey

PubMed Central

2011-01-01

Background Many western countries are facing an existing or imminent shortage of primary care physicians especially in rural areas. In Germany, working in rural areas is often thought to be associated with more working hours, a higher number of patients and a lower income than working in urban areas. These perceptions might be key reasons for the shortage. The aim of this analysis was to explore if working time, number of treated patients per week or proportion of privately insured patients vary between rural and urban areas in Germany using two different definitions of rurality within a sample of primary care physicians including general practitioners, general internists and paediatricians. Methods This is a secondary analysis of pre-collected data raised by a questionnaire that was sent to a representative random sample of 1500 primary care physicians chosen by data of the National Association of Statutory Health Insurance Physicians from all federal states in Germany. We employed two different methods of defining rurality; firstly, level of rurality as rated by physicians themselves (urban area, small town, rural area); secondly, rurality defined according to the Organisation for Economic Co-operation and Development. Results This analysis was based upon questionnaire data from 715 physicians. Primary care physicians in single-handed practices in rural areas worked on average four hours more per week than their urban counterparts (p < 0.05). Physicians' gender, the number of patients treated per week and the type of practice (single/group handed) were significantly related to the number of working hours. Neither the proportion of privately insured patients nor the number of patients seen per week differed significantly between rural and urban areas when applying the self-rated classification of rurality. Conclusion Overall this analysis identified few differences between urban and rural primary care physician working conditions. To counter future misdistribution of primary care, students should receive practical experience in rural areas to get more practical knowledge on working conditions. PMID:21988900

Practice assistants in primary care in Germany – associations with organizational attributes on job satisfaction

PubMed Central

2013-01-01

Background Job satisfaction and organizational attributes in primary care teams are important issues as they affect clinical outcomes and the quality of health care provided. As practice assistants are an integral part of these teams it is important to gain insight into their views on job satisfaction and organizational attributes. The aim of this study was to evaluate the job satisfaction of practice assistants and the organizational attributes within their general practices in Germany and to explore the existence of possible associations. Methods This observational study was based on a job satisfaction survey and measurement of organizational attributes in general practices in the German federal state of Baden-Wuerttemberg. Job satisfaction was measured with the 10-item ‘Warr-Cook-Wall job satisfaction scale’. Organizational attributes were evaluated with the 21-items ‘survey of organizational attributes for primary care’ (SOAPC). Linear regression analyses were performed in which each of SOAPC scales and the overall score of SOAPC was treated as outcome variables. Results 586 practice assistants out of 794 respondents (73.8%) from 234 general practices completed the questionnaire. Practice assistants were mostly satisfied with their colleagues and least of all satisfied with their income and recognition for their work. The regression analysis showed that ‘freedom of working method’ and ‘recognition of work’, the employment status of practice assistants and the mode of practice were almost always significantly associated with each subscale and overall score of SOAPC. Conclusions Job satisfaction is highly associated with different aspects of organizational attributes for primary care (‘communication’, ‘decision-making’ and ‘stress’). Consequently, improved job satisfaction could lead to a better-organized primary care team. This implication should be investigated directly in further intervention studies with a special focus on improving the recognition for work and income. PMID:23915225

[Awareness of breast cancer screening among general practitioners in Mohammedia (Morocco)].

PubMed

Zine, Karima; Nani, Samira; Lahmadi, Imad Ait; Maaroufi, Abderrahmane

2016-01-01

Breast cancer is a major public health problem in Morocco. It is the most common cancer in women. Our study aims to evaluate the extent of breast cancer awareness among general practitioners (GP) in the prefecture of Mohammedia, Morocco. We conducted a cross-sectional, descriptive, exhaustive study including 97 GP working in primary health care facilities (public and private sector) of the province of Mohammedia. Participation rate was 87%. The average age of GP was 49.6 ± 8.1. Eighty percent (n = 55) of the GP misstated the incidence of breast cancer, 77.6% (n = 85) recognized the existence of a national plan to prevent and control cancer (NPPCC) in Morocco and 67.1% of GP reported the existence of a cancer registry in Morocco. General practice sector was significantly related to the awareness of NPPCC among GP and to the existence of guidelines for the early detection of breast cancer (p = 0.003 and p = 0.001 respectively). A significant relationship was found between seniority and the existence of guidelines for the early detection of breast cancer and a breast cancer registry (p = 0.005 and p = 0.002 respectively). In light of these results GP awareness and practices should be enhanced by promoting initial and continuing training on breast cancer screening.

Family medicine practice performance and knowledge management.

PubMed

Orzano, A John; McInerney, Claire R; Tallia, Alfred F; Scharf, Davida; Crabtree, Benjamin F

2008-01-01

Knowledge management (KM) is the process by which people in organizations find, share, and develop knowledge for action. KM affects performance by influencing work relationships to enhance learning and decision making. To identify how family medicine practices exhibit KM. A model and a template of KM concepts were derived from a comprehensive organizational literature review. Two higher and two lower performing family medicine practices were purposefully selected from existing comparative case studies based on prevention delivery rates and innovation. Interviews, fieldnotes of operations, and clinical encounters were coded independently using the template. Face-to-face discussions resolved coding differences. All practices had processes and tools for finding, sharing, and developing knowledge; however, KM overall was limited despite implementation of expensive technologies like an electronic medical record. Where present, KM processes and tools were used by individuals but not integrated throughout the organization. Loss of information was prominent, and finding knowledge was underdeveloped. The use of technical tools and developing knowledge by reconfiguration and measurement were particularly limited. Socially related tools, such as face-to-face-communication for sharing and developing knowledge, were more developed. As in other organizations, tool use was tailored for specific outcomes and leveraged by other organizational capacities. Differences in KM occur within family practices and between family practices and other organizations and may have implications for improving practice performance. Understanding interaction patterns of work relationships and KM may explain why costly technical or externally imposed "one size fits all" practice organizational interventions have had mixed results and limited sustainability.

A Focus Group Study Exploring Student Nurse's Experiences of an Educational Intervention Focuse don Working with People with a Diagnosis of Personality Disorder.

PubMed

Stacey, G; Baldwin, V; Thompson, B; Aubeeluck, A

2018-05-21

Negative attitudes exist in practice towards those with a diagnosis of personality disorder. Preregistration training offers the opportunity to address this by developing understanding of the diagnosis, confidence in working with people with the diagnosis and empowering new nurses to challenge prevailing attitudes. Attempts to integrate and evaluate specific educational interventions of this nature into pre-registration nurse education have not been explored elsewhere. To explore preregistration nurses' experience of a programme of training focused on personality disorder and their perception of its influence on attitudes, understanding of clients and their experience of practice. A qualitative study using thematic analysis of two focus groups of pre-registration mental health nursing students. Evidence of positive attitudes and confidence to supportively challenge negative attitudes in practice were found. Students showed a shift away from a focus on changing the perceived 'difficult' behaviour of a client towards an understanding of their own emotional responses to the behaviours. The Knowledge and Understanding Framework training shows potential for students to change attitudes and develop progressive practice working with people with personality disorder. The integration of the Knowledge and Understanding Framework should be considered as part of preregistration training. Further research into the sustained influence of the training post registration is required. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Theoretical Applications of Positive Psychology to Vocational Rehabilitation After Traumatic Brain Injury.

PubMed

Mills, Ana L; Kreutzer, Jeffrey S

2016-03-01

Traumatic brain injury (TBI) produces broad-reaching and often persistent challenges that impact an individual’s ability to engage in vocational productivity. Return to work (RTW) rates after TBI are markedly poor and the efficacy of current TBI vocational rehabilitation (VR) practices is unclear. Positive psychology, the practice of fostering positive emotions and traits, offers novel approaches that might enhance the effectiveness of existing TBI VR practices. This article assesses the potential relevance of positive psychology principles and practices to VR for clients recovering from TBI. A literature search was conducted using the database resources of a large university hospital, including PubMed, ProQuest, PsycINFO, and Web of Science. Content from this search was reviewed and synthesized, including literature on VR for TBI, vocational applications of positive psychology, and general rehabilitation applications of positive psychology. Ten guiding principles for positively-informed TBI VR are proposed. Specific positive psychology measures and interventions for improving emotional, social, and cognitive functioning are identified and discussed as they might be applied to TBI VR. Theoretically, positive psychology principles and practices appear to be well suited to improving VR outcomes for individuals with TBI. In addition to examining the feasibility of incorporating positive psychology techniques, future research should examine the impact of positive psychology interventions on RTW rates, job satisfaction, job stability, and other vocational outcomes. With additional investigation, positive psychology measures and interventions may prove to be a beneficial compliment to existing VR practices.

Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students.

PubMed

Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan

2016-11-01

With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The ‘grey’ assessment practice of IA screening: Prevalence, influence and applied rationale

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

Bidstrup, Morten, E-mail: Bidstrup@plan.aau.dk

Research focusing on the practices surrounding screening in Impact Assessment (IA) is limited. Yet, it has been found that development proposals sometimes are adjusted through an informal dialog with IA practitioners prior to or during screening. Such practice is often referred to as ‘grey IA’ in Denmark. This article explores the prevalence, influence and applied rationale of grey IA. Through a questionnaire, data was collected from 121 IA practitioners working within the fields of environmental impact assessment and strategic environmental assessment. It was found that grey IA is a common practice, which influences the outcomes of formal screening procedures throughmore » consideration of impacts on neighbours and spatial zones of protection. Grey IA is to some extent motivated by the opportunity to save the resources required for full-scale IA, but an additional ‘green’ rationale also exists. Grey IA may influence the effectiveness of IA systems, but further research is needed before any conclusions can be made. - Highlights: • Screening procedures may function as an informal, ‘grey’ assessment. • Grey assessment is common and influences formal screening outcomes. • Grey assessment is motivated by an opportunity to cut IA costs. • Yet, an environmental, ‘green’ rationale for grey assessment also exists.« less

Smoking behavior and patient education practices of oncology nurses in six countries.

PubMed

Lally, Robin M; Chalmers, Karen I; Johnson, Judith; Kojima, Misako; Endo, Emiko; Suzuki, Shizue; Lai, Yeur-Hur; Yang, Young-Hee; Degner, Lesley; Anderson, Elsie; Molassiotis, Alexander

2008-09-01

Worldwide, tobacco is the leading cause of preventable death, resulting in approximately 5 million deaths annually. Nurses are keenly positioned to work toward reducing tobacco-related illness and deaths. Therefore, guided by the health belief model, the purpose of this study was to explore the smoking behavior, beliefs, smoking cessation education practices, and existing smoking policies at the institutions of a sample of practicing oncology nurses in Canada, Japan, Korea, Taiwan, United Kingdom, and the United States. A 27-item structured survey, designed for this study in English and translated and reverse translated by the Asian countries, was distributed to a convenience sample of nurses attending oncology meetings in each country. Totally 759 surveys were completed and analyzed using descriptive statistics. Principle findings indicate that 4.5% of these nurses currently smoke, although 23.3% reported smoking previously. While many nurses (74%) reported frequently assessing the smoking status of patients, only 50% reported discussing cessation with their patients that smoke. Although the majority (80%) reported feeling comfortable with asking their patients about smoking, only 23% felt it was the nurse's role. The findings indicate that while internationally oncology nurses recognize the importance of smoking cessation, significant room for improvement exists in translating this into practice.

'Land-marks of the universe': John Herschel against the background of positional astronomy.

PubMed

Case, Stephen

2015-01-01

John Herschel (1792-1871) was the leading British natural philosopher of the nineteenth century, widely known and regarded for his work in philosophy, optics and chemistry as well as his important research and popular publications on astronomy. To date, however, there exists no extended treatment of his astronomical career. This paper, part of a larger study exploring Herschel's contributions to astronomy, examines his work in the context of positional astronomy, the dominant form of astronomical practice throughout his lifetime. Herschel, who did not himself practice positional astronomy and who was known for his non-meridional observations of specific stellar objects, was nonetheless a strong advocate for positional astronomy-but for very different reasons than the terrestrial applications to which it was most often put. For Herschel, the star catalogues of positional astronomy were the necessary observational foundation upon which information about the stars as physical objects could be constructed. Positional astronomy practiced in the great national observatories was not about navigation or timekeeping; it was a way to standardize stellar observations and make them useful data for constructing theories of the stars themselves. For Herschel, the seeds of the new astronomy emerged from the practices of the old.

Practice-related improvement in working memory is modulated by changes in processing external interference.

PubMed

Berry, Anne S; Zanto, Theodore P; Rutman, Aaron M; Clapp, Wesley C; Gazzaley, Adam

2009-09-01

Working memory (WM) performance is impaired by the presence of external interference. Accordingly, more efficient processing of intervening stimuli with practice may lead to enhanced WM performance. To explore the role of practice on the impact that interference has on WM performance, we studied young adults with electroencephalographic (EEG) recordings as they performed three motion-direction, delayed-recognition tasks. One task was presented without interference, whereas two tasks introduced different types of interference during the interval of memory maintenance: distractors and interruptors. Distractors were to be ignored, whereas interruptors demanded attention based on task instructions for a perceptual discrimination. We show that WM performance was disrupted by both types of interference, but interference-induced disruption abated across a single experimental session through rapid learning. WM accuracy and response time improved in a manner that was correlated with changes in early neural measures of interference processing in visual cortex (i.e., P1 suppression and N1 enhancement). These results suggest practice-related changes in processing interference exert a positive influence on WM performance, highlighting the importance of filtering irrelevant information and the dynamic interactions that exist between neural processes of perception, attention, and WM during learning.

Standby Rates for Combined Heat and Power Systems

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

Sedano, Richard; Selecky, James; Iverson, Kathryn

2014-02-01

Improvements in technology, low natural gas prices, and more flexible and positive attitudes in government and utilities are making distributed generation more viable. With more distributed generation, notably combined heat and power, comes an increase in the importance of standby rates, the cost of services utilities provide when customer generation is not operating or is insufficient to meet full load. This work looks at existing utility standby tariffs in five states. It uses these existing rates and terms to showcase practices that demonstrate a sound application of regulatory principles and ones that do not. The paper also addresses areas formore » improvement in standby rates.« less

Improving the workplace environment for female physicists

NASA Astrophysics Data System (ADS)

Butcher, Gillian

2013-03-01

The ideal workplace is one in which women and men can work to their potential and are respected and recognized for their contribution. But what are the conditions that would create this environment, and how can we achieve this? This paper highlights some of the best practices, discussed in a single-session workshop, to improve the workplace environment for female (and male) physicists. While there are many actions that can be taken at the personal, local, and even national level, it is necessary to understand when the issues have broader societal implications. Likewise, working toward the ideal environment should not lead us to ignore the necessity of training and assisting women to work effectively in the existing environment.

Organizational culture of a psychiatric hospital and resilience of nursing workers.

PubMed

Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani

2016-01-01

to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.

Women in medicine: historical perspectives and recent trends.

PubMed

Jefferson, Laura; Bloor, Karen; Maynard, Alan

2015-06-01

Women now outnumber men in British medical schools. This paper charts the history of women in medicine and provides current demographic trends. A historical literature review and routinely collected data from Department of Health and the Health and Social Care Information Centre. Clear gender differences are apparent in working practices, including greater likelihood of working part time and specializing in certain areas of medicine. The increasing need to increase activity among the existing medical workforce is timely amidst a changing workforce demographic. Workforce planners, policymakers and Royal Colleges should continue to develop interventions that may reduce disparities in career choices, as well as considering ways to increase participation and activity. Further research is needed to explore the cost-effectiveness of existing and future interventions in this field. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Good practices in Local Government - A first overview of Portuguese reality

NASA Astrophysics Data System (ADS)

Carvalhosa, P.; Portela, F.; Machado, J.; Santos, M. F.; Abelha, A.

2017-03-01

Good practices in eGov are being increasingly used by Local Governments being that it is considered by them as an advantage. The main goal is providing to the town hall a differentiation point and approximate their services to the citizens. For this, it is necessary to define and apply innovative strategies in order to increase the use of services by the citizens. This paper is framed in a research work and it presents a first overview of the existing good practices in eGov, taking in consideration the Portuguese’s reality. The good practices identified were distinguished with many awards and with a positive response from the target audience. The use of digital marketing strategies aims to increase their membership and coming closer the municipalities of its citizens through the dissemination of the good practices. At this moment the data collected are almost exclusively of good practice in Portugal, however some international practices were also identified. As a result of this study the community has a list of good practices that can be applied in their municipalities.

A Framework for Understanding Physics Students' Computational Modeling Practices

NASA Astrophysics Data System (ADS)

Lunk, Brandon Robert

With the growing push to include computational modeling in the physics classroom, we are faced with the need to better understand students' computational modeling practices. While existing research on programming comprehension explores how novices and experts generate programming algorithms, little of this discusses how domain content knowledge, and physics knowledge in particular, can influence students' programming practices. In an effort to better understand this issue, I have developed a framework for modeling these practices based on a resource stance towards student knowledge. A resource framework models knowledge as the activation of vast networks of elements called "resources." Much like neurons in the brain, resources that become active can trigger cascading events of activation throughout the broader network. This model emphasizes the connectivity between knowledge elements and provides a description of students' knowledge base. Together with resources resources, the concepts of "epistemic games" and "frames" provide a means for addressing the interaction between content knowledge and practices. Although this framework has generally been limited to describing conceptual and mathematical understanding, it also provides a means for addressing students' programming practices. In this dissertation, I will demonstrate this facet of a resource framework as well as fill in an important missing piece: a set of epistemic games that can describe students' computational modeling strategies. The development of this theoretical framework emerged from the analysis of video data of students generating computational models during the laboratory component of a Matter & Interactions: Modern Mechanics course. Student participants across two semesters were recorded as they worked in groups to fix pre-written computational models that were initially missing key lines of code. Analysis of this video data showed that the students' programming practices were highly influenced by their existing physics content knowledge, particularly their knowledge of analytic procedures. While this existing knowledge was often applied in inappropriate circumstances, the students were still able to display a considerable amount of understanding of the physics content and of analytic solution procedures. These observations could not be adequately accommodated by the existing literature of programming comprehension. In extending the resource framework to the task of computational modeling, I model students' practices in terms of three important elements. First, a knowledge base includes re- sources for understanding physics, math, and programming structures. Second, a mechanism for monitoring and control describes students' expectations as being directed towards numerical, analytic, qualitative or rote solution approaches and which can be influenced by the problem representation. Third, a set of solution approaches---many of which were identified in this study---describe what aspects of the knowledge base students use and how they use that knowledge to enact their expectations. This framework allows us as researchers to track student discussions and pinpoint the source of difficulties. This work opens up many avenues of potential research. First, this framework gives researchers a vocabulary for extending Resource Theory to other domains of instruction, such as modeling how physics students use graphs. Second, this framework can be used as the basis for modeling expert physicists' programming practices. Important instructional implications also follow from this research. Namely, as we broaden the use of computational modeling in the physics classroom, our instructional practices should focus on helping students understand the step-by-step nature of programming in contrast to the already salient analytic procedures.

The National United States Center Data Repository: Core essential interprofessional practice & education data enabling triple aim analytics.

PubMed

Pechacek, Judith; Shanedling, Janet; Lutfiyya, May Nawal; Brandt, Barbara F; Cerra, Frank B; Delaney, Connie White

2015-01-01

Understanding the impact that interprofessional education and collaborative practice (IPECP) might have on triple aim patient outcomes is of high interest to health care providers, educators, administrators, and policy makers. Before the work undertaken by the National Center for Interprofessional Practice and Education at the University of Minnesota, no standard mechanism to acquire and report outcome data related to interprofessional education and collaborative practice and its effect on triple aim outcomes existed. This article describes the development and adoption of the National Center Data Repository (NCDR) designed to capture data related to IPECP processes and outcomes to support analyses of the relationship of IPECP on the Triple Aim. The data collection methods, web-based survey design and implementation process are discussed. The implications of this informatics work to the field of IPECP and health care quality and safety include creating standardized capacity to describe interprofessional practice and measure outcomes connecting interprofessional education and collaborative practice to the triple aim within and across sites/settings, leveraging an accessible data collection process using user friendly web-based survey design to support large data scholarship and instrument testing, and establishing standardized data elements and variables that can potentially lead to enhancements to national/international information system and academic accreditation standards to further team-based, interprofessional, collaborative research in the field.

Applying mixed reality to simulate vulnerable populations for practicing clinical communication skills.

PubMed

Chuah, Joon Hao; Lok, Benjamin; Black, Erik

2013-04-01

Health sciences students often practice and are evaluated on interview and exam skills by working with standardized patients (people that role play having a disease or condition). However, standardized patients do not exist for certain vulnerable populations such as children and the intellectually disabled. As a result, students receive little to no exposure to vulnerable populations before becoming working professionals. To address this problem and thereby increase exposure to vulnerable populations, we propose using virtual humans to simulate members of vulnerable populations. We created a mixed reality pediatric patient that allowed students to practice pediatric developmental exams. Practicing several exams is necessary for students to understand how to properly interact with and correctly assess a variety of children. Practice also increases a student's confidence in performing the exam. Effective practice requires students to treat the virtual child realistically. Treating the child realistically might be affected by how the student and virtual child physically interact, so we created two object interaction interfaces - a natural interface and a mouse-based interface. We tested the complete mixed reality exam and also compared the two object interaction interfaces in a within-subjects user study with 22 participants. Our results showed that the participants accepted the virtual child as a child and treated it realistically. Participants also preferred the natural interface, but the interface did not affect how realistically participants treated the virtual child.

The National United States Center Data Repository: Core essential interprofessional practice & education data enabling triple aim analytics

PubMed Central

Pechacek, Judith; Shanedling, Janet; Lutfiyya, May Nawal; Brandt, Barbara F.; Cerra, Frank B.; Delaney, Connie White

2015-01-01

Abstract Understanding the impact that interprofessional education and collaborative practice (IPECP) might have on triple aim patient outcomes is of high interest to health care providers, educators, administrators, and policy makers. Before the work undertaken by the National Center for Interprofessional Practice and Education at the University of Minnesota, no standard mechanism to acquire and report outcome data related to interprofessional education and collaborative practice and its effect on triple aim outcomes existed. This article describes the development and adoption of the National Center Data Repository (NCDR) designed to capture data related to IPECP processes and outcomes to support analyses of the relationship of IPECP on the Triple Aim. The data collection methods, web-based survey design and implementation process are discussed. The implications of this informatics work to the field of IPECP and health care quality and safety include creating standardized capacity to describe interprofessional practice and measure outcomes connecting interprofessional education and collaborative practice to the triple aim within and across sites/settings, leveraging an accessible data collection process using user friendly web-based survey design to support large data scholarship and instrument testing, and establishing standardized data elements and variables that can potentially lead to enhancements to national/international information system and academic accreditation standards to further team-based, interprofessional, collaborative research in the field. PMID:26652631

Transition to adult care in pediatric solid-organ transplant: development of a practice guideline.

PubMed

Gold, Anna; Martin, Kathy; Breckbill, Katie; Avitzur, Yaron; Kaufman, Miriam

2015-06-01

Transition to adult-centered care is becoming an increasingly important area of practice in pediatric organ transplant. Standardized, best-practice guidelines are needed to assist transplant practitioners in providing optimal transitional care for this population of patients. To describe the development and implementation of a practice guideline for the transitional care of pediatric transplant recipients. A quality improvement project was undertaken in a pediatric multiorgan transplant program setting. Strategies employed included (1) creation of an interdisciplinary working group, (2) survey of transition-related practices and learning needs of transplant practitioners, (3) review of the literature and existing transition-related materials, and (4) creation of transition guidelines. An interdisciplinary survey of transplant practitioners at our institution identified practice strengths related to transitional care and learning needs. Review of relevant literature and other materials revealed limited but emerging research related to the transition of pediatric transplant recipients from pediatric to adult care. Existing transition tools were examined and applicable items identified. A practice guideline for use with pediatric transplant recipients transitioning to adult care was developed. Strategies to educate staff about the guideline and promote ongoing guideline use were implemented. Preparing pediatric transplant recipients and their families for transition to adult-centered care is an emerging challenge for transplant teams. These guidelines provide practitioners with a developmentally sensitive overview of important transition-related domains and strategies directed toward patients and their caregivers, who may experience the process of transition differently. Dissemination of the pediatric transplant transition guideline will make transition information more widely available to transplant practitioners.

Treatment Recommendations for Single-Unit Crowns: Findings from The National Dental Practice-Based Research Network

PubMed Central

McCracken, Michael S.; Louis, David R.; Litaker, Mark S.; Minyé, Helena M.; Mungia, Rahma; Gordan, Valeria V.; Marshall, Don G.; Gilbert, Gregg H.

2016-01-01

Background Objectives were to: (1) quantify practitioner variation in likelihood to recommend a crown; and (2) test whether certain dentist, practice, and clinical factors are significantly associated with this likelihood. Methods Dentists in the National Dental Practice-Based Research Network completed a questionnaire about indications for single-unit crowns. In four clinical scenarios, practitioners ranked their likelihood of recommending a single-unit crown. These responses were used to calculate a dentist-specific “Crown Factor” (CF; range 0–12). A higher score implies a higher likelihood to recommend a crown. Certain characteristics were tested for statistically significant associations with the CF. Results 1,777 of 2,132 eligible dentists responded (83%). Practitioners were most likely to recommend crowns for teeth that were fractured, cracked, endodontically-treated, or had a broken restoration. Practitioners overwhelmingly recommended crowns for posterior teeth treated endodontically (94%). Practice owners, Southwest practitioners, and practitioners with a balanced work load were more likely to recommend crowns, as were practitioners who use optical scanners for digital impressions. Conclusions There is substantial variation in the likelihood of recommending a crown. While consensus exists in some areas (posterior endodontic treatment), variation dominates in others (size of an existing restoration). Recommendations varied by type of practice, network region, practice busyness, patient insurance status, and use of optical scanners. Practical Implications Recommendations for crowns may be influenced by factors unrelated to tooth and patient variables. A concern for tooth fracture -- whether from endodontic treatment, fractured teeth, or large restorations -- prompted many clinicians to recommend crowns. PMID:27492046

Living and working in space

NASA Technical Reports Server (NTRS)

Allen, J.

1977-01-01

The feasibility of space colonization depends partly on the answer to the practical question whether construction workers can exist and work in zero-g for the time necessary to build the colony framework to the point just prior to spinning it into its artificial-g mode. Based on definitive Skylab experience, there seems to be every reason to believe that workers in zero-g can perform their construction tasks with the same skill as under 1-g conditions. Attention is also given to basic reasons and motivations for the conduction of space flights and the establishment of space colonies.

Knowledge Representation Standards and Interchange Formats for Causal Graphs

NASA Technical Reports Server (NTRS)

Throop, David R.; Malin, Jane T.; Fleming, Land

2005-01-01

In many domains, automated reasoning tools must represent graphs of causally linked events. These include fault-tree analysis, probabilistic risk assessment (PRA), planning, procedures, medical reasoning about disease progression, and functional architectures. Each of these fields has its own requirements for the representation of causation, events, actors and conditions. The representations include ontologies of function and cause, data dictionaries for causal dependency, failure and hazard, and interchange formats between some existing tools. In none of the domains has a generally accepted interchange format emerged. The paper makes progress towards interoperability across the wide range of causal analysis methodologies. We survey existing practice and emerging interchange formats in each of these fields. Setting forth a set of terms and concepts that are broadly shared across the domains, we examine the several ways in which current practice represents them. Some phenomena are difficult to represent or to analyze in several domains. These include mode transitions, reachability analysis, positive and negative feedback loops, conditions correlated but not causally linked and bimodal probability distributions. We work through examples and contrast the differing methods for addressing them. We detail recent work in knowledge interchange formats for causal trees in aerospace analysis applications in early design, safety and reliability. Several examples are discussed, with a particular focus on reachability analysis and mode transitions. We generalize the aerospace analysis work across the several other domains. We also recommend features and capabilities for the next generation of causal knowledge representation standards.

Survey of Manual Methods of Measurements of Asbestos, Beryllium, Lead, Cadmium, Selenium, and Mercury in Stationary Source Emissions. Environmental Monitoring Series.

ERIC Educational Resources Information Center

Coulson, Dale M.; And Others

The purpose of this study is to evaluate existing manual methods for analyzing asbestos, beryllium, lead, cadmium, selenium, and mercury, and from this evaluation to provide the best and most practical set of analytical methods for measuring emissions of these elements from stationary sources. The work in this study was divided into two phases.…

Imagine a Place Where Teaching and Learning Are Inspirational: A Decade of Collected Wisdom from the Field

ERIC Educational Resources Information Center

Musser, P. Maureen; Caskey, Micki M.; Samek, Linda L.; Kim, Younghee M.; Greene, William L.; Carpenter, Jan M.; Casbon, Jay

2013-01-01

The purpose of this article is to share wisdom collected from the field and offer a view of meaningful learning, explore the tensions that exist in educators' work, and invite conversation about the future of educational practice. The anecdotes and data come from a series of research studies conducted from 2001 to 2011 by a cadre of middle grades…

Automatic Detection of Steganographic Content

DTIC Science & Technology

2005-06-30

Practically, it is mostly embedded into the media files, especially the image files. Consequently, a lot of the anti- steganography algorithms work with raw...1: not enough memory * -2: error running the removal algorithm EXPORT IMAGE *StegRemove( IMAGE * image , int *error); 2.8 Steganography Extraction API...researcher just invented a reliable algorithm that can detect the existence of a steganography if it is embedded anywhere in any uncompressed image . The

The Aboriginal Practical Experience and Its Impact on Pre-Service Teacher's Decisions about Living and Working in Remote in Indigenous Communities in Australia

ERIC Educational Resources Information Center

Jay, Jenny; Moss, Lynette; Cherednichenko, Brenda

2009-01-01

In June 2008, 10 pre-service teachers and 2 teacher educators from Edith Cowan University (ECU) participated in an existing community education program in rural and remote Indigenous communities in central Australia. From an intrepid start with a mountain of overloaded baggage and camping cutlery setting off the scanning machine at the airport,…

Solutions for the diurnally forced advection-diffusion equation to estimate bulk fluid velocity and diffusivity in streambeds from temperature time series

Treesearch

Charles H. Luce; Daniele Tonina; Frank Gariglio; Ralph Applebee

2013-01-01

Work over the last decade has documented methods for estimating fluxes between streams and streambeds from time series of temperature at two depths in the streambed. We present substantial extension to the existing theory and practice of using temperature time series to estimate streambed water fluxes and thermal properties, including (1) a new explicit analytical...

Safety and health in the construction of fixed offshore installations in the petroleum industry

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

Not Available

1981-01-01

A meeting convened by the ILO (International Labor Office) on safety problems in the offshore petroleum industry recommended the preparation of a code of practice setting out standards for safety and health during the construction of fixed offshore installations. Such a code, to be prepared by the ILO in co-operation with other bodies, including the Inter-Governmental Maritime Consultative Organisation (IMCO), was to take into consideration existing standards applicable to offshore construction activities and to supplement the ILO codes of practice on safety and health in building and civil engineering work, shipbuilding and ship repairing. (Copyright (c) International Labour Organisation 1981.)

The case for reassessment of health care technology. Once is not enough.

PubMed

Banta, H D; Thacker, S B

1990-07-11

Assessment of health care technologies should be an iterative process, not a single event. In the United States there are an increasing number of organized attempts at reassessment of technologies by the health industry, professional societies, and national government agencies, such as the Medical Necessity Project of Blue Cross/Blue Shield, the Clinical Efficacy Assessment Project of the American College of Physicians, and the work of the US Preventive Services Task Force. We examine four clinical practices--electronic fetal monitoring, episiotomy, electroencephalography, and hysterectomy--to illustrate the need to continuously reassess existing technologies and to challenge our current inertia in this critical arena of health practice.

Roles and identities in transition: boundaries of work and inter-professional relationships at the interface between telehealth and primary care.

PubMed

Segar, Julia; Rogers, Anne; Salisbury, Chris; Thomas, Clare

2013-11-01

Shifting the balance of care towards home and community is viewed as requiring interventions which enhance or complement primary care. Technology-based interventions are seen as key to the future in this work. Telehealthcare implicates a new agenda for inter-professional working across boundaries of healthcare. One such interface is between telehealthcare professionals and professionals located in primary care. This study reports the findings from a qualitative study forming part of a broader project examining the potential of developing and implementing telehealth interventions to support patients with long-term conditions. Semi-structured interviews were undertaken with telehealth nurse care managers, practice nurses and general practitioners in their respective work settings (39 interviews with 62 participants). Observation was undertaken at a telehealth call centre. The research took place between April 2010 and March 2011. Thematic analysis of qualitative data was undertaken. Telehealth nurse care managers' interviews suggested narrative constructions of new roles and identities to fit telehealth work, combining a holistic ideal and retro-appeal with 'traditional' values of nursing, which distinguished and distanced them from counterparts in general practices. Practice nurses and general practitioners were ambivalent and often sceptical about the contribution of telehealth to long-term condition work. Practice nurses' accounts suggested a sense of protectiveness about maintaining boundaries around established remits of managing long-term conditions; general practitioners, having devolved much of the care of long-term conditions to nurses, were keen to retain their positions as gatekeepers to resources. Perceptions of shifts of professional roles, new ways of working and how they are valued form a relevant contextual element to the introduction of telehealth interventions. A pre-emptive view and response to how professionals understand and approach increasingly complex and multi-faceted roles within primary care is likely to prepare and facilitate the introduction and integration of telehealth innovations into existing patient services. © 2013 John Wiley & Sons Ltd.

From novice to master surgeon: improving feedback with a descriptive approach to intraoperative assessment.

PubMed

Huang, Emily; Wyles, Susannah M; Chern, Hueylan; Kim, Edward; O'Sullivan, Patricia

2016-07-01

A developmental and descriptive approach to assessing trainee intraoperative performance was explored. Semistructured interviews with 20 surgeon educators were recorded, transcribed, deidentified, and analyzed using a grounded theory approach to identify emergent themes. Two researchers independently coded the transcripts. Emergent themes were also compared to existing theories of skill acquisition. Surgeon educators characterized intraoperative surgical performance as an integrated practice of multiple skill categories and included anticipating, planning for contingencies, monitoring progress, self-efficacy, and "working knowledge." Comments concerning progression through stages, broadly characterized as "technician," "anatomist," "anticipator," "strategist," and "executive," formed a narrative about each stage of development. The developmental trajectory with narrative, descriptive profiles of surgeons working toward mastery provide a standardized vocabulary for communicating feedback, while fostering reflection on trainee progress. Viewing surgical performance as integrated practice rather than the conglomerate of isolated skills enhances authentic assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

Precarity and Preparedness: Non-Adherence as Institutional Work in Diagnosing and Treating Malaria in Uganda.

PubMed

Umlauf, René

2017-07-01

Access to anti-malarial drugs is increasingly governed by novel regulation technologies like rapid diagnostic tests (RDTs). However, high rates of non-adherence particularly to negative RDT results have been reported, threatening the cost-effectiveness of the two interrelated goals of improving diagnosis and reducing the over-prescription of expensive anti-malarial drugs. Below I set out to reconstruct prior treatment forms like presumptive treatment of malaria by paying particular attention to their institutional groundings. I show how novel regulation technologies affect existing institutions of care and argue that the institutional work of presumptive treatment goes beyond the diagnosis and treatment of a currently observed fever episode. Instead, in contexts of precarity, through what I will call "practices of preparedness," presumptive treatment includes a variety of practices, performances, temporalities, and opportunities that allow individuals to prepare for future episodes of fever.

Industrial-hygiene characterization of ethylene oxide exposures of hospital and nursing-home workers

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

Ringenburg, V.L.; Elliott, L.J.; Morelli-Schroth, P.

Industrial-hygiene surveys were conducted at 12 hospitals and one nursing home to determine possible employee exposure to ethylene oxide (EtO). Different types of exposure situations existed at each of the facilities as a result of various engineering controls, administrative controls and work practices. Sampling indicated that the time-weighted averages (TWAs) of exposure over periods of 36 to 724 minutes ranged from below the limit of detection to 6.7 parts per million (ppm). Personal short-term exposure levels covering 2 to 30 minutes ranged from less than the limit of detection to 103.2ppm. Factors found to be responsible for these higher-than-permissible levelsmore » of EtO exposure included improper installation or lack of engineering controls (such as improper placement of the sterilizing operations), unbalanced ventilation systems, and lack of administrative controls resulting in inappropriate work practices.« less

Design and implementation of practical bidirectional texture function measurement devices focusing on the developments at the University of Bonn.

PubMed

Schwartz, Christopher; Sarlette, Ralf; Weinmann, Michael; Rump, Martin; Klein, Reinhard

2014-04-28

Understanding as well as realistic reproduction of the appearance of materials play an important role in computer graphics, computer vision and industry. They enable applications such as digital material design, virtual prototyping and faithful virtual surrogates for entertainment, marketing, education or cultural heritage documentation. A particularly fruitful way to obtain the digital appearance is the acquisition of reflectance from real-world material samples. Therefore, a great variety of devices to perform this task has been proposed. In this work, we investigate their practical usefulness. We first identify a set of necessary attributes and establish a general categorization of different designs that have been realized. Subsequently, we provide an in-depth discussion of three particular implementations by our work group, demonstrating advantages and disadvantages of different system designs with respect to the previously established attributes. Finally, we survey the existing literature to compare our implementation with related approaches.

Ensuring continuing fitness to practice in the pharmacy workforce: Understanding the challenges of revalidation.

PubMed

Schafheutle, Ellen Ingrid; Hassell, Karen; Noyce, Peter R

2013-01-01

Revalidation is about assuring that health practitioners remain up to date and fit to practice, and demonstrating that they continue to meet the requirements of their professional regulator. To critically discuss issues that need to be considered when designing a system of revalidation for pharmacy professionals. Although providing international context, the article focuses in particular on Great Britain (GB), where both pharmacists (Phs) and pharmacy technicians (PTs) are regulated. Following a brief historical overview, the article draws on emerging evidence in context. Revalidation may involve discrete periodic assessment or a continuous process of assessment against clearly identified standards. The evolving scope of pharmacy practice involves increasingly clinical roles and also practitioners in nonpatient-facing roles. The potential risk to patients and the public may require consideration. Although revalidation, or systems for recertification/relicensure, exist in numerous jurisdictions, most center on the collection of continuing education credits; continuous professional development and reflective practice are increasingly found. Revalidation may involve assessment of other sources, such as appraisals or monitoring visits. Existing revalidation systems are coordinated centrally, but particularly in larger jurisdictions, like GB, where approximately 67,000 pharmacy professionals are regulated, some responsibility may need to be devolved. This would require engagement with employers and contracting organizations to ensure suitability and consistency. Existing systems, such as company appraisals, are unfit for the assessment of fitness to practice owing to a focus on organizational/business targets. Certain groups of pharmacy professionals may pose particular challenges, such as self-employed locums, pharmacy owners, those working in different sectors, or returning after a break. To ensure proportionality, it must be considered whether the same standards and/or sources of evidence should apply to all pharmacy professionals, either dependent on whether they are patient facing, their scope of practice, or whether Phs and PTs should be treated differently. Copyright © 2013 Elsevier Inc. All rights reserved.

Perceptions of Work-Life Balance Practices Offered in the Collegiate Practice Setting.

PubMed

Mazerolle, Stephanie M; Eason, Christianne M; Eberman, Lindsey E

2017-12-01

  Organizational factors have been identified as barriers to finding work-life balance (WLB) in athletic training. Despite the existence of organizational policies to address WLB, little is known about athletic trainers' (ATs') awareness of these policies that could assist them.   To better understand the perceptions of ATs regarding the workplace practices available to them, which may help them achieve WLB.   Phenomenologic study.   Collegiate practice setting.   Twenty-one ATs (women = 10, men = 11) employed at the collegiate level (National Collegiate Athletic Association Division I = 12, Division II = 5, Division III = 4) volunteered for our study. The average age of the participants was 33 ± 9 years. Saturation of the data was met at n = 21.   Participants completed an in-depth, 1-on-1 phone interview, which was then transcribed verbatim. Data were analyzed using a phenomenologic approach. Credibility was determined by member checks, peer review, and researcher triangulation.   Our analyses revealed that participants (1) had a limited awareness of formal policies that were offered within their university or collegiate infrastructure; (2) used informal policies to manage their personal, family, and work obligations; and (3) thought that more formal policies, such as adherence to adequate staffing patterns and work schedules, could help establish WLB within collegiate athletic training settings.   Informal workplace policies were more commonly used by our participants and were viewed as a means of creating a supportive atmosphere. Administrators and supervisors should consider creating or endorsing more formal policies specific to the demands of an AT in the collegiate setting to help with WLB.

The physical therapy profile questionnaire (PTPQ): development, validation and pilot testing.

PubMed

Dizon, Janine Margarita R; Grimmer-Somers, Karen; Kumar, Saravana

2011-09-19

Country by country similarities and differences in physical therapy practice exists. Therefore, before updates in practice can be provided, such as trainings in evidence-based practice, it is necessary to identify the profile and nature of practice in a given country or setting. Following a search of the international literature, no appropriate tool was identified to collect and establish data to create the profile of physical therapy practice in the Philippines. We therefore developed, validated and pilot tested a survey instrument which would comprehensively describe the practice of physical therapy in the Philippines We used a mixed methods design to answer our study aims. A focus group interview was conducted among a group of physical therapists to establish the content and contexts of items to be included in the survey instrument. Findings were amalgamated with the information from the literature on developing survey instruments/questionnaires. A survey instrument was drafted and named as the Physical Therapy Profile Questionnaire (PTPQ). The PTPQ was then validated and pilot tested to a different group of physical therapists.The final version consisted of five separate parts namely (A) General information and demographics, (B) Practice Profile, (C) Treatment Preferences, (D) Bases for clinical work and (E) Bases for educational/research work. At present the PTPQ is relevant to the Philippines and could be used by any country which has a similar nature of practice with the Philippines. The Physical Therapy Practice Questionnaire (PTPQ) was shown to have good face and content validity among the Filipino physical therapists and their context of practice. It has also been found to be useful, easy to administer tool and in a format appealing to respondents. The PTPQ is expected to assist comprehensive data collection to create a profile of physical therapy practice in the Philippines.

Organizational culture of a private hospital.

PubMed

Vegro, Thamiris Cavazzani; Rocha, Fernanda Ludmilla Rossi; Camelo, Silvia Helena Henriques; Garcia, Alessandra Bassalobre

2016-06-01

Objective To assess the values and practices that characterize the organizational culture of a private hospital in the state of São Paulo in the perspective of nursing professionals. Methods Quantitative, descriptive, cross-sectional study. Data collection was conducted between January and March 2013 using the Brazilian Instrument for Assessing Organizational Culture. Twenty-one nurses and sixty-two nursing aides and technicians participated in the study. The responses of the participants were coded into numerical categories, generating an electronic database to be analyzed by means of the software Statistical Package for the Social Sciences. Results Scores of cooperative professionalism values (3.24); hierarchical strictness values (2.83); individual professionalism values (2.69); well-being values (2.71); external integration practices (3.73); reward and training practices (2.56); and relationship promotion practices (2.83). Conclusion In the perception of workers, despite the existence of hierarchical strictness there is cooperation at work and the institution pursues customer satisfaction and good interpersonal relationships.

Assessing Interprofessional education in a student-faculty collaborative practice network.

PubMed

Young, Grace J; Cohen, Marya J; Blanchfield, Bonnie B; Jones, Meissa M; Reidy, Patricia A; Weinstein, Amy R

2017-07-01

Although interprofessional relationships are ubiquitous in clinical practice, undergraduate medical students have limited opportunities to develop these relationships in the clinical setting. A few student-faculty collaborative practice networks (SFCPNs) have been working to address this issue, but limited data exist examining the nature and extent of these practices. A systematic survey at a Harvard-affiliated SFCPN is utilised to evaluate the quantity and quality of interprofessional interactions, isolate improvements, and identify challenges in undergraduate interprofessional education (IPE). Our data corroborate previous findings in which interprofessional clinical learning was shown to have positive effects on student development and align with all four domains of Interprofessional Education Collaborative core competencies, including interprofessional ethics and values, roles and responsibilities, interprofessional communication, and teams and teamwork. These results highlight the unique opportunity and growing necessity of integrating IPE in SFCPNs to endorse the development of collaborative and professional competencies in clinical modalities of patient care.

Methodological convergence of program evaluation designs.

PubMed

Chacón-Moscoso, Salvador; Anguera, M Teresa; Sanduvete-Chaves, Susana; Sánchez-Martín, Milagrosa

2014-01-01

Nowadays, the confronting dichotomous view between experimental/quasi-experimental and non-experimental/ethnographic studies still exists but, despite the extensive use of non-experimental/ethnographic studies, the most systematic work on methodological quality has been developed based on experimental and quasi-experimental studies. This hinders evaluators and planners' practice of empirical program evaluation, a sphere in which the distinction between types of study is changing continually and is less clear. Based on the classical validity framework of experimental/quasi-experimental studies, we carry out a review of the literature in order to analyze the convergence of design elements in methodological quality in primary studies in systematic reviews and ethnographic research. We specify the relevant design elements that should be taken into account in order to improve validity and generalization in program evaluation practice in different methodologies from a practical methodological and complementary view. We recommend ways to improve design elements so as to enhance validity and generalization in program evaluation practice.

Lessons learned from a secret Facebook support group.

PubMed

Oliver, Debra Parker; Washington, Karla; Wittenberg-Lyles, Elaine; Gage, Ashley; Mooney, Megan; Demiris, George

2015-05-01

The National Association of Social Workers developed practice standards for social workers using technology in their practice. These standards were derived from the foundation of the social work code of ethics and are helpful as social workers explore the use of new tools for the benefit of their clients. Hospice caregivers, both active and bereaved, are in great need of support but are often unable to attend traditional support groups. Facebook secret groups offer social workers a potential tool, given the geographic barriers that exist for traditional face-to-face support groups. The authors' experience with a secret Facebook group indicates that the technology can be useful when managed by a social worker facilitator. As social workers continue to explore helpful ways to use technology with clients, it is critical that they evaluate that practice and assess the clinical outcomes to establish an evidence base behind this practice.

Exploring UK medical and social work students' legal literacy: comparisons, contrasts and implications.

PubMed

Preston-Shoot, Michael; McKimm, Judy

2013-05-01

To ensure acceptable practice standards both doctors and social workers should draw on relevant legal rules when reaching professional judgements concerning, for instance, children requiring protection, people with severe mental distress and adults at risk, information sharing, consent to intervention and service user involvement in their care and treatment. Many practitioners use the law to maintain high standards of professionalism. However, research has uncovered limited awareness of legal rules and poor standards of health and social care. Academic benchmarks and practice requirements for health and social care professions centrally position legal knowledge for secure decision-making. Model curricula exist. However, the outcomes of the taught curriculum on students' confidence in their legal knowledge and skills have been relatively overlooked. This article introduces the concept of legal literacy, a distillation of knowledge, understanding, skills and values that enables practitioners to connect relevant legal rules with their professional practice, to appreciate the roles and duties of other practitioners and to communicate effectively across organisational boundaries. It presents the outcomes for a 2006-2009 study of 1154 UK medical and 638 social work students of their law learning for practice, response rates of 46% and 68%. Significant differences were found between medical and social work students' attitudes towards the law, and in their self-ratings of legal knowledge and skills. Confidence levels were low and anxiety high, especially among medical students, although law teaching had some positive outcomes on knowledge and skill development. Social work and medical students associated different themes with the law, the latter especially foregrounding ethics, negligence and liability, which could affect inter-professional working. Students are not fully prepared for legally literate practice, with a consequent need to review the time allocated for, and the content of law learning and the subsequent availability of continuing professional development. © 2013 Blackwell Publishing Ltd.

Knowledge into action - supporting the implementation of evidence into practice in Scotland.

PubMed

Davies, Sandra; Herbert, Paul; Wales, Ann; Ritchie, Karen; Wilson, Suzanne; Dobie, Laura; Thain, Annette

2017-03-01

The knowledge into action model for NHS Scotland provides a framework for librarians and health care staff to support getting evidence into practice. Central to this model is the development of a network of knowledge brokers to facilitate identification, use, creation and sharing of knowledge. To translate the concepts described in the model into tangible activities with the intention of supporting better use of evidence in health care and subsequently improving patient outcomes. Four areas of activity were addressed by small working groups comprising knowledge services staff in local and national boards. The areas of activity were as follows: defining existing and required capabilities and developing learning opportunities for the knowledge broker network; establishing national search and summarising services; developing actionable knowledge tools; and supporting person-to-person knowledge sharing. This work presents the development of practical tools and support to translate a conceptual model for getting knowledge into action into a series of activities and outputs to support better use of evidence in health care and subsequently improved patient outcomes. © 2017 Health Libraries Group.

Healthcare reforms: implications for the education and training of acute and critical care nurses.

PubMed

Glen, S

2004-12-01

This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.

Building Power Between Polarities: On the Space-in-Between.

PubMed

Ventres, William B

2016-02-01

In this article, I introduce the concept of the space-in-between. This space-in-between is born of the realization that, between the expression of any two polarities (across dimensions such as emotion, thought, geography, and ideology), there exists a philosophical construct useful for framing thinking about practice, research, and managerial relationships in the health professions. Out of this construct emerge practical considerations useful for structuring the conduct of meaningful interpersonal and intercultural interactions. I describe how the idea of a space-in-between developed out of my medical practice, grew as a result of my experiences in international environments. and has found fulfillment in my ongoing work. I explore the application of a space-in-between in public health, medical anthropology, medical ethics, and global health. I review how, as a result of incorporating this space in their daily work, clinicians, educators, researchers, and managers can grow as leaders by sharing the presence that arises from the space-in-between them and the people in the communities they serve. © The Author(s) 2015.

Advancing Social Work Education for Health Impact.

PubMed

Browne, Teri; Keefe, Robert H; Ruth, Betty J; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie

2017-12-01

Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy.

[Development of a medical equipment support information system based on PDF portable document].

PubMed

Cheng, Jiangbo; Wang, Weidong

2010-07-01

According to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives. Analyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions. The practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable. The medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

An exemplar of naturalistic inquiry in general practice research.

PubMed

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2017-01-23

Background Before beginning any research project, novice researchers must consider which methodological approach will best address their research questions. The paucity of literature describing a practical application of naturalistic inquiry adds to the difficulty they may experience. Aim To provide a practical example of how naturalistic inquiry was applied to a qualitative study exploring collaboration between registered nurses and general practitioners working in Australian general practice. Discussion Naturalistic inquiry is not without its critics and limitations. However, by applying the axioms and operational characteristics of naturalistic inquiry, the authors captured a detailed 'snapshot' of collaboration in general practice in the time and context that it occurred. Conclusion Using qualitative methods, naturalistic inquiry provides the scope to construct a comprehensive and contextual understanding of a phenomenon. No individual positivist paradigm could provide the level of detail achieved in a naturalistic inquiry. Implications for practice This paper presents a practical example of naturalistic inquiry for the novice researcher. It shows that naturalistic inquiry is appropriate when the researcher seeks a rich and contextual understanding of a phenomenon as it exists in its natural setting.

Evaluating Heuristics for Planning Effective and Efficient Inspections

NASA Technical Reports Server (NTRS)

Shull, Forrest J.; Seaman, Carolyn B.; Diep, Madeline M.; Feldmann, Raimund L.; Godfrey, Sara H.; Regardie, Myrna

2010-01-01

A significant body of knowledge concerning software inspection practice indicates that the value of inspections varies widely both within and across organizations. Inspection effectiveness and efficiency can be measured in numerous ways, and may be affected by a variety of factors such as Inspection planning, the type of software, the developing organization, and many others. In the early 1990's, NASA formulated heuristics for inspection planning based on best practices and early NASA inspection data. Over the intervening years, the body of data from NASA inspections has grown. This paper describes a multi-faceted exploratory analysis performed on this · data to elicit lessons learned in general about conducting inspections and to recommend improvements to the existing heuristics. The contributions of our results include support for modifying some of the original inspection heuristics (e.g. Increasing the recommended page rate), evidence that Inspection planners must choose between efficiency and effectiveness, as a good tradeoff between them may not exist, and Identification of small subsets of inspections for which new inspection heuristics are needed. Most Importantly, this work illustrates the value of collecting rich data on software Inspections, and using it to gain insight into, and Improve, inspection practice.

Is there competition between breast-feeding and maternal employment?

PubMed

Roe, B; Whittington, L A; Fein, S B; Teisl, M F

1999-05-01

Theory suggests that the decision to return to employment after childbirth and the decision to breast-feed may be jointly determined. We estimate models of simultaneous equations for two different aspects of the relationship between maternal employment and breast-feeding using 1993-1994 data from the U.S. Food and Drug Administration's Infant Feeding Practices Study. We first explore the simultaneous duration of breast-feeding and work leave following childbirth. We find that the duration of leave from work significantly affects the duration of breast-feeding, but the effect of breast-feeding on work leave is insignificant. We also estimate models of the daily hours of work and breast-feedings at infant ages 3 months and 6 months postpartum. At both times, the intensity of work effort significantly affects the intensity of breast-feeding, but the reverse is generally not found. Competition clearly exists between work and breast-feeding for many women in our sample.

The rural nurse work environment and structural empowerment.

PubMed

Krebs, Julianne P; Madigan, Elizabeth A; Tullai-McGuinness, Susan

2008-02-01

Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.

Causality and Causal Inference in Social Work: Quantitative and Qualitative Perspectives

PubMed Central

Palinkas, Lawrence A.

2015-01-01

Achieving the goals of social work requires matching a specific solution to a specific problem. Understanding why the problem exists and why the solution should work requires a consideration of cause and effect. However, it is unclear whether it is desirable for social workers to identify cause and effect, whether it is possible for social workers to identify cause and effect, and, if so, what is the best means for doing so. These questions are central to determining the possibility of developing a science of social work and how we go about doing it. This article has four aims: (1) provide an overview of the nature of causality; (2) examine how causality is treated in social work research and practice; (3) highlight the role of quantitative and qualitative methods in the search for causality; and (4) demonstrate how both methods can be employed to support a “science” of social work. PMID:25821393

NIOSH testimony to DOL on the Occupational Safety And Health Administration's proposed rule on occupational exposure to asbestos, tremolite, anthophyllite, and actinolite by J. D. Millar, January 24, 1991

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

Not Available

1991-01-24

The testimony contains the comments of NIOSH regarding the proposed rule on occupational exposure to asbestos (1332214), tremolite (14567738), anthophyllite (17068789) and actinolite (77536664) exposures. NIOSH supports OSHA in proposing changes to the existing asbestos standard to minimize the risk of asbestos related diseases in workers. The current standard is insufficient to protect the health of workers exposed to asbestos, and the proposed changes represent a prudent and necessary approach to accomplish this goal. Specific topics addressed in the testimony include exposure limits for asbestos; methods for sampling and analysis of airborne fibers; use of time weighted averages to measuremore » exposure; use of engineering controls, good work practices and personal protective equipment; use of engineering controls and work practices for brake and clutch repair and service; required use of specific work practices during maintenance of vinyl asbestos floor tile; housekeeping; definitions of small scale and short duration operations; exemption of roofing operations from the requirement for negative pressure enclosures; communication among employers and owners; regulated areas for asbestos removal, maintenance, demolition, and renovation operations; use of glove bags; definition of competent person; and notification to OSHA and method of notification.« less

Overview of Best Practices in Mitigating the Impact of Natural Disasters and Extreme Weather Phenomena on European Aviation - The MOWE-IT Project

NASA Astrophysics Data System (ADS)

Muehlhausen, Thorsten; Kreuz, Michael; Temme, Annette; Nokkala, Marko; Nurmi, Pertti; Perrels, Adriaan; Hyvarinen, Otto; Yuga, Ilkka; Pylkko, Pirkko; Kral, Stephan; Schaetter, Frank; Bartsch, Mariana; Wiens, Marcus; Michaelides, Silas; Tymvios, Filippos; Papadakis, Matheos; Athanasatos, Spyros

2014-05-01

The European transport system has shown various degrees of vulnerability to external shocks such as severe weather events, which have partially or, in some cases, totally shut down part of the transport system. Under climate change conditions, the identification of Best Practices within the European area and the proposal of short, medium and long term solutions in order to deal with induced disruptions are vital to upkeep the efficiency and integrity of the European transport network. The MOWE-IT (Management of weather events in the transport system) project is a continuation of the work performed in up-to-date European projects such as the EWENT, WEATHER and ECCONET projects. Its aim is to identify such existing best practices and to develop methodologies in order to assist transport operators, authorities and transport system users to mitigate the impact of natural disasters and extreme weather phenomena on transport system performance. While the MOWE-IT project covers a wide number of transportation modes such as road, rail, marine transport, aviation and inland waterways, in this current work, an overview of the project's work performed in the aviation sector in Europe is presented. The MOWE-IT project is funded by the European Union, under its 7th Framework Programme (TRANSPORT SUPPORT ACTIONS).

Worker, workplace or families: What influences family focused practices in adult mental health?

PubMed

Maybery, D; Goodyear, M; Reupert, A E; Grant, A

2016-04-01

WHAT IS KNOWN ON THE SUBJECT?: Family focused practice leads to positive outcomes for parents and children. There are barriers and enablers for practitioners being family focused. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Worker skill, knowledge and confidence about family work are the most important factors associated with family focused practices. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses require specific skill training in family focused practices, time to engage with clients on parenting issues and that there are adequate services to refer family members to. Introduction Family focused practice is thought to lead to positive outcomes for all family members. However, there are multiple barriers and enablers in adult mental health services to practitioners undertaking these actions. Aim The aim of this study was to examine the relative importance of worker, workforce and family factors to predict family focused practices (FFPs) in adult mental health services. Method Three hundred and seven adult mental health workers completed a 45 items family focused practice measure of 16 family focused practices. Thesis It was found that worker skill and knowledge about family work and an ability to assess the degree of parental insight into the child's connections to other family members and the community were important predictors of FFP, along with the closely related-worker confidence. While aspects of the worker, workplace and family each contribute to FFPs, this study highlighted the importance of worker skill, knowledge and confidence as central issues for adult mental health workers. Implications for practice Study implications include the need for training in specific FFPs, the provision of time to engage with clients on parenting issues and the need 5 to ensure that there are adequate services for workers to refer family members to. © 2016 John Wiley & Sons Ltd.

Competence of novice nurses: role of clinical work during studying

PubMed Central

Manoochehri, H; Imani, E; Atashzadeh-Shoorideh, F; Alavi-Majd, A

2015-01-01

Aim: Clinical competence is to carry out the tasks with excellent results in a different of adjustments. According to various studies, one of the factors influencing clinical competence is work experience. This experience affects the integrity of students' learning experience and their practical skills. Many nursing students practice clinical work during their full-time studying. The aim of this qualitative research was to clarify the role of clinical work during studying in novice nurses' clinical competence. Methods: This qualitative content analysis performed with the conventional approach. All teaching hospitals of Hormozgan University of Medical Sciences selected as the research environment. To collect data, deep and semi-structured interviews, presence in the scene and manuscripts used. To provide feedback for the next release and the capacity of the data, interviews were transcribed verbatim immediately. Results: 45 newly-graduated nurses and head nurses between 23 and 40 with 1 to 18 years of experience participated in the study. After coding all interviews, 1250 original codes were derived. The themes extracted included: task rearing, personality rearing, knowledge rearing, and profession rearing roles of clinical work during studying. Conclusion: Working during studying can affect performance, personality, knowledge, and professional perspectives of novice nurses. Given the differences that may exist in clinical competencies of novice nurses with and without clinical work experience, it is important to pay more attention to this issue and emphasize on their learning in this period. PMID:28316703

Office of Nuclear Energy Knowledge Management Program Situational Analysis Report

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

Kimberlyn C. Mousseau

2011-12-01

Knowledge management (KM) has been a high priority for the Department of Energy (DOE) Office of Nuclear Energy (NE) for the past several years. NE Programs are moving toward well-established knowledge management practices and a formal knowledge management program has been established. Knowledge management is being practiced to some level within each of the NE programs. Although it continues to evolve as NE programs evolve, a formal strategic plan that guides the implementation of KM has been developed. Despite the acceptance of KM within DOE NE, more work is necessary before the NE KM program can be considered fully successful.more » Per Dr. David J. Skyrme[1], an organization typically moves through the following evolutionary phases: (1) Ad-hoc - KM is being practiced to some level in some parts of the organization; (2) Formal - KM is established as a formal project or program; (3) Expanding - the use of KM as a discipline grows in practice across different parts of the organization; (4) Cohesive - there is a degree of coordination of KM; (5) Integrated - there are formal standards and approaches that give every individual access to most organizational knowledge through common interfaces; and (6) Embedded - KM is part-and-parcel of everyday tasks; it blends seamlessly into the background. According to the evolutionary phases, the NE KM program is operating at the two lower levels, Ad-hoc and Formal. Although KM is being practiced to some level, it is not being practiced in a consistent manner across the NE programs. To be fully successful, more emphasis must be placed on establishing KM standards and processes for collecting, organizing, sharing and accessing NE knowledge. Existing knowledge needs to be prioritized and gathered on a routine basis, its existence formally recorded in a knowledge inventory. Governance to ensure the quality of the knowledge being used must also be considered. For easy retrieval, knowledge must be organized according to a taxonomy that mimics nuclear energy programs. Technologies need to be established to make accessing the knowledge easier for the user. Finally, knowledge needs to be used as part of a well defined work process.« less

Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models across the Continuum of Education to Practice--Workshop Summary

ERIC Educational Resources Information Center

Cuff, Patricia A.

2013-01-01

Every year, the Global Forum undertakes two workshops whose topics are selected by the more than 55 members of the Forum. It was decided in this first year of the Forum's existence that the workshops should lay the foundation for future work of the Forum and the topic that could best provide this base of understanding was…

2017 INFORMS PRIZE. The Nomination of The United States Air Force

DTIC Science & Technology

2017-02-08

practice of market design. Shapley, a World War II veteran of the Army Air Corps who received the Bronze Star for his work in breaking a Soviet weather...theorem, the Gale-Shapley algorithm, the potential game concept, market games, authority distribution, multi-person utility, and non-atomic games...new field offices where they did not yet exist. The field OA offices were organized according to these same general principles . Some analysts were

How Effective Is Telecommuting? Assessing the Status of Our Scientific Findings.

PubMed

Allen, Tammy D; Golden, Timothy D; Shockley, Kristen M

2015-10-01

Telecommuting has become an increasingly popular work mode that has generated significant interest from scholars and practitioners alike. With recent advances in technology that enable mobile connections at ever-affordable rates, working away from the office as a telecommuter has become increasingly available to many workers around the world. Since the term telecommuting was first coined in the 1970s, scholars and practitioners have debated the merits of working away from the office, as it represents a fundamental shift in how organizations have historically done business. Complicating efforts to truly understand the implications of telecommuting have been the widely varying definitions and conceptualizations of telecommuting and the diverse fields in which research has taken place.Our objective in this article is to review existing research on telecommuting in an effort to better understand what we as a scientific community know about telecommuting and its implications. In so doing, we aim to bring to the surface some of the intricacies associated with telecommuting research so that we may shed insights into the debate regarding telecommuting's benefits and drawbacks. We attempt to sift through the divergent and at times conflicting literature to develop an overall sense of the status of our scientific findings, in an effort to identify not only what we know and what we think we know about telecommuting, but also what we must yet learn to fully understand this increasingly important work mode.After a brief review of the history of telecommuting and its prevalence, we begin by discussing the definitional challenges inherent within existing literature and offer a comprehensive definition of telecommuting rooted in existing research. Our review starts by highlighting the need to interpret existing findings with an understanding of how the extent of telecommuting practiced by participants in a study is likely to alter conclusions that may be drawn. We then review telecommuting's implications for employees' work-family issues, attitudes, and work outcomes, including job satisfaction, organizational commitment and identification, stress, performance, wages, withdrawal behaviors, and firm-level metrics. Our article continues by discussing research findings concerning salient contextual issues that might influence or alter the impact of telecommuting, including the nature of the work performed while telecommuting, interpersonal processes such as knowledge sharing and innovation, and additional considerations that include motives for telecommuting such as family responsibilities. We also cover organizational culture and support that may shape the telecommuting experience, after which we discuss the community and societal effects of telecommuting, including its effects on traffic and emissions, business continuity, and work opportunities, as well as the potential impact on societal ties. Selected examples of telecommuting legislation and policies are also provided in an effort to inform readers regarding the status of the national debate and its legislative implications. Our synthesis concludes by offering recommendations for telecommuting research and practice that aim to improve the quality of data on telecommuting as well as identify areas of research in need of development. © The Author(s) 2015.

Day laborers' life satisfaction: the role of familismo, spirituality, work, health, and discrimination.

PubMed

Ojeda, Lizette; Piña-Watson, Brandy

2013-07-01

Limited research exists on day laborers' mental health. This study identifies relevant factors that influence the life satisfaction of 143 predominantly undocumented Latino male day laborers. Findings demonstrated the importance of familismo, spirituality, work satisfaction, perceived health, and perceived discrimination on life satisfaction. Given the deleterious impact discrimination can have on mental health, we examined whether perceived discrimination's role on life satisfaction would be buffered by familismo, spirituality, work satisfaction, and perceived health. Among these variable, spirituality and perceived health were identified as protective factors against the role of perceived discrimination on life satisfaction. Implications for research and practice with Latino male day laborers are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Revitalizing communities together: the shared values, goals, and work of education, urban planning, and public health.

PubMed

Cohen, Alison Klebanoff; Schuchter, Joseph W

2013-04-01

Inequities in education, the urban environment, and health co-exist and mutually reinforce each other. Educators, planners, and public health practitioners share commitments to place-based, participatory, youth-focused, and equitable work. They also have shared goals of building community resilience, social capital, and civic engagement. Interdisciplinary programs that embody these shared values and work towards these shared goals are emerging, including school-based health centers, full-service community schools, community health centers, Promise Neighborhoods, and Choice Neighborhoods. The intersection of these three fields represents an opportunity to intervene on social determinants of health. More collaborative research and practice across public health, education, and planning should build from the shared values identified to continue to address these common goals.

Prejudice reduction: what works? A review and assessment of research and practice.

PubMed

Paluck, Elizabeth Levy; Green, Donald P

2009-01-01

This article reviews the observational, laboratory, and field experimental literatures on interventions for reducing prejudice. Our review places special emphasis on assessing the methodological rigor of existing research, calling attention to problems of design and measurement that threaten both internal and external validity. Of the hundreds of studies we examine, a small fraction speak convincingly to the questions of whether, why, and under what conditions a given type of intervention works. We conclude that the causal effects of many widespread prejudice-reduction interventions, such as workplace diversity training and media campaigns, remain unknown. Although some intergroup contact and cooperation interventions appear promising, a much more rigorous and broad-ranging empirical assessment of prejudice-reduction strategies is needed to determine what works.

A Clinical Nurse Leader (CNL) practice development model to support integration of the CNL role into microsystem care delivery.

PubMed

Kaack, Lorraine; Bender, Miriam; Finch, Michael; Borns, Linda; Grasham, Katherine; Avolio, Alice; Clausen, Shawna; Terese, Nadine A; Johnstone, Diane; Williams, Marjory

The Veterans Health Administration (VHA) Office of Nursing Services (ONS) was an early adopter of Clinical Nurse Leader (CNL) practice, generating some of the earliest pilot data of CNL practice effectiveness. In 2011 the VHA ONS CNL Implementation & Evaluation Service (CNL I&E) piloted a curriculum to facilitate CNL transition to effective practice at local VHA settings. In 2015, the CNL I&E and local VHA setting stakeholders collaborated to refine the program, based on lessons learned at the national and local level. The workgroup reviewed the literature to identify theoretical frameworks for CNL practice and practice development. The workgroup selected Benner et al.'s Novice-to-Expert model as the defining framework for CNL practice development, and Bender et al.'s CNL Practice Model as the defining framework for CNL practice integration. The selected frameworks were cross-walked against existing curriculum elements to identify and clarify additional practice development needs. The work generated key insights into: core stages of transition to effective practice; CNL progress and expectations for each stage; and organizational support structures necessary for CNL success at each stage. The refined CNL development model is a robust tool that can be applied to support consistent and effective integration of CNL practice into care delivery. Published by Elsevier Inc.

Information and Communication Technologies in Social Work

PubMed Central

Perron, Brian E.; Taylor, Harry O.; Glass, Joseph E.; Margerum-Leys, Jon

2011-01-01

Information and communication technologies (ICTs) are electronic tools used to convey, manipulate and store information. The exponential growth of Internet access and ICTs greatly influenced social, political, and economic processes in the United States, and worldwide. Regardless of the level of practice, ICTs will continue influencing the careers of social workers and the clients they serve. ICTs have received some attention in the social work literature and curriculum, but we argue that this level of attention is not adequate given their ubiquity, growth and influence, specifically as it relates to upholding social work ethics. Significant attention is needed to help ensure social workers are responsive to the technological changes in the health care system, including the health care infrastructure and use of technology among clients. Social workers also need ICT competencies in order to effectively lead different types of social change initiatives or collaborate with professionals of other disciplines who are using ICTs as part of existing strategies. This paper also identifies potential pitfalls and challenges with respect to the adoption of ICTs, with recommendations for advancing their use in practice, education, and research. PMID:21691444

Health visitor views on consultation using the Solihull approach: a grounded theory study.

PubMed

Stefanopoulou, Evgenia; Coker, Sian; Greenshields, Maria; Pratt, Richard

2011-07-01

Consultation is integral to maintaining competence for health professionals and involves a collaborative relationship between specialist and primary care services. Although consultation aims to support them in their work, existing literature exploring health visitors' experiences of consultation is limited. This study explored health visitors' experiences of consultation in relation to their clinical practice, their experience of their work and its impact on the wider service. In all, 10 health visitors were interviewed using a semi-structured guide and analysis was subjected to a grounded theory framework. Participants' views were influenced by a combination of factors--consultants' training specific to their role, their communication and engagement, consultation's support of joint-working and/or transitions, and its relevance to and impact upon practice. Findings suggest that such interface activities require effective co-ordination, communication and structuring strategies, highlighting the importance of future initiatives in developing health visitors' mental health role further. Given the comparative lack of evaluation of such activities, these findings may inform policy-making and service development to ensure high quality of service delivery.

Implementing evidence-based medicine in general practice: a focus group based study

PubMed Central

Hannes, Karin; Leys, Marcus; Vermeire, Etienne; Aertgeerts, Bert; Buntinx, Frank; Depoorter, Anne-Marie

2005-01-01

Background Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore the barriers of Flemish GPs (General Practitioners) to the implementation of EBM in routine clinical work and to identify possible strategies for integrating EBM in daily work. Methods We used a qualitative research strategy to gather and analyse data. We organised focus groups between September 2002 and April 2003. The focus group data were analysed using a combined strategy of 'between-case' analysis and 'grounded theory approach'. Thirty-one general practitioners participated in four focus groups. Purposeful sampling was used to recruit participants. Results A basic classification model documents the influencing factors and actors on a micro-, meso- as well as macro-level. Patients, colleagues, competences, logistics and time were identified on the micro-level (the GPs' individual practice), commercial and consumer organisations on the meso-level (institutions, organisations) and health care policy, media and specific characteristics of evidence on the macro-level (policy level and international scientific community). Existing barriers and possible strategies to overcome these barriers were described. Conclusion In order to implement EBM in routine general practice, an integrated approach on different levels needs to be developed. PMID:16153300

Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice.

PubMed

Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

2015-12-01

Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. To assess the potential impact of the availability of digital clinician-patient communication on marginalised groups' access to general practice in the UK. Realist review in general practice. A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician-patient relationship. Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. © British Journal of General Practice 2015.

Improving the working relationship between doctors and pharmacists: is inter-professional education the answer?

PubMed

Gallagher, Ruth M; Gallagher, Helen C

2012-05-01

Despite their common history, there are many cultural, attitudinal and practical differences between the professions of medicine and pharmacy that ultimately influence patient care and health outcomes. While poor communication between doctors and pharmacists is a major cause of medical errors, it is clear that effective, deliberate doctor-pharmacist collaboration within certain clinical settings significantly improves patient care. This may be particularly true for those patients with chronic illnesses and/or requiring regular medication reviews. Moreover, in hospitals, clinical and antibiotic pharmacists are successfully influencing prescribing and infection control policy. Under the new Irish Pharmacy Act (2007), pharmacists are legally obliged to provide pharmaceutical care to their patients, thus fulfilling a more patient-centred role than their traditional 'dispensing' one. However, meeting this obligation relies on the existence of good doctor-pharmacist working relationships, such that inter-disciplinary teamwork in monitoring patients becomes the norm in all healthcare settings. As discussed here, efforts to improve these relationships must focus on the strategic introduction of agreed changes in working practices between the two professions and on educational aspects of pharmaceutical care. For example, standardized education of doctors/medical students such that they learn to prescribe in an optimal manner and ongoing inter-professional education of doctors and pharmacists in therapeutics, are likely to be of paramount importance. Here, insights into the types of factors that help or hinder the improvement of these working relationships and the importance of education and agreed working practices in defining the separate but inter-dependent professions of pharmacy and medicine are reviewed and discussed.

'Once I had money in my pocket, I was every colour under the sun': using 'appearance biographies' to explore the meanings of appearance for people with dementia.

PubMed

Ward, Richard; Campbell, Sarah; Keady, John

2014-08-01

Appearance and the work invested in it by and for people with dementia are a neglected issue within dementia studies. In policy and practice there exists an assumption that the role of supporting a person to manage their appearance is easily assumed by another within caring encounters, only to be subsumed within the daily task-oriented provision of care. This paper reports on interviews conducted as part of the Hair and Care project, which explored questions of appearance and the meanings it holds with people with dementia. The research used 'appearance biographies', a method which allows for a range of topics to be considered about appearance throughout the life course, acting as a conduit for reminiscence and life story work. The paper reports on the key themes and findings from these interviews, discussing them in the context of a wider debate on dementia, self-expression and agency. A key question posed by the authors is whether appearance and the work invested in it are legitimate considerations for dementia care policy and practice. And if so, how should we make sense of this work and what significance should we attach to it? In seeking to answer these questions the authors position the perspectives and experiences of people with dementia as central to their analysis. A narrative framework is suggested as a useful basis on which to understand the work of managing appearance over the life course. The implications for policy and practice are outlined. Copyright © 2014 Elsevier Inc. All rights reserved.

Practical implementation of spectral-intensity dispersion-canceled optical coherence tomography with artifact suppression

NASA Astrophysics Data System (ADS)

Shirai, Tomohiro; Friberg, Ari T.

2018-04-01

Dispersion-canceled optical coherence tomography (OCT) based on spectral intensity interferometry was devised as a classical counterpart of quantum OCT to enhance the basic performance of conventional OCT. In this paper, we demonstrate experimentally that an alternative method of realizing this kind of OCT by means of two optical fiber couplers and a single spectrometer is a more practical and reliable option than the existing methods proposed previously. Furthermore, we develop a recipe for reducing multiple artifacts simultaneously on the basis of simple averaging and verify experimentally that it works successfully in the sense that all the artifacts are mitigated effectively and only the true signals carrying structural information about the sample survive.

Use of Simulators to Explore Specialty Recommendation for a Palpable Breast Mass

PubMed Central

Laufer, Shlomi; Ray, Rebecca D.; D'Angelo, Anne-Lise D.; Jones, Grace F.; Pugh, Carla M.

2015-01-01

Background The study aim was to evaluate recommendation patterns of different specialties for the work-up of a palpable breast mass using simulated scenarios and clinical breast examination (CBE) models. Methods Study participants were a convenience sample of physicians (n=318) attending annual surgical, family practice and obstetrics and gynecology (OB/GYN) conferences. Two different silicone-based breast models (superficial mass vs chest wall mass) were used to test CBE skills and recommendation patterns (imaging, tissue sampling, and follow-up). Results Participants were more likely to recommend mammography (p<.001) and core biopsy (p<.0001) and less likely to recommend needle aspiration (p<.043) and 1-month follow up (p<.001) for the chest wall mass compared to the superficial mass. Family practitioners were less likely to recommend ultrasound (p<.001) and OB/GYNs were less likely to recommend mammogram (p<.006) across models. Surgeons were more likely to recommend core biopsy and less likely to recommend needle aspiration across models (p<.001) Conclusions Recommendation patterns differed across the two models in line with existing practice guidelines. Additionally, differences in practice patterns between primary care and specialty providers may represent varying clinician capabilities, health care resources, and individual preferences. Our work shows that simulation may be used to track adherence to practice guidelines for breast masses. PMID:26198334

Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care.

PubMed

Holst, Jens; Normann, Oliver; Herrmann, Markus

2015-01-01

After decades of providing a dense network of quality medical care, Germany is facing an increasing shortage of medical doctors in rural areas. Current graduation rates of generalists do not counterbalance the loss due to retirement. Informed by international evidence, different strategies to ensure rural medical care are under debate, including innovative teaching approaches during undergraduate training. The University of Magdeburg in Saxony-Anhalt was the first medical school in Germany to offer a rural elective for graduate students. During the 2014 summer semester, 14 medical students attended a two-weekend program in a small village in Northern Saxony-Anhalt that allowed them to become more familiar with a rural community and rural health issues. The elective course raised a series of relevant topics for setting up rural practice and provided students with helpful insight into living and working conditions in rural practice. Preliminary evaluations indicate that the rural medicine course allowed medical students to reduce pre-existing concerns and had positive impact on their willingness to set up a rural medical office after graduation. Even short-term courses in rural practice can help reduce training-related barriers that prevent young physicians from working in rural areas. Undergraduate medical training is promising to attenuate the emerging undersupply in rural areas.

State-Level Farmers Market Activities: A Review of CDC-Funded State Public Health Actions That Support Farmers Markets

PubMed Central

Kahin, Sahra A.; Wright, Demia S.; Pejavara, Anu; Kim, Sonia A.

2016-01-01

Context Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels. Objective For this project, we identified state-level farmers market activities completed with CDC’s DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state. Design and Participants We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words “farm,” “market,” “produce market,” and “produce stand.” State data with at least one state-level farmers market action present were then coded for the presence of itemized activities. Results Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices. Implications for Policy & Practice Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land-use policies, can be adopted as methods for farmers market policy and practice work. Conclusion The activities identified in this study can inform future planning at the state and federal levels on environment, policy, and systems approaches that improve the food environment through farmers markets. PMID:27798521

Development and qualitative evaluation of an adapted return to work guideline for the sick-listed unemployed and temporary agency workers with minor psychological problems

PubMed Central

2012-01-01

Background Among the working population, unemployed and temporary agency workers with psychological problems are a particularly vulnerable group, at risk for sickness absence and prolonged work disability. There is a need for the development of a new protocol for this group, because the existing return to work (RTW) interventions, including practice guidelines, do not address the situation when there is no workplace to return to. The purpose of this study was to (1) describe the adaptations needed in the practice guideline for employed workers to enable its use by insurance physicians (IPs) for counselling of sick-listed unemployed and temporary agency workers with minor psychological problems; and (2) evaluate the experiences of IPs when using the new guidance document for minor psychological problems (MPP guidance document). Methods The MPP guidance document for unemployed and temporary agency workers was developed through discussions with nine IPs and with the help of an expert. Semi-structured interviews with five IPs were then held to evaluate the IPs’ field experience using the MPP guidance document, in terms of (a) feasibility and (b) perceived usefulness of the MPP guidance document. Results The main adaptation introduced in the guideline is that interaction with the workplace, which is absent in this population, needed to be established in an alternative way, i.e., through the involvement of vocational rehabilitation agencies and labour experts. Overall, the guideline required minimal changes. In total, nineteen sick-listed workers were counselled using the MPP guidance document. The overall experience of the IPs was that the MPP guidance document was feasible and useful for the IP, while they had mixed responses on its usefulness for the sick-listed worker, in part due to the follow-up period of this study. Conclusions An existing practice guideline for employed workers was adapted for use as a guidance document for unemployed and temporary agency workers with minor psychological problems. IPs were positive about applying the MPP guidance document. The guidance document provides opportunities for RTW counselling for unemployed and temporary agency workers with minor psychological problems. PMID:23014258

What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance.

PubMed

Le Boutillier, Clair; Leamy, Mary; Bird, Victoria J; Davidson, Larry; Williams, Julie; Slade, Mike

2011-12-01

Recovery is a multifaceted concept, and the need for operationalization in practice has been identified. Although guidance on recovery-oriented practice exists, it is from disparate sources and is difficult to apply. The aims of the study were to identify the key characteristics of recovery-oriented practice guidance on the basis of current international perspectives and to develop an overarching conceptual framework to aid the translation of recovery guidance into practice. A qualitative analysis of 30 international documents offering recovery-oriented practice guidance was conducted. Inductive, semantic-level, thematic analysis was used to identify dominant themes. Interpretive analysis was then undertaken to group the themes into practice domains. The guidance documents were diverse; from six countries-the United States, England, Scotland, Republic of Ireland, Denmark, and New Zealand-and varied in document type, categories of guidance, and level of service user involvement in guidance development. The emerging conceptual framework consists of 16 dominant themes, grouped into four practice domains: promoting citizenship, organizational commitment, supporting personally defined recovery, and working relationship. A key challenge for mental health services is the lack of clarity about what constitutes recovery-oriented practice. The conceptual framework contributes to this knowledge gap and provides a synthesis of recovery-oriented practice guidance.

Practice and professional development plans (PPDPs): results of a feasibility study.

PubMed

Elwyn, G; Carlisle, S; Hocking, P; Smail, S

2001-01-01

Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Qualitative observational study. All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. This work supports the view that organisational development has considerable potential for bringing about effective change, and individual contributions could form a valuable component of personal portfolios. We believe that the existing structures in education and management in the health service are not yet able to support these processes. Evidence from the fields of risk management and quality improvement all point to the need to develop effective organisational systems and the results of this feasibility study indicate that alternative models of sustaining organisational development need careful evaluation.

Practice and professional development plans (PPDPs): results of a feasibility study

PubMed Central

Elwyn, Glyn; Carlisle, Sandra; Hocking, Paul; Smail, Simon

2001-01-01

Background Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. Aims Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. Design Qualitative observational study. Study sample All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. Method Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. Results Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. Conclusions This work supports the view that organisational development has considerable potential for bringing about effective change, and individual contributions could form a valuable component of personal portfolios. We believe that the existing structures in education and management in the health service are not yet able to support these processes. Evidence from the fields of risk management and quality improvement all point to the need to develop effective organisational systems and the results of this feasibility study indicate that alternative models of sustaining organisational development need careful evaluation. PMID:11299046

[Reflections on stress and burnout and their relationship with nursing].

PubMed

Murofuse, Neide Tiemi; Abranches, Sueli Soldati; Napoleão, Anamaria Alves

2005-01-01

This bibliographic review aimed to differentiate between stress and Burnout and to establish their relationship with nursing work to support the understanding of psychical suffering at work. The study was based on the analysis and interpretation of articles, thesis and dissertations produced between 1990 and 2001. Although there is a consensus among the individuals on the existence of stress and burnout, there are several controversies surrounding these terms. These theories were created in the context of capitalist production increase. Stress refers to a personal tiring that interferes in the life of the person but not necessarily in his/her relationship with the work. Burnout is a syndrome involving negative attitudes and behaviors towards users, clients, organization and work. It is a gradual process of subjective experiences that result in practical and emotional problems to workers and organizations. Nursing work facilitates stress and burnout and causes suffering and illness among workers.

Advancing Social Work Education for Health Impact

PubMed Central

Keefe, Robert H.; Ruth, Betty J.; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie

2017-01-01

Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy. PMID:29236540

Considerations in reporting palliative care clinical trials: Standardizing information reported and authorship practices

PubMed Central

LeBlanc, Thomas W.; Abernethy, Amy P.; Currow, David C.; Kutner, Jean S.

2014-01-01

Purpose of Review The nature of palliative care practice, especially the reliance on referrals and differing models of service delivery, poses unique challenges for the creation and interpretation of an evidence base, frequently limiting the applicability of data to patient care. Here we discuss two core aspects of clinical trials reporting in palliative medicine: 1) proposed standards governing the collection and reporting of data, and 2) rules governing authorship and publication. Recent Findings Existing literature often inadequately describes the characteristics of patients, caregivers, clinicians, systems, and interventions included in studies, thereby limiting the utility of results. Summary A generalizability framework is needed to ensure a robust evidence base that advances practice. Lessons learned through the development of research cooperative groups in palliative care reinforce the importance of an authorship protocol for large trials and working groups. PMID:23080306

OA26 How inclusive partnership working influences local policy and practice: the case of the end of life partnership.

PubMed

Zammit, Rachel

2015-04-01

: Ageing, death, dying and loss are universal issues that have a range of health, wellbeing, financial and socio-economic costs for society. The End of Life Partnership (EoLP) is a charitable collaborative in Cheshire, which aims to transform end of life experience and care, by working with a wide range partners from the public, private and third sectors and by engaging individuals, families and communities. Launched in April 2014, the EoLP merged three existing programmes focussing on public health, education and service development and added an additional research focus. There are now four dedicated departments: Public Health and Wellbeing; Research, Evaluation and Technology; Service Development; Education and Practice Development. In October 2014 a Dementia work stream was added. The work of The EoLP is shaped, overseen and monitored by a Strategic Partnership Executive, with representation from key local stakeholders and a board of trustees. The EoLP meets national objectives and delivers on local priorities agreed with stakeholders, including patients and the public. This is strengthened through a dedicated Cheshire Living Well, Dying Well Partnership to enable community voices to be heard. Significant milestones have already been realised as a partnership collaborative. For example, response to the national review of the Liverpool Care Pathway incorporated development of a local care plan with stakeholders, educational strategy to ensure effective roll-out, public consultation and work to measure impact. The EoLP works to influence and shape policy and practice at a local, regional, national and international level. © 2015, 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.

Fatal hand tool injuries in construction.

PubMed

Trent, R B; Wyant, W D

1990-08-01

Past research on occupational hand tool injuries has generally focused on nonfatal injuries. Most such injuries occur at the point where energy is transferred to the material being worked, eg, at the edge of a saw blade or the point of a drill. Assuming that hand tool injuries that are fatal will differ from nonfatal injuries, 62 Occupation Safety and Health Administration reports were analyzed. Four patterns emerged when the type of contact with energy was used to classify incidents. Fatal injuries occurred when (1) contact was made with energy that supplies power to the hand tool, (2) energy normally transferred to the material being worked is transferred to the worker, (3) workers or materials fall, and (4) potential energy is encountered in the work environment. Analysis showed that almost all such injuries could be prevented by application of existing safe work practices.

A Qualitative Study of the Work Environments of Mexican Nurses

PubMed Central

Squires, Allison; Juarez, Adrian

2012-01-01

Background Studies of the nursing work environment are increasingly common in developed countries, but few exist in developing countries. Because of resource differences between the two contexts, researchers need to clarify what aspects of the work environments are similar and different. Objectives To study the perspectives of Mexican nurses about their work environments to determine similarities and differences to results from developed world studies. Design A secondary, directed content analysis of qualitative data from 46 Spanish language interviews using workplace-oriented themes Setting Purposively selected Mexican states from four regions of the country that reflect the country’s socioeconomic differences. Participants Practicing Mexican nurses with at least one year of clinical experience and currently working in nursing. Participants were recruited through convenience and snowball sampling techniques. Methods Initial data collection occurred in 2006 and 2008 during a broader study about professionalization processes that occurred in Mexican nursing between 1980 and 2005. The secondary, directed content analysis focused on an in-depth exploration of a central theme that emerged from the two original studies: The Workplace. The directed content analysis used themes from the global nursing work environment literature to structure the analysis: Professional relationships, organizational administrative practices, and quality of care and services. Results The three themes from the global literature were relevant for the Mexican context and a new one emerged related to hiring practices. By category, the same factors that created positive or negative perceptions of the work environment matched findings from other international studies conducted in developed countries. The descriptors of the category, however, had different conceptual meanings that illustrate the health system challenges in Mexico. Conclusions Findings from this study suggest that studies that seek to measure nursing work environments will most likely apply in Mexico and other Latin American or middle-income countries. Instruments designed to measure the work environment of nurses in these countries may prove relevant in those contexts, but require careful adaptation and systematic translations to ensure it. PMID:22386989

Defining the Path Forward: Guidance for Laboratory Medicine Guidelines

PubMed Central

Jones, Patricia M.; Chin, Alex C.; Christenson, Robert H.

2015-01-01

The National Academy of Clinical Biochemistry (NACB) has developed consensus-based guidelines for the laboratory evaluation and monitoring of patients with specified disorders for two decades. In 1997, the NACB recognized the need to standardize the process of guideline development and promulgated its first Standard Operating Procedure (SOP) for this purpose. In 2010, the American Association of Clinical Chemistry (AACC) and NACB created the Evidence-Based Laboratory Medicine Committee (EBLMC). Among other roles, this group was given responsibility to provide oversight of clinical practice guideline development in accordance with SOP guidance and using currently accepted good practices. In 2011, the U.S. Institute of Medicine (IOM) published two reports of relevance: ‘Clinical Practice Guidelines We Can Trust’ and ‘Finding What Works in Health Care – Standards for Systematic Reviews.’ These reports were created as part of a response to a legislative mandate from the U.S. Congress requesting that steps be taken to implement recommendations from lOM’s report on ‘Knowing What Works in Health Care’ (2008). The latest revision of the laboratory medicine practice guidelines (LMPG) SOP was in part driven by these reports. NACB continues to develop LMPGs at a rate of roughly one per year through standard processes detailed in its 2014 revision of the SOP. This article describes the NACB and EBLMC experience in developing LMPGs with a focus on the evolution and use of the latest SOP. AACC and NACB have established a solid track record in collaboratively working with many clinical societies and professional organizations on clinical practice guideline development. Presently, three LMPG’s are in various stages of development and all with the collaboration of other clinical/professional groups. The practices and tools being used for current LMPGs in progress are also highlighted in the context of the challenges that presently exist for effective clinical practice guideline development in the U.S. PMID:27683491

Modular Affective Reasoning-Based Versatile Introspective Architecture (MARVIN)

DTIC Science & Technology

2008-08-14

monolithic kernels found in most mass market OSs, where these kinds of system processes run within the kernel , and thus need to be highly optimized as well as...without modifying pre- existing process management elements, we expect the process of transitioning this component from MINIX to monolithic kernels to...necessary to incorporate them into a monolithic kernel . To demonstrate how the APMM would work in practice, we used it as the basis for building a simulated

A computer-based specification methodology

NASA Technical Reports Server (NTRS)

Munck, Robert G.

1986-01-01

Standard practices for creating and using system specifications are inadequate for large, advanced-technology systems. A need exists to break away from paper documents in favor of documents that are stored in computers and which are read and otherwise used with the help of computers. An SADT-based system, running on the proposed Space Station data management network, could be a powerful tool for doing much of the required technical work of the Station, including creating and operating the network itself.

Trout Creek, Oregon Watershed Assessment; Findings, Condition Evaluation and Action Opportunities, 2002 Technical Report.

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

Runyon, John

The purpose of the assessment is to characterize historical and current watershed conditions in the Trout Creek Watershed. Information from the assessment is used to evaluate opportunities for improvements in watershed conditions, with particular reference to improvements in the aquatic environment. Existing information was used, to the extent practicable, to complete this work. The assessment will aid the Trout Creek Watershed Council in identifying opportunities and priorities for watershed restoration projects.

[Specific features of hygienic standardization of noise in Metro].

PubMed

Mel'nichenko, P I; Svizhevskiĭ, V A; Matveev, A A

2012-01-01

There are various harmful physical factors in the passenger and work premises of the Moscow underground. Noise is the most common harmful factor. The normative documents regulating noise in the underground were found to have discrepancies, which in practice makes it difficult to define whether the level of the sound is in compliance with the existing specifications and hence to determine effective actions made to mitigate its negative impact on the underground passengers and personnel.

Laser Rewelding of 304L Stainless Steel.

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

Maguire, Michael Christopher; Rodelas, Jeffrey

Laser welding of 304L stainless steel during component fabrication has been found to alter the chemical composition of the steel due to material evaporation. During repair or rework, or during potential reuse/ rewelding of certain components, the potential exists to alter the composition to the extent that the material becomes prone to solidification cracking. This work aims to characterize the extent of this susceptibility in order to make informed decisions regarding rewelding practice and base metal chemistry allowances.

Social network of PESCA (Open Source Platform for eHealth).

PubMed

Sanchez, Carlos L; Romero-Cuevas, Miguel; Lopez, Diego M; Lorca, Julio; Alcazar, Francisco J; Ruiz, Sergio; Mercado, Carmen; Garcia-Fortea, Pedro

2008-01-01

Information and Communication Technologies (ICTs) are revolutionizing how healthcare systems deliver top-quality care to citizens. In this way, Open Source Software (OSS) has demonstrated to be an important strategy to spread ICTs use. Several human and technological barriers in adopting OSS for healthcare have been identified. Human barriers include user acceptance, limited support, technical skillfulness, awareness, resistance to change, etc., while Technological barriers embrace need for open standards, heterogeneous OSS developed without normalization and metrics, lack of initiatives to evaluate existing health OSS and need for quality control and functional validation. The goals of PESCA project are to create a platform of interoperable modules to evaluate, classify and validate good practices in health OSS. Furthermore, a normalization platform will provide interoperable solutions in the fields of healthcare services, health surveillance, health literature, and health education, knowledge and research. Within the platform, the first goal to achieve is the setup of the collaborative work infrastructure. The platform is being organized as a Social Network which works to evaluate five scopes of every existing open source tools for eHealth: Open Source Software, Quality, Pedagogical, Security and privacy and Internationalization/I18N. In the meantime, the knowledge collected from the networking will configure a Good Practice Repository on eHealth promoting the effective use of ICT on behalf of the citizen's health.

[Opinion of the primary care veterinarians of Andalusia concerning the management of their professional practice].

PubMed

Conti Cuesta, F; Baena Parejo, M I; Pinzón Pulido, S A

1999-01-01

This study describes the opinion of the veterinarians in Andalusia regarding the organization and management of their professional practice and pinpoints solutions to the problems found for the purpose of providing planning and management aspects in view of the reforms undertaken in the Andalusian Health Service Strategy Plan. Descriptive opinion poll employing a questionnaire filled out by each individual among all of the Primary Care (PC) veterinarians in Andalusia (including those who have been currently employed who possess at least one year's experience, except substitutes). A description was provided of their personal traits, their opinion of the management-related factors involved in their professional practice. A description was also provided of the suggestions for improving the problems found to exist. Over 70% said they were aware of the objectives, although only the coordinators found them to be clearly motivating the practice. Their opinion was that the indicators of activity neither include any quality-related criteria nor afford the possibility of evaluating the activity they are carrying out. They believed that the contributions from other members of the multidisciplinary team improve their work and are in favor of continuing their involvement therein. They were satisfied with doing their work (the coordinators to a greater degree). They found the productivity pay to be too low and not useful as regards providing them with any incentive. They were not satisfied with the training with which they are provided and thought that what they are offered is far less than their other colleagues in the health care field. Most were of the opinion that they should remain under the authority of the Andalusian Health Service. This group prefers to continue working for the same organization, but improving the following management aspects: training offer, practice incentives and activity indicators.

Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations.

PubMed

Williams-Whitt, Kelly; Bültmann, Ute; Amick, Benjamin; Munir, Fehmidah; Tveito, Torill H; Anema, Johannes R

2016-12-01

Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.

Improving Existing EPO Efforts with Data Access through the National Virtual Observatory

NASA Astrophysics Data System (ADS)

Raddick, M. J.; Christian, C. A.; O'Mullane, W. J.

2005-05-01

The National Virtual Observatory (NVO) is developing tools to enable astronomy data to be shared seamlessly across the Internet. The goal of the NVO is to allow anyone on the Internet to access all astronomy data ever measured, with any instrument, in any wavelength. The NVO's research efforts focus on allowing scientists to access existing online data, adding value to each dataset by virtue of its connection to others. Similarly, the NVO's Education and Public Outreach (EPO) efforts focus on connecting existing projects with the our seamless access to real, modern astronomy data from thousands of research projects. We hope that this connection will provide countless opportunities to expand and enhance existing EPO projects. Some of the projects currently working with NVO are the CLEA labs at Gettysburg College, Project LITE at Boston University, and Adler Planetarium. In this poster, I will describe the current EPO efforts that incorporate the NVO's data access tools. I will also provide a tutorial for EPO developers, with practical suggestions on how to incorporate NVO tools into existing projects. I will also give contact information for further help.

Analysis of MoDOT communication and outreach effectiveness

DOT National Transportation Integrated Search

2008-07-01

Personal interviews were held with MoDOT personnel to assess MoDOTs current communication practices and existing customer segmentation practices. Focus groups were then held to help gauge the effectiveness of existing communication practices and t...

Hooked on a feeling: emotional labor as an occupational hazard of the post-industrial age.

PubMed

Andrews, Bonnie K; Karcz, Susan; Rosenberg, Beth

2008-01-01

Emotional labor is a subtle but serious occupational hazard that is likely to spread rapidly as the global service economy continues to grow. Emotional labor requires more than just acting friendly and being helpful to customers; the worker must manage his or her emotions to create a company-dictated experience for customers. The practice of emotional labor in an unsupportive work environment produces work-related stress, which has a wide range of potentially serious health effects. Though many employers do not acknowledge the existence of emotional labor, it is a real occupational hazard that may generate life-altering effects on physical and emotional health. While no official regulations or identification standards specify emotional labor as an occupational hazard, some guidelines exist regarding its outcome: occupational stress. Emotional labor should be recognized as an occupational hazard by the Occupational Safety and Health Administration (OSHA), but this hazard does not lend itself to regulation through standards. The business culture that demands its performance is questioned.

Satisfaction of women urologists with maternity leave and childbirth timing.

PubMed

Lerner, Lori B; Baltrushes, Robin J; Stolzmann, Kelly L; Garshick, Eric

2010-01-01

Women physicians must consider many conflicting issues when timing childbirth. We characterized maternity leave, breast-feeding practices and satisfaction associated with pregnancy timing in women urologists. A 114-item anonymous survey including questions on maternity leave duration for firstborn children, workplace policies, attitudes and satisfaction was mailed to all 365 American board certified women urologists in May and July 2007. Logistic regression was used to identify factors associated with greater satisfaction. A total of 243 women urologists (69%) responded, of whom 158 had at least 1 biological child. Average maternal age at first birth was 32.6 years. Of the children 10%, 32% and 52% were born before, during and after residency, respectively. Only 42% of women reported the existence of a formal maternity leave policy. Of the women 70% took 8 weeks or less of leave. Those with 9 weeks or greater were 3.8 times more likely to report satisfaction (p = 0.001). Although women in practice were 2.0 times more likely to take 9 weeks or greater compared to those in training or earlier (p = 0.046), only 30% in practice took this much time. Dissatisfaction with leave was not related to birth timing (residency vs practice) or maternal age at delivery but to work/residency related issues in 69% of respondents, financial concerns in 13% and personal/other in 18%. For breast-feeding 67% of respondents were satisfied with the duration and 22% were not. Dissatisfaction was secondary to work factors. Satisfaction with leave was related to the amount of maternity leave with women with 9 weeks or greater more likely to report satisfaction. Women in practice were more likely to take 9 weeks or greater but most did not due to strong stressors related to work, partners/peers or finances. Work factors were cited for dissatisfaction with breast-feeding.

Adaptive decision rules for the acquisition of nature reserves.

PubMed

Turner, Will R; Wilcove, David S

2006-04-01

Although reserve-design algorithms have shown promise for increasing the efficiency of conservation planning, recent work casts doubt on the usefulness of some of these approaches in practice. Using three data sets that vary widely in size and complexity, we compared various decision rules for acquiring reserve networks over multiyear periods. We explored three factors that are often important in real-world conservation efforts: uncertain availability of sites for acquisition, degradation of sites, and overall budget constraints. We evaluated the relative strengths and weaknesses of existing optimal and heuristic decision rules and developed a new set of adaptive decision rules that combine the strengths of existing optimal and heuristic approaches. All three of the new adaptive rules performed better than the existing rules we tested under virtually all scenarios of site availability, site degradation, and budget constraints. Moreover, the adaptive rules required no additional data beyond what was readily available and were relatively easy to compute.

Deconstructing dementia and delirium hospital practice: using cultural historical activity theory to inform education approaches.

PubMed

Teodorczuk, Andrew; Mukaetova-Ladinska, Elizabeta; Corbett, Sally; Welfare, Mark

2015-08-01

Older patients with dementia and delirium receive suboptimal hospital care. Policy calls for more effective education to address this though there is little consensus on what this entails. The purpose of this clarification study is to explore how practice gaps are constructed in relation to managing the confused hospitalised older patient. The intent is to inform educational processes in the work-place beyond traditional approaches such as training. Adopting grounded theory as a research method and working within a social constructionist paradigm we explored the practice gaps of 15 healthcare professionals by interview and conducted five focus groups with patients, carers and Liaison mental health professionals. Data were thematically analysed by constant comparison and theoretical sampling was undertaken until saturation reached. Categories were identified and pragmatic concepts developed grounded within the data. Findings were then further analysed using cultural historical activity theory as a deductive lens. Practice gaps in relation to managing the confused older patient are determined by factors operating at individual (knowledge and skill gaps, personal philosophy, task based practice), team (leadership, time and ward environmental factors) and organisational (power relationships, dominance of medical model, fragmentation of care services) levels. Conceptually, practice appeared to be influenced by socio-cultural ward factors and compounded by a failure to join up existing "patient" knowledge amongst professionals. Applying cultural historical activity theory to further illuminate the findings, the central object is defined as learning about the patient and the mediating artifacts are the care relationships. The overarching medical dominance emerges as an important cultural historical factor at play and staff rules and divisions of labour are exposed. Lastly key contradictions and tensions in the system that work against learning about the patient are identified. Cultural historical activity theory can be used to advance understanding of practice gaps in order to develop a broader transformative approach to dementia and delirium practice and education. Structural changes at an individual, team and systems level resulting from this novel understanding of practice complexity are proposed. Contradictions can be used as foci for expansive learning. Lastly, interprofessional education (formal and informal) is advocated to further knotwork and improve the care of the older confused patient.

Changes to nurses' practice environment over time.

PubMed

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

2016-07-01

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

Benefit or burden: introducing paraprofessional support staff to health visiting teams: the case of Starting Well.

PubMed

Mackenzie, Mhairi

2006-11-01

With increased public-sector funding to expand and improve frontline services, pre-existing skill shortages within key professional workforces have become more acute. One response to this has been to encourage the development of skill-mix approaches which allow tasks previously undertaken by professional staff groupings to be assumed by new paraprofessional employees. Within the UK National Health Service, one group of professionals who are being challenged to change their way of working in this way are health visitors. Starting Well, one of Scotland's four health demonstration projects, which was established in 2000 to bring about a step-change in child health within deprived communities in Glasgow, operated as a pilot for such a skill-mix model of health visiting. The project was evaluated using a multimethod approach that encompassed the study of both processes and outcomes. The present paper reports on a process evaluation of the project's implementation that addressed the rationale underlying the development of Starting Well's skill-mix approach and the challenges which this model faced in practice. The perceptions of both managerial staff (n=18) and those working in practice (n=33) were gathered using semistructured interviews which sought to elicit and test Starting Well's theory of change in relation to the use of paraprofessional staff. Two sets of interviews were conducted with each group of staff between 2001 and 2003. Two main types of challenge were identified: deploying potentially vulnerable members of staff; and co-management of paraprofessionals by the health service and a voluntary-sector organisation. A potential challenge identified from the literature, i.e. that of implementing a new role within an existing team, proved to be less problematic within Starting Well. These issues are discussed in relation to current policy and practice debates.

Phases of "pre-engagement" capacity building: discovery, exploration, and trial alliance.

PubMed

Campbell-Voytal, Kimberly

2010-01-01

Academic prevention researchers who engage limited-resource communities may find that organizational or community capacity for prevention is low. Community organizations, neighborhoods, and academic partners may lack shared issue awareness, mutual interests, and interactive skills necessary for collaborative intervention. Existing capacity building models either ignore a 'pre-engagement' phase or acknowledge it without offering strategic detail. An exploratory or developmental phase before active engagement can be achieved through co-located work in a community setting. The construct, "ecology of practice," provides conceptual background for examining how "shared work" introduces and prepares partners for future collaboration consistent with community-based participatory research (CBPR) principles. This paper presents two case studies where pre-engagement capacity building involved partners who were initially unaware, disinterested, or unable to engage in preventive interventions. These cases illustrate how mutual participation in shared "ecologies of practice" enabled an exchange of cultural knowledge, skill, and language that laid the groundwork for future preventive intervention. A trajectory of developmental work in each case occurred over 5 years. Historical timelines, interviews, and personal communications between community and academic leaders were reviewed and common themes identified. A model of "pre-capacity building" emerged. Capacity-building models that detail strategies for developing equitable engagement in under-resourced settings will more effectively move best practices into vulnerable communities. Preventive interventions must be translated equitably if health disparities are to be reduced.

Updating the OMERACT filter: implications for patient-reported outcomes.

PubMed

Kirwan, John R; Bartlett, Susan J; Beaton, Dorcas E; Boers, Maarten; Bosworth, Ailsa; Brooks, Peter M; Choy, Ernest; de Wit, Maarten; Guillemin, Francis; Hewlett, Sarah; Kvien, Tore K; Landewé, Robert B; Leong, Amye L; Lyddiatt, Anne; March, Lyn; May, James; Montie, Pamela Lesley; Nikaï, Enkeleida; Richards, Pam; Voshaar, Marieke M J H; Smeets, Wilma; Strand, Vibeke; Tugwell, Peter; Gossec, Laure

2014-05-01

At a previous Outcome Measures in Rheumatology (OMERACT) meeting, participants reflected on the underlying methods of patient-reported outcome (PRO) instrument development. The participants requested proposals for more explicit instrument development protocols that would contribute to an enhanced version of the "Truth" statement in the OMERACT Filter, a widely used guide for outcome validation. In the present OMERACT session, we explored to what extent these new Filter 2.0 proposals were practicable, feasible, and already being applied. Following overview presentations, discussion groups critically reviewed the extent to which case studies of current OMERACT Working Groups complied with or negated the proposed PRO development framework, whether these observations had a more general application, and what issues remained to be resolved. Several aspects of PRO development were recognized as particularly important, and the need to directly involve patients at every stage of an iterative PRO development program was endorsed. This included recognition that patients contribute as partners in the research and not merely as subjects. Correct communication of concepts with the words used in questionnaires was central to their performance as measuring instruments, and ensuring this understanding crossed cultural and linguistic boundaries was important in international studies or comparisons. Participants recognized, endorsed, and were generally already putting into practice the principles of PRO development presented in the plenary session. Further work is needed on some existing instruments and on establishing widespread good practice for working in close collaboration with patients.

Breast health educational interventions. Changes in beliefs and practices of working women.

PubMed

Thomas, Barbara; Stamler, Lynnette Leeseberg; Lafreniere, Kathryn D; Delahunt, Tabitha D

2002-10-01

Health education programs supported by women's groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the women's decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.

Study of two-phase flow in helical and spiral coils

NASA Technical Reports Server (NTRS)

Keshock, Edward G.; Yan, AN; Omrani, Adel

1990-01-01

The principal purposes of the present study were to: (1) observe and develop a fundamental understanding of the flow regimes and their transitions occurring in helical and spiral coils; and (2) obtain pressure drop measurements of such flows, and, if possible, develop a method for predicting pressure drop in these flow geometries. Elaborating upon the above, the general intent is to develop criteria (preferably generalized) for establishing the nature of the flow dynamics (e.g. flow patterns) and the magnitude of the pressure drop in such configurations over a range of flow rates and fluid properties. Additionally, the visualization and identification of flow patterns were a fundamental objective of the study. From a practical standpoint, the conditions under which an annular flow pattern exists is of particular practical importance. In the possible practical applications which would implement these geometries, the working fluids are likely to be refrigerant fluids. In the present study the working fluids were an air-water mixture, and refrigerant 113 (R-113). In order to obtain records of flow patterns and their transitions, video photography was employed extensively. Pressure drop measurements were made using pressure differential transducers connected across pressure taps in lines immediately preceding and following the various test sections.

Achieving organizational change in pediatric pain management

PubMed Central

Dowden, Stephanie; McCarthy, Maria; Chalkiadis, George

2008-01-01

BACKGROUND: Pain in hospitalized children is often under-treated. Little information exists to guide the process of organizational change with a view to improving pain management practices. OBJECTIVES: To describe the process and results of a hospital-wide review of pain management practices designed to identify deficiencies in service provision and recommend directions for change in a pediatric hospital. DESIGN: Prospective consultation of the clinical staff of a specialist pediatric hospital, using qualitative research methodology involving semistructured individual and group interviews. Recommendations based on the interview findings were made by a hospital-appointed working party. RESULTS: A total of 454 staff (27% of all clinical staff) from a variety of professional backgrounds, representing almost every hospital unit or department, were interviewed. Procedural and persistent (chronic) pain was identified as the area needing the most improvement. Barriers to improving pain management included variability in practice, outmoded beliefs and inadequate knowledge, factors which were seen to contribute to a culture of slow or no change. Recommendations of the working party and changes achieved after the review are described. CONCLUSION: The review process identified deficiencies in the management of pain in children, and barriers to its effective management. With institutional support, the present review has guided improvement. PMID:18719714

Friedensdid Aktische Bausteine für Ausbildung, Unterricht und Sozialarbeit

NASA Astrophysics Data System (ADS)

Esser, Johannes

1983-09-01

In the context of the peace movement in the Federal Republic of Germany, certain central basic elements of peace activity at higher education institutions, school and/or in social welfare work are considered. Principles and objectives of effective teaching and practice in discerning peace work are focussed upon against a background of disturbing and menacing influences both within and between nations, increasingly threatening existence itself. Endeavours to achieve reform capable of changing society should be marked by the development and realisation of a repugnance of violence, civil disobedience and social sensitivity, and demonstrated in action and by specific measures by the general public. This supersedes by far the traditional set-up of peace education (so called) in educational institutions and areas of social work up to the present time.

Building competencies for nurse administrators in the Republic of Georgia.

PubMed

Nishiyama, M; Wold, J L; Partskhladze, N

2008-06-01

To assess the level of competency among nurse administrators in the Republic of Georgia (Georgia) and to recommend interventions to implement effective nursing management practices in a resource constrained setting. The collapse of the Soviet Union in 1991 resulted in deterioration of the healthcare system in Georgia. Even though the 1995 healthcare reformers recognized that baccalaureate educated nurses were essential resources for quality health care, limited resources delayed further steps. Hence, Georgia has struggled to raise nursing education levels and to establish nursing as a professional occupation. Using an exploratory descriptive research technique, surveys of nurse managers were conducted in 2004 and in 2005. This study assessed the level of practice among Georgian nurse administrators compared with the international competencies of the International Council of Nurses. There were no organized procedures to evaluate competencies of nurses on a regular basis. While minimal clinical nursing practice guidelines exist, nurse managers did not fully utilize them for either mentoring the staff nurses or assuring an adequate quality of nursing care. Many nurse managers viewed financial constraints as an obstacle to delivering better nursing care. Recommendations include: (1) establishing effective protocols to evaluate the competencies of nurses, (2) mandating the use of existing nursing guidelines, (3) establishing effective resource inventory systems, and (4) mandating safety education and ensuring a safe work environment.

Impact-acoustics inspection of tile-wall bonding integrity via wavelet transform and hidden Markov models

NASA Astrophysics Data System (ADS)

Luk, B. L.; Liu, K. P.; Tong, F.; Man, K. F.

2010-05-01

The impact-acoustics method utilizes different information contained in the acoustic signals generated by tapping a structure with a small metal object. It offers a convenient and cost-efficient way to inspect the tile-wall bonding integrity. However, the existence of the surface irregularities will cause abnormal multiple bounces in the practical inspection implementations. The spectral characteristics from those bounces can easily be confused with the signals obtained from different bonding qualities. As a result, it will deteriorate the classic feature-based classification methods based on frequency domain. Another crucial difficulty posed by the implementation is the additive noise existing in the practical environments that may also cause feature mismatch and false judgment. In order to solve this problem, the work described in this paper aims to develop a robust inspection method that applies model-based strategy, and utilizes the wavelet domain features with hidden Markov modeling. It derives a bonding integrity recognition approach with enhanced immunity to surface roughness as well as the environmental noise. With the help of the specially designed artificial sample slabs, experiments have been carried out with impact acoustic signals contaminated by real environmental noises acquired under practical inspection background. The results are compared with those using classic method to demonstrate the effectiveness of the proposed method.

Recruiting and retaining men in nursing: a review of the literature.

PubMed

Villeneuve, M J

1994-01-01

A review of literature published primarily since 1980 was conducted to identify (1) historical events that have influenced the sex imbalance in the nursing workforce, (2) the existence and types of barriers affecting the recruitment of male nurses, and (3) feasible strategies that might form the basis of intervention studies in the future. Nursing continues to be undervalued as an end-point career by some, and most potential candidates lack exposure to male nurses and nursing in general. Family resistance and salary remain concerns, but they may be as important a deterrent for some women as for men. Significant barriers to men exist in nursing education and practice, and the language and history of nursing have sexualized nursing practice itself by labeling it as women's work. The latter pattern has influenced legal decisions affecting the clinical practice of male nurses and has contributed to perhaps the most significant barrier to the recruitment of male candidates: the job title and its associated images. Proactive recruitment from selected target groups, the use of role models, and the exploitation of appropriate media sources are but three feasible strategies identified from the literature review that might be considered if nurses really would value changing the sex imbalance in the nursing workforce.

Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice

PubMed Central

Huxley, Caroline J; Atherton, Helen; Watkins, Jocelyn Anstey; Griffiths, Frances

2015-01-01

Background Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. Aim To assess the potential impact of the availability of digital clinician–patient communication on marginalised groups’ access to general practice in the UK. Design and setting Realist review in general practice. Method A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. Results Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician–patient relationship. Conclusion Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction. PMID:26622034

Cultural change after migration: Circumcision of girls in Western migrant communities.

PubMed

Johnsdotter, Sara; Essén, Birgitta

2016-04-01

This paper reviews the current knowledge on cultural change after migration in the practice of female circumcision, also named genital cutting or mutilation. Explorative studies show trends of radical change of this practice, especially the most extensive form of its kind (type III or the 'Pharaonic' type). The widespread interpretation that Islam would require circumcision of girls is questioned when, for example, Somalis meet other Muslim migrants, such as Arab Muslims, who do not circumcise their daughters. The few criminal court cases for circumcision of girls that have taken place in Western countries corroborate the conclusion that substantial change in the practice has occurred among migrants. In this literature review, an absence of reports is identified from healthcare providers who have witnessed circumcision after migration. Concurrently, a substantial knowledge exists on how to take care of already circumcised women and girls, and there is a system of recommendations in place regarding best practices for prevention. There is a great potential for healthcare providers to encourage this development towards general abandonment of circumcision of girls. The challenge for the future is how to incorporate culturally sensitive efforts of prevention on the one hand, and the examination of suspicious cases of illegal circumcision on the other. We recommend using--in a cautious way--the existing routines for identifying child abuse in general. Experiences from African contexts show that failure to generate significant change of the harmful practices/tradition may be due to the lack of multidisciplinary collaboration in different sectors of the society. In Western societies, the tendency toward abandonment of the practice could be reinforced by professionals who work toward better inclusion of men and women originally from countries where circumcision is practised. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluation of an Interdisciplinary Curriculum Teaching Team-based Palliative Care Integration in Oncology

PubMed Central

Head, Barbara A.; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeifer, Mark

2015-01-01

For students of the health care professions to succeed in today's healthcare environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences. PMID:25708910

Empowering school personnel for positive youth development: the case of Hong Kong school social workers.

PubMed

To, Siu-ming

2009-01-01

While empowerment has become a popular concept in working with adolescents, few attempts have been made to explore the possibilities for empowering school personnel to create an environment in which young people can make maximum use of the opportunity to learn and grow. Based on the field experiences of 15 Hong Kong school social workers, this article examines how practitioners use various strategies to interact with school personnel to generate empowering practices in the school setting: namely, (1) exerting influence on school personnel in daily conversations and interactions; (2) creating an environment conducive to the teacher-student relationship; (3) achieving consensus with school personnel through lobbying and negotiation; and (4) collaborating with school personnel to organize life education and positive youth development programs. The findings provide valuable reference materials to guide other practitioners in applying the empowerment approach in actual practice. It also helps fill the gap in existing literature on empowerment and school social work.

Comparing 2 National Organization-Level Workplace Health Promotion and Improvement Tools, 2013–2015

PubMed Central

Lang, Jason E.; Davis, Whitney D.; Jones-Jack, Nkenge H.; Mukhtar, Qaiser; Lu, Hua; Acharya, Sushama D.; Molloy, Meg E.

2016-01-01

Creating healthy workplaces is becoming more common. Half of employers that have more than 50 employees offer some type of workplace health promotion program. Few employers implement comprehensive evidence-based interventions that reach all employees and achieve desired health and cost outcomes. A few organization-level assessment and benchmarking tools have emerged to help employers evaluate the comprehensiveness and rigor of their health promotion offerings. Even fewer tools exist that combine assessment with technical assistance and guidance to implement evidence-based practices. Our descriptive analysis compares 2 such tools, the Centers for Disease Control and Prevention’s Worksite Health ScoreCard and Prevention Partners’ WorkHealthy America, and presents data from both to describe workplace health promotion practices across the United States. These tools are reaching employers of all types (N = 1,797), and many employers are using a comprehensive approach (85% of those using WorkHealthy America and 45% of those using the ScoreCard), increasing program effectiveness and impact. PMID:27685429

Evaluation of an Interdisciplinary Curriculum Teaching Team-Based Palliative Care Integration in Oncology.

PubMed

Head, Barbara A; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeiffer, Mark

2016-06-01

For students of the health care professions to succeed in today's health care environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work, and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences.

Design and Implementation of Practical Bidirectional Texture Function Measurement Devices Focusing on the Developments at the University of Bonn

PubMed Central

Schwartz, Christopher; Sarlette, Ralf; Weinmann, Michael; Rump, Martin; Klein, Reinhard

2014-01-01

Understanding as well as realistic reproduction of the appearance of materials play an important role in computer graphics, computer vision and industry. They enable applications such as digital material design, virtual prototyping and faithful virtual surrogates for entertainment, marketing, education or cultural heritage documentation. A particularly fruitful way to obtain the digital appearance is the acquisition of reflectance from real-world material samples. Therefore, a great variety of devices to perform this task has been proposed. In this work, we investigate their practical usefulness. We first idey a set of necessary attributes and establish a general categorization of different designs that have been realized. Subsequently, we provide an in-depth discussion of three particular implementations by our work group, demonstrating advantages and disadvantages of different system designs with respect to the previously established attributes. Finally, we survey the existing literature to compare our implementation with related approaches. PMID:24787638

Nursing Education Transformation: Promising Practices in Academic Progression.

PubMed

Gorski, Mary Sue; Farmer, Patricia D; Sroczynski, Maureen; Close, Liz; Wortock, Jean M

2015-09-01

Health care has changed over the past decade; yet, nursing education has not kept pace with social and scientific advances. The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, called for a more highly educated nursing work-force and an improved nursing education system. Since the release of that report, the Future of Nursing: Campaign for Action, supported by the Robert Wood Johnson Foundation, AARP, and the AARP Foundation, has worked with nursing education leaders to better understand existing and evolving nursing education structures. Through a consensus-building process, four overarching promising practice models, with an emphasis on seamless academic progression, emerged to advance the goals of education transformation. Key nurse educators and other stakeholders refined those models through a series of meetings, collaborative partnerships, and focused projects that were held across the United States. This article summarizes that process and provides a description of the models, challenges, common themes, recommendations, and progress to date. Copyright 2015, SLACK Incorporated.

Expert searcher, teacher, content manager, and patient advocate: an exploratory study of clinical librarian roles.

PubMed

Tan, Maria C; Maggio, Lauren A

2013-01-01

The research explored the roles of practicing clinical librarians embedded in a patient care team. Six clinical librarians from Canada and one from the United States were interviewed to elicit detailed descriptions of their clinical roles and responsibilities and the context in which these were performed. Participants were embedded in a wide range of clinical service areas, working with a diverse complement of health professionals. As clinical librarians, participants wore many hats, including expert searcher, teacher, content manager, and patient advocate. Unique aspects of how these roles played out included a sense of urgency surrounding searching activities, the broad dissemination of responses to clinical questions, and leverage of the roles of expert searcher, teacher, and content manager to advocate for patients. Detailed role descriptions of clinical librarians embedded in patient care teams suggest possible new practices for existing clinical librarians, provide direction for training new librarians working in patient care environments, and raise awareness of the clinical librarian specialty among current and budding health information professionals.

Nurses' attitudes towards end-of-life decisions in medical practice: a nationwide study in Flanders, Belgium.

PubMed

Inghelbrecht, E; Bilsen, J; Mortier, F; Deliens, L

2009-10-01

We investigated on a nationwide level the attitudes of nurses towards end-of-life decisions (ELDs) that may hasten death and towards their role in those decisions. We took a representative random sample of 6000 nurses in Flanders, Belgium. Response rate was 62.5%. Most nurses agreed with the practice of withholding/withdrawing potentially life-prolonging treatments (93%), with decisions to alleviate symptoms with possible life-shortening side effects (96%) and with the practice of euthanasia (92%). Their support for the different decisions existed regardless of whether they had cared for terminally ill patients or not. Most nurses also thought that they have an important role to play especially in the ELD-making process. Nurses' views on their proper role in the administration of drugs in euthanasia and continuous deep sedation showed a large dispersal. Overall, nurses' work setting determines their opinions on nurses' role in ELDs. In conclusion, nurses accept a wide variety of ELDs being practiced with terminally ill patients.

Interpreting international governance standards for health IT use within general medical practice.

PubMed

Mahncke, Rachel J; Williams, Patricia A H

2014-01-01

General practices in Australia recognise the importance of comprehensive protective security measures. Some elements of information security governance are incorporated into recommended standards, however the governance component of information security is still insufficiently addressed in practice. The International Organistion for Standardisation (ISO) released a new global standard in May 2013 entitled, ISO/IEC 27014:2013 Information technology - Security techniques - Governance of information security. This standard, applicable to organisations of all sizes, offers a framework against which to assess and implement the governance components of information security. The standard demonstrates the relationship between governance and the management of information security, provides strategic principles and processes, and forms the basis for establishing a positive information security culture. An analysis interpretation of this standard for use in Australian general practice was performed. This work is unique as such interpretation for the Australian healthcare environment has not been undertaken before. It demonstrates an application of the standard at a strategic level to inform existing development of an information security governance framework.

A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement.

PubMed

Chen, Yaolong; Yang, Kehu; Marušic, Ana; Qaseem, Amir; Meerpohl, Joerg J; Flottorp, Signe; Akl, Elie A; Schünemann, Holger J; Chan, Edwin S Y; Falck-Ytter, Yngve; Ahmed, Faruque; Barber, Sarah; Chen, Chiehfeng; Zhang, Mingming; Xu, Bin; Tian, Jinhui; Song, Fujian; Shang, Hongcai; Tang, Kun; Wang, Qi; Norris, Susan L

2017-01-17

The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. It developed a checklist and an explanation and elaboration statement. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelines, support journal editors and peer reviewers when considering guideline reports, and help health care practitioners understand and implement a guideline.

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.

Knowledge Translation in Audiology

PubMed Central

Kothari, Anita; Bagatto, Marlene P.; Seewald, Richard; Miller, Linda T.; Scollie, Susan D.

2011-01-01

The impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitate the development and dissemination of evidence for clinical audiology practice. Finally, a project that uses the knowledge-to-action (KTA) framework for the development of outcome measures in pediatric audiology is introduced. PMID:22194314

Practical comparison of distributed ledger technologies for IoT

NASA Astrophysics Data System (ADS)

Red, Val A.

2017-05-01

Existing distributed ledger implementations - specifically, several blockchain implementations - embody a cacophony of divergent capabilities augmenting innovations of cryptographic hashes, consensus mechanisms, and asymmetric cryptography in a wide variety of applications. Whether specifically designed for cryptocurrency or otherwise, several distributed ledgers rely upon modular mechanisms such as consensus or smart contracts. These components, however, can vary substantially among implementations; differences involving proof-of-work, practical byzantine fault tolerance, and other consensus approaches exemplify distinct distributed ledger variations. Such divergence results in unique combinations of modules, performance, latency, and fault tolerance. As implementations continue to develop rapidly due to the emerging nature of blockchain technologies, this paper encapsulates a snapshot of sensor and internet of things (IoT) specific implementations of blockchain as of the end of 2016. Several technical risks and divergent approaches preclude standardization of a blockchain for sensors and IoT in the foreseeable future; such issues will be assessed alongside the practicality of IoT applications among Hyperledger, Iota, and Ethereum distributed ledger implementations suggested for IoT. This paper contributes a comparison of existing distributed ledger implementations intended for practical sensor and IoT utilization. A baseline for characterizing distributed ledger implementations in the context of IoT and sensors is proposed. Technical approaches and performance are compared considering IoT size, weight, and power limitations. Consensus and smart contracts, if applied, are also analyzed for the respective implementations' practicality and security. Overall, the maturity of distributed ledgers with respect to sensor and IoT applicability will be analyzed for enterprise interoperability.

Data Policy Construction Set - Building Blocks from Childhood Constructions

NASA Astrophysics Data System (ADS)

Fleischer, Dirk; Paul-Stueve, Thilo; Jobmann, Alexandra; Farrenkopf, Stefan

2016-04-01

A complete construction set of building blocks usually comes with instructions and these instruction include building stages. The products of these building stages usually build from very general parts become highly specialized building parts for very unique features of the whole construction model. This sounds very much like the construction or organization of an interdisciplinary research project, institution or association, doesn't it! The creation process of an overarching data policy for a project group or institution is exactly the combination of individual interests with the common goal of a collaborative data policy and can be compared with the building stages of a construction set of building blocks and the building instructions. Keeping this in mind we created the data policy construction set of textual building blocks. This construction set is subdivided into several building stages or parts each containing multiple building blocks as text blocks. By combining building blocks of all subdivisions it is supposed to create a cascading data policy document. Cascading from the top level as a construction set provider for all further down existing levels such as project, themes, work packages or Universities, faculties, institutes down to the working level of working groups. The working groups are picking from the remaining building blocks in the provided construction set the suitable blocks for its working procedures to create a very specific policy from the available construction set provided by the top level community. Nevertheless, if a working group realized that there are missing building blocks or worse that there are missing building parts, then they have the chance to add the missing pieces to the construction set of direct an future use. This cascading approach enables project or institution wide application of the encoded rules from the textual level on access to data storage infrastructure. This structured approach is flexible enough to allow for the fact that interdisciplinary research projects always bring together very diverse amount of working habits, methods and requirements. All these need to be considered for the creation of the general document on data sharing and research data management. This approach focused on the recommendation of the RDA practical policy working group to implement practical policies derived from the textual level. Therefore it aims to move the data policy creation procedure and implementation towards the consortium or institutional formation with all the benefits of an existing data policy construction set already during the proposal creation and proposal review. Picking up the metaphor of real building blocks in context of data policies provides also the insight that existing building blocks and building parts can be reused as they are, but also can be redesigned with very little changes or a full overhaul.

Faculty Grading of Quantitative Problems: A Mismatch between Values and Practice

NASA Astrophysics Data System (ADS)

Petcovic, Heather L.; Fynewever, Herb; Henderson, Charles; Mutambuki, Jacinta M.; Barney, Jeffrey A.

2013-04-01

Grading practices can send a powerful message to students about course expectations. A study by Henderson et al. (American Journal of Physics 72:164-169, 2004) in physics education has identified a misalignment between what college instructors say they value and their actual scoring of quantitative student solutions. This work identified three values that guide grading decisions: (1) a desire to see students' reasoning, (2) a readiness to deduct points from solutions with obvious errors and a reluctance to deduct points from solutions that might be correct, and (3) a tendency to assume correct reasoning when solutions are ambiguous. These authors propose that when values are in conflict, the conflict is resolved by placing the burden of proof on either the instructor or the student. Here, we extend the results of the physics study to earth science ( n = 7) and chemistry ( n = 10) instructors in a think-aloud interview study. Our results suggest that both the previously identified three values and the misalignment between values and grading practices exist among science faculty more generally. Furthermore, we identified a fourth value not previously recognized. Although all of the faculty across both studies stated that they valued seeing student reasoning, the combined effect suggests that only 49% of faculty across the three disciplines graded work in such a way that would actually encourage students to show their reasoning, and 34% of instructors could be viewed as penalizing students for showing their work. This research may contribute toward a better alignment between values and practice in faculty development.

A medical home: value and implications of knowledge management.

PubMed

Orzano, A John; McInerney, Claire R; McDaniel, Reuben R; Meese, Abigail; Alajmi, Bibi; Mohr, Stewart M; Tallia, Alfred F

2009-01-01

Central to the "medical home" concept is the premise that the delivery of effective primary care requires a fundamental shift in relationships among practice members and between practice members and patients. Primary care practices can potentially increase their capacity to deliver effective care through knowledge management (KM), a process of sharing and making existing knowledge available or by developing new knowledge among practice members and patients. KM affects performance by influencing work relationships to enhance learning, decision making, and task execution. We extend our previous work to further characterize, describe, and contrast how primary care practices exhibit KM and explain why KM deserves attention in medical home redesign initiatives. Case studies were conducted, drawn from two higher and lower performing practices, which were purposely selected based on disease management, prevention, and productivity measures from an improvement trial. Observations of operations, clinical encounters, meetings, and interviews with office members and patients were transcribed and coded independently using a KM template developed from a previous secondary analysis. Face-to-face discussions resolved coding differences among research team members. Confirmation of findings was sought from practice participants. Practices manifested varying degrees of KM effectiveness through six interdependent processes and multiple overlapping tools. Social tools, such as face-to-face-communication for sharing and developing knowledge, were often more effective than were expensive technical tools such as an electronic medical record. Tool use was tailored for specific outcomes, interacted with each other, and leveraged by other organizational capacities. Practices with effective KM were more open to adopting and sustaining new ways of functioning, ways reflecting attributes of a medical home. Knowledge management differences occur within and between practices and can explain differences in performance. By relying more on social tools rather than costly, high-tech investment, KM leverages primary care's relationship-centered strength, facilitating practice redesign as a medical home.

Shaping the future: a primary care research and development strategy for Scotland.

PubMed

Hannaford, P; Hunt, J; Sullivan, F; Wyke, S

1999-09-01

Primary care is at the centre of the National Health Service (NHS) in Scotland; however, its R & D capacity is insufficiently developed. R&D is a potentially powerful way of improving the health and well-being of the population, and of securing high quality care for those who need it. In order to achieve this, any Scottish strategy for primary care R&D should aim to develop both a knowledge-based service and a research culture in primary care. In this way, decisions will be made based upon best available evidence, whatever the context. Building on existing practice and resources within primary care research, this strategy for achieving a thriving research culture in Scottish primary care has three key components: A Scottish School of Primary Care which will stimulate and co-ordinate a cohesive programme of research and training. A comprehensive system of funding for training and career development which will ensure access to a range of research training which will ensure that Scotland secures effective leadership for its primary care R&D. Designated research and development practices (DRDPs) which will build on the work of existing research practices, in the context of Local Health Care Co-operatives (LHCCs) and Primary Care Trusts (PCTs), to create a co-operative environment in which a range of primary care professionals can work together to improve their personal and teams' research skills, and to support research development in their areas. A modest investment will create substantial increases in both the quality and quantity of research being undertaken in primary care. This investment should be targeted at both existing primary care professionals working in service settings in primary care, LHCCs and PCTs, and at centres of excellence (including University departments). A dual approach will foster collaboration and will allow existing centres of excellence both to undertake more primary care research and to support the development of service based primary care professionals in their research. Resources should be distributed equitably, taking into account demography, geography and the health needs of patients in Scotland. The strategy and its components must be seen as a whole. The Scottish School of Primary Care will stimulate and co-ordinate both research and training programmes. DRDPs will become research active and will participate in School-led training and research, and will contribute to research programmes. Comprehensive funding for training and career development will ensure that staff have the skills to participate in both DRDPs and in the School's activities. Thus, inadequate commitment to any one component of the strategy will mean that other components will be less successful. Commitment to all three components will maximise the chances of success.

[On practicability of implementing the speciality "podiatry" in traumatology and orthopedics].

PubMed

2011-01-01

The absence of single opinion concerning the classification of foot and ankle joint pathology does not permit to formulate universal and practical approach to the identification of pathological syndromes in case of patient foot lesion. The situation is aggravated by the unsolved issues related to the terminological definition of podiatry as a direction in orthopedics to solve the issues of foot and ankle joint pathology. In actual conditions the implementation of new technologies into the structure of traumatological orthopedics care is needed. This approach permits to combine the qualities of models of effective and optimized care to patients with foot and ankle joint pathology. The study of issue related to the systematization of podiatric pathology revealed that actually no single universal classification easy-to-use in practice exists. Hence the development of original applied working scheme of foot and ankle joint pathology is proposed.

Development of quality measures for monitoring and improving care in gastroenterology.

PubMed

Germansky, Katharine A; Leffler, Daniel A

2011-06-01

Over the past decade, most quality assurance (QA) efforts in gastroenterology have been aimed at endoscopy. Endoscopic quality improvement was the rational area to begin QA work in gastroenterology due to the relatively acute nature of complications and the high volume of procedures performed. While endoscopy is currently the focus of most quality assurance (QA) measures in gastroenterology, more recent efforts have begun to address clinical gastroenterology practices both in the outpatient and inpatient settings. Clinical outpatient and inpatient gastroenterology is laden with areas where standardization could benefit patient care. While data and experience in clinical gastroenterology QA is relatively limited, it is clear that inconsistent use of guidelines and practice variations in gastroenterology can lead to lower quality care. In this review, we review a variety of areas in clinical gastroenterology where existing guidelines and published data suggest both the need and practicality of active QA measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Problem solving therapy - use and effectiveness in general practice.

PubMed

Pierce, David

2012-09-01

Problem solving therapy (PST) is one of the focused psychological strategies supported by Medicare for use by appropriately trained general practitioners. This article reviews the evidence base for PST and its use in the general practice setting. Problem solving therapy involves patients learning or reactivating problem solving skills. These skills can then be applied to specific life problems associated with psychological and somatic symptoms. Problem solving therapy is suitable for use in general practice for patients experiencing common mental health conditions and has been shown to be as effective in the treatment of depression as antidepressants. Problem solving therapy involves a series of sequential stages. The clinician assists the patient to develop new empowering skills, and then supports them to work through the stages of therapy to determine and implement the solution selected by the patient. Many experienced GPs will identify their own existing problem solving skills. Learning about PST may involve refining and focusing these skills.

Sensitivity Analysis of earth and environmental models: a systematic review to guide scientific advancement

NASA Astrophysics Data System (ADS)

Wagener, Thorsten; Pianosi, Francesca

2016-04-01

Sensitivity Analysis (SA) investigates how the variation in the output of a numerical model can be attributed to variations of its input factors. SA is increasingly being used in earth and environmental modelling for a variety of purposes, including uncertainty assessment, model calibration and diagnostic evaluation, dominant control analysis and robust decision-making. Here we provide some practical advice regarding best practice in SA and discuss important open questions based on a detailed recent review of the existing body of work in SA. Open questions relate to the consideration of input factor interactions, methods for factor mapping and the formal inclusion of discrete factors in SA (for example for model structure comparison). We will analyse these questions using relevant examples and discuss possible ways forward. We aim at stimulating the discussion within the community of SA developers and users regarding the setting of good practices and on defining priorities for future research.

Balancing theory and practicality: engaging non-ethicists in ethical decision making related to radiological protection.

PubMed

Martinez, Nicole; Wueste, Daniel

2016-12-01

This paper discusses an approach for engaging radiation protection professionals in the ethical aspects of decision-making, with discussion on how this approach fits in with the existing system of radiological protection. It explores finding common ground between ethical and scientific theory, how to present relevant moral theory in accessible language, and provides a practical framework for dealing with real-world problems. Although establishing the ethical theory behind the system of radiological protection is an important ongoing endeavour within the community, it is equally important to communicate this information in a way that is useful to non-ethicists. Discussion of both ethical theory and a useful strategy for applying the theory makes ethics more accessible to those working in the field by providing them with the knowledge and confidence to apply ethical principles in decisions and practice.

Large-eddy simulation of a boundary layer with concave streamwise curvature

NASA Technical Reports Server (NTRS)

Lund, Thomas S.

1994-01-01

Turbulence modeling continues to be one of the most difficult problems in fluid mechanics. Existing prediction methods are well developed for certain classes of simple equilibrium flows, but are still not entirely satisfactory for a large category of complex non-equilibrium flows found in engineering practice. Direct and large-eddy simulation (LES) approaches have long been believed to have great potential for the accurate prediction of difficult turbulent flows, but the associated computational cost has been prohibitive for practical problems. This remains true for direct simulation but is no longer clear for large-eddy simulation. Advances in computer hardware, numerical methods, and subgrid-scale modeling have made it possible to conduct LES for flows or practical interest at Reynolds numbers in the range of laboratory experiments. The objective of this work is to apply ES and the dynamic subgrid-scale model to the flow of a boundary layer over a concave surface.

A review of improved ethical practices in environmental and public health research: case examples from native communities.

PubMed

Quigley, Dianne

2006-04-01

This article presents a review of 14 case studies and articles of research ethics issues in the conduct of environmental and public health research with Native American and other indigenous populations. The purpose of this review is to highlight new practices in the ethical conduct of research with native community populations. The findings from this review can promote more dialogue and policy development on the issue of community protections in research. Formal guidelines exist in ethical codes for individual rights as human subjects, but there is a lack of development on community rights in the ethics of research. This review illustrates how community-based participatory research practices can provide working guidelines that can overcome past research harms. More important, the compilations of guidelines offer tested field methods for improving the ethical conduct of research with native community populations.

Leading organisational learning in health care.

PubMed

Carroll, J S; Edmondson, A C

2002-03-01

As healthcare organisations seek to enhance safety and quality in a changing environment, organisational learning practices can help to improve existing skills and knowledge and provide opportunities to discover better ways of working together. Leadership at executive, middle management, and local levels is needed to create a sense of shared purpose. This shared vision should help to build effective relationships, facilitate connections between action and reflection, and strengthen the desirable elements of the healthcare culture while modifying outdated assumptions, procedures, and structures.

Microeconomics of 300-mm process module control

NASA Astrophysics Data System (ADS)

Monahan, Kevin M.; Chatterjee, Arun K.; Falessi, Georges; Levy, Ady; Stoller, Meryl D.

2001-08-01

Simple microeconomic models that directly link metrology, yield, and profitability are rare or non-existent. In this work, we validate and apply such a model. Using a small number of input parameters, we explain current yield management practices in 200 mm factories. The model is then used to extrapolate requirements for 300 mm factories, including the impact of simultaneous technology transitions to 130nm lithography and integrated metrology. To support our conclusions, we use examples relevant to factory-wide photo module control.

Branding in children: a barbaric practice still exists in India.

PubMed

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era.

Patient Handoffs between Emergency Department and Inpatient Physicians: A Qualitative Study to Inform Standardization of Practice and Organization Theory

ERIC Educational Resources Information Center

Hilligoss, Phillip Brian

2011-01-01

This dissertation is motivated by two problems. First, existing literature characterizes patient handoff as an information transfer activity in which safety and quality are compromised by practice variation. This has prompted a movement to standardize practice. However, existing research has not closely examined how practice variations may be…

Quality improvement in pediatrics: past, present, and future.

PubMed

Schwartz, Stephanie P; Rehder, Kyle J

2017-01-01

Almost two decades ago, the landmark report "To Err is Human" compelled healthcare to address the large numbers of hospitalized patients experiencing preventable harm. Concurrently, it became clear that the rapidly rising cost of healthcare would be unsustainable in the long-term. As a result, quality improvement methodologies initially rooted in other high-reliability industries have become a primary focus of healthcare. Multiple pediatric studies demonstrate remarkable quality and safety improvements in several domains including handoffs, catheter-associated blood stream infections, and other serious safety events. While both quality improvement and research are data-driven processes, significant differences exist between the two. Research utilizes a hypothesis driven approach to obtain new knowledge while quality improvement often incorporates a cyclic approach to translate existing knowledge into clinical practice. Recent publications have provided guidelines and methods for effectively reporting quality and safety work and improvement implementations. This review examines not only how quality improvement in pediatrics has led to improved outcomes, but also looks to the future of quality improvement in healthcare with focus on education and collaboration to ensure best practice approaches to caring for children.

Attitudes and norms affecting scientists’ data reuse

PubMed Central

Curty, Renata Gonçalves; Specht, Alison; Grant, Bruce W.; Dalton, Elizabeth D.

2017-01-01

The value of sharing scientific research data is widely appreciated, but factors that hinder or prompt the reuse of data remain poorly understood. Using the Theory of Reasoned Action, we test the relationship between the beliefs and attitudes of scientists towards data reuse, and their self-reported data reuse behaviour. To do so, we used existing responses to selected questions from a worldwide survey of scientists developed and administered by the DataONE Usability and Assessment Working Group (thus practicing data reuse ourselves). Results show that the perceived efficacy and efficiency of data reuse are strong predictors of reuse behaviour, and that the perceived importance of data reuse corresponds to greater reuse. Expressed lack of trust in existing data and perceived norms against data reuse were not found to be major impediments for reuse contrary to our expectations. We found that reported use of models and remotely-sensed data was associated with greater reuse. The results suggest that data reuse would be encouraged and normalized by demonstration of its value. We offer some theoretical and practical suggestions that could help to legitimize investment and policies in favor of data sharing. PMID:29281658

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study

PubMed Central

2012-01-01

Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were ‘technically oriented’, ‘improvising’ or ‘socially oriented’. Conclusion We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools. PMID:23256484

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study.

PubMed

Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick

2012-12-20

The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were 'technically oriented', 'improvising' or 'socially oriented'. We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools.

A cultural diversity seen in Croatian family medicine: a lady from Janjevo.

PubMed

Pavlov, Renata

2014-12-01

The role of cultural diversities in doctor's everyday work is going more and more important in globalised world, therefore it draws lots of attention in literature. Cultural differences that exist between people, such as language, dress and traditions, are usually distinguished from the term cultural diversity which is mainly understood as having different cultures respect each other's differences. The great effort is made to educate culturally competent practitioners, nurses or doctors. The presented case of lady from Janjevo was a good role model for work with all patients with culturally different background coming to family practice. This lady example could also help to other colleagues to learn from experience on systematic way.

[Anesthetic gases and nurses in operating room].

PubMed

Dosil Caamaño, Alicia; Dosil Caamaño, Susana

2011-04-01

Summary The growing number of women of childbearing age joining the job market and remaining work active during pregnancy determines the importance of preventing the potential hazards of the workplace during pregnancy and while breastfeeding. We must take into account that regular working practices may not be acceptable for women during pregnancy or while breastfeeding. One of the daily risks of operation theatre nurses is exposure to inhaled anaesthetics used during surgery In most cases, nurses are unaware if exposure is permitted during pregnancy or while breastfeeding. In this article, it is intended to publicize these risks, as well as the ways to prevent, taking into account the existing health and safety laws.

Policing Matters: Addressing the Controversial Issue of Policing Through Education for Reconciliation

NASA Astrophysics Data System (ADS)

Cusack, Mella

2009-05-01

Policing is widely held to constitute a contentious issue in classrooms on both sides of the border on the island of Ireland, despite the fact that the ongoing peace process has led to a normalising of cross-border policing relationships. The Education for Reconciliation Project works with teachers and members of the two police services to produce teaching/learning modules on law and policing for use in Citizenship Education classrooms. This paper examines the commonly-held teacher perception of policing as a controversial issue and the reasons why these perceptions exist. It takes into consideration the opinion that it is time for schools to begin work on policing, and investigates the implications for practice.

NOSTOS: a paper-based ubiquitous computing healthcare environment to support data capture and collaboration.

PubMed

Bång, Magnus; Larsson, Anders; Eriksson, Henrik

2003-01-01

In this paper, we present a new approach to clinical workplace computerization that departs from the window-based user interface paradigm. NOSTOS is an experimental computer-augmented work environment designed to support data capture and teamwork in an emergency room. NOSTOS combines multiple technologies, such as digital pens, walk-up displays, headsets, a smart desk, and sensors to enhance an existing paper-based practice with computer power. The physical interfaces allow clinicians to retain mobile paper-based collaborative routines and still benefit from computer technology. The requirements for the system were elicited from situated workplace studies. We discuss the advantages and disadvantages of augmenting a paper-based clinical work environment.

NOSTOS: A Paper–Based Ubiquitous Computing Healthcare Environment to Support Data Capture and Collaboration

PubMed Central

Bång, Magnus; Larsson, Anders; Eriksson, Henrik

2003-01-01

In this paper, we present a new approach to clinical workplace computerization that departs from the window–based user interface paradigm. NOSTOS is an experimental computer–augmented work environment designed to support data capture and teamwork in an emergency room. NOSTOS combines multiple technologies, such as digital pens, walk–up displays, headsets, a smart desk, and sensors to enhance an existing paper–based practice with computer power. The physical interfaces allow clinicians to retain mobile paper–based collaborative routines and still benefit from computer technology. The requirements for the system were elicited from situated workplace studies. We discuss the advantages and disadvantages of augmenting a paper–based clinical work environment. PMID:14728131

Interprofessional education increases knowledge, promotes team building, and changes practice in the care of Parkinson's disease.

PubMed

Cohen, Elaine V; Hagestuen, Ruth; González-Ramos, Gladys; Cohen, Hillel W; Bassich, Celia; Book, Elaine; Bradley, Kathy P; Carter, Julie H; Di Minno, Mariann; Gardner, Joan; Giroux, Monique; González, Manny J; Holten, Sandra; Joseph, Ricky; Kornegay, Denise D; Simpson, Patricia A; Tomaino, Concetta M; Vandendolder, Richard P; Walde-Douglas, Maria; Wichmann, Rosemary; Morgan, John C

2016-01-01

Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice.

PubMed

Margham, Tom; Symes, Natalie; Hull, Sally A

2018-04-01

Identifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations. This study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety. Mixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice. The project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians. Trigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs' work is generally reactive and GPs welcomed an approach that identified patients who were 'under the radar' of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time. Electronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks. © British Journal of General Practice 2018.

Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

PubMed

von Babo, Michelle; Chmiel, Corinne; Müggler, Simon Andreas; Rakusa, Julia; Schuppli, Caroline; Meier, Philipp; Fischler, Manuel; Urner, Martin

2018-01-01

Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin <130 g/L for men and by 57% at <120 g/L in non-pregnant women). 62% and 43% respectively, did not define anemia in men and in women according to the World Health Organization. Fifty percent reported not to transfuse RBC according to international guidelines. Following factors were indicated to influence the decision to transfuse: educational background of the physicians, geographical region of employment, severity of anemia, and presence of known coronary artery disease. 60% indicated that their knowledge on Transfusion-related Acute Lung Injury (TRALI) did not influence transfusion practice. 50% of physicians stated that no local transfusion guidelines exist and 84% supported the development of national recommendations on transfusion in non-acutely bleeding, anemic patients. This study highlights the lack of adherence to current transfusion guidelines in Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

The sequence relay selection strategy based on stochastic dynamic programming

NASA Astrophysics Data System (ADS)

Zhu, Rui; Chen, Xihao; Huang, Yangchao

2017-07-01

Relay-assisted (RA) network with relay node selection is a kind of effective method to improve the channel capacity and convergence performance. However, most of the existing researches about the relay selection did not consider the statically channel state information and the selection cost. This shortage limited the performance and application of RA network in practical scenarios. In order to overcome this drawback, a sequence relay selection strategy (SRSS) was proposed. And the performance upper bound of SRSS was also analyzed in this paper. Furthermore, in order to make SRSS more practical, a novel threshold determination algorithm based on the stochastic dynamic program (SDP) was given to work with SRSS. Numerical results are also presented to exhibit the performance of SRSS with SDP.

The use of pre-natal diagnostic techniques for sex selection: the Indian scene.

PubMed

Kusum

1993-04-01

The use of pre-natal diagnostic techniques only for sex determination followed by termination of pregnancy on a finding of female foetus, is an atrocious and unethical practice. The bias against a female has been stretched further back: from cradle to grave, it is now from womb to the grave. One cannot however ignore the conditions of the society which breed and encourage such practices. A girl suffers neglect and discrimination right from childhood; she is tortured, harassed and maltreated after marriage. At the work place she is exploited. A widow or a divorcee is looked down upon by the family and the society. All these things make her life miserable and not worth existence....

The role of the situation in leadership.

PubMed

Vroom, Victor H; Jago, Arthur G

2007-01-01

Leadership depends on the situation. Few social scientists would dispute the validity of this statement. But the statement can be interpreted in many different ways, depending, at least in part, on what one means by leadership. This article begins with a definition of leadership and a brief description of 3 historically important theories of leadership. The most recent of these, contingency theories, is argued to be most consistent with existing evidence and most relevant to professional practice. The Vroom, Yetton, and Jago contingency models of participation in decision making are described in depth, and their work provides the basis for identifying 3 distinct ways in which situational or contextual variables are relevant to both research on and the practice of leadership. ((c) 2007 APA, all rights reserved)

How the dual process model of human cognition can inform efforts to de‐implement ineffective and harmful clinical practices: A preliminary model of unlearning and substitution

PubMed Central

Rose, Adam J.; Hartmann, Christine W.; van Bodegom‐Vos, Leti; Graham, Ian D.; Wood, Suzanne J.; Majerczyk, Barbara R.; Good, Chester B.; Pogach, Leonard M.; Ball, Sherry L.; Au, David H.; Aron, David C.

2018-01-01

Abstract Rationale and objectives One way to understand medical overuse at the clinician level is in terms of clinical decision‐making processes that are normally adaptive but become maladaptive. In psychology, dual process models of cognition propose 2 decision‐making processes. Reflective cognition is a conscious process of evaluating options based on some combination of utility, risk, capabilities, and/or social influences. Automatic cognition is a largely unconscious process occurring in response to environmental or emotive cues based on previously learned, ingrained heuristics. De‐implementation strategies directed at clinicians may be conceptualized as corresponding to cognition: (1) a process of unlearning based on reflective cognition and (2) a process of substitution based on automatic cognition. Results We define unlearning as a process in which clinicians consciously change their knowledge, beliefs, and intentions about an ineffective practice and alter their behaviour accordingly. Unlearning has been described as “the questioning of established knowledge, habits, beliefs and assumptions as a prerequisite to identifying inappropriate or obsolete knowledge underpinning and/or embedded in existing practices and routines.” We hypothesize that as an unintended consequence of unlearning strategies clinicians may experience “reactance,” ie, feel their professional prerogative is being violated and, consequently, increase their commitment to the ineffective practice. We define substitution as replacing the ineffective practice with one or more alternatives. A substitute is a specific alternative action or decision that either precludes the ineffective practice or makes it less likely to occur. Both approaches may work independently, eg, a substitute could displace an ineffective practice without changing clinicians' knowledge, and unlearning could occur even if no alternative exists. For some clinical practice, unlearning and substitution strategies may be most effectively used together. Conclusions By taking into account the dual process model of cognition, we may be able to design de‐implementation strategies matched to clinicians' decision‐making processes and avoid unintended consequence. PMID:29314508

Validity of a measure to assess healthy eating and physical activity policies and practices in Australian childcare services.

PubMed

Dodds, Pennie; Wyse, Rebecca; Jones, Jannah; Wolfenden, Luke; Lecathelinais, Christophe; Williams, Amanda; Yoong, Sze Lin; Finch, Meghan; Nathan, Nicole; Gillham, Karen; Wiggers, John

2014-06-09

Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously validated measures exist to measure healthy eating and physical activity policies and practices in this setting, and no such measures exist that are specific to the childcare setting in Australia. This was a cross sectional study, comparing two measures (pen and paper survey and observation) of healthy eating and physical activity policies and practices in childcare services. Research assistants attended consenting childcare services (n = 42) across the Hunter region of New South Wales, Australia and observed practices for one day. Nominated Supervisors and Room Leaders of the service also completed a pen and paper survey during the day of observation. Kappa statistics and proportion agreement were calculated for a total of 43 items relating to healthy eating and physical activity policies and practices. Agreement ranged from 38%-100%. Fifty one percent of items showed agreement of greater than or equal to 80%. Items assessing the frequency with which staff joined in active play with children reported the lowest percent agreement, while items assessing availability of beverages such as juice, milk and cordial, as well as the provision of foods such as popcorn, pretzels and sweet biscuits, reported the highest percent agreement. Kappa scores ranged from -0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement. The study found that Nominated Supervisors and Room Leaders were able to accurately report on a number of healthy eating and physical activity policies and practices. Items assessing healthy eating practices tended to have higher kappa scores than those assessing physical activity related policies or practices. The tool represents a useful instrument for public health researchers and policy makers working in this setting.

Labour saver or building a cohesive interprofessional team? The role of the nurse practitioner within hospitals.

PubMed

Hurlock-Chorostecki, Christina; Forchuk, Cheryl; Orchard, Carole; van Soeren, Mary; Reeves, Scott

2014-05-01

Nurse practitioners (NP) are employed within hospital interprofessional (IP) teams in several countries worldwide. There have been some efforts to describe the nature of the NP role within IP teams largely focussing on how the role may augment care processes. Here, using a constructivist grounded theory approach, the perceptions of NPs about their role were compared and integrated into a previously published team perspective as the second phase of a larger study. Seventeen hospital-based (HB) NPs across Ontario, Canada, participated in group and individual interviews. The NP perspective substantiated and expanded the previously reported team perspective, resulting in an IP perspective. The three practice foci illustrating role value meaning of this perspective became: evolve NP role and advance the specialty, focus on team working, and hold patient care together. The IP perspective, juxtaposed with an existing contingency approach, revealed that NPs were promoting IP work, predominantly at the collaboration and teamwork levels, and aiding IP team transitions to appropriate forms of IP work. The practice, "focus on team working"' was strongly related to promoting IP work. The findings were consistent with HB NPs enacting a role in building IP team cohesiveness rather than merely acting as a labour saver. This is the first study to align NP and team understanding of HB NP role value using an IP framework.

How are people with dementia involved in care-planning and decision-making? An Irish social work perspective.

PubMed

Donnelly, Sarah; Begley, Emer; O'Brien, Marita

2018-01-01

In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes. Data collection included a mixed method approach; an on-line survey of social workers from across the country who reported on their open caseload during the month of June 2015 (N = 38 social workers reporting on the experiences of 788 older people, of which 39% of older people had a formal diagnosis of dementia). In addition, semi-structured telephone interviews were conducted with social workers working in the nine Community Health Organisation areas (N = 21). Findings show that people with dementia were high users of social work services, accounting for 44.5% of the client group. Social workers reported that there were no standardised approaches to how Health and Social Care Professionals involved people with dementia in care planning and decision-making. Overall, people with dementia were more likely to be excluded from decision-making processes due to (i) assumptions that they lacked capacity, (ii) family members preferences that the person was not involved, (iii) communication difficulties, (iv) time constraints, (v) little or no opportunity given or (vi) the person delegated decision-making to others. Good practices were identified through multidisciplinary team approaches and formal care planning meetings. This research highlights variability in how people with dementia participate in decision-making around their care. It sheds light on existing barriers which challenge the full implementation of the Irish Assisted Decision-Making legislation; highlighting the need for appropriate guidance and education for Health and Social Care Professionals. The findings also show that family dynamics and existing relationships can play a role in how people with dementia participate and are involved. To ensure consistent opportunities for participation, effective practices and approaches to supporting the participation of people living with dementia in care planning needs to be developed and rolled out in all care settings through increased training and adoption of standardised approaches.

Persistent Identifiers: a Prerequisite to Establish the Framework for Scholarly Link Exchange—Scholix

NASA Astrophysics Data System (ADS)

Stocker, M.; Mokrane, M.; Burton, A.; Koers, H.

2016-12-01

The Scholix framework—Scholarly Link Exchange—is a set of aspirational principles and practical guidelines developed under the umbrella of a joint Working Group of the Research Data Alliance (RDA) and the World Data System (WDS). It supports a global open information ecosystem unveiling the links between scholarly literature and underpinning research data. The core objectives of the framework are to (1) increase visibility and discoverability of data and articles, (2) place data in context to enable re-use, and (3) support credit attribution mechanisms. Thus, facilitating reproducibility and the transparent evaluation of science. Scholix provides an evolving lightweight set of Guidelines to increase interoperability rather than a normative standard. It consists initially of a conceptual and information models, information standards and encoding guidelines, and options for encoding and exchange protocols. An essential prerequisite to enable the proposed framework is the use of global, unique and persistent identifiers for research objects (such as data and literature). Scholix provides incentives and encourages best practice in the use of such identifiers and standardised referencing. The Data and Literature Interlinking Service (DLI: dliservice.research-infrastructures.eu) is the first exemplar of an aggregation and query service supported by the Scholix framework which will allow the emergence of third party services such as domain-specific aggregations, integrations with other global services, discovery tools, impact assessments, etc. Scholix is already implemented by existing hubs or global aggregators of data-literature link information such as DataCite, CrossRef, OpenAIRE, and EMBL-EBI building on the capacities of existing Persistent Identifier Systems (PIDs) such as Digital Object Identifiers (DOI) and Accession Numbers. These hubs in turn work with their natural communities of data centres or literature publishers to collect the information through existing community-specific workflows and standards. Scholix as a technical solution to wholesale information aggregation will need to be complemented by other policy, practice and cultural change advocacy initiatives. This approach could be extended over time to other types of research objects in and beyond research.

Branding in children: a barbaric practice still exists in India

PubMed Central

Patra, Pratap Kumar

2016-01-01

Branding is an inhuman traditional practice most commonly employed to treat various disorders in neonates and children in certain community in India. Though stringent law exists to prevent such harmful practices, cases of branding is not uncommon in current era. PMID:27217887

How do dentists and their teams incorporate evidence about preventive care? An empirical study.

PubMed

Sbaraini, Alexandra; Carter, Stacy Marie; Evans, Robin Wendell; Blinkhorn, Anthony

2013-10-01

To identify how dentists and their teams adopt evidence-based preventive care. A qualitative study using grounded theory methodology was conducted. We interviewed 23 participants working in eight dental practices about their experience and work processes, while adopting evidence-based preventive care. During the study, Charmaz's grounded theory methodology was employed to examine the social process of adopting preventive dental care in dental practices. Charmaz's iteration of the constant comparative method was used during the data analysis. This involved coding of interview transcripts, detailed memo-writing and drawing diagrams. The transcripts were analyzed as soon as possible after each round of interviews in each dental practice. Coding was conducted primarily by AS, supported by team meetings and discussions when researchers compared their interpretations. Participants engaged in a slow process of adapting evidence-based protocols and guidelines to the existing logistics of the practices. This process was influenced by practical, philosophical, and historical aspects of dental care, and a range of barriers and facilitators. In particular, dentists spoke spontaneously about two deeply held 'rules' underpinning continued restorative treatment, which acted as barriers to provide preventive care: (i) dentists believed that some patients were too 'unreliable' to benefit from prevention; and (ii) dentists believed that patients thought that only tangible restorative treatment offered 'value for money'. During the adaptation process, some dentists and teams transitioned from their initial state - selling restorative care - through an intermediary stage - learning by doing and educating patients about the importance of preventive care - and finally to a stage where they were offering patients more than just restorative care. Resources were needed for the adaptation process to occur, including: the ability to maintain the financial viability of the practice, appropriate technology, time, and supportive dental team relationships. The findings from this study show that with considerable effort, motivation and coordination, it is possible for dental practices to work against the dental 'mainstream' and implement prevention as their clinical norm. This study has shown that dental practice is not purely scientific, but it includes cultural, social, and economic resources that interfere with the provision of preventive care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A masterclass to teach public health professionals to conduct practice-based research to promote evidence-based practice: a case study from The Netherlands.

PubMed

Jansen, Maria W J; Hoeijmakers, Marjan

2013-01-01

Public health professionals have a pivotal position in efforts to obtain more practice-based evidence about what people need and what works in real circumstances. Close collaboration with researchers should enable public health professionals to design and conduct research in practical settings to address today's complex public health problems and increase the external validity of results. This requires expanding the research competencies of public health professionals. We developed and implemented a masterclass for public health professionals, modeled on an existing scientific training course for general practitioners and rehabilitation physicians. The masterclass was evaluated using a multiple method design, involving quantitative and qualitative methods. Evaluation took place during, at the end of, and 9 months after the masterclass. Twenty-one candidates (mean age, 41 y) started the program, 66% of whom completed it. Teaching materials, lectures, organization, and facilities were favorably evaluated. At the end of the masterclass, participants were able to design and implement a research proposal in their daily work setting, write a draft article, and critically appraise scientific research for practice and policy purposes. Participants had become more confident about their research competence. Management support from their employer proved crucial. Results obtained with the different methods were consistent. The masterclass appeared to be an effective instrument to increase the practice-based research skills of public health professionals, provided the research is implemented in a supportive organization with management backing and supervision by senior university researchers. We recommend using masterclasses to contribute to the improvement of practice-based evidence for projects addressing current and future public health problems.

Internal medicine specialists' attitudes towards working part-time: a comparison between 1996 and 2004

PubMed Central

Lugtenberg, Marjolein; Heiligers, Phil JM; de Jong, Judith D; Hingstman, Lammert

2006-01-01

Background Although medical specialists traditionally hold negative views towards working part-time, the practice of medicine has evolved. Given the trend towards more part-time work and that there is no evidence that it compromises the quality of care, attitudes towards part-time work may have changed as well in recent years. The aim of this paper was to examine the possible changes in attitudes towards part-time work among specialists in internal medicine between 1996 and 2004. Moreover, we wanted to determine whether these attitudes were associated with individual characteristics (age, gender, investments in work) and whether attitudes of specialists within a partnership showed more resemblance than specialists' attitudes from different partnerships. Methods Two samples were used in this study: data of a survey conducted in 1996 and in 2004. After selecting internal medicine specialists working in general hospitals in The Netherlands, the sample consisted of 219 specialists in 1996 and 363 specialists in 2004. They were sent a questionnaire, including topics on the attitudes towards part-time work. Results Internal medicine specialists' attitudes towards working part-time became slightly more positive between 1996 and 2004. Full-time working specialists in 2004 still expressed concerns regarding the investments of part-timers in overhead tasks, the flexibility of task division, efficiency, communication and continuity of care. In 1996 gender was the only predictor of the attitude, in 2004 being a full- or a part-timer, age and the time invested in work were associated with this attitude. Furthermore, specialists' attitudes were not found to cluster much within partnerships. Conclusion In spite of the increasing number of specialists working or preferring to work part-time, part-time practice among internal medicine specialists seems not to be fully accepted. The results indicate that the attitudes are no longer gender based, but are associated with age and work aspects such as the number of hours worked. Though there is little evidence to support them, negative ideas about the consequences of part-time work for the quality of care still exist. Policy should be aimed at removing the organisational difficulties related to part-time work and create a system in which part-time practice is fully integrated and accepted. PMID:17026741

The importance of employee participation and perceptions of changes in procedures in a teamworking intervention

PubMed Central

Nielsen, Karina; Randall, Raymond

2012-01-01

The powerful positive results of implementing teamwork are not always achieved. It has been suggested that attempts to implement theories regarding teamwork do not always lead to those theories being put into practice, and as a result positive outcomes are not always found. The participation of employees in the development and implementation of an intervention may help to ensure that changes take place. In this longitudinal study (N = 583) of teamwork implementation in Denmark we examined the links between pre-intervention working conditions and well-being, levels of participation in planning and implementation, employees’ reports of changes in procedures, and intervention outcomes. Pre-intervention levels of autonomy and job satisfaction predicted the degree of employee participation in the planning and implementation of the intervention. Pre-intervention well-being and social support were linked directly to the degree to which employees reported changes in existing work practices concerning teamwork. In addition, participation and changes in work procedures were significantly associated with post-intervention autonomy, social support and well-being. The results indicate that employee participation in intervention processes is crucial in what appears to be an important association with perceived changes in procedures and, therefore, in intervention outcomes. PMID:22745519

Collaborative deliberation: a model for patient care.

PubMed

Elwyn, Glyn; Lloyd, Amy; May, Carl; van der Weijden, Trudy; Stiggelbout, Anne; Edwards, Adrian; Frosch, Dominick L; Rapley, Tim; Barr, Paul; Walsh, Thom; Grande, Stuart W; Montori, Victor; Epstein, Ronald

2014-11-01

Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Improving the Quality of Care for Patients Diagnosed With Glioma During the Perioperative Period

PubMed Central

Riblet, Natalie B.V.; Schlosser, Evelyn M.; Homa, Karen; Snide, Jennifer A.; Jarvis, Lesley A.; Simmons, Nathan E.; Sargent, David H.; Mason, Linda P.; Cooney, Tobi J.; Kennedy, Nancy L.; Fadul, Camilo E.

2014-01-01

Purpose: Although there is agreement on the oncologic management of patients with glioma, few guidelines exist to standardize other aspects of care, including supportive care. Methods: A quality improvement (QI) project was chartered to improve the care provided to patients with glioma. A multidisciplinary team was convened and identified 10 best-practice measures. Using a plan-do-study-act framework, the team brainstormed and implemented various improvement interventions between June 2011 and October 2012. Statistical process control charts were used to evaluate progress. A dashboard of quality measures was generated to allow for ongoing measurement and reporting. Results: The retrospective assessment phase consisted of 43 patients with diagnosis of glioma. A manual medical record review for these patients showed that compliance with 10 best-practice measures ranged from 23% to 100%. Several factors contributed to less-than-ideal process performance, including poor communication among disciplines and lack of familiarity with the larger system of care. After implementing improvement interventions, performance was measured in 96 consecutive patients with glioma. The proportion of patients who met criteria for 10 practice measures significantly improved (pre-QI work, 63%; post-QI work, 85%; P = .003). The largest improvement was observed in the measure assessing for preoperative notification of the neuro-oncology program (pre-QI work, 39%; post-QI work, 97%; P < .001). Conclusion: QI principles were used by a multidisciplinary team to improve the quality of care for patients with glioma during the perioperative period. Leadership involvement, ongoing dialogue across departments, and reporting of system performance were important for sustaining process improvements. PMID:25294392

The juxtaposition of ageing and nursing: the challenges and enablers of continuing to work in the latter stages of a nursing career.

PubMed

Clendon, Jill; Walker, Léonie

2016-05-01

To identify why some nurses cope well with continuing to work as they age and others struggle. There is a need to understand better the challenges older nurses face and how they manage them. Secondary analysis of existing data. Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data (n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews (n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies. Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice. While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers. © 2016 John Wiley & Sons Ltd.

The multiple meanings of global health governance: a call for conceptual clarity.

PubMed

Lee, Kelley; Kamradt-Scott, Adam

2014-04-28

The term global health governance (GHG) is now widely used, with over one thousand works published in the scholarly literature, almost all since 2002. Amid this rapid growth there is considerable variation in how the term is defined and applied, generating confusion as to the boundaries of the subject, the perceived problems in practice, and the goals to be achieved through institutional reform. This paper is based on the results of a separate scoping study of peer reviewed GHG research from 1990 onwards which undertook keyword searches of public health and social science databases. Additional works, notably books, book chapters and scholarly articles, not currently indexed, were identified through Web of Science citation searches. After removing duplicates, book reviews, commentaries and editorials, we reviewed the remaining 250 scholarly works in terms of how the concept of GHG is applied. More specifically, we identify what is claimed as constituting GHG, how it is problematised, the institutional features of GHG, and what forms and functions are deemed ideal. After examining the broader notion of global governance and increasingly ubiquitous term "global health", the paper identifies three ontological variations in GHG scholarship - the scope of institutional arrangements, strengths and weaknesses of existing institutions, and the ideal form and function of GHG. This has produced three common, yet distinct, meanings of GHG that have emerged - globalisation and health governance, global governance and health, and governance for global health. There is a need to clarify ontological and definitional distinctions in GHG scholarship and practice, and be critically reflexive of their normative underpinnings. This will enable greater precision in describing existing institutional arrangements, as well as serve as a prerequisite for a fuller debate about the desired nature of GHG.

The multiple meanings of global health governance: a call for conceptual clarity

PubMed Central

2014-01-01

Background The term global health governance (GHG) is now widely used, with over one thousand works published in the scholarly literature, almost all since 2002. Amid this rapid growth there is considerable variation in how the term is defined and applied, generating confusion as to the boundaries of the subject, the perceived problems in practice, and the goals to be achieved through institutional reform. Methodology This paper is based on the results of a separate scoping study of peer reviewed GHG research from 1990 onwards which undertook keyword searches of public health and social science databases. Additional works, notably books, book chapters and scholarly articles, not currently indexed, were identified through Web of Science citation searches. After removing duplicates, book reviews, commentaries and editorials, we reviewed the remaining 250 scholarly works in terms of how the concept of GHG is applied. More specifically, we identify what is claimed as constituting GHG, how it is problematised, the institutional features of GHG, and what forms and functions are deemed ideal. Results After examining the broader notion of global governance and increasingly ubiquitous term “global health”, the paper identifies three ontological variations in GHG scholarship - the scope of institutional arrangements, strengths and weaknesses of existing institutions, and the ideal form and function of GHG. This has produced three common, yet distinct, meanings of GHG that have emerged – globalisation and health governance, global governance and health, and governance for global health. Conclusions There is a need to clarify ontological and definitional distinctions in GHG scholarship and practice, and be critically reflexive of their normative underpinnings. This will enable greater precision in describing existing institutional arrangements, as well as serve as a prerequisite for a fuller debate about the desired nature of GHG. PMID:24775919

The Geoscience Paper of the Future: Best Practices for Documenting and Sharing Research from Data to Software to Provenance

NASA Astrophysics Data System (ADS)

Gil, Y.; Yu, X.; David, C. H.; Demir, I.; Essawy, B.; Fulweiler, R. W.; Goodall, J. L.; Karlstrom, L.; Lee, H.; Mills, H. J.; Pierce, S. A.; Pope, A.; Tzeng, M.; Villamizar, S. R.

2016-12-01

Geoscientists live in a world rich with digital data and methods, and their computational research cannot be fully captured in traditional publications. The Geoscience Paper of the Future (GPF) proposes best practices for GPF authors to make data, software, and methods openly accessible, citable, and well documented. Those best practices come from recommendations by both scholars and organizations concerning open science, reproducible publications, and digital scholarship. The publication of digital objects empowers scientists to manage their research products as valuable scientific assets in an open and transparent way that enables broader access by other scientists, students, decision makers, and the public. Improving documentation and dissemination of research will accelerate the pace of scientific discovery by improving the ability of others to build upon published work. This presentation summarizes these best practices, as well as the practical experiences of several GPF authors in different geosciences disciplines. It will also discuss existing challenges for authors and publishers to produce GPFs in practice, and the opportunities to develop new approaches and infrastructure to implement those best practices. The adoption of GPF recommendations requires awareness and social change in the scientific community, including clear communication of the benefits and best practices that may be new to geoscientists.

[Identification of Good-Practice Projects in Promoting Physical Activity - Methods, Pitfalls and Sampled Outcomes].

PubMed

Henn, Annette; Karger, Claudia; Wöhlken, Katrin; Meier, Diana; Ungerer-Röhrich, Ulrike; Graf, Christine; Woll, Alexander

2017-03-01

The aim of this paper is to identify and show examples of good practice of public health promotion. For this, uniform quality criteria were worked out under consideration of national and international scientific literature.For the identification of examples of good practice, a comparison of different quality criteria was carried out and combined with each other in a first step. In the following step, examples of good practice were identified after a comprehensive search. The choice of the "good-practice" projects is exemplary and lays no claim to completeness.6 main quality criteria (QC) of programs promoting physical activity could be identified in the national and international context. The analysis showed altogether 10 projects which can exemplarily be classified as examples of good practice of the target groups of children and teenagers, adults, older people and people with pre-existing illnesses. These projects, however, show major differences in their (methodological) quality.The analysis reports a lack of "Good-Practice" examples. Deficits lie mainly in documentation and sustainability. Because of incomplete documentation, an assessment as a "Good-Practice" example is only possible to a limited extent; a lot of information, particularly in the evaluation, is missing. © Georg Thieme Verlag KG Stuttgart · New York.

Sharing lessons learned and best practices in deactivation and decommissioning techniques among U.S. Department of Energy contractors

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

Lackey, Michael B.; Waisley, Sandra L.; Dusek, Lansing G.

2007-07-01

Approximately $153.2 billion of work currently remains in the United States Department of Energy's (DOE's) Office of Environmental Management (EM) life cycle budget for United States projects. Contractors who manage facilities for the DOE have been challenged to identify transformational changes to reduce the life cycle costs and develop a knowledge management system that identifies, disseminates, and tracks the implementation of lessons learned and best practices. At the request of the DOE's EM Office of Engineering and Technology, the Energy Facility Contractors Group (EFCOG) responded to the challenge with formation of the Deactivation and Decommissioning (D and D) and Facilitymore » Engineering (DD/FE) Working Group. Since October 2006, members have already made significant progress in realizing their goals: adding new D and D best practices to the existing EFCOG Best Practices database; participating in lessons learned forums; and contributing to a DOE initiative on identifying technology needs. The group is also participating in a DOE project management initiative to develop implementation guidelines, as well as a DOE radiation protection initiative to institute a more predictable and standardized approach to approving authorized limits and independently verifying cleanup completion at EM sites. Finally, a D and D hotline to provide real-time solutions to D and D challenges is also being launched. (authors)« less

Sex and Employment-Setting Differences in Work-Family Conflict in Athletic Training.

PubMed

Mazerolle, Stephanie M; Eason, Christianne M; Pitney, William A; Mueller, Megan N

2015-09-01

Work-family conflict (WFC) has received much attention in athletic training, yet several factors related to this phenomenon have not been examined, specifically a practitioner's sex, occupational setting, willingness to leave the profession, and willingness to use work-leave benefits. To examine how sex and occupational differences in athletic training affect WFC and to examine willingness to leave the profession and use work-leave benefits. Cross-sectional study. Multiple occupational settings, including clinic/outreach, education, collegiate, industrial, professional sports, secondary school, and sales. A total of 246 athletic trainers (ATs) (men = 110, women = 136) participated. Of these, 61.4% (n = 151) were between 20 and 39 years old. Participants responded to a previously validated and reliable WFC instrument. We created and validated a 3-item instrument that assessed willingness to use work-leave benefits, which demonstrated good internal consistency (Cronbach α = 0.88), as well as a single question about willingness to leave the profession. The mean (± SD) WFC score was 16.88 ± 4.4 (range = 5 [least amount of conflict] to 25 [highest amount of conflict]). Men scored 17.01 ± 4.5, and women scored 16.76 ± 4.36, indicating above-average WFC. We observed no difference between men and women based on conflict scores (t244 = 0.492, P = .95) or their willingness to leave the profession (t244 = -1.27, P = .21). We noted differences among ATs in different practice settings (F8,245 = 5.015, P <.001); those in collegiate and secondary school settings had higher reported WFC scores. A negative relationship existed between WFC score and comfort using work-leave benefits (2-tailed r = -0.533, P < .001). Comfort with using work-leave benefits was different among practice settings (F8,245 = 3.01, P = .003). The ATs employed in traditional practice settings reported higher levels of WFC. Male and female ATs had comparable experiences of WFC and willingness to leave the profession.

Experiences of undergraduate nursing students in peer assisted learning in clinical practice: a qualitative systematic review.

PubMed

Carey, Matthew C; Kent, Bridie; Latour, Jos M

2018-05-01

The objective of this qualitative systematic review was to identify and synthesize the best available evidence on experiences of peer assisted learning (PAL) among student nurses in clinical practice so as to understand the value of PAL for this population. Peer-assisted learning considers the benefits of peers working in collaboration and supporting each other in professional roles. This approach to facilitate learning is effective within universities, but there is limited exploration within the clinical practice environment. Within the UK, 50% of student nurses' learning is undertaken within clinical practice, providing a large portion of student allocation within these areas, but is unexplored in relation to PAL. Therefore, existing evidence examining PAL in clinical practice needs further exploration for a better understanding of its value to student nurses' learning. The systematic review considered studies that included male and female nursing students aged 18-50 years that explored undergraduate nursing students' experiences of PAL within the clinical practice environment. Studies that utilized designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered. Other text such as opinion papers and reports were to be considered if no qualitative studies could be located. The review excluded quantitative studies, as well as those addressing PAL outside the nursing profession and students within the nursing profession but not including undergraduate student nurses. This review considered studies that included aspects related to experiences of PAL in the clinical practice setting, as seen by undergraduate nursing students and the researcher. A three-step search strategy was undertaken to find both published and unpublished studies in English from 2003 to 2017 in various databases, and included searching of reference lists within articles selected for appraisal. Each of the included studies were assessed for methodological quality independently by two reviewers, using the Joanna Briggs Institute Critical Appraisal Form for Interpretive and Critical Research. Qualitative data was extracted using the standardized JBI qualitative data extraction tool. Qualitative research findings were synthesized using JBI methodology. From the eight included studies, 37 findings were extracted. These findings were further aggregated into seven categories, and then into three synthesized findings. These three synthesized findings are: 1) Challenges of clinical practice are mitigated by peer support; 2) Peers are role models for enhancing clinical knowledge; and 3) Support and feedback develop competence and confidence, and reduce stress and anxiety. Peer-assisted learning exists in clinical practice in both formal and informal circumstances. Friendship and community are often expressed as occurring when peers work together. Support and feedback help students develop in their clinical role and enhance clinical knowledge. Outcomes include enhancing the competency and confidence of peers, and reducing stress and anxiety. Challenges of clinical practice are mitigated through PAL.

Sustaining a culture of practice development in an acute adolescent inpatient mental health unit.

PubMed

Vella, Natalie; Page, Laura; Edwards, Clair; Wand, Timothy

2014-08-01

It is recognized that facilitating change in workplace culture is a significant challenge in healthcare service delivery. Practice development strategies and principles provide a framework for initiating and sustaining programs focused on enhancing patient-centered care by concentrating on the therapeutic attributes of nursing. However, little literature exists on explicating "what worked" in practice development programs. This paper details the processes, people, resources, and relationships that enabled the successful implementation, and led to the sustainability, of a practice development program employed in an acute adolescent mental health unit in Sydney, Australia. Following an external review of the unit, a meeting of key stakeholders was convened and subsequently an advisory panel formed to address specific issues facing nursing staff. This process resulted in the development of an educational package and adoption of the tidal model as the framework for mental health nursing practice in the unit. Clinical reasoning sessions and journal article presentations were incorporated to consolidate and maintain the change in nursing care. A planned, structured, and inclusive practice development program has transformed the nursing culture and vastly improved the care provided to adolescents presenting in acute states of distress to this mental health unit. © 2014 Wiley Periodicals, Inc.

Experiences of mental health nursing staff working with voice hearers in an acute setting: An interpretive phenomenological approach.

PubMed

McMullan, E; Gupta, A; Collins, S C

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice-hearing experiences and accessing reflective practice forums. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Introduction Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were interviewed. The data were analysed using Interpretative Phenomenological Analysis. Results A group analysis elicited three master themes: "It's quite scary really, not unlike a horror movie;" "I can only influence what's in front of me;" and "Just chipping away". Discussion Staff working with voice hearers in acute settings experience feelings of powerlessness and helplessness, as they feel unable to reduce the distress experienced by voice hearers in their care. Staff employ coping strategies to help manage these difficult feelings, including using structured tools in their work with voice hearers and attending reflective practice forums. Implications for Practice Acute mental health services may need to protect time for staff to access regular reflective practice and other supervision forums to help manage their feelings of powerlessness and helplessness arising from their work with voice hearers. © 2017 John Wiley & Sons Ltd.

Numerical simulation on dimension decrease for annular casing of one centrifugal boiler circulation pump

NASA Astrophysics Data System (ADS)

Fan, Y. Z.; Zuo, Z. G.; Liu, S. H.; Wu, Y. L.; Sha, Y. J.

2012-11-01

Primary formulation derivation indicates that the dimension of one existing centrifugal boiler circulation pump casing is too large. As great manufacture cost can be saved by dimension decrease, a numerical simulation research is developed in this paper on dimension decrease for annular casing of this pump with a specific speed equaling to 189, which aims at finding an appropriately smaller dimension of the casing while hydraulic performance and strength performance will hardly be changed according to the requirements of the cooperative company. The research object is one existing centrifugal pump with a diffuser and a semi-spherical annular casing, working as the boiler circulation pump for (ultra) supercritical units in power plants. Dimension decrease, the modification method, is achieved by decreasing the existing casing's internal radius (marked as "Ri0") while keeping the wall thickness. The research analysis is based on primary formulation derivation, CFD (Computational Fluid Dynamics) simulation and FEM (Finite Element Method) simulation. Primary formulation derivation estimates that a design casing's internal radius should be less than 0.75 Ri0. CFD analysis indicates that smaller casing with 0.75 Ri0 has a worse hydraulic performance when working at large flow rates and a better hydraulic performance when working at small flow rates. In consideration of hydraulic performance and dimension decrease, an appropriate casing's internal radius is determined, which equals to 0.875 Ri0. FEM analysis then confirms that modified pump casing has nearly the same strength performance as the existing pump casing. It is concluded that dimension decrease can be an economical method as well as a practical method for large pumps in engineering fields.

A new method for designing dual foil electron beam forming systems. I. Introduction, concept of the method

NASA Astrophysics Data System (ADS)

Adrich, Przemysław

2016-05-01

In Part I of this work existing methods and problems in dual foil electron beam forming system design are presented. On this basis, a new method of designing these systems is introduced. The motivation behind this work is to eliminate the shortcomings of the existing design methods and improve overall efficiency of the dual foil design process. The existing methods are based on approximate analytical models applied in an unrealistically simplified geometry. Designing a dual foil system with these methods is a rather labor intensive task as corrections to account for the effects not included in the analytical models have to be calculated separately and accounted for in an iterative procedure. To eliminate these drawbacks, the new design method is based entirely on Monte Carlo modeling in a realistic geometry and using physics models that include all relevant processes. In our approach, an optimal configuration of the dual foil system is found by means of a systematic, automatized scan of the system performance in function of parameters of the foils. The new method, while being computationally intensive, minimizes the involvement of the designer and considerably shortens the overall design time. The results are of high quality as all the relevant physics and geometry details are naturally accounted for. To demonstrate the feasibility of practical implementation of the new method, specialized software tools were developed and applied to solve a real life design problem, as described in Part II of this work.

The work and challenges of care managers in the implementation of collaborative care: A qualitative study.

PubMed

Overbeck, G; Kousgaard, M B; Davidsen, A S

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: In collaborative care models between psychiatry and general practice, mental health nurses are used as care managers who carry out the treatment of patients with anxiety or depression in general practice and establish a collaborating relationship with the general practitioner. Although the care manager is the key person in the collaborative care model, there is little knowledge about this role and the challenges involved in it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our study shows that before the CMs could start treating patients in a routine collaborative relationship with GPs, they needed to carry out an extensive amount of implementation work. This included solving practical problems of location and logistics, engaging GPs in the intervention, and tailoring collaboration to meet the GP's particular preferences. Implementing the role requires high commitment and an enterprising approach on the part of the care managers. The very experienced mental health nurses of this study had these skills. However, the same expertise cannot be presumed in a disseminated model. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: When introducing new collaborative care interventions, the care manager role should be well defined and be well prepared, especially as regards the arrival of the care manager in general practice, and supported during implementation by a coordinated leadership established in collaboration between hospital psychiatry and representatives from general practice. Introduction In collaborative care models for anxiety and depression, the care manager (CM), often a mental health nurse, has a key role. However, the work and challenges related to this role remain poorly investigated. Aim To explore CMs' experiences of their work and the challenges they face when implementing their role in a collaborative care intervention in the Capital Region of Denmark. Methods Interviews with eight CMs, a group interview with five CMs and a recording of one supervision session were analysed by thematic analysis. Results The CM carried out considerable implementation work. This included finding suitable locations; initiating and sustaining communication with the GPs and maintaining their engagement in the model; adapting to the patient population in general practice; dealing with personal security issues, and developing supportive peer relations and meaningful supervision. Discussion We compare our findings to previous studies of collaborative care and advanced nursing roles in general practice. The importance of organizational leadership to support the CM's bridge-building role is emphasized. Implications for practice The planners of new collaborative care interventions should not only focus on the CM's clinical tasks but also on ensuring the sufficient organizational conditions for carrying out the role. © 2017 John Wiley & Sons Ltd.

48 CFR 227.7105-3 - Acquisition of modified existing works.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Rights in Technical Data 227.7105-3 Acquisition of modified existing works. Use the clause at 252.227-7020, Rights in Special Works, in solicitations and contracts for modified existing works in lieu of the clause at 252.227-7021, Rights in Data—Existing Works. ...

24 CFR 107.51 - Findings of noncompliance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... shall be made in any case in which the facts establish the existence of a discriminatory practice under § 107.15(g) (c) The existence or use of a policy or practice, or any arrangement, criterion or other... business necessity or governmental purpose of the respondent; (2) The policy or practice effectively...

Developing Culturally Responsive Teaching through Professional Noticing within Teacher Educator Modelling

ERIC Educational Resources Information Center

Averill, Robin; Anderson, Dayle; Drake, Michael

2015-01-01

Much evidence exists that culturally responsive and equitable teaching practices are challenging to develop. Evidence exists that in-the-moment coaching of "rehearsals" of practice can help foster mathematics teaching strategies, but how such coaching can assist the development of culturally responsive practice is less clear. Drawn from…

State-Level Farmers Market Activities: A Review of CDC-Funded State Public Health Actions That Support Farmers Markets.

PubMed

Kahin, Sahra A; Wright, Demia S; Pejavara, Anu; Kim, Sonia A

Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)'s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels. For this project, we identified state-level farmers market activities completed with CDC's DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state. We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words "farm," "market," "produce market," and "produce stand." State data with at least one state-level farmers market action present were then coded for the presence of itemized activities. Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices. Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land-use policies, can be adopted as methods for farmers market policy and practice work. The activities identified in this study can inform future planning at the state and federal levels on environment, policy, and systems approaches that improve the food environment through farmers markets.

21 CFR 1309.62 - Termination of registration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... terminate if and when such person dies, ceases legal existence, or discontinues business or professional practice. Any registrant who cases legal existence or discontinues business or professional practice shall...

Can Western quality improvement methods transform the Russian health care system?

PubMed

Tillinghast, S J

1998-05-01

The Russian health care system largely remains the same system that was in place during the existence of the Soviet Union. It is almost entirely state owned and operated, although ownership and management have developed from the central government to the oblast (province). The ZdravReform (Health Reform) Program (ZRP) in Russia, which began in 1993, included the goal of improving the quality and cost-effectiveness of the health care system. Work on introducing continuous quality improvement (CQI), evidence-based practice guidelines, and indicators of quality was conducted in 1995-1996. INTRODUCING EVIDENCE-BASED MEDICINE: As a result of the poor quality of Russian-language medical journals and the inability to gain access to the knowledge available in Western medical literature, Russian medical practices have not kept up with the rapid evolution of evidence-based medical practice that has begun transforming Western medicine. A number of evidence-based clinical practice guidelines were translated and disseminated to Russian-speaking physicians working in facilities participating in ZRP in Russia and Central Asia. Given the limitations of existing measures of the quality of care, indicators were developed for participating ambulatory polyclinics in several oblasts in Siberia. Russian physicians responsible for quality of care for their respective oblasts formed a working group to develop the indicators. A clinical information system that would provide automated collection and analysis of the indicator data-as well as additional patient record information-was also developed. CQI activities, entailing a multidisciplinary, participatory team approach, were conducted in four oblasts in western Siberia. Projects addressed the management of community-acquired pneumonia and reduction of length of stay after myocardial infarction (MI). One of the oblasts provided an example of a home-grown evidence-based protocol for post-MI care, which was adopted in the other three oblasts. Evidence-based medicine is critically needed to improve the quality of research and publications, medical education, and medical practice. Physicians everywhere are data driven; they change their practices when convinced by good data. The key to successful introduction of evidence-based medicine is understanding the fundamentals of good scientific method as applied to medicine. The Russian health care system's experience in reporting to higher authorities' process and outcomes data that resemble our modern indicators can provide the basis for accurate and valid measures of quality. In contrast with American expectations that a significant cultural change in an organization could take years, even with great effort, Russian physicians and other clinicians rapidly assimilated the new concepts of QI and put them to use. More on-site assistance by international medical consultants will still be needed for several years to hasten the process of change and ensure that it does not become stalled.

Gender-based salary inequity in social work: mediators of gender's effect on salary.

PubMed

Koeske, Gary F; Krowinski, William J

2004-04-01

This study examined the direct effect of gender, controlling for years of experience, job role, and other variables, in a sample of 359 Pennsylvania social workers. Men social workers received significantly more yearly salary (an estimated 3,665 dollars more) than women social workers. A path analysis suggested that the salary advantage for men that was attributable to their acquiring more experience and management positions was slightly larger than the direct effect of gender. The ability of merit variables to explain salary was somewhat greater for men than women. Other variables that mediated the effect of gender on salary were MSW specialization, working in a social work or a related area, and practice area (children and youths, health, mental health, or other area). The results suggest that substantial gender disparity continues to exist in social worker salaries.