The role of extended duties dental nurses in applying fluoride varnish for the prevention and control of dental caries.

PubMed

Jones, Colwyn M; Walker, Alan

2010-10-01

The role of extended duties dental nurses (EDDNs) in undertaking preventive dental care has provided an opportunity for their direct involvement in patient care, both at an individual patient level and as part of a population wide health improvement initiative. The article describes the developing role of the dental nurse in the clinical application of fluoride varnish, with associated evidence of effectiveness for the prevention and control of dental caries. The use of fluoride varnish as being central to caries preventive programmes for individual patients judged at risk of future dental caries is considered. A Scottish dental public health initiative which utilizes these extended skills and the benefits of fluoride varnish application is described. This paper illustrates how EDDNs can help to foster a greater team approach to overall patient care and preventive practice by applying fluoride varnish as part of an effective caries preventive programme.

Extended roles for allied health professionals: an updated systematic review of the evidence

PubMed Central

Saxon, Robyn L; Gray, Marion A; Oprescu, Florin I

2014-01-01

Background Internationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services. Methods A systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction. Results A total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review. Conclusion Literature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer-accepted investment that health services can make to improve patient outcomes. PMID:25342909

New roles and challenges within the healthcare workforce: a Heideggerian perspective.

PubMed

Wilson, Anthea

2015-01-01

The purpose of this paper is to explore insights based on the phenomenology of Martin Heidegger, on the dynamic relationships between human experience and work roles. Drawing on the findings of a hermeneutic phenomenological study of nurse mentors, the topics of new roles and role challenges are explored, along with a consideration of their relevance to wider issues of workforce redesign. Heidegger's philosophy of Dasein, in particular his concepts of inauthentic and authentic self, provided an interpretational lens. This paper applies these philosophical concepts to challenges associated with a changing workforce. Concepts elaborating human existence as proposed by Heidegger may offer analytic structures for understanding shifts in the lived experience of a changing workplace. In particular, the concepts could help managers to explore the implications of introducing novel work roles or extending roles. The understanding gained can also extend to situations where work practices may need to be challenged. As work roles and skill mix undergo rapid shifts, this paper offers an original way of understanding the experience of work roles.

Public health for the twenty-first century: what role do veterinarians in clinical practice play?

PubMed

Trevejo, Rosalie T

2009-03-01

All veterinarians, regardless of their formal job description, serve the public good and contribute to public health. The public health activities veterinarians engage in most frequently in clinical practice are in the areas of disease detection, reporting, and prevention. This article provides a brief overview of the basic functions of public health, while emphasizing the public health roles that veterinary clinicians play in their day-to-day practice of veterinary medicine and how they might extend their interest and involvement in this field. The multidisciplinary nature of the field of public health and the benefits of collaboration with other health care and public health professionals are also discussed.

Role of champions in the implementation of patient safety practice change.

PubMed

Soo, Stephanie; Berta, Whitney; Baker, G Ross

2009-01-01

Practitioners of patient safety practice change agree that champions are central to the success of implementation. The clinical champion role is a concept that has been widely promoted yet empirically underdeveloped in health services literature. Questions remain as to who these champions are, what roles they play in patient safety practice change and what contexts serve to facilitate their efforts. This investigation used a multiple-case study design to critically examine the role of champions in the implementation of rapid response teams (RRTs), an innovative complex patient safety intervention, in two large urban acute care facilities. An analysis of interviews with key individuals involved in the RRT implementation process revealed a typology of the patient safety practice champion that extended beyond clinical personnel to include managerial and executive staff. Champions engaged to a varying extent in a number of core activities, including education, advocacy, relationship building and boundary spanning. Individuals became champions both through informal emergence and a combination of formal appointment and informal emergence. By identifying and elaborating upon specific features of the champion role, this study aims to expand the dialogue about champions for patient safety practice change.

Delineating advanced practice nursing in New Zealand: a national survey.

PubMed

Carryer, J; Wilkinson, J; Towers, A; Gardner, G

2018-03-01

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

A study of role expansion: a new GP role in cardiology care

PubMed Central

2014-01-01

Background The National Health Service is reconfiguring health care services in order to meet the increasing challenge of providing care for people with long-term conditions and to reduce the demand on specialised outpatient hospital services by enhancing primary care. A review of cardiology referrals to specialised care and the literature on referral management inspired the development of a new GP role in Cardiology. This new extended role was developed to enable GPs to diagnose and manage patients with mild to moderate heart failure or atrial fibrillation and to use a range of diagnostics effectively in primary care. This entailed GPs participating in a four-session short course with on-going clinical supervision. The new role was piloted in a small number of GP practices in one county in England for four months. This study explores the impact of piloting the Extended Cardiology role on the GP’s role, patients’ experience, service delivery and quality. Methods A mixed methods approach was employed including semi-structured interviews with GPs, a patient experience survey, a quality review of case notes, and analysis on activity and referral data. Results The participating GPs perceived the extended GP role as a professional development opportunity that had the potential to reduce healthcare utilisation and costs, through a reduction in referrals, whilst meeting the patient’s wishes for the provision of care closer to home. Patient experience of the new GP service was positive. The standard of clinical practice was judged acceptable. There was a fall in referrals during the study period. Conclusion This new role in cardiology was broadly welcomed as a model of care by the participating GPs and by patients, because of the potential to improve the quality of care for patients in primary care and reduce costs. As this was a pilot study further development and continuing evaluation of the model is recommended. PMID:24885826

The Role of Educational Psychologists in Supporting Post-16 Transition: Findings from the Literature

ERIC Educational Resources Information Center

Morris, Rachel; Atkinson, Cathy

2018-01-01

The Children and Families Act (2014) has seen the extension of the role of educational psychologists (EPs) to cover the age range from birth to 25 years. EPs have had to develop and extend their practice to meet the needs of post-16 young people with special educational needs and disabilities. Research on transition from compulsory education to…

The Principal's Role in Leading Instructional Change: A Case Study in New Program Adoption

ERIC Educational Resources Information Center

Breon, Amy

2016-01-01

The noise in generating an agreed upon definition of instructional leadership that extends beyond theory to the practice of principals has been almost deafening in the last few decades. Many emphasize the need for the role of the principal to adapt to meet the demands of leadership that maximizes student achievement, but lack the specificity to…

VA staff perceptions of the role of the extended care referral process in home and community-based services versus nursing home use posthospital discharge.

PubMed

Miller, Edward Alan; Intrator, Orna; Gadbois, Emily; Gidmark, Stefanie; Rudolph, James L

2017-01-01

Little is known about how the extended care referral process-its structure and participants-influences Veterans' use of home and community-based services (HCBS) over nursing home care within the Veterans Health Administration (VHA). This study thus characterizes the extended care referral process within the VHA and its impact on HCBS versus nursing home use at hospital discharge. Data derive from 35 semistructured interviews at 12 Veterans Affairs Medical Centers (VAMCs). Findings indicate that the referral process is characterized by a commitment by care teams to consider HCBS if possible, varied practice depending on the clinician that most heavily influences care team recommendations, and care team emphasis on respecting Veteran/family preferences even when they are contrary to care team recommendations. Potential modifications include adopting systematic assessment practices; improving Veteran, family, and provider education; and promoting informed selection through shared decision making.

A Critical Evaluation of Phrónêsis as a Key Tool for Professional Excellence for Modern Managers

ERIC Educational Resources Information Center

Thomas, Shinto

2017-01-01

Phrónêsis or practical wisdom is an important element of Aristotelian virtue ethics. This paper is an attempt to study what is meant by Phrónêsis, how it might be understood, reinterpreted, applied, and extended in contemporary professional management practice and its role in enhancing professional excellence in modern managers. Phrónêsis can…

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan.

PubMed

Hashmi, Furqan K; Hassali, Mohamed Azmi; Khalid, Adnan; Saleem, Fahad; Aljadhey, Hisham; Babar, Zaheer Ud Din; Bashaar, Mohammad

2017-07-19

In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

Faith community nursing scope of practice: extending access to healthcare.

PubMed

Balint, Katherine A; George, Nancy M

2015-01-01

The role of the Faith Community Nurse (FCN) is a multifaceted wholistic practice focused on individuals, families, and the faith and broader communities. The FCN is skilled in professional nursing and spiritual care, supporting health through attention to spiritual, physical, mental, and social health. FCNs can help meet the growing need for healthcare, especially for the uninsured, poor, and homeless. The contribution of FCNs on, primary prevention, health maintenance, and management of chronic disease deserves attention to help broaden understanding of the scope of FCN practice.

Seeking balance between the past and the present: Vietnamese refugee parenting practices and adolescent well-being.

PubMed

Tingvold, Laila; Hauff, Edvard; Allen, James; Middelthon, Anne-Lise

2012-07-01

This qualitative study examines the resources that Vietnamese refugee parents use in raising their adolescent youth in exile and how they, and their adolescents, regard their experiences of different parenting styles. The study is based on 55 semi-structured interviews and several focus groups performed with a small sample of Vietnamese refugee parents and their adolescent children. Three main themes from the interviews were identified: the role of the extended family and siblings in bringing up children; language acquisition and cultural continuity and, finally, religion and social support. Our findings suggest extended kin are involved in the raising of adolescent children, providing additional family ties and support. Parents regarded Vietnamese language acquisition by their youth as facilitating both communication with extended kin and cultural transmission. Several parents stressed the importance of religious community to socialising and creating a sense of belonging for their youth. Vietnamese refugee parents seek a balance between Vietnamese values and their close extended family social networks, and the opportunities in Norway to develop autonomy in pursuit of educational and economic goals. Together these parenting practices constituted a mobilization of resources in support of their youth. These findings may have important implications for future research on resiliency and the role of these strategies as protective factors mediating mental health outcomes. They may also have implications for treatment, in terms of the types of resources treatment can access and for prevention strategies that maximize key cultural resources for Vietnamese refugee youth.

Effects of Organizational Role and Culture on Participation in Continuing Professional Education.

ERIC Educational Resources Information Center

Grzyb, Stanley W.; And Others

This study extends the investigation of professionals' reasons for participation in continuing education beyond personal and practice-based factors into the arena of organizational structure and culture. The Participation Reasons Scale (PRS) and the Respondent Information Form (RIF) were used to examine the motives influencing Army Engineers…

Kortright Centre for Conservation: Forestry Theme.

ERIC Educational Resources Information Center

Foster, Allan

One of a series of four reports on specific conservation themes, this report on forestry is intended to consolidate techniques which will best communicate the legislation, role, objectives and practices of the Metropolitan Toronto and Region Conservation Authority in retaining forest cover and extending it over additional areas. Facilities and…

Intercultural Identities: Addressing the Global Dimension through Art Education

ERIC Educational Resources Information Center

Bianchi, June

2011-01-01

Recent educational policy and practice have established an extended role for all subjects in addressing children and young peoples' academic and interpersonal development, with strategies facilitating key skills and wider learning across areas of Citizenship and Personal, Social and Health education providing an integrated approach to education…

Relative professional roles in antenatal care: results of a survey in Scottish rural general practice.

PubMed

Farmer, Jane; Stimpson, Paul; Tucker, Janet

2003-11-01

There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.

A qualitative study exploring midwives' perceptions and views of extending their role to the examination of the newborn baby.

PubMed

Rogers, Catherine; Bloomfield, Linda; Townsend, Joy

2003-03-01

to explore midwives' attitudes and perceptions about extending their role to the examination of the newborn baby, as well as their general perceptions and attitudes to new role developments. qualitative, data collected using semi-structured interviews, which were exploratory and interactive in form. six maternity hospitals in South-east England. ten midwives were purposefully selected, including five trained in the examination of the newborn baby and currently conducting examinations and five who had not. Most of the midwives had been qualified for over ten years and had a wide range of clinical experience in hospital and community settings. midwives identified many benefits to themselves, to their profession and to the mothers as a result of developing their role into the examination of the newborn baby. The major benefit cited was improved job satisfaction, which was directly related to their ability to give continuity and total care to mothers and babies. Midwives also perceived that undertaking the examination strengthened their position as autonomous practitioners, by enabling them to provide total care to mothers and babies who fitted their criteria of normality. Moreover, midwives thought that improvements in the overall quality of care to mothers would result from them performing the examination, including improved communication, greater continuity of care and a more holistic examination. Although midwives were concerned about possible increase in workloads and pressure to take on new roles, the examination was generally perceived as being easily incorporated into their current practice without compromising overall standards in midwifery care. Midwives expressed concern about 'extending' practice into areas that did not fit their perceptions of normality and about being 'pressurised' into taking on new roles. it would appear from this study that an important consideration for midwives in their acceptance of new roles, is the relationship of that role to their position as experts in normality. Midwives in this study viewed the examination of the newborn baby as 'fitting in' with their perceptions of the core values of midwifery.

An Examination of the Role of Emotions in Antiracist Pedagogy: Implications, Scholarship, and Practices

ERIC Educational Resources Information Center

Grosland, Tanetha J.

2013-01-01

Tanetha Grosland's goal is to inform and extend the current knowledge base concerning the intersection of antiracist pedagogy and emotions, and its implications for reconceptualizing such pedagogy. Therefore, she begins by addressing some fundamental theoretical claims about antiracist education. Then utilizing two sources to contextualize…

Complexity Thinking Mentorship: An Emergent Pedagogy of Graduate Research Development

ERIC Educational Resources Information Center

Kalin, Nadine M.; Barney, Daniel T.; Irwin, Rita L.

2009-01-01

In this article we articulate a view of mentoring that extends into interactive and relational forms, fostering a redefinition of traditional roles and practices within mentor-protege models. From the perspectives of a senior administrator and two assistant professors, we revisit the mentoring spaces and relations within which we were engaged…

The Role of Identity and Culture on Web Site Design

ERIC Educational Resources Information Center

Eugene, Wanda; Clark, Kevin

2009-01-01

Purpose: The purpose of this paper is to outline an instructional design approach for further development of an African ancestry learning center in order to enhance its educational utility. This is being done in an effort to use technology in transformative ways that extends the practices and opportunities for African Americans.…

Innovative Practices and Developments in Vocational Sex Equity. Volume 1, Number 1.

ERIC Educational Resources Information Center

Griffin, Ervin V., Ed.; Olson, Linnea, Ed.

This monograph includes the following papers: "Vocational Sex Equity in Virginia: Ten Years of Progress" (Hawa); "Reducing the Cost of Sexual Harassment in American Organizations" (Tate); "The Role of a Career Resource Center in Extending Vocational Sex Equity into the Classroom" (McCune); "Non-traditional Exploratory Programs for Women: An…

Teacher Knowledge and Classroom Practice: Examining the Connection

ERIC Educational Resources Information Center

Gilbert, Michael; Gilbert, Barbara

2013-01-01

This paper extends existing research regarding content knowledge for teaching (CKT) and the role it plays in advancing student learning. Two teachers, with high and low measured CKT respectively, are observed on the same day teaching similar content. Many studies have recently been published linking student achievement to teacher's CKT and many US…

Fostering a Sense of Place: Bioregional Education in Theory and Practice.

ERIC Educational Resources Information Center

Diffenderfer, Mark; Earle, Jason

1997-01-01

Discusses the nature of bioregional education and describes a program at the Mather Museum in Cleveland. Students learned about the ecology of Lake Erie, environmental impact, and the roles of regulatory agencies and individual action in its preservation. Bioregional education focuses on the ethics of caring and an extended definition of…

Status Report on Speech Research: A Report on the Status and Progress of Studies on the Nature of Speech, Instrumentation for Its Investigation, and Practical Applications, January 1-June 30, 1974. Report No. SR-37/38(1974).

ERIC Educational Resources Information Center

Haskins Labs., New Haven, CT.

This report, covering the period of January 1 to June 30, 1974, is one of a regular series on the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical applications. Among the 17 manuscripts and extended reports are "The Role of Speech in Language: Introduction to the Conference,""The Human…

Attributes of innovations and approaches to scalability - lessons from a national program to extend the scope of practice of health professionals.

PubMed

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches - letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers).

The role of paediatric nurses in medication safety prior to the implementation of electronic prescribing: a qualitative case study.

PubMed

Farre, Albert; Heath, Gemma; Shaw, Karen; Jordan, Teresa; Cummins, Carole

2017-04-01

Objectives To explore paediatric nurses' experiences and perspectives of their role in the medication process and how this role is enacted in everyday practice. Methods A qualitative case study on a general surgical ward of a paediatric hospital in England, one year prior to the planned implementation of ePrescribing. Three focus groups and six individual semi-structured interviews were conducted, involving 24 nurses. Focus groups and interviews were audio-recorded, transcribed, anonymized and subjected to thematic analysis. Results Two overarching analytical themes were identified: the centrality of risk management in nurses' role in the medication process and the distributed nature of nurses' medication risk management practices. Nurses' contribution to medication safety was seen as an intrinsic feature of a role that extended beyond just preparing and administering medications as prescribed and placed nurses at the heart of a dynamic set of interactions, practices and situations through which medication risks were managed. These findings also illustrate the collective nature of patient safety. Conclusions Both the recognized and the unrecognized contributions of nurses to the management of medications needs to be considered in the design and implementation of ePrescribing systems.

A model to advance nursing science in trauma practice and injury outcomes research.

PubMed

Richmond, Therese S; Aitken, Leanne M

2011-12-01

This discussion paper reports development of a model to advance nursing science and practice in trauma care based on an analysis of the literature and expert opinion. The continuum of clinical care provided to trauma patients extends from the time of injury through to long-term recovery and final outcomes. Nurses bring a unique expertise to meet the complex physical and psychosocial needs of trauma patients and their families to influence outcomes across this entire continuum. Literature was obtained by searching CINAHL, PubMed and OvidMedline databases for 1990-2010. Search terms included trauma, nursing, scope of practice and role, with results restricted to those published in English. Manual searches of relevant journals and websites were undertaken. Core concepts in this trauma outcomes model include environment, person/family, structured care settings, long-term outcomes and nursing interventions. The relationships between each of these concepts extend across all phases of care. Intermediate outcomes are achieved in each phase of care and influence and have congruence with long-term outcomes. Implications for policy and practice.  This model is intended to provide a framework to assist trauma nurses and researchers to consider the injured person in the context of the social, economic, cultural and physical environment from which they come and the long-term goals that each person has during recovery. The entire model requires testing in research and assessment of its practical contribution to practice. Planning and integrating care across the trauma continuum and recognition of the role of the injured person's background, family and resources will lead to improved long-term outcomes. © 2011 Blackwell Publishing Ltd.

Exploring the scope of oncology specialist nurses' practice in the UK.

PubMed

Farrell, Carole; Molassiotis, Alexander; Beaver, Kinta; Heaven, Cathy

2011-04-01

Revolutionary changes have taken place to nurses' roles and clinical responsibilities over the past decade, leading to new ways of working and higher levels of nursing practice. However, despite the development of nurse-led clinics and services within oncology there has been little formal evaluation. A survey of 103 UK oncology specialist nurses was undertaken to explore their scope of practice, with emphasis on nurse-led services. The survey highlighted significant developments within nurses' roles and nurse-led services, although there was a distinct lack of clarity between nurses' titles and their roles/responsibilities. Most nurses had extended their role. However there were significant differences in the nature of clinical practice, such as clinical examination and nurse prescribing. Overall, new roles were greatly valued by the multidisciplinary team, reducing waiting times and providing benefits for patients. However other nurses felt frustrated by deficiencies in infrastructure and support, which often overshadowed potential benefits. There is a great diversity in oncology specialist nurses' roles; however lack of clarity in titles, training, competencies and responsibilities is creating confusion. Role developments and nurse-led clinics have been ad hoc and poorly evaluated. The introduction of a competency framework, national standards and a system of clinical appraisals seems key to providing increased transparency and vital safeguards for both nurses and patients. Without further exploration and evaluation of nurse-led initiatives it is difficult to fully appreciate their impact on patients, staff and service delivery. Copyright © 2010 Elsevier Ltd. All rights reserved.

Continuing Professional Development in Higher Education: The Role of the Scholarship of Teaching and Learning

ERIC Educational Resources Information Center

Elton, Lewis

2009-01-01

It is argued that Humboldt's original definition of "scholarship" ("Wissenschaft"), as well as Humboldt's concept of the purpose of a university, continue to be relevant--with appropriate adaptations. They should be extended to include not only a unity between the practice of teaching and learning and research into teaching and…

Leveraging Technology to Alleviate Student Bottlenecks: The Self-Paced Online Tutorial--Writing (SPOT)

ERIC Educational Resources Information Center

Moore, Scott D.; Sanchez, Rudolph J.; Inoue, Asao B.; Statham, Russel D.; Zelezny, Lynnette; Covino, William A.

2014-01-01

The Self-Paced Online Tutorial (SPOT) represents the best kind of innovation because it uses digital technologies wisely and because it is based on well-established theory, research, and practice. Extended education plays a pivotal role in the attainment of the California State University's (CSU) vision of providing a high-quality, affordable, and…

How School Social Workers Integrate Service Opportunities into Multiple Elements of Practice

ERIC Educational Resources Information Center

Leyba, Erin

2010-01-01

This article reports the results from a research study regarding how school social workers extend opportunities for students to volunteer, serve others, or contribute to their communities and how social workers engaged students in service activities within their roles. The results are one part of the findings of a large research study on the role…

On the number of genes controlling the grass stage in longleaf pine

Treesearch

C. Dana Nelson; C. Weng; Thomas L. Kubisiak; M. Stine; C.L. Brown

2003-01-01

The grass stage is an inherent and distinctive developmental trait of longleaf pine (Pinus palustris), in which height growth in the first few years after germination is suppressed. In operational forestry practice the grass stage extends for nvo to several years and often plays a role in planting failures and decisions to plant alternative species....

Medication use review in Qatar: are community pharmacists prepared for the extended professional role?

PubMed

Babiker, Ahmed Hussein; Carson, Louise; Awaisu, Ahmed

2014-12-01

The incidence of chronic illnesses is increasing globally. Non-adherence to medications and other medication-related problems are common among patients receiving long-term medications. Medication use review (MUR) is a service provision with an accredited pharmacist undertaking structured, adherence-centered reviews with patients receiving multiple medications. MUR services are not yet available in community pharmacies in Qatar. The current study aims to evaluate community pharmacists' knowledge, attitudes, and perception towards establishing MUR as an extended role in patient care. Private community pharmacies in Qatar including chains and independent pharmacies. Methodology A cross-sectional survey using a self-administered questionnaire was conducted among licensed community pharmacists from December 2012 to January 2013. Data analysis was conducted using descriptive and inferential statistics. Knowledge, attitudes, and practices related to MUR concept and services. A total of 123 participants responded to the survey (response rate 56%). The mean total knowledge score was 71.4 ± 14.7%. An overwhelming proportion of the participants (97%) were able to identify the scope of MUR in relation to chronic illnesses and at enhancing the quality of pharmaceutical care. Furthermore, 80% of the respondents were able to identify patients of priority for inclusion in an MUR program. However, only 43% of the participants knew that acute medical conditions were not the principal focus of an MUR service, while at least 97% acknowledged that the provision of MUR services is a great opportunity for an extended role of community pharmacists and that MUR makes excellent use of the pharmacist's professional skills in the community. The participants generally reported concerns about time, dedicated consultation area, and support staff as significant barriers towards MUR implementation. This study suggests that community pharmacists in Qatar had sufficient knowledge about the concept of MUR and its scope, but there were still important deficiencies that warrant further education. The findings have important implications on policy and practice pertaining to the implementation of MUR as an extended role of pharmacists and as part of Qatar's National Health Strategy to move primary health care forward.

Review of extended producer responsibility: A case study approach.

PubMed

Gupt, Yamini; Sahay, Samraj

2015-07-01

Principles of extended producer responsibility have been the core of most of the recent policies and legislation dealing with the end-of-life management of recyclable goods. This article makes an exploratory review of 27 cases of extended producer responsibility from developed and developing economies with and without informal recycling, to ascertain the most important aspect of extended producer responsibility. A comparative analysis of the cases with respect to role of stakeholders in the upstream and downstream stages of the extended producer responsibility has been carried out. Further, the study uses exploratory factor analysis to determine the important aspects of the extended producer responsibility in practice using 13 variables identified from the review. Findings of the comparative analysis reveal that financial responsibility of the producers and separate collecting and recycling agencies contributed significantly to the success of the extended producer responsibility-based environmental policies. Regulatory provisions, take-back responsibility and financial flow come out to be the three most important aspects of the extended producer responsibility. Presence of informal sector had a negative impact on the regulatory provisions. The outcomes of this study could serve as a guideline for designing of effective extended producer responsibility-based policies. © The Author(s) 2015.

Domestic food practices: A study of food management behaviors and the role of food preparation planning in reducing waste.

PubMed

Romani, Simona; Grappi, Silvia; Bagozzi, Richard P; Barone, Ada Maria

2018-02-01

Recent research has started to show the key role of daily food provision practices in affecting household food waste. Building on and extending these previous contributions, the objective of this paper is to investigate how individuals' everyday practices regarding food (e.g., shopping, cooking, eating, etc.) lead to food waste, and how policy makers and the food industry can implement effective strategies to influence such practices and ultimately help consumers reduce food waste. The research performs three Studies; a critical incident qualitative study (Study 1; N = 514) and a quantitative, survey-based study (Study 2; N = 456) to identify and examine relevant food management behaviors associated with domestic waste. Lastly, findings from a field experiment (Study 3; N = 210) suggest that a specific educational intervention, directed at increasing consumers' perceived skills related to food preparation planning behaviors, reduces domestic food waste. Implications of the research for policy makers and the food industry are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of change for nurses: lessons from the discipline of organizational studies.

PubMed

Shanley, Chris

2007-07-01

This paper explores the literature on change management from the discipline of organizational studies to provide insights that nurse managers can use in their professional practice. The paper will benefit nurse managers by extending the nursing discourse on change management to include wider theoretical and academic perspectives. Important aspects of change management explored are the roles of power and political behaviour, how much change can be planned and controlled, how to combine top-down and bottom-up approaches to change, the role of emotions in the change management process, a comparison of prescriptive and analytical approaches to understanding change, and the connection between theory and practice in managing change. While nurses can draw much useful information from within the nursing discipline, they can also benefit by exploring other disciplinary areas. In the case of change management, there are many useful lessons nurses can carry over into their professional practice.

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

PubMed

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

2013-09-01

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

Attributes of innovations and approaches to scalability – lessons from a national program to extend the scope of practice of health professionals

PubMed Central

Masso, Malcolm; Thompson, Cristina

2016-01-01

The context for the paper was the evaluation of a national program in Australia to investigate extended scopes of practice for health professionals (paramedics, physiotherapists, and nurses). The design of the evaluation involved a mixed-methods approach with multiple data sources. Four multidisciplinary models of extended scope of practice were tested over an 18-month period, involving 26 organizations, 224 health professionals, and 36 implementation sites. The evaluation focused on what could be learned to inform scaling up the extended scopes of practice on a national scale. The evaluation findings were used to develop a conceptual framework for use by clinicians, managers, and policy makers to determine appropriate strategies for scaling up effective innovations. Development of the framework was informed by the literature on the diffusion of innovations, particularly an understanding that certain attributes of innovations influence adoption. The framework recognizes the role played by three groups of stakeholders: evidence producers, evidence influencers, and evidence adopters. The use of the framework is illustrated with four case studies from the evaluation. The findings demonstrate how the scaling up of innovations can be influenced by three quite distinct approaches – letting adoption take place in an uncontrolled, unplanned, way; actively helping the process of adoption; or taking deliberate steps to ensure that adoption takes place. Development of the conceptual framework resulted in two sets of questions to guide decisions about scalability, one for those considering whether to adopt the innovation (evidence adopters), and the other for those trying to decide on the optimal strategy for dissemination (evidence influencers). PMID:27616889

The Role of Extended Time on the SAT[R] for Students with Learning Disabilities and/or Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Lindstrom, Jennifer Hartwig; Gregg, Noel

2007-01-01

Accommodation policymaking and practice should be guided by empirical research and informed clinical judgment. Findings from our study can provide information to test users about the validity of inferences that can be made from scores obtained from accommodated test administrations for students with disabilities. The factor structure of the newly…

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)…

Student Agency: An Analysis of Students' Networked Relations across the Informal and Formal Learning Domains

ERIC Educational Resources Information Center

Rappa, Natasha Anne; Tang, Kok-Sing

2017-01-01

Agency is a construct facilitating our examination of when and how young people extend their own learning across contexts. However, little is known about the role played by adolescent learners' sense of agency. This paper reports two cases of students' agentively employing and developing science literacy practices--one in Singapore and the other…

Extended training to prepare GPs for future workforce needs: a qualitative investigation of a 1-year fellowship in urgent care.

PubMed

Dale, Jeremy; Russell, Rachel; Harkness, Frances; Wilkie, Veronica; Aiello, Matthew

2017-09-01

It has been argued that UK general practice specialist training should be extended to better prepare GPs for the challenges facing 21st-century health care. Evidence is needed to inform how this should occur. To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice; and its impact on subsequent career development. Semi-structured interviews conducted longitudinally over 2 years augmented by observational data in the West Midlands, England. Participants were interviewed on at least three occasions: twice while undertaking the fellowship, and at least once post-completion. Participants' clinical and academic activities were observed. Data were analysed using a framework approach. Seven GPs participated in the pilot scheme. The fellowship was highly rated and felt to be balanced in terms of the opportunities for skill development, academic advancement, and confidence building. GPs experienced enhanced employability on completing the scheme, and at follow-up were working in a variety of primary care/urgent care interface clinical and leadership roles. Participants believed it was making general practice a more attractive career option for newly qualified doctors. The 1-year fellowship provides a defined framework for training GPs to work in an enhanced manner across organisational interfaces with the skills to support service improvement and integration. It appears to be well suited to preparing GPs for portfolio roles, but its wider applicability and impact on NHS service delivery needs further investigation. © British Journal of General Practice 2017.

Attitudes among dentists and dental hygienists towards extended scope and independent practice of dental hygienists.

PubMed

Reinders, Jan J; Krijnen, Wim P; Onclin, Pieter; van der Schans, Cees P; Stegenga, Boudewijn

2017-02-01

Attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice are described in several studies, but the results are heterogenous. The purpose of this systematic review was to compare the attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice. PubMed, AMED and CINAHL were screened by two independent assessors to identify relevant studies. Only quantitative studies that reported the percentages of dentists' and dental hygienists' attitude towards extended scope and independent dental hygiene practice were included. The random-effects model was used to synthesise possible heterogenous influences. Meta proportions with regard to a positive attitude towards extended scope of practice are 0.54 for dentists and 0.81 for dental hygienists. Meta proportions of a positive attitude towards independent practice are 0.14 for dentists and 0.59 for dental hygienists. A meta analysis with regard to negative attitudes could only be performed on extended scope of practice and did not reveal a difference between the two professions. We obtained homogeneous outcomes of the studies included regarding negative attitudes of dentists . A minority of dentists hold negative attitudes towards extended scope of dental hygiene practice. Study outcomes regarding negative attitudes of dental hygienists were heterogeneous. Positive attitudes are present among a majority of dentists and dental hygienists with regard to extended scope of dental hygiene practice, while for independent dental hygiene practice this holds for a minority of dentists and a majority of dental hygienists. © 2016 FDI World Dental Federation.

Executive functions in early childhood: the role of maternal and paternal parenting practices.

PubMed

Lucassen, Nicole; Kok, Rianne; Bakermans-Kranenburg, Marian J; Van Ijzendoorn, Marinus H; Jaddoe, Vincent W V; Hofman, Albert; Verhulst, Frank C; Lambregtse-Van den Berg, Mijke P; Tiemeier, Henning

2015-11-01

We investigated the association between mothers' and fathers' harsh parenting and sensitive parenting practices and child's executive functions (EF) in early childhood in 607 families. We focused on three broad dimensions of child EF: Emergent metacognition, inhibitory self-control, and flexibility measured with the parent-reported Behavior Rating Inventory of Executive Function-Preschool Version. Less sensitive parenting of the mother and harsher parenting of the father were related to lower scores of emergent metacognition and inhibitory self-control. Parenting was not associated with child flexibility. This study extends previous research on the association between parenting and EF by the focus on the role of the father and demonstrates independent effects of mother and father on child EF. © 2015 The British Psychological Society.

Extension of the Job Demands-Resources model in the prediction of burnout and engagement among teachers over time.

PubMed

Lorente Prieto, Laura; Salanova Soria, Marisa; Martínez Martínez, Isabel; Schaufeli, Wilmar

2008-08-01

Our purpose was to extend the Job Demand-Resources Model (Schaufeli & Bakker, 2004) by including personal resources, job demands and job resources to predict burnout (exhaustion, cynicism, depersonalization) and work engagement (vigour and dedication). The sample comprised 274 teachers from 23 secondary schools of the Valencian Community (Spain). Hierarchical multiple regression analyses have revealed: (1) the predictor effect of quantitative overload on exhaustion and dedication at T2, (2) role conflict on cynicism and (3) role ambiguity on dedication. Lastly, the mediating role of burnout and engagement at T2. Practical implications and directions of future research are discussed.

Second-Guessing Scientists and Engineers: Post Hoc Criticism and the Reform of Practice in Green Chemistry and Engineering.

PubMed

Lynch, William T

2015-10-01

The article examines and extends work bringing together engineering ethics and Science and Technology Studies, which had built upon Diane Vaughan's analysis of the Challenger shuttle accident as a test case. Reconsidering the use of her term "normalization of deviance," the article argues for a middle path between moralizing against and excusing away engineering practices contributing to engineering disaster. To explore an illustrative pedagogical case and to suggest avenues for constructive research developing this middle path, it examines the emergence of green chemistry and green engineering. Green chemistry began when Paul Anastas and John Warner developed a set of new rules for chemical synthesis that sought to learn from missed opportunities to avoid environmental damage in the twentieth century, an approach that was soon extended to engineering as well. Examination of tacit assumptions about historical counterfactuals in recent, interdisciplinary discussions of green chemistry illuminate competing views about the field's prospects. An integrated perspective is sought, addressing how both technical practice within chemistry and engineering and the influence of a wider "social movement" can play a role in remedying environmental problems.

Twenty-First-Century Headteacher: Pedagogue, Visionary Leader or Both? Phase 1--A Reflection on the Historical Perspective and Critical Analysis of Contemporary Perception and Practice

ERIC Educational Resources Information Center

Barrett-Baxendale, Denise; Burton, Diana

2009-01-01

In recent years the UK secondary educational landscape has witnessed significant change, with the introduction of an ever-extending spectrum of competing government initiatives and policies. This has resulted in the steady erosion of the traditionally recognized role of headteacher. This paper presents the results of a practitioner-based study…

Patterns of Students' and Teachers' Interactions in Learning Centres: A Case Study of Three Teacher Leaders in an Elementary School

ERIC Educational Resources Information Center

Badger, James

2016-01-01

This study investigated the instructional practices of three teacher leaders employed in a diverse, elementary school in the USA. Through extended observations, it was found that learning centres occupied a central role in the organisation and learning in each of the classrooms. Bernstein's theory of classification and framing was used to analyse…

Practical Application of Polarization and Light Control for Reduction of Reflected Glare.

ERIC Educational Resources Information Center

Crouch, C. L.; Kaufman, J. E.

1963-01-01

The role of reflected glare and visual viewing angles in near task performance is discussed, and following statements are reported--(1) a worker at a desk normally assumes a position in which his eyes traverse an area of work extending from a point approximately vertically below his eyes to a point not more than 40 degrees from the vertical, (2) a…

Time utilization, productivity and costs of solo and extended duty auxiliary dental practice.

PubMed

Tan, H H; van Gemert, H G

1977-07-01

A study was conducted to compare the time utilization of the dentist, and productivity and costs for solo (one dentist, one chairside assistant and one treatment room) and extended duty settings (one dentist, two extended duty dental hygienists, one chairside assistant and two treatment rooms). Only amalgam and composite restorations done in a general group practice were included. In the extended duty setting the dentist spent more time in managerial activities and less time in treatment than in the solo setting. Nevertheless, the dentist in the extended duty setting produced 53% more restorations as compared with solo practice. The cost ratio of solo to extended duty practice was computed to 1:1.52. From the point of view of microeconomics, the extended duty setting was found no worse than the solo setting.

The Perioperative Nurse Surgeon's Assistant: Issues and challenges associated with this emerging advanced practice nursing role in Australia.

PubMed

Lynn, Andrew; Brownie, Sonya

2015-01-01

The aim of this study was to obtain Perioperative Nurse Surgeon's Assistants' views about their emerging new role in contemporary nursing practice in Australia. Internationally advanced practice nursing has led to a range of specialist roles aimed at delivering higher quality, efficient nursing care. In 2005 an Australian university developed the Perioperative Nurse Surgeon's Assistant graduate education and training program to provide nurses with an opportunity to gain advanced practice knowledge and extended skills specifically in the perioperative setting. This study was a qualitative research design that used online surveys and in-depth interviews to explore the issues and challenges associated with the introduction of the (currently non-accredited) Perioperative Nurse Surgeon's Assistant role in Australia. Experienced Australia perioperative nurses who had undertaken graduate education and training in this field were recruited for this study. Data were collected between August and October 2011. An inductive thematic analysis was used to interpret the findings. Eighteen nurses completed the online survey and six were interviewed (n = 24). Nurses cited their commitment to professional development and the delivery of high quality patient care, along with surgeons' encouragement for them to complete specialist clinical training, as key reasons for undertaking Perioperative Nurse Surgeon's Assistant education and training. The Perioperative Nurse Surgeon's Assistant role led to greater job satisfaction and autonomy, and assisted nurses to better meet the needs of patients, surgeons and clinical perioperative teams. Without formal recognition of the Perioperative Nurse Surgeon's Assistant role its future in the Australian health care system is under threat.

Physiotherapists in emergency departments: responsibilities, accountability and education.

PubMed

Crane, Jacqueline; Delany, Clare

2013-06-01

Emergency physiotherapy roles have evolved within the UK and are increasingly being adopted in Australia in response to a need for greater workforce flexibility and improved service provision to meet growing patient demand. This paper discusses the need for the physiotherapy profession to develop evidence-based regulatory, ethical and educative frameworks to keep pace with the changing clinical environment and service delivery in emergency departments. Definitions of Emergency Physiotherapy as either advanced practice or extended scope of practice are identified, and the implications for both regulation of practice and education are highlighted. Suggestions for education in areas of clinical skills, ethical understanding and legal and professional knowledge are highlighted as important areas to support physiotherapists moving into this area of practice. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Speech and language therapy in Sure Start Local Programmes: a survey-based analysis of practice and innovation.

PubMed

Fuller, Alison

2010-01-01

Sure Start has been a flagship policy for the UK Labour Government since 1998. Its aim was to improve the life chances of children under five years of age who live in areas of socio-economic disadvantage by means of multi-agency, multidisciplinary Sure Start Local Programmes (SSLPs). Speech and language therapists have played a key part in many SSLPs, and have had the opportunity to extend their roles. Despite the scrutiny paid to Sure Start, there has been no comprehensive analysis of speech and language therapists' contribution to date. Studies have focused on individual programmes or small samples: there has been no attempt to collate the full range of practice. As Sure Start evolved and Children's Centres emerged, it became vital to learn from the Sure Start experience and inform the mainstreaming of practice, before the window of opportunity closed. The survey aims were, firstly, to identify the range of practice amongst speech and language therapists working in SSLPs, highlighting new practice, and, secondly, to categorize the practices according to the tiered model of UK health and social services of the Royal College of Speech and Language Therapists (RCSLT 2006). An online mixed-method, semi-structured survey was designed to elicit primarily quantitative and categorical data. A total of 501 Sure Start Local Programmes were invited to take part. A total of 128 speech and language therapists responded, giving a response rate of 26%. A descriptive analysis of the response data was undertaken. A total of 103 respondents (80%) reported maintaining a clinical role as well as extending their roles to include preventative services. Of those 103 respondents, 69% were able to see referred children at a younger average age and 80% saw them more quickly than before Sure Start. A wide variety of preventative practice was identified. A widening of access to speech and language therapist was reported in terms of venues used and hours offered. Respondents reported on their use of evaluation or outcome measures, which was at a higher rate for new practice than for established practice. A total of 121 respondents (95%) reported at least one example of new practice; 103 (80%) reported at least one use of evaluation or outcome measures. The tiered model of UK health and social services provided an effective way of categorizing practice. A categorized record of Sure Start speech and language therapist is presented that may contribute to establishing a broad curriculum of practice for speech and language therapist in the early years. The effectiveness of the practices is not investigated: suggestions are made for further research to develop the evidence base. 2010 Royal College of Speech & Language Therapists.

Beyond competencies: using a capability framework in developing practice standards for advanced practice nursing.

PubMed

O'Connell, Jane; Gardner, Glenn; Coyer, Fiona

2014-12-01

This paper presents a discussion on the application of a capability framework for advanced practice nursing standards/competencies. There is acceptance that competencies are useful and necessary for definition and education of practice-based professions. Competencies have been described as appropriate for practice in stable environments with familiar problems. Increasingly competencies are being designed for use in the health sector for advanced practice such as the nurse practitioner role. Nurse practitioners work in environments and roles that are dynamic and unpredictable necessitating attributes and skills to practice at advanced and extended levels in both familiar and unfamiliar clinical situations. Capability has been described as the combination of skills, knowledge, values and self-esteem which enables individuals to manage change, be flexible and move beyond competency. A discussion paper exploring 'capability' as a framework for advanced nursing practice standards. Data were sourced from electronic databases as described in the background section. As advanced practice nursing becomes more established and formalized, novel ways of teaching and assessing the practice of experienced clinicians beyond competency are imperative for the changing context of health services. Leading researchers into capability in health care state that traditional education and training in health disciplines concentrates mainly on developing competence. To ensure that healthcare delivery keeps pace with increasing demand and a continuously changing context there is a need to embrace capability as a framework for advanced practice and education. © 2014 John Wiley & Sons Ltd.

FOOD IN THE FAMILY: BRINGING YOUNG PEOPLE BACK IN

PubMed Central

Hunt, Geoffrey; Fazio, Adam; MacKenzie, Kathleen; Moloney, Molly

2011-01-01

This article analyzes eating and beliefs about family meals in the qualitative interview narratives of 30 “at-risk” gang-involved young women in the San Francisco Bay Area. We begin our examination of consumption practices with a study of households and identify three major types–extended, single-parent and blended. Within these households, food purchasing and consumption activities are varied, and in many cases, our respondents rely upon extended family members and non-kin relations for support. In examining eating within the family, we identify two sets of practices and meanings: eating alone, and eating with others. Eating alone is symbolic of independence from one’s family of origin, or is the result of familial conflict at the dinner table; however, it does not necessarily change our respondents’ eating patterns. Eating with others in the family remains important, and many of the young women value family meals, although there are significant obstacles to eating regularly with the entire nuclear family. Many of these young women play an important role in the purchasing and preparation of food for family members as well. This paper highlights the importance of understanding family eating practices from the perspective of young people in the family, whose contribution to family ingestive practices has tended to be underestimated in much of available research literature. PMID:21219948

“I’ll Be There for You”: Coparenting Relationships among Teen Parents*

PubMed Central

Mollborn, Stefanie; Jacobs, Janet

2017-01-01

Marriage promotion policy agendas have focused research attention on coparenting relationships, but little is known about coparenting among teen parents. Qualitative interviews with 76 teen mothers and fathers, supplemented with site observations at a school and clinic, investigated coparenting relationships and those relationships’ embeddedness in extended families and social institutions. We identified prevalent coparenting trajectories and analyzed individual-, interaction-, and institutional-level influences on coparenting. Coparenting trajectories diverged depending on whether the couple stayed together and assumed traditionally gendered parenting roles. Participants perceived that coparenting relationships strongly shaped their current and future socioeconomic, emotional, and practical circumstances and their success at “being there” for their child. Extended families, institutions, and social programs often pushed teen parents apart, although many participants felt they needed a functional relationship with the other parent. Coparenting relationships, considered jointly with extended families and social institutions, are fundamental for understanding teen parenthood and shaping effective social policies. PMID:28620246

Another Simple yet Effective Best Practice for Increasing Enrollments at an Extended Campus

ERIC Educational Resources Information Center

Christensen, Steven S.; Howell, Scott L.; Hall, C. Giles

2016-01-01

This article is a follow-up to a previous article, "Six Ways to Increase Enrollments at an Extended Campus," published in this journal (vol. 17, no. 4, winter 2015), wherein a seventh best practice to increase course offerings and increase enrollments at an extended campus is presented. This best practice seeks to identify those areas of…

The role of collaborative ontology development in the knowledge negotiation process

NASA Astrophysics Data System (ADS)

Rivera, Norma

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

TH-E-19A-01: Quality and Safety in Radiation Therapy

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

Ford, E; Ezzell, G; Miller, B

2014-06-15

Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

Graduates' development of interprofessional practice capability during their early socialisation into professional roles.

PubMed

Morgan, C Jane

2017-07-01

Graduates entering the healthcare workforce can expect to undertake interprofessional practices, requiring them to work at the intersection of knowledge and practice boundaries that have been built over years of socialisation in their respective professions. Yet, in complex health environments, where health challenges go beyond the knowledge and skills of any single profession, there is a growing concern that healthcare practitioners lack capability to collaborate with each other. This article presents the findings from a year-long hermeneutic phenomenological study of graduates' temporal experiences of practice roles in their respective fields of healthcare and in collaboration with other professions. Research findings emerged through an inductive analytic process using thematic analysis techniques and provides an insight into graduates' early professional practice in contemporary healthcare contexts and the development of their professional practice at the interface of professional boundaries. The 18 graduates from six health professions developed their professional practice in working contexts where intersecting professional boundaries resulted in strengthening professional identity in their chosen professions, through articulating distinct knowledge and skills to other professions during collaborative work. Concurrently they established flexible working relationships with members of other professions, resulting in expanding health perspectives and extending practice knowledge and skills beyond their distinct professions. The study provides new understanding of the relationship between areas of professionalism, identity, and collaborative practice in an evolving health workforce, through the experiences of graduates in their early work as registered health practitioners.

Implementation of nurse-delivered vestibular rehabilitation in primary care: a qualitative study of nurses' views on involvement in an innovative service.

PubMed

Walsh, Bronagh; Yardley, Lucy; Donovan-Hall, Maggie; Smith, Helen

2007-06-01

To explore practice nurses' perceptions of vestibular rehabilitation and its place in relation to their general role development. Vestibular rehabilitation has been known for a long time to be effective for chronically dizzy patients in secondary care, but its use in primary care has been limited. A recent pragmatic trial of vestibular rehabilitation delivered by practice nurses in primary care has confirmed its utility in a community setting. This type of role is increasingly common for practice nurses, but few studies explore the nurses' perspective. A qualitative study was undertaken; 19 nurses took part in focus group sessions. Participants discussed their views on vestibular rehabilitation and its potential for integration with their existing role. A thematic analysis of the data was undertaken. Four main themes were identified: creating a unique nursing role; the therapeutic role; responsibility and role boundaries; and time. Nurses were positive about developing extended roles, but sought ways to achieve this without eroding fundamental nursing skills. Vestibular rehabilitation was seen as fulfilling both the need for a distinct nursing identity and professional development. Concerns over responsibility for patient assessment and time management constraints are potential obstacles to overcome in the wider development of this therapy in primary care. Understanding the perspective of nurses will be vital in future development of chronic disease management within primary care. Whilst nurses may be positive about such role expansion, the implementation of services of this type will require clarity about nurses' responsibilities and flexibility in managing workload. Vestibular rehabilitation is simple, low-tech and appropriate for widespread development in primary care. Nurses wishing to provide vestibular rehabilitation or similar chronic disease management activities will need to work with medical colleagues to define role boundaries.

Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress.

PubMed

Cousins, Rosanna; Donnell, Christine

2012-04-01

Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored. To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice. In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice. Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay. Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.

Special aspects of social support: Qualitative analysis of oncologic rehabilitation through a belly dancing peer support group.

PubMed

Szalai, M; Szirmai, A; Füge, K; Makai, A; Erdélyi, G; Prémusz, V; Bódis, J

2017-11-01

Tumour-related peer support groups (PSGs) show long-term development in quality of life and coping, and decrease distress in cancer care. To clarify channels of social support in oncologic rehabilitation by combined exercise and psychosocial therapy, individual semi-structured interviews were conducted after 1 year additional belly dance rehabilitation in a closed PSG among 51 patients with malignant tumour diagnosis in Budapest, Hungary. Interview data were transcribed and analysed using qualitative content analysis (ATLAS.ti 6 Win). Results suggest that group experience provides emotional-, practical- and informational support. We could point out specific social effects of "role model" function and extend the coping model. The group dispose all the features of effective suggestion and may be effectively applied as additional therapy for patients with malignancies. The extended coping model and the introduction of "role model" function could be useful for PSGs' efficacy assessment. © 2017 John Wiley & Sons Ltd.

Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

PubMed

Whittaker, William; Anselmi, Laura; Kristensen, Søren Rud; Lau, Yiu-Shing; Bailey, Simon; Bower, Peter; Checkland, Katherine; Elvey, Rebecca; Rothwell, Katy; Stokes, Jonathan; Hodgson, Damian

2016-09-01

Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators. Throughout 2014, 56 primary care practices (346,024 patients) in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients) providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access) in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866), and a 26.6% (95% CI -39.2% to -14.1%) relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184). There was an insignificant relative reduction of 3.1% in total emergency department visits (95% CI -6.4% to 0.2%). Our results were robust to several sensitivity checks. A lack of detailed cost reporting of the running costs of extended access and an inability to capture health outcomes and other health service impacts constrain the study from assessing the full cost-effectiveness of extended access to primary care. The study found that extending access was associated with a reduction in emergency department visits in the first 12 months. The results of the research have already informed the decision by National Health Service England to extend primary care access across Greater Manchester from 2016. However, further evidence is needed to understand whether extending primary care access is cost-effective and sustainable.

Drug promotion practices: A review.

PubMed

Jacob, Nilan T

2018-01-18

Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from preclinical studies to multicentric clinical trials and postmarketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved, which puts pressure on the manufacturers to maximize the profit from approved drugs. It is in this key area that the practice of drug promotion plays its role. The World Health Organization defines drug promotion as "all informational and persuasive activities by manufacturers and distributors, the effect of which is to influence the prescription, supply, purchase or use of medicinal drugs". With its humble intent of creating awareness among healthcare professionals and updating their knowledge on recent advances in treatment options, drug promotion has been an important tool, but gradually it has evolved to embrace aggressive marketing strategies and sometimes unethical business and scientific practices where the need for profit-making eclipses commitment to patient care and scientific exploration. In this review, we discuss the evolution of drug promotion practices, the various types, its merits and demerits, the influence of drug promotion on physician prescribing behaviour, the role of regulatory bodies, unethical promotional practices and finally summarize with future directions. © 2018 The British Pharmacological Society.

Food in the family. Bringing young people back in.

PubMed

Hunt, Geoffrey; Fazio, Adam; MacKenzie, Kathleen; Moloney, Molly

2011-04-01

This article analyzes eating and beliefs about family meals in the qualitative interview narratives of 30 "at-risk" gang-involved young women in the San Francisco Bay Area. We begin our examination of consumption practices with a study of households and identify three major types-extended, single-parent and blended. Within these households, food purchasing and consumption activities are varied, and in many cases, our respondents rely upon extended family members and non-kin relations for support. In examining eating within the family, we identify two sets of practices and meanings: eating alone, and eating with others. Eating alone is symbolic of independence from one's family of origin, or is the result of familial conflict at the dinner table; however, it does not necessarily change our respondents' eating patterns. Eating with others in the family remains important, and many of the young women value family meals, although there are significant obstacles to eating regularly with the entire nuclear family. Many of these young women play an important role in the purchasing and preparation of food for family members as well. This paper highlights the importance of understanding family eating practices from the perspective of young people in the family, whose contribution to family ingestive practices has tended to be underestimated in much of available research literature. Copyright © 2011 Elsevier Ltd. All rights reserved.

Differential Changes with Extended Practice.

DTIC Science & Technology

1983-06-01

This project was designed to answer a series of questions involving extended practice on motor skills tasks. The tasks employed were video games , and principal interest was focused on whether: (1) performance late in practice involves fewer underlying factors than early in practice; (2) video games coverge or diverge differentially upon one another; and (3) factorial content of

'I expected just to walk in, get my tablets and then walk out': on framing new community pharmacy services in the English healthcare system.

PubMed

Latif, Asam; Waring, Justin; Watmough, Deborah; Boyd, Matthew J; Elliott, Rachel A

2018-04-19

Reconfiguration of the healthcare division of labour is becoming increasingly attractive in the context of increased patient demand and resource constraints. One example is the introduction of extended roles for pharmacists to provide patients additional support to manage their medicines, while also reducing work pressures experienced by other health professionals. Understanding how such policies are framed by those delivering and receiving care has been under-theorised. Using Goffman's frame theory, we examine one newly introduced community pharmacy service (New Medicines Service (NMS)) to illustrate how a policy intended to support patient medicine-taking through the extended roles of pharmacists is framed and where this deviates from its proposed aims. Three themes emerged: (i) the spatial-material artefacts; (ii) existing discursive culture and practice around medicine-taking; and (iii) the NMS interactions that shape and govern framing and subsequent interpretation of the NMS. Our study offers an explanatory and dynamic view of the framing process with important lessons for reconfiguring medicine management policy and practice. As well as illustrating framing as being variegated, complementary or conflicting, it also shows how this plurality and fragility had consequences for patient engagement and sense-making. The consequences for engagement and recommendations for implementing future initiatives are discussed. © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis

PubMed Central

Whittaker, William; Anselmi, Laura; Lau, Yiu-Shing; Bower, Peter; Checkland, Katherine; Elvey, Rebecca; Stokes, Jonathan

2016-01-01

Background Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators. Methods and Findings Throughout 2014, 56 primary care practices (346,024 patients) in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients) providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in “minor” patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access) in patient-initiated emergency department visits for “minor” problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866), and a 26.6% (95% CI -39.2% to -14.1%) relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184). There was an insignificant relative reduction of 3.1% in total emergency department visits (95% CI -6.4% to 0.2%). Our results were robust to several sensitivity checks. A lack of detailed cost reporting of the running costs of extended access and an inability to capture health outcomes and other health service impacts constrain the study from assessing the full cost-effectiveness of extended access to primary care. Conclusions The study found that extending access was associated with a reduction in emergency department visits in the first 12 months. The results of the research have already informed the decision by National Health Service England to extend primary care access across Greater Manchester from 2016. However, further evidence is needed to understand whether extending primary care access is cost-effective and sustainable. PMID:27598248

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

PubMed

Baxter, Louisa; Nash, David B

2013-01-01

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

A cooperative inquiry into action learning and praxis development in a community nursing module.

PubMed

Jenkins, Emrys R; Mabbett, Gaynor M; Surridge, Andrea G; Warring, Joanna; Gwynn, Elizabeth D

2009-09-01

As nurse lecturers we investigated practice development and action learning approaches aimed at enabling postregistration bachelor's- and master's-level nursing students (Community Health Studies, Nursing in the Home) to advance practice in the context of policy and professional developments. A patchwork text was used to assess summatively what students achieved (practice change/development) and how this was informed critically, via an extended epistemology. First-person inquiry supplemented by cooperative inquiry postcourse completion (including reflective discussions with 16 students and 16 practice mentors) were used to assist coresearcher constructions of meaning. A relational, tripartite approach to learning and assessment (students', teachers', and practice mentors' collective contributions) depends on continuing reflective attention. Action learning enhances interrelation of experience with dialectic thinking. The patchwork text functions to promote creative writing, evaluative thinking, and praxis development. Role modeling by all, being genuine and not just "talking" genuine, is challenging yet crucial if people are to function as mutual resources for learning.

Cognitive Transformations and Extended Expertise

ERIC Educational Resources Information Center

Menary, Richard; Kirchhoff, Michael

2014-01-01

Expertise is extended by becoming immersed in cultural practices. We look at an example of mathematical expertise in which immersion in cognitive practices results in the transformation of expert performance.

Supporting Worth Mapping with Sentence Completion

NASA Astrophysics Data System (ADS)

Cockton, Gilbert; Kujala, Sari; Nurkka, Piia; Hölttä, Taneli

Expectations for design and evaluation approaches are set by the development practices within which they are used. Worth-Centred Development (WCD) seeks to both shape and fit such practices. We report a study that combined two WCD approaches. Sentence completion gathered credible quantitative data on user values, which were used to identify relevant values and aversions of two player groups for an on-line gambling site. These values provided human value elements for a complementary WCD approach of worth mapping. Initial worth maps were extended in three workshops, which focused on outcomes and user experiences that could be better addressed in the current product and associated marketing materials. We describe how worth maps were prepared for, and presented in, workshops, and how product owners and associated business roles evaluated the combination of WCD approaches. Based on our experiences, we offer practical advice on this combinination.

Finding science in students' talk

NASA Astrophysics Data System (ADS)

Yeo, Jennifer

2009-12-01

What does it mean to understand science? This commentary extends Brown and Kloser's argument on the role of native language for science learning by exploring the meaning of understanding in school science and discusses the extent that science educators could tolerate adulterated forms of scientific knowledge. Taking the perspective of social semiotics, this commentary looks at the extent that school science can be represented with other discourse practices. It also offers an example to illustrate how everyday language can present potential hindrance to school science learning.

GENERAL: Scattering Phase Correction for Semiclassical Quantization Rules in Multi-Dimensional Quantum Systems

NASA Astrophysics Data System (ADS)

Huang, Wen-Min; Mou, Chung-Yu; Chang, Cheng-Hung

2010-02-01

While the scattering phase for several one-dimensional potentials can be exactly derived, less is known in multi-dimensional quantum systems. This work provides a method to extend the one-dimensional phase knowledge to multi-dimensional quantization rules. The extension is illustrated in the example of Bogomolny's transfer operator method applied in two quantum wells bounded by step potentials of different heights. This generalized semiclassical method accurately determines the energy spectrum of the systems, which indicates the substantial role of the proposed phase correction. Theoretically, the result can be extended to other semiclassical methods, such as Gutzwiller trace formula, dynamical zeta functions, and semiclassical Landauer-Büttiker formula. In practice, this recipe enhances the applicability of semiclassical methods to multi-dimensional quantum systems bounded by general soft potentials.

Task delegation to physician extenders--some comparisons.

PubMed Central

Glenn, J K; Goldman, J

1976-01-01

This study uses a task delegation questionnaire to compare 1973 physician extender practices in seven primary care-oriented sites with a physician attitude survey made in 1969. One additional site using no physician extenders was included as a control. The study involves both major types of physician extenders (physician assistants and nurse practitioners) in ambulatory practices with at least one year of experience in using such personnel. With minor exceptions, actual task delegation patterns conform with the 1969 attitudes of physicians as to which tasks "could and should" be delegated to physician extenders. PMID:2022

Child Survival and Development toward Health for All: roles and strategies for Asia-Pacific universities.

PubMed

Raymond, J S; Patrick, W

1989-01-01

Recently, discussion among academics and practitioners has focused on the potential roles, strategies, and functions of universities in the Asia-Pacific region in the next ten to fifteen years in the global initiative commonly referred to as the Child Survival and Development Revolution toward Health for All. (1) The purpose of this paper is to capture the practical key elements of recent discussions and to extend the current thinking into potentially useful guidelines or frameworks for universities of the region. Universities may then be better prepared to move forward in ways which promote the goals and interests of the Health For All movement and the well-being of particularly the world's children.

"Refreshed…reinforced…reflective": A qualitative exploration of interprofessional education facilitators' own interprofessional learning and collaborative practice.

PubMed

Evans, Sherryn; Shaw, Nicole; Ward, Catherine; Hayley, Alexa

2016-11-01

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators' own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants' reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals' roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.

A national survey exploring oral healthcare service provision across Australian community pharmacies

PubMed Central

Freeman, Christopher R; Abdullah, Nabilah; Ford, Pauline J; Taing, Meng-Wong

2017-01-01

Objectives This study investigated pharmacists’ and pharmacy assistants’ current practices and perspectives with regard to oral healthcare provision across Australian community pharmacies. Design Cross-sectional study. A questionnaire for each pharmacist and pharmacy assistant cohort was developed and administered by online or postal means. Pearson’s χ2 test was used to examine relationships between categorical variables. Participants Pharmacists and pharmacy assistants working within 2100 randomly selected Australian community pharmacies. Results The overall response rate was 58.5% (644/1100) for the pharmacist cohort and 28% (280/1000) for the pharmacy assistant cohort. This represents pharmacy staff responses from 803 community pharmacies across Australia (approximately 14.6%, 803/5500 of community pharmacies nationally). Overall, the majority of pharmacists (80.2%; 516/644) and pharmacy assistants (83.6%; 234/280) reported providing oral health advice/consultations to health consumers up to five times each week. More than half of community pharmacists and pharmacy assistants were involved in identifying signs and symptoms for oral health problems; and the majority believed health consumers were receptive to receiving oral health advice. Additionally, more than 80% of pharmacists and 60% of pharmacy assistants viewed extended oral healthcare roles positively and supported integrating them within their workplace; extended roles include provision of prevention, early intervention and referral to oral healthcare services. The most commonly reported barriers to enhance pharmacy staff involvement in oral healthcare within Australian community pharmacies include lack of knowledge, ongoing training and resources to assist practice. Conclusion This study highlights that Australian pharmacists have an important role in oral health and provides evidence supporting the need for growing partnerships/collaborations between pharmacy and dental healthcare professionals and organisations to develop, implement and evaluate evidence-based resources, interventions and services to deliver improved and responsive oral healthcare within Australian communities. PMID:28963314

Promotion of nutrition care by Australian fitness businesses: a website analysis.

PubMed

Barnes, K; Ball, L; Desbrow, B

2016-11-01

To investigate the intention of fitness businesses to promote the provision of nutrition care from personal trainers. Cross-sectional evaluation of webpage content. Fitness businesses within two Australian federal electorates were identified using the Fitness Australia list of registered fitness businesses. Inductive content analysis of these fitness business websites and associated social media sites was undertaken to compare website content to the Fitness Australia Position Statement outlining the Roles and Responsibilities of Registered Fitness Professionals. Fitness businesses were classified as 'within scope of practice' if they referred to national nutrition guidelines or dietetic services. 'At risk of being beyond scope' included websites which did not include enough information to definitively state within or beyond scope. Fitness businesses were classified as 'definitely beyond scope of practice' if they advertised nutrition care which clearly extended beyond translation of the national dietary guidelines. Of the businesses reviewed, 15% were within scope despite none referring to a dietitian; 34% were at risk of being beyond scope; and 51% were beyond scope as they advertised nutrition care such as personalized diets without indicating dietetic input. A considerable portion of fitness businesses reviewed advertised their personal trainers as able to provide nutrition care outside the recommended scope of practice. Strategies that help fitness businesses and personal trainers to support clients to have healthy dietary behaviours without extending outside the scope of practice are warranted. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Evaluation of community pharmacy-based services for type-2 diabetes in an Indonesian setting: pharmacist survey.

PubMed

Wibowo, Yosi; Parsons, Richard; Sunderland, Bruce; Hughes, Jeffery

2015-10-01

Diabetes is an emerging chronic disease in developing countries. Currently the management of diabetes in developing countries is mainly hospital or clinic based. With burgeoning numbers of patients with diabetes, other models need to be evaluated for service delivery in developing countries. Community pharmacists are an important option for provision of diabetes care. Currently, data regarding practices of community pharmacists in diabetes care have been limited to developed countries. To evaluate current community pharmacy-based services and perceived roles of pharmacists in type 2 diabetes care, and characteristics (pharmacist and pharmacy) associated with current practice. Community pharmacies in a developing country setting (Surabaya, Indonesia). A questionnaire was administered to pharmacists managing a random sample of 400 community pharmacies in Surabaya, Indonesia. Current practice and pharmacists' perceived roles were rated using Likert scales, whilst an open-ended question was used to identify priority roles. Logistic regression models determined characteristics associated with current practice. A response rate of 60% was achieved. Dispensing (100%) and education on how to use medications (72.6%) were common current pharmacy practices. More than 50% of pharmacists were supportive towards providing additional services beyond dispensing. The highest priorities for services beyond dispensing were education on medications [i.e. directions for use (58.6%) and common/important adverse effects (25.7%)], education on exercise (36.5%), education on diet (47.7%), and monitoring medication compliance (27.9%). Facilitators identified were: being perceived as part of a pharmacist's role (for all priority services), pharmacies with more than 50 diabetes customers per month (for diet education), and pharmacists' involvement in diabetes training (for compliance monitoring). The key barrier identified was lower pharmacist availability (for diet education as well as compliance monitoring). Most community pharmacies in Surabaya, Indonesia have only provided a basic service of dispensing for type 2 diabetes patients. Many pharmacists believed that they should extend their roles particularly regarding patient education and monitoring. The development of pharmacist professional roles would assist in managing the burgeoning burden of diabetes. The identified facilitators/barriers provide baseline data to support the development of community pharmacy-based diabetes services.

The first two years of practice: a longitudinal perspective on the learning and professional development of promising novice physical therapists.

PubMed

Hayward, Lorna M; Black, Lisa L; Mostrom, Elizabeth; Jensen, Gail M; Ritzline, Pamela D; Perkins, Jan

2013-03-01

Physical therapists work in complex health care systems requiring professional competence in clinical reasoning and confidence in decision-making skills. For novice physical therapists, the initial practice years are a time for developing professional identity and practical knowledge. The study purpose was to extend previous research describing the experiences, learning, and professional development of 11 promising novice therapists during their first year of practice. The present study examined the continued development of the same therapists during their second year of clinical practice. Seven researchers from 4 physical therapist educational programs in the eastern and midwestern United States used a longitudinal, qualitative, multiple case study approach. Eleven physical therapist graduates identified as "promising novices" were recruited using purposive sampling. Participants ranged in age from 24 to 29 years and entered varied practice settings. Data were collected for 2 years using semistructured interviews, reflective journals, and participant observation. A conceptual model describing the participants' ongoing development during the second year of practice emerged. The 3 themes were formal and informal learning, increasing confidence and expansion of skills, and engagement in an environment characterized by collaborative exchange and opportunities for teaching. The second year represented consolidation and elaboration of practice-based learning and skills. The expansion of confidence, skills, and responsibilities and the externalization of learning the participants experienced promoted professional role formation. Learning previously directed inward and self-focused turned outward, fueled by growing self-confidence. Research illuminating the professional role formation experienced during early clinical practice is not widely available. The current study and further research into the learning and development of novice practitioners may assist educators in the design of pedagogical strategies and learning environments that enhance the professional development of physical therapists.

Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey

PubMed Central

Cowling, Thomas E; Harris, Matthew; Majeed, Azeem

2017-01-01

Background The UK government plans to extend the opening hours of general practices in England. The ‘extended hours access scheme’ pays practices for providing appointments outside core times (08:00 to 18.30, Monday to Friday) for at least 30 min per 1000 registered patients each week. Objective To determine the association between extended hours access scheme participation and patient experience. Methods Retrospective analysis of a national cross-sectional survey completed by questionnaire (General Practice Patient Survey 2013–2014); 903 357 survey respondents aged ≥18 years old and registered to 8005 general practices formed the study population. Outcome measures were satisfaction with opening hours, experience of making an appointment and overall experience (on five-level interval scales from 0 to 100). Mean differences between scheme participation groups were estimated using multilevel random-effects regression, propensity score matching and instrumental variable analysis. Results Most patients were very (37.2%) or fairly satisfied (42.7%) with the opening hours of their general practices; results were similar for experience of making an appointment and overall experience. Most general practices participated in the extended hours access scheme (73.9%). Mean differences in outcome measures between scheme participants and non-participants were positive but small across estimation methods (mean differences ≤1.79). For example, scheme participation was associated with a 1.25 (95% CI 0.96 to 1.55) increase in satisfaction with opening hours using multilevel regression; this association was slightly greater when patients could not take time off work to see a general practitioner (2.08, 95% CI 1.53 to 2.63). Conclusions Participation in the extended hours access scheme has a limited association with three patient experience measures. This questions expected impacts of current plans to extend opening hours on patient experience. PMID:27343274

Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey.

PubMed

Cowling, Thomas E; Harris, Matthew; Majeed, Azeem

2017-05-01

The UK government plans to extend the opening hours of general practices in England. The 'extended hours access scheme' pays practices for providing appointments outside core times (08:00 to 18.30, Monday to Friday) for at least 30 min per 1000 registered patients each week. To determine the association between extended hours access scheme participation and patient experience. Retrospective analysis of a national cross-sectional survey completed by questionnaire (General Practice Patient Survey 2013-2014); 903 357 survey respondents aged ≥18 years old and registered to 8005 general practices formed the study population. Outcome measures were satisfaction with opening hours, experience of making an appointment and overall experience (on five-level interval scales from 0 to 100). Mean differences between scheme participation groups were estimated using multilevel random-effects regression, propensity score matching and instrumental variable analysis. Most patients were very (37.2%) or fairly satisfied (42.7%) with the opening hours of their general practices; results were similar for experience of making an appointment and overall experience. Most general practices participated in the extended hours access scheme (73.9%). Mean differences in outcome measures between scheme participants and non-participants were positive but small across estimation methods (mean differences ≤1.79). For example, scheme participation was associated with a 1.25 (95% CI 0.96 to 1.55) increase in satisfaction with opening hours using multilevel regression; this association was slightly greater when patients could not take time off work to see a general practitioner (2.08, 95% CI 1.53 to 2.63). Participation in the extended hours access scheme has a limited association with three patient experience measures. This questions expected impacts of current plans to extend opening hours on patient experience. 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/.

Keeping experience at the bedside: the emergency consultant nurse role.

PubMed

Currie, Jane

The consultant nurse concept has not yet been transferred to the military setting. The motivation for developing the role in the NHS was to improve the quality of patient care by strengthening professional leadership and extending the clinical career ladder. The consultant nurse may be defined as an expert in their clinical field, possessing expert leadership and visionary skills. The role is based on four domains: expert practice, professional leadership, education and research. Typically, the emergency consultant nurse spends 50% of their time working clinically, thereby providing senior clinical expertise and adding value to the clinical role. In a military context the consultant nurse role could be perceived as the coming together of the senior command and administrative role and the clinical role. The military has the opportunity to develop a senior clinical emergency nurse role encompassing elements of the civilian consultant nurse model, which may strengthen leadership, provide a central resource of expertise and raise the profile of military nursing. This has the added potential to provide inspiration for junior nurses and retain experienced emergency nurses in the clinical arena.

Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners.

PubMed

Usta, Jinan; Feder, Gene; Antoun, Jumana

2014-06-01

Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence. To explore physicians' attitudes about responding to DV, their perception of the physician's role, and the factors that influence their response. Qualitative study using individual interviews among primary care practitioners working in Lebanon. Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role. Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV. Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV. © British Journal of General Practice 2014.

Parental Involvement in the Care and Intervention of Children with Hearing Loss

PubMed Central

Erbasi, Ennur; Scarinci, Nerina; Hickson, Louise; Ching, Teresa Y.C.

2016-01-01

Objective The present study aimed to explore the nature of parental involvement in the intervention of children with hearing loss, as experienced by parents. Design A qualitative descriptive methodology was adopted to conduct semi-structured in-depth interviews with a purposive sample of parents who have a child with hearing loss. Study Sample Seventeen parents of 11 children aged 6 to 9 years participated in this study. Results The overarching theme of parents taking the central role was identified using thematic analysis. This overarching theme connected five themes which described the nature of parental involvement: (1) parents work behind the scenes; (2) parents act as ‘case managers’; (3) parents always have their child’s language development in mind; (4) parents’ role extends to advocacy for all children with hearing loss; and (5) parents serve a number of roles, but at the end of the day, they are parents. Conclusions The results indicate that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices. These findings have important implications for the provision of family-centred practices. PMID:27599106

What role can the rural pipeline play in the recruitment and retention of rural allied health professionals?

PubMed

Durey, Angela; Haigh, Margaret; Katzenellenbogen, Judith M

2015-01-01

People living in rural areas have poorer health than their urban counterparts with higher morbidity and mortality rates and lower life expectancy. Challenges attracting health professionals to work in rural locations in Australia and elsewhere have been well- documented. In response, the idea of a rural pipeline emerged in the medical literature as a career pathway for doctors, conceptualised as a career continuum starting at school and ending in a committed, appropriately trained and supported rural doctor. This article draws on the literature to consider how the concept of a rural pipeline can be used to enhance recruitment and retention of allied health professionals (AHPs) in Australia. The complexity of the issue is taken into account, acknowledging the diverse professional, organisational and social needs within and between AHPs and their different career pathways. With this in mind, the rural pipeline is adapted and extended to focus on AHPs who enter at any stage of their career to work in rural areas. Barriers to recruitment and retention require multifaceted strategies to encourage and support AHPs at various stages along the pipeline to enter, and remain in, rural practice. Findings from the literature identify discrete themes within and between AHPs about factors influencing their rural recruitment and retention choices and include career stage at entry to rural practice, age, gender, social context, professional support, organisational environment and public-private practice mix in service delivery. These findings underscored the development of an extended rural pipeline adapted to specifically target AHPs. This flexible framework of entry to rural practice can be applied at any stage of their career and includes suggestions of strategies to support retention. Evidence from studies of rural AHPs suggests a flexible approach to recruitment and retention is needed that takes into account the complexity of the issue. The extended rural pipeline adapted to AHPs avoids a one-size-fits-all approach. Instead, it offers a more nuanced approach that addresses the diversity within and between professions and reflects the different stages at which AHPs enter rural practice that can inform recruitment and retention strategies that better meet their needs.

Refocusing website marketing: physician-patient relationships.

PubMed

Sanchez, Peter M

2002-01-01

Physician websites have become commonplace in the world of health care marketing. Most, if not all of these websites, focus on practice enhancement tactics as a means of increasing office traffic in an increasingly competitive environment. Websites developed in this way fail to tap the interactive potential of website technology and provide little support for the development of physician-patient relationships. In this paper, we extend a model of medical service care so as to refocus attention on the importance of physician-patient relationships and the role websites can play in this process.

Educating nurses to protect the past or to advance health care?: A polemic.

PubMed

Nay, R; Pearson, A

2001-01-01

Internationally, nursing is challenged by recruitment and retention issues. On the one hand nursing is expanding and extending practice whilst on the other, lesser skilled workers are undertaking many roles which were previously fulfilled by nurses. This opinion paper contextualises the current debate and outlines many of the reasons that have been proffered for the apparent shortage. It then progresses to suggest strategies that may ensure nursing remains relevant to contemporary health care. Essentially a presentation of the authors' views, the intent of the paper is to generate debate.

Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder.

PubMed

Price, Maggi; Spinazzola, Joseph; Musicaro, Regina; Turner, Jennifer; Suvak, Michael; Emerson, David; van der Kolk, Bessel

2017-04-01

Yoga has been found to be an effective posttraumatic stress disorder (PTSD) treatment for a variety of trauma survivors, including females with chronic PTSD. Aim/Purpose: The current study builds on extant research by examining an extended trauma-sensitive yoga treatment for women with chronic PTSD. The study sought to optimize the results of a treatment protocol examined in a recent randomized controlled trial with a shorter duration and without assignment or monitoring of home practice. The authors examined a 20-week trauma-sensitive yoga treatment in a non-randomized single-group treatment feasibility study for women with chronic treatment-resistant PTSD (N = 9). The authors examined PTSD and dissociation symptom reduction over several assessment periods. The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration. The findings suggest that more intensive trauma-sensitive yoga treatment characterized by longer duration and intentional assignment and monitoring of home practice may be more advantageous for individuals with severe and chronic PTSD. The implications of the findings for the potentially more substantial role of yoga as an intervention for a subset of adults with chronic treatment-resistant PTSD are discussed.

The role of biofeedback in the treatment of gastrointestinal disorders.

PubMed

Chiarioni, Giuseppe; Whitehead, William E

2008-07-01

Biofeedback is a form of treatment that has no adverse effects and can be provided by physician extenders. The therapy relies on patients' ability to learn how to influence their bodily functions through dedicated machinery and teaching. This Review provides a comprehensive overview of all potential therapeutic applications of biofeedback for functional constipation, fecal incontinence, functional anorectal pain, IBS, functional dyspepsia, and aerophagia. Practical clinical applications of biofeedback therapy supported by randomized, controlled trials (RCTs) are limited to fecal incontinence and dyssynergic defecation. For fecal incontinence, RCTs suggest that biofeedback combining strength training and sensory discrimination training is effective in approximately 75% of patients and is more effective than placebo. However, verbal feedback provided by a therapist during extended digital examination may be equally effective, and children whose fecal incontinence is associated with constipation plus fecal impaction do no better with biofeedback than medical management. For dyssynergic defecation, RCTs show that biofeedback combining pelvic floor muscle relaxation training, practice in defecating a water-filled balloon, and instruction in effective straining is effective in approximately 70% of patients who have failed to respond to laxative treatment. For both incontinence and dyssynergic defecation, the benefits of biofeedback last at least 12 months.

The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.

PubMed

Li, Julie; Westbrook, Johanna; Callen, Joanne; Georgiou, Andrew

2012-04-02

The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care. ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits.

Student nurses as school nurse extenders.

PubMed

Rossman, Carol L; Dood, Florence V; Squires, Darcy A

2012-12-01

The severe underuse of school nurses leaves students with unaddressed health needs that impact their safety and learning ability. An undergraduate pediatric clinical focusing on nursing students and the role of a school nurse in an elementary school setting can be a unique approach to combining the needs of school children and educating student nurses. One school of nursing created such a project to help address these needs and collect data on the activities student nurses performed in school nurse role and their impact on student health. This project serves as both a practice improvement project and an innovation in pediatric clinical education. The purposes of this project were to quantify baccalaureate nursing student activities related to the school nurse role and to evaluate the results that have the potential to impact on student health in an urban elementary school. Copyright © 2012 Elsevier Inc. All rights reserved.

Beyond parenting practices: extended kinship support and the academic adjustment of African-American and European-American teens.

PubMed

Pallock, Linda L; Lamborn, Susie D

2006-10-01

This study examined adolescents' perceptions of parenting practices and extended kinship support in relation to academic adjustment for 104 African American and 60 European American 9th and 10th graders (14 and 15 year olds). For African-American teens, parental acceptance was associated with school values, teacher bonding, and work orientation. Higher levels of behavioral control and lower levels of psychological control were associated with a stronger work orientation. After accounting for the demographic variables and the three parenting practices, higher levels of extended kinship support related to stronger school values, higher teacher bonding, and a stronger work orientation. For European-American teens, parental acceptance related to academic adjustment, including stronger school values, higher teacher bonding, and a stronger work orientation. European-American adolescents with stronger extended kinship networks reported higher teacher bonding and a stronger work orientation. Results indicate the importance of extended kinship support for both African-American and European-American adolescents.

Higgs data does not rule out a sequential fourth generation with an extended scalar sector

NASA Astrophysics Data System (ADS)

Das, Dipankar; Kundu, Anirban; Saha, Ipsita

2018-01-01

Contrary to common perception, we show that the current Higgs data does not eliminate the possibility of a sequential fourth generation that get their masses through the same Higgs mechanism as the first three generations. The inability to fix the sign of the bottom-quark Yukawa coupling from the available data plays a crucial role in accommodating a chiral fourth generation which is consistent with the bounds on the Higgs signal strengths. We show that effects of such a fourth generation can remain completely hidden not only in the production of the Higgs boson through gluon fusion but also to its subsequent decay to γ γ and Z γ . This, however, is feasible only if the scalar sector of the standard model is extended. We also provide a practical example illustrating how our general prescription can be embedded in a realistic model.

Extending Quantum Chemistry of Bound States to Electronic Resonances

NASA Astrophysics Data System (ADS)

Jagau, Thomas-C.; Bravaya, Ksenia B.; Krylov, Anna I.

2017-05-01

Electronic resonances are metastable states with finite lifetime embedded in the ionization or detachment continuum. They are ubiquitous in chemistry, physics, and biology. Resonances play a central role in processes as diverse as DNA radiolysis, plasmonic catalysis, and attosecond spectroscopy. This review describes novel equation-of-motion coupled-cluster (EOM-CC) methods designed to treat resonances and bound states on an equal footing. Built on complex-variable techniques such as complex scaling and complex absorbing potentials that allow resonances to be associated with a single eigenstate of the molecular Hamiltonian rather than several continuum eigenstates, these methods extend electronic-structure tools developed for bound states to electronic resonances. Selected examples emphasize the formal advantages as well as the numerical accuracy of EOM-CC in the treatment of electronic resonances. Connections to experimental observables such as spectra and cross sections, as well as practical aspects of implementing complex-valued approaches, are also discussed.

A physiotherapy perspective of musculoskeletal imaging in sport.

PubMed

Callaghan, M J

2012-08-01

This paper presents a physiotherapy perspective on the role that imaging is now playing in the diagnosis and management of musculoskeletal and sporting injuries. Although the Royal College of Radiologists and the UK Chartered Society of Physiotherapy were founded in the latter part of the nineteenth century, it is 100 years later that developments in the UK NHS have led to increased roles for non-medical healthcare professionals and allied health professionals, such as physiotherapists, in an extended clinical role. Physiotherapists, perhaps because of their knowledge of clinical and applied anatomy, have keenly taken up the opportunities offered to request and interpret imaging in its various forms; the most commonly available are plain radiography, musculoskeletal ultrasound and MRI. This has meant taking formal courses under the auspices of universities with mentorship and tutoring within the clinical setting, which are part of a continuing professional development. The ability to request several forms of imaging has enhanced physiotherapy practice and has increased the appreciation of the responsibilities which accompany this new role.

Corporate social responsibility practices in the Nigerian oil sector: The case of Royal Dutch Shell

NASA Astrophysics Data System (ADS)

Rwabizambuga, Alexis

The thesis contributes to the perspective on the role of stakeholder engagement in negotiating corporate social responsibility (CSR) policies and practices in developing country context. It critically examines the role of societal pressures as drivers of Shell's CSR agenda, and explores the forms of relationships existing between Shell and its stakeholders in Nigeria, as the company implements its CSR programme, both in the light of its strategic business objectives and of its social responsibilities and environmental liabilities. Furthermore, it examines the role of government in the oil MNCs' CSR agenda, and explores the conditions under which the government, in its dual role as business partner and as state authority, promotes CSR policies and practices in Nigeria. Shell's CSR policies and practices in Nigeria were examined under the theoretical lenses of the resource-based view perspective extended to notions of legitimacy and the licence to operate. Additionally, the stakeholder engagement perspective was applied as the theoretical framework for examining Shell's stakeholder engagement, and the role of the company's stakeholders in negotiating its current CSR policies and practices in Nigeria. Data collection was undertaken during field research in Nigeria. The evidence presented is drawn from individual interviews with corporate executives at Shell Nigeria, Shell International, several stakeholders in the Nigerian oil sector, and from an online survey conducted in 2005 on Shell Nigeria's stakeholders. Both quantitative and qualitative methods were used throughout the analysis presented in the thesis. The research findings suggest that the relationship between the firm's pursuit of the social licence to operate through CSR initiatives and stakeholder engagement is more complex than assumed. It adds to the understanding of the dynamics of a MNC's stakeholder engagement in the local context. It highlights the various interdependencies that develop between stakeholder groups and the company at the institutional level as well as within the context of the organisation, as the corporation develops and implements its CSR agenda. As such, the research invites an examination not just of the differences and barriers existing between the firm and its stakeholders, home and host country practices, but also of the ways in which they are embedded in each other, and how this affects their collaboration.

Physiotherapy Practice: Opportunities for International Collaboration on Workforce Reforms, Policy and Research.

PubMed

Grimmer, K; Morris, J; Kim, S; Milanese, S; Fletcher, W

2017-07-01

Physiotherapy or Physical Therapy (PT) is the most commonly practised allied health discipline globally. International PT workforce reforms are underway to deal with increasing patient numbers, shrinking medical and nursing workforces and lengthy waiting lists. It is timely to consider international differences in PT, with the aims of identifying opportunities for shared learning and forming stronger international alliances to support consistent and evidence-based workforce reforms. This paper synthesizes freely available information on PT training and service delivery across the UK, Australia and United States (California). The paper considers differences in roles, workplaces, training, legislation and registration, continuing professional development, and accountability. There are similarities between UK, Australia and United States (California) in many areas of PT roles, training, registration, legislation and professional practice. However, none has a standard national mechanism by which to demonstrate PT accountability, patient safety or quality care. Moreover, there are different approaches to workforce reforms. There is considerable duplication in physiotherapy governance. There are opportunities for targeted international collaborations regarding workforce reforms such as extending scope of practice, and determining and implementing internationally agreed ways of demonstrating PT accountability. The findings of this review have significant policy implications, and identify areas for collaborative research. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Deriving consensus on the characteristics of advanced practice nursing: meta-summary of more than 2 decades of research.

PubMed

Hutchinson, Marie; East, Leah; Stasa, Helen; Jackson, Debra

2014-01-01

Over recent decades, there has been considerable research and debate about essential features of advanced nursing practice and differences among various categories of advanced practice nurses. This study aimed to derive an integrative description of the defining characteristics of advanced practice nursing through a meta-summary of the existing literature. A three-phase approach involved (a) systematic review of the literature to identify the specific activities characterized as advanced practice nursing, (b) qualitative meta-summary of practice characteristics extracted from manuscripts meeting inclusion criteria; and (c) statistical analysis of domains across advanced practice categories and country in which the study was completed. A descriptive framework was distilled using qualitative and quantitative results. Fifty manuscripts met inclusion criteria and were retained for analysis. Seven domains of advanced nursing practice were identified: (a) autonomous or nurse-led extended clinical practice; (b) improving systems of care; (c) developing the practice of others; (d) developing/delivering educational programs/activities; (e) nursing research/scholarship; (f) leadership external to the organization; and (g) administering programs, budgets, and personnel. Domains were similar across categories of advanced nursing practice; the domain of developing/delivering educational programs/activities was more common in Australia than in the United States or United Kingdom. Similarity at the domain level was sufficient to suggest that advanced practice role categories are less distinct than often argued. There is merit in adopting a more integrated and consistent interpretation of advanced practice nursing.

Extended Education's Role: Facilitating Higher Education to Historically Underrepresented Groups

ERIC Educational Resources Information Center

Moore, Scott D.; Statham, Russel D.; Zelezny, Lynnette

2013-01-01

Extended Education, the home for outreach and access, is an often overlooked resource for accomplishing the university's mission. This article focuses on the role Extended Education has played in serving underrepresented minority groups in the California Central Valley. Through both description and analytical review of data generated from the…

Status and progress of studies on the nature of speech, instrumentation for its investigation and practical applications

NASA Astrophysics Data System (ADS)

Liberman, A. M.

1983-09-01

This report is one of a regular series on the status and progress of studies on the nature of speech, instrumentation for its investigation, and practical applications. Manuscripts cover the following topics: The association between comprehension of spoken sentences and early reading ability: The role of phonetic representation; Phonetic coding and order memory in relation to reading proficiency: A comparison of short-term memory for temporal and spatial order information; Exploring the oral and written language errors made by language disabled children; Perceiving phonetic events; Converging evidence in support of common dynamical principles for speech and movement coordination; Phase transitions and critical behavior in human bimanual coordination; Timing and coarticulation for alveolo-palatals and sequences of alveolar +J in Catalan; V-to-C coarticulation in Catalan VCV sequences: An articulatory and acoustical study; Prosody and the /S/-/c/ distinction; Intersections of tone and intonation in Thai; Simultaneous measurements of vowels produced by a hearing-impaired speaker; Extending format transitions may not improve aphasics' perception of stop consonant place of articulation; Against a role of chirp identification in duplex perception; Further evidence for the role of relative timing in speech: A reply to Barry; Review (Phonological intervention: Concepts and procedures); and Review (Temporal variables in speech).

Leadership Practices that Contribute to Extended Presidential Tenure and the Development of High-Performing Community Colleges

ERIC Educational Resources Information Center

Poole, David

2012-01-01

The purpose of this mixed methods study was to identify and better understand leadership styles and practices that contribute to extended presidential tenure and the development of high-performing community colleges. Profiles were developed drawing from the six California community college chancellors, presidents, and superintendent/presidents who…

Fasting: Molecular Mechanisms and Clinical Applications

PubMed Central

Longo, Valter D.; Mattson, Mark P.

2014-01-01

Fasting has been practiced for millennia, but only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. PMID:24440038

Community Campaigns, Supply Chains, and Protecting the Health and Well-Being of Workers

PubMed Central

Quinlan, Michael

2009-01-01

The growth of contingent work (also known as precarious employment), the informal sector, and business practices that diffuse employer responsibility for worker health and safety (such as outsourcing and the development of extended national and international contracting networks [supply chains]) pose a serious threat to occupational health and safety that disproportionately affects low-wage, ethnic minority, and immigrant workers. Drawing on cases from the United States and Australia, we examine the role that community-based campaigns can play in meeting these challenges, including several successful campaigns that incorporate supply chain regulation. PMID:19890154

Community campaigns, supply chains, and protecting the health and well-being of workers.

PubMed

Quinlan, Michael; Sokas, Rosemary K

2009-11-01

The growth of contingent work (also known as precarious employment), the informal sector, and business practices that diffuse employer responsibility for worker health and safety (such as outsourcing and the development of extended national and international contracting networks [supply chains]) pose a serious threat to occupational health and safety that disproportionately affects low-wage, ethnic minority, and immigrant workers. Drawing on cases from the United States and Australia, we examine the role that community-based campaigns can play in meeting these challenges, including several successful campaigns that incorporate supply chain regulation.

Hospitals should be exemplars of healthy workplaces.

PubMed

Russell, Lesley M; Anstey, Matthew H R; Wells, Susan

2015-05-04

As major employers and flagship health care organisations, hospitals can influence the norms of the communities they serve by adopting model policies and practices that promote the health of patients, visitors, employees, students and trainees. Hospitals must become healthy workplaces in every sense and extend their role to focus on health and wellness, not just illness. Reorienting hospital policies can: ensure the provision and stewardship of healthy, ecologically sound and sustainable environments; increase the focus on promoting health and prevention; foster interpersonal safety; and improve workplace safety. Such efforts deliver improvements in health outcomes and savings in hospital budgets.

Direct-to-consumer advertising: Australian pharmacists' experiences with non-prescription medicines.

PubMed

Chaar, Betty; Kwong, Kenelm

2010-02-01

Direct-to-consumer advertising (DTCA) of over-the-counter or prescribed medicines is a highly controversial issue relating to public health care. Advocates highlight the advantages of DTCA in terms of patient awareness and autonomy. Opponents voice concerns about safety and patients' best interests. The views of physicians and consumers about DTCA have been widely investigated. There has been little research, however, in relation to pharmacists' experiences with DTCA and the impact of DTCA on pharmacy practice. The aim of this study was therefore to explore pharmacists' perceptions of DTCA in Australia and its impact on pharmacy practice. A semi-structured in-depth interview was conducted with a purposive convenience sample of retail pharmacists in Sydney, Australia. Interviews were recorded, transcribed ad verbatim and continued until data saturation. Emerging themes were extracted and analysed according to the grounded theory approach. Pharmacists participating in this study reported concern about potential harm to patient health and well-being as a result of the influence of DTCA. DTCA was seen to impede pharmacists in the discharge of their fundamental ethical responsibilities, leading to a strong sense of disempowerment. Pharmacists' gate-keeping role was challenged by DTCA encouraging consumers to self-medicate and inducing a range of drug-seeking behaviours. Although pharmacists acknowledged that DTCA may have a role in promoting patient autonomy, in practice DTCA compromised their role in safeguarding consumers from inappropriate use of medicines. This study highlighted that the impact of DTCA is not restricted to prescription medicines, but extended also to over-the-counter, pharmacist-only and other pharmacy-related products. Pharmacists perceived that DTCA disempowered them, compromising their role in safeguarding the community from inappropriate medicine use.

Making working memory work: The effects of extended practice on focus capacity and the processes of updating, forward access, and random access

PubMed Central

Price, John M.; Colflesh, Gregory J. H.; Cerella, John; Verhaeghen, Paul

2014-01-01

We investigated the effects of 10 hours of practice on variations of the N-Back task to investigate the processes underlying possible expansion of the focus of attention within working memory. Using subtractive logic, we showed that random access (i.e., Sternberg-like search) yielded a modest effect (a 50% increase in speed) whereas the processes of forward access (i.e., retrieval in order, as in a standard N-Back task) and updating (i.e., changing the contents of working memory) were executed about 5 times faster after extended practice. We additionally found that extended practice increased working memory capacity as measured by the size of the focus of attention for the forward-access task, but not for variations where probing was in random order. This suggests that working memory capacity may depend on the type of search process engaged, and that certain working-memory-related cognitive processes are more amenable to practice than others. PMID:24486803

Collective inquiry in the context of school-wide reform: Exploring science curriculum and instruction through team-based professional development

NASA Astrophysics Data System (ADS)

Eddy Spicer, David Henning

Teacher collaboration and joint reflective inquiry have been viewed as central elements of progressive educational reform for more than two decades. More recently, researchers, policy-makers, and practitioners have heralded "blended" or "hybrid" approaches that combine online and on-site environments for collaborative learning as especially promising for "scaling up" instructional improvement. Yet, relatively little is known about how teachers working together navigate organizational and interpersonal constraints to develop and sustain conditions essential to collective inquiry. This in-depth study of meaning making about curriculum and instruction among a group of 11 physics teachers in a public, urban secondary school in the U.S. is an effort to explore collective inquiry as a resource for teacher learning and innovations in teaching practice. Through extended observations, multiple interviews, and close analyses of interaction, the study followed teachers for 7 months as they worked together across 3 settings organized in fundamentally different ways to promote joint inquiry into teaching practice. The explanatory framework of the study rests on the mutually-reinforcing conceptual underpinnings of sociocultural theory and systemic functional linguistics to establish connections between micro-social interactions and macro-social processes. Drawing on systemic functional linguistics, the study explores interpersonal meaning making through close analyses of speech function and speech role in 6 extended sequences of generative interaction. Concepts from activity theory elucidate those features of settings and school that directly impinged on or advanced teachers' collaborative work. Findings run counter to prevailing congenial views of teacher collegiality by identifying ways in which collective inquiry is inherently unstable. That instability makes itself apparent at two levels: (a) the dynamics of authority within the group, and (b) middle-level features of setting and school that favored preserving solidarity above developing a critical stance towards practice. The study offers a theoretically-informed description of collective inquiry and an analytic framework to trace its development in naturally-occurring interaction. The analytic framework extends the tools of functional analysis into a new realm, that of teachers' collaborative work, and offers means to understand better the complex array of forces shaping and shaped by teachers' everyday interactions around their practice.

Experimental evaluation of the extended Dytlewski-style dead time correction formalism for neutron multiplicity counting

NASA Astrophysics Data System (ADS)

Lockhart, M.; Henzlova, D.; Croft, S.; Cutler, T.; Favalli, A.; McGahee, Ch.; Parker, R.

2018-01-01

Over the past few decades, neutron multiplicity counting has played an integral role in Special Nuclear Material (SNM) characterization pertaining to nuclear safeguards. Current neutron multiplicity analysis techniques use singles, doubles, and triples count rates because a methodology to extract and dead time correct higher order count rates (i.e. quads and pents) was not fully developed. This limitation is overcome by the recent extension of a popular dead time correction method developed by Dytlewski. This extended dead time correction algorithm, named Dytlewski-Croft-Favalli(DCF), is detailed in reference Croft and Favalli (2017), which gives an extensive explanation of the theory and implications of this new development. Dead time corrected results can then be used to assay SNM by inverting a set of extended point model equations which as well have only recently been formulated. The current paper discusses and presents the experimental evaluation of practical feasibility of the DCF dead time correction algorithm to demonstrate its performance and applicability in nuclear safeguards applications. In order to test the validity and effectiveness of the dead time correction for quads and pents, 252Cf and SNM sources were measured in high efficiency neutron multiplicity counters at the Los Alamos National Laboratory (LANL) and the count rates were extracted up to the fifth order and corrected for dead time. In order to assess the DCF dead time correction, the corrected data is compared to traditional dead time correction treatment within INCC. The DCF dead time correction is found to provide adequate dead time treatment for broad range of count rates available in practical applications.

The impact of fluoride application training: survey of trained dental nurses from King's College Hospital NHS Trust.

PubMed

Carter, E; Parker, M; Gallagher, J E

2012-05-25

To explore the perceived benefits of a fluoride varnish training scheme, subsequent use of extended skills and any barriers that exist, in order to inform future training and practice. Questionnaire survey of the first four cohorts of fluoride varnish training at one London dental hospital. Thirty-six (62%) nurses responded to the survey, 89% of whom were using fluoride varnishing. 'Personal development', 'NHS initiatives' and 'having a supportive principal' were key drivers for course attendance. Over 2,500 fluoride application treatments were carried out (range = 0-630) with six nurses providing 71% of the treatments. Twenty nurses (56%) worked in the salaried primary dental care service and provided 69% of treatments, the remaining 31% of treatments were provided by the 44% (n = 16) of nurses in general dental practice. Barriers were 'systems-related' and 'professional', including lack of community programmes, consultant oversight, referrals, materials and concerns regarding insurance and consent. The majority felt that the course contributed to their professional career (97%), and expressed their confidence in conducting fluoride application (80%). The findings highlight the potential for using extended roles to deliver evidence-based prevention and variation in their use; however, there is some evidence that organisational and professional barriers exist.

Summary of: the impact of fluoride application training: survey of trained dental nurses from King's College Hospital NHS Trust.

PubMed

Levine, R S

2012-05-25

To explore the perceived benefits of a fluoride varnish training scheme, subsequent use of extended skills and any barriers that exist, in order to inform future training and practice. Questionnaire survey of the first four cohorts of fluoride varnish training at one London dental hospital. Thirty-six (62%) nurses responded to the survey, 89% of whom were using fluoride varnishing. 'Personal development', 'NHS initiatives' and 'having a supportive principal' were key drivers for course attendance. Over 2,500 fluoride application treatments were carried out (range = 0-630) with six nurses providing 71% of the treatments. Twenty nurses (56%) worked in the salaried primary dental care service and provided 69% of treatments, the remaining 31% of treatments were provided by the 44% (n = 16) of nurses in general dental practice. Barriers were 'systems-related' and 'professional', including lack of community programmes, consultant oversight, referrals, materials and concerns regarding insurance and consent. The majority felt that the course contributed to their professional career (97%), and expressed their confidence in conducting fluoride application (80%). The findings highlight the potential for using extended roles to deliver evidence-based prevention and variation in their use; however, there is some evidence that organisational and professional barriers exist.

Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder

PubMed Central

Price, Maggi; Musicaro, Regina; Turner, Jennifer; Suvak, Michael; Emerson, David; van der Kolk, Bessel

2017-01-01

Abstract Background: Yoga has been found to be an effective posttraumatic stress disorder (PTSD) treatment for a variety of trauma survivors, including females with chronic PTSD. Aim/Purpose: The current study builds on extant research by examining an extended trauma-sensitive yoga treatment for women with chronic PTSD. The study sought to optimize the results of a treatment protocol examined in a recent randomized controlled trial with a shorter duration and without assignment or monitoring of home practice. Materials and Methods: The authors examined a 20-week trauma-sensitive yoga treatment in a non-randomized single-group treatment feasibility study for women with chronic treatment-resistant PTSD (N = 9). The authors examined PTSD and dissociation symptom reduction over several assessment periods. Results: The results indicate that participants experienced significant reductions in PTSD and dissociative symptomatology above and beyond similar treatments of a shorter duration. Conclusions: The findings suggest that more intensive trauma-sensitive yoga treatment characterized by longer duration and intentional assignment and monitoring of home practice may be more advantageous for individuals with severe and chronic PTSD. The implications of the findings for the potentially more substantial role of yoga as an intervention for a subset of adults with chronic treatment-resistant PTSD are discussed. PMID:28121466

Mentoring for NHS doctors: perceived benefits across the personal–professional interface

PubMed Central

Steven, A; Oxley, J; Fleming, WG

2008-01-01

Summary Objective To investigate NHS doctors' perceived benefits of being involved in mentoring schemes and to explore the overlaps and relationships between areas of benefit. Design Extended qualitative analysis of a multi-site interview study following an interpretivist approach. Setting Six NHS mentoring schemes across England. Main outcome measures Perceived benefits. Results While primary analysis resulted in lists of perceived benefits, the extended analysis revealed three overarching areas: professional practice, personal well-being and development. Benefits appear to go beyond a doctor's professional role to cross the personal–professional interface. Problem solving and change management seem to be key processes underpinning the raft of personal and professional benefits reported. A conceptual map was developed to depict these areas and relationships. In addition secondary analysis suggests that in benefitting one area mentoring may lead to consequential benefits in others. Conclusions Prior research into mentoring has mainly taken place in a single health care sector. This multi-site study suggests that the perceived benefits of involvement in mentoring may cross the personal/professional interface and may override organizational differences. Furthermore the map developed highlights the complex relationships which exist between the three areas of professional practice, personal wellbeing and personal and professional development. Given the consistency of findings across several studies it seems probable that organizations would be strengthened by doctors who feel more satisfied and confident in their professional roles as a result of participation in mentoring. Mentoring may have the potential to take us beyond individual limits to greater benefits and the conceptual map may offer a starting point for the development of outcome criteria and evaluation tools for mentoring schemes. PMID:19029356

Extended Duration Vascular Endothelial Growth Factor Inhibition in the Eye: Failures, Successes, and Future Possibilities.

PubMed

Stewart, Michael W

2018-01-27

Vascular endothelial growth factor (VEGF) plays a pivotal role in the development of neovascularization and edema from several common chorioretinal vascular conditions. The intravitreally injected drugs (aflibercept, bevacizumab, conbercept, pegaptanib, and ranibizumab) used to treat these conditions improve the visual acuity and macular morphology in most patients. Monthly or bimonthly injections were administered in the phase III pivotal trials but physicians usually individualize therapy with pro re nata (PRN) or treat and extend regimens. Despite these lower frequency treatment regimens, frequent injections and clinic visits are still needed to produce satisfactory outcomes. Newly developed drugs and refillable reservoirs with favorable pharmacokinetic profiles may extend durations of action and require fewer office visits. However, we have learned from previous experiences that the longer durations of action seen in strategically designed phase III trials often do not translate to less frequent injections in real-life clinical practice. Unfortunately, long-acting therapies that produce soluble VEGF receptors (encapsulated cell technology and adenovirus injected DNA) have failed in phase II trials. The development of longer duration therapies remains a difficult and frustrating process, and frequent drug injections are likely to remain the standard-of-care for years to come.

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

PubMed

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

2016-06-01

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

The role of extended family in diverse teens’ sexual health

PubMed Central

Grossman, Jennifer M.; Tracy, Allison; Richer, Amanda; Erkut, Sumru

2016-01-01

Despite increasing extended family involvement in childrearing, particularly in minority families, few studies investigate their role in talking with teens about sex or how this relates to teens’ sexual behavior. This mixed methods study assesses extended family sexuality communication through a survey of 1492 diverse middle school students and interviews with 32 students. Logistic regression shows that participants who report having had sex are more likely to report talking with extended family than those who report not having had sex. Interview themes explored reasons for and content of teen sexuality conversations with extended family. More sexually active teens’ reporting communication with extended family is interpreted as extended family members gaining importance in sexuality communication as teens become sexually active. PMID:27110060

The Hidden Job Requirements for a Software Engineer

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

Marinovici, Maria C.; Kirkham, Harold; Glass, Kevin A.

In a world increasingly operated by computers, where innovation depends on software, the software engineer’s role is changing continuously and gaining new dimensions. In commercial software development as well as scientific research environments, the way software developers are perceived is changing, because they are more important to the business than ever before. Nowadays, their job requires skills extending beyond the regular job description posted by HR, and more is expected. To advance and thrive in their new roles, the software engineers must embrace change, and practice the themes of the new era (integration, collaboration and optimization). The challenges may bemore » somehow intimidating for freshly graduated software engineers. Through this paper the authors hope to set them on a path for success, by helping them relinquish their fear of the unknown.« less

Commentary Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Health Care Settings

PubMed Central

Fisher, Edward M.; Shaffer, Ronald E.

2015-01-01

Public health organizations, such as the Centers for Disease Control and Prevention (CDC), are increasingly recommending the use of N95 filtering facepiece respirators (FFRs) in health care settings. For infection control purposes, the usual practice is to discard FFRs after close contact with a patient (“single use”). However, in some situations, such as during contact with tuberculosis patients, limited FFR reuse (i.e., repeated donning and doffing of the same FFR by the same person) is practiced. A related practice, extended use, involves wearing the same FFR for multiple patient encounters without doffing. Extended use and limited FFR reuse have been recommended during infectious disease outbreaks and pandemics to conserve FFR supplies. This commentary examines CDC recommendations related to FFR extended use and limited reuse and analyzes available data from the literature to provide a relative estimate of the risks of these practices compared to single use. Analysis of the available data and the use of disease transmission models indicate that decisions regarding whether FFR extended use or reuse should be recommended should continue to be pathogen- and event-specific. Factors to be included in developing the recommendations are the potential for the pathogen to spread via contact transmission, the potential that the event could result in or is currently causing a FFR shortage, the protection provided by FFR use, human factors, potential for self-inoculation, the potential for secondary exposures, and government policies and regulations. While recent findings largely support the previous recommendations for extended use and limited reuse in certain situations, some new cautions and limitations should be considered before issuing recommendations in the future. In general, extended use of FFRs is preferred over limited FFR reuse. Limited FFR reuse would allow the user a brief respite from extended wear times, but increases the risk of self-inoculation and preliminary data from one study suggest that some FFR models may begin to lose effectiveness after multiple donnings. PMID:24628658

Nurse awareness of clinical research: a survey in a Japanese University Hospital

PubMed Central

2014-01-01

Background Clinical research plays an important role in establishing new treatments and improving the quality of medical practice. Since the introduction of the concept of clinical research coordinators (CRC) in Japan, investigators and CRC work as a clinical research team that coordinates with other professionals in clinical trials leading to drug approval (registration trials). Although clinical nurses collaborate with clinical research teams, extended clinical research teams that include clinical nurses may contribute to the ethical and scientific pursuit of clinical research. Methods As knowledge of clinical research is essential for establishing an extended clinical research team, we used questionnaires to survey the knowledge of clinical nurses at Tokushima University Hospital. Five-point and two-point scales were used. Questions as for various experiences were also included and the relationship between awareness and experiences were analyzed. Results Among the 597 nurses at Tokushima University Hospital, 453 (75.9%) responded to the questionnaires. In Japan, registration trials are regulated by pharmaceutical affairs laws, whereas other types of investigator-initiated research (clinical research) are conducted based on ethical guidelines outlined by the ministries of Japan. Approximately 90% of respondents were aware of registration trials and clinical research, but less than 40% of the nurses were aware of their difference. In clinical research terminology, most respondents were aware of informed consent and related issues, but ≤50% were aware of other things, such as the Declaration of Helsinki, ethical guidelines, Good Clinical Practice, institutional review boards, and ethics committees. We found no specific tendency in the relationship between awareness and past experiences, such as nursing patients who were participating in registration trials and/or clinical research or taking a part in research involving patients as a nursing student or a nurse. Conclusions These findings suggest that clinical nurses have only limited knowledge on clinical research and the importance to have chances to make nurses aware of clinical research-related issues is suggested to establish an extended research team. Because of the study limitations, further study is warranted to determine the role of clinical nurses in establishing a suitable infrastructure for ethical pursuit of clinical research. PMID:24989623

Beyond Parenting Practices: Extended Kinship Support and the Academic Adjustment of African-American and European-American Teens

ERIC Educational Resources Information Center

Pallock, Linda L.; Lamborn, Susie D.

2006-01-01

This study examined adolescents' perceptions of parenting practices and extended kinship support in relation to academic adjustment for 104 African American and 60 European American 9th and 10th graders (14 and 15 year olds). For African-American teens, parental acceptance was associated with school values, teacher bonding, and work orientation.…

Clinical education facilitators: a literature review.

PubMed

Lambert, Veronica; Glacken, Michèle

2005-07-01

The aim of this literature review, set within an Irish context, is to present a broad overview of former and existing clinical support personnel, explore the concept of facilitation and examine what is known about the role of the clinical education facilitator. The importance of providing a supportive clinical environment to enhance clinical teaching and learning is strongly portrayed in the literature. While the past two decades have borne witness to various clinical support personnel, the literature identifies conflicting demands that these personnel face. No suggestions are advanced as to how to overcome these difficulties, which inevitably influence the quality and quantity of their clinical teaching role. An identifiable gap exists over who has prime responsibility for clinical teaching. It is timely that alternative possibilities for organizing clinical teaching are investigated. A new post emerging in practice settings is that of the clinical education facilitator who is meant to be the key linchpin in clinical areas for reducing the theory-practice gap. Relevant literature for this review was sourced using the computerized databases CINAHL, Medline and Synergy. Manual searching of relevant nursing journals and sourcing of secondary references extended the search. Government reports and other relevant documents were obtained through pertinent websites. Papers that explicitly examined the concept of facilitation and explored the posts of clinical education facilitators were included; six research papers were accessed and reviewed. In addition seven non-empirical papers were included. It is clear that considerable lack of role clarity resides over what constitutes clinical facilitation and the role of the clinical facilitator. Thus, it is paramount to strengthen this support role with Irish empirical evidence. A major advantage in having a ward-based clinical education facilitator is the benefit of having access to someone who can concentrate solely on clinical education and support with attempts to narrow the theory-practice divide.

The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments

PubMed Central

2012-01-01

Background The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. Methods A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. Results The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care. Conclusions ICT is a facilitator through which the disruptive impact of NPs can be extended. However, integration of ICT into work practices without detracting from provider-patient interaction is crucial to ensure utilisation of such interventions and realisation of potential benefits. PMID:22462409

The role of traditional healers in the provision of health care and family planning services: Malay traditional and indigenous medicine.

PubMed

Raden Sanusi, H R; Werner, R

1985-01-01

The practitioners of traditional and indigenous medicine rely mainly upon medicinal plants and herbs for the preparation of therapeutic substances. The therapeutic properties of several medicinal plants and popular traditional medicine remedies are being investigated and validated. Present health care systems place people from developing countries in a dilemma. Countries can either continue providing a type of health care which cannot be extended to all in need or rethink and offer more inclusive types of medical care and delivery systems. Traditional medicine has a clear role to play in society, and even the World Health Organization supports the practice of traditional medicine to complement modern medicine. Traditional Malay medicine is the distillation of vast historical experience dating back more than 1000 years. It is often based upon observation, clinical trials, and experiments. The promotion and development of Malay traditional medicine can both foster dignity and self-confidence in communities through self-reliance, while considerably reducing the country's drug costs. The integrity and dignity of a people stems from self-respect and self-reliance. The practice of traditional medicine practitioners can help promote such conditions in many ways. It serves as an important focus for international technical cooperation and offers the potential for major breakthroughs in therapeutics and health care delivery. Effort should be taken to keep the practice of traditional medicine alive in Malaysia.

Setting the Stage for Developing Pre-service Teachers' Conceptions of Good Science Teaching: The role of classroom videos

NASA Astrophysics Data System (ADS)

Wong, Siu Ling; Yung, Benny Hin Wai; Cheng, Man Wai; Lam, Kwok Leung; Hodson, Derek

2006-01-01

This paper reports findings about a curriculum innovation conducted at The University of Hong Kong. A CD-ROM consisting of videos of two lessons by different teachers demonstrating exemplary science teaching was used to elicit conceptions of good science teaching of student-teachers enrolled for the 1-year Postgraduate Diploma in Education at several stages during the programme. It was found that the videos elicited student-teachers’ conceptions and had impact on those conceptions prior to the commencement of formal instruction. It has extended student-teachers’ awareness of alternative teaching methods and approaches not experienced in their own schooling, broadened their awareness of different classroom situations, provided proof of existence of good practices, and prompted them to reflect on their current preconceptions of good science teaching. In several ways, the videos acted as a catalyst in socializing the transition of student-teachers from the role of student to the role of teacher.

Clinical review: the role of the intensive care physician in mass casualty incidents: planning, organisation, and leadership.

PubMed

Shirley, Peter J; Mandersloot, Gerlinde

2008-01-01

There is a long-standing, broad assumption that hospitals will ably receive and efficiently provide comprehensive care to victims following a mass casualty event. Unfortunately, the majority of medical major incident plans are insufficiently focused on strategies and procedures that extend beyond the pre-hospital and early-hospital phases of care. Recent events underscore two important lessons: (a) the role of intensive care specialists extends well beyond the intensive care unit during such events, and (b) non-intensive care hospital personnel must have the ability to provide basic critical care. The bombing of the London transport network, while highlighting some good practices in our major incident planning, also exposed weaknesses already described by others. Whilst this paper uses the events of the 7 July 2005 as its point of reference, the lessons learned and the changes incorporated in our planning have generic applications to mass casualty events. In the UK, the Department of Health convened an expert symposium in June 2007 to identify lessons learned from 7 July 2005 and disseminate them for the benefit of the wider medical community. The experiences of clinicians from critical care units in London made a large contribution to this process and are discussed in this paper.

The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

PubMed

Taylor, Anita; Staruchowicz, Lynda

This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much informed by the experiences of the United States and United Kingdom and for the most part there exists a parallel between the international experience and the Australian experience of nurse practitioners.This review will focus on orthopaedic nurse practitioners in an international context. However the local context of the primary reviewer which informs this review is Australian. Australia has mirrored the trends around nurse practitioner practice found elsewhere. In the last 20 years (post implementation of the 1986 Australian nursing career structure), the debate around advanced nursing practice and nurse practitioners, in an Australian context, has developed. The inaugural 'legal & policy' nurse practitioner framework was developed in New South Wales (NSW) in 1998, with the first Australian nurse practitioner authorised to practise in NSW in 2000. It is posited that evaluation of emerging roles began to be seen in the research literature from 1990 onwards. In response to a need for creative workforce re-engineering and against a context of limited health resources, nurse practitioners in Australia over the last 20 years have emerged as an alternative model of health care delivery. For the last 10 years there has been a proliferation of influential 'reports' written by nurse researchers, generated to review the progress of Australia's nurse practitioners, commissioned by the health departments of respective state governments and other service planners to guide health workforce planning.In a national context the Australian Nursing & Midwifery Council (ANMC) as the peak national nursing body, defines a nurse practitioner as a Registered Nurse (RN) who is educated and authorised to practice autonomously and collaboratively in an advanced and extended clinical role. The ANMC Competency Standards for the Nurse Practitioner encompass three generic standards which are further defined by nine competencies. The competency standards provide a framework for practice and licensure of nurse practitioners in Australia. In order for the nurse practitioner to be endorsed by the Australian Health Practitioner Regulation Agency (AHPRA) to practise as a nurse practitioner they must have met the competency standards and be endorsed to practise by the Nursing and Midwifery Board of Australia (NMBA) as a nurse practitioner under section 95 of the National Law. The nurse practitioner's endorsement in Australia is contextualised by their scope of practice, as is the case internationally.At September 2011, 450 endorsed nurse practitioners were nationally registered with AHPRA; 54 of these were endorsed to practise in South Australia. The first orthopaedic nurse practitioner was authorised in South Australia in 2005. To date there are eight endorsed orthopaedic nurse practitioners in Australia authorised to practise in a diverse range of orthopaedic settings that include acute care, community care, outpatient settings, rehabilitation, private practice and rural settings. The current scope of practice for Australian orthopaedic nurse practitioners spans the clinical range of trauma, arthroplasty, fragility fracture and ortho-geriatric care, surgical care: spinal/neurology and paediatric care. Orthopaedic nurse practitioners work within contemporary orthopaedic/musculoskeletal client disease models. These clinical models of care articulate the health care needs of populations living with musculoskeletal conditions, disorders and disease. Osteoarthritis and osteoporosis are 'highly prevalent long term [musculoskeletal] conditions known to predominantly affect the elderly and comprise the most common cause of disability in Australia'. Musculoskeletal trauma or injury as a result of an 'external force' such as vehicle accident, a fall, industrial or home environment accident or assault comprises a leading cause of hospital admission that requires orthopaedic management and care.There is some evidence to suggest that orthopaedic nursing is a 'specialty under threat' as orthopaedic-specific hospital wards are increasingly being absorbed into general surgical units; a trend observed in the United States in the mid 1990's in response to the American experience of 'downsizing' orthopaedic nursing services. Despite a limited evidence base, early citations with specific reference to orthopaedic nurses in the American context in particular started to populate the literature on or around this time. Several proponents of the specialty began to refer to a core nursing skill set that was 'highly orthopaedic' when describing 'specialist' orthopaedic nursing practice. More recently commentators point to differences in certain variables when patients are 'outlied' or managed in a non-orthopaedic ward environment by non-orthopaedic nurses.Despite 'in-principle' support for expanded scopes of practice for various health practitioner roles, the observation exists from within the specialty of orthopaedic nursing that progress in establishing the orthopaedic nurse practitioner role for this group of specialist clinicians has been slow and their journey has not been without challenge. The majority of orthopaedic nurse practitioners in Australia at least have emerged from extended practice roles similar to the generally well established experience of other nurse practitioners emerging from their own practice interest. The orthopaedic nurse practitioner is considered a 'pioneer' as they fill a 'gap' in clinical need and develop an orthopaedic nurse practitioner role. An emerging evidence base suggests that barriers such as a lack of role understanding, lack of 'team' support and a lack of resources at a system, organisational and practice level, constrain nurse practitioner practice and integration of the role into practice settings. Nurse practitioners function in an advanced clinical role. Some attempts have been made at quantifying the work of nurse practitioners. For example, Gardner et al in 2010 divided the work of nurse practitioners into three domains of practice: direct care, indirect care and service-related activities. Within these domains nurse practitioners perform a variety of tasks. Reporting on such activity by way of performance outcome measures is a variable practice amongst nurse practitioners however numbers seen/occasions of service, waiting times, effectiveness of interventions, referral patterns, patient/client satisfaction, clinical quality of care indicators are typical of the data maintained and reported by nurse practitioners to either justify their existence, embed their role service wide and/or contribute to workforce planning. Furthermore the orthopaedic nurse practitioner must effectively define and characterise the patient population to which they deliver care within the nurse practitioner's own scope of practice, ultimately to form an 'indicator' for the nurse practitioner role.The international literature pertaining to nurse practitioners or advanced practice nurses resonates with the many challenges faced by these nurses when it comes to role development and role implementation. Furthermore there is a body of evidence that validates the effectiveness of these roles. This becomes increasingly important in a context of building the health workforce of the future: a redefined workforce that must ensure adequate numbers of suitably qualified health workers who provide 'care the first time and every time'.A search of the Joanna Briggs Institute (JBI) Library of Systematic Reviews, Cochrane Library, PubMed and CINAHL has shown there are no existing or systematic reviews underway on this topic. The JBI undertook a systematic review commissioned by the Department of Health South Australia on Advanced Practice in Nursing and Midwifery and recommended a framework for advanced practice in a report released in early 2008. The framework defined advanced practice, levels of advanced practice, scope of practice, credentialing, education, preparation and regulation of advanced practitioners. The search identified a published systematic review protocol in the JBI Library for a qualitative systematic review by Ramis looking broadly at the experience of advanced practice nurses working in acute settings. The JBI Library of Systematic Reviews also contains a systematic review examining the effectiveness of nurse practitioners in residential aged care. Whilst these publications provide valuable context to this review neither specifically examines the clinical practice of orthopaedic nurse practitioners.Similarly a search of the Cochrane Library revealed a review on the topic of substitution of doctors by nurses in primary care. The focus of this particular intervention review was neither specific to nurse practitioners nor the acute care setting, but the topic of 'doctor substitution' complements the practice of nurse practitioners and may be a consideration in this review. Doctor substitution or care provided by a nurse other than an orthopaedic nurse practitioner is a natural comparator when examining the role and practice of orthopaedic nurse practitioners.Given the breadth of this topic a comprehensive approach has been chosen to systematically review the evidence as it relates to orthopaedic nurse practitioner role and practice.

'It was not just a walking experience': reflections on the role of care in dog-walking.

PubMed

Degeling, Chris; Rock, Melanie

2013-09-01

Research into physical activity and human health has recently begun to attend to dog-walking. This study extends the literature on dog-walking as a health behaviour by conceptualizing dog-walking as a caring practice. It centres on qualitative interviews with 11 Canadian dog-owners. All participants resided in urban neighbourhoods identified through previous quantitative research as conducive to dog-walking. Canine characteristics, including breed and age, were found to influence people's physical activity. The health of the dog and its position in the life-course influenced patterns of dog-walking. Frequency, duration and spatial patterns of dog-walking all depended on relationships and people's capacity to tap into resources. In foregrounding networks of care, inclusive of pets and public spaces, a relational conceptualization of dog-walking as a practice of caring helps to make sense of heterogeneity in patterns of physical activity among dog-owners.

The Resilience Function of Character Strengths in the Face of War and Protracted Conflict.

PubMed

Shoshani, Anat; Slone, Michelle

2015-01-01

This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13-15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments.

Respiratory assessment in critical care units.

PubMed

Cox, C L; McGrath, A

1999-08-01

As healthcare delivery changes in critical care, nursing continues to extend its practice base. Nursing practice is expanding to incorporate skills once seen as the remit of the medical profession. Critical care nurses are equipping themselves with evidence-based knowledge and skills that can enhance the care they provide to their patients. Assessment of patients is a major role in nursing and, by expanding assessment techniques, nurses can ensure patients receive the care most appropriate to their needs. Nurses in critical care are well placed to perform a more detailed assessment which can help to focus nursing care. This article describes the step-by-step process of undertaking a full and comprehensive respiratory assessment in critical care settings. It identifies many of the problems that patients may have and the signs and symptoms that a nurse may not whilst undertaking the assessment and preparing to prescribe care.

Making working memory work: the effects of extended practice on focus capacity and the processes of updating, forward access, and random access.

PubMed

Price, John M; Colflesh, Gregory J H; Cerella, John; Verhaeghen, Paul

2014-05-01

We investigated the effects of 10h of practice on variations of the N-Back task to investigate the processes underlying possible expansion of the focus of attention within working memory. Using subtractive logic, we showed that random access (i.e., Sternberg-like search) yielded a modest effect (a 50% increase in speed) whereas the processes of forward access (i.e., retrieval in order, as in a standard N-Back task) and updating (i.e., changing the contents of working memory) were executed about 5 times faster after extended practice. We additionally found that extended practice increased working memory capacity as measured by the size of the focus of attention for the forward-access task, but not for variations where probing was in random order. This suggests that working memory capacity may depend on the type of search process engaged, and that certain working-memory-related cognitive processes are more amenable to practice than others. Copyright © 2014 Elsevier B.V. All rights reserved.

Voices of Informal Caregivers and Community Stakeholders: Whether and How to Develop an Informal Caregiver Training Program

PubMed Central

Phillips, Sara S.; Ragas, Daiva M.; Tom, Laura S.; Hajjar, Nadia; Dong, XinQi; Simon, Melissa A.

2015-01-01

Our primary objective was to gather pilot data from caregivers and stakeholders to guide the development of a training program to assist informal caregivers in re-entering the job market. The goal of the program would be to help caregivers rebound from their incurred economic burden by transitioning into a paid caregiving or other health-service role. The economic burden they bear often necessitates a return to the workforce following caregiving; yet the act of returning is complicated by an extended absence from the workforce and a lack of experience in other verifiably skilled and paid roles. We interviewed 37 stakeholders and 25 caregivers of a chronically or terminally ill family member or friend in a suburban collar county close to Chicago. The interview questions considered the economic impact of illness, as well as the feasibility, logistics, and options of a training program for caregivers. Our data gathered from caregivers and leaders within this community support the acceptability of such a training program for informal caregivers, and also provide practical advice for development and implementation related to training cost, length, content, and instructional practices. PMID:26607814

Voices of Informal Caregivers and Community Stakeholders: Whether and How to Develop an Informal Caregiver Training Program.

PubMed

Phillips, Sara S; Ragas, Daiva M; Tom, Laura S; Hajjar, Nadia; Dong, XinQi; Simon, Melissa A

2016-06-01

Our primary objective was to gather pilot data from caregivers and stakeholders to guide the development of a training program to assist informal caregivers in re-entering the job market. The goal of the program would be to help caregivers rebound from their incurred economic burden by transitioning into a paid caregiving or other health-service role. The economic burden they bear often necessitates a return to the workforce following caregiving; yet the act of returning is complicated by an extended absence from the workforce and a lack of experience in other verifiably skilled and paid roles. We interviewed 37 stakeholders and 25 caregivers of a chronically or terminally ill family member or friend in a suburban collar county close to Chicago. The interview questions considered the economic impact of illness, as well as the feasibility, logistics, and options of a training program for caregivers. Our data gathered from caregivers and leaders within this community support the acceptability of such a training program for informal caregivers, and also provide practical advice for development and implementation related to training cost, length, content, and instructional practices.

Fasting: molecular mechanisms and clinical applications.

PubMed

Longo, Valter D; Mattson, Mark P

2014-02-04

Fasting has been practiced for millennia, but, only recently, studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity, in part, by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease, and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma, and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

Space civil engineering - A new discipline

NASA Technical Reports Server (NTRS)

Sadeh, Willy Z.; Criswell, Marvin E.

1991-01-01

Space Civil Engineering is an emerging engineering discipline that focuses on extending and expanding the Civil Engineering know-how and practice to the development and maintenance of infrastructure on celestial bodies. Space Civil Engineering is presently being developed as a new discipline within the Department of Civil Engineering at Colorado State University under a recently established NASA Space Grant College Program. Academic programs geared toward creating Space Civil Engineering Options at both undergraduate and graduate levels are being formulated. Basic ideas and concepts of the curriculum in the Space Civil Engineering Option at both undergraduate and graduate levels are presented. The role of Space Civil Engineering in the Space Program is discussed.

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

PubMed Central

Tracy, Elizabeth M.; Munson, Michelle R.; Peterson, Lance T.; Floersch, Jerry E.

2010-01-01

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery. PMID:20953326

Mediator and moderator effects in developmental and behavioral pediatric research.

PubMed

Rose, Brigid M; Holmbeck, Grayson N; Coakley, Rachael Millstein; Franks, Elizabeth A

2004-02-01

The terms mediation and moderation are defined and clarified with particular emphasis on the role of mediational and moderational analyses in developmental and behavioral pediatric research. The article highlights the applicability of mediational and moderational analyses to longitudinal, intervention, and risk and protective factor research, and it provides basic information about how these analyses might be conducted. Also included is a discussion of various ways that both mediator and moderator variables can be incorporated into a single model. The article concludes with extended examples of both types of analyses using a longitudinal pediatric study for illustration. The article provides recommendations for applying mediational and moderational research in clinical practice.

Integrating acute stroke telemedicine consultations into specialists' usual practice: a qualitative analysis comparing the experience of Australia and the United Kingdom.

PubMed

Bagot, Kathleen L; Cadilhac, Dominique A; Bladin, Christopher F; Watkins, Caroline L; Vu, Michelle; Donnan, Geoffrey A; Dewey, Helen M; Emsley, Hedley C A; Davies, D Paul; Day, Elaine; Ford, Gary A; Price, Christopher I; May, Carl R; McLoughlin, Alison S R; Gibson, Josephine M E; Lightbody, Catherine E

2017-11-21

Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012). Semi-structured interviews were conducted pre- and post-implementation, recorded and transcribed verbatim. Deductive thematic and content analysis (NVivo) was undertaken by two independent coders using Normalisation Process Theory to explore integration of telemedicine into practice. Agreement between coders was M = 91%, SD = 9 and weighted average κ = 0.70. Cross-cultural similarities and differences were found. In both countries, specialists described old and new consulting practices, the purpose and value of telemedicine systems, and concerns regarding confidence in the assessment and diagnostic skills of unknown colleagues requesting telemedicine support. Australian specialists discussed how remote consultations impacted on usual roles and suggested future improvements, while United Kingdom specialists discussed system governance, policy and procedures. Australian and United Kingdom specialists reported telemedicine required changes in work practice and development of new skills. Both groups described potential for improvements in stroke telemedicine systems with Australian specialists more focused on role change and the United Kingdom on system governance issues. Future research should examine if cross-cultural variation reflects different models of care and extends to other networks.

Extended use of electronic health records by primary care physicians: Does the electronic health record artefact matter?

PubMed

Raymond, Louis; Paré, Guy; Marchand, Marie

2017-04-01

The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact 'does matter', its clinical functionalities explaining why certain physicians make more extended use of their system than others.

Two-Hierarchy Entanglement Swapping for a Linear Optical Quantum Repeater

NASA Astrophysics Data System (ADS)

Xu, Ping; Yong, Hai-Lin; Chen, Luo-Kan; Liu, Chang; Xiang, Tong; Yao, Xing-Can; Lu, He; Li, Zheng-Da; Liu, Nai-Le; Li, Li; Yang, Tao; Peng, Cheng-Zhi; Zhao, Bo; Chen, Yu-Ao; Pan, Jian-Wei

2017-10-01

Quantum repeaters play a significant role in achieving long-distance quantum communication. In the past decades, tremendous effort has been devoted towards constructing a quantum repeater. As one of the crucial elements, entanglement has been created in different memory systems via entanglement swapping. The realization of j -hierarchy entanglement swapping, i.e., connecting quantum memory and further extending the communication distance, is important for implementing a practical quantum repeater. Here, we report the first demonstration of a fault-tolerant two-hierarchy entanglement swapping with linear optics using parametric down-conversion sources. In the experiment, the dominant or most probable noise terms in the one-hierarchy entanglement swapping, which is on the same order of magnitude as the desired state and prevents further entanglement connections, are automatically washed out by a proper design of the detection setting, and the communication distance can be extended. Given suitable quantum memory, our techniques can be directly applied to implementing an atomic ensemble based quantum repeater, and are of significant importance in the scalable quantum information processing.

Two-Hierarchy Entanglement Swapping for a Linear Optical Quantum Repeater.

PubMed

Xu, Ping; Yong, Hai-Lin; Chen, Luo-Kan; Liu, Chang; Xiang, Tong; Yao, Xing-Can; Lu, He; Li, Zheng-Da; Liu, Nai-Le; Li, Li; Yang, Tao; Peng, Cheng-Zhi; Zhao, Bo; Chen, Yu-Ao; Pan, Jian-Wei

2017-10-27

Quantum repeaters play a significant role in achieving long-distance quantum communication. In the past decades, tremendous effort has been devoted towards constructing a quantum repeater. As one of the crucial elements, entanglement has been created in different memory systems via entanglement swapping. The realization of j-hierarchy entanglement swapping, i.e., connecting quantum memory and further extending the communication distance, is important for implementing a practical quantum repeater. Here, we report the first demonstration of a fault-tolerant two-hierarchy entanglement swapping with linear optics using parametric down-conversion sources. In the experiment, the dominant or most probable noise terms in the one-hierarchy entanglement swapping, which is on the same order of magnitude as the desired state and prevents further entanglement connections, are automatically washed out by a proper design of the detection setting, and the communication distance can be extended. Given suitable quantum memory, our techniques can be directly applied to implementing an atomic ensemble based quantum repeater, and are of significant importance in the scalable quantum information processing.

Assisted or Hastened Death: The Healthcare Practitioner’s Dilemma

PubMed Central

MacLeod, Rod D; Wilson, Donna M; Malpas, Phillipa

2012-01-01

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in most countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for the legalisation of euthanasia and assisted suicide has never been stronger. While some studies have documented the reluctance of medical and other healthcare professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to hastening death. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisting death, including a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare practices but the duty of care has not changed. The dilemmas for healthcare practitioners thus who have competent patients requesting hastened death extends far beyond acting within a country’s laws as they go to the very heart of the relationship between the practitioner and patient. PMID:23121745

Extending the amygdala in theories of threat processing

PubMed Central

Fox, Andrew S.; Oler, Jonathan A.; Tromp, Do P.M.; Fudge, Julie L.; Kalin, Ned H.

2015-01-01

The central extended amygdala is an evolutionarily conserved set of interconnected brain regions that play an important role in threat processing to promote survival. Two core components of the central extended amygdala, the central nucleus of the amygdala (Ce) and the lateral bed nucleus of the stria terminalis (BST) are highly similar regions that serve complimentary roles by integrating fear- and anxiety-relevant information. Survival depends on the central extended amygdala's ability to rapidly integrate and respond to threats that vary in their immediacy, proximity, and characteristics. Future studies will benefit from understanding alterations in central extended amygdala function in relation to stress-related psychopathology. PMID:25851307

General practice training environment and its impact on preparedness.

PubMed

Wiener-Ogilvie, Sharon; Bennison, Jenny; Smith, Victor

2014-01-01

The notion of preparedness for practice is poorly defined in medical education literature. It is unclear what preparedness means and how the training environment impacts on preparedness for practice. This paper aims to explore the meaning that GP trainees and newly qualified GPs attach to the notion of preparedness, and to examine the ways in which they perceive their training environment to impact on preparedness. We used a qualitative interpretive approach and conducted 27 in-depth semi-structured interviews with 15 newly qualified GPs and 12 GP trainees at the end of their training. Two central categories describing preparedness emerged; 'confidence' and 'adaptability'. Inclusive training practices, characterised by non-hierarchical relationships between the doctors, particularly vis-à-vis trainees, were reported to be more 'progressive' and were better at preparing trainees. The way the training practice can impact on preparedness can be explained drawing on Lave and Wenger's theory of 'situated learning'. The role of the trainer was also pivotal in preparing trainees. Supervision tailored to trainees' needs, and guided decision making enhanced confidence of trainees in their ability to work independently in the future. We suggest that for GP trainees to be better prepared it is not enough to extend GP training; rather it is important that GP trainees' time is spent in inclusive training environments.

Experimental evaluation of the extended Dytlewski-style dead time correction formalism for neutron multiplicity counting

DOE PAGES

Lockhart, M.; Henzlova, D.; Croft, S.; ...

2017-09-20

Over the past few decades, neutron multiplicity counting has played an integral role in Special Nuclear Material (SNM) characterization pertaining to nuclear safeguards. Current neutron multiplicity analysis techniques use singles, doubles, and triples count rates because a methodology to extract and dead time correct higher order count rates (i.e. quads and pents) was not fully developed. This limitation is overcome by the recent extension of a popular dead time correction method developed by Dytlewski. This extended dead time correction algorithm, named Dytlewski-Croft-Favalli (DCF), is detailed in reference Croft and Favalli (2017), which gives an extensive explanation of the theory andmore » implications of this new development. Dead time corrected results can then be used to assay SNM by inverting a set of extended point model equations which as well have only recently been formulated. Here, we discuss and present the experimental evaluation of practical feasibility of the DCF dead time correction algorithm to demonstrate its performance and applicability in nuclear safeguards applications. In order to test the validity and effectiveness of the dead time correction for quads and pents, 252Cf and SNM sources were measured in high efficiency neutron multiplicity counters at the Los Alamos National Laboratory (LANL) and the count rates were extracted up to the fifth order and corrected for dead time. To assess the DCF dead time correction, the corrected data is compared to traditional dead time correction treatment within INCC. In conclusion, the DCF dead time correction is found to provide adequate dead time treatment for broad range of count rates available in practical applications.« less

Experimental evaluation of the extended Dytlewski-style dead time correction formalism for neutron multiplicity counting

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

Lockhart, M.; Henzlova, D.; Croft, S.

Over the past few decades, neutron multiplicity counting has played an integral role in Special Nuclear Material (SNM) characterization pertaining to nuclear safeguards. Current neutron multiplicity analysis techniques use singles, doubles, and triples count rates because a methodology to extract and dead time correct higher order count rates (i.e. quads and pents) was not fully developed. This limitation is overcome by the recent extension of a popular dead time correction method developed by Dytlewski. This extended dead time correction algorithm, named Dytlewski-Croft-Favalli (DCF), is detailed in reference Croft and Favalli (2017), which gives an extensive explanation of the theory andmore » implications of this new development. Dead time corrected results can then be used to assay SNM by inverting a set of extended point model equations which as well have only recently been formulated. Here, we discuss and present the experimental evaluation of practical feasibility of the DCF dead time correction algorithm to demonstrate its performance and applicability in nuclear safeguards applications. In order to test the validity and effectiveness of the dead time correction for quads and pents, 252Cf and SNM sources were measured in high efficiency neutron multiplicity counters at the Los Alamos National Laboratory (LANL) and the count rates were extracted up to the fifth order and corrected for dead time. To assess the DCF dead time correction, the corrected data is compared to traditional dead time correction treatment within INCC. In conclusion, the DCF dead time correction is found to provide adequate dead time treatment for broad range of count rates available in practical applications.« less

The activities of a dietitian-led gastroenterology clinic using extended scope of practice.

PubMed

Ryan, Dominique; Pelly, Fiona; Purcell, Elizabeth

2016-10-21

Extending the scope of practice of allied health professionals has been a strategy adopted in the United Kingdom to address issues within the health system. Australia's health system is currently undermined by similar issues, heightening government interest in adopting the extended scope health care model. The aim of the current study was to describe the activities and outcomes of a dietitian-led gastroenterology clinic which operated under an extended scope of practice model in an outpatient gastroenterology department at a tertiary hospital in regional Queensland, Australia, and to assess patient satisfaction with the initiative. A descriptive, cross-sectional case series undertaken over 50 clinics involving 82 category 2 and 3 patients with suspected/confirmed coeliac disease or inflammatory bowel disease; low haemoglobin; gastroesophageal reflux disease, or; malnutrition. Data was analysed using Microsoft Excel 2010, and presented as descriptive statistics. Sixty out of 82 selected patients (median age 51 years) attended an initial appointment with the dietitian. Twenty-four review appointments were attended. Average waiting period for an initial appointment was 148 days (range 31-308 days). A total of 149 management strategies were provided, and 94 (63 %) of these involved the dietitian utilising extended scope of practice. The dietitian managed 47 (78 %) patients without need for gastroenterologist referral, and 25 (42 %) were discharged after dietetic management. Patients reported high levels of satisfaction with the clinic. Seventy-eight percent of category 2 and 3 patients referred to the gastroenterologist could be managed exclusively in the dietitian-led clinic. This extended scope model of care could potentially benefit the efficiency and acceptability of Australia's public health system.

Teacher Perspectives of Interdisciplinary Coteaching Relationships in a Clinical Skills Course: A Relational Coordination Theory Analysis.

PubMed

Daniel, Michelle M; Ross, Paula; Stalmeijer, Renée E; de Grave, Willem

2018-01-01

Phenomenon: Interdisciplinary coteaching has become a popular pedagogic model in medical education, yet there is insufficient research to guide effective practices in this context. Coteaching relationships are not always effective, which has the potential to affect the student experience. The purpose of this study was to explore interdisciplinary coteaching relationships between a physician (MD) and social behavioral scientist (SBS) in an undergraduate clinical skills course. We aimed to gain an in-depth understanding of what teachers perceive as influencing the quality of relationships to begin to construct a framework for collaborative teaching in medical education. A qualitative study was conducted consisting of 12 semistructured interviews (6 MD and 6 SBS) and 2 monodisciplinary focus groups. Sampling was purposive and aimed at maximal variation from among 64 possible faculty. The data were analyzed using the constant comparative method to develop a grounded theory. Five major themes resulted from the analysis that outline a framework for interdisciplinary coteaching: respect, shared goals, shared knowledge and understanding, communication, and complementary pairings. Insights: The first 4 themes align with elements of relational coordination theory, an organizational theory of collaborative practice that describes how work roles interact. The complementary pairings extend this theory from work roles to individuals, with unique identities and personal beliefs and values about teaching. Prior studies on coteaching have not provided a clear linkage to theory. The conceptual framework helps suggest future directions for coteaching research and has practical implications for administrative practices and faculty development. These findings contribute to the sparse research in medical education on interdisciplinary coteaching relationships.

Independent extended and supplementary nurse prescribing practice in the UK: a national questionnaire survey.

PubMed

Courtenay, Molly; Carey, Nicola; Burke, Joanna

2007-09-01

Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended prescribers. Little or no attention has focussed on supplementary nurse prescribing. To provide an overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing. National questionnaire survey. United Kingdom. A convenience sample of 868 qualified independent extended/supplementary nurse prescribers self-completed a written questionnaire. A total of 756 (87%) used independent extended prescribing; 304 (35%) used supplementary prescribing to treat a range of chronic conditions (including asthma, diabetes and hypertension); 710 (82%) nurses worked in primary care. Nurses in general practice reported the largest number of reasons preventing prescribing. Reasons included the inability to computer generate prescriptions and to implement the Clinical Management Plan. Nurses in primary care reported more continuing professional development needs. These needs included update on prescribing policy and the treatment management of conditions. A total of 277 (32%) nurses were unable to access continuing professional development. Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. These nurses are highly qualified and have many years clinical experience. Supplementary prescribing is used by a minority of nurses. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing. The continuing professional development needs of independent extended/supplementary nurse prescribers are frequently unmet. It will become increasingly important that these needs are met once nurses are able to prescribe the full range of medicines included in the British National Formulary, limited only by their area of competence.

The practicality of using ozone with fruit and vegetables.

PubMed

Glowacz, Marcin; Rees, Deborah

2016-11-01

The fresh produce industry is constantly growing as a result of increasing consumer demand. Food quality and safety management are still major issues for the supply chain. The use of ozone has been identified as a feasible solution to reduce microorganisms present in food, in this way extending the shelf-life of fresh produce. A number of factors that may affect the efficiency of ozone treatment have been identified, e.g. microbial populations, ozone concentration and time of exposure, type of produce, temperature, relative humidity and packaging material, and they are briefly discussed. Furthermore, practical information derived from studies with ozone conducted by the authors and from their knowledge of the subject directs the reader's attention to the key aspects of ozone use under commercial conditions, i.e. from the practical point of view. Finally, one possible direction for future research with the postharvest use of ozone, i.e. the important role of fruit cuticle in response to this postharvest treatment, is indicated. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

'Nurse entrepreneurs' a case of government rhetoric?

PubMed

Traynor, Michael; Drennan, Vari; Goodman, Claire; Mark, Annabelle; Davis, Kathy; Peacock, Richard; Banning, Maggi

2008-01-01

Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and 'modernizing' project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups. Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions. The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses. Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and 'sold' to the nursing profession as enhancing its status compared with medicine.

Differentiating Knowledge, Differentiating (Occupational) Practice

ERIC Educational Resources Information Center

Hordern, Jim

2016-01-01

This paper extends arguments for differentiating knowledge into conceptualisations of occupational practice. It is argued that specialised forms of knowledge and practice require recognition and differentiation in ways that many contemporary approaches to practice theory deny. Drawing on Hager's interpretation of MacIntyre, it is suggested that…

The Role of A Facilitated Online Workspace Component of A Community of Practice: Knowledge Building and Value Creation for NASA

NASA Astrophysics Data System (ADS)

Davey, B.

2014-12-01

This study examined the role of an online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Study participants were 75 Education and Public Outreach community members of NASA's Science Mission Directorate Earth Forum. In this mixed methods study, online workspace metrics were used to track participation and a survey completed by 21 members was used to quantify participation. For a more detailed analysis, 15 community members (5 highly active users, 5 average users, and 5 infrequent users) selected based on survey responses, were interviewed. Finally, survey data was gathered from 7 online facilitators to understand their role in the community. Data collected from these 21 community members and 5 facilitating members suggest that highly active users (logging into the workspace daily), were more likely to have transformative experiences, co-create knowledge, feel ownership of community knowledge, have extended opportunities for community exchange, and find new forms of evaluation. Average users shared some similar characteristics with both the highly active members and infrequent users, representing a group in transition as they become more engaged and active in the online workspace. Inactive users viewed the workspace as having little value, being difficult to navigate, being mainly for gaining basic information about events and community news, and as another demand on their time. Results show the online workspace component of the Earth Science Education and Outreach Forum is playing an important and emerging role for this community by supporting knowledge building and knowledge sharing, and growing in value for those that utilizing it more frequently. The evidence suggests that with increased participation or "usage" comes increased value to the participant and the organization. This research illustrates the possible change in mindset held by participating community members when it comes to the nature of co-location. Additionally, it may be of particular importance in exploring changes in the community members' feelings of connection and belonging.

An Evaluation of Understandability of Patient Journey Models in Mental Health.

PubMed

Percival, Jennifer; McGregor, Carolyn

2016-07-28

There is a significant trend toward implementing health information technology to reduce administrative costs and improve patient care. Unfortunately, little awareness exists of the challenges of integrating information systems with existing clinical practice. The systematic integration of clinical processes with information system and health information technology can benefit the patients, staff, and the delivery of care. This paper presents a comparison of the degree of understandability of patient journey models. In particular, the authors demonstrate the value of a relatively new patient journey modeling technique called the Patient Journey Modeling Architecture (PaJMa) when compared with traditional manufacturing based process modeling tools. The paper also presents results from a small pilot case study that compared the usability of 5 modeling approaches in a mental health care environment. Five business process modeling techniques were used to represent a selected patient journey. A mix of both qualitative and quantitative methods was used to evaluate these models. Techniques included a focus group and survey to measure usability of the various models. The preliminary evaluation of the usability of the 5 modeling techniques has shown increased staff understanding of the representation of their processes and activities when presented with the models. Improved individual role identification throughout the models was also observed. The extended version of the PaJMa methodology provided the most clarity of information flows for clinicians. The extended version of PaJMa provided a significant improvement in the ease of interpretation for clinicians and increased the engagement with the modeling process. The use of color and its effectiveness in distinguishing the representation of roles was a key feature of the framework not present in other modeling approaches. Future research should focus on extending the pilot case study to a more diversified group of clinicians and health care support workers.

The role of driver rehabilitation in extending the driving lifetimes and enhancing the mobility of older adults.

DOT National Transportation Integrated Search

2013-06-01

This study explored the role and impact of driver rehabilitation for older adults on extending : driving lifetimes and enhancing mobility. Specifically, the focus was on the effects of driver : rehabilitation on older adults abilities to continue ...

Job satisfaction and job content in Dutch dental hygienists.

PubMed

Jerković-Ćosić, K; van Offenbeek, M A G; van der Schans, C P

2012-08-01

This study compares the scope of practice of Dutch dental hygienists (DHs) educated through a 2- or 3-year curriculum ('old-style DHs') with that of hygienists educated through a new extended 4-year curriculum leading to a bachelor's degree ('new-style DHs'), with the aim to investigate whether an extended scope of practice positively affects perceived skill variety, autonomy and job satisfaction. The questionnaires were obtained from old- and new-style DHs (n = 413, response 38%; n = 219, response 59%, respectively), in which respondents had recorded their dental tasks, perceived skill variety, autonomy and job satisfaction. T -tests were used to analyse differences between old- and new-style DHs, and regression analyses were performed to assess the relation between scope of practice and skill variety, autonomy and job satisfaction. New-style DHs have a more extended scope of practice compared with old-style DHs. Despite their more complex jobs, which are theoretically related to higher job satisfaction, new-style DHs perceive lower autonomy and job satisfaction (P < 0.05). Skill variety is the strongest predictor for DHs' job satisfaction (β = 0.462), followed by autonomy (β = 0.202) and caries decisive tasks, the last affecting job satisfaction negatively (β = -0.149). Self-employment is the strongest significant predictor for autonomy (β = 0.272). The core business of DHs remains the prevention and periodontology services. New-style DHs combine these tasks with extended tasks in the caries field, which can lead to comparatively less job satisfaction, because of a lower experienced autonomy in performing these extended tasks. © 2012 John Wiley & Sons A/S.

Employment and contextual impact of safe and unsafe sexual practices for STI and HIV: the situation in China.

PubMed

Wang, S M; Gao, M Y

2000-08-01

China's dual employment system plays a crucial role in sexually transmitted infections (STIs) and HIV-related safe and unsafe sexual practices among young Chinese people. Social and psychological determinants of safe and unsafe sexual practices for HIV infection among young people in Sichuan, China were examined. Our findings indicate that changes in China's social structure and employment system impact upon the social contextual involvement and socio-sexual practice of young Chinese people. The findings in the study suggest that the employment-related contextual involvement was a major predictor in the relationships between demography, information, and psychological risk-taking factors on one hand and the people's safe and unsafe sexual practices on the other. Self-employed people (officially called 'getihu') were more likely than the state-employed people to engage in unprotected sex with casual sexual partners. As China undergoes social restructuring and many state-employed people are laid off, the risk may also extend into the broader non-self-employed population as more state-employed people become involved not only in the self-employed getihu's socioeconomic activities but also in their unconventional socio-sexual practices. Collective vulnerability to STI and HIV, due to the current socio-sexual practices of the getihu young people, has created a new frontier for STI and HIV prevention in today's China, as well as demonstrating the importance of collective action with STI and AIDS prevention strategies within relevant social and sub-cultural contexts.

The role of HIV/AIDS committees in effective workplace governance of HIV/AIDS in South African small and medium-sized enterprises (SMEs).

PubMed

Vaas, Jocelyn R

2008-04-01

The primary purpose of this study was to assess the role, status and scope of workplace HIV/AIDS committees as a means of effective workplace governance of the HIV/AIDS impact, and their role in extending social protective HIV/AIDS-related rights to employees. In-depth qualitative case studies were conducted in five South African small and medium-sized enterprises (SMEs) that were actively implementing HIV/AIDS policies and programmes. Companies commonly implemented HIV/AIDS policies and programmes through a workplace committee dedicated to HIV/AIDS or a generic committee dealing with issues other than HIV/ AIDS. Management, through the human resources department and the occupational health practitioner often drove initial policy formulation, and had virtually sole control of the HIV/AIDS budget. Employee members of committees were mostly volunteers, and were often production or blue collar employees, while there was a notable lack of participation by white-collar employees, line management and trade unions. While the powers of workplace committees were largely consultative, employee committee members often managed in an indirect manner to secure and extend social protective rights on HIV/AIDS to employees, and monitor their effective implementation in practice. In the interim, workplace committees represented one of the best means to facilitate more effective workplace HIV/AIDS governance. However, the increased demands on collective bargaining as a result of an anticipated rises in AIDS-related morbidity and mortality might prove to be beyond the scope of such voluntary committees in the longer term.

A grounded theory study on the role of differentiated instruction in effective middle school science teaching

NASA Astrophysics Data System (ADS)

Jones, Brian Kirby

The purpose of this grounded theory study was to develop a model explaining the role of differentiated instruction (DI) in effective middle school science teaching. The study examined the best teaching practices and differentiated elements from eight general education middle school science teachers, all scoring at the highest level of a teaching effectiveness measure on their evaluations, through a collection of observational, interview, survey, and teaching artifact data. The data were analyzed through the methodology of a systematic grounded theory qualitative approach using open, axial, and selective coding to develop a model describing how and to what degree effective middle school science teachers differentiated their best teaching practices. The model that emerged from the data shows instruction as a four-phase process and highlights the major elements of best practices and DI represented at each phase. The model also depicts how teachers narrowed the scope of their differentiating strategies as instruction progressed. The participants incorporated DI into their pedagogies, though in different degrees at each phase, and primarily by using variety to present concepts with multiple types of instruction followed by a series of sense-making activities related to several learning modalities. Teachers scaffolded students carefully, using informal and formal assessment data to inform future instructional decisions and especially their plans to reteach or extend on a concept. The model is intended to provide insight into the value of DI for middle school science teaching.

Systematic review of the qualitative literature on return to work after injury.

PubMed

MacEachen, Ellen; Clarke, Judy; Franche, Renée-Louise; Irvin, Emma

2006-08-01

This paper reports on a systematic review of the international qualitative research literature on return to work. This review was undertaken in order to better understand the dimensions, processes, and practices of return to work. Because return to work often includes early return before full recovery while a person is undergoing rehabilitation treatment, physical recovery is embedded in complicated ways with workplace processes and practices and social organization. These process-oriented dimensions of return to work are well described in the qualitative literature. This systematic review of the literature covered peer-reviewed papers that focused on musculoskeletal and pain-related injuries and were published in English or French between 1990 and 2003. Findings from papers meeting relevance and quality criteria were synthesized using the meta-ethnographic approach. This review found that return to work extends beyond concerns about managing physical function to the complexities related to beliefs, roles, and perceptions of many players. Good will and trust are overarching conditions that are central to successful return-to-work arrangements. In addition, there are often social and communication barriers to return to work, and intermediary players have the potential to play a key role in facilitating this process. This paper identifies key mechanisms of workplace practice, process, and environment that can affect the success of return to work. The findings illustrate the contribution that qualitative literature can make to important aspects of implementation in relation to return to work.

Magnetic resonance imaging and spectroscopy of the murine cardiovascular system.

PubMed

Akki, Ashwin; Gupta, Ashish; Weiss, Robert G

2013-03-01

Magnetic resonance imaging (MRI) has emerged as a powerful and reliable tool to noninvasively study the cardiovascular system in clinical practice. Because transgenic mouse models have assumed a critical role in cardiovascular research, technological advances in MRI have been extended to mice over the last decade. These have provided critical insights into cardiac and vascular morphology, function, and physiology/pathophysiology in many murine models of heart disease. Furthermore, magnetic resonance spectroscopy (MRS) has allowed the nondestructive study of myocardial metabolism in both isolated hearts and in intact mice. This article reviews the current techniques and important pathophysiological insights from the application of MRI/MRS technology to murine models of cardiovascular disease.

Magnetic resonance imaging and spectroscopy of the murine cardiovascular system

PubMed Central

Akki, Ashwin; Gupta, Ashish

2013-01-01

Magnetic resonance imaging (MRI) has emerged as a powerful and reliable tool to noninvasively study the cardiovascular system in clinical practice. Because transgenic mouse models have assumed a critical role in cardiovascular research, technological advances in MRI have been extended to mice over the last decade. These have provided critical insights into cardiac and vascular morphology, function, and physiology/pathophysiology in many murine models of heart disease. Furthermore, magnetic resonance spectroscopy (MRS) has allowed the nondestructive study of myocardial metabolism in both isolated hearts and in intact mice. This article reviews the current techniques and important pathophysiological insights from the application of MRI/MRS technology to murine models of cardiovascular disease. PMID:23292717

Coping with Schedules for Extended Hours: A Survey of Attitudes and Practices.

ERIC Educational Resources Information Center

Wells, Dorothy P.

1979-01-01

Presents results of survey questionnaires sent to 49 university libraries requesting information concerning work schedules for public service librarians and gives suggestions for dealing with extended hours and flexible schedules. (CWM)

Horticulture in Portugal 1850-1900: The role of science and public utility in shaping knowledge.

PubMed

Rodrigues, Ana Duarte; Simões, Ana

2017-07-01

In this paper, we address the emergence of horticultural practice, agents, spaces and institutions in the two urban settings of Lisbon and Porto, in Portugal, during the second half of the nineteenth century. We do so by following the networking activities of two players: the self-made horticulturist and entrepreneur José Marques Loureiro, who created, in Porto, a commercial horticultural establishment and founded the Journal of Practical Horticulture; and the agronomist Francisco Simões Margiochi, head of the gardens and green grounds department of the municipality, who created the first course on gardening and horticulture, and founded the Royal Horticultural Society, both in Lisbon. Their joint activities were aimed at establishing horticulture as an applied science and to cater simultaneously to an extended audience of citizens. They enable us to enrich the narratives on the emergence and development of horticulture in Europe by calling attention to the participation in circulatory extended networks of actors who are often absent from these accounts. Additionally, they allow a comparative assessment of the outcome of their actions at the national level, and to understand their results in terms consonant with recent historiographical trends on the co-construction of centres and peripheries. AML - Arquivo Municipal de Lisboa (Municipal Archive of Lisbon).; ANTT - Arquivo Nacional da Torre do Tombo (National Archives at Torre do Tombo).; AHCPL - Arquivo Histórico da Casa Pia de Lisboa (Historical Archive of the Casa Pia of Lisbon).; JHP - Jornal de Horticultura Practica (Journal of Practical Horticulture). Online at: http://www.fc.up.pt/fa/?p=nav&f=html.fbib-Periodico-oa&item=378 ; BSNHP - Boletim da Sociedade Nacional de Horticultura de Portugal (Bulletin of the National Society of Horticulture of Portugal).

Risk factors and spatial distribution of extended spectrum β-lactamase-producing- Escherichia coli at retail poultry meat markets in Malaysia: a cross-sectional study.

PubMed

Aliyu, A B; Saleha, A A; Jalila, A; Zunita, Z

2016-08-02

The significant role of retail poultry meat as an important exposure pathway for the acquisition and transmission of extended spectrum β-lactamase-producing Escherichia coli (ESBL-EC) into the human population warrants understanding concerning those operational practices associated with dissemination of ESBL-EC in poultry meat retailing. Hence, the objective of this study was to determine the prevalence, spatial distribution and potential risk factors associated with the dissemination of ESBL-EC in poultry meat retail at wet-markets in Selangor, Malaysia. Poultry meat (breast, wing, thigh, and keel) as well as the contact surfaces of weighing scales and cutting boards were sampled to detect ESBL-EC by using culture and disk combination methods and polymerase chain reaction assays. Besides, questionnaire was used to obtain data and information pertaining to those operational practices that may possibly explain the occurrence of ESBL-EC. The data were analysed using logistic regression analysis at 95 % CI. The overall prevalence of ESBL-EC was 48.8 % (95 % CI, 42 - 55 %). Among the risk factors that were explored, type of countertop, sanitation of the stall environment, source of cleaning water, and type of cutting board were found to be significantly associated with the presence of ESBL-EC. Thus, in order to prevent or reduce the presence of ESBL-EC and other contaminants at the retail-outlet, there is a need to design a process control system based on the current prevailing practices in order to reduce cross contamination, as well as to improve food safety and consumer health.

The role of organizational research in implementing evidence-based practice: QUERI Series

PubMed Central

Yano, Elizabeth M

2008-01-01

Background Health care organizations exert significant influence on the manner in which clinicians practice and the processes and outcomes of care that patients experience. A greater understanding of the organizational milieu into which innovations will be introduced, as well as the organizational factors that are likely to foster or hinder the adoption and use of new technologies, care arrangements and quality improvement (QI) strategies are central to the effective implementation of research into practice. Unfortunately, much implementation research seems to not recognize or adequately address the influence and importance of organizations. Using examples from the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI), we describe the role of organizational research in advancing the implementation of evidence-based practice into routine care settings. Methods Using the six-step QUERI process as a foundation, we present an organizational research framework designed to improve and accelerate the implementation of evidence-based practice into routine care. Specific QUERI-related organizational research applications are reviewed, with discussion of the measures and methods used to apply them. We describe these applications in the context of a continuum of organizational research activities to be conducted before, during and after implementation. Results Since QUERI's inception, various approaches to organizational research have been employed to foster progress through QUERI's six-step process. We report on how explicit integration of the evaluation of organizational factors into QUERI planning has informed the design of more effective care delivery system interventions and enabled their improved "fit" to individual VA facilities or practices. We examine the value and challenges in conducting organizational research, and briefly describe the contributions of organizational theory and environmental context to the research framework. Conclusion Understanding the organizational context of delivering evidence-based practice is a critical adjunct to efforts to systematically improve quality. Given the size and diversity of VA practices, coupled with unique organizational data sources, QUERI is well-positioned to make valuable contributions to the field of implementation science. More explicit accommodation of organizational inquiry into implementation research agendas has helped QUERI researchers to better frame and extend their work as they move toward regional and national spread activities. PMID:18510749

Barriers and facilitators to hospital pharmacists' engagement in medication safety activities: a qualitative study using the theoretical domains framework.

PubMed

Mekonnen, Alemayehu B; McLachlan, Andrew J; Brien, Jo-Anne E; Mekonnen, Desalew; Abay, Zenahebezu

2018-01-01

Hospital pharmacists play a central role in medication safety activities. However, in Ethiopia, this role has been launched recently and little is known regarding the current status of this extended service. Using the Theoretical Domains Framework (TDF), we aimed to identify the barriers and facilitators to hospital pharmacists' engagement in medication safety activities across various public hospitals in the Amhara region of Ethiopia. Eight focus group discussions, using an interview guide that was drawn upon the TDF, were conducted with 44 hospital pharmacists to explore their beliefs regarding their involvement in clinical services. Group discussions were audio-recorded, transcribed verbatim, and analysed using directed content analysis based on the TDF. Relevant domains were identified by applying relevance criteria to each of the domains in the TDF. Content analysis revealed six domains that influence hospital pharmacists' engagement in medication safety activities. These domains included 'Knowledge', 'Skills', 'Environmental context and resources', 'Motivations and goals', 'Social influences' and 'Social/professional role'. Most hospital pharmacists believed knowledge gap was an issue, as was the lack of training and supportive skills although some expressed as they were competent enough for their skills in identifying medication related problems. Most participants were very much enthusiastic for their extended roles and were positive towards the future of the profession; however, competing priorities along with the lack of remuneration and awareness (of other health care professionals) regarding the profession's role were barriers to service delivery. There were also a number of resource constraints, such as staffing, infrastructure and government funding, and acceptance rate of pharmacist's recommendation that were likely to influence the clinical practice of pharmacists. Using the TDF , this study identified a wide range of barriers and facilitators to hospital pharmacists' engagement in medication safety activities in resource-limited settings. There existed considerable interrelationships between domains that were perceived to influence hospital pharmacists' behaviours, and this may assist in designing behaviour change interventions that target common behavioural domains.

Comparing the Effects of Massed and Distributed Practice on Skill Acquisition for Children with Autism

ERIC Educational Resources Information Center

Haq, Shaji S.; Kodak, Tiffany; Kurtz-Nelson, Evangeline; Porritt, Marilynn; Rush, Kristin; Cariveau, Tom

2015-01-01

We replicated and extended the findings of Haq and Kodak (2015) by evaluating the efficiency of massed and distributed practice for teaching tacts and textual and intraverbal behavior to 3 children with autism. Massed practice included all practice opportunities conducted on 1 day during each week, and distributed practice included practice…

Study protocol of an economic evaluation of an extended implementation strategy for the treatment of low back pain in general practice: a cluster randomised controlled trial.

PubMed

Jensen, Cathrine Elgaard; Riis, Allan; Pedersen, Kjeld Møller; Jensen, Martin Bach; Petersen, Karin Dam

2014-10-08

In Denmark, guidelines on low back pain management are currently being implemented; in association with this, a clinical trial is conducted. A health economic evaluation is carried out alongside the clinical trial to assess the cost-effectiveness of an extended implementation strategy to increase the general practitioners' adherence to the guidelines. In addition to usual dissemination, the extended implementation strategy is composed of visits from a guideline facilitator, stratification tools, and feedback on guideline adherence. The aim of this paper is to provide the considerations on the design of the health economic evaluation. The economic evaluation is carried out alongside a cluster randomised controlled trial consisting of 60 general practices in the North Denmark Region. An expected 1,200 patients between the age of 18 and 65 years with a low back pain diagnosis will be enrolled. The economic evaluation comprises both a cost-effectiveness analyses and a cost-utility analysis. Effectiveness measures include referral to secondary care, health-related quality of life measured by EQ-5D-5L, and disability measured by the Roland Morris disability questionnaire. Cost measures include all relevant additional costs of the extended implementation strategy compared to usual implementation. The economic evaluation will be performed from both a societal perspective and a health sector perspective with a 12-month time horizon. It is expected that the extended implementation strategy will reduce the number of patients referred to secondary care. It is hypothesised that the additional upfront cost of extended implementation will be counterbalanced by improvements in clinical practice and patient-related outcomes, thereby rendering the extended implementation strategy cost-effective. ClinicalTrials.gov: NCT01699256.

Learning from Decoding across Disciplines and within Communities of Practice

ERIC Educational Resources Information Center

Miller-Young, Janice; Boman, Jennifer

2017-01-01

This final chapter synthesizes the findings and implications derived from applying the Decoding the Disciplines model across disciplines and within communities of practice. We make practical suggestions for teachers and researchers who wish to apply and extend this work.

Children, AIDS and the politics of orphan care in Ethiopia: the extended family revisited.

PubMed

Abebe, Tatek; Aase, Asbjorn

2007-05-01

The astounding rise in the number of orphans due to the HIV/AIDS epidemic has left many Ethiopian families and communities with enormous childcare problems. Available studies on the capacity and sustainability of the extended family system, which culturally performs the role of care for children in need, suggest two competing theories. The first is grounded in the social rupture thesis and assumes that the traditional system of orphan care is stretched by the impact of the epidemic, and is actually collapsing. By contrast, the second theory counter-suggests that the flexibility and strength of the informal childcare practise, if supported by appropriate interventions, can still support a large number of orphans. Based on a seven-month period of child-focused, qualitative research fieldwork in Ethiopia involving observations; in-depth interviews with orphans (42), social workers (12) and heads of households (18); focus group discussions with orphans (8), elderly people and community leaders (6); and story-writing by children in school contexts, this article explores the trade-offs and social dynamics of orphan care within extended family structures in Ethiopia. It argues that there is a rural-urban divide in the capacity to cater for orphans that emanates from structural differences as well as the socio-cultural and economic values associated with children. The care of orphans within extended family households is also characterised by multiple and reciprocal relationships in care-giving and care-receiving practices. By calling for a contextual understanding of the 'orphan burden', the paper concludes that interventions for orphans may consider care as a continuum in the light of four profiles of extended families, namely rupturing, transient, adaptive, and capable families.

Moral discourses and pharmaceuticalised governance in households.

PubMed

Dew, Kevin; Norris, Pauline; Gabe, Jonathan; Chamberlain, Kerry; Hodgetts, Darrin

2015-04-01

This article extends our understanding of the everyday practices of pharmaceuticalisation through an examination of moral concerns over medication practices in the household. Moral concerns of responsibility and discipline in relation to pharmaceutical consumption have been identified, such as passive or active medication practices, and adherence to orthodox or unorthodox accounts. This paper further delineates dimensions of the moral evaluations of pharmaceuticals. In 2010 and 2011 data were collected from 55 households across New Zealand and data collection techniques, such as photo- and diary-elicitation interviews, allowed the participants to develop and articulate reflective stories of the moral meaning of pharmaceuticals. Four repertoires were identified: a disordering society repertoire where pharmaceuticals evoke a society in an unnatural state; a disordering self repertoire where pharmaceuticals signify a moral failing of the individual; a disordering substances repertoire where pharmaceuticals signify a threat to one's physical or mental equilibrium; a re-ordering substances repertoire where pharmaceuticals signify the restoration of function. The research demonstrated that the dichotomies of orthodox/unorthodox and compliance/resistance do not adequately capture how medications are used and understood in everyday practice. Attitudes change according to why pharmaceuticals are taken and who is taking them, their impacts on social relationships, and different views on the social or natural production of disease, the power of the pharmaceutical industry, and the role of health experts. Pharmaceuticals are tied to our identity, what we want to show of ourselves, and what sort of world we see ourselves living in. The ordering and disordering understandings of pharmaceuticals intersect with forms of pharmaceuticalised governance, where conduct is governed through pharmaceutical routines, and where self-responsibility entails following the prescription of other agents. Pharmaceuticals symbolise forms of governance with different sets of roles and responsibilities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder?

PubMed

Ullsperger, Josie M; Nigg, Joel T; Nikolas, Molly A

2016-01-01

Ineffective parenting practices may maintain or exacerbate attention deficit/hyperactivity disorder (ADHD) symptoms and shape subsequent development of disruptive behavior disorders (DBD's) in youth with ADHD. Recent theoretical models have suggested that parenting may exert effects on ADHD via its role in child temperament. The current study aimed to evaluate the indirect effects of parenting dimensions on child ADHD symptoms via child temperament. Youth ages 6-17 years (N = 498; 50.4 % ADHD, 55 % male) completed a multi-stage, multi-informant assessment that included parent, child, and teacher report measures of parenting practices, child temperament, and ADHD symptoms. Statistical models examined the direct and indirect effects of maternal and paternal involvement, poor supervision, and inconsistent discipline on inattention and hyperactivity-impulsivity via child temperament and personality traits. Results indicated differential patterns of effect for negative and positive parenting dimensions. First, inconsistent discipline exerted indirect effects on both ADHD symptom dimensions via child conscientiousness, such that higher levels of inconsistency predicted lower levels of conscientiousness, which in turn, predicted greater ADHD symptomatology. Similarly, poor supervision also exerted indirect effects on inattention via child conscientiousness as well as significant indirect effects on hyperactivity-impulsivity via its impact on both child reactive control and conscientiousness. In contrast, primarily direct effects of positive parenting (i.e., involvement) on ADHD emerged. Secondary checks revealed that similar pathways may also emerge for comorbid disruptive behavior disorders. Current findings extend upon past work by examining how parenting practices influence child ADHD via with-in child mechanisms and provide support for multi-pathway models accounting for heterogeneity in the disorder.

Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder?

PubMed Central

Nigg, Joel T.; Nikolas, Molly A.

2015-01-01

Ineffective parenting practices may maintain or exacerbate attention deficit/hyperactivity disorder (ADHD) symptoms and shape subsequent development of disruptive behavior disorders (DBD’s) in youth with ADHD. Recent theoretical models have suggested that parenting may exert effects on ADHD via its role in child temperament. The current study aimed to evaluate the indirect effects of parenting dimensions on child ADHD symptoms via child temperament. Youth ages 6–17 years (N=498; 50.4 % ADHD, 55 % male) completed a multi-stage, multi-informant assessment that included parent, child, and teacher report measures of parenting practices, child temperament, and ADHD symptoms. Statistical models examined the direct and indirect effects of maternal and paternal involvement, poor supervision, and inconsistent discipline on inattention and hyperactivity-impulsivity via child temperament and personality traits. Results indicated differential patterns of effect for negative and positive parenting dimensions. First, inconsistent discipline exerted indirect effects on both ADHD symptom dimensions via child conscientiousness, such that higher levels of inconsistency predicted lower levels of conscientiousness, which in turn, predicted greater ADHD symptomatology. Similarly, poor supervision also exerted indirect effects on inattention via child conscientiousness as well as significant indirect effects on hyperactivity-impulsivity via its impact on both child reactive control and conscientiousness. In contrast, primarily direct effects of positive parenting (i.e., involvement) on ADHD emerged. Secondary checks revealed that similar pathways may also emerge for comorbid disruptive behavior disorders. Current findings extend upon past work by examining how parenting practices influence child ADHD via within child mechanisms and provide support for multi-pathway models accounting for heterogeneity in the disorder. PMID:25684446

Implications of the concept of minimal risk in research on informed choice in clinical practice

PubMed Central

Wada, Kyoko; Nisker, Jeff

2015-01-01

The concept of a minimal risk threshold in research, beneath which exception to informed consent and ethics review processes may occur, has been codified for over 30 years in many national research regulations and by the Council for International Organizations of Medical Sciences. Although minimal risk in research constitutes one of the criteria for allowing waiver of informed consent or modification to the consent process and a large body of literature exists, discussion of a minimal risk threshold in clinical practice has not occurred. One reason for lack of discussion may be that implicit consent is accepted for a wide range of routine clinical practices. Extending the role of minimal risk in research to clinical practice might assist clinicians in identifying circumstances for which implicit consent is indeed sufficient and circumstances in which it is not. Further, concepts from minimal risk in research might assist clinicians regarding when information provision in health promotion is required. We begin by reviewing concepts in both minimal risk in research and informed choice in clinical practice. We then explore how a clinical minimal risk concept may clarify recommendations for information provision in clinical practice and support the patient's informed choice regarding therapeutic and diagnostic procedures and also health promotion. Given that clinical practice involves a broad scope of health information, professional practice guidelines on information provision based on the application of the minimal risk threshold in research could be developed to guide clinicians in what information must be provided to their patients. PMID:26108215

Role of small-norm components in extended random-phase approximation

NASA Astrophysics Data System (ADS)

Tohyama, Mitsuru

2017-09-01

The role of the small-norm amplitudes in extended random-phase approximation (RPA) theories such as the particle-particle and hole-hole components of one-body amplitudes and the two-body amplitudes other than two-particle/two-hole components are investigated for the one-dimensional Hubbard model using an extended RPA derived from the time-dependent density matrix theory. It is found that these amplitudes cannot be neglected in strongly interacting regions where the effects of ground-state correlations are significant.

Cognitive and learning sciences in biomedical and health instructional design: A review with lessons for biomedical informatics education.

PubMed

Patel, Vimla L; Yoskowitz, Nicole A; Arocha, Jose F; Shortliffe, Edward H

2009-02-01

Theoretical and methodological advances in the cognitive and learning sciences can greatly inform curriculum and instruction in biomedicine and also educational programs in biomedical informatics. It does so by addressing issues such as the processes related to comprehension of medical information, clinical problem-solving and decision-making, and the role of technology. This paper reviews these theories and methods from the cognitive and learning sciences and their role in addressing current and future needs in designing curricula, largely using illustrative examples drawn from medical education. The lessons of this past work are also applicable, however, to biomedical and health professional curricula in general, and to biomedical informatics training, in particular. We summarize empirical studies conducted over two decades on the role of memory, knowledge organization and reasoning as well as studies of problem-solving and decision-making in medical areas that inform curricular design. The results of this research contribute to the design of more informed curricula based on empirical findings about how people learn and think, and more specifically, how expertise is developed. Similarly, the study of practice can also help to shape theories of human performance, technology-based learning, and scientific and professional collaboration that extend beyond the domain of medicine. Just as biomedical science has revolutionized health care practice, research in the cognitive and learning sciences provides a scientific foundation for education in biomedicine, the health professions, and biomedical informatics.

Does Print Size Matter for Reading? A Review of Findings from Vision Science and Typography

PubMed Central

Legge, Gordon E.; Bigelow, Charles A.

2012-01-01

The size and shape of printed symbols determine the legibility of text. In this paper we focus on print size because of its crucial role in understanding reading performance and its significance in the history and contemporary practice of typography. We present evidence supporting the hypothesis that the distribution of print sizes in historical and contemporary publications falls within the psychophysically defined range of fluent print size — the range over which text can be read at maximum speed. The fluent range extends over a factor of 10 in angular print size (x-height) from approximately 0.2° to 2°. Assuming a standard reading distance of 40 cm (16 inches), the corresponding physical x-heights are 1.4 mm (4 points) and 14 mm (40 points). We provide new data on the distributions of print sizes in published books and newspapers and in type founders' specimens, and consider factors influencing these distributions. We discuss theoretical concepts from vision science concerning visual size coding that help inform our understanding of historical and modern typographical practices. While economic, social, technological and artistic factors influence type design and selection, we conclude that properties of human visual processing play a dominant role in constraining the distribution of print sizes in common use. PMID:21828237

Does print size matter for reading? A review of findings from vision science and typography.

PubMed

Legge, Gordon E; Bigelow, Charles A

2011-08-09

The size and shape of printed symbols determine the legibility of text. In this paper, we focus on print size because of its crucial role in understanding reading performance and its significance in the history and contemporary practice of typography. We present evidence supporting the hypothesis that the distribution of print sizes in historical and contemporary publications falls within the psychophysically defined range of fluent print size--the range over which text can be read at maximum speed. The fluent range extends over a factor of 10 in angular print size (x-height) from approximately 0.2° to 2°. Assuming a standard reading distance of 40 cm (16 inches), the corresponding physical x-heights are 1.4 mm (4 points) and 14 mm (40 points). We provide new data on the distributions of print sizes in published books and newspapers and in typefounders' specimens, and consider factors influencing these distributions. We discuss theoretical concepts from vision science concerning visual size coding that help inform our understanding of historical and modern typographical practices. While economic, social, technological, and artistic factors influence type design and selection, we conclude that properties of human visual processing play a dominant role in constraining the distribution of print sizes in common use.

The role of dental therapists in pharmacological and non-pharmacological treatment of anxious and phobic patients.

PubMed

MacLeavey, Christine

2013-01-01

Dental Therapists are in a prime position to be involved with the management of anxious and phobic patients. They earn less than dentists and are therefore a more cost-effective way of providing specialised care for anxious patients. Dental Therapists can spend more time educating and acclimatising these patients, do most if not all of the patient's treatment, only referring back to the dentist for RCT, crown/bridgework/dentures and permanent extractions. Ultimately this means that the patient receives high quality continuity of care. Treating anxious and phobic patients is time-consuming but ultimately very rewarding. If handled correctly and sensitively the anxious and phobic patient will not always be anxious or phobic, in the same way that children won't always be children. Dental Therapists can now extend their duties to include Relative Analgesia. This should enhance their employability and role within the dental team especially in the management of anxious and phobic patients. Employing a therapist with a toolbox of techniques at their disposal can be seen as part of a long-term practice plan to ensure that anxious and phobic patients become rehabilitated, happy, compliant and loyal to the practice! In fact .... the sort of patients every dentist really wants to see.

The perceived benefits of a two-year period of extended specialty training in general practice: the trainees' perspective.

PubMed

Agius, Steven; Lewis, Barry; Kirk, Bob; Hayden, Jacky

2014-01-01

Evidence suggests that, in the UK, the current three-year specialty training period in general practice is inadequate for equipping newly qualified GPs with mastery in all the necessary clinical and generic skills that would allow them to respond with optimum effect to the complexities and uncertainties of the generalist workplace. The North Western Deanery initiated an innovative pilot programme of extended (by 24 months) specialty training in general practice (GPST4-5). Nine ST3 trainees who had just 'graduated' from GPST, holding nMRCGP, were recruited, thereby formally deferring their application for a Certificate of Completion of Training (CCT). The programme was evaluated using established qualitative research techniques. Semi-structured interviews were conducted at fixed points and data were analysed for recurring discourses and themes using a framework thematic analysis. We obtained evidence of the benefits of extended specialty training in encouraging the development of clinical mastery alongside additional specialist skills, generalist and leadership competencies. We also identified the enabling factors for beneficial extended training, including workplace-based training under educational mentorship, combined with a blended learning programme and sustained expert- and peer-support.

Genetic methods for detection of antibiotic resistance: focus on extended-spectrum β-lactamases.

PubMed

Chroma, Magdalena; Kolar, Milan

2010-12-01

In 1928, the first antibiotic, penicillin, was discovered. That was the beginning of a great era in the development and prescription of antibiotics. However, the introduction of these antimicrobial agents into clinical practice was accompanied by the problem of antibiotic resistance. Currently, bacterial resistance to antibiotics poses a major problem in both hospital and community settings throughout the world. This review provides examples of modern genetic methods and their practical application in the field of extended-spectrum β-lactamase detection. Since extended-spectrum β-lactamases are the main mechanism of Gram-negative bacterial resistance to oxyimino-cephalosporins, rapid and accurate detection is requested in common clinical practice. Currently, the detection of extended-spectrum β-lactamases is primarily based on the determination of bacterial phenotypes rather than genotypes. This is because therapeutic decisions are based on assessing the susceptibility rather than presence of resistance genes. One of the main disadvantages of genetic methods is high costs, including those of laboratory equipment. On the other hand, if these modern methods are introduced into diagnostics, they often help in rapid and accurate detection of certain microorganisms or their resistance and pathogenic determinants.

Review: the legal duty of care for nurses and other health professionals.

PubMed

Young, Andy

2009-11-01

To explore the nature and extent of the legal duty of care in relation to contemporary healthcare practice. The paper seeks to re-frame and update the legal duty of care for clinical nursing practice in the 21st century, taking into account collaborative and partnership working in healthcare practice. Doctrinal legal 'approach'. 'Black letter' legal research methodology used for data collection and analysis. Literature search using Westlaw and LexisNexis database(s) to identify recent common law decisions. There has been a perceptible doctrinal shift away from paternalism and toward patient empowerment and autonomy in the last decade. This has implications for nurses and other healthcare professionals in terms of consenting patients and acting reasonably to ensure quality patient care. A number of experienced nurses are currently assuming extended roles and some are completing medical tasks, traditionally allocated to doctors. These specialist practitioners must remember that additional responsibility invariably means increased professional risk and accountability. Therefore, it is essential that those engaging in advanced nursing practice, fully understand the nature and reach of their professional duty of care and the significance of statutory and common law developments. Nurses and other healthcare professionals must update their clinical skills and practice within a legal framework and to certain standards. The cases cited and discussed are relevant to all branches of nursing and indeed to all health professions.

Pitfalls of implementing acute care surgery.

PubMed

Kaplan, Lewis J; Frankel, Heidi; Davis, Kimberly A; Barie, Philip S

2007-05-01

Incorporating emergency general surgery into the current practice of the trauma and critical care surgeon carries sweeping implications for future practice and training. Herein, we examine the known benefits of the practice of emergency general surgery, contrast it with the emerging paradigm of acute care surgery, and examine pitfalls already encountered in integration of emergency general surgery into a traditional trauma/critical care surgery service. A MEDLINE literature search was supplemented with local experience and national presentations at major meetings to provide data for this review. Considerations including faculty complement, service structure, resident staffing, physician extenders, the decreased role of community hospitals in providing trauma and emergency general surgery care, and the effects on an elective operative schedule are inadequately explored at present. There are no firm recommendations as to how to incorporate emergency general surgery into a trauma/critical care practice that will satisfy both academic and community practice paradigms. The near future seems likely to embrace the expanded training and clinical care program termed acute care surgery. A host of essential elements have yet to be examined to undertake a critical analysis of the applicability, advisability, and appropriate structure of both emergency general surgery and acute care surgery in the United States. Proceeding along this pathway may be fraught with training, education, and implementation pitfalls that are ideally addressed before deploying acute care surgery as a national standard.

Parents' and children's knowledge of oral health: a qualitative study of children with cleft palate.

PubMed

Davies, Karen; Lin, Yin-Ling; Callery, Peter

2017-07-01

Children with cleft lip and/or palate (CLP) are prone to poorer oral health outcomes than their peers, with serious implications for treatment. Little is known of the knowledge and practice of children with CLP in caring for teeth and how these contribute to oral health. To investigate (i) parents' and children's knowledge of oral health, (ii) how knowledge is acquired, and (iii) how knowledge is implemented. A qualitative design was used to investigate knowledge, beliefs, and practices reported by parents and children, age 5-11 years with CLP. Data were collected from 22 parents and 16 children and analysed using thematic analysis. Four themes were derived as follows: (i) implicit knowledge: children express simple knowledge underpinned by basic rationales, (ii) situated knowledge: children gain skills as part of everyday childhood routines, (iii) maintaining good practice in oral health: parents take a lead role in motivating, monitoring, and maintaining children's toothbrushing, and (iv) learning opportunities: pivotal moments provide opportunities for children to extend their knowledge. Developers of oral health education interventions should take account of children's implicit knowledge and the transmission of beliefs between generations that influence toothbrushing behaviours. This could enhance interventions to support parents and children's practice. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PCI Choice: Cardiovascular clinicians' perceptions of shared decision making in stable coronary artery disease.

PubMed

Coylewright, Megan; O'Neill, Elizabeth S; Dick, Sara; Grande, Stuart W

2017-06-01

Describe cardiovascular clinicians' perceptions of Shared Decision Making following use of a decision aid (DA) for stable coronary artery disease (CAD) "PCI Choice", in a randomized controlled trial. We conducted a semi-structured qualitative interview study with cardiologists and physician extenders (n=13) after using PCI Choice in practice. Interviews were transcribed then coded. Codes were organized into salient themes. Final themes were determined by consensus with all authors. Most clinicians (70%) had no prior knowledge of SDM or DAs. Mixed views about the role of the DA in the visit were related to misconceptions of how patient education differed from SDM. Qualitative assessment of clinician perceptions generated three themes: 1) Gaps exist in clinician knowledge around SDM; 2) Clinicians are often uncomfortable with modifying baseline practice; and 3) Clinicians express interest in using DAs after initial exposure within a research setting. Use of DAs by clinicians during clinic visits may improve understanding of SDM. Initial use is marked by a reluctance to modify established practice patterns. As clinicians explore new approaches to benefit their patients, there is an opportunity for DAs that provide clinician instruction on core elements of SDM to lead to enhanced SDM in clinical practice. Copyright © 2017 Elsevier B.V. All rights reserved.

7 CFR 631.11 - Conservation practice maintenance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... resource management systems or conservation practices applied under the contract for the duration of the... contract. (b) If the life span of the practices or resource management systems extends beyond the period of....11 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES...

Extending the Territory: From Open Educational Resources to Open Educational Practices

ERIC Educational Resources Information Center

Ehlers, Ulf-Daniel

2011-01-01

This article examines the findings of the recent OPAL report "Beyond OER: Shifting Focus from Resources to Practices". In doing so, it defines current understanding of open educational resources and open educational practices, and highlights the shift from open content to open practice. The article includes a framework for supporting…

Role-exit theory and marital discord following extended military deployment.

PubMed

Gambardella, Lucille C

2008-07-01

The purpose of this study was to determine the effectiveness of applying role-exit theory concepts in the counseling of military couples experiencing marital discord following extended periods of deployment. Qualitative case-study methodology was utilized to assess, diagnose, and treat 10 military couples using a framework based on role-exit theory. Six couples self-reported improvement in the marital relationship following this counseling approach. Role-exit theory based counseling may benefit other couples who experience marital discord due to role issues. The clinical nurse specialist might consider this paradigm when working with couples in marital therapy.

VI. Uterine fibroid embolization: developing a clinical service.

PubMed

Chrisman, Howard B; Smith, Steven J; Sterling, Keith M; Vogelzang, Robert; Bonn, Joseph; Andrews, Robert T; Worthington-Kirsch, Robert L; Goodwin, Scott C; Lipman, John C; Siskin, Gary P; Hovsepian, David M

2002-03-01

Building a uterine fibroid embolization (UFE) practice can be a complex process. Choices must be made regarding whether to align oneself with a gynecologist or to accept direct referrals. For the interventional radiologist, the responsibilities of evaluation and patient care pose unique and time-consuming administrative and clinical challenges. Physician extenders, either nurse practitioners or physician's assistants, play key roles as clinical coordinators by guiding the patient through the medical system and making certain that she is cleared for the procedure medically and logistically. In some settings, they may also assist in many of the technical aspects of the procedure and postoperative care. Interventional radiologists must be prepared for battles with insurance companies and be willing to go through the appeals process. Business officers must also be trained to properly code for the procedures to insure optimal reimbursement. The success of building a UFE practice may also be bolstered by directly marketing to patients and by providing them with access via the Internet. Copyright 2002, Elsevier Science (USA). All rights reserved.

The Resilience Function of Character Strengths in the Face of War and Protracted Conflict

PubMed Central

Shoshani, Anat; Slone, Michelle

2016-01-01

This study investigated the role of character strengths and virtues in moderating relations between conflict exposure and psychiatric symptoms among 1078 adolescents aged 13–15 living in southern Israel, who were exposed to lengthy periods of war, terrorism and political conflict. Adolescents were assessed for character strengths and virtues, political violence exposure using the Political Life Events (PLE) scale, and psychiatric symptoms using the Brief Symptom Inventory and the UCLA PTSD Index. Results confirmed that political violence exposure was positively correlated with psychiatric symptoms. Interpersonal, temperance and transcendence strengths were negatively associated with psychiatric symptoms. Moderating effects of the interpersonal strengths on the relation between political violence exposure and the psychiatric and PTSD indices were confirmed. The findings extend existing knowledge about the resilience function of character strengths in exposure to protracted conflict and have important practical implications for applying strength-building practices for adolescents who grow up in war-affected environments. PMID:26793139

The Effect of Racial Socialization on Urban African American Use of Child Mental Health Services

PubMed Central

Cavaleri, Mary A.; Rodriguez, James; McKay, Mary M.

2009-01-01

SUMMARY Objective To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. Methods A cross-sectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. Results At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. Conclusion Parental endorsement of racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued. PMID:20228964

The cultural dialogue on the domestic dimension of care to immigrant caregivers in Spain1

PubMed Central

Morales-Moreno, Isabel; Giménez-Fernández, Maravillas; Echevarría-Pérez, Paloma

2015-01-01

Objectives: to determine how the immigration phenomenon influences the response to informal care in the domestic level through the caregiver activity, and to analyze the cultural dialogue established in the residential area of Murcia (Spain). Method: This is an ethnographic study, conducted in 26 informal immigrant caregivers. As data collection instruments, semi-structured interviews and participant observation were employed. MAXQDA-2 assisted content analysis was also applied. Results: the immigrant caregiver is the main consumer of traditional medicines, extending these health practices to her home group. A cultural dialogue is established on informal care, characterized by interculturalism and mutual adaptation. Conclusions: cultural hybridization was identified for informal caregivers, immigrants and cultural integration: new health care practices and cultural behaviors in informal systems. There is a transformation in the roles of family members attended in domestic environments, increasing quality of life and self care. They represent an alternative to medicalization, promoting self-management of health. PMID:26487131

The Extended Mind Theory of Cognitive Distortions in Sex Offenders

ERIC Educational Resources Information Center

Ward, Tony

2009-01-01

An innovative theory of the nature of cognition, the extended mind theory (EMT), has emerged recently in the cognitive science literature. According to the EMT, the boundaries of the mind extend beyond the boundaries of skull and skin, into the world beyond. My aim in this paper is to consider the practical implications of the EMT for therapists…

The impact of extended half-life versus conventional factor product on hemophilia caregiver burden.

PubMed

Schwartz, Carolyn E; Powell, Victoria E; Su, Jun; Zhang, Jie; Eldar-Lissai, Adi

2018-05-01

Extended half-life factor products have reduced annualized bleeding rates in hemophilia patients. The impact of extended half-life versus conventional factor products on hemophilia caregiver burden has not been investigated. This study aimed to evaluate caregiver burden in extended half-life versus conventional factor products for hemophilia A and B. This cross-sectional web-based study of caregivers of people with hemophilia A or B was recruited from a panel research company and by word of mouth. Participants completed the Hemophilia Caregiver Impact measure, the PedsQL Family Impact Module (PedsQL), and the Work Productivity and Activity Impairment Questionnaire (WPAI). We also collected demographic, insurance coverage, and medical information related to the hemophilia patient(s). Burden differences were assessed using linear regression and matched cohort analyses. The sample (n = 448) included 49 people who were caring for people on extended half-life factor products. Worse caregiver burden was associated with more infusions per week and more bleeds in the past 6 months. Regression analyses suggested that caring for someone who is on a extended half-life factor product is associated with lower emotional impact (β = - 0.11, p < 0.05, Adjusted R 2  = 0.06), and shows a trend association with lower practical impact (β = - 0.09, p < 0.10, Adjusted R 2  = 0.05). The matched cohort analysis also revealed that people on extended half-life factor product had lower Emotional Impact and Practical Impact scores (t = - 2.95 and - 2.94, respectively, p < 0.05 in both cases). No differences were detected on the PedsQL or the WPAI. The reduced required frequency of factor product infusions of extended half-life factor products appears to reduce the emotional distress and practical burden of caregiving. Future work should evaluate the longitudinal impact.

Nurse prescribing: reflections on safety in practice.

PubMed

Bradley, Eleanor; Hynam, Brian; Nolan, Peter

2007-08-01

This qualitative study explores how recently qualified nurse prescribers describe, and rate, the safety of their prescribing. Internationally, the costs of drug errors are enormous and they can have serious implications for staff and patients. Nurses are now undertaking extended prescribing practice throughout the UK. Nurse prescribers work across different work settings and although safe prescribing is a priority in all of them, it is essential to ascertain the conditions that foster the highest levels of safety and how nurses can be supported in practice. Thirty-one nurses form the West Midlands area of England agreed to participate in an in-depth interview which sought to elicit their responses to various aspects of their prescribing work. They came from a variety of specialities and from hospital, community and general practice backgrounds. On completion of their training nurses were acutely aware of the responsibility that prescribing imposed on them. Although this awareness was thought to encourage caution and safety, it may also account for the fact that 26% of the nurses (n=8) had not prescribed since qualifying. Nurses felt that the multidisciplinary team had a vital role to play in supporting their prescribing practice as did collaborative working. It is concluded that those working in specialty areas that are less well-defined in terms of scope of practice (e.g. older adult nursing and learning disability) would benefit in particular from ongoing mentoring relationships with experienced prescribers and the development of individual formularies.

Biological phosphorus removal in an extended ASM2 model: Roles of extracellular polymeric substances and kinetic modeling.

PubMed

Yang, Shan-Shan; Pang, Ji-Wei; Guo, Wan-Qian; Yang, Xiao-Yin; Wu, Zhong-Yang; Ren, Nan-Qi; Zhao, Zhi-Qing

2017-05-01

This paper presents the results of an extended ASM2 model for the modeling and calibration of the role of extracellular polymeric substances (EPS) in phosphorus (P) removal in an anaerobic-aerobic process. In this extended ASM2 model, two new components, the bound EPS (X EPS ) and the soluble EPS (S EPS ), are introduced. Compared with the ASM2, 7.71, 8.53, and 9.28% decreases in polyphosphate (polyP) were observed in the extended ASM2 in three sequencing batch reactors feeding with different COD/P ratios, indicating that 7.71-9.28% of P in the liquid was adsorbed by EPS. Sensitive analysis indicated that, five parameters were the significant influential parameters and had been chosen for further model calibration by using the least square method to simulate by MATLAB. This extended ASM2 has been successfully established to simulate the output variables and provides a useful reference for the mathematic simulations of the role of EPS in biological phosphorus removal process. Copyright © 2017. Published by Elsevier Ltd.

Equipping family physician trainees as teachers: a qualitative evaluation of a twelve-week module on teaching and learning.

PubMed

de Villiers, Marietjie R; Cilliers, Francois J; Coetzee, Francois; Herman, Nicoline; van Heusden, Martie; von Pressentin, Klaus B

2014-10-22

There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master's programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years. A qualitative study was undertaken, interviewing thirteen graduates of the programme. Thematic analysis of data was done by a team comprising tutors and graduates of the programme and an independent researcher. Ethical clearance was obtained. The module influenced knowledge, skills and attitudes of respondents. Perceptions and evidence of changes in behaviour, changes in practice beyond the individual respondent and benefits to students and patients were apparent. Factors underlying these changes included the role of context and the role of personal factors. Contextual factors included clinical workload and opportunity pressure i.e., the pressure and responsibility to undertake teaching. Personal factors comprised self-confidence, modified attitudes and perceptions towards the roles of a family physician and towards learning and teaching, in addition to the acquisition of knowledge and skills in teaching and learning. The interaction between opportunity pressure and self-confidence influenced the application of what was learned about teaching. A module on teaching and learning influenced graduates' perceptions of, and self-reported behaviour relating to, teaching as practicing family physicians. This has important implications for educating family physicians in and for Africa and indirectly on expanding capacity to educate health care professionals in Africa.

Gaps in governance: protective mechanisms used by nurse leaders when policy and practice are misaligned.

PubMed

Knight, Kaye M; Kenny, Amanda; Endacott, Ruth

2015-04-09

Due to large geographical distances, the telephone is central to enabling rural Australian communities to access care from their local health service. While there is a history of rural nurses providing care via the telephone, it has been a highly controversial practice that is not routinely documented and little is known about how the practice is governed. The lack of knowledge regarding governance extends to the role of Directors of Nursing as clinical leaders charged with the responsibility of ensuring practice safety, quality, regulation and risk management. The purpose of this study was to identify clinical governance processes related to managing telephone presentations, and to explore Directors of Nursing perceptions of processes and clinical practices related to the management of telephone presentations to health services in rural Victoria, Australia. Qualitative documentary analysis and semi structured interviews were used in the study to examine the content of health service policies and explore the perceptions of Directors of Nursing in eight rural health services regarding policy content and enactment when people telephone rural health services for care. Participants were purposively selected for their knowledge and leadership role in governance processes and clinical practice. Data from the interviews were analysed using framework analysis. The process of analysis resulted in the identification of five themes. The majority of policies reviewed provided little guidance for managing telephone presentations. The Directors of Nursing perceived policy content and enactment to be largely inadequate. When organisational structures failed to provide appropriate governance for the context, the Directors of Nursing engaged in protective mechanisms to support rural nurses who manage telephone presentations. Rural Directors of Nursing employed intuitive behaviours to protect rural nurses practicing within a clinical governance context that is inadequate for the complexities of the environment. Protective mechanisms provided indicators of clinical leadership and governance effectiveness, which may assist rural nurse leaders to strengthen quality and safe care by unlocking the potential of intuitive behaviours. Kanter's theory of structural power provides a way of conceptualising these protective mechanisms, illustrating how rural nurse leaders enact power.

Portal vein embolization for induction of selective hepatic hypertrophy prior to major hepatectomy: rationale, techniques, outcomes and future directions

PubMed Central

Li, David; Madoff, David C.

2016-01-01

The ability to modulate the future liver remnant (FLR) is a key component of modern oncologic hepatobiliary surgery practice and has extended surgical candidacy for patients who may have been previously thought unable to survive liver resection. Multiple techniques have been developed to augment the FLR including portal vein embolization (PVE), associating liver partition and portal vein ligation (ALPPS), and the recently reported transhepatic liver venous deprivation (LVD). PVE is a well-established means to improve the safety of liver resection by redirecting blood flow to the FLR in an effort to selectively hypertrophy and ultimately improve functional reserve of the FLR. This article discusses the current practice of PVE with focus on summarizing the large number of published reports from which outcomes based practices have been developed. Both technical aspects of PVE including volumetry, approaches, and embolization agents; and clinical aspects of PVE including data supporting indications, and its role in conjunction with chemotherapy and transarterial embolization will be highlighted. PVE remains an important aspect of oncologic care; in large part due to the substantial foundation of information available demonstrating its clear clinical benefit for hepatic resection candidates with small anticipated FLRs. PMID:28154774

A method of designing smartphone interface based on the extended user's mental model

NASA Astrophysics Data System (ADS)

Zhao, Wei; Li, Fengmin; Bian, Jiali; Pan, Juchen; Song, Song

2017-01-01

The user's mental model is the core guiding theory of product design, especially practical products. The essence of practical product is a tool which is used by users to meet their needs. Then, the most important feature of a tool is usability. The design method based on the user's mental model provides a series of practical and feasible theoretical guidance for improving the usability of the product according to the user's awareness of things. In this paper, we propose a method of designing smartphone interface based on the extended user's mental model according to further research on user groups. This approach achieves personalized customization of smartphone application interface and enhance application using efficiency.

Investigating Mathematics Teacher Learning within an In-Service Community of Practice: The Centrality of Confidence

ERIC Educational Resources Information Center

Graven, Mellony

2004-01-01

This paper is part of a broader study that draws on Wenger's (Wenger, E.: 1998, "Communities of Practice: Learning, Meaning, and Identity", Cambridge University Press, New Work) social practice perspective to investigate teacher learning. The study extends Wenger's complex model of interrelated components of learning (as meaning, practice,…

Contribution by primary health nurses and general practitioners to the Diabetes Annual Review (Get Checked) programme in Auckland, New Zealand.

PubMed

Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert

2013-08-16

To describe primary health care (practice and specialist) nurses involvement in the government-funded annual diabetes review 'Get Checked' programme and the division of care between nurses and general practitioners in Auckland, New Zealand. Of the total 911 practice and specialist nurses identified and working in the greater Auckland region, 276 (30%) were randomly selected and invited to undertake a self-administered questionnaire and telephone interview in 2006-8. An 86% response rate was achieved. Over 60% of practice nurses and over half of specialist nurses participate in 'Get Checked' reviews. Of those nurses, 40% of practice and 70% specialist nurses, reported completing over half of the total number of 'Get Checked' reviews at their practice. Of the nurses sampled who work in general practice (n=198), 38% reported that 'nurses mostly complete' the reviews, 45% stated that 'nurses and doctors equally complete' them and 17% reported that only 'doctors' did so. For the nurses who reported that 'nurses and doctors equally complete' the reviews (n=89), most nurses undertake blood pressure measurements (90%), weigh patients (88%), give lifestyle advice (87%), examine patient's feet (73%), and 44% carried out the complete review of the patients they consult. These findings show the 'Get Checked' programme was successful in engaging practice and community-based specialist nurses in the community management of diabetes and has revealed positive relationships between nurses and doctors, extended roles for nurses and the importance of engaging nurses in the design of health care programmes.

Implementing the Next Generation Science Standards: How Instructional Coaches Mediate Standards-Based Educational Reform to Teacher Practice

NASA Astrophysics Data System (ADS)

Laxton, Katherine E.

This dissertation takes a close look at how district-level instructional coaches support teachers in learning to shifting their instructional practice, related to the Next Generation Science Standards. This dissertation aims to address how re-structuring professional development to a job-embedded coaching model supports individual teacher learning of new reform-related instructional practice. Implementing the NGSS is a problem of supporting professional learning in a way that will enable educators to make fundamental changes to their teaching practice. However, there are few examples in the literature that explain how coaches interact with teachers to improve teacher learning of reform-related instructional practice. There are also few examples in the literature that specifically address how supporting teachers with extended professional learning opportunities, aligned with high-leverage practices, tools and curriculum, impacts how teachers make sense of new standards-based educational reforms and what manifests in classroom instruction. This dissertation proposes four conceptual categories of sense-making that influence how instructional coaches interpret the nature of reform, their roles and in instructional improvement and how to work with teachers. It is important to understand how coaches interpret reform because their interpretations may have unintended consequences related to privileging certain views about instruction, or establishing priorities for how to work with teachers. In this dissertation, we found that re-structuring professional development to a job-embedded coaching model supported teachers in learning new reform-related instructional practice. However, individual teacher interpretations of reform emerged and seemed to be linked to how instructional coaches supported teacher learning.

What Can Students Learn in an Extended Role-Play Simulation on Technology and Society?

ERIC Educational Resources Information Center

Loui, Michael C.

2009-01-01

In a small course on technology and society, students participated in an extended role-play simulation for two weeks. Each student played a different adult character in a fictional community, which faces technological decisions in three scenarios set in the near future. The three scenarios involved stem cell research, nanotechnology, and privacy.…

Extended suicide with a pet.

PubMed

Cooke, Brian K

2013-01-01

The combination of the killing of a pet and a suicide is a perplexing scenario that is largely unexplored in the literature. Many forensic psychiatrists and psychologists may be unaccustomed to considering the significance of the killing of a pet. The subject is important, however, because many people regard their pets as members of their family. A case is presented of a woman who killed her pet dog and herself by carbon monoxide poisoning. The purpose of this article is to provide an initial exploration of the topic of extended suicide with a pet. Forensic mental health evaluations may have a role in understanding the etiology of this event and in opining as to the culpability of individuals who attempt to or successfully kill a pet and then commit suicide. Because the scientific literature is lacking, there is a need to understand this act from a variety of perspectives. First, a social and anthropological perspective will be presented that summarizes the history of the practice of killing of one's pet, with a focus on the ancient Egyptians. A clinical context will examine what relationship animals have to mental illness. A vast body of existing scientific data showing the relevance of human attachment to pets suggests that conclusions from the phenomena of homicide-suicide and filicide-suicide are applicable to extended suicide with a pet. Finally, recommendations will be proposed for both clinical and forensic psychiatrists faced with similar cases.

Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management.

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Yallop, Julie; Griffiths, Rhonda; Daly, John

2007-08-01

Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a Project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. 1. Practice nurses have an important role in developing systems and processes for CVD management; 2. A change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. Future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. Considerable challenges exist in conducting research in general practice; and 5. Changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.

78 FR 23702 - Copayment for Extended Care Services

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-22

... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts, Grant programs--health, Grant programs--veterans, Health care, Health facilities... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO59 Copayment for Extended Care Services...

Building morale through personal development.

PubMed

Handysides, S

1994-01-08

Once general practitioners have established themselves as principals it may seem there is little else to work for. Lack of stimulation may lead to demoralisation, and it is essential that they have other ways to continue to develop their careers. Meeting other doctors to discuss cases and problems and postgraduate education often help but many doctors want to take on extra roles. The options available include undergraduate teacher, tutor for postgraduate education, and participation in medical audit advisory groups, local medical committees, or royal college faculties. Some general practitioners work part time to allow them to fit in these activities. It may also be possible to obtain extended study leave or a sabbatical to broaden experience. Others even more practice to provide new challenges.

[The impact of childhood caries].

PubMed

Madrid, Carlos; Abarca, Marcelo; Bouferrache, Kahina; Gehri, Mario; Bodenmann, Patrick; Pop, Sabina

2012-04-04

The early childhood caries affect primary dentition before the eruption of the permanent teeth. It is set to extended use of a bottle containing fermentable carbohydrates. The early childhood caries is not only a dental disease: it is a social, cultural and behavioral condition that reflects the practices and beliefs around the child. Swiss data indicate that in aged 2 children, one of for could be affected by this devastating oral disease, mainly in vulnerable populations. The primary care physician has an important role in the screening of preschool children, in determining the risk level of the child for early childhood caries. Physicians can advise families, especially pregnant women, about preventive measures and behavior, leading to a dramatic drop of early childhood caries prevalence.

The self-consistent multiparticle-multihole configuration mixing. Motivations, state of the art and perspectives

NASA Astrophysics Data System (ADS)

Pillet, N.; Robin, C.; Dupuis, M.; Hupin, G.; Berger, J.-F.

2017-03-01

The main objective of this paper is to review the state of the art of the multiparticle-multihole configuration mixing approach which was proposed and implemented using the Gogny interaction ˜ 10 years ago. Various theoretical aspects are re-analyzed when a Hamiltonian description is chosen: the link with exact many-body theories, the impact of truncations in the multiconfigurational space, the importance of defining single-particle orbitals which are consistent with the correlations introduced in the many-body wave function, the role of the self-consistency, and more practically the numerical convergence algorithm. Several applications done with the phenomenological effective Gogny interaction are discussed. Finally, future directions to extend and generalize the method are discussed.

An integrative model linking feedback environment and organizational citizenship behavior.

PubMed

Peng, Jei-Chen; Chiu, Su-Fen

2010-01-01

Past empirical evidence has suggested that a positive supervisor feedback environment may enhance employees' organizational citizenship behavior (OCB). In this study, we aim to extend previous research by proposing and testing an integrative model that examines the mediating processes underlying the relationship between supervisor feedback environment and employee OCB. Data were collected from 259 subordinate-supervisor dyads across a variety of organizations in Taiwan. We used structural equation modeling to test our hypotheses. The results demonstrated that supervisor feedback environment influenced employees' OCB indirectly through (1) both positive affective-cognition and positive attitude (i.e., person-organization fit and organizational commitment), and (2) both negative affective-cognition and negative attitude (i.e., role stressors and job burnout). Theoretical and practical implications are discussed.

On the (mis)categorization of unattractive brides and attractive prostitutes: extending evaluative congruency effects to social category activation.

PubMed

Ruys, Kirsten I; Dijksterhuis, Ap; Corneille, Olivier

2008-01-01

Numerous studies have shown that social categorization is a flexible process that partly depends on contextual variables. However, little is known about the role of affect in people's access to categorical dimensions. We investigated the hypothesis that social category activation is facilitated on evaluatively congruent dimensions. Two studies provide support for this evaluative-matching hypothesis, in which social categorization was found to be faster and more accurate for evaluatively congruent categories (i.e., unattractive foreigners, unattractive prostitutes, attractive fellow-citizens and attractive brides) than for evaluatively incongruent categories (i.e., attractive foreigners, attractive prostitutes, unattractive fellow-citizens and unattractive brides). We discuss the theoretical and practical implications of these findings.

International guidelines for contrast-enhanced ultrasonography: ultrasound imaging in the new millennium

PubMed Central

Lorentzen, Torben

2016-01-01

The intent of this review is to discuss and comment on common clinical scenarios in which contrast-enhanced ultrasonography (CEUS) may play a decisive role and to illustrate important points with typical cases. With the advent of CEUS, the scope of indications for ultrasonography has been dramatically extended, and now includes functional imaging and tissue characterization, which in many cases enable tumor diagnosis without a biopsy. It is virtually impossible to imagine the practice of modern medicine as we know it in high-income countries without the use of imaging, and yet, an estimated two thirds of the global population may receive no such care. Ultrasound imaging with CEUS has the potential to correct this inequity. PMID:26867761

The future of diabetes education: expanded opportunities and roles for diabetes educators.

PubMed

Martin, Annette Lenzi; Lipman, Ruth D

2013-01-01

The purpose of the article is to explore challenges and opportunities associated with the state of practice for diabetes education and diabetes educators. Observations, assumptions, predictions, and recommendations based on a literature review and the 2011 workforce study and workforce summit held by the American Association of Diabetes Educators (AADE) are presented. Demand for diabetes educators is projected to increase. The employer base will broaden beyond traditional outpatient venues and extend into industry, retail pharmacy clinics, and community-based organizations. Increasing roles in management, quality assurance, and technology interface design are possible for diabetes educators. Challenges limiting diabetes education such as poor understanding of what diabetes educators do and underutilization of diabetes education continue to need redress. Increasing utilization of diabetes education and insight about health care trends can allow diabetes educators to thrive in the workplace of the future. Diabetes educators are urged to promote the evidence concerning the benefits of diabetes education, to work to increase physician referrals, and to acquire needed competencies for the workplace of the future.

The role of passive sampling in monitoring the environmental impacts of produced water discharges from the Norwegian oil and gas industry.

PubMed

Hale, Sarah E; Oen, Amy M P; Cornelissen, Gerard; Jonker, Michiel T O; Waarum, Ivar-Kristian; Eek, Espen

2016-10-15

Stringent and periodic iteration of regulations related to the monitoring of chemical releases from the offshore oil and gas industry requires the use of ever changing, rapidly developing and technologically advancing techniques. Passive samplers play an important role in water column monitoring of produced water (PW) discharge to seawater under Norwegian regulation, where they are used to; i) measure aqueous concentrations of pollutants, ii) quantify the exposure of caged organisms and investigate PW dispersal, and iii) validate dispersal models. This article summarises current Norwegian water column monitoring practice and identifies research and methodological gaps for the use of passive samplers in monitoring. The main gaps are; i) the range of passive samplers used should be extended, ii) differences observed in absolute concentrations accumulated by passive samplers and organisms should be understood, and iii) the link between PW discharge concentrations and observed acute and sub-lethal ecotoxicological end points in organisms should be investigated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Externalizing Behaviors of Ukrainian Children: The Role of Parenting

PubMed Central

Burlaka, Viktor

2016-01-01

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9–16 years of age (50% males) in 11 communities in Eastern, Southern and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors, such as aggression, delinquency and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogues about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and non-governmental organizations and mass media that work with child abuse prevention in Ukraine. PMID:26907365

Prosocial emotions and helping: the moderating role of group membership.

PubMed

Stürmer, Stefan; Snyder, Mark; Omoto, Allen M

2005-03-01

In this article, the authors introduce and test a group-level perspective on the role of empathy and interpersonal attraction in helping. In line with our predictions, Study 1, a longitudinal field study of 166 AIDS volunteers, confirmed that empathy was a stronger predictor of helping when the recipient of assistance was an in-group member than when that person was an out-group member. Also as hypothesized, attraction was a stronger predictor of helping when the recipient was an out-group member than when that person was an in-group member. Study 2 replicated and further extended these results in a laboratory experiment on spontaneous helping of a person with hepatitis. Strengthening the validity of the findings, in both studies the effects of empathy and attraction held up even when the authors statistically controlled for potential alternative predictors of helping. The theoretical and practical implications of these findings for helping in intergroup contexts are discussed. ((c) 2005 APA, all rights reserved).

Externalizing behaviors of Ukrainian children: The role of parenting.

PubMed

Burlaka, Viktor

2016-04-01

The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9-16 years of age (50% males) in 11 communities in Eastern, Southern, and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors such as aggression, delinquency, and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogs about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and nongovernmental organizations, and mass media that work with child abuse prevention in Ukraine. Copyright © 2016 Elsevier Ltd. All rights reserved.

Restorative Practices as a Tool for Organizational Change

ERIC Educational Resources Information Center

Boulton, John; Mirsky, Laura

2006-01-01

Restorative practices focus on repairing the harm to relationships rather than piling on more punishment for violations. Originally popularized in formal conferences between a victim and offender in the justice system, restorative practices have been extended to educational and treatment settings. This article describes how the adversarial climate…

Positive Affect Is Associated With Reduced Fixation in a Realistic Medical Simulation.

PubMed

Crane, Monique F; Brouwers, Sue; Forrest, Kirsty; Tan, Suyin; Loveday, Thomas; Wiggins, Mark W; Munday, Chris; David, Leila

2017-08-01

This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation. The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation. Twelve practicing anesthetists (4 females; M age = 39 years; SD = 6.71) were involved in a medical simulation. Prior to the simulation, practitioners rated the frequency they had experienced various positive and negative emotions in the previous three days. During the simulation, the patient deteriorated rapidly, and anesthetists were observed for their degree of fixation. After the simulation, practitioners indicated the frequency of these same emotions during the simulation. Nonparametric correlations were used to explore the independent relationships between positive and negative affect and the behavioral measures. Only positive affect impacted the likelihood of fixation. Anesthetists who reported more frequent recent positive affect in the three days prior to the simulation and during the simulation tended to be less fixated as judged by independent raters, identified a decline in patient oxygen saturation more quickly, and more rapidly implemented the necessary intervention (surgical cricothyroidotomy). These findings have some real-world implications for positive affect in patient safety. This research has broad implications for professions where fixation may impair practice. This research suggests that professional training should teach practitioners to identify their emotions and understand the role of these emotions in fixation.

Why are women more likely than men to extend paid work? The impact of work-family life history.

PubMed

Finch, Naomi

2014-03-01

Extending working life beyond the state pension age is a key European Union policy. In the UK, women are more likely to extend paid work than men, indicating that factors other than the state pension age play a role in working longer. Women are less able to build pension income due to their role as carer within the family. It, therefore, follows that gender inequalities over the life course continue into older age to influence need, capacity and desire to undertake paid work after state pension age. This paper explores how work, marital and fertility history impact upon the likelihood of extending employment. It uses the British Household Panel Survey's retrospective data from the first 14 waves to summarise work-family histories, and logistic regression to understand the impact of work and family histories on extending paid work. Findings show that, on the one hand, women are extending paid work for financial reasons to make up for 'opportunity costs' as a result of their caring role within the family, with short breaks due to caring, lengthy marriages, divorcing and remaining single with children all being important. Yet, there is also evidence of 'status maintenance' from working life, with the women most likely to extend paid work, also those with the highest work orientation, prior to state pension age. But lengthy dis-attachment (due to caring) from the labour market makes extending working life more difficult. This has implications for policy strategies to entice women into paid work to make up for low independent financial resources.

Counseling and Values in a Time Perspective

ERIC Educational Resources Information Center

Smith, Darrell; Peterson, James A.

1977-01-01

Smith and Peterson answer the question, "What are the common values and ethics that influence our practice?" Their searching analysis extends for beyond professional beliefs and extends into the influence of issues such as the space race, sexism, race relations, Viet Nam, and Watergate. (Author)

Role of Vascular Networks in Extending Glucose Sensor Function: Impact of Angiogenesis and Lymphangiogenesis on Continuous Glucose Monitoring in vivo

PubMed Central

Klueh, Ulrike; Antar, Omar; Qiao, Yi; Kreutzer, Donald L.

2014-01-01

The concept of increased blood vessel (BV) density proximal to glucose sensors implanted in the interstitial tissue increases the accuracy and lifespan of sensors is accepted, despite limited existing experimental data. Interestingly, there is no previous data or even conjecture in the literature on the role of lymphatic vessels (LV) alone, or in combination with BV, in enhancing continuous glucose monitoring (CGM) in vivo. To investigate the impact of inducing vascular networks (BV and LV) at sites of glucose sensor implantation, we utilized adenovirus based local gene therapy of vascular endothelial cell growth factor-A (VEGF-A) to induce vessels at sensor implantation sites. The results of these studies demonstrated that 1) VEGF-A based local gene therapy increases vascular networks (blood vessels and lymphatic vessels) at sites of glucose sensor implantation; and 2) this local increase of vascular networks enhances glucose sensor function in vivo from 7 days to greater than 28 days post sensor implantation. This data provides “proof of concept” for the effective usage of local angiogenic factor (AF) gene therapy in mammalian models in an effort to extend CGM in vivo. It also supports the practice of a variety of viral and non-viral vectors as well as gene products (e.g. anti-inflammatory and anti-fibrosis genes) to engineer “implant friendly tissues” for the usage with implantable glucose sensors as well as other implantable devices. PMID:24243850

Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infections: The attitudes of hospital health care workers.

PubMed

Seale, Holly; Chughtai, Abrar A; Kaur, Rajneesh; Phillipson, Lyn; Novytska, Yuliya; Travaglia, Joanne

2016-03-01

Any approach promoting a culture of safety and the prevention of health care-associated infections (HCAIs) should involve all stakeholders, including by definition the patients themselves. This qualitative study explored the knowledge and attitudes of health care workers toward the concept of patient empowerment focused on improving infection control practices. Semi-structured interviews were undertaken with 29 staff from a large hospital in Sydney, Australia. There was virtually unanimous agreement among the participants that patients should be thought of as a stakeholder and should have a role in the prevention of HCAI. However, the degree of patient responsibility and level of system engagement varied. Although very few had previously been exposed to the concept of empowerment, they were accepting of the idea and were surprised that hospitals had not yet adopted the concept. However, they felt that a lack of support, busy workloads, and negative attitudes would be key barriers to the implementation of any empowerment programs. Although the World Health Organization has recommended that patients have a role in encouraging hand hygiene as a means of preventing infection, patient engagement remains an underused method. By extending the concept of patient empowerment to a range of infection prevention opportunities, the positive impact of this intervention will not only extend to the patient but to the system itself. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Bridging the Divide: Examining Professional Unity and the Extended Teacher Union Role in Sweden

ERIC Educational Resources Information Center

Milner, Alison

2018-01-01

Sweden has experienced increasing educational inequity levels within its highly decentralized school system. With a reduced capacity to bargain collectively, the two Swedish teacher trade unions, the Swedish Teachers' Union (Lärarförbundet) and the National Union of Teachers in Sweden (Lärarnas Riksförbund), have sought to extend their role in…

Swimming against the tide: A Canadian qualitative study examining the implementation of a province-wide public health initiative to address health equity.

PubMed

McPherson, Charmaine; Ndumbe-Eyoh, Sume; Betker, Claire; Oickle, Dianne; Peroff-Johnston, Nancy

2016-08-19

Effectively addressing the social determinants of health and health equity are critical yet still-emerging areas of public health practice. This is significant for contemporary practice as the egregious impacts of health inequities on health outcomes continue to be revealed. More public health organizations seek to augment internal organizational capacity to address health equity while the evidence base to inform such leadership is in its infancy. The purpose of this paper is to report on findings of a study examining key factors influencing the development and implementation of the social determinants of health public health nurse (SDH-PHN) role in Ontario, Canada. A descriptive qualitative case study approach examined the first Canadian province-wide initiative to add SDH-PHNs to each public health unit. Data sources were documents and staff from public health units (i.e., SDH-PHNs, Managers, Directors, Chief Nursing Officers, Medical Officers of Health) as well as external stakeholders. Data were collected through 42 individual interviews and 226 documents. Interview data were analyzed using framework analysis methods; Prior's approach guided document analysis. Three themes related to the SDH-PHN role implementation were identified: (1) 'Swimming against the tide' to lead change as staff navigated ideological tensions, competency development, and novel collaborations; (2) Shifting organizational practice environments impacted by initial role placement and action to structurally embed health equity priorities; and (3) Bridging policy implementation gaps related to local-provincial implementation and reporting expectations. This study extends our understanding of the dynamic interplay among leadership, change management, ideological tensions, and local-provincial public health policy impacting health equity agendas. Given that the social determinants of health lie outside public health, collaboration with communities, health partners and non-health partners is essential to public health practice for health equity. The study findings have implications for increasing our knowledge and capacity for effective system-wide intervention towards health equity as a critical strategic priority for public health and for broader public policy and community engagement. Appropriate and effective public health leadership at multiple levels and by multiple actors is tantamount to adequately making inroads for health equity.

Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review

PubMed Central

2012-01-01

Background The convergence of rising health care costs and physician shortages have made health care transformation a priority in many countries resulting in the emergence of new models of care that often involve the extension of the scope of practice for allied health professionals. Physiotherapists in advanced practice/extended scope roles have emerged as key providers in such new models, especially in settings providing services to patients with musculoskeletal disorders. However, evidence of the systematic evaluation of advance physiotherapy practice (APP) models of care is scarce. A systematic review was done to update the evaluation of physiotherapists in APP roles in the management of patients with musculoskeletal disorders. Methods Structured literature search was conducted in 3 databases (Medline, Cinahl and Embase) for articles published between 1980 and 2011. Included studies needed to present original quantitative data that addressed the impact or the effect of APP care. A total of 16 studies met all inclusion criteria and were included. Pairs of raters used four structured quality appraisal methodological tools depending on design of studies to analyse included studies. Results Included studies varied in designs and objectives and could be categorized in four areas: diagnostic agreement or accuracy compared to medical providers, treatment effectiveness, economic efficiency or patient satisfaction. There was a wide range in the quality of studies (from 25% to 93%), with only 43% of papers reaching or exceeding a score of 70% on the methodological quality rating scales. Their findings are however consistent and suggest that APP care may be as (or more) beneficial than usual care by physicians for patients with musculoskeletal disorders, in terms of diagnostic accuracy, treatment effectiveness, use of healthcare resources, economic costs and patient satisfaction. Conclusions The emerging evidence suggests that physiotherapists in APP roles provide equal or better usual care in comparison to physicians in terms of diagnostic accuracy, treatment effectiveness, use of healthcare resources, economic costs and patient satisfaction. There is a need for more methodologically sound studies to evaluate the effectiveness APP care. PMID:22716771

Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

PubMed

Mick, D J; Ackerman, M H

2000-01-01

This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical nurse specialist role changes and the acute care nurse practitioner role emerges, it is imperative that advanced practice nurses describe their contribution to health care. Associating advanced practice nursing activities with outcomes will help further characterize these 2 advanced practice roles.

Opportunity for change in the future roles for the health library and information professional: meeting the challenges in NHS Scotland.

PubMed

Maclean, Gerry

2006-12-01

NHS Education for Scotland (NES) is the Special Health Board responsible for supporting best practice in education, training and development for all staff groups within NHS Scotland. As part of its remit, the Knowledge Services Group within NES is responsible for the e-Library, a national electronic resource providing and supporting access to the evidence base. The Knowledge Services Group also supports the national development of library services to NHS Scotland. This article aims to provide a reflective overview of some recent challenges within the health library and information field in Scotland, and the positive role opportunities these have afforded. The information was gathered through extensive professional interaction with staff across the sector over the first year of establishing the new role of Librarian Staff Development Manager. New roles have emerged for health library and information professionals generally; for example, in response to new technology or new user groups. The development of the NHS Scotland e-Library provides examples of role development that emerges symbiotically from core skills applied to a new situation or applied in an innovative way. Role development among health library and information professionals operating at the local service level can be both reactive and proactive. Working together, the partnership between the national Knowledge Services Group and local library and knowledge services for NHS Scotland has resulted in the emergence of additional new roles, extending the role portfolio of the local professional (for example, the Librarian-Tutor role) and supported by other national infrastructures (for example, the competency framework initiative).

Learning to speak for nature: A case study of the development of scientists and their representational practices

NASA Astrophysics Data System (ADS)

Torralba, Jose Antonio (Tony)

This is an ethnographic study of how learning and development take place among a group of professional biologists as a result of their engagement with the material, representational, and interactional resources for constructing scientific claims. The study examines these processes through the everyday activities of a research project conducted by this group of biologists to understand different aspects of subterranean termites. As part of its ethnographic approach, this study offers extended descriptions of how biologists designed and organized resources across distinct settings (e.g., field sites, laboratories, and meeting rooms) as they attempt to produce scientific claims. As part of its developmental approach, the study examines how individuals and their representational practices changed as a result of engagement with the claim-making process. By examining the everyday practices of biologists inside of a laboratory, this study attempts to highlight elements of disciplinary context and practice that play an important role in how individuals learn and develop disciplinary competence. The study offers a developmental model of how individuals and their representational practices change in virtue of each other as these individuals engage in the claim-making process. The study attends to the various ways scientists actually know, learn, and become competent in a discipline like entomology (the study of insects) with the intent of finding out what should be considered in designing learning environments within the science for those beginning to engage with the subject matter.

The Impact of the Next Generation Science Standards on Future Professional Development and Astronomy Education Research

NASA Astrophysics Data System (ADS)

Buxner, Sanlyn

2013-06-01

The Next Generation Science Standards will have a profound impact on the future science education of students and professional development for teachers. The science and engineering practices, crosscutting concepts, and disciplinary core ideas laid out in the Framework for K-12 Science Education (NRC, 2011) will change the focus and methods of how we prepare teachers to meet these new standards. Extending beyond just the use of inquiry in the classroom, teachers will need support designing and implementing integrated experiences for students that require them to apply knowledge of content and practices. Integrating the three dimensions central to the new standards will pose curricular challenges and create opportunities for innovative space science projects and instruction. The science research and technology community will have an important role in supporting authentic classroom practices as well as training and support of teachers in these new ways of presenting science and technology. These changes will require a new focus for teacher professional development and new ways to research impacts of teacher training and changes in classroom practice. In addition, new and innovative tools will be needed to assess mastery of students’ knowledge of practices and the ways teachers effectively help students achieve these new goals. The astronomy education community has much to offer as K-12 and undergraduate level science educators rethink and redefine what it means to be scientifically literate and figure out how to truly measure the success of these new ways of teaching science.

Practical solution concepts for planning and designing roadways in Kentucky.

DOT National Transportation Integrated Search

2008-10-01

Kentucky's highway agency has embarked upon an initiative tagged "Practical Solutions" which sets its goal toward reducing costs throughout the project development process extended into operations and maintenance of all highway facilities. This study...

Follow-up on family practice residents' perspectives on length and content of training.

PubMed

Duane, Marguerite; Dovey, Susan M; Klein, Lisa S; Green, Larry A

2004-01-01

The structure of family practice residency programs remains essentially unchanged from the model first proposed more than 35 years ago. Advances in medical technology and knowledge combined with increasing restrictions on resident work hours and decreasing medical student interest invite reconsideration of how family physicians are trained. We resurveyed 442 third-year family practice residents who had participated in a prior study in 2000 to determine whether their opinions about the length and content of residency had changed and whether they would still choose to be a physician and a family physician. Thirty-seven percent of responding third-year residents favored extending family practice residency to 4 years. Compared as groups, there was relatively little change in opinion between first- and third-year residents. However, residents' individual responses about the settings and content areas for which they would be willing to consider extending training varied considerably between years 1 and 3. Personal characteristics did not seem to influence residents' opinions about length and content of training. Reasons for favoring a 4-year program and barriers to change were similar to those reported previously. Residents' commitment to medicine and family medicine was still strong and was not associated with their opinions about length of training. Although most surveyed residents favored a 3-year residency program, a substantial minority still supported extending training to 4 years, and the majority would still choose to enter family medicine programs if they were extended. Given a lack of consensus about specific content areas, family medicine should consider a period of experimentation to determine how to best prepare future family physicians.

Understanding Preservice Teachers' Development of Pedagogical Knowledge Practices When Co-Teaching Primary Science to Peers

ERIC Educational Resources Information Center

Hudson, Peter

2014-01-01

Preservice teachers articulate the need for more teaching experiences for developing their practices, however, extending beyond existing school arrangements may present difficulties. Thus, it is important to understand preservice teachers' development of pedagogical knowledge practices when in the university setting. This mixed-method study…

Understanding medical practice team roles.

PubMed

Hills, Laura

2015-01-01

Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

Identifying the factors that affect the job satisfaction of early career Notre Dame graduate physiotherapists.

PubMed

Bacopanos, Eleni; Edgar, Susan

2016-11-01

Objective Previous studies have highlighted the short career intentions and high attrition rates of physiotherapists from the profession. The aim of the present study was to examine the job satisfaction and attrition rates of early career physiotherapists graduating from one Western Australian university. Methods A self-administered online survey was conducted of 157 Notre Dame physiotherapy graduates (2006-2012), incorporating a job satisfaction rating scale. Results Results showed that lowered job satisfaction was related to working in the cardiorespiratory area of physiotherapy and working in multiple jobs since graduation. The majority of graduates did not predict a long-term career in physiotherapy, highlighting a lack of career progression and limited scope of practice as influential factors. Conclusions Job satisfaction in early career physiotherapists varies across different clinical areas of practice related to several factors, including challenge and flexibility. New roles in the profession, including extended scope roles, may impact on the future job satisfaction of physiotherapists. Further studies are needed to explore the effect of these roles on workforce trends, including attrition rates. What is known about the topic? Physiotherapists predict careers of 10 years or less on entry into the profession. No previous studies have explored the individual factors influencing job satisfaction in early career physiotherapists across different clinical settings. What does this paper add? This study highlights specific factors influencing the job satisfaction of early career physiotherapists, including clinical area of practice. Physiotherapists working in the cardiorespiratory area were less satisfied, as were physiotherapists undertaking multiple positions since graduation. What are the implications for practitioners? This study informs employers and workforce planners on the factors affecting job satisfaction in early career physiotherapists. In addition, knowledge of issues affecting job satisfaction in the early career stage may assist educational institutions in their preparation of graduates for the future health workforce.

Recommendations for the Integration of Genomics into Clinical Practice

PubMed Central

Bowdin, Sarah; Gilbert, Adel; Bedoukian, Emma; Carew, Christopher; Adam, Margaret P; Belmont, John; Bernhardt, Barbara; Biesecker, Leslie; Bjornsson, Hans T.; Blitzer, Miriam; D’Alessandro, Lisa C. A.; Deardorff, Matthew A.; Demmer, Laurie; Elliott, Alison; Feldman, Gerald L.; Glass, Ian A.; Herman, Gail; Hindorff, Lucia; Hisama, Fuki; Hudgins, Louanne; Innes, A. Micheil; Jackson, Laird; Jarvik, Gail; Kim, Raymond; Korf, Bruce; Ledbetter, David H.; Li, Mindy; Liston, Eriskay; Marshall, Christian; Medne, Livija; Meyn, M. Stephen; Monfared, Nasim; Morton, Cynthia; Mulvihill, John J.; Plon, Sharon E.; Rehm, Heidi; Roberts, Amy; Shuman, Cheryl; Spinner, Nancy B.; Stavropoulos, D. James; Valverde, Kathleen; Waggoner, Darrel J.; Wilkens, Alisha; Cohn, Ronald D.; Krantz, Ian D.

2017-01-01

The introduction of diagnostic clinical genome and exome sequencing (CGES) is changing the scope of practice for clinical geneticists. Many large institutions are making a significant investment in infrastructure and technology, allowing clinicians to access CGES especially as health care coverage begins to extend to clinically indicated genomic sequencing-based tests. Translating and realizing the comprehensive clinical benefits of genomic medicine remains a key challenge for the current and future care of patients. With the increasing application of CGES, it is necessary for geneticists and other health care providers to understand its benefits and limitations, in order to interpret the clinical relevance of genomic variants identified in the context of health and disease. Establishing new, collaborative working relationships with specialists across diverse disciplines (e.g., clinicians, laboratorians, bioinformaticians) will undoubtedly be key attributes of the future practice of clinical genetics and may serve as an example for other specialties in medicine. These new skills and relationships will also inform the development of the future model of clinical genetics training curricula. To address the evolving role of the clinical geneticist in the rapidly changing climate of genomic medicine, two Clinical Genetics Think Tank meetings were held which brought together physicians, laboratorians, scientists, genetic counselors, trainees and patients with experience in clinical genetics, genetic diagnostics, and genetics education. This paper provides recommendations that will guide the integration of genomics into clinical practice. PMID:27171546

A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada.

PubMed

Doran, Diane; Duffield, Christine; Rizk, Paul; Nahm, Sang; Chu, Charlene H

2014-01-01

The purpose was to describe the number, demographic characteristics, work patterns, exit rates, and work perceptions of nurses in Ontario, Canada, in 4 specialty classifications: advanced practice nurse (APN)-clinical nurse specialist (CNS), APN-other, primary healthcare nurse practitioner [RN(extended class [EC])], and registered nurse (RN) with specialty certification. The objectives were to (1) describe how many qualified nurses are available by specialty class; (2) create a demographic profile of specialist nurses; (3) determine the proportions of specialist and nonspecialist nurses who leave (a) direct patient care and (b) nursing practice annually; (4) determine whether specialist and nonspecialist nurses differ in their self-ratings of work environment, job satisfaction, and intention to remain in nursing. Employment patterns refer to nurses' employment status (eg, full-time, part-time, casual), work duration (ie, length of employment in nurses and in current role), and work transitions (ie, movement in and out of the nursing workforce, and movement out of current role). A longitudinal analysis of the Ontario nurses' registration database from 2005 to 2010 and a survey of specialist nurses in Canada was conducted. The setting was Canada. The database sample consisted of 3 specialist groups, consisting of RN(EC), CNS, and APN-other, as well as 1 nonspecialist RN staff nurse group. The survey sample involved 359 nurses who were classified into groups based on self-reported job title and RN specialty-certification status. Data sources included College of Nurses of Ontario registration database and survey data. The study measures were the Nursing Work Index, a 4-item measure of job satisfaction, and 1-item measure of intent to leave current job. Nurses registered with the College of Nurses of Ontario were tracked over the study period to identify changes in their employment status with comparisons made between nurses employed in specialist roles and those registered as general staff nurses. Analysis involved descriptive summaries, mean comparisons with independent-samples t test, and χ(2) tests for categorical data. Exit rates from direct practice were highest for APN-other (7.6%) and CNS (6.2%) and lowest for RN(EC) (1.0%) and staff nurses (1.2%). χ(2) Tests indicated yearly exit rates of both APN-other and CNS nurse groups were significantly higher than those of staff nurses in all years evaluated (α = .025). Every specialist employment group scored significantly higher than staff nurses on measures of work environment and satisfaction outcomes. We provided a description of specialist nurses in Ontario and examined the relationship between specialization and employment patterns of nurses to inform nurse retention strategies in the future. Employment in specialist nursing positions is significantly associated with differences in transitions or exits from nursing among the specialist and nonspecialist groups. Registered nurses (EC) displayed improved retention characteristics compared with staff nurses. Advanced practice nurse-other and APN-CNS exit rates from nursing practice in Ontario were comparable to staff nurses, but exit rates from direct clinical practice roles were higher than those of staff nurses. Targeted strategies are required to retain CNS and APN-other in direct clinical practice roles.

Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use.

PubMed

Ruiz, Sarah; Snyder, Lynne Page; Rotondo, Christina; Cross-Barnet, Caitlin; Colligan, Erin Murphy; Giuriceo, Katherine

2017-03-01

While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits. Two models achieved significant reductions in Medicare expenditures, and three models reduced utilization in the form of emergency department visits, hospitalizations, or both for beneficiaries relative to comparators. These findings present a strong case for the potential value of home visits by practice-extender teams to reduce Medicare expenditures and service use in a particularly vulnerable and costly segment of the Medicare population. Project HOPE—The People-to-People Health Foundation, Inc.

An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

PubMed Central

Laws, Rachel A; Kemp, Lynn A; Harris, Mark F; Davies, Gawaine Powell; Williams, Anna M; Eames-Brown, Rosslyn

2009-01-01

Background Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. Methods The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. Results The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. Conclusion The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. PMID:19825189

The power of presence: the role of mindfulness at work for daily levels and change trajectories of psychological detachment and sleep quality.

PubMed

Hülsheger, Ute R; Lang, Jonas W B; Depenbrock, Franziska; Fehrmann, Carmen; Zijlstra, Fred R H; Alberts, Hugo J E M

2014-11-01

In this research, we examined the role of mindfulness for recovery from work using a daily diary design (N = 121; 5 days; 3 measurement occasions per day). The first goal of the study was to investigate the relationship of mindfulness with sleep quality and the mediating role of psychological detachment from a day-level perspective. A second goal was to extend the process perspective in recovery research beyond the day level and consider systematic change trajectories in recovery variables over the course of the work week and the role of mindfulness in these trajectories. Results regarding day-level relationships confirmed that mindfulness experienced during work was related to subsequent sleep quality, and this relationship was mediated by psychological detachment from work in the evening. Furthermore, an investigation of the role of mindfulness in recovery change trajectories supported the idea that psychological detachment trajectories increase over the work week for individuals low on mindfulness while there was no systematic mean-level change for individuals high on mindfulness. In contrast, sleep quality followed a linear increase from Monday to Friday for all individuals, irrespective of their levels of trait mindfulness. Practical and theoretical implications for the mindfulness and the recovery literature are discussed in conclusion. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Extended Length of Stay in Elderly Patients after Anterior Cervical Discectomy and Fusion Is Not Attributable to Baseline Illness Severity or Postoperative Complications.

PubMed

Adogwa, Owoicho; Lilly, Daniel T; Vuong, Victoria D; Desai, Shyam A; Ouyang, Bichun; Khalid, Syed; Khanna, Ryan; Bagley, Carlos A; Cheng, Joseph

2018-04-22

Health care systems are increasing efforts to minimize postoperative hospital stays to improve resource use. Common explanations for extended postoperative stay are baseline patient sickness, postoperative complications, or physician practice differences. However, the degree to which extended length of stay (LOS) represents patient illness or postoperative complications remains unknown. The aim is to investigate the influence of postoperative complications and elderly patient comorbidities on extended LOS after anterior cervical discectomy and fusion. This retrospective study was performed from January 1, 2008, to December 31, 2014, on data from the American College of Surgeons National Surgical Quality Improvement Program. Patient demographics, comorbidities, LOS, and inpatient complications were recorded. Multivariable logistic regression analysis was used to determine the odds ratio for risk-adjusted extended LOS. The primary outcome was the degree extended LOS represented patient illness or postoperative complications. Of 4730 participants, 1351 (28.56%) had extended LOS. A minority of patients with extended LOS had a history of relevant comorbidities-diabetes (29.53%), chronic obstructive pulmonary disease (9.4%), congestive heart failure (1.04%), myocardial infarction (0.33%), acute renal failure (0.3%), and stroke (5.92%). Among patients with normal LOS, 96.8% had no complications, 2.7% had 1 complication, and 0.5% had greater than 1 complication. In patients with extended LOS, 79.4% had no complications, 14.5% had 1 complication, and 6.1% had greater than 1 complication (P < 0.0001). Our study suggests much of LOS variation after an anterior cervical discectomy and fusion is not attributable to baseline patient illness or complications and most likely represents differences in practice style or surgeon preference. Copyright © 2018 Elsevier Inc. All rights reserved.

The role of neuroscience within psychology: A call for inclusiveness over exclusiveness.

PubMed

Schwartz, Seth J; Lilienfeld, Scott O; Meca, Alan; Sauvigné, Katheryn C

2016-01-01

In the present article, we appraise the increasingly prominent role of neuroscience within psychology and offer cautions and recommendations regarding the future of psychology as a field. We contend that the conflict between eliminative reductionism (the belief that the neural level of analysis will eventually render the psychological level of analysis superfluous) and emergent properties (the assumption that higher-order mental functions are not directly reducible to neural processes) is critical if we are to identify the optimal role for neuroscience within psychology. We argue for an interdisciplinary future for psychology in which the considerable strengths of neuroscience complement and extend the strengths of other subfields of psychology. For this goal to be achieved, a balance must be struck between an increasing focus on neuroscience and the continued importance of other areas of psychology. We discuss the implications of the growing prominence of neuroscience for the broader profession of psychology, especially with respect to funding agency priorities, hiring practices in psychology departments, methodological rigor, and the training of future generations of students. We conclude with recommendations for advancing psychology as both a social science and a natural science. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

24/7 SM slavery.

PubMed

Dancer, Peter L; Kleinplatz, Peggy J; Moser, Charles

2006-01-01

This study describes the nature of 24/7 SM slavery as practiced within the SM (sadomasochistic) community. These SM participants, who attempt to live full-time in owner-slave roles, represent a small proportion of those with SM interests. SM slaves have not been studied systematically to determine if and how they differ from other SM practitioners. An online questionnaire was used to obtain responses from individuals who self-identified as slaves. A total of 146 respondents participated, 53% female and 47% male, ranging in age from 18 to 72. We explored the depth of their relationships, how well they approximated "slavery," and how their relationships were structured to maintain distinct roles. Data showed that in long-term SM slave relationships, a power differential exists which extends beyond time-limited SM or sexual interactions. Owners and slaves often use common, daily life experiences or situations, such as the completion of household chores, money management, and morning or evening routines, to distinguish and maintain their respective roles. In addition, contrary to the perception of total submission, results revealed that slaves exercise free will when it is in their best interests to do so. These relationships were long-lasting and satisfying to the respondents.

Agricultural Policy Environmental eXtender simulation of three adjacent row-crop watersheds in the claypan region

USDA-ARS?s Scientific Manuscript database

The Agricultural Policy Environmental Extender (APEX) model can simulate crop yields, and pollutant loadings in whole farms or small watersheds with variety of management practices. The study objectives were to identify sensitive parameters and parameterize, calibrate and validate the APEX model fo...

7 CFR 51.1175 - Classification of defects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the surface. Creasing Materially weakens the skin, or extends over more than one-third of the surface Seriously weakens the skin, or extends over more than one-half of the surface Very seriously weakens the skin, or is distributed over practically the entire surface. Dryness or mushy condition Affecting all...

Documents, Dialogue and the Emergence of Tertiary Orality

ERIC Educational Resources Information Center

Turner, Deborah; Allen, Warren

2013-01-01

Introduction: This investigation opens with a description of why studying non-traditional, oral documents can inform efforts to extend traditional library and information science practices, of description, storage, and retrieval, to artefacts made available through emerging media. Method: This study extends the method used to identify a document,…

Extended School Non-Attenders' Views: Developing Best Practice

ERIC Educational Resources Information Center

Gregory, Isabel Rose; Purcell, Anita

2014-01-01

Despite the abundance of legislation and research initiatives concerning children's participation in decision-making, there is less research in this area with regard to extended school non-attenders. Using semi-structured interviews, this research explores how the views of children and their families who have experienced school non-attendance can…

Six Ways to Increase Enrollments at an Extended Campus

ERIC Educational Resources Information Center

Christensen, Steven S.; Howell, Scott L.; Christensen, Jordan

2015-01-01

This is a "best practices" article focused on sharing six new academic scheduling strategies recently employed by the BYU Salt Lake Center to optimize course offerings and increase enrollments. These strategies are generalizable to other academic programs that help extend academic programs at a distance, including online courses. The…

Statistically Modeling Individual Students' Learning over Successive Collaborative Practice Opportunities

ERIC Educational Resources Information Center

Olsen, Jennifer; Aleven, Vincent; Rummel, Nikol

2017-01-01

Within educational data mining, many statistical models capture the learning of students working individually. However, not much work has been done to extend these statistical models of individual learning to a collaborative setting, despite the effectiveness of collaborative learning activities. We extend a widely used model (the additive factors…

Playing, Debugging, Learning: A Proposal between Game and Instructional Designs via Extended Prototyping

ERIC Educational Resources Information Center

Gandolfi, Enrico

2018-01-01

This article investigates the phenomenon of open and participative development (e.g. beta testing, Kickstarter projects)--i.e. extended prototyping--in digital entertainment as a potential source of insights for instructional interventions. Despite the increasing popularity of this practice and the potential implications for educators and…

WOC practice in cyberspace: legal and ethical issues.

PubMed

Hoyman, K

2001-07-01

WOC nurses have the opportunity to extend their practice geographically by using electronic media, also called telehealth or "practicing in cyberspace." Currently, laws and regulations affecting this aspect of practice are in rapid flux. In addition, practicing electronically makes the ethical issues of choice, privacy, and confidentiality more acute. This article describes the current status of relevant legislation, discusses relevant ethical issues, and provides guidelines for WOC nurses who are considering the use of e-mail and video conferencing within their practice.

An Evaluation of Understandability of Patient Journey Models in Mental Health

PubMed Central

2016-01-01

Background There is a significant trend toward implementing health information technology to reduce administrative costs and improve patient care. Unfortunately, little awareness exists of the challenges of integrating information systems with existing clinical practice. The systematic integration of clinical processes with information system and health information technology can benefit the patients, staff, and the delivery of care. Objectives This paper presents a comparison of the degree of understandability of patient journey models. In particular, the authors demonstrate the value of a relatively new patient journey modeling technique called the Patient Journey Modeling Architecture (PaJMa) when compared with traditional manufacturing based process modeling tools. The paper also presents results from a small pilot case study that compared the usability of 5 modeling approaches in a mental health care environment. Method Five business process modeling techniques were used to represent a selected patient journey. A mix of both qualitative and quantitative methods was used to evaluate these models. Techniques included a focus group and survey to measure usability of the various models. Results The preliminary evaluation of the usability of the 5 modeling techniques has shown increased staff understanding of the representation of their processes and activities when presented with the models. Improved individual role identification throughout the models was also observed. The extended version of the PaJMa methodology provided the most clarity of information flows for clinicians. Conclusions The extended version of PaJMa provided a significant improvement in the ease of interpretation for clinicians and increased the engagement with the modeling process. The use of color and its effectiveness in distinguishing the representation of roles was a key feature of the framework not present in other modeling approaches. Future research should focus on extending the pilot case study to a more diversified group of clinicians and health care support workers. PMID:27471006

Assessing the risk of recurrent venous thromboembolism--a practical approach.

PubMed

Fahrni, Jennifer; Husmann, Marc; Gretener, Silvia B; Keo, Hong H

2015-01-01

Recurrent venous thromboembolism (VTE) is associated with increased morbidity and mortality. This risk is lowered by anticoagulation, with a large effect in the initial phase following the venous thromboembolic event, and with a smaller effect in terms of secondary prevention of recurrence when extended anticoagulation is performed. On the other hand, extended anticoagulation is associated with an increased risk of major bleeding and thus leads to morbidity and mortality. Therefore, it is necessary to assess the risk of recurrence for VTE on an individual basis, and a recommendation for secondary prophylaxis should be specifically based on risk calculation of recurrence of VTE and bleeding. In this review, we provide a comprehensive summary of relevant risk factors for recurrent VTE and a practical approach for assessing the risk of recurrence in daily practice.

Practice management.

PubMed

Althausen, Peter L; Mead, Lisa

2014-07-01

The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

Online Counseling: Prioritizing Psychoeducation, Self-Help, and Mutual Help for Counseling Psychology Research and Practice

ERIC Educational Resources Information Center

Chang, Tai

2005-01-01

This reaction article extends the research and practice recommendations for online counseling from the Major Contribution to the November 2005 issue of "The Counseling Psychologist" by prioritizing research and practice in online psychoeducation, self-help, and mutual help. Research suggests that tens of millions of Americans use the Internet for…

iSTART Therefore I Understand: But Metacognitive Supports Did Not Enhance Comprehension Gains

ERIC Educational Resources Information Center

McCarthy, Kathryn S.; Jacovina, Matthew E.; Snow, Erica L.; Guerrero, Tricia A.; McNamara, Danielle S.

2017-01-01

iSTART is an intelligent tutoring system designed to provide self-explanation instruction and practice to improve students' comprehension of complex, challenging text. This study examined the effects of extended game-based practice within the system as well as the effects of two metacognitive supports implemented within this practice. High school…

Communities of Practice Transition Online - Lessons learned from NASA's EPO Online Workspace

NASA Astrophysics Data System (ADS)

Davey, B.

2012-12-01

The Earth Forum Education and Public Outreach (EP/O) community has long interacted to better their practice as a community as well as individually. Working together to share knowledge and grow, they function as a community of practice. In 2009, NASA designed and implemented an online workspace in hopes of promoting the communities continued interactions. This study examines the role of an online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Study participants were 75 Education and Public Outreach community members of NASA's Science Mission Directorate Earth Forum. In this mixed methods study, online workspace metrics were used to track participation and a survey completed by 21 members was used to quantify participation. For a more detailed analysis, 15 community members (five highly active users, five average users, and five infrequent users) selected based on survey responses, were interviewed. Finally, survey data was gathered from seven online facilitators to understand their role in the community. Data collected from these 21 community members and five facilitating members suggest that highly active users (logging into the workspace daily), were more likely to have transformative experiences, co-create knowledge, feel ownership of community knowledge, have extended opportunities for community exchange, and find new forms of evaluation. Average users shared some similar characteristics with both the highly active members and infrequent users, representing a group in transition as they become more engaged and active in the online workspace. Inactive users viewed the workspace as having little value, being difficult to navigate, being mainly for gaining basic information about events and community news, and as another demand on their time. Results show the online workspace component of the Earth Science Education and Outreach Forum is playing an important and emerging role for this community by supporting knowledge building and knowledge sharing, and growing in value for those that utilizing it more frequently. The evidence suggests that with increased participation or "usage" comes increased value to the participant and the organization. This research illustrates the possible change in mindset held by participating community members when it comes to the nature of co-location. Additionally, it may be of particular importance in exploring changes in the community members' feelings of connection and belonging.

STS-47 MS Jemison extends side hatch mockup CES pole during JSC training

NASA Technical Reports Server (NTRS)

1992-01-01

STS-47 Endeavour, Orbiter Vehicle (OV) 105, Mission Specialist (MS) Mae C. Jemison extends crew escape system (CES) pole through a side hatch mockup during launch emergency egress (bailout) training in JSC's Mockup and Integration Laboratory (MAIL) Bldg 9A. MS Jerome Apt (right) looks on. The crewmembers practiced extending the CES pole prior to donning their launch and entry suits (LESs) and conducting the simulation in the Crew Compartment Trainer (CCT).

An exploration of the roles of nurse managers in evidence-based practice implementation.

PubMed

Wilkinson, Joyce E; Nutley, Sandra M; Davies, Huw T O

2011-12-01

Internationally, nurses face ongoing difficulties in making a reality of evidence-based practice. Existing studies suggest that nurse managers (NMs) should play a key role in leading and facilitating evidence-based practice, but the nature of this role has not yet been fully explored or articulated. This is one of the first studies to investigate the roles of NMs in evidence-based practice implementation. METHODOLOGY AND METHODS: Using a case study approach the study explores five propositions in relation to the NMs' potential evidence-based practice role and the extent to which their attitudes, knowledge, and skills support such a role. In doing so, it draws on interviews (n= 51), documentary analysis and observational data. Data analysis reveals that the role of NMs in facilitating evidence-based practice is under-articulated, largely passive and currently limited by competing demands. Progress in implementing evidence-based practice in the case study sites is largely explained by factors other than the role played by NMs. As such, the findings expose significant discrepancies between NMs' actual roles and those espoused in the literature as being necessary. Contextual factors are important and it is clear that the role of the contemporary NM places considerable emphasis on management and administration to the detriment of clinical practice concerns. The study reveals that NMs are only involved in evidence-based practice implementation in a passive role, not the full engagement described in the literature as being necessary. This study adds previously lacking detail of the roles of NMs. It elucidates why exhortations to NMs to become more involved in evidence-based practice implementation are ineffective without action to address the problems identified. Copyright ©2011 Sigma Theta Tau International.

Schools without Walls

ERIC Educational Resources Information Center

Howe, Dorothea

2008-01-01

The state of Ohio made globalizing its education a priority. The Ohio Department of Education benchmarked its practices against world-class standards, expanded visiting teacher programs, and promoted Chinese Mandarin language instruction and curriculum development in Ohio classrooms. Numerous partnerships extended and supported those practices.…

Asphalt surface treatment practice in southeastern United States : [tech summary].

DOT National Transportation Integrated Search

2014-09-01

Pavement preservation is an approach in enhancing pavement performance using a set of practices that extends the life : of the pavement and improves safety and ride quality. According to the World Banks Pavement Deterioration Model, the : cost of ...

A Model for the Formation and Melting of Ice on Surface Waters.

NASA Astrophysics Data System (ADS)

de Bruin, H. A. R.; Wessels, H. R. A.

1988-02-01

Ice covers have an important influence on the hydrology of surface waters. The growth of ice layer on stationary waters, such as lakes or canals, depends primarily on meteorological parameters like temperature and humidity of the air, windspeed and radiation balance. The more complicated ice formation in rapidly flowing rivers is not considered in this study. A model is described that simulates ice growth and melting utilizing observed or forecast weather data. The model includes situations with a snow cover. Special attention is given to the optimal estimation of the net radiation and to the role of the stability of the near-surface air. Since a major practical application in the Netherlands is the use of frozen waters for recreation skating, the model is extended to include artificial ice tracks.

Psychosocial Issues in Palliative Care: A Review of Five Cases

PubMed Central

Onyeka, Tonia C

2010-01-01

Palliative care is not just vital in controlling symptoms of the patient’s disease condition, but also aims to extend the patient’s life, giving it a better quality. However, several times in the course of management, the psychosocial impact of cancer, HIV/AIDS, and other life-limiting disease conditions may not be noticed and dealt with during the admission period, thereby giving rise to a more complex situation than the disease condition itself. This article aims to review some psychosocial issues and measures that can be taken to address them. It highlights the various roles and the importance of the clinician, nurse, social worker, and other members of the multidisciplinary team in tackling these issues and will help healthcare professionals in this field achieve better practice in the future. PMID:21218001

Are anthropomorphic persuasive appeals effective? The role of the recipient's motivations.

PubMed

Tam, Kim-Pong

2015-03-01

Anthropomorphic persuasive appeals are prevalent. However, their effectiveness has not been well studied. The present research addresses this issue with two experiments in the context of environmental persuasion. It shows that anthropomorphic messages, relative to non-anthropomorphic ones, appear to motivate more conservation behaviour and elicit more favourable message responses only among recipients who have a strong need for effectance or social connection. Among recipients whose such need is weak, anthropomorphic appeals seem to backfire. These findings extend the research on motivation and persuasion and add evidence to the motivational bases of anthropomorphism. In addition, joining some recent studies, the present research highlights the implications of anthropomorphism of nature for environmental conservation efforts, and offers some practical suggestions for environmental persuasion. © 2014 The British Psychological Society.

NASA Applied Sciences' DEVELOP Program Fosters the Next Generation of Earth Remote Sensing Scientists

NASA Technical Reports Server (NTRS)

Childs, Lauren M.; Brozen, Madeline W.; Gleason, Jonathan L.; Silcox, Tracey L.; Rea, Mimi; Holley, Sharon D.; Renneboog, Nathan; Underwood, Lauren W.; Ross, Kenton W.

2009-01-01

Satellite remote sensing technology and the science associated with the evaluation of the resulting data are constantly evolving. To meet the growing needs related to this industry, a team of personnel that understands the fundamental science as well as the scientific applications related to remote sensing is essential. Therefore, the workforce that will excel in this field requires individuals who not only have a strong academic background, but who also have practical hands-on experience with remotely sensed data, and have developed knowledge of its real-world applications. NASA's DEVELOP Program has played an integral role in fulfilling this need. DEVELOP is a NASA Science Mission Directorate Applied Sciences training and development program that extends the benefits of NASA Earth science research and technology to society.

The management of new primary care organizations: an international perspective.

PubMed

Meads, Geoffrey; Wild, Andrea; Griffiths, Frances; Iwami, Michiyo; Moore, Phillipa

2006-08-01

Management practice arising from parallel policies for modernizing health systems is examined across a purposive sample of 16 countries. In each, novel organizational developments in primary care are a defining feature of the proposed future direction. Semistructured interviews with national leaders in primary care policy development and local service implementation indicate that management strategies, which effectively address the organized resistance of medical professions to modernizing policies, have these four consistent characteristics: extended community and patient participation models; national frameworks for interprofessional education and representation; mechanisms for multiple funding and accountabilities; and the diversification of non-governmental organizations and their roles. The research, based on a two-year fieldwork programme, indicates that at the meso-level of management planning and practice, there is a considerable potential for exchange and transferable learning between previously unconnected countries. The effectiveness of management strategies abroad, for example, in contexts where for the first time alternative but comparable new primary care organizations are exercising responsibilities for local resource utilization, may be understood through the application of stakeholder analyses, such as those employed to promote parity of relationships in NHS primary care trusts.

Relaxation and health-related quality of life in multiple sclerosis: the example of autogenic training.

PubMed

Sutherland, Georgina; Andersen, Mark B; Morris, Tony

2005-06-01

This study was a pilot project to explore the effect of an autogenic training program (AT; a relaxation intervention) on the health-related quality of life (HRQOL) and well-being for people with multiple sclerosis. Participants either met weekly for sessions in AT for 10 weeks (n = 11) or were assigned to the control group (n = 11). The AT group was also asked to practice the technique daily at home. Scales designed to measure HRQOL and aspects of well-being (mood and depressed affect) were taken preintervention and at week 8 of the 10-week program. ANCOVAs using a measure of social support and pretest scores as covariates revealed that at the posttest the AT group reported more energy and vigor than the control group and were less limited in their roles due to physical and emotional problems. Future research should involve studies conducted over an extended period, together with sufficiently sized samples to explore the effect of frequency of practice of relaxation training on HRQOL and well-being for people with multiple sclerosis.

Challenges to counseling customers at the pharmacy counter--why do they exist?

PubMed

Kaae, Susanne; Traulsen, Janine Morgall; Nørgaard, Lotte Stig

2012-01-01

Challenges to engage pharmacy customers in medicine dialogues at the counter have been identified comprising a new and extended clinical role for pharmacists in the health care system. This article seeks to expand understanding of factors involved in successful interaction at the pharmacy counter between customers and pharmacy staff to develop their relationship further. Practical challenges to customer encounters experienced by community pharmacists are discussed using theory from the field of mainly inter-relational communication and particular studies on pharmacy communication. Preconceived expectation of customers, the type of question asked by pharmacy staff, and differences in perception of illness and medicines between staff and customers are discussed. Both staff and customer influence the outcome of attempts by pharmacy staff to engage customers in dialogue about their medicine use through a complex mechanism of interaction. It is recommended that practitioners and researchers begin to distinguish, both theoretically and practically, between the content of a conversation and the underlying relationship when exploring and further developing the therapeutic relationship between pharmacy personnel and customers. Copyright © 2012 Elsevier Inc. All rights reserved.

Extended International Normalized Ratio testing intervals for warfarin-treated patients.

PubMed

Barnes, G D; Kong, X; Cole, D; Haymart, B; Kline-Rogers, E; Almany, S; Dahu, M; Ekola, M; Kaatz, S; Kozlowski, J; Froehlich, J B

2018-05-15

Essentials Warfarin typically requires International Normalized Ratio (INR) testing at least every 4 weeks. We implemented extended INR testing for stable warfarin patients in six anticoagulation clinics. Use of extended INR testing increased from 41.8% to 69.3% over the 3 year study. Use of extended INR testing appeared safe and effective. Background A previous single-center randomized trial suggested that patients with stable International Normalized Ratio (INR) values could safely receive INR testing as infrequently as every 12 weeks. Objective To test the success of implementation of an extended INR testing interval for stable warfarin patients in a practice-based, multicenter collaborative of anticoagulation clinics. Methods At six anticoagulation clinics, patients were identified as being eligible for extended INR testing on the basis of prior INR value stability and minimal warfarin dose changes between 2014 and 2016. We assessed the frequency with which anticoagulation clinic providers recommended an extended INR testing interval (> 5 weeks) to eligible patients. We also explored safety outcomes for eligible patients, including next INR values, bleeding events, and emergency department visits. Results At least one eligible period for extended INR testing was identified in 890 of 3362 (26.5%) warfarin-treated patients. Overall, the use of extended INR testing in eligible patients increased from 41.8% in the first quarter of 2014 to 69.3% in the fourth quarter of 2016. The number of subsequent out-of-range next INR values were similar between eligible patients who did and did not have an extended INR testing interval (27.3% versus 28.4%, respectively). The numbers of major bleeding events were not different between the two groups, but rates of clinically relevant non-major bleeding (0.02 per 100 patient-years versus 0.09 per 100 patient-years) and emergency department visits (0.07 per 100 patient-years versus 0.19 per 100 patient-years) were lower for eligible patients with extended INR testing intervals than for those with non-extended INR testing intervals. Conclusions Extended INR testing for stable warfarin patients can be successfully and safely implemented in diverse, practice-based anticoagulation clinic settings. © 2018 International Society on Thrombosis and Haemostasis.

"Who's on the team today?" The status of briefing amongst operating theatre practitioners in one UK hospital.

PubMed

Allard, Jon; Bleakley, Alan; Hobbs, Adrian; Vinnell, Tina

2007-03-01

Accidents in health care are mainly due to systemic communication errors. Errors occur more frequently in the operating theatre (OT) than other clinical settings. Hence, it is important that preventive communication practices are adopted in OT teams. Formal team pre-briefing has been shown to improve safety in high risk settings such as aviation, but such briefing is not common practice in OT teams. This paper reviews key literature demonstrating the value of briefing in high-risk practices; presents and analyses the results of a questionnaire survey on the status of briefing after its introduction to OT teams in one UK hospital; and analyses processes that frustrate widespread adoption of briefing. In comparison with other OT practitioners, surgeons generally reported differing perceptions of the meaning and value of briefing, often holding broad notions of what constitutes a "brief", but also showing scepticism towards briefing. However, surgeons who had introduced briefing reported positive results such as greater efficiency, shared understanding, and increased team morale. Collaborative briefing that extends beyond the technical to include the interpersonal could be initiated in principle by any member of the OT team, but a number of factors inhibit this, and surgeons play a pivotal role in establishing briefing.

Enacting Firm, Fair and Friendly Practice: A Model for Strengths-Based Child Protection Relationships?

PubMed

Oliver, Carolyn; Charles, Grant

2016-06-01

Strengths-based solution-focused approaches are gaining ground in statutory child protection work, but few studies have asked front line practitioners how they navigate the complex worker-client relationships such approaches require. This paper describes one component of a mixed-methods study in a large Canadian statutory child protection agency in which 225 workers described how they applied the ideas of strengths-based practice in their daily work. Interviews with twenty-four practitioners were analysed using an interpretive description approach. Only four interviewees appeared to successfully enact a version of strengths-based practice that closely mirrored those described by key strengths-based child protection theorists and was fully congruent with their mandated role. They described navigating a shifting balance of collaboration and authority in worker-client relationships based on transparency, impartial judgement, attentiveness to the worker-client interaction and the value that clients were fellow human beings. Their accounts extend current conceptualisations of the worker-client relationship in strengths-based child protection work and are congruent with current understandings of effective mandated relationships. They provide what may be a useful model to help workers understand and navigate relationships in which they must reconcile their own authority and expertise with genuine support for the authority and expertise of their clients.

From challenges to advanced practice registered nursing role development: Qualitative interview study.

PubMed

Jokiniemi, Krista; Haatainen, Kaisa; Pietilä, Anna-Maija

2015-12-01

The aim of this study is to describe the factors hindering and facilitating the implementation of the advanced practice registered nurses role at Finnish university hospitals, and to examine the implications for its future development. A descriptive qualitative approach, using thematic individual interviews, was conducted in 2011 with a sample of 11 advanced practice registered nurses. The data were analysed using qualitative content analysis. The advanced practice registered nurses role barriers had an impact on the role development needs. In turn, the facilitating factors helped encounter the challenges of the role, therefore having an impact on both the current role achievement, as well as contributing to the future role development. The factors hindering and facilitating the advanced practice registered nurses role need to be acknowledged to support the role implementation and planning of the future of the role. © 2014 Wiley Publishing Asia Pty Ltd.

Identifying Effective Spelling Interventions Using a Brief Experimental Analysis and Extended Analysis

ERIC Educational Resources Information Center

McCurdy, Merilee; Clure, Lynne F.; Bleck, Amanda A.; Schmitz, Stephanie L.

2016-01-01

Spelling is an important skill that is crucial to effective written communication. In this study, brief experimental analysis procedures were used to examine spelling instruction strategies (e.g., whole word correction; word study strategy; positive practice; and cover, copy, and compare) for four students. In addition, an extended analysis was…

Extending Learning Communities: New Technologies, Multiple Literacies, and Culture Blind Pedagogies

ERIC Educational Resources Information Center

Knight, Michelle G.; Dixon, Iris R.; Norton, Nadjwa E. L.; Bentley, Courtney

2004-01-01

Technologies such as videoconferencing used for distance education are creating ways for high schools to extend their learning communities to connect youth with professional communities of practice in ways that approximate the face-to-face interactions in traditional classrooms. These technologies are often touted as a way to augment course…

Extending Face-to-Face Interactions: Understanding and Developing an Online Teacher and Family Community

ERIC Educational Resources Information Center

Zhang, Chun; Du, Jianxia; Sun, Li; Ding, Yi

2018-01-01

Technology has been quickly changing human interactions, traditional practices, and almost every aspect of our lives. It is important to maintain effective face-to-face communication and interactions between teachers and families. Nonetheless, technology and its tools can also extend and enhance family-teacher relationships and partnerships. This…

Development and evaluation of the microbial fate and transport module for the Agricultural Policy/Environmental eXtender (APEX) model

USDA-ARS?s Scientific Manuscript database

Microbial contamination of waters in agricultural watershed is the critical public health issue. The watershed-scale model has been proven to be one of the candidate tools for predicting microbial water quality and evaluating management practices. The Agricultural Policy/Environmental eXtender (APEX...

National survey on the practice of radiation therapists in Australia.

PubMed

Sale, Charlotte; Halkett, Georgia; Cox, Jenny

2016-06-01

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

[Diagnostic radiology in the technological era. Comparison between two models].

PubMed

Andrade-Barreto, O A; Villa-Caballero, Leonel

2005-01-01

Diagnostic Radiology is a medical specialty that has played a dynamic role in the medical arena during the last three decades of the XX century. As a part of the evolution of this specialty, medicine and society at large have received diverse benefits in areas of diagnosis and for the decision making process in the clinical practice. Modern radiology has provided numerous advances and refined tools that give more convenience speed and precise diagnosis in the current medical practice. At the present time, these technologies are part of the standard of care in the US and other industrialized countries, representing the ultimate desire or goal to reach for other healthcare systems in developing countries as well. Unfortunately, many of the clinical skills in the health care personal have not evolved at the same pace of those modern technologies, conditioning a reduction in the performance of sensitive areas to the patient's interest, such as the caring, compassion and quality of health care. It is unquestionable the value and benefits that technologies such as CAT and MRI scans have brought to the standard practice in the recent time. Nonetheless, it is desirable to maintain the highest possible level of clinical skills despite the extended use of modern technologies by the health personnel, without compromising the quality of care. Yet is pending the future role and rational use for those technologies in radiology, especially in times when delivering good, reliable health care have become a priority for many health institutions worldwide. This approach would be the ultimate goal to reach in times and circumstances where health for all is the highest precious value to obtain at global level.

Discourses of student orientation to medical education programs

PubMed Central

Ellaway, Rachel H.; Cooper, Gerry; Al-Idrissi, Tracy; Dubé, Tim; Graves, Lisa

2014-01-01

Background Although medical students’ initial orientation is an important point of transition in medical education, there is a paucity of literature on the subject and major variations in the ways that different institutions orient incoming medical students to their programs. Methods We conducted a discourse analysis of medical education orientation in the literature and on data from a survey of peer institutions’ approaches to orientation. Results These two discourses of orientation had clear similarities, in particular, the critical role of ceremony and symbols, and the focus on developing professionalism and physician identities. There were also differences between them, in particular, in the way that the discourse in the literature focused on the symbolic and professional aspects of orientation; something we have called ‘cultural orientation’. Meanwhile, those who were responsible for orientation in their own institutions tended to focus on the practical and social dimensions. Conclusion By examining how orientation has been described and discussed, we identify three domains of orientation: cultural, social, and practical. These domains are relatively distinct in terms of the activities associated with them, and in terms of who is involved in organizing and running these activities. We also describe orientation as a liminal activity system on the threshold of medical school where incoming students initially cross into the profession. Interestingly, this state of ambiguity also extends to the scholarship of orientation with only some of its aspects attracting formal enquiry, even though there is a growing interest in transitions in medical education as a whole. We hope, therefore, that this study can help to legitimize enquiry into orientation in all its forms and that it can begin to situate the role of orientation more firmly within the firmament of medical education practice and research. PMID:24646440

Comparing the effects of massed and distributed practice on skill acquisition for children with autism.

PubMed

Haq, Shaji S; Kodak, Tiffany; Kurtz-Nelson, Evangeline; Porritt, Marilynn; Rush, Kristin; Cariveau, Tom

2015-01-01

We replicated and extended the findings of Haq and Kodak (2015) by evaluating the efficiency of massed and distributed practice for teaching tacts and textual and intraverbal behavior to 3 children with autism. Massed practice included all practice opportunities conducted on 1 day during each week, and distributed practice included practice opportunities conducted across several days during the week. The results indicated that distributed practice was more efficient for all participants. Suggested areas for future research and implications for practice are discussed. © Society for the Experimental Analysis of Behavior.

Theory, practice and performance

NASA Astrophysics Data System (ADS)

Gallagher, Shaun

2017-01-01

I focus on the enactivist and extended mind approaches to embodied cognition (EC), and specifically on the concepts of body schema, affectivity, distributed cognition and intersubjectivity to show how EC has relevance to questions about expert performance, and to the theory and practice of performing arts.

Identifying the core competencies of mental health telephone triage.

PubMed

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to improve the quality, consistency and accuracy of telephone-based mental health triage assessment. © 2012 Blackwell Publishing Ltd.

Nourishing networks: an interprofessional learning model and its application to the Australian rural health workforce.

PubMed

Little, F; Brown, L; Grotowski, M; Harris, D

2012-01-01

Access to continuing professional development for rural health clinicians requires strategies to overcome barriers associated with finances, travel and a lack of resources. Approaches to providing professional development need to transcend conventional educational methods and consider interprofessional educational opportunities to meet the diverse needs of the rural health workforce. Rural clinicians often work in professional isolation and frequently work collaboratively with clinicians from a range of other health disciplines. Interprofessional learning and practice is therefore important in a rural areas as clinicians working in these settings are often more reliant on each other and require an understanding of other's roles to provide effective health care. In addition, specialist services are limited in rural areas, with health professionals increasingly required to perform extended roles at an advanced-practice level. A model for interprofessional learning has been developed to attempt to address the barriers related to the delivery of interprofessional education in the rural health setting in Australia. This model demonstrates a flexible approach to interprofessional learning which meets different educational needs across a number of health disciplines, and is tailored to varying levels of expertise. It incorporates three learning approaches: traditional learning, flexible learning and advanced practice. Each of these components of the model are described and the Nourishing Networks program is provided as an example of the application of the model in a rural setting, utilising 'eating disorders' as the educational topic. Interprofessional learning can be delivered effectively in a rural setting by utilising technology to help bridge the isolation experienced in rural practice. Challenges in delivering the interprofessional learning program included: engaging rural general practitioners, utilising technology and maintaining participant engagement. The use of technology is essential to access a broad group of rural clinicians however, there are limitations in its use that must be acknowledged. The pilot of the Stepped Interprofessional Rural Learning Model and its application to eating disorders has scope for use in delivering education for other health topics.

The Extended African American Family: A Pragmatic Strategy That Blunts the Blade of Injustice.

ERIC Educational Resources Information Center

Ford, Donna Yvette; And Others

1991-01-01

Considers the extended African-American family, beginning with a historical perspective of the nuclear family and other family arrangements. The importance of the group rather than the individual for African-American culture is explored. Analyses of the function of the extended family indicate its role in adaptation and survival. (SLD)

Students Working Online for Group Projects: A Test of an Extended Theory of Planned Behaviour Model

ERIC Educational Resources Information Center

Cheng, Eddie W. L.

2017-01-01

This study examined an extended theory of planned behaviour (TPB) model that specified factors affecting students' intentions to collaborate online for group work. Past behaviour, past experience and actual behavioural control were incorporated in the extended TPB model. The mediating roles of attitudes, subjective norms and perceived behavioural…

Extended Length of Stay in Elderly Patients After Lumbar Decompression and Fusion Surgery is May Not be Attributable to Baseline Illness Severity or Postoperative Complications.

PubMed

Adogwa, Owoicho; Desai, Shyam A; Vuong, Victoria D; Lilly, Daniel T; Ouyang, Bichun; Davison, Mark; Khalid, Syed; Bagley, Carlos A; Cheng, Joseph

2018-05-31

Hospital leaders are seeking ways to improve resource utilization and minimize long postoperative hospital stays. Common explanations for extended stay are baseline patient illness, postoperative complications, or physician practice differences. However, the degree extended length of stay (LOS) represents illness severity or postoperative complications remains unknown. The aim is to investigate the influence of postoperative complications and patient comorbidities on extended length of stay after lumbar spine surgery in elderly patients. In this retrospective cohort study from 2008-2014, we analyzed data from the American College of Surgeons National Surgical Quality Improvement Program for elderly patients undergoing lumbar spine surgery. Patient demographics, comorbidities, LOS, and complications were recorded. Multivariable logistic regression analysis was used to determine the odds-ratio for risk-adjusted LOS. The primary outcome was the degree extended LOS represented patient illness or postoperative complications. Of 9,482 cases, 1,909 (20.13%) had extended LOS. A minority of extended LOS patients had a history of relevant comorbidities-diabetes (21.76%), COPD (8.17%), CHF (0.94%), MI (0%), acute renal failure (0.47%), and stroke (2.23%). 93% of patients with normal LOS had no complication, 5.19% had one complication, and 1.69% had greater than one complication. Among extended LOS patients, 73.65% had no complications, 18.96% had one complication, and 7.39% had greater than one complication (p<0.000). Our study suggests much of the variation in LOS for elderly lumbar spine surgery patients is not attributable to baseline patient illness or postoperative complications and therefore, most likely represents differences in practice style or surgeon preference. Copyright © 2018 Elsevier Inc. All rights reserved.

Novice to expert practice via postprofessional athletic training education: a grounded theory.

PubMed

Neibert, Peter J

2009-01-01

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)-accredited postprofessional athletic training education programs. Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Qualitative study using grounded theory procedures. Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.

The role of strigolactones and ethylene in disease caused by Pythium irregulare.

PubMed

Blake, Sara N; Barry, Karen M; Gill, Warwick M; Reid, James B; Foo, Eloise

2016-06-01

Plant hormones play key roles in defence against pathogen attack. Recent work has begun to extend this role to encompass not just the traditional disease/stress hormones, such as ethylene, but also growth-promoting hormones. Strigolactones (SLs) are the most recently defined group of plant hormones with important roles in plant-microbe interactions, as well as aspects of plant growth and development, although the knowledge of their role in plant-pathogen interactions is extremely limited. The oomycete Pythium irregulare is a poorly controlled pathogen of many crops. Previous work has indicated an important role for ethylene in defence against this oomycete. We examined the role of ethylene and SLs in response to this pathogen in pea (Pisum sativum L.) at the molecular and whole-plant levels using a set of well-characterized hormone mutants, including an ethylene-insensitive ein2 mutant and SL-deficient and insensitive mutants. We identified a key role for ethylene signalling in specific cell types that reduces pathogen invasion, extending the work carried out in other species. However, we found no evidence that SL biosynthesis or response influences the interaction of pea with P. irregulare or that synthetic SL influences the growth or hyphal branching of the oomycete in vitro. Future work should seek to extend our understanding of the role of SLs in other plant interactions, including with other fungal, bacterial and viral pathogens, nematodes and insect pests. © 2015 BSPP AND JOHN WILEY & SONS LTD.

The consultant nurse - expert practitioner and much more.

PubMed

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

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

Upper Elementary Reading Instruction in the Age of Accountability: Balancing Best Practices with Pressures to Achieve on High-Stakes Tests

ERIC Educational Resources Information Center

Saunders, Christina Henry

2017-01-01

The present study identifies reading instructional practices used in upper elementary classrooms during the age of high-stakes test accountability and compares reading practices among schools of varying accreditation status and socio-economic status (SES). The current study partially replicates and extends a study conducted by Baumann, Hoffman,…

Beyond Talking about Books: Implications of the Reading Comprehension Instruction and Pedagogical Beliefs of a Special Educator Perceived as Effective

ERIC Educational Resources Information Center

Feiker Hollenbeck, Amy R.

2013-01-01

This investigation extends the study of the reading comprehension practices used with students with learning disabilities (LD) via a case study, exploring the beliefs and practices in reading comprehension of "Wendy," a cross-categorical special educator nominated as effective in her work with sixth-grade students. Wendy's practices serve as a…

"It’s like Big Mama’s house": Examining Extended Family Influences on the Dietary Behaviors of African American Children

PubMed Central

Brown, Natasha A.; Thornton, Rachel L. J.; Smith, Katherine Clegg; Surkan, Pamela J.; Levine, David M.

2014-01-01

The family environment plays an important role in influencing children’s dietary behaviors. Traditionally, African American extended family members play a key role in child socialization. We examine the role of extended families in how children are socialized to adopt dietary norms. We conducted in-depth, semi-structured interviews with 24 individuals across eight family units to elicit information regarding the influences of culture and families on children’s dietary behaviors. Findings suggest that families teach children to value activities that combine quality time and enjoying food together; adults are inconsistent in how they teach children to adopt desired dietary behaviors. This work has implications for improving family-based interventions for African American children through promoting healthful behaviors that are also respectful of family dietary traditions, improving communication between adults and children, and leveraging family members as attitudinal and behavioral referents. PMID:24564191

Online Attention Training for Older Adults.

PubMed

Wennberg, Alexandra; Kueider, Alexandra; Spira, Adam; Adams, Gregory; Rager, Robert; Rebok, George

Evidence suggests that cognitive training interventions can improve older adults' cognitive performance. Successful training programs are adaptable and train multiple cognitive domains to target individual strengths and weaknesses. Computerized training programs are useful because they allow older adults to easily access training. This pilot study used an online attention training program, ATTENTION WORKOUT™, to enhance three aspects of attention- coordination , allocation , and selective focus -in community-dwelling older adults randomized to either an abbreviated (n=13) or an extended (n=17) practice training program over a 6-week period. Participants in the extended practice group significantly improved on selective focus reading distraction tasks with unrelated words (U=39.5; Z=-2.34; p =.02) and blanks (U=26.5; Z=-3.05; p =.002) as well as a matching attributes task (U=49.5; Z=-2.33; p =.02). The extended practice group significantly improved on three tasks of coordinating attention - radio-tuning (U=30; Z=-2.73; p =.01), circuit-breaker resetting (U=46; Z=-2.24; p =.03), and the combination of the two tasks (U=15; Z=-3.51; p <.0001) - as well as a memory generalization task (U=20; Z=-3.27; p =.001). A post-test satisfaction survey found both groups enjoyed the program, but the abbreviated practice group felt the tasks were more difficult. These findings suggest online attention training programs, like ATTENTION WORKOUT, can improve attention-related skills in community-dwelling older adults.

The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

PubMed

Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Seven studies met the inclusion criteria. Given the small number of included studies and variable methodological quality, care must be taken when interpreting the review findings. There is some evidence that cessation of single room isolation and cohorting of MRSA patients does not increase nosocomial MRSA transmission when hand-washing compliance and standard precautions are maintained. Indeed, there is some evidence that reduced MRSA transmission can be achieved by improving compliance with contact precautions alone.The low level of hand hygiene compliance reported in the literature suggests that staff compliance with isolation practices is a significant factor in evaluating any infection-controlled intervention in the clinical setting. While staff compliance data are conflicting, regular audit and feedback of performance may improve compliance. The heterogeneous nature of the topic and methodological weaknesses of included studies impairs the ability to aggregate data and develop specific practice recommendations.While this review presents evidence to suggest that ceasing single room or cohort isolation does not lead to increased MRSA transmission, these studies maintained high levels of hand hygiene or standard precautions. Additionally, the role of extraneous factors, such as environmental reservoirs, specific MRSA strains and patient mix, is unclear. None of the included studies measured financial, social or psychological factors associated with isolation practices. There is an urgent need for well-designed research with significant sample sizes to develop an evidence base upon which to underpin future clinical practice.

The role of patient isolation and compliance with isolation practices in the control of nosocomial MRSA in acute care.

PubMed

Halcomb, Elizabeth J; Griffiths, Rhonda; Fernandez, Ritin

2008-06-01

Background  Nosocomial infection remains the most common complication of hospitalisation. Despite infection control efforts, nosocomial methicillin resistant Staphylococcus aureus (MRSA) transmission continues to rise. Various isolation practices are used to minimise MRSA transmission in acute care. However, the effectiveness of these practices has seldom been evaluated. Objectives  This review sought to evaluate the efficacy of isolation practices in minimising MRSA transmission in the acute hospital setting and explore staff, visitor and patient compliance with isolation practices. This review updates a review published in 2002. Search strategy  A systematic search for relevant published or unpublished English language literature was undertaken using electronic databases, the reference lists of retrieved papers and the Internet. This extended the search published in the original review. Databases searched included: Medline, CINAHL, EMBASE, Cochrane Library and Joanna Briggs Institute Evidence Library. Selection criteria  All English language research reports published between 1990 and August 2005 that focused on the role of isolation practices on the nosocomial transmission of MRSA in adult, paediatric or neonatal acute care settings were eligible for inclusion in the review. Studies that evaluated multiple infection control strategies or control of MRSA outbreaks were excluded. The main outcome of interest was the incidence of new cases of MRSA. The secondary outcome was staff, visitor and patient compliance with the isolation practices. Data collection and analysis  Two reviewers assessed each paper against the inclusion criteria and a validated quality scale. Data extraction was undertaken using a tool designed specifically for this review. Statistical comparisons of findings were not possible, so findings are presented in a narrative form. Results  Seven studies met the inclusion criteria. Given the small number of included studies and variable methodological quality, care must be taken when interpreting the review findings. There is some evidence that cessation of single room isolation and cohorting of MRSA patients does not increase nosocomial MRSA transmission when hand-washing compliance and standard precautions are maintained. Indeed, there is some evidence that reduced MRSA transmission can be achieved by improving compliance with contact precautions alone. The low level of hand hygiene compliance reported in the literature suggests that staff compliance with isolation practices is a significant factor in evaluating any infection-controlled intervention in the clinical setting. While staff compliance data are conflicting, regular audit and feedback of performance may improve compliance. Implications for clinical practice  The heterogeneous nature of the topic and methodological weaknesses of included studies impairs the ability to aggregate data and develop specific practice recommendations. While this review presents evidence to suggest that ceasing single room or cohort isolation does not lead to increased MRSA transmission, these studies maintained high levels of hand hygiene or standard precautions. Additionally, the role of extraneous factors, such as environmental reservoirs, specific MRSA strains and patient mix, is unclear. None of the included studies measured financial, social or psychological factors associated with isolation practices. There is an urgent need for well-designed research with significant sample sizes to develop an evidence base upon which to underpin future clinical practice. © 2008 The Authors. Journal Compilation © Blackwell Publishing Asia Pty Ltd.

Volunteer Development. Practice Application Brief.

ERIC Educational Resources Information Center

Kerka, Sandra

Certain practices in volunteer development have proved successful to help organizations make the best use of their volunteers. Development should be a comprehensive, continuous process through which individuals can extend, update, and adapt their knowledge, skills, and abilities to enhance their performance and potential. A model for volunteer…

Refining Pragmatically-Appropriate Oral Communication via Computer-Simulated Conversations

ERIC Educational Resources Information Center

Sydorenko, Tetyana; Daurio, Phoebe; Thorne, Steven L.

2018-01-01

To address the problem of limited opportunities for practicing second language speaking in interaction, especially delicate interactions requiring pragmatic competence, we describe computer simulations designed for the oral practice of extended pragmatic routines and report on the affordances of such simulations for learning pragmatically…

Enabling narrative pedagogy: inviting, waiting, and letting be.

PubMed

Ironside, Pamela M

2014-01-01

This article describes how teachers enable Narrative Pedagogy in their courses by explicating the Concernful Practice Inviting: Waiting and Letting Be. Narrative Pedagogy, a research-based, phenomenological approach to teaching and learning, extends conventional pedagogies and offers nursing faculty an alternative way of transforming their schools and courses. Using hermeneutic phenomenology, interview data collected over a 10-year period were analyzed by coding practical examples of teachers' efforts to enact Narrative Pedagogy. When Narrative Pedagogy is enacted, teachers and students focus on thinking and learning together about nursing phenomena and seek new understandings about how they may provide care in the myriad situations they encounter. Although the Concernful Practices co-occur, explicating inviting experiences can assist new teachers, and those seeking to extend their pedagogical literacy, by providing new understandings of how Narrative Pedagogy can be enacted.

Assessing the risk of recurrent venous thromboembolism – a practical approach

PubMed Central

Fahrni, Jennifer; Husmann, Marc; Gretener, Silvia B; Keo, Hong H

2015-01-01

Recurrent venous thromboembolism (VTE) is associated with increased morbidity and mortality. This risk is lowered by anticoagulation, with a large effect in the initial phase following the venous thromboembolic event, and with a smaller effect in terms of secondary prevention of recurrence when extended anticoagulation is performed. On the other hand, extended anticoagulation is associated with an increased risk of major bleeding and thus leads to morbidity and mortality. Therefore, it is necessary to assess the risk of recurrence for VTE on an individual basis, and a recommendation for secondary prophylaxis should be specifically based on risk calculation of recurrence of VTE and bleeding. In this review, we provide a comprehensive summary of relevant risk factors for recurrent VTE and a practical approach for assessing the risk of recurrence in daily practice. PMID:26316770

Far transfer in cognitive training of older adults

PubMed Central

Zelinski, Elizabeth M.

2014-01-01

Purpose This article reviews the literature on far transfer effects in training of older adults. Methods Adapting a taxonomy of transfer developed by Barnett and Ceci (2002), to rehabilitation or enhancement of existing cognitive skills; results of studies assessing transfer effects from training of memory, reasoning, UFOV, dual task performance, and complex training are classified. Results Comparisons of the transfer outcomes of both strategy training and extended practice approaches suggest that far transfer has been observed. Conclusions Outcomes for strategy studies training memory have had less success than extended practice studies in obtaining far transfer. Reasons for this are discussed, as are suggestions for improved assessment of transfer outcomes. PMID:19847070

Far transfer in cognitive training of older adults.

PubMed

Zelinski, Elizabeth M

2009-01-01

This article reviews the literature on far transfer effects in training of older adults. Adapting a taxonomy of transfer developed by Barnett and Ceci (2002), to rehabilitation or enhancement of existing cognitive skills; results of studies assessing transfer effects from training of memory, reasoning, UFOV, dual task performance, and complex training are classified. Comparisons of the transfer outcomes of both strategy training and extended practice approaches suggest that far transfer has been observed. Outcomes for strategy studies training memory have had less success than extended practice studies in obtaining far transfer. Reasons for this are discussed, as are suggestions for improved assessment of transfer outcomes.

Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England

PubMed Central

Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

2013-01-01

Purpose: Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Method: Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Results: Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. Conclusions: The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. Implications for Rehabilitation The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke. PMID:23530624

Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England.

PubMed

Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

2013-01-01

Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke.

Maintaining remission in ulcerative colitis – role of once daily extended-release mesalamine

PubMed Central

Oliveira, Lilliana; Cohen, Russell D

2011-01-01

The aminosalicylates (5-ASA; also referred to as mesalamine-based agents) are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC). Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance. PMID:21448448

Maintaining remission in ulcerative colitis--role of once daily extended-release mesalamine.

PubMed

Oliveira, Lilliana; Cohen, Russell D

2011-02-27

The aminosalicylates (5-ASA; also referred to as mesalamine-based agents) are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC). Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance.

Extended working hours: Impacts on workers

Treesearch

D. Mitchell; T. Gallagher

2010-01-01

Some logging business owners are trying to manage their equipment assets by increasing the scheduled machine hours. The intent is to maximize the total tons produced by a set of equipment. This practice is referred to as multi-shifting, double-shifting, or extended working hours. One area often overlooked is the impact that working non-traditional hours can have on...

Design of Optical Systems with Extended Depth of Field: An Educational Approach to Wavefront Coding Techniques

ERIC Educational Resources Information Center

Ferran, C.; Bosch, S.; Carnicer, A.

2012-01-01

A practical activity designed to introduce wavefront coding techniques as a method to extend the depth of field in optical systems is presented. The activity is suitable for advanced undergraduate students since it combines different topics in optical engineering such as optical system design, aberration theory, Fourier optics, and digital image…

Extended School Year: Legal and Practical Considerations for Educators

ERIC Educational Resources Information Center

Burke, Meghan M.; Decker, Janet R.

2017-01-01

This article clarifies what extended school year (ESY) is and who is eligible for it. It also describes, how it looks different for individual students, where and when it can be provided, and how to determine whether students are eligible. To illustrate common challenges in determining ESY, vignettes are provided based on four students' cases.…

"Because That's Who I Am": Extending Theories of Culturally Responsive Pedagogy to Consider Religious Identity, Belief, and Practice

ERIC Educational Resources Information Center

Dallavis, Christian

2011-01-01

In this conceptual article the author explores the intersection of culturally responsive pedagogy and religious school contexts. He extends theories of culturally responsive pedagogy to consider how religion, a dimension of student culture that has largely been overlooked in the literature surrounding culturally responsive pedagogy, can inflect…

Risk Assessment of Sexual Offenders for Extended Supervision Orders in New Zealand: Basic Principles and Current Practice

ERIC Educational Resources Information Center

Vess, James

2009-01-01

A growing number of jurisdictions in North America, the United Kingdom, and Australasia have enacted legislation allowing for special sentencing, civil commitment, and community supervision options for high risk sexual offenders. In New Zealand, one example of this concern for public protection is the Parole (Extended Supervision) Amendment Act…

Opening the gender diversity black box: causality of perceived gender equity and locus of control and mediation of work engagement in employee well-being.

PubMed

Sharma, Radha R; Sharma, Neha P

2015-01-01

The study is aimed at assessing the role of perceived gender equity and locus of control in employee well-being at the workplace and ascertaining if work engagement mediates between perceived gender equity, locus of control, and employee well-being (measured through optimism, general satisfaction with life and work, and executive burnout). Adopting a personal survey method data was collected from 373 managers (both males and females) from the public and private sectors representing manufacturing and service industry in India. The study bridges the knowledge gap by operationalizing the construct of perceived gender equity and studying its role in the work engagement and employee well-being. Conceptualization of the well-being in an unconventional way covering both the positive and the negative aspects extends the understanding of the emerging concept of well-being. It has practical implications for talent management and work engagement besides promoting gender equity at the workplace for employee well-being. It opens vistas for the gender based theory and cross cultural research on gender equity.

The role of privacy protection in healthcare information systems adoption.

PubMed

Hsu, Chien-Lung; Lee, Ming-Ren; Su, Chien-Hui

2013-10-01

Privacy protection is an important issue and challenge in healthcare information systems (HISs). Recently, some privacy-enhanced HISs are proposed. Users' privacy perception, intention, and attitude might affect the adoption of such systems. This paper aims to propose a privacy-enhanced HIS framework and investigate the role of privacy protection in HISs adoption. In the proposed framework, privacy protection, access control, and secure transmission modules are designed to enhance the privacy protection of a HIS. An experimental privacy-enhanced HIS is also implemented. Furthermore, we proposed a research model extending the unified theory of acceptance and use of technology by considering perceived security and information security literacy and then investigate user adoption of a privacy-enhanced HIS. The experimental results and analyses showed that user adoption of a privacy-enhanced HIS is directly affected by social influence, performance expectancy, facilitating conditions, and perceived security. Perceived security has a mediating effect between information security literacy and user adoption. This study proposes several implications for research and practice to improve designing, development, and promotion of a good healthcare information system with privacy protection.

Opening the gender diversity black box: causality of perceived gender equity and locus of control and mediation of work engagement in employee well-being

PubMed Central

Sharma, Radha R.; Sharma, Neha P.

2015-01-01

The study is aimed at assessing the role of perceived gender equity and locus of control in employee well-being at the workplace and ascertaining if work engagement mediates between perceived gender equity, locus of control, and employee well-being (measured through optimism, general satisfaction with life and work, and executive burnout). Adopting a personal survey method data was collected from 373 managers (both males and females) from the public and private sectors representing manufacturing and service industry in India. The study bridges the knowledge gap by operationalizing the construct of perceived gender equity and studying its role in the work engagement and employee well-being. Conceptualization of the well-being in an unconventional way covering both the positive and the negative aspects extends the understanding of the emerging concept of well-being. It has practical implications for talent management and work engagement besides promoting gender equity at the workplace for employee well-being. It opens vistas for the gender based theory and cross cultural research on gender equity. PMID:26500566

Direct design of aspherical lenses for extended non-Lambertian sources in two-dimensional geometry

PubMed Central

Wu, Rengmao; Hua, Hong; Benítez, Pablo; Miñano, Juan C.

2016-01-01

Illumination design for extended sources is very important for practical applications. The existing direct methods that are all developed for extended Lambertian sources are not applicable to extended non-Lambertian sources whose luminance is a function of position and direction. What we present in this Letter is to our knowledge the first direct method for extended non-Lambertian sources. In this method, the edge rays and the interior rays are both used, and the output intensity at a given direction is calculated to be the integral of the luminance function of all the outgoing rays at this direction. No cumbersome iterative illuminance compensation is needed. Two examples are presented to demonstrate the elegance of this method in prescribed intensity design for extended non-Lambertian sources in two-dimensional geometry. PMID:26125361

Why and how do general practitioners teach? An exploration of the motivations and experiences of rural Australian general practitioner supervisors.

PubMed

Ingham, Gerard; Fry, Jennifer; O'Meara, Peter; Tourle, Vianne

2015-10-29

In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. A qualitative study involving semi-structured interviews with 20 rural GP supervisors who work within one Regional Training Provider region in Australia explored their reasons for being a supervisor and how they performed their role. Data was analysed using a thematic analysis approach. GP supervisors identified both personal and professional benefits in being a supervisor, as well as some benefits for their practice. Supervision fulfilled a perceived broader responsibility to the profession and community, though they felt it had little impact on rural retention of doctors. While financial issues did not provide significant motivation to teach, the increasing financial inequity compared with providing direct patient care might impact negatively on the decision to be or to remain a supervisor in the future. The principal challenge for supervisors was finding time for teaching. Despite this, there was little evidence of supervisors adopting strategies to reduce teaching load. Teaching methods were reported in the majority to be case-based with styles extending from didactic to coach/facilitator. The two-way collegiate relationship with a registrar was valued, with supervisors taking an interest in the registrars beyond their development as a clinician. Supervisors report positively on their teaching and mentoring roles. Recruitment strategies that highlight the personal and professional benefits that supervision offers are needed. Practices need assistance to adopt models of supervision and teaching that will help supervisors productively manage the increasing number of learners in their practices. Educational institutions should facilitate the development and maintenance of supportive supervision and a learning culture within teaching practices. Given the variety of teaching approaches, evaluation of in-practice teaching is recommended.

The Child Welfare Agency as the Extended Family

ERIC Educational Resources Information Center

Taylor, Joseph L.

1972-01-01

In helping disturbed, deprived children and their families, an agency's concept of its treatment task is of vital importance. An effective approach focuses on an agency's functioning as an extended family, and assuming a parenting role. (Editor)

Professional Development in a Reform Context: Understanding the Design and Enactment of Learning Experiences Created by Teacher Leaders for Science Educators

NASA Astrophysics Data System (ADS)

Shafer, Laura

Teacher in-service learning about education reforms like NGSS often begin with professional development (PD) as a foundational component (Supovitz & Turner, 2000). Teacher Leaders, who are early implementers of education reform, are positioned to play a contributing role to the design of PD. As early implementers of reforms, Teacher Leaders are responsible for interpreting the purposes of reform, enacting reforms with fidelity to meet those intended goals, and are positioned to share their expertise with others. However, Teacher Leader knowledge is rarely accessed as a resource for the design of professional development programs. This study is unique in that I analyze the knowledge Teacher Leaders, who are positioned as developers of PD, bring to the design of PD around science education reform. I use the extended interconnected model of professional growth (Clarke & Hollingsworth, 2002; Coenders & Terlouw, 2015) to analyze the knowledge pathways Teacher Leaders' access as PD developers. I found that Teacher Leaders accessed knowledge pathways that cycled through their personal domain, domain of practice and domain of consequence. Additionally the findings indicated when Teacher Leaders did not have access to these knowledge domains they were unwilling to continue with PD design. These findings point to how Teacher Leaders prioritize their classroom experience to ground PD design and use their perceptions of student learning outcomes as an indicator of the success of the reform. Because professional development (PD) is viewed as an important resource for influencing teachers' knowledge and beliefs around the implementation of education reform efforts (Garet, et al., 2001; Suppovitz & Turner, 2000), I offer that Teacher Leaders, who are early implementers of reform measures, can contribute to the professional development system. The second part of this dissertation documents the instantiation of the knowledge of Teacher Leaders, who are positioned as designers and facilitators of PD. I examine the extent to which Teacher Leader knowledge is instantiated into specific resources and tasks during PD specifically for the Next Generation Science Standards (NGSS). The findings indicate that Teacher Leaders' knowledge is instantiated in tasks that promote and facilitate alignment of Teacher Leader goals for NGSS science practices-based instruction, which are framed around student learning outcomes. I offer a number of ways in which these findings can help educators and PD developers to better structure activities that present an alternative vision for science education that also provides the needed resources to shape how classroom tasks are designed and managed in ways that attend to and build on the practical knowledge of Teacher Leaders. The third part of this dissertation addresses the role Teacher Leaders play in this reform context with respect to their contributions to the professional development system. Based on the analyses of the Teacher Leaders in this study, I claim Teacher Leaders are essential contributors to the professional development system that extends beyond their typical role of participant. I argue that Teacher Leaders bring special expertise to the role of designers and facilitators of PD programs, and to the role of ambassadors for professional learning communities in a reform context. Because Teacher Leaders have a broader influence on the professional development system as pictured here, the Teacher Leaders in this study represent an essential piece of the reform puzzle.

Beyond the School Gates: Can Full Service and Extended Schools Overcome Disadvantage?

ERIC Educational Resources Information Center

Cummings, Colleen; Dyson, Alan; Todd, Liz

2011-01-01

This book, for the first time ever, critically examines the role of full service and extended schools. The authors draw on their extensive international evaluations of this radical new phenomenon to ask: (1) What do extended or full service schools hope to achieve, and why should services based on schools be any more effective than services…

Unlocking ePortfolio Practice: Teaching Beliefs

ERIC Educational Resources Information Center

Henscheid, Jean M.; Brown, Gary; Gordon, Aifang; Chen, Helen L.

2014-01-01

The Association for Authentic, Experiential, and Evidence-Based Learning (AAEEBL) annual ePortfolio survey focuses on understanding ePortfolio practitioners' teaching beliefs and practices. The action research reported here extends that survey research to a population of emerging educators (i.e., graduate students in education). In addition to…

The Multimodal Writing Process: Changing Practices in Contemporary Classrooms

ERIC Educational Resources Information Center

Edwards-Groves, Christine Joy

2011-01-01

This paper presents research exploring "writing and text construction" practices in contemporary primary classrooms. In particular, the ways 17 teachers and their students engaged with technologies in the construction of classroom texts were investigated. The case studies presented prompt the necessity to extend more traditional…

Interaction as Method and Result of Language Learning

ERIC Educational Resources Information Center

Hall, Joan Kelly

2010-01-01

The premise of this paper is that the interactional practices constituting teacher-student interaction and language learning are interdependent in that the substance of learners' language knowledge is inextricably tied to their extended involvement in the regularly occurring interactional practices constituting their specific contexts of learning.…

Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners

PubMed Central

Usta, Jinan; Feder, Gene; Antoun, Jumana

2014-01-01

Background Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence. Aim To explore physicians’ attitudes about responding to DV, their perception of the physician’s role, and the factors that influence their response. Design and setting Qualitative study using individual interviews among primary care practitioners working in Lebanon. Method Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role. Results Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV. Conclusion Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV. PMID:24868068

Creating a Framework for Medical Professionalism: An Initial Consensus Statement From an Arab Nation.

PubMed

Abdel-Razig, Sawsan; Ibrahim, Halah; Alameri, Hatem; Hamdy, Hossam; Haleeqa, Khaled Abu; Qayed, Khalil I; Obaid, Laila O; Al Fahim, Maha; Ezimokhai, Mutairu; Sulaiman, Nabil D; Fares, Saleh; Al Darei, Maitha Mohammed; Shahin, Nhayan Qassim; Al Shamsi, Noora Abdulla Omran; Alnooryani, Rashed Arif; Al Falahi, Salama Zayed

2016-05-01

Background Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations. Objective We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East. Methods We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement. Results The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine. Conclusions Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region.

Creating a Framework for Medical Professionalism: An Initial Consensus Statement From an Arab Nation

PubMed Central

Abdel-Razig, Sawsan; Ibrahim, Halah; Alameri, Hatem; Hamdy, Hossam; Haleeqa, Khaled Abu; Qayed, Khalil I.; Obaid, Laila O.; Al Fahim, Maha; Ezimokhai, Mutairu; Sulaiman, Nabil D.; Fares, Saleh; Al Darei, Maitha Mohammed; Shahin, Nhayan Qassim; Al Shamsi, Noora Abdulla Omran; Alnooryani, Rashed Arif; Al Falahi, Salama Zayed

2016-01-01

Background Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations. Objective We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East. Methods We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement. Results The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine. Conclusions Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region. PMID:27168882

Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions Among Men Who Have Sex With Men in India.

PubMed

Tomori, Cecilia; Srikrishnan, Aylur K; Ridgeway, Kathleen; Solomon, Sunil S; Mehta, Shruti H; Solomon, Suniti; Celentano, David D

2018-01-01

Men who have sex with men (MSM) remain at high risk for HIV infection. Culturally specific sexual identities, encompassing sexual roles, behavior, and appearance, may shape MSM's experiences of stigmatization and discrimination, and affect their vulnerability to HIV. This multi-site qualitative study (n = 363) encompassing 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) across 15 sites in India investigated sexual identity formation, identity practices, and transitions and their implications for HIV prevention. IDIs and FGDs were transcribed, translated, and underwent thematic analysis. Our findings document heterogeneous sexual identity formation, with MSM who have more gender nonconforming behaviors or appearance reporting greater family- and community-level disapproval, harassment, violence, and exclusion. Concealing feminine aspects of sexual identities was important in daily life, especially for married MSM. Some participants negotiated their identity practices in accordance with socioeconomic and cultural pressures, including taking on identity characteristics to suit consumer demand in sex work and on extended periods of joining communities of hijras (sometimes called TG or transgender women). Participants also reported that some MSM transition toward more feminine and hijra or transgender women identities, motivated by intersecting desires for feminine gender expression and by social exclusion and economic marginalization. Future studies should collect information on gender nonconformity stigma, and any changes in sexual identity practices or plans for transitions to other identities over time, in relation to HIV risk behaviors and outcomes.

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.

49 CFR 385.323 - May FMCSA extend the period under § 385.319(c) for a new entrant to take corrective action to...

Code of Federal Regulations, 2010 CFR

2010-10-01

...) for a new entrant to take corrective action to remedy its safety management practices? 385.323 Section....319(c) for a new entrant to take corrective action to remedy its safety management practices? (a... determines the new entrant is making a good faith effort to remedy its safety management practices. (b) FMCSA...

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes.

PubMed

Kibicho, Jennifer; Pinkerton, Steven D; Owczarzak, Jill; Mkandawire-Valhmu, Lucy; Kako, Peninnah M

2015-01-01

To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Cross-sectional study. Four Midwestern cities in the United States in August through October 2009. 28 community-based pharmacists practicing in 17 pharmacies. Interviews. Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings.

Nutra-ergonomics: influence of nutrition on physical employment standards and the health of workers.

PubMed

Shearer, Jane; Graham, Terry E; Skinner, Tina L

2016-06-01

The importance of ergonomics across several scientific domains, including biomechanics, psychology, sociology, and physiology, have been extensively explored. However, the role of other factors that may influence the health and productivity of workers, such as nutrition, is generally overlooked. Nutra-ergonomics describes the interface between workers, their work environment, and performance in relation to their nutritional status. It considers nutrition to be an integral part of a safe and productive workplace that encompasses physical and mental health as well as the long-term wellbeing of workers. This review explores the knowledge, awareness, and common practices of nutrition, hydration, stimulants, and fortified product use employed prior to physical employment standards testing and within the workplace. The influence of these nutra-ergonomic strategies on physical employment standards, worker safety, and performance will be examined. Further, the roles, responsibilities, and implications for the applicant, worker, and the employer will be discussed within the context of nutra-ergonomics, with reference to the provision and sustainability of an environment conducive to optimize worker health and wellbeing. Beyond physical employment standards, workplace productivity, and performance, the influence of extended or chronic desynchronization (irregular or shift work) in the work schedule on metabolism and long-term health, including risk of developing chronic and complex diseases, is discussed. Finally, practical nutra-ergonomic strategies and recommendations for the applicant, worker, and employer alike will be provided to enhance the short- and long-term safety, performance, health, and wellbeing of workers.

An exploration of the feasibility of radiation therapist participation in treatment reviews

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

Monk, Clare Maree; Wrightson, Stephanie Jane; Smith, Tony Neil

2013-09-15

As radiation oncologists' (ROs') workload has increased over time, treatment review clinics have become recognized as an area of RO practice into which radiation therapist (RT) practice could extend. There has been limited utilization of RTs in this role in Australia and a paucity of data on the acceptability and opinions regarding RTs practising in this role in an Australian context. The purpose of this audit was to investigate the feasibility of RT participation in review clinics at Calvary Mater Newcastle. Feasibility was determined by two methods: an audit of 200 treatment reviews to determine medical intervention (MI) levels requiredmore » and a survey of 80 clinical staff to explore attitudes towards RT participation in clinics. Medical intervention was required in 59% (n = 118) of observed reviews, with the lowest being for breast (33%) and prostate (28%) cancers. MI peaked at 73% between fractions 16–20 and was lowest early and late in the treatment period at 48%. There were 60 responses to the staff survey. All but one respondent agreed that RTs would be willing to participate in treatment review clinics, but all five consultant ROs indicated they would not be willing to delegate reviews to RTs. Neither feasibility measure reached acceptable levels to recommend RT participation in treatment review clinics. Further investigation and RT education are required to help meet the future RO workforce shortfall. As MI rates are lowest for breast and prostate cancer RT participation could be targeted to these clinics.« less

70 Years of Making the World Safer: Extended

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

None

Extended version with narration. This video shows our roles in making the world safer — working to end World War II, providing stable isotopes for research, providing unique precision manufacturing capabilities, and meeting nonproliferation and global security missions.

A Central Role for Triacylglycerol in Membrane Lipid Breakdown, Fatty Acid β -Oxidation, and Plant Survival under Extended Darkness

DOE PAGES

Fan, Jilian; Yu, Linhui; Xu, Changcheng

2017-06-01

Triacylglycerol is a key intermediate in membrane lipid breakdown and fatty acid β-oxidation, and blocking triacylglycerol hydrolysis reduces oxidative stress and enhances plant survival under extended darkness.

A national survey of pain clinics within the United Kingdom and Ireland focusing on the multidisciplinary team and the incorporation of the extended nursing role.

PubMed

Kailainathan, Pungavi; Humble, Stephen; Dawson, Helen; Cameron, Fiona; Gokani, Shyam; Lidder, Gursimren

2018-02-01

Inconsistencies in the availability and quality of pain service provision have been noted nationally, as have lengthy waiting times for appointments and lack of awareness of the Pain Clinic role. The 2013 NHS England report stated that specialist pain services must offer multispecialty and multidisciplinary pain clinics. This national survey of multidisciplinary pain service provision in the United Kingdom and Ireland provides a snapshot of pain service provision in order to review and highlight what variations exist in multidisciplinary team (MDT) provision and working patterns. A common perception among clinicians is that financial pressures have led to alternate ways of staff utilisation with variable degrees of success. The survey included 143 pain clinics, focusing principally on MDT working patterns, MDT composition and adoption of the extended role. The results identified that the majority of Pain Clinics utilise the MDT approach. However, provision of critical components such as regular MDT meetings is highly variable as is the composition of the MDT itself and also working patterns of the individual clinicians. The survey reports the successful use of the extended roles for specialist nurses in follow up clinics. In contrast, the survey highlights that a large proportion of clinicians surveyed have reservations about both the effectiveness and the safety of utilising specialist nurses in the extended role to see new referrals of complex pain patients to pain clinics. This survey underlines the essential requirement for incorporation of greater MDT working locally and nationally and allocation of appropriate resources to facilitate this.

A Central Role for Triacylglycerol in Membrane Lipid Breakdown, Fatty Acid β-Oxidation, and Plant Survival under Extended Darkness1[OPEN

PubMed Central

2017-01-01

Neutral lipid metabolism is a key aspect of intracellular homeostasis and energy balance and plays a vital role in cell survival under adverse conditions, including nutrient deprivation in yeast and mammals, but the role of triacylglycerol (TAG) metabolism in plant stress response remains largely unknown. By thoroughly characterizing mutants defective in SUGAR-DEPENDENT1 (SDP1) triacylglycerol lipase or PEROXISOMAL ABC TRANSPORTER 1 (PXA1), here we show that TAG is a key intermediate in the mobilization of fatty acids from membrane lipids for peroxisomal β-oxidation under prolonged dark treatment. Disruption of SDP1 increased TAG accumulation in cytosolic lipid droplets and markedly enhanced plant tolerance to extended darkness. We demonstrate that blocking TAG hydrolysis enhances plant tolerance to dark treatment via two distinct mechanisms. In pxa1 mutants, in which free fatty acids accumulated rapidly under extended darkness, SDP1 disruption resulted in a marked decrease in levels of cytotoxic lipid intermediates such as free fatty acids and phosphatidic acid, suggesting a buffer function of TAG accumulation against lipotoxicity under fatty acid overload. In the wild type, in which free fatty acids remained low and unchanged under dark treatment, disruption of SDP1 caused a decrease in reactive oxygen species production and hence the level of lipid peroxidation, indicating a role of TAG in protection against oxidative damage. Overall, our findings reveal a crucial role for TAG metabolism in membrane lipid breakdown, fatty acid turnover, and plant survival under extended darkness. PMID:28572457

A Central Role for Triacylglycerol in Membrane Lipid Breakdown, Fatty Acid β-Oxidation, and Plant Survival under Extended Darkness.

PubMed

Fan, Jilian; Yu, Linhui; Xu, Changcheng

2017-07-01

Neutral lipid metabolism is a key aspect of intracellular homeostasis and energy balance and plays a vital role in cell survival under adverse conditions, including nutrient deprivation in yeast and mammals, but the role of triacylglycerol (TAG) metabolism in plant stress response remains largely unknown. By thoroughly characterizing mutants defective in SUGAR-DEPENDENT1 (SDP1) triacylglycerol lipase or PEROXISOMAL ABC TRANSPORTER 1 (PXA1), here we show that TAG is a key intermediate in the mobilization of fatty acids from membrane lipids for peroxisomal β-oxidation under prolonged dark treatment. Disruption of SDP1 increased TAG accumulation in cytosolic lipid droplets and markedly enhanced plant tolerance to extended darkness. We demonstrate that blocking TAG hydrolysis enhances plant tolerance to dark treatment via two distinct mechanisms. In pxa1 mutants, in which free fatty acids accumulated rapidly under extended darkness, SDP1 disruption resulted in a marked decrease in levels of cytotoxic lipid intermediates such as free fatty acids and phosphatidic acid, suggesting a buffer function of TAG accumulation against lipotoxicity under fatty acid overload. In the wild type, in which free fatty acids remained low and unchanged under dark treatment, disruption of SDP1 caused a decrease in reactive oxygen species production and hence the level of lipid peroxidation, indicating a role of TAG in protection against oxidative damage. Overall, our findings reveal a crucial role for TAG metabolism in membrane lipid breakdown, fatty acid turnover, and plant survival under extended darkness. © 2017 American Society of Plant Biologists. All Rights Reserved.

Enhancing the strategic management of practice learning through the introduction of the role of Learning Environment Manager.

PubMed

Congdon, Graham; Baker, Tracey; Cheesman, Amanda

2013-03-01

This paper describes a process evaluation project designed to enhance the strategic management of practice learning within a large Hospital in the North of England. The aim of the project was to introduce the role of the Learning Environment Manager with dedicated responsibility for practice learning of undergraduate student nurses within the Hospital's 49 practice-settings. Whilst aspects of this role were already evident in several of these settings, the project sought to locate and standardise responsibilities related to the organisation and management of learning and teaching in practice explicitly within the existing staffing structure of each practice-setting. Focus group interviews were used to explore significant aspects of the project with key stakeholder groups comprising Learning Environment Managers, the Hospital Clinical Educator, Hospital Department Managers, Ward Managers, Mentors, University Link Lecturers and undergraduate Student Nurses. Interview data were analysed using thematic content analysis. The findings of the project suggest that the Learning Environment Manager role affords providers of practice learning with a robust approach to establish organisation-wide benchmarks that standardise the strategic management of practice learning in collaboration with partner Universities. The role incorporated many operational activities previously undertaken by the Hospital Clinical Educator, thus enabling the Hospital Clinical Educator to make a more strategic contribution to the on-going quality monitoring and enhancement of practice learning across the Hospital. The Learning Environment Manager role was found to provide mentors with high levels of support which in turn helped to promote consistent, positive and holistic practice learning experiences for undergraduate student nurses across the Hospital. Importantly, the role offers a potent catalyst for nurses in practice to regain responsibility for practice learning and re-establish the value of practice teaching. Copyright © 2012 Elsevier Ltd. All rights reserved.

The role of modelling in prioritising and planning clinical trials.

PubMed

Chilcott, J; Brennan, A; Booth, A; Karnon, J; Tappenden, P

2003-01-01

To identify the role of modelling in planning and prioritising trials. The review focuses on modelling methods used in the construction of disease models and on methods for their analysis and interpretation. Searches were initially developed in MEDLINE and then translated into other databases. Systematic reviews of the methodological and case study literature were undertaken. Search strategies focused on the intersection between three domains: modelling, health technology assessment and prioritisation. The review found that modelling can extend the validity of trials by: generalising from trial populations to specific target groups; generalising to other settings and countries; extrapolating trial outcomes to the longer term; linking intermediate outcome measures to final outcomes; extending analysis to the relevant comparators; adjusting for prognostic factors in trials; and synthesising research results. The review suggested that modelling may offer greatest benefits where the impact of a technology occurs over a long duration, where disease/technology characteristics are not observable, where there are long lead times in research, or for rapidly changing technologies. It was also found that modelling can inform the key parameters for research: sample size, trial duration and population characteristics. One-way, multi-way and threshold sensitivity analysis have been used in informing these aspects but are flawed. The payback approach has been piloted and while there have been weaknesses in its implementation, the approach does have potential. Expected value of information analysis is the only existing methodology that has been applied in practice and can address all these issues. The potential benefit of this methodology is that the value of research is directly related to its impact on technology commissioning decisions, and is demonstrated in real and absolute rather than relative terms; it assesses the technical efficiency of different types of research. Modelling is not a substitute for data collection. However, modelling can identify trial designs of low priority in informing health technology commissioning decisions. Good practice in undertaking and reporting economic modelling studies requires further dissemination and support, specifically in sensitivity analyses, model validation and the reporting of assumptions. Case studies of the payback approach using stochastic sensitivity analyses should be developed. Use of overall expected value of perfect information should be encouraged in modelling studies seeking to inform prioritisation and planning of health technology assessments. Research is required to assess if the potential benefits of value of information analysis can be realised in practice; on the definition of an adequate objective function; on methods for analysing computationally expensive models; and on methods for updating prior probability distributions.

Accounting for Independent Schools. Second Edition.

ERIC Educational Resources Information Center

National Association of Independent Schools, Boston, MA.

This is a thoroughly revised edition of the 1969 publication, "Accounting for Independent Schools," a guide that attempted to codify basic accounting principles and practices for specific application to independent schools. The focus of the second edition is more on refining practices than on initiating them, and more on extending the managerial…

12 CFR 747.13 - Change of time limits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ADMINISTRATIVE ACTIONS, ADJUDICATIVE HEARINGS, RULES OF PRACTICE AND PROCEDURE, AND INVESTIGATIONS Uniform Rules of Practice and Procedure § 747.13 Change of time limits. Except as otherwise provided by law, the administrative law judge may, for good cause shown, extend the time limits prescribed by the Uniform Rules or by...

McMindfulness in the Workplace: Vocational Learning and the Commodification of the Present Moment

ERIC Educational Resources Information Center

Hyland, Terry

2015-01-01

Originating in Buddhist contemplative traditions, mindfulness theory and practice--which foregrounds present-moment awareness and attention--has extended its modern secular and therapeutic applications into an exponentially expanding range of fields and disciplines including psychology, psychotherapy, mind--body health practices and education at…

Collegiate Grading Practices and the Gender Pay Gap.

ERIC Educational Resources Information Center

Dowd, Alicia C.

2000-01-01

Presents a theoretical analysis showing that relatively low grading quantitative fields and high grading verbal fields create a disincentive for college women to invest in quantitative study. Extends research by R. Sabot and J. Wakeman-Linn. Models pressures on grading practices using higher education production functions. (Author/SLD)

12 CFR 227.21 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DECEPTIVE ACTS OR PRACTICES (REGULATION AA) Consumer Credit Card Account Practices Rule § 227.21 Definitions... product of multiplying each periodic rate for a balance or transaction on a consumer credit card account.... (b) “Consumer” means a natural person to whom credit is extended under a consumer credit card account...

Story Nights: An Apprenticeship into Literacy through Bilingual Story Reading

ERIC Educational Resources Information Center

Brown, Sally

2016-01-01

This article documents an extended Mexican family's social practices surrounding literacy as they engage with bilingual children's literature in a unique context that draws from both home and school without the pressures of curriculum mandates. The research is situated within the southeastern United States where English-dominant practices permeate…

Multisite evaluation of APEX for water quality: 1. Best professional judgement parameterization

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) model is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. The current practice is to fully calibrate the model for each site simulation, a tas...

Teaching for Social Justice: From Conceptual Frameworks to Classroom Practices

ERIC Educational Resources Information Center

Dover, Alison G.

2013-01-01

In this article, the author presents the results of a multistate study examining how teachers, and specifically secondary English Language Arts (ELA) teachers, conceptualize and implement teaching for social justice in standards-based contexts. Additional analysis underscores how this practice both reflects and extends earlier equity-oriented…

Extending Engineering Practice Research with Shared Qualitative Data

ERIC Educational Resources Information Center

Trevelyan, James

2016-01-01

Research on engineering practice is scarce and sharing of qualitative research data can reduce the effort required for an aspiring researcher to obtain enough data from engineering workplaces to draw generalizable conclusions, both qualitative and quantitative. This paper describes how a large shareable qualitative data set on engineering…

Examining Psychosocial Identity Development Theories: A Guideline for Professional Practice

ERIC Educational Resources Information Center

Karkouti, Ibrahim Mohamad

2014-01-01

This paper provides an overview of Erikson's psychosocial identity development theory, identifies prominent theorists who extended his work, examines the limitations of the theory and explains how this theory can be applied to student affairs practices. Furthermore, two different studies that clarify the relationship between psychosocial factors…

Beyond SMART? A New Framework for Goal Setting

ERIC Educational Resources Information Center

Day, Trevor; Tosey, Paul

2011-01-01

This article extends currently reported theory and practice in the use of learning goals or targets with students in secondary and further education. Goal-setting and action-planning constructs are employed in personal development plans (PDPs) and personal learning plans (PLPs) and are advocated as practice within the English national policy…

Cross-cultural Education at the International Space University

NASA Astrophysics Data System (ADS)

Burke, J. D.; Peeters, W.; Hill, H.

2006-12-01

A typical nine-week summer session of the International Space University includes 100 graduate students and young professionals from as many as thirty countries. In addition to lectures and team projects covering a variety of space-related disciplines, the curriculum contains several modes of cross-cultural education. In role- playing workshops, students (asked to behave in accord with known cultural norms of various countries) engage in negotiations on problems such as the rescue and return of astronauts as mandated in international agreements and treaties. Culture shock that could derail such negotiations in actual practice is observed, and the participants come away with heightened sensitivity to cultural differences. This technique could be extended to other educational settings, such as the activities of the UN's Regional Centres in developing countries and the outreach efforts associated with the International Heliophysical Year.

The impact and determinants of the energy paradigm on economic growth in European Union.

PubMed

Andrei, Jean Vasile; Mieila, Mihai; Panait, Mirela

2017-01-01

Contemporary economies are strongly reliant on energy and analyzing the determining factors that trigger the changes in energy paradigm and their impact upon economic growth is a topical research subject. Our contention is that energy paradigm plays a major role in achieving the sustainable development of contemporary economies. In order to prove this the panel data methodology of research was employed, namely four panel unit root tests (LLC, IPS, F-ADF and F-PP) aiming to reveal the connections and relevance among 17 variables denoting energy influence on economic development. Moreover, it was introduced a specific indicator to express energy consumption per capita. Our findings extend the classical approach of the changes in energy paradigm and their impact upon economic growth and offer a comprehensive analysis which surpasses the practices and policy decisions in the field.

Reversible first-order transition in Pauli percolation

NASA Astrophysics Data System (ADS)

Maksymenko, Mykola; Moessner, Roderich; Shtengel, Kirill

2015-06-01

Percolation plays an important role in fields and phenomena as diverse as the study of social networks, the dynamics of epidemics, the robustness of electricity grids, conduction in disordered media, and geometric properties in statistical physics. We analyze a new percolation problem in which the first-order nature of an equilibrium percolation transition can be established analytically and verified numerically. The rules for this site percolation model are physical and very simple, requiring only the introduction of a weight W (n )=n +1 for a cluster of size n . This establishes that a discontinuous percolation transition can occur with qualitatively more local interactions than in all currently considered examples of explosive percolation; and that, unlike these, it can be reversible. This greatly extends both the applicability of such percolation models in principle and their reach in practice.

Towards a framework of smart city diplomacy

NASA Astrophysics Data System (ADS)

Mursitama, T. N.; Lee, L.

2018-03-01

This article addresses the impact of globalization on the contemporary society, particularly the role of the city that is becoming increasingly important. Three distinct yet intertwine aspects such as decentralization, technology, and para diplomacy become antecedent of competitiveness of the city. A city has more power and authority in creating wealth and prosperity of the society by utilizing technology. The smart city, in addition to the importance of technology as enabler, we argue that possessing the sophisticated technology and apply it towards the matter is not enough. The smart city needs to build smart diplomacy at the sub-national level. In this article, we extend the discussion about smart city by proposing a new framework of smart city diplomacy as one way to integrate information technology, public policy and international relations which will be the main contribution to literature and practice.

Safety with surgical lasers.

PubMed

McKenzie, A L

1984-01-01

As the sales of surgical lasers continue to grow, the problem of laser safety in hospitals becomes increasingly more urgent. This article considers both the principles and the practice of laser safety, and indicates how safety codes should be organized within a hospital. Eye safety is of paramount importance, and the effects of different wavelengths of laser radiation on the eye are described, both for intrabeam and extended-source exposure. An account is given of the concept of Maximum Permissible Exposure (MPE) and how it depends upon wavelength and exposure duration. The standard laser classification is developed in relation to MPE. The use of laser protective eyewear is discussed for the surgeon, other theatre staff and the patient. Finally, the role of the Laser Protection Supervisor and of the Laser Protection Adviser are explained in the context of establishing a local laser safety code.

The role of middle-class status in payday loan borrowing: a multivariate approach.

PubMed

Lim, Younghee; Bickham, Trey; Broussard, Julia; Dinecola, Cassie M; Gregory, Alethia; Weber, Brittany E

2014-10-01

Payday loans refer to small-dollar, high-interest, short-term loans usually extended to lower-income consumers. Despite much research to the contrary, the payday loan industry asserts that it primarily serves middle-class Americans. This article discusses the authors' investigation of the industry's claim, by analyzing data from a U.S. bankruptcy court serving a Southern district. Results of the multivariate binary logistic regression analysis showed that, controlling for various sociodemographic and economic variables, two middle-class indicators--home-ownership and annual income at or greater than the median income--are associated with a decreased likelihood of using payday loans. The article concludes with a discussion of the implications of the results for social work practice and advocacy in regard to financial capability, particularly asset development, income maintenance, and payday loan regulation.

Progress in the biosensing techniques for trace-level heavy metals.

PubMed

Mehta, Jyotsana; Bhardwaj, Sanjeev K; Bhardwaj, Neha; Paul, A K; Kumar, Pawan; Kim, Ki-Hyun; Deep, Akash

2016-01-01

Diverse classes of sensors have been developed over the past few decades for on-site detections of heavy metals. Most of these sensor systems have exploited optical, electrochemical, piezoelectric, ion-selective (electrode), and electrochemical measurement techniques. As such, numerous efforts have been made to explore the role of biosensors in the detection of heavy metals based on well-known interactions between heavy metals and biomolecules (e.g. proteins, peptides, enzymes, antibodies, whole cells, and nucleic acids). In this review, we cover the recent progress made on different types of biosensors for the detection of heavy metals. Our major focus was examining the use of biomolecules for constructing these biosensors. The discussion is extended further to cover the biosensors' performance along with challenges and opportunities for practical utilization. Copyright © 2015 Elsevier Inc. All rights reserved.

A gradual update method for simulating the steady-state solution of stiff differential equations in metabolic circuits.

PubMed

Shiraishi, Emi; Maeda, Kazuhiro; Kurata, Hiroyuki

2009-02-01

Numerical simulation of differential equation systems plays a major role in the understanding of how metabolic network models generate particular cellular functions. On the other hand, the classical and technical problems for stiff differential equations still remain to be solved, while many elegant algorithms have been presented. To relax the stiffness problem, we propose new practical methods: the gradual update of differential-algebraic equations based on gradual application of the steady-state approximation to stiff differential equations, and the gradual update of the initial values in differential-algebraic equations. These empirical methods show a high efficiency for simulating the steady-state solutions for the stiff differential equations that existing solvers alone cannot solve. They are effective in extending the applicability of dynamic simulation to biochemical network models.

Substance Related Disorders among Juvenile Offenders: What Role Do Psychopathic Traits Play?

PubMed Central

Kimonis, Eva R.; Tatar, Joseph R.; Cauffman, Elizabeth

2012-01-01

Substance use disorders are associated with psychopathy, a personality disorder that is heterogeneous in both adults and youth; secondary variants of psychopathy with comorbid psychopathology and primary variants without comorbidity show distinct correlates and outcomes. In adult criminal populations, secondary variants report greater substance abuse compared with primary variants. The primary aim of this study is to replicate and extend these findings to a juvenile offender population. Compared with primary variants of juvenile psychopathy, secondary variants (a) reported significantly more frequent substance—particularly alcohol—use within the six months prior to incarceration (d = .43), (b) were almost twice as likely to abuse substances while incarcerated, and (c) were more likely to be diagnosed with a current DSM-IV substance use disorder. Practical implications for working with justice-involved youth are discussed. PMID:22564205

A Shift in the Role of Glutamatergic Signaling in the Nucleus Accumbens Core with the Development of an Addicted Phenotype

PubMed Central

Doyle, Susan E.; Ramôa, Carolina; Garber, Garrett; Newman, Joshua; Toor, Shaun; Lynch, Wendy J.

2014-01-01

Background While dopamine signaling in the nucleus accumbens (NAc) plays a well-established role in motivating cocaine use in early “non-addicted” stages, recent evidence suggests that other signaling pathways may be critical once addiction has developed. Given the importance of glutamatergic signaling in the NAc for drug-seeking and relapse, here we examined its role in motivating cocaine self-administration under conditions known to produce either a “non-addicted” or an “addicted” phenotype. Methods Following acquisition, male and female Sprague Dawley rats were given either short access (3 fixed-ratio 1 sessions, 20 infusions/day) or extended 24-hr access (10 days; 4 trials/hr; up to 96 infusions/day) to cocaine. Following a 14-day abstinence period, motivation for cocaine was assessed under a progressive-ratio schedule, and once stable, the effects of intra-NAc infusions of the glutamate AMPA/KA receptor antagonist CNQX (0.0, 0.01, 0.03, 0.1 μg/side) were determined. As an additional measure for the development of an addicted phenotype, separate groups of rats were screened under an extinction/cue-induced reinstatement procedure following abstinence from short versus extended access self-administration. Results Motivation for cocaine and levels of extinction and reinstatement responding were markedly higher following extended versus short access self-administration confirming the development of an addicted phenotype in the extended access group. CNQX dose-dependently reduced motivation for cocaine in the extended access group, but was without effect in the short access group. Conclusions These results suggest that the role of glutamatergic signaling in the NAc, though not essential for motivating cocaine use in “non-addicted” stages, becomes critical once addiction has developed. PMID:24629536

Agricultural consultancy--a career choice for veterinarians.

PubMed

Taylor, K L; Swan, R A; Chapman, H M

2000-07-01

To document the personal, educational and professional skills that characterise veterinarians pursuing careers as agricultural consultants and to determine the future direction for veterinary-related advisory services to agriculture in Australia. Thirty-six veterinarians practising as consultants in agriculture throughout Australia were sent a postal survey in 1994. A descriptive analysis was chosen because of the relatively small population available to sample. Comparisons were made on a percentage basis where appropriate. Twenty-four useable responses to the questionnaire were received. Consultants were mostly men with an agricultural background, aged 31 to 40 years. They considered their undergraduate veterinary studies to be a stepping stone into further education and practical experience and ultimately consultancy. Consultants predicted an increased reliance for their work on corporate farms, private agribusiness, research and development and sub-contracted work, rather than on family-owned farms. Consultants disagreed on the wisdom of combining consultancy activities with alternative businesses (for instance mixed veterinary practice). Only 13 consultants derived greater than 76% of their income from consultancy and 14 combined another business with consulting. The need for continuing education was considered important. Consultants predicted various future prospects for the industry. Many predicted that there would not be enough veterinarians to fulfill the demand for this type of work. IMPLICATIONS FOR THE VETERINARY PROFESSION: Results from this survey suggest that veterinary consulting will extend into finance, agronomy and marketing in addition to current skills in animal nutrition, parasite control and animal reproduction. As clients demand specialised skills and knowledge, the formation of co-operatives or companies of specialists may be beneficial to both client and consultant in the future. The consultant's role can be characterised as one of extending relevant information to clients in a useful form. Excellent communication skills are necessary, as is an understanding of rural issues and animal industries.

Promoting leadership and management in Australian general practice nursing: what will it take?

PubMed

Halcomb, Elizabeth J; Davidson, Patricia M; Patterson, Elizabeth

2008-10-01

This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns. There is an urgent need to develop practice nurse leaders and managers to not only embrace the challenges of Australian general practice from an operational perspective, but also undertake a clinical leadership role. As clinical leaders, these nurses will need to develop a culture that not only optimizes health outcomes but also advances the status of the nursing profession.

Baryogenesis in extended inflation. 2: Baryogenesis via primordial black holes

NASA Technical Reports Server (NTRS)

Barrow, John D.; Copeland, Edmund J.; Kolb, Edward W.; Liddle, Andrew R.

1990-01-01

Baryogenesis at the end of extended inflation is studied. Extended inflation is brought to an end by the collisions of bubble walls surrounding regions of true vacuum, a process which produces particles well out of thermal equilibrium. The possibility that the wall collisions may provide a significant density of primordial black holes is considered and their possible role in generating a baryon asymmetry is examined.

A Role for Science in Responding to Health Crises

PubMed Central

Brothers, Reginald; Murata, Christina E.

2016-01-01

The Department of Homeland Security's (DHS) Science and Technology (S&T) Directorate plays a role in public health that extends beyond biodefense. These responsibilities were exercised as part of the 2014-16 Ebola outbreak, leading to productive and beneficial contributions to the international public health response and improved operations in the United States. However, we and others have identified numerous areas for improvement. Based on our successes and lessons learned, we propose a number of ways that DHS, the interagency, and academia can act now to ensure improved responses to future public health crises. These include pre-developing scientific capabilities to respond agnostically to threats, and disease-specific master question lists to organize and inform initial efforts. We are generating DHS-specific playbooks and tools for anticipating future needs and capturing requests from DHS components and our national and international partners, where efforts will also be used to refine and exercise communication and information-sharing practices. These experiences and improvement efforts have encouraged discussions on the role of science in developing government policy, specifically responding to public health crises. We propose specific considerations for both scientists and government decision makers to ensure that the best available science is incorporated into policy and operational decisions to facilitate highly effective responses to future health crises. PMID:27482881

Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

PubMed

Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

2017-05-01

Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

Recent Pathophysiological Aspects of Peyronie's Disease: Role of Free Radicals, Rationale, and Therapeutic Implications for Antioxidant Treatment—Literature Review

PubMed Central

Romano, Gennaro; Paulis, Luca; Barletta, Davide

2017-01-01

Peyronie's disease (PD) is a chronic inflammation of tunica albuginea of the corpora cavernosa that causes an inelastic plaque resulting in penis deformation. Although its etiology is not completely known, there is general consensus that PD is genetically transmitted and secondary to penile trauma. In recent years, numerous studies demonstrated the role played by oxidative stress in PD pathogenesis, and other studies have described successful use of antioxidants in PD treatment. Oxidative stress is an integral part of this disease, influencing its progression. In the early stages of PD, the inflammatory infiltrate cells produce high quantities of free radicals and proinflammatory and profibrotic cytokines, with consequent activation of transcription factor NF-κB. While conservative therapies commonly used in the early stages of PD include oral substances (Potaba, tamoxifen, colchicine, and vitamin E), intralesional treatment (verapamil, interferon, steroids, and more recently collagenase clostridium histolyticum-Xiaflex), and local physical treatment (iontophoresis, extracorporeal shock wave therapy, and penile extender), the significant results obtained by emerging treatments with the antioxidants cited in this article suggest these therapeutic agents interfere at several levels with the disease's pathogenetic mechanisms. Antioxidants therapy outcomes are interesting for good clinical practice and also confirm the fundamental role played by oxidative stress in PD. PMID:28744308

Multilingualism in South Africa with Particular Reference to the Role of African Languages in Education

NASA Astrophysics Data System (ADS)

Desai, Zubeida

2001-07-01

In this paper it is argued that language policy can play a central role in enabling citizens of a country to participate in the political, educational, social and economic life of that country. Or it can deny them that right. In discussions on the role of African languages, there is a tendency to confine the discussion to language in education. I argue that unless we locate the discussion in a broader context, we are not going to make much progress in extending the use of African languages beyond the home domain. The paper therefore consists of three sections. The first section looks broadly at the domains where language has an impact. The second section briefly outlines a process underway in South Africa to develop a framework for a national language policy, whilst the final section looks at the implications of this for education. Here I look at language in Education Policy in Practice. I give examples from a piece of primary research that I have conducted with Xhosa -speaking Grade 4 and Grade 7 learners who have been given pictures to describe first in Xhosa and then in English. The examples show the rich vocabulary children have when they express themselves in Xhosa and the poor vocabulary they have when they express themselves in English.

Are Older Adults Prepared to Ensure Food Safety during Extended Power Outages and Other Emergencies?: Findings from a National Survey

ERIC Educational Resources Information Center

Kosa, Katherine M.; Cates, Sheryl C.; Karns, Shawn; Godwin, Sandria L.; Coppings, Richard J.

2012-01-01

Natural disasters and other emergencies can cause an increased risk of foodborne illness. We conducted a nationally representative survey to understand consumers' knowledge and use of recommended practices during/after extended power outages and other emergencies. Because older adults are at an increased risk for foodborne illness, this paper…

High School Teachers' Problem Solving Activities to Review and Extend Their Mathematical and Didactical Knowledge

ERIC Educational Resources Information Center

Santos-Trigo, Manuel; Barrera-Mora, Fernando

2011-01-01

The study documents the extent to which high school teachers reflect on their need to revise and extend their mathematical and practicing knowledge. In this context, teachers worked on a set of tasks as a part of an inquiring community that promoted the use of different computational tools in problem solving approaches. Results indicated that the…

Special Theme Section--Representation and Blindness: The Effect of Extended Acoustic Training on Spatial Updating in Adults Who Are Congenitally Blind.

ERIC Educational Resources Information Center

Easton, Randolph D.; Bentzen, Billie Louise

1999-01-01

A study, including research and practice notes by various authors, investigated whether extended training in an acoustically rich environment could enhance the spatial updating ability of 12 adults with congenital blindness. After training, the adults' distance perception from a home-base location and novel locations was superior to a sighted…

Women, sex and marriage. Restraint as a feminine strategy.

PubMed

Kishwar, M

1997-01-01

The expression of sexuality varies in different cultures, and most societies attempt to control sexuality through the institution of marriage. In the West, the availability of cheap, effective contraceptives separated sex from reproduction and promoted the sexual liberation of women. Today, while divorce is common, sexually liberated people nevertheless engage in a form of serial monogamy. Sexual liberation in the West causes women to be exploited by men and creates instability in nuclear families. In India, feminism is tempered by a belief that familial rights have precedence over individual rights. India women practice sexual self-denial after being widowed to protect their children and to gain power and respect in the community. The power of chastity was illustrated by Mahatma Gandhi who marshalled his spiritual forces to fight for independence. The stories of many individual women illustrate how they attain status and prestige through chastity. Other women maintain absolute marital faithfulness as a marital strategy to control wayward husbands. These women deemphasize their roles as wives and emphasize their roles as mothers. The children of such women often recognize their sacrifices and become their strongest allies. On the other hand, examples of women who have chosen sexual freedom show that such a choice places them at the mercy of men, makes them social outcasts, and causes other women to distrust them as competitors for their husbands. In patriarchal societies, women can not win if they try to mimic men's capacity for irresponsible sex. Sexual freedom can only work for women in matrilineal communities that shun marriage in favor of strong ties within a woman's natal family. Indian women rooted in the extended family enjoy the resilience and flexibility attendant upon playing a larger role than simply pleasing men. Opting for sexual restraint can be an effective though costly strategy to achieve the sympathy and support of an extended family when a man is being sexually irresponsible.

A thematic analysis of the experience of UK mental health nurses who have trained in Solution Focused Brief Therapy.

PubMed

Smith, S; Macduff, C

2017-03-01

WHAT IS KNOWN ON THE SUBJECT?: Solution Focused Brief Therapy (SFBT) is an effective model of brief psychotherapy. Evidence suggests that nurses can be trained to deliver SFBT with only a few days training. It has been argued that SFBT reflects the core values of nursing practice, but no empirical research has been undertaken to validate this assertion. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: This is the first time the impact of such training on nurses' sense of professional and personal identity has been explored. Drawing upon data derived from twenty interviews, this paper explores the key themes reported by nurses in relation to their personal experience of training in SFBT. This paper extends our understanding of the lived experience of mental health nurses and facilitates discussion on the preparation and practice of their role. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Training in SFBT can provide a framework for nurses to empower their clients/patients to take control of their own recovery in a shared and trusting relationship. Training in SFBT can enhance nurses' sense of trust in their clients. Training in solution-focused interactions may provide a framework for many nurses to provide the type of collaborative, patient-led care they aspire to. Introduction SFBT is a psychotherapeutic model that aims to 'build solutions' rather than 'solve problems'. It has evolved into a structured communication framework utilized across a range of disciplines, focusing on the future, as opposed to the past, and on participant's strengths and abilities, as opposed to their problems and deficits. There have been no studies exploring the experience of training in SFBT from the perspective of the nurses being trained. Aim This study sought to explore the experience of nurses who had completed a six-month training course in SFBT. Methods Using a qualitative methodology, 20 nurses who had undertaken SFBT training were interviewed at various locations across Scotland. Results Five main themes emerged from analysis of the 20 interviews. Many of the participants reported increased trust in their clients and enhanced role satisfaction. Implications for Practice Training in SFBT provides nurses with an alternative model of practice to the dominant 'medical' and 'psychological' models of contemporary practice. The experiences of the participants in this study suggest that SFBT can be a useful intervention in nursing practice and that nurses can easily incorporate SFBT into their practice. © 2017 John Wiley & Sons Ltd.

Reconsiderations about Greek homosexualities.

PubMed

Percy, William Armstrong

2005-01-01

Focusing his analysis on (mostly Athenian) vase paintings of the sixth- and early fifth-century and on a handful of texts from the late fifth- and early fourth-century (again Athenian), Dover depicted the pederastic relationship of erastes (age 20 to 30) and eromenos (age 12-18) as defined by sexual roles, active and passive, respectively. This dichotomy he connected to other sexual and social phenomena, in which the active/ penetrating role was considered proper for a male adult Athenian citizen, while the passive/penetrated role was denigrated, ridiculed, and even punished. Constructing various social and psychological theories, Foucault and Halperin, along with a host of others, have extended his analysis, but at the core has remained the Dover dogma of sexual-role dichotomization. Penetration has become such a focal point in the scholarship that anything unable to be analyzed in terms of domination is downplayed or ignored. To reduce homosexuality or same-sex behaviors to the purely physical or sexual does an injustice to the complex phenomena of the Greek male experience. From Sparta to Athens to Thebes and beyond, the Greek world incorporated pederasty into their educational systems. Pederasty became a way to lead a boy into manhood and full participation in the polis, which meant not just participation in politics but primarily the ability to benefit the city in a wide range of potential ways. Thus the education, training, and even inspiration provided in the pederastic relationship released creative forces that led to what has been called the Greek 'miracle.' From around 630 BCE we find the institution of Greek pederasty informing the art and literature to a degree yet to be fully appreciated. Moreover, this influence not only extends to the 'higher' realms of culture, but also can be seen stimulating society at all levels, from the military to athletic games, from philosophy to historiography. An understanding of sexual practices-useful, even essential, to an appreciation of Greek pederasty- cannot fully explicate its relationship to these other phenomena; pederasty is found in many societies, and certainly existed before the Greeks. It is time that we move beyond Dover and recover the constructive dynamics of Greek pederasty.

Uncovering clinical knowledge and caring practices.

PubMed

Feldman, M E

1993-06-01

Narrative storytelling is a means by which knowledge embedded in nursing practice is uncovered and examined. Benner uses this method to study and explore skill acquisition and experience-based knowledge in nursing practice. By sharing these stories, knowledge that is unique to the experienced clinician is preserved and extended. The narrative presented here describes the expert coaching, discretionary judgment, and skilled involvement in the care of a patient in the PACU.

Novice to Expert Practice via Postprofessional Athletic Training Education: A Grounded Theory

PubMed Central

Neibert, Peter J

2009-01-01

Objective: To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)–accredited postprofessional athletic training education programs. Design: Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Setting: Qualitative study using grounded theory procedures. Patients and Other Participants: Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. Data Collection and Analysis: The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. Results: The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. Conclusions: The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice. PMID:19593420

Impact of business infrastructure on financial metrics in departments of surgery.

PubMed

Wai, Philip Y; O'Hern, Tim; Andersen, Dave O; Kuo, Marissa C; Weber, Cynthia E; Talbot, Lindsay J; Kuo, Paul C

2012-10-01

In the current environment, pressure is ever increasing to maximize financial performance in surgery departments. Factors such as physician extenders, billing and collection, payor mix, contracting, incentives from the Centers for Medicare and Medicaid Services, and administrative incentives may greatly influence financial performance. However, despite a plethora of information from the University HealthSystem Consortium and the Association of American Medical Colleges, best-practice information for business infrastructure is lacking. To obtain a sampling of current practices, we conducted a survey of departments of surgery. An anonymous 30-question survey addressing demographics, productivity, revenue and expense profile, payor mix, physician extender and staff personnel, billing and collections methodology, and financial performance was distributed among members of the Society of Surgical Chairs via SurveyMonkey. This was approved by the Loyola Institutional Research Board. Multivariate linear regression analyses and t tests/rank-sum tests were performed, as appropriate. Data are presented as mean ± SEM. A total of 25 (19%) departments responded; 14 were integrated with the hospital/health system, and 11 were integrated with the medical school. In 60% (n = 15), the main hospital had 500 to 1,000 beds; 48% (n = 12) had >4 hospitals in their system. For FY10, MD clinical full-time equivalents (FTEs) were 49 ± 10; total work relative value units (wRVUs) were 320 ± 8 k; and total billed cases were 43 ± 16 k. A total of 23 of 25 used physician-extenders with an average of 18 ± 5 per department and in 22 of 23, the physician extenders billed. On average, there were 18 ± 6 clinical-support staff, 25 ± 11 front-office staff, and 13 ± 3 back-office support staff FTEs. Among these FTEs, there were 16 ± 5 devoted to business operations (billing, coding, denial/claims management, financial oversight). Collections/wRVUs were $60 ± 3 (range, 39-80). Regression modeling demonstrated that total wRVUs were determined by the number of MD FTEs (P = .01), number of physician extenders (P = .01), number of front-office staff (P = .01), number of back-office staff (P = .02), and number of total business staff (P = .01). Collections/wRVUs were predicted by number of hospitals (P = .04), number of MD FTEs (P = .03), number of physician extenders (P = .01), and number of cases/total business staff (P = .02). Interestingly, wRVUs/MD was predicted by number of MD FTEs (P = .01) but were not greatly impacted by numbers of clinical or business support staff. In 4 of 25, the billing and coding staff were incentivized and had a Collections/wRVU = 64 ± 5 whereas nonincentivized staff had collections/wRVU = 59 ± 3. (P = NS) Also, %Accounts receivable >90 days (15% vs 25%) were not substantially different. Only 48% (12/25) have departments have recouped Centers for Medicare and Medicaid dollars for Physician Quality Reporting Initiative, Meaningful Use, Patient-Centered Medical Homes, or other Accountable Care-like programs. One-half (13) of the departments had both an inpatient and outpatient electronic medical record. Finally, on a scale of 1-10 (10 = highest), the average level of satisfaction with billing and collections processes was 6. Our results indicate that the physician extender, clinical support staff, and business staff environment can impact surgeon productivity, and there is opportunity for improvement. Determining best practices for ratios of support staff/MD and optimizing the role of electronic medical record in workflow and billing/collections are critical in the current environment. Our pilot study requires extension across more institutions for validation. Copyright © 2012 Mosby, Inc. All rights reserved.

Patient reactions to community pharmacies' roles: evidence from the Portuguese market.

PubMed

Nunes, Francisco G; Anderson, Janet E; Martins, Luis M

2015-12-01

There is little knowledge about how patients perceive and react to the extended role of community pharmacies. To develop a model describing the expanded role of Portuguese community pharmacies as comprising three roles - medicines supplier, advice provider and community health promoter - and two important patient reactions: satisfaction and loyalty. In 2010, 1200 face-to-face interviews were conducted with patients of community pharmacies in Portugal. A model comprising the three pharmacy roles and the two patient reactions was developed and tested using structural equation modelling. The results showed that the model was appropriate and that the roles of medicines supplier, advice provider and community health promoter were positively related to patients' satisfaction and loyalty. These results show that patients are aware of the different roles played by community pharmacies in Portugal. The data support the idea that the movement of Portuguese pharmacists' extended role, framed within a global context where society sends expectations regarding the role of organizations in the community in which they operate, is producing positive results for both patients and pharmacists. © 2014 John Wiley & Sons Ltd.

Polysomnographic record and successful management of augmentation in restless legs syndrome/Willis-Ekbom disease.

PubMed

Maestri, Michelangelo; Fulda, Stephany; Ferini-Strambi, Luigi; Zucconi, Marco; Marelli, Sara; Staedler, Claudio; Bassetti, Claudio L; Manconi, Mauro

2014-05-01

Dopamine agonists (DAs) represent the first-line treatment in restless legs syndrome (RLS); however, in the long term, a substantial proportion of patients will develop augmentation, which is a severe drug-related exacerbation of symptoms and the main reason for late DA withdrawal. Polysomnographic features and mechanisms underlining augmentation are unknown. No practice guidelines for management of augmentation are available. A clinical case series of 24 consecutive outpatients affected by RLS with clinically significant augmentation during treatment with immediate-release DA was performed. All patients underwent a full-night polysomnographic recording during augmentation. A switchover from immediate-release DAs (l-dopa, pramipexole, ropinirole, rotigotine) to the long-acting, extended-release formula of pramipexole was performed. Fifty percent of patients presented more than 15 periodic limb movements per hour of sleep during augmentation, showing longer sleep latency and shorter total sleep time than subjects without periodic limb movements. In all patients, resolution of augmentation was observed within two to four weeks during which immediate-release dopamine agonists could be completely withdrawn. Treatment efficacy of extended-release pramipexole has persisted, thus far, over a mean follow-up interval of 13 months. Pramipexole extended release could be an easy, safe, and fast pharmacological option to treat augmentation in patients with restless legs syndrome. As such it warrants further prospective and controlled investigations. This observation supports the hypothesis that the duration of action of the drug plays a key role in the mechanism of augmentation. Copyright © 2014 Elsevier B.V. All rights reserved.

Characteristics and career intentions of Scottish rural and urban GP registrars: cause for concern?

PubMed

Ross, S; Gillies, J C

1999-01-01

To investigate the differences between the characteristics and career intentions of GP registrars in urban and rural areas, and to make recommendations to reduce a potential work force crisis in rural practice. Postal survey. All general practices in Scotland. In February 1996, 40/196 (20%) of urban and 45/150 (30%) of rural GP registrar places available in Scotland, were vacant (chi 2 = 4.22, df = 1, p = 0.02). Postal questionnaires were sent to all 261 GP registrars in post. Of 235 respondents (90%), the majority wished to remain in general practice (63% of urban and 53% of rural registrars), but only 22% of urban and 18% of rural registrars intended to apply for principal posts immediately after training. Fewer urban (8%) than rural registrars (21%) stated an intention to go abroad to work after training. Rural registrars tended to want to work in rural areas, and vice versa. Part-time and job-sharing were attractive employment options for both groups, and more flexible career structures were favoured by over 80%. Though much more attention has been paid to recruitment in inner cities, the findings from this study suggest that in Scotland difficulties in finding principals may occur first in rural areas. As general practitioners have an extended role in rural areas, including that of emergency care, shortages could have a serious impact on patient care.

In full swing? How do pendulum migrant labourers in Vietnam adjust their sexual perspectives to their rural-urban lives?

PubMed

Nguyen, Huong Ngoc; Hardesty, Melissa; Hong, Khuat Thu

2011-11-01

Having emerged only recently due to fast urbanisation and globalisation, pendulum migrant labourers in Vietnam are economically, culturally and socially difficult to locate - though they are estimated to number in their millions. Defined by their frequent migration between village and city, pendulum migrant labourers occupy an extended period of liminality. Are they traditional villagers or liberal city people when it comes to sex? Does city life radically change their views on sexuality? Starting with the premise that living environments play a key role in structuring the practical and symbolic realities of sex, this paper explores how extended periods of circular migration between the village and city - living environments that differ markedly in terms of socioeconomic and cultural conditions - affect the sexual views and perspectives of Vietnamese pendulum migrant labourers. Analysis from in-depth interviews with 23 married pendulum migrant labourers revealed that even though they had been living the pendulum life for several years, they continued to identify themselves, sexually, as traditional villagers. Among labourers the link between sexuality and living environment was a matter of pragmatism - matching 'suitable' sexual behaviour to social, even if imagined, location - and of privilege or 'leagues' - matching behaviour and comportment to social pedigree.

Divisions of general practice in Australia: how do they measure up in the international context?

PubMed Central

Smith, Judith; Sibthorpe, Beverly

2007-01-01

Background Since the late 1980s, there has been evidence of an international trend towards more organised primary care. This has taken a number of forms including the emergence of primary care organisations. Underpinning such developments is an inherent belief in evidence that suggests that well-developed primary care is associated with improved health outcomes and greater cost-effectiveness within health systems. In Australia, primary care organisations have emerged as divisions of general practice. These are professionally-led, regionally-based, and largely government-funded voluntary associations of general practitioners that seek to co-ordinate local primary care services, and improve the quality of care and health outcomes for local communities. Discussion In this paper, we examine and debate the development of divisions in the international context, using six roles of primary care organisations outlined in published research. The six roles that are used as the basis for the critique are the ability of primary care organisations to: improve health outcomes; manage demand and control costs; engage primary care physicians; enable greater integration of health services; develop more accessible services in community and primary care settings; and enable greater scrutiny and assurance of quality of primary care services. Summary We conclude that there has been an evolutionary approach to divisions' development and they now appear embedded as geographically-based planning and development organisations within the Australian primary health care system. The Australian Government has to date been cautious in its approach to intervention in divisions' direction and performance. However, options for the next phase include: making greater use of contracts between government and divisions; introducing and extending proposed national quality targets for divisions, linked with financial or other incentives for performance; government sub-contracting with state-based organisations to act as purchasers of care; pursuing a fund-holding approach within divisions; and developing divisions as a form of health maintenance organisation. The challenge for the Australian Government, should it wish to see divisions' role expand, is to find mechanisms to enable this without compromising the relatively strong GP engagement that increasingly distinguishes divisions of general practice within the international experience of primary care organisations. PMID:17626642

Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study.

PubMed

van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda

2017-02-07

Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about the PA/NP profession and legislations was often lacking. Role standardisations, long-term political planning and support from professional associations are needed to support policy makers in implementing skill mix in primary care.

A spatial analysis of the expanding roles of nurses in general practice.

PubMed

Pearce, Christopher; Hall, Sally; Phillips, Christine; Dwan, Kathryn; Yates, Rachael; Sibbald, Bonnie

2012-08-07

Changes to the workforce and organisation of general practice are occurring rapidly in response to the Australian health care reform agenda, and the changing nature of the medical profession. In particular, the last five years has seen the rapid introduction and expansion of a nursing workforce in Australian general practices. This potentially creates pressures on current infrastructure in general practice. This study used a mixed methods, 'rapid appraisal' approach involving observation, photographs, and interviews. Nurses utilise space differently to GPs, and this is part of the diversity they bring to the general practice environment. At the same time their roles are partly shaped by the ways space is constructed in general practices. The fluidity of nursing roles in general practice suggests that nurses require a versatile space in which to maximize their role and contribution to the general practice team.

Remedial Drama: A Handbook for Teachers and Therapists.

ERIC Educational Resources Information Center

Jennings, Sue

The primary purpose of this book is to provide a practical working handbook for teachers and therapists. Chapter one is a general discussion of drama, with emphasis on its relevance to therapeutic work. Chapter two offers practical suggestions for starting a therapeutic session and for creating and extending specific environments. Chapter three…

Multi-site evaluation of APEX for crop and grazing land in the Heartland region of the US

USDA-ARS?s Scientific Manuscript database

The Agricultural and Policy Environmental Extender (APEX) is capable of estimating edge-of-field water, nutrient, and sediment transport and is used to assess the environmental impacts of management practices. Current practice is to fully calibrate the model for each site simulation, which requires ...

12 CFR 263.13 - Change of time limits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.13 Change of time limits. Except as otherwise provided by law, the administrative law judge may, for good cause shown, extend the time limits prescribed by the Uniform Rules or by any notice or order issued in the proceedings. After...

12 CFR 308.13 - Change of time limits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PRACTICE AND PROCEDURE Uniform Rules of Practice and Procedure § 308.13 Change of time limits. Except as otherwise provided by law, the administrative law judge may, for good cause shown, extend the time limits prescribed by the Uniform Rules or by any notice or order issued in the proceedings. After the referral of...

Communities of Practice as Agents of Future Faculty Development

ERIC Educational Resources Information Center

Stark, Audriana M.; Smith, Gary A.

2016-01-01

The need for faculty development continues to increase despite the limited resources of many developers to serve growing demands. To address this conundrum, we explore existing literature about communities of practice (CoPs) in higher education and case studies of CoPs at our institution as an avenue to extend and supplement future professional…

Researching New Literacies: Web 2.0 Practices and Insider Perspectives

ERIC Educational Resources Information Center

Lankshear, Colin; Knobel, Michele

2007-01-01

This article argues that "new literacies" is a useful construct for recognizing and understanding the extent to which changes in the current conjuncture are extending social practices of using codes for making and exchanging meanings in directions that warrant serious rethinking of how and why we research literacies. It provides a…

reClaiming Space & Dialogue in Adult Education

ERIC Educational Resources Information Center

Kawalilak, Colleen A.

2006-01-01

This paper critiques current trends in adult education against a backdrop of practice that was once testimony to an educational model that extended beyond formal learning and a business and industry agenda. Adult educators are called upon to reclaim an identity as leaders, in support of a shift in perspective and practice, more aligned to…

Form-focused Communicative Practice via CMC: What Language Learners Say

ERIC Educational Resources Information Center

Meskill, Carla; Anthony, Natasha

2007-01-01

Computer-mediated communication (CMC) is being used widely to support and extend foreign language instruction. Language learners are practicing the target language by communicating with their instructors, peers, and native speakers at a distance. This study examines high-beginning and low-intermediate learners of Russian and their uses of, and…

The Ruling Relation of Evidence-Based Practice: The Case of Documentary Governance in a Social Welfare Service

ERIC Educational Resources Information Center

Pilerot, Ola

2016-01-01

Introduction: Evidence-based practice has broadened and spread into new areas including librarianship. This reorientation has resulted in increased uncertainty regarding what counts as evidence and has caused a tension between formalised procedures and professional judgment. This theoretical paper aims to extend the knowledge about how…

Discursive Shadowing in Linguistic Ethnography. Situated Practices and Circulating Discourses in Multilingual Schools

ERIC Educational Resources Information Center

Dewilde, Joke; Creese, Angela

2016-01-01

We consider discursive shadowing as methodology in linguistic ethnography and how it refines our analyses of participants' situated practices. In addition to the constant and extended company the researcher and key participant keep with one another in the field, shadowing in a linguistic ethnographic approach includes the ubiquitous…

Developing Management Student Cultural Fluency for the Real World: A Situated Cultural Learning Approach

ERIC Educational Resources Information Center

Zhu, Yunxia; Okimoto, Tyler G.; Roan, Amanda; Xu, Henry

2017-01-01

Purpose: To connect students with the real world of management practice, the purpose of this paper is to extend and operationalize the situated cultural learning approach (SiCuLA) through five learning processes occurring within communities of practice. These include integration of cultural contexts, authentic activities, reflections,…

Latino/a Student Threat and School Disciplinary Policies and Practices

ERIC Educational Resources Information Center

Welch, Kelly; Payne, Allison Ann

2018-01-01

Using a nationally representative sample of approximately 3,500 public schools, this study builds on and extends our knowledge of how ''minority threat'' manifests within schools. We test whether various disciplinary policies and practices are mobilized in accordance with Latino/a student composition, presumably the result of a group response to…

Discrimination in Legal Practice: An Examination of Policies Impacting on Educational Opportunities for Women

ERIC Educational Resources Information Center

Cavanagh, Jillian; Fisher, Ron

2008-01-01

Purpose: This research aims to extend the traditional cultural divide between male and female lawyers by examining contradictory workplace policies that discriminate against the work and education of female auxiliary workers within general legal practice in Australia. Design/methodology/approach: The study uses membership categorisation devices,…

Preschool Home Literacy Practices and Children's Literacy Development: A Longitudinal Analysis

ERIC Educational Resources Information Center

Hood, Michelle; Conlon, Elizabeth; Andrews, Glenda

2008-01-01

In this 3-year longitudinal study, the authors tested and extended M. Senechal and J. Le Fevre's (2002) model of the relationships between preschool home literacy practices and children's literacy and language development. Parent-child reading (Home Literacy Environment Questionnaire plus a children's Title Recognition Test) and parental teaching…

Not Just One Shot: Extending the Dialogues about Information Literacy in Composition Classes

ERIC Educational Resources Information Center

Artman, Margaret; Frisicaro-Pawlowski, Erica; Monge, Robert

2010-01-01

While composition programs are frequently responsible for teaching basic research writing, it is still common practice to limit lessons in information literacy to "one-shot" library instruction sessions. This practice reinforces the perception that the research process is separate from (and simpler than) the writing process, that teaching students…

Generalizing from Observations of Mathematics Teachers' Instructional Practice Using the Instructional Quality Assessment

ERIC Educational Resources Information Center

Wilhelm, Anne Garrison; Kim, Sungyeun

2015-01-01

One crucial question for researchers who study teachers' classroom practice is how to maximize information about what is happening in classrooms while minimizing costs. This report extends prior studies of the reliability of the Instructional Quality Assessment (IQA), a widely used classroom observation toolkit, and offers insight into the often…

The Practice Set: A New Spin on an Old Idea

ERIC Educational Resources Information Center

Savage, Helen M.; Law, David B.

2003-01-01

In this article, the authors describe their experience in extending a manual practice set to accounting software. The "Systems Understanding Aid" by Arens and Ward (2001) has been used for some time in the authors' Accounting Information Systems course. The extension involved requiring students to redo the project using Peachtree Complete…

Measuring the Quality of Inclusive Practices: Findings from the Inclusive Classroom Profile Pilot

ERIC Educational Resources Information Center

Soukakou, Elena P.; Winton, Pam J.; West, Tracey A.; Sideris, John H.; Rucker, Lia M.

2014-01-01

The purpose of this study was to test the reliability and validity of the Inclusive Classroom Profile (ICP), an observation measure designed to assess the quality of classroom practices in inclusive preschool programs. The measure was field tested in 51 inclusive classrooms. Results confirmed and extended previous research findings, providing…

Applied behavior analysis: New directions from the laboratory

PubMed Central

Epling, W. Frank; Pierce, W. David

1983-01-01

Applied behavior analysis began when laboratory based principles were extended to humans inorder to change socially significant behavior. Recent laboratory findings may have applied relevance; however, the majority of basic researchers have not clearly communicated the practical implications of their work. The present paper samples some of the new findings and attempts to demonstrate their applied importance. Schedule-induced behavior which occurs as a by-product of contingencies of reinforcement is discussed. Possible difficulties in treatment and management of induced behaviors are considered. Next, the correlation-based law of effect and the implications of relative reinforcement are explored in terms of applied examples. Relative rate of reinforcement is then extended to the literature dealing with concurrent operants. Concurrent operant models may describe human behavior of applied importance, and several techniques for modification of problem behavior are suggested. As a final concern, the paper discusses several new paradigms. While the practical importance of these models is not clear at the moment, it may be that new practical advantages will soon arise. Thus, it is argued that basic research continues to be of theoretical and practical importance to applied behavior analysis. PMID:22478574

Confirmatory factor analysis of the Malay version comprehensive feeding practices questionnaire tested among mothers of primary school children in Malaysia.

PubMed

Shohaimi, Shamarina; Wei, Wong Yoke; Shariff, Zalilah Mohd

2014-01-01

Comprehensive feeding practices questionnaire (CFPQ) is an instrument specifically developed to evaluate parental feeding practices. It has been confirmed among children in America and applied to populations in France, Norway, and New Zealand. In order to extend the application of CFPQ, we conducted a factor structure validation of the translated version of CFPQ (CFPQ-M) using confirmatory factor analysis among mothers of primary school children (N = 397) in Malaysia. Several items were modified for cultural adaptation. Of 49 items, 39 items with loading factors >0.40 were retained in the final model. The confirmatory factor analysis revealed that the final model (twelve-factor model with 39 items and 2 error covariances) displayed the best fit for our sample (Chi-square = 1147; df = 634; P < 0.05; CFI = 0.900; RMSEA = 0.045; SRMR = 0.0058). The instrument with some modifications was confirmed among mothers of school children in Malaysia. The present study extends the usability of the CFPQ and enables researchers and parents to better understand the relationships between parental feeding practices and related problems such as childhood obesity.

Determinants of the choice of GP practice registration in England: evidence from a discrete choice experiment.

PubMed

Lagarde, Mylene; Erens, Bob; Mays, Nicholas

2015-04-01

There have been growing concerns that general practitioner (GP) services in England, which are based on registration with a single practice located near the patient's home, are not sufficiently convenient for patients. To inform the decision as to whether to change registration rules allowing patients to register 'out-of-area' and to estimate the demand for this wider choice, we undertook a discrete choice experiment with 1706 respondents. Latent class models were used to analyse preferences for GP practice registration comparing preferences for neighbourhood and non-neighbourhood practices. We find that there is some appetite for registering outside the neighbourhood, but this preference is not uniformly shared across the population. Specifically individuals who are less mobile (e.g. older people and those with caring responsibilities), or satisfied with their local practice are less likely to be interested in registering at a practice outside their neighbourhood. Overall, people feel most strongly about obtaining an appointment with a GP as quickly as possible. Respondents regarded weekend opening as less important than other factors, and particularly less important than extended practice opening hours from Monday to Friday. Assuming a constant demand for GP services, a policy encouraging GP practices to extend their opening hours during the week is likely to decrease the average patient waiting time for an appointment and is likely to be preferred by patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cognitive benefits of computer games for older adults.

PubMed

Zelinski, Elizabeth M; Reyes, Ricardo

2009-01-01

The purpose of this paper is to develop a basis for the hypothesis that digital action games may produce cognitive benefits for older adults. First, a discussion of the relationship between cognitive and physical health shows the increasing weight given to the role of declines in cognition in the development of dependency in older adult population studies. Second, evidence that cognitive training produces 'far transfer' in elders is presented. The key issue is that one approach, known as extended practice training, has been successful in producing far transfer to memory and other processes. Its principles, which are consistent with those associated with positive brain plasticity effects, are identified. Those principles are then related to the mechanics of digital action games, which also have the important added feature of producing the experiences of presence, engagement, and flow, the subjective elements of game play that are likely to sustain interest and emotional investment in the skills practiced so that the play produces cognitive benefits. The specific cognitive abilities proposed to be improved by different types of game genres are outlined, and recent developments in game and interface design that may affect the willingness of older adults to play are described.

Cognitive benefits of computer games for older adults

PubMed Central

Zelinski, Elizabeth M.; Reyes, Ricardo

2010-01-01

The purpose of this paper is to develop a basis for the hypothesis that digital action games may produce cognitive benefits for older adults. First, a discussion of the relationship between cognitive and physical health shows the increasing weight given to the role of declines in cognition in the development of dependency in older adult population studies. Second, evidence that cognitive training produces ‘far transfer’ in elders is presented. The key issue is that one approach, known as extended practice training, has been successful in producing far transfer to memory and other processes. Its principles, which are consistent with those associated with positive brain plasticity effects, are identified. Those principles are then related to the mechanics of digital action games, which also have the important added feature of producing the experiences of presence, engagement, and flow, the subjective elements of game play that are likely to sustain interest and emotional investment in the skills practiced so that the play produces cognitive benefits. The specific cognitive abilities proposed to be improved by different types of game genres are outlined, and recent developments in game and interface design that may affect the willingness of older adults to play are described. PMID:25126043

Dependence and caring in clinical communication: The relevance of attachment and other theories

PubMed Central

Salmon, Peter; Young, Bridget

2009-01-01

Objective Clinical relationships are usually asymmetric, being defined by patients’ dependence and practitioners’ care. Our aims are to: (i) identify literature that can contribute to theory for researching and teaching clinical communication from this perspective; (ii) highlight where theoretical development is needed; and (iii) test the utility of the emerging theory by identifying whether it leads to implications for educational practice. Methods Selective and critical review of research concerned with dependence and caring in clinical and non-clinical relationships. Results Attachment theory helps to understand patients’ need to seek safety in relationships with expert and authoritative practitioners but is of limited help in understanding practitioners’ caring. Different theories that formulate practitioners’ care as altruistic, rewarded by personal connection or as a contract indicate the potential importance of practitioners’ emotions, values and sense of role in understanding their clinical communication. Conclusion Extending the theoretical grounding of clinical communication can accommodate patients’ dependence and practitioners’ caring without return to medical paternalism. Practice implications A broader theoretical base will help educators to address the inherent subjectivity of clinical relationships, and researchers to distinguish scientific questions about how patients and clinicians are from normative questions about how they should be. PMID:19157761

Dressing disrupted: negotiating care through the materiality of dress in the context of dementia.

PubMed

Buse, Christina; Twigg, Julia

2018-02-01

This paper explores how the materiality of dress mediates and shapes practices of care in the context of dementia. Earlier research called for an approach to conceptualising care that recognised the role played by everyday artefacts. We extend this to a consideration of dress and dressing the body in relation to people with dementia that involves the direct manipulation of material objects, as well as the materiality of bodies. The paper draws on an ESRC funded study Dementia and Dress, which examined experiences of dress for people with dementia, families and care-workers using ethnographic and qualitative methods. Our analysis explores the process of dressing the body, the physicality of guiding and manipulating bodies into clothing, dealing with fabrics and bodies which 'act back' and are resistant to the process of dressing. We consider how the materiality of clothing can constrain or enable practices of care, exploring tensions between garments that support ease of dressing and those that sustain identity. Examining negotiations around dress also reveals tensions between competing 'logics' of care (Mol ). © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Negotiating competency, professionalism and risk: the integration of complementary and alternative medicine by nurses and midwives in NHS hospitals.

PubMed

Cant, Sarah; Watts, Peter; Ruston, Annmarie

2011-02-01

This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.

The family, neuroscience, and academic skills: An interdisciplinary account of social class gaps in children's test scores.

PubMed

Potter, Daniel; Mashburn, Andrew; Grissmer, David

2013-03-01

Current explanations of social class gaps in children's early academic skills tend to focus on non-cognitive skills that more advantaged children acquire in the family. Accordingly, social class matters because the cultural resources more abundant in advantaged families cultivate children's repertories and tool kits, which allow them to more easily navigate social institutions, such as schools. Within these accounts, parenting practices matter for children's academic success, but for seemingly arbitrary reasons. Alternatively, findings from current neuroscience research indicate that family context matters for children because it cultivates neural networks that assist in learning and the development of academic skills. That is, children's exposure to particular parenting practices and stimulating home environments contribute to the growth in neurocognitive skills that affect later academic performance. We synthesize sociological and neuroscience accounts of developmental inequality by focusing on one such skill-fine motor skills-to illustrate how family context alters children's early academic performance. Our findings support an interdisciplinary account of academic inequality, and extend current accounts of the family's role in the transmission of social inequality. Copyright © 2012 Elsevier Inc. All rights reserved.

Vitamin D receptor activation and survival in chronic kidney disease.

PubMed

Kovesdy, C P; Kalantar-Zadeh, K

2008-06-01

Replacement of activated vitamin D has been the cornerstone of therapy for secondary hyperparathyroidism (SHPT). Recent findings from several large observational studies have suggested that the benefits of vitamin D receptor activators (VDRA) may extend beyond the traditional parathyroid hormone (PTH)-lowering effect, and could result in direct cardiovascular and metabolic benefits. The advent of several new analogs of the activated vitamin D molecule has widened our therapeutic armamentarium, but has also made therapeutic decisions more complicated. Treatment of SHPT has become even more complex with the arrival of the first calcium-sensing receptor (CSR) agonist (cinacalcet hydrochloride) and with the uncovering of novel mechanisms responsible for SHPT. We provide a brief overview of the physiology and pathophysiology of SHPT, with a focus on vitamin D metabolism, and discuss various practical aspects of VDRA therapy and its reported association with survival in recent observational studies. A detailed discussion of the available agents is aimed at providing the practicing physician with a clear understanding of the advantages or disadvantages of the individual medications. A number of open questions are also analyzed, including the present and future roles of CSR agonists and 25(OH) vitamin D replacement.

The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on.

PubMed

Halcomb, Elizabeth J; Salamonson, Yenna; Davidson, Patricia M; Kaur, Rajneesh; Young, Samantha Am

2014-03-25

Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses' role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses' role in general practice was slightly decreased over time. This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce.

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Walrath-Greene, Christine M

2009-12-31

The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

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.

Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers.

PubMed

Fealy, Gerard M; Casey, Mary; O'Leary, Denise F; Mcnamara, Martin S; O'Brien, Denise; O'Connor, Laserina; Smith, Rita; Stokes, Diarmuid

2018-06-12

The aim of this discursive paper is to collate, synthesise and discuss published evidence and expert professional opinion on enablers and barriers to the development and sustainability of specialist and advanced practice roles in nursing and midwifery. Expanded practice is a response to population health needs, healthcare costs and practitioners' willingness to expand their scope of practice through enhanced responsibility, accountability and professional autonomy. This discursive paper is based on a rapid review of literature on enablers and barriers to the development and sustainability of specialist and advanced practice roles and is part of a wider policy analysis. We analysed and synthesised of 36 research articles, reviews and discussion papers on enablers and barriers in the development and sustainability of expanded practice roles. Several factors enable role expansion, including: role clarity; credentialing and endorsement; availability of education for expanded roles; individual practitioners' dispositions towards role expansion; support from peers, other professionals and the work organisation; and costs. Where limited or absent, these same factors can constrain role expansion. Enabling nurses and midwives to practice to their full scope of education and expertise is a global challenge for disciplinary leadership, a national challenge for professional regulation, and a local challenge for employers and individual clinicians. These challenges need to be addressed through multi-stakeholder coordinated efforts at these four levels. This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Accelerate Healthcare Data Analytics: An Agile Practice to Perform Collaborative and Reproducible Analyses.

PubMed

Hao, Bibo; Sun, Wen; Yu, Yiqin; Li, Jing; Hu, Gang; Xie, Guotong

2016-01-01

Recent advances in cloud computing and machine learning made it more convenient for researchers to gain insights from massive healthcare data, while performing analyses on healthcare data in current practice still lacks efficiency for researchers. What's more, collaborating among different researchers and sharing analysis results are challenging issues. In this paper, we developed a practice to make analytics process collaborative and analysis results reproducible by exploiting and extending Jupyter Notebook. After applying this practice in our use cases, we can perform analyses and deliver results with less efforts in shorter time comparing to our previous practice.

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

PubMed

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

2018-07-01

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

The Paradox of Mitochondrial Dysfunction and Extended Longevity

PubMed Central

Munkácsy, Erin; Rea, Shane L.

2014-01-01

Mitochondria play numerous, essential roles in the life of eukaryotes. Disruption of mitochondrial function in humans is often pathological or even lethal. Surprisingly, in some organisms mitochondrial dysfunction can result in life extension. This paradox has been studied most extensively in the long-lived Mit mutants of the nematode Caenorhabditis elegans. In this review, we explore the major responses that are activated following mitochondrial dysfunction in these animals and how these responses potentially act to extend their life. We focus our attention on five broad areas of current research – reactive oxygen species signaling, the mitochondrial unfolded protein response, autophagy, metabolic adaptation, and the roles played by various transcription factors. Lastly, we also examine why disruption of complexes I and II differ in their ability to induce the Mit phenotype and extend lifespan. PMID:24699406

Integrating new practices: a qualitative study of how hospital innovations become routine.

PubMed

Brewster, Amanda L; Curry, Leslie A; Cherlin, Emily J; Talbert-Slagle, Kristina; Horwitz, Leora I; Bradley, Elizabeth H

2015-12-05

Hospital quality improvement efforts absorb substantial time and resources, but many innovations fail to integrate into organizational routines, undermining the potential to sustain the new practices. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. We conducted a qualitative study using a purposive sample of hospitals that participated in the State Action on Avoidable Rehospitalizations (STAAR) initiative, a collaborative to reduce hospital readmissions that encouraged members to adopt new practices. We selected hospitals where risk-standardized readmission rates (RSRR) had improved (n = 7) or deteriorated (n = 3) over the course of the first 2 years of the STAAR initiative (2010-2011 to 2011-2012) and interviewed a range of staff at each site (90 total). We recruited hospitals until reaching theoretical saturation. The constant comparative method was used to conduct coding and identification of key themes. When innovations were successfully integrated, participants consistently reported that a small number of key staff held the innovation in place for as long as a year while more permanent integrating mechanisms began to work. Depending on characteristics of the innovation, one of three categories of integrating mechanisms eventually took over the role of holding new practices in place. Innovations that proved intrinsically rewarding to the staff, by making their jobs easier or more gratifying, became integrated through shifts in attitudes and norms over time. Innovations for which the staff did not perceive benefits to themselves were integrated through revised performance standards if the innovation involved complex tasks and through automation if the innovation involved simple tasks. Hospitals have an opportunity to promote the integration of new practices by planning for the extended effort required to hold a new practice in place while integration mechanisms take hold. By understanding how integrating mechanisms correspond to innovation characteristics, hospitals may be able to foster integrating mechanisms most likely to work for particular innovations.

Manned orbital systems concepts study. Book 2: Requirements for extended-duration missions

NASA Technical Reports Server (NTRS)

1975-01-01

In order to provide essential data needed in long-range program planning, the Manned Orbital Systems Concepts (MOSC) study attempted to define, evaluate, and compare concepts for manned orbital systems that provide extended experiment mission capabilities in space, flexibility of operation, and growth potential. Specific areas discussed include roles and requirements for man in future space missions, requirements for extended capability, mission/payload concepts, and preliminary design and operational requirements.

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

2016-01-01

Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148

A Cognitive Vulnerability Model of Sleep and Mood in Adolescents under Naturalistically Restricted and Extended Sleep Opportunities

PubMed Central

Bei, Bei; Wiley, Joshua F.; Allen, Nicholas B.; Trinder, John

2015-01-01

Study Objectives: School terms and vacations represent naturally occurring periods of restricted and extended sleep opportunities. A cognitive model of the relationships among objective sleep, subjective sleep, and negative mood was tested across these periods, with sleep-specific (i.e., dysfunctional beliefs and attitudes about sleep) and global (i.e., dysfunctional attitudes) cognitive vulnerabilities as moderators. Design: Longitudinal study over the last week of a school term (Time-E), the following 2-w vacation (Time-V), and the first week of the next term (Time-S). Setting: General community. Participants: 146 adolescents, 47.3% male, mean age = 16.2 years (standard deviation ± 1 year). Interventions: N/A. Measurements and Results: Objective sleep was measured continuously by actigraphy. Sociodemographics and cognitive vulnerabilities were assessed at Time-E; subjective sleep, negative mood (anxiety and depressive symptoms), and academic stress were measured at each time point. Controlling for academic stress and sex, subjective sleep quality mediated the relationship between objective sleep and negative mood at all time points. During extended (Time-V), but not restricted (Time-E and Time-S) sleep opportunity, this mediation was moderated by global cognitive vulnerability, with the indirect effects stronger with higher vulnerability. Further, at Time-E and Time-V, but not Time-S, greater sleep-specific and global cognitive vulnerabilities were associated with poorer subjective sleep quality and mood, respectively. Conclusions: Results highlighted the importance of subjective sleep perception in the development of sleep related mood problems, and supported the role of cognitive vulnerabilities as potential mechanisms in the relationships between objective sleep, subjective sleep, and negative mood. Adolescents with higher cognitive vulnerability are more susceptible to perceived poor sleep and sleep related mood problems. These findings have practical implications for interventions. Citation: Bei B, Wiley JF, Allen NB, Trinder J. A cognitive vulnerability model of sleep and mood in adolescents under naturalistically restricted and extended sleep opportunities. SLEEP 2015;38(3):453–461. PMID:25325471

The State Role in School Turnaround: Emerging Best Practices

ERIC Educational Resources Information Center

Rhim, Lauren Morando, Ed.; Redding, Sam, Ed.

2014-01-01

This publication explores the role of the state education agency (SEA) in school turnaround efforts. An emphasis is placed on practical application of research and best practices related to the SEA's critical leadership role in driving and supporting successful school turnaround efforts. The publication is organized around the four goals of…

Household chaos moderates the link between maternal attribution bias and parenting: Parenting: Science and Practice.

PubMed

Wang, Z; Deater-Deckard, K; Bell, M A

2013-10-01

Parents who attribute child misbehavior to children's intentions and dismiss situational factors tend to show more hostility and less warmth in their parenting behavior, and are at greater risk for maltreatment. We extended this literature by investigating the role of household chaos as a moderator of the link between maternal attribution biases and parenting behaviors. The current sample included 160 mothers of 3- to7-year-old children. Mothers provided reports on their attribution biases and household chaos levels. Maternal negativity and positivity were measured using self-reports and observers' ratings. The links between attribution bias and parenting behavior were stronger in more chaotic environments, with the moderating effect of chaos being particularly strong for internal attribution bias. The findings point to the importance of social cognitive biases in the etiology of maternal behavior in family contexts that lack order and predictability.

Financial Stylized Facts in the Word of Mouth Model

NASA Astrophysics Data System (ADS)

Misawa, Tadanobu; Watanabe, Kyoko; Shimokawa, Tetsuya

Recently, we proposed an agent-based model called the word of mouth model to analyze the influence of an information transmission process to price formation in financial markets. Especially, the short-term predictability of asset return was focused on and an explanation in the view of information transmission was provided to the question why the predictability was much clearly observed in the small-sized stocks. This paper, to extend the previous study, demonstrates that the word of mouth model also has a consistency with other important financial stylized facts. This strengthens the possibility that the information transmission among investors plays a crucial role in price formation. Concretely, this paper addresses two famous statistical features of returns; the leptokurtic distribution of return and the autocorrelation of return volatility. The reasons why these statistical facts receive especial attentions of researchers among financial stylized facts are their statistical robustness and practical importance, such as the applications to the derivative pricing problems.

Comparison of hand hygiene procedures for removing Bacillus cereus spores.

PubMed

Sasahara, Teppei; Hayashi, Shunji; Hosoda, Kouichi; Morisawa, Yuji; Hirai, Yoshikazu

2014-01-01

Bacillus cereus is a spore-forming bacterium. B. cereus occasionally causes nosocomial infections, in which hand contamination with the spores plays an important role. Therefore, hand hygiene is the most important practice for controlling nosocomial B. cereus infections. This study aimed to determine the appropriate hand hygiene procedure for removing B. cereus spores. Thirty volunteers' hands were experimentally contaminated with B. cereus spores, after which they performed 6 different hand hygiene procedures. We compared the efficacy of the procedures in removing the spores from hands. The alcohol-based hand-rubbing procedures scarcely removed them. The soap washing procedures reduced the number of spores by more than 2 log10. Extending the washing time increased the spore-removing efficacy of the washing procedures. There was no significant difference in efficacy between the use of plain soap and antiseptic soap. Handwashing with soap is appropriate for removing B. cereus spores from hands. Alcohol-based hand-rubbing is not effective.

Expert Comment: Is Medication Titration in Heart Failure too Complex?

PubMed Central

Hickey, Annabel

2017-01-01

Abstract Large-scale randomised controlled trials (RCTs) have demonstrated that angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers decrease mortality and hospitalisation in patients with heart failure (HF) associated with a reduced left ventricular ejection fraction. This has led to high prescription rates; however, these drugs are generally prescribed at much lower doses than the doses achieved in the RCTs. A number of strategies have been evaluated to improve medication titration in HF, including forced medication up-titration protocols, point-of-care decision support and extended scope of clinical practice for nurses and pharmacists. Most successful strategies have been multifaceted and have adapted existing multidisciplinary models of care. Furthermore, given the central role of general practitioners in long-term monitoring and care coordination in HF patients, these strategies should engage with primary care to facilitate the transition between the acute and primary healthcare sectors. PMID:28785472

Episodic work-family conflict, cardiovascular indicators, and social support: an experience sampling approach.

PubMed

Shockley, Kristen M; Allen, Tammy D

2013-07-01

Work-family conflict, a prevalent stressor in today's workforce, has been linked to several detrimental consequences for the individual, including physical health. The present study extends this area of research by examining episodic work-family conflict in relation to objectively measured cardiovascular health indicators (systolic and diastolic blood pressure and heart rate) using an experience sampling methodology. The results suggested that the occurrence of an episode of work interference with family conflict is linked to a subsequent increase in heart rate but not blood pressure; however, the relationship between episodes of family interference with work conflict and both systolic and diastolic blood pressure is moderated by perceptions of family-supportive supervision. No evidence was found for the moderating role of work-supportive family. Further theoretical and practical implications are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Dual Identity and Prejudice: The Moderating Role of Group Boundary Permeability

PubMed Central

Shi, Yuanyuan; Dang, Jianning; Zheng, Wenwen; Liu, Li

2017-01-01

Past work suggested that dual identity was effective to reduce prejudice. This study extended research on dual identity and prejudice by identifying a boundary condition in this relationship, that is, group permeability. In Study 1, we replicated previous studies with Chinese individuals and found that inducing dual identity (emphasizing subgroup differences and a common nation identity), compared to the control condition, decreased the urban residents’ prejudice against rural-to-urban migrants. In Study 2, we manipulated the group boundary permeability using the Hukou system reform, and found that when the group boundary was permeable, dual identity was effective in reducing prejudice against rural-to-urban migrants. However, this effect vanished in the condition where the group boundary was impermeable. These results point to the importance of inducing dual identity under specific conditions for research on decreasing prejudice. Some practical implications of the findings for urbanization and immigration are discussed. PMID:28261130

Training and Support of Sessional Staff to Improve Quality of Teaching and Learning at Universities.

PubMed

Knott, Gillian; Crane, Linda; Heslop, Ian; Glass, Beverley D

2015-06-25

Sessional staff is increasingly involved in teaching at universities, playing a pivotal role in bridging the gap between theory and practice for students, especially in the health professions, including pharmacy. Although sessional staff numbers have increased substantially in recent years, limited attention has been paid to the quality of teaching and learning provided by this group. This review will discuss the training and support of sessional staff, with a focus on Australian universities, including the reasons for and potential benefits of training, and structure and content of training programs. Although sessional staff views these programs as valuable, there is a lack of in-depth evaluations of the outcomes of the programs for sessional staff, students and the university. Quality assurance of such programs is only guaranteed, however, if these evaluations extend to the impact of this training and support on student learning.

Patient Satisfaction by Design.

PubMed

Jacobs, Karen

2016-11-01

The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience-the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience-office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction.

Substance-related disorders among juvenile offenders: what role do psychopathic traits play?

PubMed

Kimonis, Eva R; Tatar, Joseph R; Cauffman, Elizabeth

2012-06-01

Substance use disorders are associated with psychopathy, a personality disorder that is heterogeneous in both adults and youth; secondary variants of psychopathy with comorbid psychopathology and primary variants without comorbidity show distinct correlates and outcomes. In adult criminal populations, secondary variants report greater substance abuse compared with primary variants. The primary aim of this study is to replicate and extend these findings to a juvenile offender population. Compared with primary variants of juvenile psychopathy, secondary variants (a) reported significantly more frequent substance use--particularly alcohol--within the 6 months prior to incarceration (d = .43), (b) were almost twice as likely to abuse substances while incarcerated, and (c) were more likely to be diagnosed with a current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV; American Psychiatric Association, 2000) substance use disorder. Practical implications for working with justice-involved youth are discussed.

Too exhausted to see the truth: ego depletion and the ability to detect deception.

PubMed

Reinhard, Marc-André; Scharmach, Martin; Stahlberg, Dagmar

2013-12-01

In two experiments, recent findings showing the detrimental role of regulatory depletion in decision making are extended to the field of deception detection. In both experiments, the state of ego depletion was induced by having judges inhibit versus non-inhibit a dominant response while transcribing a text. Subsequently they judged true or deceptive messages of different stimulus persons with regard to their truthfulness. In both experiments, ego-depleted judges scored significantly lower on detection accuracy than control judges. Signal detection measures showed that this effect was not due to differences in judgmental bias between the two conditions. In Experiment 2, it was shown that the lower detection accuracy in the state of ego depletion was due to a feeling of difficulty of relying on verbal content information. Practical implications of the current findings are discussed. © 2012 The British Psychological Society.

The impact and determinants of the energy paradigm on economic growth in European Union

PubMed Central

Mieila, Mihai; Panait, Mirela

2017-01-01

Contemporary economies are strongly reliant on energy and analyzing the determining factors that trigger the changes in energy paradigm and their impact upon economic growth is a topical research subject. Our contention is that energy paradigm plays a major role in achieving the sustainable development of contemporary economies. In order to prove this the panel data methodology of research was employed, namely four panel unit root tests (LLC, IPS, F-ADF and F-PP) aiming to reveal the connections and relevance among 17 variables denoting energy influence on economic development. Moreover, it was introduced a specific indicator to express energy consumption per capita. Our findings extend the classical approach of the changes in energy paradigm and their impact upon economic growth and offer a comprehensive analysis which surpasses the practices and policy decisions in the field. PMID:28301505

Patient Satisfaction by Design

PubMed Central

Jacobs, Karen

2016-01-01

The concept of the patient experience as it relates to patient satisfaction is a complex dynamic. It is a dynamic that is becoming increasingly more important as patients are faced with multiple choices for their hearing and balance care. As reimbursement and performance policies have become more normative within health care, patient satisfaction has become a metric to measure quality. Patient satisfaction is no longer contained to just the interaction with the audiologist. It extends to the entire experience—the staff, the service, the product, and other factors. Many practices fail to capitalize on one of the primary components of the patient experience—office design. This article discusses the role of evidence-based design in facility planning as it relates to patient satisfaction. It will illustrate how design principles and ideal attributes may be used to send conscious and subconscious cues that will motivate staff, facilitate patient-centered care, and ultimately increase patient satisfaction. PMID:28028324

Reinventing the ames test as a quantitative lab that connects classical and molecular genetics.

PubMed

Goodson-Gregg, Nathan; De Stasio, Elizabeth A

2009-01-01

While many institutions use a version of the Ames test in the undergraduate genetics laboratory, students typically are not exposed to techniques or procedures beyond qualitative analysis of phenotypic reversion, thereby seriously limiting the scope of learning. We have extended the Ames test to include both quantitative analysis of reversion frequency and molecular analysis of revertant gene sequences. By giving students a role in designing their quantitative methods and analyses, students practice and apply quantitative skills. To help students connect classical and molecular genetic concepts and techniques, we report here procedures for characterizing the molecular lesions that confer a revertant phenotype. We suggest undertaking reversion of both missense and frameshift mutants to allow a more sophisticated molecular genetic analysis. These modifications and additions broaden the educational content of the traditional Ames test teaching laboratory, while simultaneously enhancing students' skills in experimental design, quantitative analysis, and data interpretation.

MRI in the assessment and monitoring of multiple sclerosis: an update on best practice

PubMed Central

Kaunzner, Ulrike W.; Gauthier, Susan A.

2017-01-01

Magnetic resonance imaging (MRI) has developed into the most important tool for the diagnosis and monitoring of multiple sclerosis (MS). Its high sensitivity for the evaluation of inflammatory and neurodegenerative processes in the brain and spinal cord has made it the most commonly used technique for the evaluation of patients with MS. Moreover, MRI has become a powerful tool for treatment monitoring, safety assessment as well as for the prognostication of disease progression. Clinically, the use of MRI has increased in the past couple decades as a result of improved technology and increased availability that now extends well beyond academic centers. Consequently, there are numerous studies supporting the role of MRI in the management of patients with MS. The aim of this review is to summarize the latest insights into the utility of MRI in MS. PMID:28607577

A theoretical framework for negotiating the path of emergency management multi-agency coordination.

PubMed

Curnin, Steven; Owen, Christine; Paton, Douglas; Brooks, Benjamin

2015-03-01

Multi-agency coordination represents a significant challenge in emergency management. The need for liaison officers working in strategic level emergency operations centres to play organizational boundary spanning roles within multi-agency coordination arrangements that are enacted in complex and dynamic emergency response scenarios creates significant research and practical challenges. The aim of the paper is to address a gap in the literature regarding the concept of multi-agency coordination from a human-environment interaction perspective. We present a theoretical framework for facilitating multi-agency coordination in emergency management that is grounded in human factors and ergonomics using the methodology of core-task analysis. As a result we believe the framework will enable liaison officers to cope more efficiently within the work domain. In addition, we provide suggestions for extending the theory of core-task analysis to an alternate high reliability environment. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Toxicological Implications and Inflammatory Response in Human Lymphocytes Challenged with Oxytetracycline

PubMed Central

Di Cerbo, A.; Palatucci, A. T.; Rubino, V.; Centenaro, S.; Giovazzino, A.; Fraccaroli, E.; Cortese, L.; Ruggiero, G.; Guidetti, G.; Canello, S.

2015-01-01

ABSTRACT Antibiotics are widely used in zoo technical and veterinary practices as feed supplementation to ensure wellness of farmed animals and livestock. Several evidences have been suggesting both the toxic role for tetracyclines, particularly for oxytetracycline (OTC). This potential toxicity appears of great relevance for human nutrition and for domestic animals. This study aimed to extend the evaluation of such toxicity. The biologic impact of the drug was assessed by evaluating the proinflammatory effect of OTC and their bone residues on cytokine secretion by in vitro human peripheral blood lymphocytes. Our results showed that both OTC and OTC‐bone residues significantly induced the T lymphocyte and non‐T cell secretion of interferon (IFN)‐γ, as cytokine involved in inflammatory responses in humans as well as in animals. These results may suggest a possible implication for new potential human and animal health risks depending on the entry of tetracyclines in the food‐processing chain. PMID:26537863

Organizational socialization in team sport environments.

PubMed

Benson, A J; Evans, M B; Eys, M A

2016-04-01

Socialization tactics are often used to manage initial group member interactions in a way that facilitates transition experiences. Although this process is heavily researched in organizational contexts, we sought to extend this line of inquiry to sport by examining the nature of socialization tactics used to integrate new members into existing teams. Interviews were conducted with 12 coaches and 12 athletes from several Canadian Interuniversity Sport teams to explore the nature of socialization and the circumstances underscoring why certain approaches are taken over others. A key process involved establishing congruency of role expectations between incoming athletes and group leaders, and socialization processes balanced expectations of conformity with encouragement of individual personalities within the group. A conceptual basis to examine socialization into team sport environments is discussed in relation to the extant organizational theories, and the practical implications of delineating sport socialization tactics are forwarded. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Breast Cancer Prognosis for Young Patients

PubMed Central

OWRANG, MEHDI; COPELAND, L. ROBERT JR; RICKS-SANTI, J. LUISEL; GASKINS, MELVIN; BEYENE, DESTA; DEWITTY, L. ROBERT JR; KANAAN, M. YASMINE

2017-01-01

Background/Aims: Breast cancer (BCa) prognostication is a vital element for providing effective treatment for patients with BCa. Studies suggest that ethnicity plays a greater role in the incidence and poor prognosis of BCa in younger women than in their older counterparts. Therefore, the goal of this study was to assess the association between age and ethnicity on the overall final prognosis. Materials and Methods: Nottingham Prognostic Index (NPI) was used to analyze BCa prognosis using Howard University Cancer Center Tumor Registry and the National Cancer Institute’s Surveillance, Epidemiology, and End Results BCa datasets. Patients were grouped according to their predicted prognosis based on NPI scheme. Results: There was no correlation between the younger patients compared to their older counterparts for any of the prognostic clusters. The significance of ethnicity in poorer prognosis for younger age is not conclusive either. Conclusion: An extended prognostic tool/system needs to be evaluated for its usefulness in a clinical practice environment. PMID:28652435

Control and formation mechanism of extended nanochannel geometry in colloidal mesoporous silica particles.

PubMed

Sokolov, I; Kalaparthi, V; Volkov, D O; Palantavida, S; Mordvinova, N E; Lebedev, O I; Owens, J

2017-01-04

A large class of colloidal multi-micron mesoporous silica particles have well-defined cylindrical nanopores, nanochannels which self-assembled in the templated sol-gel process. These particles are of broad interest in photonics, for timed drug release, enzyme stabilization, separation and filtration technologies, catalysis, etc. Although the pore geometry and mechanism of pore formation of such particles has been widely investigated at the nanoscale, their pore geometry and its formation mechanism at a larger (extended) scale is still under debate. The extended geometry of nanochannels is paramount for all aforementioned applications because it defines accessibility of nanochannels, and subsequently, kinetics of interaction of the nanochannel content with the particle surrounding. Here we present both experimental and theoretical investigation of the extended geometry and its formation mechanism in colloidal multi-micron mesoporous silica particles. We demonstrate that disordered (and consequently, well accessible) nanochannels in the initially formed colloidal particles gradually align and form extended self-sealed channels. This knowledge allows to control the percentage of disordered versus self-sealed nanochannels, which defines accessibility of nanochannels in such particles. We further show that the observed aligning the channels is in agreement with theory; it is thermodynamically favored as it decreases the Gibbs free energy of the particles. Besides the practical use of the obtained results, developing a fundamental understanding of the mechanisms of morphogenesis of complex geometry of nanopores will open doors to efficient and controllable synthesis that will, in turn, further fuel the practical utilization of these particles.

A qualitative exploration of opinions on the community pharmacists' role amongst the general public in Scotland.

PubMed

Gidman, Wendy; Cowley, Joseph

2013-10-01

To understand members of the public's opinions and experiences of pharmacy services. This exploratory study employed qualitative methods. Five focus groups were conducted with 26 members of the public resident in Scotland in March 2010. The groups comprised those perceived to be users and non-users of community pharmacy. A topic guide was developed to prompt discussion. Each focus group was recorded, transcribed, anonymised and analysed using thematic analysis. Participants made positive comments about pharmacy services although many preferred to see a general practitioner (GP). Participants discussed using pharmacies for convenience, often because they were unable to access GPs. Pharmacists were perceived principally to be suppliers of medicine, although there was some recognition of roles in dealing with minor ailments and providing advice. For those with serious and long-standing health matters GPs were usually the professional of choice for most health needs. Community pharmacy was seen to offer incomplete services which did not co-ordinate well with other primary-care services. The pharmacy environment and retail setting were not considered to be ideal for private healthcare consultations. This study suggests that despite recent initiatives to extend the role of community pharmacists many members of the general public continue to prefer a GP-led service. Importantly GPs inspire public confidence as well as offering comprehensive services and private consultation facilities. Improved communication and information sharing between community pharmacists and general practice could support community pharmacist-role expansion. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

Educational Reforms and the Practices of Professional Learning Community in Hong Kong Primary Schools

ERIC Educational Resources Information Center

Pang, Nicholas Sun-Keung; Wang, Ting; Leung, Zoe Lai-Mei

2016-01-01

This study explored the characteristics of professional learning communities (PLCs) in Hong Kong primary schools. It investigated the profiles of the strengths of professional learning community in schools under study and particularly examined the practices in schools which were identified as strong PLCs. It extends research on PLCs in the Hong…

Gelatin-Filtered Consomme: A Practical Demonstration of the Freezing and Thawing Processes

ERIC Educational Resources Information Center

Lahne, Jacob B.; Schmidt, Shelly J.

2010-01-01

Freezing is a key food processing and preservation technique widely used in the food industry. Application of best freezing and storage practices extends the shelf-life of foods for several months, while retaining much of the original quality of the fresh food. During freezing, as well as its counterpart process, thawing, a number of critical…

Reflective Activities: Helping Students Connect with Texts. Classroom Practices in Teaching English, Volume 30.

ERIC Educational Resources Information Center

Reid, Louann, Ed.; Golub, Jeffrey N., Ed.

This book offers successful classroom practices that encourage students to learn purposefully and constructively by reflecting on their own learning processes and by making connections between what they read (whether verbal or visual texts) and the lives they lead. Extending from middle and high school through college composition and English…

Comparison of the Efficiency of Two Flashcard Drill Methods on Children's Reading Performance

ERIC Educational Resources Information Center

Joseph, Laurice; Eveleigh, Elisha; Konrad, Moira; Neef, Nancy; Volpe, Robert

2012-01-01

The purpose of this study was to extend prior flashcard drill and practice research by holding instructional time constant and allowing learning trials to vary. Specifically, the authors aimed to determine whether an incremental rehearsal method or a traditional drill and practice method was most efficient in helping 5 first-grade children read,…

Focus on the Finish Line: Does High-Impact Practice Participation Influence Career Plans and Early Job Attainment?

ERIC Educational Resources Information Center

Miller, Angie L.; Rocconi, Louis M.; Dumford, Amber D.

2018-01-01

High-impact practices (HIPs) are important co-curricular educational experiences in post-secondary education, as they promote learning, development, and persistence among students. The goal of this study was to extend the research on HIPs to explore potential connections with HIP participation and career outcomes. Using data from the National…

Using Multidimensional Methods to Understand the Development, Interpretation and Enactment of Quality Assurance Policy within the Educational Development Community

ERIC Educational Resources Information Center

Smith, Karen

2018-01-01

Policy texts are representations of practice that both reflect and shape the world around them. There is, however, little higher education research that critically analyses the impact of higher education policy on educational developers and educational development practice. Extending methods from critical discourse analysis by combining textual…

Crossing Borders: The Linguistic Practices of Aspiring Bilinguals in the Malay Community

ERIC Educational Resources Information Center

Rajadurai, Joanne

2011-01-01

This paper reports on a study of Malay learners of English in Malaysia as they attempt to extend their use of English outside the classroom and thus participate in new linguistic practices. Using a multiple case study approach, the study examines the narrative accounts of learners generated through student journals and focus group discussions.…

Adoption and Assisted Reproduction. Adoption and Ethics, Volume 4.

ERIC Educational Resources Information Center

Freundlich, Madelyn

The controversies in adoption have extended across a spectrum of policy and practice issues, and although the issues have become clear, resolution has not been achieved nor has consensus developed regarding a framework on which to improve the quality of adoption policy and practice. This book is the fourth in a series to use an ethics-based…

Postpartum Maternal Moods and Infant Size Predict Performance on a National High School Entrance Examination

ERIC Educational Resources Information Center

Galler, Janina R.; Ramsey, Frank C.; Harrison, Robert H.; Taylor, John; Cumberbatch, Glenroy; Forde, Victor

2004-01-01

Background: In an earlier series of studies, we documented the effects of feeding practices and postnatal maternal mood on the growth and development of 226 Barbadian children during the first few months of life. In this report, we extend our earlier studies by examining predictive relationships between infant size, feeding practices and…

Beyond Mother Education: Maternal Practices as Predictors of Early Literacy Development in Chilean Children from Low-SES Households

ERIC Educational Resources Information Center

Mendive, Susana; Lissi, María Rosa; Bakeman, Roger; Reyes, Adriana

2017-01-01

Research Findings: To extend findings that are mainly based on North American studies with English speakers, we studied 989 Chilean mothers from households of low socioeconomic status and their prekindergarten children, posing 2 questions: (a) Do mothers' self-reported practices about literacy development predict early literacy outcomes over and…

Quality Assurance: Adapting SERVQUAL to Measure the Perceived Quality of Pre-Service Teachers' Teaching Practice Experience

ERIC Educational Resources Information Center

Oliver, Henry; Koeberg, Jeremy

2013-01-01

This article describes a work in progress study which extends traditional quality assurance mechanisms through the application of the SERVQUAL instrument. It assesses the difference between pre-service teacher expectations and actual experience during a Teaching Practice period. Anecdotal evidence points to students being the recipients of poor…

Self-Controlled Amount of Practice Benefits Learning of a Motor Skill

ERIC Educational Resources Information Center

Post, Phillip G.; Fairbrother, Jeffrey T.; Barros, Joao A. C.

2011-01-01

Self-control over factors involving task-related information (e.g., feedback) can enhance motor learning. It is unknown if these benefits extend to manipulations that do not directly affect such information. The purpose of this study was to determine if self-control over the amount of practice would also facilitate learning. Participants learned…

Do Private Religious Practices Moderate the Relation between Family Conflict and Preadolescents' Depression and Anxiety Symptoms?

ERIC Educational Resources Information Center

Davis, Kelly A.; Epkins, Catherine C.

2009-01-01

We extended past research that focused on the relation between family conflict and preadolescents' depressive and anxiety symptoms. In a sample of 160 11- to 12-year-olds, we examined whether private religious practices moderated the relations between family conflict and preadolescents' depressive and anxiety symptoms. Although preadolescents'…

The Market Forces in Adoption. Adoption and Ethics, Volume 2.

ERIC Educational Resources Information Center

Freundlich, Madelyn

The controversies in adoption have extended across a spectrum of policy and practice issues, and although the issues have become clear, resolution has not been achieved nor has consensus developed regarding a framework on which to improve the quality of adoption policy and practice. This book is the second in a series to use an ethics-based…

Understanding the HighScope Approach: Early Years Education in Practice. Understanding the... Approach

ERIC Educational Resources Information Center

Wiltshire, Monica

2011-01-01

"Understanding the HighScope Approach" is a much needed source of information for those wishing to extend and consolidate their understanding of the HighScope Approach. It will enable the reader to analyse the essential elements of the HighScope Approach to early childhood and its relationship to quality early years practice. Exploring…

Treatment for Acquired Apraxia of Speech: Examination of Treatment Intensity and Practice Schedule

ERIC Educational Resources Information Center

Wambaugh, Julie L.; Nessler, Christina; Cameron, Rosalea; Mauszycki, Shannon C.

2013-01-01

Purpose: The authors designed this investigation to extend the development of a treatment for acquired apraxia of speech (AOS)--sound production treatment (SPT)--by examining the effects of 2 treatment intensities and 2 schedules of practice. Method: The authors used a multiple baseline design across participants and behaviors with 4 speakers with…

Adoption of Aquaculture Technology by Fish Farmers in Imo State of Nigeria

ERIC Educational Resources Information Center

Ike, Nwachukwu; Roseline, Onuegbu

2007-01-01

This paper evaluated the level of adoption of aquaculture technology extended to farmers in Imo State, Nigeria. To improve aquaculture practice in Nigeria, a technology package was developed and disseminated to farmers in the state. This package included ten practices that the farmers were supposed to adopt. Eighty-two respondents were randomly…

Learning Practice and Technology: Extending the Structurational Practice Lens to Educational Technology Research

ERIC Educational Resources Information Center

Halperin, Ruth

2017-01-01

Scholars in the field of educational technology have been calling for robust use of social theory within learning technology research. In view of that, interest has been noted in applying Giddens' structuration theory to the understanding of human interaction with technology in learning settings. However, only few such attempts have been published…

Joint Inquiry: Teachers' Collective Learning about the Common Core in High-Poverty Urban Schools

ERIC Educational Resources Information Center

Stosich, Elizabeth Leisy

2016-01-01

Recent research on the relationship between standards and teachers' practice suggests that teachers are unlikely to make changes to practice without extensive opportunities for learning about standards with colleagues. This article extends this line of research, using a comparative case study of three high-poverty urban schools to examine the…

Extending the Assessment of Literacy as Social Practice

ERIC Educational Resources Information Center

Stewart, John

2011-01-01

This article explores how the FETAC standards and processes at Levels 1 and 2 can be used to recognise literacy as a social practice. A summary review of the development of the National Framework of Qualifications is provided. Levels 1 to 4 in Ireland are compared with three key international frameworks, including OECD levels and those in Northern…

Applying Metaphor in HRD Research and Practice: Innovative Session.

ERIC Educational Resources Information Center

Short, Darren C.; Ardichvili, Alexander; Daley, Barbara J.; Kalata, Erica; Kraemer, Theresa J.; Kuchinke, K. Peter; Willis, Verna J.

A group of human resource development (HRD) practitioners participated in an innovative session on applying metaphor in HRD research and practice. The session objectives were as follows: (1) facilitate a dialogue between those who wrote for and those who read the Advances in Developing Human Resources (ADHR)issue on metaphor in HRD; (2) extend the…

A qualitative study of extended care permit dental hygienists in Kansas.

PubMed

Delinger, Janette; Gadbury-Amyot, Cynthia C; Mitchell, Tanya Villalpando; Williams, Karen B

2014-06-01

Currently, 37 states allow some type of alternative practice settings for dental hygienists. This qualitative study was designed to explore the experiences of the Extended Care Permit (ECP) dental hygienist in the state of Kansas. As a first ever study of this workforce model, a qualitative research design was chosen to illuminate the education and experiences of extended dental hygiene practitioners in order to understand the impact ECP legislation has had on increasing the public's access to oral health care services and define the advantages and limitation of this model as one potential solution to access to oral care. Snowball sampling was used to identify study participants who were actively engaged in extended care practice. Nine subjects, which included one ECP consultant and eight ECP providers, participated in this study. Data obtained via personal interviews and through document analysis data were subsequently coded and thematically analyzed by three examiners. An independent audit was conducted by a fourth examiner to confirm dependability of results. Seven major categories emerged from the data analysis: entrepreneur dental hygienist, partnerships, funding, barriers, sustainability, models of care and the impact of the ECP. The findings of this study revealed that ECP hygienists are making an impact with underserved populations, primarily children, the elderly and special needs patients. Copyright © 2014 The American Dental Hygienists’ Association.

Teachers Providing Social and Emotional Support: A Study of Advisor Role Enactment in Small High Schools

ERIC Educational Resources Information Center

Phillippo, Kate L.

2010-01-01

Background/Context: This study investigates the teacher's role in the student advisory process, which to date has generated limited research literature. Teachers who serve as student advisors assume a role that extends beyond the more traditional instructional role, and includes implied or explicit expectations to provide student advisees with…

Role Resources and Work-Family Enrichment: The Role of Work Engagement

ERIC Educational Resources Information Center

Siu, Oi-ling; Lu, Jia-fang; Brough, Paula; Lu, Chang-qin; Bakker, Arnold B.; Kalliath, Thomas; O'Driscoll, Michael; Phillips, David R.; Chen, Wei-qing; Lo, Danny; Sit, Cindy; Shi, Kan

2010-01-01

This article proposes a theoretical model of work-family enrichment and tests the mediating role of work engagement. The inclusion of work engagement extends prior research on work-family interface, and allows for examination of the effects of role resources (job resources, family support) on work-family enrichment. A two-wave survey was conducted…

Faculty Practice: Something for Everyone.

ERIC Educational Resources Information Center

Nichols, Carol

1985-01-01

Faculty practice (a clinical practice based in the educational institution and staffed and directed by faculty who participate in that practice) is examined as it applies to nursing educators. Elements discussed include faculty responsibility and group functioning, director role, clinical secretary role, clinical setting, patient characteristics,…

Negotiating multiple roles: link teachers in clinical nursing practice.

PubMed

Ramage, Charlotte

2004-02-01

The background to this study was a concern about the teacher's role in clinical practice. Experience suggested that teachers believed that their role in practice was important but that there were significant forces which impeded their ability to move with ease between education and practice. A discrepancy between previous research findings and theoretical discussions, and the reality experienced by teachers, led to the adoption of grounded theory as a way of exploring uncertainties in the situation. Data were gathered over a period of 7 years and involved 28 in-depth interviews with nurses with a range of educational roles, employed in educational institutions and practice settings in inner city and provincial areas in the South of England. The data revealed four categories, 'gaining access', 'negotiating credibility', 'being effective' and the core category 'negotiating multiple roles'. The core category is addressed in this article. Experiences of moving from a position of clinical practitioner to link teacher involved: 'disassembling the self' through leaving behind old identities; 'reconstructing the self' through clarifying new ways of being; and, finally, 'realizing the self' through reciprocal interpersonal activity with students, educational and nursing colleagues. It is inevitable that an individual with a remit for change entering an established social group will experience difficulties in establishing their role. It is also clear that an individual who changes their role within a group to reflect behaviours not congruent with the primary activity in that setting will experience dimensions of social exclusion. Further work needs to address how educational roles can make a significant impact on the everyday lives of students and nurses working in practice. The findings of this study are as relevant for the new roles of practice educator, clinical facilitator and practice placement co-ordinator as they are for link teachers and lecturer practitioners. Several suggestions are made to improve links with practice.

Role Stress among Practicing School Counselors

ERIC Educational Resources Information Center

Culbreth, John R.; Scarborough, Janna L.; Banks-Johnson, Angela; Solomon, Stacey

2005-01-01

Practicing school counselors (N = 512) were surveyed, using the Role Questionnaire (J. R. Rizzo, R. J. House, & S. I. Lirtzman, 1970), to determine levels of role conflict, role incongruence, and role ambiguity. Additionally, 8 characteristics of the participants' positions as school counselors were examined to determine what factors might affect…

The making of a nurse manager: the role of experiential learning in leadership development.

PubMed

Cathcart, Eloise Balasco; Greenspan, Miriam; Quin, Matthew

2010-05-01

To articulate the experientially acquired knowledge, skill and ethics embedded in nurse manager practice and describe the ways in which they were developed. The role of the nurse manager is usually described in lists of competencies, talents and traits which fail to capture the experience-based judgment and practical knowledge in this pivotal organizational role. Using Benner's methodology of practice articulation, 32 nurse managers wrote and interpreted first person narratives of their practice. The experience level of the group ranged from new nurse managers to those with more than 10 years' role tenure. The seminars were facilitated by a seasoned nurse executive and nurse manager with expertise in narrative interpretation. Interpretation of the paradigm case of one nurse manager suggests that complex leadership challenges can be a source of significant experiential learning for the individual and for the group. CONCLUSIONS; Articulating and reflecting on experiential learning elucidates the skilled knowledge and judgment embedded in nurse manager practice which cannot be accessed in any other way. Articulating the practical knowledge which is necessary for effective nurse manager practice can hasten the development of role incumbents.

Rational accountability and rational autonomy in academic practice: An extended case study of the communicative ethic of interdisciplinary science

NASA Astrophysics Data System (ADS)

Robertson, Susan Margaret

The dissertation investigates the interaction of rational accountability and rational autonomy in interdisciplinary science within the lifeworld of the university. It focuses on the cultural, social and motivational forces that university researchers draw on, and develop, to constitute and regulate interdisciplinary science. Findings are analyzed within an applied critical social theory framework that attends to the interaction of instrumental and communicative rational action within the public spaces that constitute the lifeworld of the university as a public sphere in society. The research raises questions of how academics practice interdisciplinary science and how these practices relate to the reproduction of the regulative ideal of the university as a community that practices public reason. The conceptual framework informing the research is Habermas' (1984) theory of communicative action. Using Burawoy's (1991) extended case study method as an operational strategy, two modes of constituting and regulating interdisciplinary science were found. Instrumental rational modes dominated in social contexts of interdisciplinary science where consensus on the normative goals and purposes of rational academic action were pre-existing and pre-supposed by participants. Communicative rational modes dominated in social contexts of interdisciplinary science where the normative goals and purposes of rational academic action entered a contested domain. Endorsements for interdisciplinary science policies are coinciding with demands for increased accountability and relevance of Canada's university system. At the same time that the university system must respond to external demands, it must reproduce itself as a public institution open to the discursive redemption of factual and normative validity claims. The study found that academics participate in, but also contest the instrumental regulation of academic inquiry and conduct by using their constitutional autonomy and freedom to hold others accountable and demonstrate a rational disposition to realize mutual understanding on factual and normative validity claims. By demonstrating a rational disposition to practice autonomy and freedom in realizing mutual understanding on contested validity claims within the lifeworld of the university, public intellectuals realize a capacity for extending the regulative ideal of practicing public reason within the university into the constitution and regulation of public spaces for practicing public reason in the lifeworld of society.

Teacher-Student Relationship and SNS-Mediated Communication: Perceptions of Both Role-Players

ERIC Educational Resources Information Center

Forkosh-Baruch, Alona; Hershkovitz, Arnon; Ang, Rebecca P.

2015-01-01

Teacher-student relationships are vital for academic and social development of students, for teachers' professional and personal development, and for having a supportive learning environment. In the digital age, these relationships can extend beyond bricks and mortar and beyond school hours. Specifically, these relationships are extended today…

Evidence-based medicine: is translating evidence into practice a solution to the cost-quality challenges facing medicine?

PubMed

Larson, E B

1999-09-01

Evidence-based medicine (EBM) and practice guidelines have been embraced by increasing numbers of scholars, administrators, and medical journalists as an intellectually attractive solution to the dilemma of improving health care quality while reducing costs. However, certain factors have thus far limited the role that EBM might play in resolving cost-quality trade-offs. Beyond the quality of the guideline and the evidence base itself, critical factors for success include local clinician involvement, a unified or closed medical staff, protocols that minimize use of clinical judgment and that call for involvement of so-called physician extenders (such as nurse practitioners and physician assistants), and financial incentive. TROUBLESOME ISSUES RELATED TO COST-QUALITY TRADE-OFFS: Rationing presents many dilemmas, but for physicians one critical problem is determining what is the physician's responsibility. Is the physician to be the patient's advocate, or should the physician be the advocate of all patients (the patients' advocate)? How do we get physicians out of potentially conflicted roles? EBM guidelines are needed to help minimize the number of instances physicians are asked to ration care at the bedside. If the public can decide to share and limit resources--presumably based on shared priorities--physicians would have a basis to act as advocates for all patients. Although EBM alone is not a simple solution to the problems of increasing costs and public expectations, it can be an important source of input and information in relating the value of service and medical technology to public priorities.

Examining the implementation of collaborative competencies in a critical care setting: Key challenges for enacting competency-based education.

PubMed

Goldman, Joanne; Kitto, Simon; Reeves, Scott

2017-11-21

Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions of interprofessional collaboration in a medical surgical ICU in a community teaching hospital in Canada. Approximately 160 hours of observations were undertaken and 24 semi-structured interviews with healthcare workers were conducted over a period of 6 months. Data were analysed using a directed content approach where two national competency frameworks were used to help generate an understanding of the practice of interprofessional collaboration. Healthcare professionals demonstrated numerous instances of interprofessional communication, role understandings, and teamwork in the ICU setting, which supported a number of key collaborative competencies. However, organisational factors such as pressures for discharge and patient flow, staffing, and lack of prioritisation for interprofessional learning undermined competencies designed to improve collaboration and teamwork. The findings demonstrate that interprofessional competencies can play an important role in promoting knowledge, attitudes, skills, and behaviours needed. However, competencies that promote interprofessional collaboration are dependent on a range of contextual factors that enable (or impede) individuals to actually enact these competencies.

The clinical nurse leader: a response from practice.

PubMed

Drenkard, Karen Neil

2004-01-01

In October 2003, over 200 nurse leaders from education and practice met at the invitation of the American Association of Colleges of Nursing. A newly released white paper, describing the role of the clinical nurse leader, was discussed at the conference. This article outlines a response to that white paper from one practice setting. The article shares information about another role, that of team coordinator, that is similar to clinical nurse leader and has been implemented at an integrated not-for-profit health care system in 5 hospitals. The comparison of the team coordinator role to the clinical nurse leader role might assist in visualizing such a role in practice. Although the roles are not identical, many of the driving forces for change were similar; these included the need to meet the changing demands for improved patient outcomes and nurse retention. The team coordinator role has 4 domains of practice that are crosswalked against the clinical nurse leader 15 core competencies. An evaluation of the team coordinator role showed changes that need to be made, such as placing more emphasis on clinical progression of patients. Lessons learned are shared, including keeping the scope of the role manageable, providing documentation standards for new roles, and the leadership required of the nursing executive to implement change.