Global History. A Curriculum Guide. Second Semester. Theme III: The Emergence of the Modern World. Student Worksheets. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

This bulletin of student worksheets complements teacher strategies for Theme III entitled, "Changes in Thought and Action Led to the Emergence of the Modern World." The worksheets contain materials corresponding to specific strategies, and the questions which accompany each worksheet are included on the appropriate strategy page. Included are…

Genes2WordCloud: a quick way to identify biological themes from gene lists and free text.

PubMed

Baroukh, Caroline; Jenkins, Sherry L; Dannenfelser, Ruth; Ma'ayan, Avi

2011-10-13

Word-clouds recently emerged on the web as a solution for quickly summarizing text by maximizing the display of most relevant terms about a specific topic in the minimum amount of space. As biologists are faced with the daunting amount of new research data commonly presented in textual formats, word-clouds can be used to summarize and represent biological and/or biomedical content for various applications. Genes2WordCloud is a web application that enables users to quickly identify biological themes from gene lists and research relevant text by constructing and displaying word-clouds. It provides users with several different options and ideas for the sources that can be used to generate a word-cloud. Different options for rendering and coloring the word-clouds give users the flexibility to quickly generate customized word-clouds of their choice. Genes2WordCloud is a word-cloud generator and a word-cloud viewer that is based on WordCram implemented using Java, Processing, AJAX, mySQL, and PHP. Text is fetched from several sources and then processed to extract the most relevant terms with their computed weights based on word frequencies. Genes2WordCloud is freely available for use online; it is open source software and is available for installation on any web-site along with supporting documentation at http://www.maayanlab.net/G2W. Genes2WordCloud provides a useful way to summarize and visualize large amounts of textual biological data or to find biological themes from several different sources. The open source availability of the software enables users to implement customized word-clouds on their own web-sites and desktop applications.

Global History. A Curriculum Guide. Second Semester. Theme III: The Emergence of the Modern World. Teacher Strategies. Experimental Edition.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Div. of Curriculum and Instruction.

The global history course syllabus, Theme III, entitled, "Changes in Thought and Action Led to the Emergence of the Modern World," focuses on the European impact upon the world as well as the cross-cultural influences which resulted in important developments such as the Commercial Revolution. These influences include contributions of the…

Therapeutic Affordances of Social Media: Emergent Themes From a Global Online Survey of People With Chronic Pain

PubMed Central

Gray, Kathleen; Martin-Sanchez, Fernando

2014-01-01

Background Research continues to present tenuous suggestions that social media is well suited to enhance management of chronic disease and improve health outcomes. Various studies have presented qualitative reports of health outcomes from social media use and have examined discourse and communication themes occurring through different social media. However, there is an absence of published studies examining and unpacking the underlying therapeutic mechanisms driving social media’s effects. Objective This paper presents a qualitative analysis thoroughly describing what social media therapeutically affords people living with chronic pain who are self-managing their condition. From this therapeutic affordance perspective, we aim to formulate a preliminary conceptual model aimed at better understanding "how" social media can influence patient outcomes. Methods In total, 218 people with chronic pain (PWCP) completed an online survey, investigating patient-reported outcomes (PROs) from social media use. Supplementary to quantitative data collected, participants were also given the opportunity to provide further open commentary regarding their use of social media as part of chronic pain management; 68/218 unique users (31.2%) chose to provide these free-text responses. Through thematic content analysis, 117 free-text responses regarding 10 types of social media were coded. Quotes were extracted and tabulated based on therapeutic affordances that we had previously identified. Inductive analysis was then performed to code defining language and emergent themes central to describing each affordance. Three investigators examined the responses, developed the coding scheme, and applied the coding to the data. Results We extracted 155 quotes from 117 free-text responses. The largest source of quotes came from social network site users (78/155, 50.3%). Analysis of component language used to describe the aforementioned affordances and emergent themes resulted in a final revision

Teaching Public Administration: Key Themes 1996-2016

ERIC Educational Resources Information Center

Fenwick, John

2018-01-01

In this article, the aim is to explore some of the key themes to emerge in the journal during the past two decades. Each selected theme will be reviewed in the light of issues raised in particular papers. The aim of this approach is, first, to facilitate reflection upon the contribution of the journal as its subject matter has moved from a concern…

Genes2WordCloud: a quick way to identify biological themes from gene lists and free text

PubMed Central

2011-01-01

Background Word-clouds recently emerged on the web as a solution for quickly summarizing text by maximizing the display of most relevant terms about a specific topic in the minimum amount of space. As biologists are faced with the daunting amount of new research data commonly presented in textual formats, word-clouds can be used to summarize and represent biological and/or biomedical content for various applications. Results Genes2WordCloud is a web application that enables users to quickly identify biological themes from gene lists and research relevant text by constructing and displaying word-clouds. It provides users with several different options and ideas for the sources that can be used to generate a word-cloud. Different options for rendering and coloring the word-clouds give users the flexibility to quickly generate customized word-clouds of their choice. Methods Genes2WordCloud is a word-cloud generator and a word-cloud viewer that is based on WordCram implemented using Java, Processing, AJAX, mySQL, and PHP. Text is fetched from several sources and then processed to extract the most relevant terms with their computed weights based on word frequencies. Genes2WordCloud is freely available for use online; it is open source software and is available for installation on any web-site along with supporting documentation at http://www.maayanlab.net/G2W. Conclusions Genes2WordCloud provides a useful way to summarize and visualize large amounts of textual biological data or to find biological themes from several different sources. The open source availability of the software enables users to implement customized word-clouds on their own web-sites and desktop applications. PMID:21995939

Intuition in emergency nursing: a phenomenological study.

PubMed

Lyneham, Joy; Parkinson, Camillus; Denholm, Carey

2008-04-01

The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

A Fantasy Theme Analysis of Nixon's "Checkers" Speech.

ERIC Educational Resources Information Center

Wells, William T.

1996-01-01

Applies fantasy theme analysis to Richard Nixon's "Checkers" speech. States that three major themes emerge: Nixon as Moral Model, Nixon as the American Dream, and Nixon as Patriot. Points out that each issue responds to allegations of dishonesty that were leveled against him at the time. Argues that Nixon's speech was accepted and…

Effective use of forensic science in volume crime investigations: identifying recurring themes in the literature.

PubMed

Ludwig, Anika; Fraser, Jim

2014-01-01

New scientific, technological and legal developments, particularly the introduction of national databases for DNA and fingerprints, have led to increased use of forensic science in the investigation of crime. There is an assumption, and in some instances specific assertions, that such developments bring improvements either in broad criminal justice terms or more narrowly in terms of economic or practical efficiencies. The underlying presumption is that the new technological opportunities will be understood and effectively implemented. This research investigates whether such increases in activity have also been accompanied by improvements in the effective use of forensic science. A systematic review of thirty-six reports published (predominantly in England and Wales) since the 1980s, which have considered the use of forensic science in the investigation of volume crimes, was carried out. These reports have identified a number of recurrent themes that influenced how effectively forensic science was used in investigations. The themes identified included forensic knowledge and training of investigators, communication and information exchange between specialists and investigators, timeliness of forensic results, interagency relationships and deployment of crime scene examiner resources. The research findings suggest that these factors continue to hinder the effective use of forensic science despite technological advances and this paper considers their potential causes. © 2013.

New Themes in Physics Teaching: A Personal Retrospective

ERIC Educational Resources Information Center

Dykstra, Dewey I., Jr.

2012-01-01

For a little over 40 years, what we label now physics education research has been conducted. As a result, a new type of theme in the research and in physics education has emerged. Some of these themes are cognitivism, research as qualitative, learning as construction of knowledge, theoretical underpinnings that are not realist, student-centered…

Ask an anatomist: Identifying global trends, topics and themes of academic anatomists using twitter.

PubMed

Marsland, Madeleine J; Lazarus, Michelle D

2018-05-06

Social media (SoMe) is increasingly used in higher education (HE) to access knowledge and enable global communication. The SoMe platform Twitter ® is particularly beneficial in these contexts because it is readily accessible, easily searchable (via hashtags) and global. Given these advantages, the twitter platform @AskAnatomist was created to foster a global weekly tweet chat, where students and academics can ask and address anatomy-related questions. The aim of this study was to identify themes arising in the early stages of the @AskAnatomy Twitter community to gain insights into current needs/key areas for academic anatomists, students, and other followers. A qualitative analysis of tweets including the hashtag #AnatQ, (the associated @AskAnatomist hashtag), was undertaken to achieve this aim. Thematic analysis revealed three core themes arising in the formative stages of the @AskAnatomist Twitter site: (1) anatomical education modalities, (2) specific anatomy content, and (3) research motivations. These themes reveal controversies within the field of anatomical sciences, areas for potential education resource improvement and research, as well as the humor of anatomists. Though the original intent of the @AskAnatomist site was to engage the general public in anatomy content and knowledge, tweet analysis suggests that academic anatomists were the primary active "tweeters". Interestingly, this analysis reveals that the @AskAnatomist site progressed into a web-based community of practice (CoP), suggesting an additional benefit of SoMe communities in the field of anatomy. Anat Sci Educ 11: 270-281. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Exploratory Analysis of Marketing and Non-marketing E-cigarette Themes on Twitter

PubMed Central

Han, Sifei

2017-01-01

Electronic cigarettes (e-cigs) have been gaining popularity and have emerged as a controversial tobacco product since their introduction in 2007 in the U.S. The smoke-free aspect of e-cigs renders them less harmful than conventional cigarettes and is one of the main reasons for their use by people who plan to quit smoking. The US food and drug administration (FDA) has introduced new regulations early May 2016 that went into effect on August 8, 2016. Given this important context, in this paper, we report results of a project to identify current themes in e-cig tweets in terms of semantic interpretations of topics generated with topic modeling. Given marketing/advertising tweets constitute almost half of all e-cig tweets, we first build a classifier that identifies marketing and non-marketing tweets based on a hand-built dataset of 1000 tweets. After applying the classifier to a dataset of over a million tweets (collected during 4/2015 – 6/2016), we conduct a preliminary content analysis and run topic models on the two sets of tweets separately after identifying the appropriate numbers of topics using topic coherence. We interpret the results of the topic modeling process by relating topics generated to specific e-cig themes. We also report on themes identified from e-cig tweets generated at particular places (such as schools and churches) for geo-tagged tweets found in our dataset using the GeoNames API. To our knowledge, this is the first effort that employs topic modeling to identify e-cig themes in general and in the context of geo-tagged tweets tied to specific places of interest. PMID:28782062

Exploratory Analysis of Marketing and Non-marketing E-cigarette Themes on Twitter.

PubMed

Han, Sifei; Kavuluru, Ramakanth

2016-11-01

Electronic cigarettes (e-cigs) have been gaining popularity and have emerged as a controversial tobacco product since their introduction in 2007 in the U.S. The smoke-free aspect of e-cigs renders them less harmful than conventional cigarettes and is one of the main reasons for their use by people who plan to quit smoking. The US food and drug administration (FDA) has introduced new regulations early May 2016 that went into effect on August 8, 2016. Given this important context, in this paper, we report results of a project to identify current themes in e-cig tweets in terms of semantic interpretations of topics generated with topic modeling. Given marketing/advertising tweets constitute almost half of all e-cig tweets, we first build a classifier that identifies marketing and non-marketing tweets based on a hand-built dataset of 1000 tweets. After applying the classifier to a dataset of over a million tweets (collected during 4/2015 - 6/2016), we conduct a preliminary content analysis and run topic models on the two sets of tweets separately after identifying the appropriate numbers of topics using topic coherence. We interpret the results of the topic modeling process by relating topics generated to specific e-cig themes. We also report on themes identified from e-cig tweets generated at particular places (such as schools and churches) for geo-tagged tweets found in our dataset using the GeoNames API. To our knowledge, this is the first effort that employs topic modeling to identify e-cig themes in general and in the context of geo-tagged tweets tied to specific places of interest.

Toward the 1990s: Emerging Themes in School Counseling.

ERIC Educational Resources Information Center

Terrill, Jerry L.

1990-01-01

Over the years, school counseling has transcended its traditional vocational guidance function. Various trends and themes in school counseling are explored, including information access and use, prevention versus remediation issues, environmental engineering challenges, professional adaptability and change, and creation of school support systems…

Identifying priorities for quality improvement at an emergency Department in Ghana.

PubMed

DeWulf, Annelies; Otchi, Elom H; Soghoian, Sari

2017-08-30

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities. Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality. ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.

Rural Emergency Nurses' Suggestions for Improving End-of-Life Care.

PubMed

Beckstrand, Renea L; Smith, Kelly E; Luthy, Karlen E Beth; Macintosh, Janelle L B

2017-05-01

Many patient visits to emergency departments result in the patient dying or being pronounced dead on arrival. The numbers of deaths in emergency departments are likely to increase as a significant portion of the U.S. population ages. Consequently, emergency nurses face many obstacles to providing quality end-of-life (EOL) care when death occurs. The purpose of this study was to identify suggestions that emergency nurses have to improve EOL care, specifically in rural emergency departments. A 57-item questionnaire was sent to 53 rural hospitals in 4 states in the Intermountain West, plus Alaska. One item asked nurses to identify the one aspect of EOL care they would change for dying patients in rural emergency departments. Each qualitative response was individually reviewed by a research team and then coded into a theme. Four major themes and three minor themes were identified. The major themes were providing greater privacy during EOL care for patients and family members, increasing availability of support services, additional staffing, and improved staff and community education. Providing adequate privacy for patients and family members was a major obstacle to providing EOL care in the emergency department, largely because of poor department design, especially in rural emergency departments where space is limited. Lack of support services and adequate staffing were also obstacles to providing quality EOL care in rural emergency departments. Consequently, rural nurses are commonly pulled away from EOL care to perform ancillary duties because additional support personnel are lacking. Providing EOL care in rural emergency departments is a challenging task given the limited staffing and resources, and thus it is imperative that nurses' suggestions for improvement of EOL care be acknowledged. Because of the current lack of research in rural EOL care, additional research is needed. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights

Identifying and Addressing Themes of Job Dissatisfaction for Secondary Principals

ERIC Educational Resources Information Center

De Jong, David; Grundmeyer, Trent; Yankey, Julie

2017-01-01

Secondary principals serve in important roles that are complex, high-stress, and include demanding job responsibilities. Key stakeholders such as superintendents, school board members, and legislators must understand the challenges facing secondary principals in order to address the current themes of job dissatisfaction. Using new survey data…

Literature overview highlights lack of paediatric donation protocols but identifies common themes that could guide their development.

PubMed

Vileito, A; Siebelink, M J; Verhagen, Aae

2018-05-01

Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. PubMed, Web of Science, EMBASE and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates. This comprised title, abstract and then full-text screening of relevant data. We included 12 papers and two electronic sources that were mainly from North America and Europe. Most discussed donations after cardiac death. The recurring themes included identifying potential donors, approaching parents, palliative care and collaboration with organ procurement organisations. Most papers called for paediatric donation policies to be standardised. Scientific publications in English on paediatric donation protocols are very scarce. No comprehensive paediatric donation protocol was found. We identified several recurring themes in the literature that could be used to develop such protocols. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

International Business Education: Identifying the Emergent Topics in International Business and Their Relevance for Knowledge Development.

ERIC Educational Resources Information Center

Yeoh, Poh-Lin

2001-01-01

Sampled faculty in international business (IB) to better understand emerging themes in that area. Seven major topical areas were uncovered: general knowledge of IB, international trade and institutions, cross-cultural issues, managing global operations, international ethics, international monetary systems, and international political/regulatory…

Themes addressed by couples with advanced cancer during a communication skills training intervention.

PubMed

Porter, Laura S; Fish, Laura; Steinhauser, Karen

2018-04-25

Couple-based communication interventions have beneficial effects for patients with cancer and their partners. However, few studies have targeted patients with advanced stages of disease and little is known about how best to assist couples in discussing issues related to life-limiting illness. The purpose of the present study was to identify themes couples addressed during a couple communication skills intervention, and the frequency with which they discussed issues related to end-of-life. Content analyses were conducted on recordings of 72 sessions from 12 couples facing advanced gastrointestinal (GI) cancer. Coding was based six themes identified a priori from the framework for understanding what patients and family value at end of life. The percent of couples addressing each theme was calculated to gauge level of importance and acceptability of these topics. The majority of couples addressed topics previously identified as salient at end-of-life, including clear decision making, affirmation of the whole person, pain and symptom management, contributing to others, and preparation for death. In addition, novel aspects to these themes emerged in the context of couples' conversations, illustrating the importance of the couple relationship in adjusting to life with a life-limiting illness and anticipating the transition to end-of-life. Findings suggest that couples likely would be receptive to an intervention that combines training in communication skills with guidance in focusing on issues related to life completion to assist with transitions at end of life. Such interventions might enhance both individuals' abilities to cope with illness-related symptoms and demands, enjoy the time they have together, and derive meaning from the experience. Copyright © 2018. Published by Elsevier Inc.

Identifying barriers to the provision of bystander cardiopulmonary resuscitation (CPR) in high-risk regions: a qualitative review of emergency calls.

PubMed

Case, Rosalind; Cartledge, Susie; Siedenburg, Josine; Smith, Karen; Straney, Lahn; Barger, Bill; Finn, Judith; Bray, Janet E

2018-06-01

Understanding regional variation in bystander cardiopulmonary resuscitation (CPR) is important to improving out-of-hospital cardiac arrest (OHCA) survival. In this study we aimed to identify barriers to providing bystander CPR in regions with low rates of bystander CPR and where OHCA was recognised in the emergency call. We retrospectively reviewed emergency calls for adults in regions of low bystander CPR in the Australian state of Victoria. Included calls were those where OHCA was identified during the call but no bystander CPR was given. A thematic content analysis was independently conducted by two investigators. Saturation of themes was reached after listening to 139 calls. Calls progressed to the point of compression instructions before EMS arrival in only 26 (18.7%) of cases. Three types of barriers were identified: procedural barriers (time lost due to language barriers and communication issues; telephone problems), CPR knowledge (skill deficits; perceived benefit) and personal factors (physical frailty or disability; patient position; emotional factors). A range of factors are associated with barriers to delivering bystander CPR even in the presence of dispatcher instructions -some of which are modifiable. To overcome these barriers in high-risk regions, targeted public education needs to provide information about what occurs in an emergency call, how to recognise an OHCA and to improve CPR knowledge and skills. Copyright © 2018. Published by Elsevier B.V.

Learning from critical case reviews: emergent themes and their impact on practice.

PubMed

Crofts, Linda

2006-12-01

This paper describes the process of conducting critical case reviews as part of a leadership programme for critical care. Forty-five cases were reviewed over 2 years in five different hospitals and permission was sought from local research ethics committees and research and development committees for the discussions to be treated as research data. Typically the cases presented were patients with complex needs whose trajectory of care had not gone smoothly. Key themes to emerge from the case reviews were: The case reviews themselves were: Communication failures between professional groups, between professional themselves, between staff and families, between wards and departments and between different hospitals. Documentation was also often less than satisfactory. Teams often had problems in working together as a team and different professionals often had different expectations of other members of the team. Individual action may compensate for weaknesses in formal clinical risk system. The case reviews themselves were showcases of the difficulties the health service faces every day and the challenges of communicating effectively. The case reviews provided an effective medium to both resolve those difficulties and model a means through which teams could effectively manage and communicate patient care issues. Furthermore their strength as a learning tool was attributed to team learning as a powerful catalyst for change.

Effects of marital conflict on children: recent advances and emerging themes in process-oriented research.

PubMed

Cummings, E Mark; Davies, Patrick T

2002-01-01

The effects of marital conflict on children's adjustment are well documented. For the past decade research has increasingly focused on advancing a process-level understanding of these effects, that is, accounting for the particular responses and patterns embedded within specific contexts, histories, and developmental periods that account for children's outcomes over time. As a vehicle for presenting an update, this review follows the framework for process-oriented research initially proposed by Cummings and Cummings (1988), concentrating on recent research developments, and also considering new and emerging themes in this area of research. In this regard, areas of advancement include (a) greater articulation of the effects of specific context/stimulus characteristics of marital conflict, (b) progress in identifying the psychological response processes in children (e.g., cognitive, emotional, social, physiological) that are affected and their possible role in accounting for relations between marital conflict and child outcomes, (c) greater understanding of the role of child characteristics, family history, and other contextual factors, including effects on children due to interrelations between marital conflict and parenting, and (d) advances in the conceptualization of children's outcomes, including that effects may be more productively viewed as dynamic processes of functioning rather than simply clinical diagnoses. Understanding of the impact of marital conflict on children as a function of time-related processes remains a gap in a process-oriented conceptualization of effects. Based on this review, a revised model for a process-oriented approach on the effects of marital discord on children is proposed and suggestions are made for future research directions.

The origins of psychology in Italy: Themes and authors that emerge through a content analysis of the Rivista di Filosofia Scientifica [Journal of Scientific Philosophy].

PubMed

Bartolucci, Chiara; Lombardo, Giovanni Pietro

2012-08-01

This article examines the scientific-cultural context of the second half of the 1800s, during which psychological science emerged in Italy. The article explores the contribution made by the emergence of the primary research traditions of that period, namely, physiological anthropology and phreniatry, by means of a methodology that combines content analysis with a classical historiographical study of the period. Themes and authors deriving from the various disciplines in the human and natural sciences were identified through a content analysis of the Rivista di Filosofia Scientifica [Journal of Scientific Philosophy], a periodical that is representative of Italian positivism. The analysis highlights the epistemological perspective held by scholars who, distancing themselves from the mechanistic reductionism of the proponents of positivism, integrated a naturalistic and evolutionary conceptualization with the neo-Kantian critique. A clearly delineated naturalistic and differential perspective of scientific research that brought about the birth of psychology as an experimental discipline in Italy in the 1900s emerges from the analysis, including psychology and psychopathology as studied by the phreniatrists Gabriele Buccola, Enrico Morselli, and Eugenio Tanzi; Tito Vignoli and Giuseppe Sergi's work in comparative anthropology; Giulio Fano's approach and contribution to physiology; and Enrico Ferri's contribution to criminology. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Developing practical knowledge content of emergency nursing professionals.

PubMed

Chu, Wen; Hsu, Li-Ling

2011-06-01

There is a paucity of published research on clinical or practical nursing knowledge. The ways that nurses acquire, develop, and maintain emergency room (ER) nursing care skills is a research area, in particular, that deserves further investigation. This study examined clinical setting learning processes to better understand the practical knowledge content of ER nurses. This study used a phenomenological approach and in-depth interviews of 10 nurses. Each participant had at least 3 years of ER experience. Researchers used Moustakas' method to analyze interview data. Findings were checked for credibility, transferability, dependability, and confirmability. The authors identified four major practical knowledge themes for ER professionals. These were (a) basic emergency treatment procedure routines and symptom management; (b) disease mechanisms, pharmacodynamics, and treatment responses; (c) newly identified diseases, updated emergency treatments and techniques, and medical treatment discussions; and (d) identifying nursing values including nursing attitudes and continuing patient care. Participants in this study had experience with the first three themes and successfully combined various types of nursing knowledge in their nursing care duties. Only few participants indicated experience with the fourth theme. Findings clarify that clinical or practical knowledge in ER nurses evolves first from declarative knowledge (e.g., basic emergency treatment routines and operating procedures) to procedural knowledge (e.g., instructions from supervisors, actual practice, and drills) to conditional knowledge (e.g., observation and treatment involving direct interactions with patients). Nurses should combine and apply the various knowledge types in their nursing practice to assess comprehensively each patient's condition and administer effective treatment and service.

Identifying barriers for out of hospital emergency care in low and low-middle income countries: a systematic review.

PubMed

Kironji, Antony Gatebe; Hodkinson, Peter; de Ramirez, Sarah Stewart; Anest, Trisha; Wallis, Lee; Razzak, Junaid; Jenson, Alexander; Hansoti, Bhakti

2018-04-19

Out-of-hospital emergency care (OHEC), also known as prehospital care, has been shown to reduce morbidity and mortality from serious illness. We sought to summarize literature for low and low-middle income countries to identify barriers to and key interventions for OHEC delivery. We performed a systematic review of the peer reviewed literature from January 2005 to March 2015 in PubMed, Embase, Cochrane, and Web of Science. All articles referencing research from low and low-middle income countries addressing OHEC, emergency medical services, or transport/transfer of patients were included. We identified themes in the literature to form six categories of OHEC barriers. Data were collected using an electronic form and results were aggregated to produce a descriptive summary. A total 1927 titles were identified, 31 of which met inclusion criteria. Barriers to OHEC were divided into six categories that included: culture/community, infrastructure, communication/coordination, transport, equipment and personnel. Lack of transportation was a common problem, with 55% (17/31) of articles reporting this as a hindrance to OHEC. Ambulances were the most commonly mentioned (71%, 22/31) mode of transporting patients. However, many patients still relied on alternative means of transportation such as hired cars, and animal drawn carts. Sixty-one percent (19/31) of articles identified a lack of skilled personnel as a key barrier, with 32% (10/31) of OHEC being delivered by laypersons without formal training. Forty percent (12/31) of the systems identified in the review described a uniform access phone number for emergency medical service activation. Policy makers and researchers seeking to improve OHEC in low and low-middle income countries should focus on increasing the availability of transport and trained providers while improving patient access to the OHEC system. The review yielded articles with a primary focus in Africa, highlighting a need for future research in diverse

Riboswitches: emerging themes in RNA structure and function.

PubMed

Montange, Rebecca K; Batey, Robert T

2008-01-01

Riboswitches are RNAs capable of binding cellular metabolites using a diverse array of secondary and tertiary structures to modulate gene expression. The recent determination of the three-dimensional structures of parts of six different riboswitches illuminates common features that allow riboswitches to be grouped into one of two types. Type I riboswitches, as exemplified by the purine riboswitch, are characterized by a single, localized binding pocket supported by a largely pre-established global fold. This arrangement limits ligand-induced conformational changes in the RNA to a small region. In contrast, Type II riboswitches, such as the thiamine pyrophosphate riboswitch, contain binding pockets split into at least two spatially distinct sites. As a result, binding induces both local changes to the binding pocket and global architecture. Similar organizational themes are found in other noncoding RNAs, making it possible to begin to build a hierarchical classification of RNA structure based on the spatial organization of their active sites and associated secondary structural elements.

Perceived challenges to obtaining informed consent for a time-sensitive emergency department study of pediatric status epilepticus: results of two focus groups.

PubMed

Chamberlain, James M; Lillis, Kathleen; Vance, Cheryl; Brown, Kathleen M; Fawumi, Olubunmi; Nichols, Shari; Davis, Colleen O; Singh, Tasmeen; Baren, Jill M

2009-08-01

The objective was to describe the perspective of research personnel on issues of informed consent in a time-sensitive clinical study under emergency circumstances. The authors convened concurrent focus groups of research staff and investigators involved in a pharmacokinetic study of lorazepam for status epilepticus (SE). Moderators led discussion with open-ended questions on selected issues of parental consent, communication and understanding, patient assent, and comparison to other types of studies. Focus group transcripts were analyzed to identify themes and subthemes from the discussions. Most themes and subthemes were identified in both research staff and investigator focus groups. Focus group discussion points were categorized into three main themes: barriers to and enablers of informed consent, barriers to and enablers of actual enrollment, and overall ethical concerns about the research. Many of the issues identified were unique to emergency research. From the perspectives of research staff and investigators enrolling patients in a time-sensitive emergency department study, the authors identified several areas of concern that should be addressed when planning future emergency studies.

Language Teacher Associations: Key Themes and Future Directions

ERIC Educational Resources Information Center

Paran, Amos

2016-01-01

This article presents the themes that emerge from this Special Issue on language teacher associations (LTAs). I discuss various conceptualizations of LTAs, as well as the different theoretical frameworks which the contributors to the Special Issue use in their analyses. I then focus on some of the ways in which LTAs achieve their mission of…

Scientometric methods for identifying emerging technologies

DOEpatents

Abercrombie, Robert K; Schlicher, Bob G; Sheldon, Frederick T

2015-11-03

Provided is a method of generating a scientometric model that tracks the emergence of an identified technology from initial discovery (via original scientific and conference literature), through critical discoveries (via original scientific, conference literature and patents), transitioning through Technology Readiness Levels (TRLs) and ultimately on to commercial application. During the period of innovation and technology transfer, the impact of scholarly works, patents and on-line web news sources are identified. As trends develop, currency of citations, collaboration indicators, and on-line news patterns are identified. The combinations of four distinct and separate searchable on-line networked sources (i.e., scholarly publications and citation, worldwide patents, news archives, and on-line mapping networks) are assembled to become one collective network (a dataset for analysis of relations). This established network becomes the basis from which to quickly analyze the temporal flow of activity (searchable events) for the example subject domain.

Role of Pediatric Emergency Physicians in Identifying Bullying.

PubMed

Waseem, Muhammad; Paul, Audrey; Schwartz, Gerald; Pauzé, Denis; Eakin, Paul; Barata, Isabel; Holtzman, Doug; Benjamin, Lee S; Wright, Joseph L; Nickerson, Amanda B; Joseph, Madeline

2017-02-01

Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives. Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources. This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support. The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying. Copyright © 2016 Elsevier Inc. All rights reserved.

Chameleon Changes: An Exploration of Racial Identity Themes of Multiracial People

ERIC Educational Resources Information Center

Miville, Marie L.; Constantine, Madonna G.; Baysden, Matthew F.; So-Lloyd, Gloria

2005-01-01

The current study explored essential themes of racial identity development among 10 self-identified multiracial adults from a variety of racial backgrounds. Participants were interviewed using a semistructured protocol, and the interviews were recorded, transcribed, and then coded for themes by research team members. Four primary themes were…

Theme 1 Overview: Living in Communities in the Circumpolar North.

ERIC Educational Resources Information Center

Hodge, Tony

1998-01-01

An eight-nation intergovernmental council concerned with sustainable development in the Arctic conducted workshops on ecosystem health, youth, alternative energy, housing, transportation, and waste management. Seven themes emerged that included community involvement in decision making, consideration of local capacities, development of information…

Emergent themes in the sustainability of primary health care innovation.

PubMed

Sibthorpe, Beverly M; Glasgow, Nicholas J; Wells, Robert W

2005-11-21

A synthesis of the findings of the five studies of sustainability of primary health care innovation across six domains (political, institutional, financial, economic, client and workforce) yielded three main themes. These were: the importance of social relationships, networks and champions; the effect of political, financial and societal forces; and the motivation and capacity of agents within the system. The need for routine assessment of the sustainability of primary health care innovations is discussed. Given the dearth of literature on the sustainability of primary health care innovation, there is potential to develop a program of research directed towards a future synthesis of evidence.

Key Themes in Mobile Learning: Prospects for Learner-Generated Learning through AR and VR

ERIC Educational Resources Information Center

Aguayo, Claudio; Cochrane, Thomas; Narayan, Vickel

2017-01-01

This paper summarises the findings from a literature review in mobile learning, developed as part of a 2-year six-institution project in New Zealand. Through the development of a key themes codebook, we address selected key themes with respect to their relevance to learner-generated learning through emerging technologies, with attention to mobile…

Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework.

PubMed

Kirk, Jeanette W; Sivertsen, Ditte M; Petersen, Janne; Nilsen, Per; Petersen, Helle V

2016-10-01

The aim was to identify the factors that were perceived as most important as facilitators or barriers to the introduction and intended use of a new tool in the emergency department among nurses and a geriatric team. A high incidence of functional decline after hospitalisation for acute medical illness has been shown in the oldest patients and those who are physically frail. In Denmark, more than 35% of older medical patients acutely admitted to the emergency department are readmitted within 90 days after discharge. A new screening tool for use in the emergency department aiming to identify patients at particularly high risk of functional decline and readmission was developed. Qualitative study based on semistructured interviews with nurses and a geriatric team in the emergency department and semistructured single interviews with their managers. The Theoretical Domains Framework guided data collection and analysis. Content analysis was performed whereby new themes and themes already existing within each domain were described. Six predominant domains were identified: (1) professional role and identity; (2) beliefs about consequences; (3) goals; (4) knowledge; (5) optimism and (6) environmental context and resources. The content analysis identified three themes, each containing two subthemes. The themes were professional role and identity, beliefs about consequences and preconditions for a successful implementation. Two different cultures were identified in the emergency department. These cultures applied to different professional roles and identity, different actions and sense making and identified how barriers and facilitators linked to the new screening tool were perceived. The results show that different cultures exist in the same local context and influence the perception of barriers and facilitators differently. These cultures must be identified and addressed when implementation is planned. © 2016 The Authors. Journal of Clinical Nursing Published by John

The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) and Substance Use Among College Students.

PubMed

Allem, Jon-Patrick; Sussman, Steve; Unger, Jennifer B

2017-12-01

Transition-to-adulthood themes, or thoughts and feelings about emerging adulthood, have been measured by the Inventory of the Dimensions of Emerging Adulthood (IDEA) and found to be associated with substance use among emerging adults. It has been suggested, however, that the IDEA is lengthy and may not include the most unique and theoretically relevant constructs of emerging adulthood. The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) was developed as an alternative instrument, but research has yet to determine the relationship between the IDEA-R and substance use among emerging adults (ages 18-25 years). College students completed surveys indicating their identification with transition-to-adulthood themes and substance use. Logistic regression models examined the associations between transition-to-adulthood themes and marijuana use and binge drinking, respectively. Participants who felt emerging adulthood was a time of identity exploration were less likely to report marijuana use, while feelings of experimentation/possibility were positively associated with marijuana use and binge drinking. The IDEA-R may be useful for identifying correlates of substance use among emerging adults. Future research should evaluate the IDEA-R among representative samples of emerging adults to confirm the findings of this study. Health professionals working in substance use prevention may consider targeting the themes of identity exploration and experimentation/possibility in programs intended for emerging adults.

Transitions Regarding Palliative and End-of-Life Care in Severe Chronic Obstructive Pulmonary Disease or Advanced Cancer: Themes Identified by Patients, Families, and Clinicians

PubMed Central

REINKE, LYNN F.; ENGELBERG, RUTH A.; SHANNON, SARAH E.; WENRICH, MARJORIE D.; VIG, ELIZABETH K.; BACK, ANTHONY L.; CURTIS, J. RANDALL

2015-01-01

Background Classic trajectories of illness at end of life (EOL) suggest different care needs for patients with cancer versus chronic obstructive pulmonary disease (COPD) and may lead to different experiences of transitions over the course of a life-limiting illness. Patients may experience transitions in different ways than clinicians. No prior studies have examined this issue from patients’, families’, and clinicians’ perspectives. Objectives We sought to explore transitions, defined as experiences that patients and family members viewed as milestones in the evolution of their illnesses and therapies, and compare these perceptions with the perspectives of the patient’s physician and nurse to provide insights about communication concerning EOL care. Methods We conducted a qualitative study using grounded theory to examine participants’ perspectives on the experiences of key transitions in the context of living with advanced COPD or cancer. In-depth interviews with patients, family members, nurses, and physicians were conducted by experienced interviewers. Results Six themes were identified regarding participants’ experiences with transitions. Themes that defined transitions among both patients with COPD and those with cancer included: new or different treatments and no more treatments available. Themes unique to patients with COPD were activity limitations due to functional decline and initiation of oxygen therapy. One theme unique to clinicians was acute exacerbation of illness or hospitalization. Conclusions This study identified differences in the meaning of transitions for patients versus clinicians and for patients with COPD versus those with cancer. These findings may offer clinicians the opportunity to provide a more patient-centered approach to communication about end-of-life care by acknowledging and addressing transitions in palliative care from the perspective of the patient and family. PMID:18454613

Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

PubMed

Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

2014-12-01

Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

A Critical Analysis of Global Competition in Higher Education: Synthesizing Themes

ERIC Educational Resources Information Center

Portnoi, Laura M.; Bagley, Sylvia S.

2014-01-01

In this final chapter of the volume, the editors synthesize key themes that emerge from the preceding chapters. They also highlight the contributions the authors make through emphasizing critical perspectives and the tension between global and local forces.

Theme-Oriented Group Therapy.

ERIC Educational Resources Information Center

Richards, R. Lynn; And Others

1990-01-01

Describes the three major influences on theme-oriented groups: theme-centered interactional, structured, and behavioral groups. Provides a comparison of the composition and structure of theme groups during the current decade. Summarizes the general principles thought to be important in the construction and development of theme-oriented groups.…

Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

ERIC Educational Resources Information Center

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-01-01

Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

Themes of grief.

PubMed

Carter, S L

1989-01-01

A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

Recent Themes in Social Networking Service Research.

PubMed

Liu, John S; Ho, Mei Hsiu-Ching; Lu, Louis Y Y

2017-01-01

The body of literature addressing the phenomenon related to social networking services (SNSs) has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen.

Recent Themes in Social Networking Service Research

PubMed Central

Liu, John S.; Ho, Mei Hsiu-Ching; Lu, Louis Y. Y.

2017-01-01

The body of literature addressing the phenomenon related to social networking services (SNSs) has grown rather fast recently. Through a systematic and quantitative approach, this study identifies the recent SNS research themes, which are the issues discussed by a coherent and growing subset of this literature. A set of academic articles retrieved from the Web of Science database is used as the basis for uncovering the recent themes. We begin the analysis by constructing a citation network which is further separated into groups after applying a widely used clustering method. The resulting clusters all consist of articles coherent in citation relationships. This study suggests eight fast growing recent themes. They span widely encompassing politics, romantic relationships, public relations, journalism, and health. Among them, four focus their issues largely on Twitter, three on Facebook, and one generally on both. While discussions on traditional issues in SNSs such as personality, motivations, self-disclosure, narcissism, etc. continue to lead the pack, the proliferation of the highlighted recent themes in the near future is very likely to happen. PMID:28107541

An exploration of emergency nurses' perceptions, attitudes and experience of teamwork in the emergency department.

PubMed

Grover, Elise; Porter, Joanne E; Morphet, Julia

2017-05-01

Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Three major themes emerged from the data. The first theme 'when teamwork works' supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme 'team support' revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme 'no time for teamwork' centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Themed Space

ERIC Educational Resources Information Center

Lynch, Christopher O.

2010-01-01

This article presents a classroom activity that introduces students to the concept of themed space. Students learn to think critically about the spaces they encounter on a regular basis by analyzing existing spaces and by working in groups to create their own themed space. This exercise gives students the chance to see the relevance of critical…

Hispanic Graduate Students' Mentoring Themes: Gender Roles in a Bicultural Context

ERIC Educational Resources Information Center

Rudolph, Bonnie A.; Castillo, Carlos P.; Garcia, Vanessa G.; Martinez, Alina; Navarro, Fernando

2015-01-01

Male and female focus groups at a Hispanic Serving Institution (HSI) discussed mentoring of Hispanic graduate students. Using Thematic Analysis, investigators identified three main themes: Relationship Initiation and Development, Valued Relationship Qualities, and Context and Barriers. Relationship themes included mentor openness, trust,…

Identifying Local Hotspots of Pediatric Chronic Diseases Using Emergency Department Surveillance

PubMed Central

Lee, David C.; Yi, Stella S.; Fong, Hiu-Fai; Athens, Jessica K.; Ravenell, Joseph E.; Sevick, Mary Ann; Wall, Stephen P.; Elbel, Brian

2016-01-01

Objective To use novel geographic methods and large-scale claims data to identify the local distribution of pediatric chronic diseases in New York City. Methods Using a 2009 all-payer emergency claims database, we identified the proportion of unique children aged 0 to 17 with diagnosis codes for specific medical and psychiatric conditions. As a proof of concept, we compared these prevalence estimates to traditional health surveys and registry data using the most geographically granular data available. In addition, we used home addresses to map local variation in pediatric disease burden. Results We identified 549,547 New York City children who visited an emergency department at least once in 2009. Though our sample included more publicly insured and uninsured children, we found moderate to strong correlations of prevalence estimates when compared to health surveys and registry data at pre-specified geographic levels. Strongest correlations were found for asthma and mental health conditions by county among younger children (0.88, p=0.05 and 0.99, p<0.01, respectively). Moderate correlations by neighborhood were identified for obesity and cancer (0.53 and 0.54, p<0.01). Among adolescents, correlations by health districts were strong for obesity (0.95, p=0.05), and depression estimates had a non-significant, but strong negative correlation with suicide attempts (−0.88, p=0.12). Using SaTScan, we also identified local hotspots of pediatric chronic disease. Conclusions For conditions easily identified in claims data, emergency department surveillance may help estimate pediatric chronic disease prevalence with higher geographic resolution. More studies are needed to investigate limitations of these methods and assess reliability of local disease estimates. What’s New This study demonstrated how emergency department surveillance may improve estimates of pediatric disease prevalence with higher geographic resolution. We identified 29% of New York City children with a

Emerging Trends and New Directions in Telecollaborative Learning

ERIC Educational Resources Information Center

O'Dowd, Robert

2016-01-01

This article provides an overview of the most significant emerging trends and tendencies in telecollaborative practice. In order to achieve this, I review the recent literature in the area and I identify recurring themes from the Telecollaboration in Higher Education conference which took place in Trinity College Dublin, Ireland from 21 to 23…

Themes, Style and Language Patterns of Selected Modern Black Poets.

ERIC Educational Resources Information Center

Moore-Smith, Mary

Modern black poetry has emerged as an art form whose viewpoint (theme), style (structure), and language (diction and usage) focus on a particular kind of sensibility and consciousness in conflict with the world in which the poetry moves. The black aesthetic addresses the consciousness of blackness and deplores traditional poetic niceties in favor…

Conflict prevention, conflict mitigation, and manifestations of conflict during emergency department consultations.

PubMed

Chan, Teresa; Bakewell, Francis; Orlich, Donika; Sherbino, Jonathan

2014-03-01

The objective was to determine the causes of and mitigating factors for conflict between emergency physicians and other colleagues during consultations. From March to September 2010, a total of 61 physicians (31 residents and 30 attendings from emergency medicine [EM], internal medicine, and general surgery) were interviewed about how junior learners should be taught about emergency department (ED) consultations. During these interviews, they were asked if and how conflict manifests during the ED consultation process. Two investigators reviewed the transcripts independently to generate themes related to conflict until saturation was reached. Disagreements were resolved by consensus. The trustworthiness of the analysis was ensured by generating an audit trail, which was subsequently audited by an investigator not involved with the initial analysis. This analysis was compared to previously proposed models of trust and conflict from the sociology and business literature. All participants recalled some manifestation of conflict. There were 12 negative conflict-producing themes and 10 protective conflict-mitigating themes. When comparing these themes to a previously developed model of the domains of trust, each theme mapped to domains of the model. Conflict affects the ED consultation process. Areas that lead to conflict are identified that map to previous models of trust and conflict. This work extends the current understanding about intradisciplinary conflict in the clinical realm. These new findings may improve the understanding of the nature of conflicts that occur and form the foundation for interventions that may decrease conflict during ED consultations. © 2014 by the Society for Academic Emergency Medicine.

Summary of small group discussions: Regional themes and next steps

Treesearch

Rick Turner

2013-01-01

At the conclusion of the workshop, a breakout group session discussed common themes that had emerged regarding forest degradation monitoring in the Southeast Asia region. The participants were also asked to list any important issues that may not have been sufficiently addressed during the workshop and that may require further discussion, and recommendations for next...

Network methods to support user involvement in qualitative data analyses: an introduction to Participatory Theme Elicitation.

PubMed

Best, Paul; Badham, Jennifer; Corepal, Rekesh; O'Neill, Roisin F; Tully, Mark A; Kee, Frank; Hunter, Ruth F

2017-11-23

While Patient and Public Involvement (PPI) is encouraged throughout the research process, engagement is typically limited to intervention design and post-analysis stages. There are few approaches to participatory data analyses within complex health interventions. Using qualitative data from a feasibility randomised controlled trial (RCT), this proof-of-concept study tests the value of a new approach to participatory data analysis called Participatory Theme Elicitation (PTE). Forty excerpts were given to eight members of a youth advisory PPI panel to sort into piles based on their perception of related thematic content. Using algorithms to detect communities in networks, excerpts were then assigned to a thematic cluster that combined the panel members' perspectives. Network analysis techniques were also used to identify key excerpts in each grouping that were then further explored qualitatively. While PTE analysis was, for the most part, consistent with the researcher-led analysis, young people also identified new emerging thematic content. PTE appears promising for encouraging user led identification of themes arising from qualitative data collected during complex interventions. Further work is required to validate and extend this method. ClinicalTrials.gov, ID: NCT02455986 . Retrospectively Registered on 21 May 2015.

Content Themes of Alcohol Advertising in US Television — Latent Class Analysis

PubMed Central

Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W.G.; Stoolmiller, Michael; Sargent, James D.

2015-01-01

Background There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in US television. Studies of alcohol ads from two decades ago did not identify “partying” as a social theme. Aim of the present study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Methods Content analysis of all ads from the top 20 US beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. Results About half of the advertisements (46%) were aired between 3am and 8pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed five content classes that exploited the “Partying”, “Quality”, “Sports”, “Manly”, and “Relax” themes. The partying class, indicative of ad messages surrounding partying, love and sex, was the dominant theme, comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. Conclusions This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. PMID:26207317

Content Themes of Alcohol Advertising in U.S. Television-Latent Class Analysis.

PubMed

Morgenstern, Matthis; Schoeppe, Franziska; Campbell, Julie; Braam, Marloes W G; Stoolmiller, Michael; Sargent, James D

2015-09-01

There is little alcohol research that reports on the thematic contents of contemporary alcohol advertisements in U.S. television. Studies of alcohol ads from 2 decades ago did not identify "Partying" as a social theme. Aim of this study was to describe and classify alcohol advertisements aired in national television in terms of contents, airing times, and channel placements and to identify different marketing strategies of alcohol brands. Content analysis of all ads from the top 20 U.S. beer and spirit brands aired between July 2009 and June 2011. These were 581 unique alcohol ads accounting for 272,828 (78%) national television airings. Ads were coded according to predefined definitions of 13 content areas. A latent class analysis (LCA) was conducted to define content cluster themes and determine alcoholic brands that were more likely to exploit these themes. About half of the advertisements (46%) were aired between 3 am and 8 pm, and the majority were placed either in Entertainment (40%) and Sports (38%) channels. Beer ads comprised 64% of the sample, with significant variation in airing times and channels between types of products and brands. LCA revealed 5 content classes that exploited the "Partying," "Quality," "Sports," "Manly," and "Relax" themes. The partying class, indicative of ad messages surrounding partying, love, and sex, was the dominant theme comprising 42% of all advertisements. Ads for alcopops, flavored spirits, and liqueur were more likely to belong to the party class, but there were also some beer brands (Corona, Heineken) where more than 67% of ads exploited this theme. This is the first analysis to identify a partying theme to contemporary alcohol advertising. Future analyses can now determine whether exposure to that or other themes predicts alcohol misuse among youth audiences. Copyright © 2015 by the Research Society on Alcoholism.

A Mixed Methods Approach to Identify Cognitive Warning Signs for Suicide Attempts.

PubMed

Adler, Abby; Bush, Ashley; Barg, Frances K; Weissinger, Guy; Beck, Aaron T; Brown, Gregory K

2016-01-01

This study used a mixed methods approach to examine pathways to suicidal behavior by identifying cognitive warning signs that occurred within 1 day of a suicide attempt. Transcripts of cognitive therapy sessions from 35 patients who attempted suicide were analyzed using a modified grounded theory approach. Cognitive themes emerging from these transcripts included: state hopelessness, focus on escape, suicide as a solution, fixation on suicide, and aloneness. Differences in demographic and baseline diagnostic and symptom data were explored in relation to each cognitive theme. We propose a potential conceptual model of cognitive warning signs for suicide attempts that requires further testing.

Peplau's theory of interpersonal relations: application in emergency and rural nursing.

PubMed

Senn, Joanne F

2013-01-01

The author in this column highlights aspects of Peplau's theory of interpersonal relations and its use both in emergency nursing and rural nursing. Long and Weinert identified the concepts of rural nursing. Some differences between Peplau's theory and rural nursing can be identified through definitions of theory and conceptual models. Despite these differences, there are some common themes between both theories that are described and compared.

Google Earth Grand Tour Themes

NASA Astrophysics Data System (ADS)

De Paor, D. G.; Whitmeyer, S. J.; Bentley, C.; Dordevic, M. M.

2014-12-01

As part of an NSF TUES Type 3 project entitled "Google Earth for Onsite and Distance Education (GEODE)," we are assembling a "Grand Tour" of locations on Earth and other terrestrial bodies that every geoscience student should know about and visit at least in virtual reality. Based on feedback from colleagues at previous meetings, we have identified nine Grand Tour themes: "Plates and Plumes," "Rocks and Regions," "Geology Through Time," "The Mapping Challenge*," "U.S. National Parks*," "The Magical Mystery Tour*," "Resources and Hazards," "Planets and Moons," and "Top of the Pops." Themes marked with an asterisk are most developed at this stage and will be demonstrated in real time. The Mapping Challenge invites students to trace geological contacts, measure bedding strike and dip and the plunge, trend, and facing of a fold. There is an advanced tool for modeling periclinal folds. The challenge is presented in a game-like format with an emphasis on puzzle-solving that will appeal to students regardless of gender. For the tour of U.S. national parks, we divided the most geologically important parks into four groups—Western Pacific, West Coast, Rockies, and East Coast. We are combining our own team's GigaPan imagery with imagery already available on the Internet. There is a great deal of imagery just waiting to be annotated for geological education purposes. The Magical Mystery Tour takes students to Google Streetview locations selected by instructors. Students are presented with questions or tasks and are given automatic feedback. Other themes are under development. Within each theme, we are crowd-sourcing contributions from colleagues and inviting colleagues to vote for or against proposed locations and student interactions. The GEODE team includes the authors and: Heather Almquist, Stephen Burgin, Cinzia Cervato, Gene Cooper, Paul Karabinos, Terry Pavlis, Jen Piatek, Bill Richards, Jeff Ryan, Ron Schott, Kristen St. John, and Barb Tewksbury.

The Most Common Feedback Themes in Communication Skills Training in an Internal Medicine Residency Program: Lessons from the Resident Audio-Recording Project.

PubMed

Han, Heeyoung; Papireddy, Muralidhar Reddy; Hingle, Susan T; Ferguson, Jacqueline Anne; Koschmann, Timothy; Sandstrom, Steve

2018-07-01

Individualized structured feedback is an integral part of a resident's learning in communication skills. However, it is not clear what feedback residents receive for their communication skills development in real patient care. We will identify the most common feedback topics given to residents regarding communication skills during Internal Medicine residency training. We analyzed Resident Audio-recording Project feedback data from 2008 to 2013 by using a content analysis approach. Using open coding and an iterative categorization process, we identified 15 emerging themes for both positive and negative feedback. The most recurrent feedback topics were Patient education, Thoroughness, Organization, Questioning strategy, and Management. The residents were guided to improve their communication skills regarding Patient education, Thoroughness, Management, and Holistic exploration of patient's problem. Thoroughness and Communication intelligibility were newly identified themes that were rarely discussed in existing frameworks. Assessment rubrics serve as a lens through which we assess the adequacy of the residents' communication skills. Rather than sticking to a specific rubric, we chose to let the rubric evolve through our experience.

Understanding the Impact of Residents' Interpersonal Relationships During Emergency Department Referrals and Consultations

PubMed Central

Chan, Teresa; Sabir, Kameron; Sanhan, Sarila; Sherbino, Jonathan

2013-01-01

Background Communicating with colleagues is a key physician competency. Yet few studies have sought to uncover the complex nature of relationships between referring and consulting physicians, which may be affected by the inherent relationships between the participants. Objective Our study examines themes identified from discussions about communications and the role of relationships during the referral-consultation process. Methods From March to September 2010, 30 residents (10 emergency medicine, 10 general surgery, 10 internal medicine) were interviewed using a semistructured focus group protocol. Two investigators independently reviewed the transcripts using inductive methods and grounded theory to generate themes (using codes for ease of analysis) until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. Measures for ensuring trustworthiness of the analysis included generating an audit trail and external auditing of the material by investigators not involved with the initial analysis. Results Two main relationship-related themes affected the referral-consultation process: familiarity and trust. Various subthemes were further delineated and studied in the context of pertinent literature. Conclusions Relationships between physicians have a powerful influence on the emergency department referral-consultation dynamic. The emergency department referral-consultation may be significantly altered by the familiarity and perceived trustworthiness of the referring and consulting physicians. Our proposed framework may further inform and improve instructional methods for teaching interpersonal communication. Most importantly, it may help junior learners understand inherent difficulties they may encounter during the referral process between emergency and consulting physicians. PMID:24455004

Attitudes of intensive care and emergency physicians in Australia with regard to the organ donation process: A qualitative analysis.

PubMed

Macvean, Emily; Yuen, Eva Yn; Tooley, Gregory; Gardiner, Heather M; Knight, Tess

2018-04-01

Specialized hospital physicians have direct capacity to impact Australia's sub-optimal organ donation rates because of their responsibility to identify and facilitate donation opportunities. Australian physicians' attitudes toward this responsibility are examined. A total of 12 intensive care unit and three emergency department physicians were interviewed using a constructionist grounded theory and situational analysis approach. A major theme emerged, related to physicians' conflicts of interest in maintaining patients'/next-of-kin's best interests and a sense of duty-of-care in this context. Two sub-themes related to this main theme were identified as follows: (1) discussions about organ donation and who is best to carry these out and (2) determining whether organ donation is part of end-of-life care; including the avoidance of non-therapeutic ventilation; and some reluctance to follow clinical triggers in the emergency department. Overall, participants indicated strong support for organ donation but would not consider it part of end-of-life care, representing a major obstacle to the support of potential donation opportunities. Findings have implications for physician education and training. Continued efforts are needed to integrate the potential for organ donation into end-of-life care within intensive care units and emergency departments.

Accounting for Cheating: An Evolving Theory and Emergent Themes

ERIC Educational Resources Information Center

Brent, Edward; Atkisson, Curtis

2011-01-01

This study examines student responses to the question, "What circumstances, if any, could make cheating justified?" It then assesses how well those responses can be classified by existing theories and categories that emerge from a qualitative analysis of the data. Results show considerable support for techniques of neutralization, partial support…

Making processes reliable: a validated pubmed search strategy for identifying new or emerging technologies.

PubMed

Varela-Lema, Leonora; Punal-Riobóo, Jeanette; Acción, Beatriz Casal; Ruano-Ravina, Alberto; García, Marisa López

2012-10-01

Horizon scanning systems need to handle a wide range of sources to identify new or emerging health technologies. The objective of this study is to develop a validated Medline bibliographic search strategy (PubMed search engine) to systematically identify new or emerging health technologies. The proposed Medline search strategy combines free text terms commonly used in article titles to denote innovation within index terms that make reference to the specific fields of interest. Efficacy was assessed by running the search over a period of 1 year (2009) and analyzing its retrieval performance (number and characteristics). For comparison purposes, all article abstracts published during 2009 in six preselected key research journals and eight high impact surgery journals were scanned. Sensitivity was defined as the proportion of relevant new or emerging technologies published in key journals that would be identified in the search strategy within the first 2 years of publication. The search yielded 6,228 abstracts of potentially new or emerging technologies. Of these, 459 were classified as new or emerging (383 truly new or emerging and 76 new indications). The scanning of 12,061 journal abstracts identified 35 relevant new or emerging technologies. Of these, twenty-nine were located within the Medline search strategy during the first 2 years of publication (sensitivity = 83 percent). The current search strategy, validated against key journals, has demonstrated to be effective for horizon scanning. Even though it can require adaptations depending on the scope of the horizon scanning system, it could serve to simplify and standardize scanning processes.

Synopsis of emergent approaches

Treesearch

Malcolm North; Brandon Collins; John Keane; Jonathan W. Long; Carl Skinner; Bill Zielinski

2014-01-01

This synopsis presents three integrated themes that emerged from synthesizing information about biological resources. These themes become particularly important when managing forests to promote resilience at large landscape scales and long timeframes. This synopsis summarizes ideas in the longer chapter 1.2, “Integrative Approaches: Promoting Socioecological Resilience...

Identifying emerging issues in forestry as a tool for research planning.

Treesearch

Hans M. Gregersen; Allen L. Lundgren; Pamela J. Jakes; David N. Bengston

1989-01-01

A Delphi exercise is used to identify emerging issues in National Forest management and use, the relative importance of the issues, and barriers to resolving issues. USDA Forest Service managers agree on the importance of the 11 issues identified; however, researchers and National Forest managers do not always agree on the importance of issues or barriers.

An emerging discourse: toward epistemic diversity in nursing.

PubMed

Georges, Jane M

2003-01-01

Grounded in a postmodern feminist methodology, this article undertakes an initial analysis of a newly emerging discourse in contemporary nursing academia in the United States. Two currently prominent discourses in nursing, a dominant discourse informed by the processes and values of "science" in the Enlightenment sense and a concurrent marginalized discourse informed by postmodernism, are described as a context for the emerging discourse. A genealogy informed by the work of Foucault is presented as a basis for an analysis of the power effects resulting from the conflict between these 2 discourses. Finally, 3 recent texts in nursing are analyzed and common themes identified as indicative of a new intertextual discourse, termed "epistemic diversity," emerging from this discursive conflict.

Identifying barriers to emergency care services.

PubMed

Cannoodt, Luk; Mock, Charles; Bucagu, Maurice

2012-01-01

This paper aims to present a review of published evidence of barriers to emergency care, with attention towards both financial and other barriers. With the keywords (financial) accessibility, barriers and emergency care services, citations in PubMed were searched and further selected in the context of the objective of this article. Forty articles, published over a period of 15 years, showed evidence of significant barriers to emergency care. These barriers often tend to persist, despite the fact that the evidence was published many years ago. Several publications stressed the importance of the financial barriers in foregoing or delaying potentially life-saving emergency services, both in poor and rich countries. Other publications report non-financial barriers that prevent patients in need of emergency care (pre-hospital and in-patient care) from seeking care, from arriving in the proper emergency department without undue delay or from receiving proper treatment when they do arrive in these departments. It is clear that timely access to life-saving and disability-preventing emergency care is problematic in many settings. Yet, low-cost measures can likely be taken to significantly reduce these barriers. It is time to make an inventory of these measures and to implement the most cost-effective ones worldwide. Copyright © 2011 John Wiley & Sons, Ltd.

Looking to the Future: Themes from the Third National Conference for Counseling Psychology.

ERIC Educational Resources Information Center

Rude, Stephanie S.; And Others

1988-01-01

Presents summary of common themes from the Third National Conference for Counseling Psychology including strategies to enhance visibility and political strength, and ways to improve training of counseling psychologists by enhancing rigor, scientific thinking, professional identity, and ability to work in diverse and emerging settings. Discusses…

Emerging synthesis themes from the study of social-ecological systems of a tropical city

Treesearch

Tischa A. Munoz; A.E. Lugo; B. Quintero

2014-01-01

The synthesis of the contributions in this special issue about the tropical city of San Juan has resulted in five themes. First, the city is subject to multiple vulnerabilities, but socioeconomic factors and education level affect the perception of citizens to those vulnerabilities, even in the face of imminent threat. Second, in light of the social-ecological...

Evidence-based medicine teaching requirements in the USA: taxonomy and themes.

PubMed

Shaughnessy, Allen F; Torro, John R; Frame, Kara A; Bakshi, Munish

2016-05-01

In the USA, recent changes to oversight of residency training codify the requirements for teaching evidence-based medicine and information mastery (lifelong learning) knowledge, skills, and attitudes. The goal of this project is to determine current requirements for teaching of evidence-based medicine (EBM) and information mastery (IM) in specialty residency education in the USA. The project was a qualitative thematic analysis using content analysis. The source of the requirements for EBM and IM were the "milestone" statements for all 28 major specialties and transition year programs. Milestone descriptors related to EBM/IM were extracted and codes were developed and applied to each descriptor by four researchers. The resulting codes were coalesced into themes and tested against the milestone descriptors. The coding process identified 15 content areas comprising five themes. Two themes related to the knowledge and skills of EBM and three themes related to the knowledge, skills, and attitudes of IM. EBM themes encompassed basic critical appraisal skills and knowledge of clinical epidemiology principles and statistics. IM themes centered on identifying one's information needs for patient-specific information, using information sources, and using current awareness services to remain abreast of changes in medicine. In general, they align well with the Sicily Statement on Evidence-Based Practice. No specialty required competence in all areas. New training requirements for specialties in the USA require the development of both classic EBM skills as well as skills for managing information. However, there is marked variation in the requirements among specific specialties. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.

PubMed

Reeves, Scott; McMillan, Sarah E; Kachan, Natasha; Paradis, Elise; Leslie, Myles; Kitto, Simon

2015-05-01

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.

Theme 2 Overview: Making a Living, Training, Trade and Investment in the Circumpolar North.

ERIC Educational Resources Information Center

McLeod, Bob

1998-01-01

An intergovernmental council on sustainable development in the Arctic discussed fisheries, wildlife, forestry, mining, oil and gas, tourism, finance and marketing, communication and education, and youth initiatives. Emerging themes included community involvement in decision making, acknowledging indigenous peoples' rights and knowledge,…

Themes and Interplay of Beliefs in Mathematical Reasoning

ERIC Educational Resources Information Center

Sumpter, Lovisa

2013-01-01

Upper secondary students' task solving reasoning was analysed with a focus on arguments for strategy choices and conclusions. Passages in their arguments for reasoning that indicated the students' beliefs were identified and, by using a thematic analysis, categorized. The results stress three themes of beliefs used as arguments for…

A Qualitative Analysis of Stress and Relaxation Themes Contributing to Burnout in First-Year Psychiatry and Medicine Residents.

PubMed

Benson, Nicole M; Chaukos, Deanna; Vestal, Heather; Chad-Friedman, Emma F; Denninger, John W; Borba, Christina P C

2018-05-14

Qualitative research on trainee well-being can add nuance to the understanding of propagators of burnout, and the role for interventions aimed at supporting well-being. This qualitative study was conducted to identify (i) situations and environments that cause stress for trainees, (ii) stress-reducing activities that trainees utilize, and (iii) whether trainees who report distress (high burnout and depression scores) describe different stressors and relaxation factors than those who do not. The study was conducted with a convenience sample of first-year medicine and psychiatry residents at a large urban teaching hospital. Participants were asked to complete electronic stress and relaxation diaries daily for 1 week. Diary entries were coded for recurrent themes. Participants were screened for burnout and depression. Codes were compared by subgroup based on baseline burnout and depression status to elucidate if specific themes emerged in these subgroups. Study sample included 51 interns. Sixteen (16/50, 32%) screened positive for burnout and three (3/50, 14%) had a positive depression screen. The most common stressors related to aspects of the learning environment, compounded by feeling under-equipped, overwhelmed, or out of time. The majority of relaxation activities involved social connection, food, other comforts, and occurred outside of the hospital environment. This study reveals that interns (regardless of burnout or depression screen) identify stressors that derive primarily from organizational, interpersonal, and cultural experiences of the learning environment; whereas relaxation themes are diversely represented across realms (home, leisure, social, health), though emphasize activities that occur outside of the work place.

Types of centredness in health care: themes and concepts.

PubMed

Hughes, Julian C; Bamford, Claire; May, Carl

2008-12-01

For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers that defined or discussed the notions at a conceptual level. The reviews and papers were analyzed as text transcripts. We identified 10 themes that were common to all the types of centredness. At a conceptual level we could not identify thematic differences between the types of centredness. These findings were subjected to a philosophical critique using ideas derived from Wittgenstein. Different types of centredness are required in different contexts. The differences are justified by their practical utility. The unifying themes of centredness, however, reflect a movement in favour of increasing the social, psychological, cultural and ethical sensitivity of our human encounters.

Workplace aggression as cause and effect: Emergency nurses' experiences of working fatigued.

PubMed

Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Clark, Paul R

2017-07-01

Emergency nursing requires acute attention to detail to provide safe and effective care to potentially unstable or critically ill patients; this requirement may be significantly impaired by physical and mental fatigue. There is a lack of evidence regarding the effects of fatigue caused by factors other than a sleep deficit (e.g., emotional exhaustion). Fatigue affects nurses' ability to work safely in the emergency care setting and potentially impacts their health and quality of life outside of work. This was the qualitative arm of a mixed methods study; we used a qualitative exploratory design with focus group data from a sample of 16 emergency nurses. Themes were identified using an inductive approach to content analysis. The following themes were identified: "It's a weight on your back;" "Competitive nursing;" "It's never enough;" "You have to get away;" and "Engagement as a solution." Our participants reported high levels of fatigue, which compromised patient care, had a negative effect on their personal lives, and created a toxic unit environment. They reported lateral violence as both the cause and effect of mental and emotional fatigue, suggesting that unit culture affects nurses and the patients they care for. Copyright © 2016 Elsevier Ltd. All rights reserved.

"A Kaleidoscope of Themes": Intensive Psychotherapy with a Girl on the Autistic Spectrum

ERIC Educational Resources Information Center

Miller, Beth

2008-01-01

This paper is an account of the intensive psychotherapy of a young girl on the autistic spectrum. It describes her confusing presentation and how this suggested a tendency to oscillate between mainly unintegrated states of mind. Important themes that emerged included the phantasy of inhabiting a claustrum; the use of adhesive identification to…

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology.

PubMed

Bhargava, Rohit; Madabhushi, Anant

2016-07-11

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area.

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology

PubMed Central

Bhargava, Rohit; Madabhushi, Anant

2017-01-01

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area. PMID:27420575

Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner.

PubMed

Chan, Teresa; Orlich, Donika; Kulasegaram, Kulamakan; Sherbino, Jonathan

2013-01-01

To define the important elements of an emergency department (ED) consultation request and to develop a simple model of the process. From March to September 2010, 61 physicians (21 emergency medicine [EM], 20 general surgery [GS], 20 internal medicine [IM]; 31 residents, 30 attending staff) were questioned about how junior learners should be taught about ED consultation. Two investigators independently reviewed focus group and interview transcripts using grounded theory to generate an index of themes until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. All transcripts were coded using this index of themes; 30% of transcripts were coded in duplicate to determine the agreement. A total of 245 themes and subthemes were identified. The agreement between reviewers was 77%. Important themes in the process were as follows: initial preparation and review of investigations by EM physician (overall endorsement 87% [range 70-100% in different groups]); identification of involved parties (patient and involved physicians) (100%); hypothesis of patient's diagnosis (75% [range 62-83%]) or question for the consulting physician (70% [range 55-95%]); urgency (100%) and stability (74% [range 62-80%]); questions from the consultant (100%); discussion/communication (98% [range 95-100%]); and feedback (98% [range 95-100%]). These components were reorganized into a simple framework (PIQUED). Each clinical specialty significantly contributed to the model (χ2  =  7.9; p value  =  0.019). Each group contributed uniquely to the final list of important elements (percent contributions: EM, 57%; GS, 41%; IM, 64%). We define important elements of an ED consultation with input from emergency and consulting physicians. We propose a model that organizes these elements into a simple framework (PIQUED) that may be valuable for junior learners.

Communicating in the "gray zone": perceptions about emergency physician hospitalist handoffs and patient safety.

PubMed

Apker, Julie; Mallak, Larry A; Gibson, Scott C

2007-10-01

To identify the perceptions of emergency physicians (EPs) and hospitalists regarding interservice handoff communication as patients are transferred from the emergency department to the inpatient setting. Investigators conducted individual interviews with 12 physicians (six EPs and six hospitalists). Data evaluation consisted of using the steps of constant comparative, thematic analysis. Physicians perceived handoff communication as a gray zone characterized by ambiguity about patients' conditions and treatment. Two major themes emerged regarding the handoff gray zone. The first theme, poor communication practices and conflicting communication expectations, presented barriers that exacerbated physicians' information ambiguity. Specifically, handoffs consisting of insufficient information, incomplete data, omissions, and faulty information flow exacerbated gray zone problems and may negatively affect patient outcomes. EPs and hospitalists had different expectations about handoffs, and those expectations influenced their interactions in ways that may result in communication breakdowns. The second theme illustrated how poor handoff communication contributes to boarding-related patient safety threats for boarders and emergency department patients alike. Those interviewed talked about the systemic failures that lead to patient boarding and how poor handoffs exacerbated system flaws. Handoffs between EPs and hospitalists both reflect and contribute to the ambiguity inherent in emergency medicine. Poor handoffs, consisting of faulty communication behaviors and conflicting expectations for information, contribute to patient boarding conditions that can pose safety threats. Pragmatic conclusions are drawn regarding physician-physician communication in patient transfers, and recommendations are offered for medical education.

Theme Kits Made Easy.

ERIC Educational Resources Information Center

Eslinger, Leslie Silk

Recognizing the long-lasting impact of young childrens learning through themes as well as the amount of teacher time spent in preparing for this type of teaching, this kit is designed to help teachers avoid the shortcomings of theme-based teaching, while capitalizing on the benefits of this approach. The book is presented in two sections. The…

Theme and Thematic Progression in English Writing Teaching

ERIC Educational Resources Information Center

Jing, Wei

2015-01-01

Theme and thematic progression (T/TP) is a major aspect of the way that speakers construct their messages in a way which makes them fit smoothly into the unfolding language event. While studies have illustrated the usefulness of observing T/TP to identify English learners' writing difficulties and suggested that T/TP should be included in English…

Identifying emerging research collaborations and networks: method development.

PubMed

Dozier, Ann M; Martina, Camille A; O'Dell, Nicole L; Fogg, Thomas T; Lurie, Stephen J; Rubinstein, Eric P; Pearson, Thomas A

2014-03-01

Clinical and translational research is a multidisciplinary, collaborative team process. To evaluate this process, we developed a method to document emerging research networks and collaborations in our medical center to describe their productivity and viability over time. Using an e-mail survey, sent to 1,620 clinical and basic science full- and part-time faculty members, respondents identified their research collaborators. Initial analyses, using Pajek software, assessed the feasibility of using social network analysis (SNA) methods with these data. Nearly 400 respondents identified 1,594 collaborators across 28 medical center departments resulting in 309 networks with 5 or more collaborators. This low-burden approach yielded a rich data set useful for evaluation using SNA to: (a) assess networks at several levels of the organization, including intrapersonal (individuals), interpersonal (social), organizational/institutional leadership (tenure and promotion), and physical/environmental (spatial proximity) and (b) link with other data to assess the evolution of these networks.

The role of surgeons in identifying emerging technologies for health technology assessment.

PubMed

Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

2010-04-01

Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, "horizon-scanning" processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. We invited 18 surgeons from Alberta's 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nano technology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources.

The role of surgeons in identifying emerging technologies for health technology assessment

PubMed Central

Stafinski, Tania; Topfer, Leigh-Ann; Zakariasen, Ken; Menon, Devidas

2010-01-01

Background Health technology assessment (HTA) is a tool intended to help policy-makers decide which technologies to fund. However, given the proliferation of new technologies, it is not possible to undertake an HTA of each one before it becomes funded. Consequently, “horizon-scanning” processes have been developed to identify emerging technologies that are likely to have a substantial impact on clinical practice. Although the importance of physicians in the adoption of new technologies is well recognized, their role in horizon scanning in Canada has been limited. The purpose of this project was to pilot an approach to engage physicians, specifically surgeons, in provincial horizon-scanning activities. Methods We invited 18 surgeons from Alberta’s 2 medical schools to a horizon-scanning workshop to solicit their views on emerging technologies expected to impact surgical practice within the next 5 years and/or the importance of different attributes or characteristics of new technologies. Results Surgeons, regardless of specialty, identified developments designed to enhance existing minimally invasive surgical techniques, such as endoscopic, robotic and image-guided surgery. Several nonsurgical areas, including molecular genetics and nanotechnology, were also identified. Of the 13 technology attributes discussed, safety or risk, effectiveness and feasibility were rated as most important. Lastly, participating surgeons expressed an interest in becoming further involved in local HTA initiatives. Conclusion Surgeons, as adopters and users of health technologies, represent an important and accessible information source for identifying emerging technologies for HTA. A more formal, ongoing relationship between the government, HTA and surgeons may help to optimize the use of HTA resources. PMID:20334740

Identifying Pregnant Women Experiencing Domestic Violence in an Urban Emergency Department

ERIC Educational Resources Information Center

Datner, Elizabeth M.; Wiebe, Douglas J.; Brensinger, Colleen M.; Nelson, Deborah B.

2007-01-01

The article describes characteristics of pregnant women presenting to the Emergency Department (ED) who are experiencing current violence and presented a screening tool to identify pregnant women experiencing violence. Women completed an in-person interview regarding violence, sociodemo-graphic factors, health status, and drug use. Fifteen percent…

Model-Driven Theme/UML

NASA Astrophysics Data System (ADS)

Carton, Andrew; Driver, Cormac; Jackson, Andrew; Clarke, Siobhán

Theme/UML is an existing approach to aspect-oriented modelling that supports the modularisation and composition of concerns, including crosscutting ones, in design. To date, its lack of integration with model-driven engineering (MDE) techniques has limited its benefits across the development lifecycle. Here, we describe our work on facilitating the use of Theme/UML as part of an MDE process. We have developed a transformation tool that adopts model-driven architecture (MDA) standards. It defines a concern composition mechanism, implemented as a model transformation, to support the enhanced modularisation features of Theme/UML. We evaluate our approach by applying it to the development of mobile, context-aware applications-an application area characterised by many non-functional requirements that manifest themselves as crosscutting concerns.

Theme Binders: One Size Fits All.

ERIC Educational Resources Information Center

Baskwill, Steve

1996-01-01

Describes theme binders designed by sixth graders as an independent study component that unites the class as a learning community, showcases student work, and illustrates developmental milestones for parents. Details theme binder components: (1) cover page; (2) introductory page outlining the theme and contents; (3) evaluation sections indicating…

Social media in the emergency medicine residency curriculum: social media responses to the residents' perspective article.

PubMed

Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle

2015-05-01

In July to August 2014, Annals of Emergency Medicine continued a collaboration with an academic Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Annals Residents' Perspective article "Integration of Social Media in Emergency Medicine Residency Curriculum" by Scott et al. The objective was to describe a 14-day worldwide clinician dialogue about evidence, opinions, and early relevant innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Stuck in traffic: an emerging theme in diseases of the nervous system.

PubMed

Neefjes, Jacques; van der Kant, Rik

2014-02-01

The past decade has seen an explosion of DNA sequencing activities and many mutations and genetic variances underlying neurological and neurodegenerative diseases have been determined. This wealth of genetic data is now placed in molecular pathways revealing the nodes that underlie the disrupted processes. Many mutations in neurological diseases affect proteins controlling endosomal/lysosomal transport. Although the age of onset of these diseases range from juvenile [i.e., Niemann-Pick type C (NPC) and Charcot-Marie-Tooth (CMT) disease] to late onset (Parkinson's and Alzheimer's disease), deregulation of endosomal transport is a common theme. This review summarizes how elucidating the genetic basis for the various neurological diseases has advanced our understanding of the endo-lysosomal system and why the various mutations all translate into similar disease phenotypes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Researcher-Identified and Emergent Predictors of Pupil Control Ideologies: A Canadian Beginning Teacher Perspective

ERIC Educational Resources Information Center

Rideout, Glenn; Windle, Sheila

2013-01-01

The objectives of this study were (a) to identify the direction of pupil control ideology (PCI) shifts during participants' beginning teaching years, and (b) to identify a broader range of "emergent" (participant-identified) predictors of PCI that beginning teachers saw as accounting for the tendency for their classroom learning…

'Let other people do it…': the role of emergency department nurses in health promotion.

PubMed

Shoqirat, Noordeen

2014-01-01

To explore emergency department nurses' roles in health promotion and contributing factors involved. In many healthcare systems, emergency departments are increasingly urged to play a crucial role in health promotion. Although much has been written about health promotion and nurses in acute care settings, less has focused on emergency departments. A qualitative design was used. In-depth semi-structured interviews were used with a convenient sample of 15 nurses in a Jordanian emergency department. Data were analysed using nvivo 9 (QSR International, Doncaster, Victoria, Australia). The analysis identified two themes. The first focused on nurses' roles in health promotion, comprising two categories: having no roles and 'let other people do it'. The second theme focused on the context and constraints of health promotion comprising fear of violence, the nature of healthcare service and patients' beliefs. The majority of nurses in emergency departments do not associate health promotion with their practice, hold some negative attitudes and devote more time to clinical tasks than health promotion, which is seen as a second priority. The ideology of medicalised tasks has penetrated deeply into the core principles of health promotion, and thus, nurses' roles and potential in this area are questioned. Decision-makers and nurses within the hospital are urged to address the constraints identified in this study and debate them further. Failure to do so may lead to emergency nursing not being optimally achieved, with the absence of sustained and concerted health promotion work matching patients' cultural needs and sensitivities. © 2013 John Wiley & Sons Ltd.

Ethical, financial, and legal considerations to implementing emergency department HIV screening: a report from the 2007 conference of the National Emergency Department HIV Testing Consortium.

PubMed

Waxman, Michael J; Popick, Rachel S; Merchant, Roland C; Rothman, Richard E; Shahan, Judy B; Almond, Gregory

2011-07-01

We seek to identify and analyze, from a group of participants experienced with HIV screening, the perceived challenges and solutions to the ethical, financial, and legal considerations of emergency department (ED)-based HIV screening. We performed a qualitative analysis of the focus group discussions from the ethical, financial, and legal considerations portion of the inaugural National Emergency Department HIV Testing Consortium conference. Four groups composed of 20 to 25 consortium participants engaged in semistructured, facilitated focus group discussions. The focus group discussions were audiotaped and transcribed. A primary reader identified major themes and subthemes and representative quotes from the transcripts and summarized the discussions. Secondary and tertiary readers reviewed the themes, subthemes, and summaries for accuracy. The focus group discussions centered on the following themes. Ethical considerations included appropriateness of HIV screening in the ED and ethics of key elements of the 2006 Centers for Disease Control and Prevention HIV testing recommendations. Financial considerations included models of payment and support, role of health care insurance, financial ethics and downstream financial burdens, and advocacy approaches. Legal considerations included the adequacy of obtaining consent, partner notification, disclosure of HIV results, difficulties in addressing special populations, failure of not performing universal screening, failure to notify a person of being tested, failure to notify someone of their test results, liability of inaccurate tests, and failure to link to care. This qualitative analysis provides a broadly useful foundation to the ethical, financial, and legal considerations of implementing HIV screening programs in EDs throughout the United States. Copyright © 2011. Published by Mosby, Inc.

Trends in Literacy Software Publication and Marketing: Multicultural Themes.

ERIC Educational Resources Information Center

Balajthy, Ernest

This article provides data and discussion of multicultural theme-related issues arising from analysis of a detailed database of commercial software products targeted to reading and literacy education. The database consisted of 1152 titles, representing the offerings of 104 publishers and distributors. Of the titles, 62 were identified as having…

Real-time analysis application for identifying bursty local areas related to emergency topics.

PubMed

Sakai, Tatsuhiro; Tamura, Keiichi

2015-01-01

Since social media started getting more attention from users on the Internet, social media has been one of the most important information source in the world. Especially, with the increasing popularity of social media, data posted on social media sites are rapidly becoming collective intelligence, which is a term used to refer to new media that is displacing traditional media. In this paper, we focus on geotagged tweets on the Twitter site. These geotagged tweets are referred to as georeferenced documents because they include not only a short text message, but also the documents' posting time and location. Many researchers have been tackling the development of new data mining techniques for georeferenced documents to identify and analyze emergency topics, such as natural disasters, weather, diseases, and other incidents. In particular, the utilization of geotagged tweets to identify and analyze natural disasters has received much attention from administrative agencies recently because some case studies have achieved compelling results. In this paper, we propose a novel real-time analysis application for identifying bursty local areas related to emergency topics. The aim of our new application is to provide new platforms that can identify and analyze the localities of emergency topics. The proposed application is composed of three core computational intelligence techniques: the Naive Bayes classifier technique, the spatiotemporal clustering technique, and the burst detection technique. Moreover, we have implemented two types of application interface: a Web application interface and an android application interface. To evaluate the proposed application, we have implemented a real-time weather observation system embedded the proposed application. we used actual crawling geotagged tweets posted on the Twitter site. The weather observation system successfully detected bursty local areas related to observed emergency weather topics.

Identifying and Planning for New and Emerging Occupations: A Suggested Guide.

ERIC Educational Resources Information Center

Meleen, Paulette; And Others

Intended for use by State vocational education directors and curriculum planners, this guide documents the results of a project which developed and applied a process for identifying new and emerging occupations for skilled and technical areas, part of a larger effort to assist the alignment of vocational and technical program offerings with new…

Theme network in thematic learning in elementary school

NASA Astrophysics Data System (ADS)

Ain, N.; Rahutami, R.

2018-05-01

This research aimed at developing a network of a theme in the textbook. The method used is evaluation and development method. The source of this research data is textbook of class IV with the theme of “Care for Living Creatures” and sub-theme "Lets Love Our Environment”. The results show that there is a discrepancy between basic competence and sub-themes. Such disagreement is due to an inadequacy of basic competencies with sub-themes, and the choice of basic competencies of less appropriate to sub-themes. The results of this study can be used to developing theme network on other sub-themes as well as on other levels.

Episodes of care: is emergency medicine ready?

PubMed

Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D

2012-05-01

Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.

Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

PubMed

Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

2018-03-01

Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study.

PubMed

Ramacciati, Nicola; Ceccagnoli, Andrea; Addey, Beniamino; Rasero, Laura

2018-05-01

Physical and verbal aggression against health professionals, particularly nurses, is globally serious and widespread, with the most vulnerable being nurses working in the Accident and Emergency Department. Most international research into this issue focused on quantifying aggression, describing its nature, identifying perpetrators, stratifying risk and implementing preventive or mitigating interventions. Few studies investigated the nurses' subjective perceptions. As part of the 2016 Italian National Survey on Violence against Accident and Emergency Nurses, our research team collected qualitative data to explore their perceptions of Workplace Violence. From 19th July 2016 to 19th March 2017 we distributed online a 39-item validated questionnaire to 15,618 Emergency Nurses working in 668 Italian National Health Service Accident and Emergency Departments in all 20 Italian Regions. Answers were analysed using van Kaan's method. 1100 Emergency Nurses responded to the survey and 265 replied to our focus question. There were 144 Females, 119 Males, 2 not stated, average age 42 ± 9 years, average work experience 18 ± 9 years, average Accident and Emergency Department experience 11 ± 8 years. Four major themes emerged: the nurses' perception of physical and verbal aggression, precipitating factors, consequences, and solutions. These themes confirmed previous findings and showed that Italian nursing staff's perceptions of physical and verbal aggression is the same as emergency nurses working worldwide. How Italian Accident and Emergency nurses perceive Workplace Violence adds to our knowledge of the issue and contributes to finding shared solutions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identifying the immunomodulatory components of helminths.

PubMed

Shepherd, C; Navarro, S; Wangchuk, P; Wilson, D; Daly, N L; Loukas, A

2015-06-01

Immunomodulatory components of helminths offer great promise as an entirely new class of biologics for the treatment of inflammatory diseases. Here, we discuss the emerging themes in helminth-driven immunomodulation in the context of therapeutic drug discovery. We broadly define the approaches that are currently applied by researchers to identify these helminth molecules, highlighting key areas of potential exploitation that have been mostly neglected thus far, notably small molecules. Finally, we propose that the investigation of immunomodulatory compounds will enable the translation of current and future research efforts into potential treatments for autoimmune and allergic diseases, while at the same time yielding new insights into the molecular interface of host-parasite biology. © 2015 John Wiley & Sons Ltd.

Experiences of female partners of masculine identifying trans persons

PubMed Central

Theron, Liesl; Collier, Kate L.

2013-01-01

This study explores the intimate relationship experiences of cisgender (i.e., not transgender) female partners of masculine identifying transgender persons, with a particular focus on these partners’ self-understanding of their sexual orientation. Limited research about this topic has been conducted to date. Semi-structured interviews were conducted with eight South African women who are or have been cisgender female partners of masculine identifying trans persons. Although the interviews showed that the relationship experiences of female partners of masculine identifying trans persons are diverse, several common themes emerged in the narratives. The way that participants labelled their sexual orientation did not change from before to after their relationship with a transgender partner. The participants reported varied family and community responses to their relationships. Specific emotional and informational support needs for women with transgender partners were identified. PMID:23668602

Experiences of female partners of masculine-identifying trans persons.

PubMed

Theron, Liesl; Collier, Kate L

2013-01-01

This paper explores the intimate relationship experiences of the cisgender (i.e., not transgender) female partners of masculine-identifying transgender persons, with a particular focus on these partners' self-understanding of their sexual orientation. Limited research about this topic has been conducted to date. Semi-structured interviews were conducted with eight South African women who are or have been cisgender female partners of masculine-identifying trans persons. Although the interviews showed that the relationship experiences of female partners of masculine-identifying trans persons are diverse, several common themes emerged in the narratives. The way that participants labelled their sexual orientation did not change from before to after their relationship with a transgender partner. The participants reported varied family and community responses to their relationships. Specific emotional and informational support needs for women with transgender partners were identified.

Relational Themes in Counseling Supervision: Broadening and Narrowing Processes

ERIC Educational Resources Information Center

Gazzola, Nicola; Theriault, Anne

2007-01-01

This study investigated the experiences of broadening (i.e., thinking and acting creatively and being open to exploring new ways of being) and narrowing (i.e., the experience of perceiving one's choices as limited) in the supervisory process with the aim of identifying key relational themes from the perspective of supervisees. We interviewed 10…

The PAGES 2k Network, Phase 3: Themes and Call for Participation

NASA Astrophysics Data System (ADS)

von Gunten, L.; Mcgregor, H. V.; Martrat, B.; St George, S.; Neukom, R.; Bothe, O.; Linderholm, H. W.; Phipps, S. J.; Abram, N.

2017-12-01

The past 2000 years (the "2k" interval) provides critical context for understanding recent anthropogenic forcing of the climate and provides baseline information about the characteristics of natural climate variability. It also presents opportunities to improve the interpretation of proxy observations and to evaluate the climate models used to make future projections. Phases 1 and 2 of the PAGES 2k Network focussed on building regional and global surface temperature reconstructions for terrestrial regions and the oceans, and comparing these with model simulations to identify mechanisms of climate variation on interannual to bicentennial time scales. Phase 3 was launched in May 2017 and aims to address major questions around past hydroclimate, climate processes and proxy uncertainties. Its scientific themes are: Theme 1: "Climate Variability, Modes and Mechanisms"Further understand the mechanisms driving regional climate variability and change on interannual to centennial time scales; Theme 2: "Methods and Uncertainties"Reduce uncertainties in the interpretation of observations imprinted in paleoclimatic archives by environmental sensors; Theme 3: "Proxy and Model Understanding"Identify and analyse the extent of agreement between reconstructions and climate model simulations. Research is organized as a linked network of well-defined projects, identified and led by 2k community members. The 2k projects focus on specific scientific questions aligned with Phase 3 themes, rather than being defined along regional boundaries. New 2k projects can be proposed at any time at http://www.pastglobalchanges.org/ini/wg/2k-network/projects An enduring element of PAGES 2k is a culture of collegiality, transparency, and reciprocity. Phase 3 seeks to stimulate community based projects and facilitate collaboration between researchers from different regions and career stages, drawing on the breadth and depth of the global PAGES 2k community. All PAGES 2k projects also promote best

A 2018 Horizon Scan of Emerging Issues for Global Conservation and Biological Diversity.

PubMed

Sutherland, William J; Butchart, Stuart H M; Connor, Ben; Culshaw, Caroline; Dicks, Lynn V; Dinsdale, Jason; Doran, Helen; Entwistle, Abigail C; Fleishman, Erica; Gibbons, David W; Jiang, Zhigang; Keim, Brandon; Roux, Xavier Le; Lickorish, Fiona A; Markillie, Paul; Monk, Kathryn A; Mortimer, Diana; Pearce-Higgins, James W; Peck, Lloyd S; Pretty, Jules; Seymour, Colleen L; Spalding, Mark D; Tonneijck, Femke H; Gleave, Rosalind A

2018-01-01

This is our ninth annual horizon scan to identify emerging issues that we believe could affect global biological diversity, natural capital and ecosystem services, and conservation efforts. Our diverse and international team, with expertise in horizon scanning, science communication, as well as conservation science, practice, and policy, reviewed 117 potential issues. We identified the 15 that may have the greatest positive or negative effects but are not yet well recognised by the global conservation community. Themes among these topics include new mechanisms driving the emergence and geographic expansion of diseases, innovative biotechnologies, reassessments of global change, and the development of strategic infrastructure to facilitate global economic priorities. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014).

PubMed

Brooks, Ingrid A; Sayre, Michael R; Spencer, Caroline; Archer, Frank L

2016-02-01

The Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US. As US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach. Seventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession. Documents produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.

Suicide note themes and suicide prevention.

PubMed

Foster, Tom

2003-01-01

The aim was to determine if suicide note themes might inform suicide prevention strategies. The themes of 42 suicide notes from the Northern Ireland Suicide Study (major psychological autopsy study) were examined. The commonest themes were "apology/shame" (74%), "love for those left behind" (60%), "life too much to bear" (48%), "instructions regarding practical affairs post-mortem" (36%), "hopelessness/nothing to live for" (21%) and "advice for those left behind" (21%). Notes of suicides with major unipolar depression were more likely than notes of suicides without major unipolar depression to contain the themes "instructions regarding practical affairs post-mortem" (67% versus 19%, p = 0.005) and "hopelessness/nothing to live for" (40% versus 11%, p = 0.049). Notes of suicides with a previous history of deliberate self-harm were less likely than notes of suicides without a history of deliberate self-harm to contain the theme "apology/shame" (58% versus 87%, p = 0.04). Notes of elderly suicides were more likely than non-elderly notes to contain the theme "burden to others" (40% versus 3%, p = 0.03). The fact that three quarters of suicide notes contained the theme "apology/shame" suggests that the deceased may have welcomed alternative solutions for their predicaments. Scrutiny of suicide note themes in the light of previous research findings suggests that cognitive therapy techniques, especially problem solving, may have an important role to play in suicide prevention and that potential major unipolar depressive (possibly less impulsive) suicides, in particular, may provide fertile ground for therapeutic intervention (physical and psychological). Ideally all primary care doctors and mental health professionals working with (potentially) suicidal people should be familiar with basic cognitive therapy techniques, especially problem solving skills training.

Activities Using a Restaurant Theme.

ERIC Educational Resources Information Center

Modlin, Ruth

Designed for use with elementary students, 44 activities using a restaurant theme integrate creative thinking and decision-making skills with language arts, mathematics, and art. The activities, which can be used independently by the students, deal with types of restaurants, names and themes, floor plans, interior and exterior design, house…

Cultural Themes.

ERIC Educational Resources Information Center

Roy, Loriene, Comp.

Part of a larger report on the Four Directions Project, an American Indian technology innovation project, this section includes 10 "pathfinders" to locating information on Native American cultural themes. The pathfinders were designed by students in the Graduate School of Library and Information Science at the University of Texas at…

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men's and women's culturally-ascribed attitudes and behaviours.

PubMed

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E; Whitt, Elaine; Martin, Steven S; O'Connell, Daniel J

2015-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women's condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida, USA. The study used a qualitative study-design and collected data from 16 focus groups with a total of 67 Latino men and women. Findings from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men's classification of women as dirty-clean to determine condom use and women's assertiveness during sexual encounters negotiating condom use--in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage.

Breaking the Sound Barrier with a Hummingbird's Index to Musical Themes.

ERIC Educational Resources Information Center

Bauer, Harry C.

1978-01-01

This review of Denys Parsons'"Directory of Tunes and Musical Themes" describes its simple but effective method of identifying musical compositions. Comparisons are made with other prominent musical reference works, particularly those of Harold Barlow and Sam Morgenstern. (JD)

Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study.

PubMed

Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che

2016-05-01

Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Child protection assessment in humanitarian emergencies: case studies from Georgia, Gaza, Haiti and Yemen.

PubMed

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-12-01

The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective

Staff perceptions of best practice for information transfer about multitrauma patients on discharge from the emergency department: a focus group study.

PubMed

Calleja, Pauline; Aitken, Leanne; Cooke, Marie

2016-10-01

To understand: (1) staff perceptions of best practice for information transfer for multitrauma patients on discharge from the emergency department; (2) what information should be conveyed at transfer and (3) how information is transferred. Information transfer for multitrauma patients is an integral factor for continuity of care, safety, quality assurance and patient outcomes; however, this has not been the focus of previous studies. This was a qualitative study using focus group interviews. Data were collected during focus group interviews across five clinical areas. Themes were derived from the data with consensus from three data coders. Purposive sampling was used and included staff caring for trauma patients during patient transition out of the emergency department. Participants were representatives of the emergency department, perioperative care, intensive care unit, high dependency care unit and the trauma service unit. Twenty-six registered nurses and two medical officers participated. Five focus group interviews were held. Themes emerged from the data including 'Variability', 'Continuity' and 'Putting the pieces together'. The first three themes were all influenced by the fourth theme of 'Values/Context'. Considered together these themes influenced staff perception of the quality of information transfer for multitrauma patients on discharge from the emergency department. Staff perceived best practice for information transfer to be clear, concise, relevant documentation that travelled with the patient and interactive communication at handover that adhered to agreed principles and a minimum data set specific to trauma patients. Clinicians involved in handover need to actively listen, avoiding 'doing' at the same time, be aware of essential questions to ask about the patient. An agreed expectation between different clinical areas needs to exist about information transfer to reduce variability. The minimum data required to provide ongoing safe care for

"Isms" Theme.

ERIC Educational Resources Information Center

Garrahy, Dennis J.

One of a series of social studies units designed to develop the reading and writing skills of low achievers, this student activity book focuses on the theme of political systems and beliefs. The unit can be used for high school classes, individual study in alternative and continuing high schools, and adult education classes. Following an…

Consumerism Theme.

ERIC Educational Resources Information Center

Garrahy, Dennis J.

One of a series of social studies units designed to develop the reading and writing skills of low achievers, this student activity book focuses on the theme of consumerism. The unit can be used for high school classes, individual study in alternative and continuing high schools, and adult education classes. Following an introduction, five sections…

STEM Focus in Innoventure Competition Theme

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

None

2010-03-31

This report documents the inclusion of the STEM focus in the annual competition theme for the Innoventure youth project. The STEM concepts have always played a part in the selection of the theme. However, this year, STEM is intentionally mentioned in the description of the theme to emphasize the importance of these concepts. This work is a part of the National Security Preparedness Project (NSPP), being performed under a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant.

Technology and Interactive Multimedia. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Ashton, Ray

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the role of interactive multimedia, especially the digital, optical compact disc technologies, in providing instructional services to special education students. An overview identifies technological and economic trends,…

Loss and Transcendence Life Themes.

ERIC Educational Resources Information Center

Weenolsen, Patricia

Psychologists have often observed an underlying pattern or theme in the accounts that individuals give of their lives. To test a humanistic-existential approach to human development, 48 women were interviewed with the Loss and Transcendence (L/T) Life History Form. The L/T Life Theme is expressed in two ways: the expanded version includes the…

Predictive Ability of an Emergency Medical Dispatch Stroke Diagnostic Tool in Identifying Hospital-Confirmed Strokes.

PubMed

Clawson, Jeff J; Scott, Greg; Gardett, Isabel; Youngquist, Scott; Taillac, Peter; Fivaz, Conrad; Olola, Christopher

2016-08-01

Early hospital notification of a possible stroke arriving via emergency medical services (EMS) can prepare stroke center personnel for timely treatment, especially timely administration of tissue plasminogen activator. Stroke center notification from the emergency dispatch center-before responders reach the scene-may promote even earlier and faster system activation, meaning that stroke center teams may be ready to receive patients as soon as the ambulance arrives. This study evaluates the use of a Medical Priority Dispatch System (MPDS; Priority Dispatch Corp., Salt Lake City, UT) Stroke Diagnostic Tool (SDxT) to identify possible strokes early by comparing the tools' results to on-scene and hospital findings. The retrospective descriptive study utilized stroke data from 3 sources: emergency medical dispatch, EMS, and emergency department/hospital. A total of 830 cases were collected between June 2012 and December 2013, of which 603 (72.7%) had matching dispatch records. Of the 603 cases, 304 (50.4%) were handled using MPDS Stroke Protocol 28. The SDxT had an 86.4% ability (OR [95% CI]: 2.3 [1.5, 3.5]) to effectively identify strokes among all the hospital-confirmed stroke cases (sensitivity), and a 26.6% ability to effectively identify nonstrokes among all the hospital-confirmed nonstroke cases (specificity). The SDxT demonstrated a very high sensitivity, compared to similar tools used in the field and at dispatch. The specificity was somewhat low, but this was expected-and is intended in the creation of protocols to be used over the phone in emergency situations. The tool is a valuable method for identifying strokes early and may allow early hospital notification. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Energy Theme.

ERIC Educational Resources Information Center

Garrahy, Dennis J.

One of a series of social studies units designed to develop the reading and writing skills of low achievers, this student activity book focuses on the theme of energy. The unit can be used for high school classes, individual study in alternative and continuing high schools, and adult education classes. Separate sections cover early sources of…

Thirty years of artificial intelligence in medicine (AIME) conferences: A review of research themes.

PubMed

Peek, Niels; Combi, Carlo; Marin, Roque; Bellazzi, Riccardo

2015-09-01

Over the past 30 years, the international conference on Artificial Intelligence in MEdicine (AIME) has been organized at different venues across Europe every 2 years, establishing a forum for scientific exchange and creating an active research community. The Artificial Intelligence in Medicine journal has published theme issues with extended versions of selected AIME papers since 1998. To review the history of AIME conferences, investigate its impact on the wider research field, and identify challenges for its future. We analyzed a total of 122 session titles to create a taxonomy of research themes and topics. We classified all 734 AIME conference papers published between 1985 and 2013 with this taxonomy. We also analyzed the citations to these conference papers and to 55 special issue papers. We identified 30 research topics across 12 themes. AIME was dominated by knowledge engineering research in its first decade, while machine learning and data mining prevailed thereafter. Together these two themes have contributed about 51% of all papers. There have been eight AIME papers that were cited at least 10 times per year since their publication. There has been a major shift from knowledge-based to data-driven methods while the interest for other research themes such as uncertainty management, image and signal processing, and natural language processing has been stable since the early 1990s. AIME papers relating to guidelines and protocols are among the most highly cited. Copyright © 2015 Elsevier B.V. All rights reserved.

A qualitative systematic review of the reasons for parental attendance at the emergency department with children presenting with minor illness.

PubMed

Butun, Ahmet; Hemingway, Pippa

2018-01-01

Over 5 million children attend the Emergency Department (ED) annually in England with an ever-increasing paediatric emergency caseload echoed globally. Approximately 60% of children present with illness and the majority have non-urgent illness creating burgeoning pressures on children's ED and this crisis resonates globally. To date no qualitative systematic review exists that focuses on the parental reasons for childhood attendance at the ED in this sub-group. To identify parental reasons for attending ED for their children presenting with minor illness. A qualitative systematic review was conducted against inclusion/exclusion criteria. Five electronic databases and key journals were searched in June 2015. 471 studies were identified and following study selection, 4 qualitative studies were included. Nine themes were identified e.g. dissatisfaction with family medical services, perceived advantages of ED and 'child suffering' with novel and insightful sub-themes of 'hereditary anxiety', 'taking it off our hands', ED as a 'magical place'. This novel qualitative systematic review examined parental attendance presenting with childhood minor illness of interest to emergency care reformers and clinicians. ED attendance is complex and multifactorial but parents provide vital insight to ED reformers on parental reasons for ED attendance in this sub-group. Copyright © 2017 Elsevier Ltd. All rights reserved.

FY16 Strategic Themes.

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

Leland, Robert W.

2017-03-01

I am pleased to present this summary of the Division 1000 Science and Technology Strategic Plan. This plan was created with considerable participation from all levels of management in Division 1000, and is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. The plan is characterized by four strategic themes: Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Each theme is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16. I want to be clear that this is notmore » a strategy to be pursued in tension with the Laboratory strategic plan. Rather, it is intended to describe “how” we intend to show up for the “what” described in Sandia’s Strategic Plan. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming year.« less

Applying Common Latino Magazine Cover Line Themes to Health Communications

ERIC Educational Resources Information Center

Delaney, Colleen L.; Barrios, Pamela; Lozada, Carolina; Soto-Balbuena, Kenlly; Martin-Biggers, Jennifer; Byrd-Bredbenner, Carol

2016-01-01

This study aimed to describe strategies used in magazine cover lines to capture the attention of Latino consumers. A content analysis of cover lines (n = 581) from six top-selling Latino women's and parenting magazines (n = 217 issues) sold in the United States identified 12 common themes: great/inspiring, beauty/health, bad/negative,…

Themes in Action.

ERIC Educational Resources Information Center

Cania, Lisa M.

1989-01-01

A communications audit, analyzed programs and publications at St. Lawrence University, audience by audience, message by message, and month by month. The ways St. Lawrence integrated themes into major projects as well as into small details is discussed. (MLW)

Nonurgent use of a pediatric emergency department: a preliminary qualitative study.

PubMed

Chin, Nancy P; Goepp, Julius G; Malia, Timothy; Harris, LeWanza; Poordabbagh, Armin

2006-01-01

To understand patterns of decision making among families presenting to a pediatric emergency department (ED) for nonacute care and to understand pediatric ED staff responses. Cross-sectional qualitative study using in-depth interviews, direct observations, and nonidentifying demographic data. Eleven percent of visits made during the study period were identified as nonacute. All were made by families from low-income areas. Three main themes emerged: (1) most families had been referred by their primary care providers; (2) the complexity of living in low-income areas makes the ED a choice of convenience for these stressed families; and (3) mistrust of primary health services was not identified by our respondents as a motivator for ED utilization, in contrast with other published data. Two themes emerged from ED staff: (1) actual nonurgent visit rates were lower than staff estimates; and (2) these visits produced frustration among staff members, although their degrees of insight and understanding of factors motivating these visits were variable. In this setting, nonacute visits occurred with lower than perceived frequency and caused disproportionate frustration among staff and families. These visits appear to be driven more by consequences of system design and structure than by family members' decision making. Mistrust of primary care services was not a strong family decision-making factor; the study's setting may have limited its ability to capture such data. Recommended system changes to lower barriers to primary care include expanded office hours, subsidized staffing for offices in medically underserved areas, and lowering barriers to sick care.

Theme: Urban Agriculture.

ERIC Educational Resources Information Center

Ellibee, Margaret; And Others

1990-01-01

On the theme of secondary agricultural education in urban areas, this issue includes articles on opportunities, future directions, and implications for the profession; creative supervised experiences for horticulture students; floral marketing, multicultural education; and cultural diversity in urban agricultural education. (JOW)

Universal design characteristic on themed streets

NASA Astrophysics Data System (ADS)

Harsritanto, Bangun IR; Indriastjario; Wijayanti

2017-12-01

People around the world can access the streets to fulfil their daily activities regardless of their gender, age, and abilities. The streetscape is an urban public space which is built to facilitate the basic needs of people as social being. The themed street is an urban streetscape designed and built in detail with a theme or special purpose in an of urban development process. Universal design facilitates the full range of human diversity as physical appearance, perception, cognitive abilities, sizes, and shapes. By designing for the diversity, the specialized streets become more functional and user-friendly. The purpose of this study is to examine several design characteristics of themed streets in several countries from three different continents using universal design principles for giving proper directions to develop more user-friendly streets. Literature review and case study were used as research methods. The literature review was extracted and compiled from manuscripts, streetscape design books, and from universal design principles. Furthermore, the constructed theory were used to examine the case studies of themed streets. The findings indicated that themed streets’ character design were strongly influenced by local cultural aspect even though the basic guidelines were universal design principles; the resumed design direction can be suggested universal along with the richness of local aspects.

911 (nueve once): Spanish-speaking parents' perspectives on prehospital emergency care for children.

PubMed

Watts, Jennifer; Cowden, John D; Cupertino, A Paula; Dowd, M Denise; Kennedy, Chris

2011-06-01

Racial, ethnic and language-based disparities occur throughout the US health system. Pediatric prehospital emergency medical services are less likely to be used by Latinos. We identified perceptions of and barriers to prehospital pediatric emergency care (911) access among Spanish-speaking parents. A qualitative study involving six focus groups was conducted. Spanish-speaking parents participated with a bilingual moderator. Topics discussed included experiences, knowledge, beliefs, fears, barriers, and improvement strategies. All groups were audiotaped, transcribed, and reviewed for recurring themes. Forty-nine parents participated. Though parents believed 911 was available to all, many were uncertain how to use it, and what qualified as an emergency. Barriers included language discordance, fear of exposing immigration status, and fear of financial consequences. Parents strongly desired to learn more about 911 through classes, brochures, and media campaigns. Prehospital emergency care should be available to all children. Further quantitative studies may help solidify the identified barriers and uncover areas needing improvement within Emergency Medical Systems. Addressing barriers to 911 use in Spanish-speaking communities could improve the equity of health care delivery, while also decreasing the amount of non-emergency 911 use.

'Registrar in charge shifts': learning how to run a busy emergency department.

PubMed

Craig, Simon; Dowling, Jonathan

2013-04-01

In Australasia, emergency registrars usually gain experience 'running' an ED overnight - without supervision. This paper describes the introduction of FACEM-supervised daytime 'registrar in charge' (RIC) shifts into a tertiary adult ED over a 6 month period. Each registrar was allocated at least one RIC shift during their 13 week ED term. Structured questionnaires gathered data regarding the educational impact of the shifts, any adverse effects on departmental function, changes to work practices, and perceptions of teaching and learning. Data were analysed using thematic analysis. During the study period, 16 senior ED registrars were rostered for 26 RIC shifts. Questionnaires were completed by 16/16 registrars and 13/16 emergency physicians. The RIC shifts were viewed positively by the emergency registrars - 93% reported useful feedback, felt that the shifts provided a good insight into their workplace behaviour, and that they should be rolled out across other departments. FACEMs were also positive in their evaluation, and reported little negative impact on departmental function. Major themes identified by both registrars and emergency physicians included communication skills, knowledge and experience, delegation, professionalism and organisational skills. Additional themes that were more prominent in FACEM responses included multitasking, dealing with interruptions, managing patient flow and being aware of the whole department. RIC shifts are a feasible and acceptable method to teach running the floor in the ED. Further study should assess impact on patient outcomes. © 2013 The Authors. EMA © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review.

PubMed

Ramsbottom, Anna; O'Brien, Eleanor; Ciotti, Lucrezio; Takacs, Judit

2018-04-01

Public health emergency preparedness (PHEP) all too often focusses only on institutional capabilities, including their technical expertise and political influence, while overlooking community capabilities. However, the success of institutional emergency preparedness plans depends upon communities and institutions working together to ensure successful anticipation, response and recovery. Broader community engagement is therefore recommended worldwide. This literature review was carried out to identify enablers and barriers to community and institutional synergies in emergency preparedness. Searches were undertaken across bibliographic databases and grey literature sources. The literature identified was qualitative in nature. A qualitative, 'best fit' framework approach using a pre-existing framework was used to analyse the literature, whereby themes were added and changed as analysis progressed. A working definition of community was identified, based on a 'whole community' approach, inclusive of the whole multitude of stakeholders including community residents and emergency management staff. Given the diversity in community make-up, the types of emergencies that could be faced, the socio-economic, environmental and political range of communities, there are no set practices that will be effective for all communities. The most effective way of engaging communities in emergency preparedness is context-dependent and the review did draw out some important key messages for institutions to consider.

Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids.

PubMed

Conrardy, Michael; Lank, Patrick; Cameron, Kenzie A; McConnell, Ryan; Chevrier, Alison; Sears, Jill; Ahlstrom, Eric; Wolf, Michael S; Courtney, D Mark; McCarthy, Danielle M

2016-01-01

To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids. Mixed methods analysis of data from a randomized controlled trial. Urban academic ED (>88,000 visits). One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain. The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories. Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction. In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2016. This work is written by US Government

On the Threshold of Safety: A Qualitative Exploration of Nurses' Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments.

PubMed

Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Clark, Paul R; Moon, Michael D

2017-03-01

The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study is to explore emergency nurses' perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations. We used a qualitative exploratory design with focus group data from a sample of 26 emergency nurses. Themes were identified using a constructivist perspective and an inductive approach to content analysis. Five themes were identified: (1) unsafe environment of care, (2) components of safety, (3) patient outcomes: risky care, (4) nursing outcomes: leaving the profession, and (5) possible solutions. Participants reported that staffing levels are determined by the number of beds in the department (as in inpatient units) but not by patient acuity or the number of patients waiting for treatment. Participants identified both absolute numbers of staff, as well as experience mix, as components of safe staffing. Inability to predict the acuity of patients waiting to be seen was a major component of nurses' perceptions of unsafe staffing. Emergency nurses perceive staffing to be inadequate, and therefore unsafe, because of the potential for poor patient outcomes, including missed or delayed care, missed deterioration (failure to rescue), and additional ED visits resulting from ineffective discharge teaching. Both absolute numbers of staff, as well as skill and experience mix, should be considered to provide staffing levels that promote optimal patient and nurse outcomes. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Don't Label Me: A Qualitative Study of Patients' Perceptions and Experiences of Sedation During Behavioral Emergencies in the Emergency Department.

PubMed

Yap, Celene Y L; Knott, Jonathan C; Kong, David C M; Gerdtz, Marie; Stewart, Kay; Taylor, David M

2017-08-01

Behavioral emergencies are commonly seen in emergency departments (EDs). Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and the staff. While the experience of staff caring for this population has been reported, patients' experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies. Face-to-face semistructured interviews were conducted with adults aged 18 years or older, who had received parenteral sedative medication for the management of a behavioral emergency and were deemed capable to participate. The participants were asked about their experiences of receiving care in the ED during the episode and their perceptions of sedation. All interviews were transcribed verbatim and analyzed thematically. Data saturation was reached after 13 interviews. Two broad themes emerged: trusting relationships and needs or wants following sedation. A trusting relationship is built through 1) confidence in care, 2) sedation as an appropriate treatment, 3) insight into own behavior, and 4) humane treatment. Four subthemes of needs or wants were identified: 1) empathy, 2) debrief, 3) addressing concerns, and 4) follow-up. A trusting relationship was identified as crucial to minimize the negative impact of coercive measures used to manage behavioral emergencies. Participants expressed similar needs to patients presenting with medical problems. This study illustrates their needs for compassionate communication, adequate information about the treatment provided, and follow-up care. © 2017 by the Society for Academic Emergency Medicine.

Advances in ADHD Research through the Lifespan: Common Themes and Implications

ERIC Educational Resources Information Center

Houghton, Stephen

2006-01-01

This short commentary synthesises all of the articles presented in Volume 53, Special Issues 1 and 2 of the "International Journal of Disability, Development and Education" and identifies some common themes among them. It also links some of the research findings to the influential International Consensus Statement on Attention Deficit…

Rating teams' non-technical skills in the emergency department: A qualitative study of nurses' experience.

PubMed

Porter, Joanne E; Cant, Robyn P; Cooper, Simon J

2018-05-01

Non-technical skills (NTS) teamwork training can enhance clinicians' understanding of roles and improve communication. We evaluated a quality improvement project rating teams' NTS performance to determine the value of formal rating and debriefing processes. In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Main themes were: 'Team composition' (allocation of resuscitation team roles), 'Resuscitation leadership' (including both nursing and medical leadership roles) and 'TEAM™ ratings promote reflective practice' (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance. Copyright © 2018 Elsevier Ltd. All rights reserved.

THE FUKUSHIMA RADIOLOGICAL EMERGENCY AND CHALLENGES IDENTIFIED FOR FUTURE PUBLIC HEALTH RESPONSES

PubMed Central

Miller, Charles W.

2015-01-01

On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of “public health concern.” This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency. PMID:22469934

The Fukushima radiological emergency and challenges identified for future public health responses.

PubMed

Miller, Charles W

2012-05-01

On 11 March 2011, northern Japan was rocked by first a magnitude 9.0 earthquake off the eastern coast and then an ensuing tsunami. The Fukushima Daiichi Nuclear Power Plant complex was hit by these twin disasters, and a cascade of events was initiated that led to radionuclide releases causing widespread radioactive contamination of residential areas, agricultural land, and coastal waters. Radioactive material from Japan was subsequently transmitted to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to be a concern for health effects, but the presence of this material in the environment was enough to create a public health emergency in the U.S. The radiation safety and public health communities in the U.S. are identifying challenges they faced in responding to this incident. This paper discusses three of those challenges: (1) The growing shortage of trained radiation subject matter experts in the field of environmental transport and dosimetry of radionuclides; (2) the need to begin expressing all radiation-related quantities in terms of the International System of Units; and (3) the need to define when a radiation dose is or is not one of "public health concern." This list represents only a small subset of the list of challenges being identified by public health agencies that responded to the Fukushima incident. However, these three challenges are fundamental to any radiological emergency response. Addressing them will have a significant positive impact on how the U.S. responds to the next radiological emergency.

A structured review and theme analysis of papers published on 'quality of life' in head and neck cancer: 2000-2005.

PubMed

Rogers, S N; Ahad, S A; Murphy, A P

2007-10-01

Over the past 10 years, quality of life (QOL) has been increasingly recognised as an important outcome parameter in head and neck cancer. Validated questionnaires have emerged and there has been an increase in the number of papers published each year. The aim of this article is to review the literature over the past five years (2000-2005 inclusive), to identify papers reporting outcomes using patient self-competed questionnaires and group these into themes. The tabulated summary allows for the areas of health related quality of life research to be identified and to explore issues that are perhaps deficit in the literature. The three authors independently searched the literature published in the English language using the ISI search engine with cross-reference using Pub Med and Ovid. The search terms were; quality of life, questionnaire, and head and neck cancer. Studies were placed in to one of five themes. There were 165 studies identified. The numbers in each theme were predictors of QOL [Hassanein KA, Musgrove BT, Bradbury E. Functional status of patients with oral cancer and its relation to style of coping, social support and psychological status. Br J Oral Maxillofac Surg 2001;39:340-5.], functional outcome [Klug C, Neuburg J, Glaser C, Schwarz B, Kermer C, Millesi W. Quality of life 2-10 years after combined treatment for advanced oral and oropharyngeal cancer. Int J Oral Maxillofac Surg 2002;31:664-9.], questionnaire development [Hanna E, Sherman A, Cash D, Adams D, Vural E, Fan CY, et al. Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation. Arch Otolaryngol Head Neck Surg 2004;130:875-9.], randomised clinical trials [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 2004;86:6-10.], and reviews [Kanatas AN, Rogers SN. A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll

Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

PubMed

Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

2018-04-09

Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

Theme: Laboratory Instruction.

ERIC Educational Resources Information Center

Bruening, Thomas H.; And Others

1992-01-01

A series of theme articles discuss setting up laboratory hydroponics units, the school farm at the Zuni Pueblo in New Mexico, laboratory experiences in natural resources management and urban horticulture, the development of teaching labs at Derry (PA) High School, management of instructional laboratories, and industry involvement in agricultural…

Theme: Agricultural Literacy.

ERIC Educational Resources Information Center

Deeds, Jacquelyn P.; And Others

1991-01-01

Six theme articles attempt to define and advocate agricultural literacy, review the status of K-8 agricultural literacy programs in states, discuss an Oklahoma study of agricultural literacy, clarify the meaning of sustainable agriculture, and describe the Future Farmers of America's Food for America program for elementary students. (SK)

Occupational injuries identified by an emergency department based injury surveillance system in Nicaragua

PubMed Central

Noe, R; Rocha, J; Clavel-Arcas, C; Aleman, C; Gonzales, M; Mock, C

2004-01-01

Objectives: To identify and describe the work related injuries in both the formal and informal work sectors captured in an emergency department based injury surveillance system in Managua, Nicaragua. Setting: Urban emergency department in Managua, Nicaragua serving 200–300 patients per day. Methods: Secondary analysis from the surveillance system data. All cases indicating an injury while working and seen for treatment at the emergency department between 1 August 2001 and 31 July 2002 were included. There was no exclusion based on place of occurrence (home, work, school), age, or gender. Results: There were 3801 work related injuries identified which accounted for 18.6% of the total 20 425 injures captured by the surveillance system. Twenty seven work related fatalities were recorded, compared with the 1998 International Labor Organization statistic of 25 occupational fatalities for all of Nicaragua. Injuries occurring outside of a formal work location accounted for more than 60% of the work related injuries. Almost half of these occurred at home, while 19% occurred on the street. The leading mechanisms for work related injuries were falls (30%), blunt objects (28%), and stabs/cuts (23%). Falls were by far the most severe mechanism in the study, causing 37% of the work related deaths and more than half of the fractures. Conclusions: Occupational injuries are grossly underreported in Nicaragua. This study demonstrated that an emergency department can be a data source for work related injuries in developing countries because it captures both the formal and informal workforce injuries. Fall prevention initiatives could significantly reduce the magnitude and severity of occupational injuries in Managua, Nicaragua. PMID:15314050

Research fronts analysis : A bibliometric to identify emerging fields of research

NASA Astrophysics Data System (ADS)

Miwa, Sayaka; Ando, Satoko

Research fronts analysis identifies emerging areas of research through observing co-clustering in highly-cited papers. This article introduces the concept of research fronts analysis, explains its methodology and provides case examples. It also demonstrates developing research fronts in Japan by looking at the past winners of Thomson Reuters Research Fronts Awards. Research front analysis is currently being used by the Japanese government to determine new trends in science and technology. Information professionals can also utilize this bibliometric as a research evaluation tool.

Development of a novel scoring system for identifying emerging chemical risks in the food chain.

PubMed

Oltmanns, J; Licht, O; Bitsch, A; Bohlen, M-L; Escher, S E; Silano, V; MacLeod, M; Serafimova, R; Kass, G E N; Merten, C

2018-02-21

The European Food Safety Authority (EFSA) is responsible for risk assessment of all aspects of food safety, including the establishment of procedures aimed at the identification of emerging risks to food safety. Here, a scoring system was developed for identifying chemicals registered under the European REACH Regulation that could be of potential concern in the food chain using the following parameters: (i) environmental release based on maximum aggregated tonnages and environmental release categories; (ii) biodegradation in the environment; (iii) bioaccumulation and in vivo and in vitro toxicity. The screening approach was tested on 100 data-rich chemicals registered under the REACH Regulation at aggregated volumes of at least 1000 tonnes per annum. The results show that substance-specific data generated under the REACH Regulation can be used to identify potential emerging risks in the food chain. After application of the screening procedure, priority chemicals can be identified as potentially emerging risk chemicals through the integration of exposure, environmental fate and toxicity. The default approach is to generate a single total score for each substance using a predefined weighting scenario. However, it is also possible to use a pivot table approach to combine the individual scores in different ways that reflect user-defined priorities, which enables a very flexible, iterative definition of screening criteria. Possible applications of the approaches are discussed using illustrative examples. Either approach can then be followed by in-depth evaluation of priority substances to ensure the identification of substances that present a real emerging chemical risk in the food chain.

Theme-Based Tests: Teaching in Context

ERIC Educational Resources Information Center

Anderson, Gretchen L.; Heck, Marsha L.

2005-01-01

Theme-based tests provide an assessment tool that instructs as well as provides a single general context for a broad set of biochemical concepts. A single story line connects the questions on the tests and models applications of scientific principles and biochemical knowledge in an extended scenario. Theme-based tests are based on a set of…

What is shared, what is different? Core relational themes and expressive displays of eight positive emotions.

PubMed

Campos, Belinda; Shiota, Michelle N; Keltner, Dacher; Gonzaga, Gian C; Goetz, Jennifer L

2013-01-01

Understanding positive emotions' shared and differentiating features can yield valuable insight into the structure of positive emotion space and identify emotion states, or aspects of emotion states, that are most relevant for particular psychological processes and outcomes. We report two studies that examined core relational themes (Study 1) and expressive displays (Study 2) for eight positive emotion constructs--amusement, awe, contentment, gratitude, interest, joy, love, and pride. Across studies, all eight emotions shared one quality: high positive valence. Distinctive core relational theme and expressive display patterns were found for four emotions--amusement, awe, interest, and pride. Gratitude was associated with a distinct core relational theme but not an expressive display. Joy and love were each associated with a distinct expressive display but their core relational themes also characterised pride and gratitude, respectively. Contentment was associated with a distinct expressive display but not a core relational theme. The implications of this work for the study of positive emotion are discussed.

Children Exploring Their World: Theme Teaching in Elementary School.

ERIC Educational Resources Information Center

Walmsley, Sean A.

With this book as a guide, elementary school teachers can build classroom themes that offer students substantive encounters with knowledge, literature, and language. The book discusses a rationale for theme teaching; an explanation of the different kinds of themes; a variety of ways in which themes can be treated in the classroom; a detailed…

[The most cited themes in the research in the field of Mental Health: analyses of six international nursing and medical journals].

PubMed

Cunico, Laura; Fredo, Susanna; Bernini, Massimo

2017-01-01

The review aimed to identify and analyse the future development on the topic by analysing the main themes discussed in number of scientific journal focused on Mental Health both by nurses and physicians.. 4 international journals focused on Mental health and psychiatry International Journal of Mental Health Nursing, Archives of Psychiatric Nursing, American Journal of Psychiatry, Australian and New Zeland Journal of Psychiatry as well as two journal focused generically on health, Journal of Advanced Nursing and Lancet were scrutinized. We have analysed the papers of 2012-2015 for the specialised journals and last and first 6 months of 2012 and 2013 and 2014-2015 for the generic. Editorials, comments and contributions regarding theoretical models were exluded. From the analysis we identified 9 themes and for each theme the pertinent category. For the diagnostic grouping we used the International Statistical Classification of Diseases and Related Health Problems 10th Revision. A trend in research about mood disorders, schizophrenia and addictions and comorbidity emerged according to the 2099 abstracts analysed. Within medical research antidepressants were the most studied psychotropic medication and cognitive behaviour therapy was the most studied psychotherapy. Within nursing research: the nurse-patient relationship, adherence and monitoring of pharmacological therapy, the treatment planning and the working environment, the nursing training and its efficacy. The clinical research trials were twice as frequent in the medical versus nursing research where qualitative research prevails. The research challenge will be to find a new paradigm fit for the future psychiatry having at its disposition the patient's genoma, and needing to routinely use biomarkers for a personalised therapy. A further challenge might be the promotion of interprofessional research between doctors and nurses and the acquisition of new competences of health professionals needed to tackle the

The arcuate fasciculus and the disconnection theme in language and aphasia: History and current state

PubMed Central

Catani, Marco; Mesulam, Marsel

2009-01-01

Few themes have been more central to neurological models of aphasia than the disconnection paradigm and the role of the arcuate fasciculus. Introduced by luminaries of 19th Century neurology and resurrected by the charismatic work of Norman Geschwind, the disconnection theme has triggered spectacular advances of modern understanding of language and aphasia. But the disconnection paradigm had alternate fortunes, ranging from irrational exuberance to benign neglect, and its followers have not always shared the same view on its functional consequences and anatomical correlates. Our goal in this paper is, first, to survey the 19th Century roots of the connectionist approach to aphasia and, second, to describe emerging imaging technologies based on diffusion tensor imaging (DTI) that promise to consolidate and expand the disconnection approach to language and its disorders. PMID:18614162

The arcuate fasciculus and the disconnection theme in language and aphasia: history and current state.

PubMed

Catani, Marco; Mesulam, Marsel

2008-09-01

Few themes have been more central to neurological models of aphasia than the disconnection paradigm and the role of the arcuate fasciculus. Introduced by luminaries of 19th Century neurology and resurrected by the charismatic work of Norman Geschwind, the disconnection theme has triggered spectacular advances of modern understanding of language and aphasia. But the disconnection paradigm had alternate fortunes, ranging from irrational exuberance to benign neglect, and its followers have not always shared the same view on its functional consequences and anatomical correlates. Our goal in this paper is, first, to survey the 19th Century roots of the connectionist approach to aphasia and, second, to describe emerging imaging technologies based on diffusion tensor imaging (DTI) that promise to consolidate and expand the disconnection approach to language and its disorders.

The role of tobacco advertising and promotion: themes employed in litigation by tobacco industry witnesses

PubMed Central

Goldberg, Marvin E; Davis, Ronald M; O'Keefe, Anne Marie

2006-01-01

Objectives To identify key themes related to tobacco advertising and promotion in testimony provided by tobacco industry‐affiliated witnesses in tobacco litigation, and to present countervailing evidence and arguments. Methods Themes in industry testimony were identified by review of transcripts of testimony in the Tobacco Deposition and Trial Testimony Archive (http://tobaccodocuments.org/datta) from a sample of defence witnesses, including three academic expert witnesses, six senior executives of tobacco companies, and one industry advertising consultant. Counterarguments to the themes embodied in defence testimony were based on information from peer‐reviewed literature, advertising trade publications, government reports, tobacco industry documents, and testimony provided by expert witnesses testifying for plaintiffs. Results Five major themes employed by defence witnesses were identified: (1) tobacco advertising has a relatively weak “share of voice” in the marketing environment and is a weak force in affecting smoking behaviour; (2) tobacco advertising and promotion do not create new smokers, expand markets, or increase total tobacco consumption; (3) the tobacco industry does not target, study, or track youth smoking; (4) tobacco advertising and promotion do not cause smoking initiation by youth; and (5) tobacco companies and the industry adhere closely to relevant laws, regulations, and industry voluntary codes. Substantial evidence exists in rebuttal to these arguments. Conclusions Tobacco industry‐affiliated witnesses have marshalled many arguments to deny the adverse effects of tobacco marketing activities and to portray tobacco companies as responsible corporate citizens. Effective rebuttals to these arguments exist, and plaintiffs' attorneys have, with varying degrees of success, presented them to judges and juries. PMID:17130625

The role of tobacco advertising and promotion: themes employed in litigation by tobacco industry witnesses.

PubMed

Goldberg, Marvin E; Davis, Ronald M; O'Keefe, Anne Marie

2006-12-01

To identify key themes related to tobacco advertising and promotion in testimony provided by tobacco industry-affiliated witnesses in tobacco litigation, and to present countervailing evidence and arguments. Themes in industry testimony were identified by review of transcripts of testimony in the Tobacco Deposition and Trial Testimony Archive (http://tobaccodocuments.org/datta) from a sample of defence witnesses, including three academic expert witnesses, six senior executives of tobacco companies, and one industry advertising consultant. Counterarguments to the themes embodied in defence testimony were based on information from peer-reviewed literature, advertising trade publications, government reports, tobacco industry documents, and testimony provided by expert witnesses testifying for plaintiffs. Five major themes employed by defence witnesses were identified: (1) tobacco advertising has a relatively weak "share of voice" in the marketing environment and is a weak force in affecting smoking behaviour; (2) tobacco advertising and promotion do not create new smokers, expand markets, or increase total tobacco consumption; (3) the tobacco industry does not target, study, or track youth smoking; (4) tobacco advertising and promotion do not cause smoking initiation by youth; and (5) tobacco companies and the industry adhere closely to relevant laws, regulations, and industry voluntary codes. Substantial evidence exists in rebuttal to these arguments. Tobacco industry-affiliated witnesses have marshalled many arguments to deny the adverse effects of tobacco marketing activities and to portray tobacco companies as responsible corporate citizens. Effective rebuttals to these arguments exist, and plaintiffs' attorneys have, with varying degrees of success, presented them to judges and juries.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

ERIC Educational Resources Information Center

Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

Emerging themes in heterotrimeric G-protein signaling in plants.

PubMed

Pandey, Sona; Vijayakumar, Anitha

2018-05-01

Heterotrimeric G-proteins are key signaling components involved during the regulation of a multitude of growth and developmental pathways in all eukaryotes. Although the core proteins (Gα, Gβ, Gγ subunits) and their basic biochemistries are conserved between plants and non-plant systems, seemingly different inherent properties of specific components, altered wirings of G-protein network architectures, and the presence of novel receptors and effector proteins make plant G-protein signaling mechanisms somewhat distinct from the well-established animal paradigm. G-protein research in plants is getting a lot of attention recently due to the emerging roles of these proteins in controlling many agronomically important traits. New findings on both canonical and novel G-protein components and their conserved and unique signaling mechanisms are expected to improve our understanding of this important module in affecting critical plant growth and development pathways and eventually their utilization to produce plants for the future needs. In this review, we briefly summarize what is currently known in plant G-protein research, describe new findings and how they are changing our perceptions of the field, and discuss important issues that still need to be addressed. Copyright © 2018 Elsevier B.V. All rights reserved.

Converging cellular themes for the hereditary spastic paraplegias.

PubMed

Blackstone, Craig

2018-05-10

Hereditary spastic paraplegias (HSPs) are neurologic disorders characterized by prominent lower-extremity spasticity, resulting from a length-dependent axonopathy of corticospinal upper motor neurons. They are among the most genetically-diverse neurologic disorders, with >80 distinct genetic loci and over 60 identified genes. Studies investigating the molecular pathogenesis underlying HSPs have emphasized the importance of converging cellular pathogenic themes in the most common forms of HSP, providing compelling targets for therapy. Most notably, these include organelle shaping and biogenesis as well as membrane and cargo trafficking. Published by Elsevier Ltd.

Theme: Developing Entrepreneurship.

ERIC Educational Resources Information Center

Lawrence, Layle D.; And Others

1990-01-01

Eight articles discuss the theme of entrepreneurship in the rural United States. Includes results of a survey of vocational agricultural graduates who are either sole proprietors or partners in agricultural occupations and a description of an award-winning program at Western High School in Russiaville, Indiana. Also discusses the economics of a…

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men’s and women’s culturally-ascribed attitudes and behaviours

PubMed Central

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E.; Whitt, Elaine; Martin, Steven S.; O’Connell, Daniel J.

2014-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet, there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women’s condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida (USA). The study used a qualitative study-design and collected data from sixteen focus groups with a total of 67 Latino men and women. Finding from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men’s classification of women as clean/dirty to determine condom use and women’s assertiveness during sexual encounters negotiating condom use-in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage. PMID:25530309

Identifying nontechnical skills associated with safety in the emergency department: a scoping review of the literature.

PubMed

Flowerdew, Lynsey; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria

2012-05-01

Understanding the nontechnical skills specifically applicable to the emergency department (ED) is essential to facilitate training and more broadly consider interventions to reduce error. The aim of this scoping review is to first identify and then explore in depth the nontechnical skills linked to safety in the ED. The review was conducted in 2 stages. In stage 1, online databases were searched for published empirical studies linking nontechnical skills to safety and performance in the ED. Articles were analyzed to identify key ED nontechnical skills. In stage 2, these key skills were used to generate additional key words, which enabled a second search of the literature to be undertaken and expand on the evidence available for review. In stage 1, 11 articles were retrieved for data analysis and 9 core emergency medicine nontechnical skills were identified. These were communicating, managing workload, anticipating, situational awareness, supervising and providing feedback, leadership, maintaining standards, using assertiveness, and decisionmaking. In stage 2, a secondary search, using these 9 skills and related terms, uncovered a further 21 relevant articles. Therefore, 32 articles were used to describe the main nontechnical skills linked to safety in the ED. This article highlights the challenges of reviewing a topic for which the terms are not clearly defined in the literature. A novel methodological approach is described that provides a structured and transparent process for reviewing the literature in emerging areas of interest. A series of literature reviews focusing on individual nontechnical skills will provide a clearer understanding of how the skills identified contribute to safety in the ED. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Identifying Strategies to Decrease Overtime, Absenteeism and Agency Use: Insights from Healthcare Leaders.

PubMed

Jeffs, Lianne; Grinspun, Doris; Closson, Tom; Mainville, Marie-Claude

2015-09-01

Working overtime, absenteeism and agency use can negatively impact working environments, the health of staff and patient outcomes, and increase healthcare costs. The purpose of this study was to explore how healthcare leaders in Ontario hospitals implement and sustain best practices that advance workforce stability within their organization. Qualitative study design using semi-structured interviews and thematic analysis. Participants included 23 healthcare leaders from 16 hospital sites. Two main themes emerged: (1) enacting proactive human resource practices and (2) having strong, caring and strategic leaders that create learning and supportive work environments. A number of sub-themes identified were reported through narratives stratified according to size (small/large) and performance (low/high) of each site. Insights gained from this study may offer healthcare leaders strategies to maximize the nursing workforce and minimize overtime, absenteeism and agency use to ensure safe, efficient and quality healthcare. Copyright © 2015 Longwoods Publishing.

How to Plan a Theme Based Field Day

ERIC Educational Resources Information Center

Shea, Scott A.; Fagala, Lisa M.

2006-01-01

Having a theme-based field day is a great way to get away from doing the traditional track-and-field type events, such as the softball throw, 50 yard dash, and sack race, year after year. In a theme-based field day format all stations or events are planned around a particular theme. This allows the teacher to be creative while also adding…

Semantic Theme Analysis of Pilot Incident Reports

NASA Technical Reports Server (NTRS)

Thirumalainambi, Rajkumar

2009-01-01

Pilots report accidents or incidents during take-off, on flight and landing to airline authorities and Federal aviation authority as well. The description of pilot reports for an incident contains technical terms related to Flight instruments and operations. Normal text mining approaches collect keywords from text documents and relate them among documents that are stored in database. Present approach will extract specific theme analysis of incident reports and semantically relate hierarchy of terms assigning weights of themes. Once the theme extraction has been performed for a given document, a unique key can be assigned to that document to cross linking the documents. Semantic linking will be used to categorize the documents based on specific rules that can help an end-user to analyze certain types of accidents. This presentation outlines the architecture of text mining for pilot incident reports for autonomous categorization of pilot incident reports using semantic theme analysis.

Common themes in changing vector-borne disease scenarios.

PubMed

Molyneux, David H

2003-01-01

The impact of climate change on disease patterns is controversial. However, global burden of disease studies suggest that infectious diseases will contribute a proportionately smaller burden of disease over the next 2 decades as non-communicable diseases emerge as public health problems. However, infectious diseases contribute proportionately more in the poorest quintile of the population. Notwithstanding the different views of the impact of global warming on vector-borne infections this paper reviews the conditions which drive the changing epidemiology of these infections and suggests that such change is linked by common themes including interactions of generalist vectors and reservoir hosts at interfaces with humans, reduced biodiversity associated with anthropogenic environmental changes, increases in Plasmodium falciparum: P. vivax ratios and well-described land use changes such as hydrological, urbanization, agricultural, mining and forest-associated impacts (extractive activities, road building, deforestation and migration) which are seen on a global scale.

Theme: Delivering Agricultural Literacy.

ERIC Educational Resources Information Center

Reed, Warren D.; And Others

1990-01-01

Eight articles in this theme issue deal with the nationwide implementation of agricultural literacy programs--discovering how to do it. Discussed are experiences in planning and conducting agricultural literacy programs at state and local levels. (JOW)

FY16 Strategic Themes White Paper.

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

Leland, Robert W.

The Science and Technology (S&T) Division 1000 Strategic Plan includes the Themes, Goals, and Actions for FY16. S&T will continue to support the Labs Strategic plan, Mission Areas and Program Management Units by focusing on four strategic themes that align with the targeted needs of the Labs. The themes presented in this plan are Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Collectively they emphasize diverse, collaborative teams and a self-reliant culture of safety that will deliver on our promise of exceptional service in the national interest like never before. Mission Engagement focuses on increasing collaboration at allmore » levels but with emphasis at the strategic level with mission efforts across the labs. Bold Outcomes seeks to increase the ability to take thoughtful risks with the goal of achieving transformative breakthroughs more frequently. Collaborative environment strives for a self-aware, collaborative working environment that bridges the many cultures of Sandia. Finally, Safety Imperative aims to minimize the risk of serious injury and to continuously strengthen the safety culture. Each of these themes is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16 and leading into FY17.« less

Application of Transcultural Themes in International Classrooms

ERIC Educational Resources Information Center

Van Hook, Steven R.

2007-01-01

The effective use of transcultural themes and images may help promote positive resonance in international settings, such as found in the traditional and online classrooms of globalizing higher education. Findings of transculturally resonant themes and images may be applied to international classroom pedagogy through such means as multimedia…

Theme: In-Agriculture Curriculum.

ERIC Educational Resources Information Center

Elliot, Jack, Ed.; And Others

1991-01-01

Seven theme articles review the history and philosophy of vocational agriculture, its relationship to the national goals for education, the place of sustainable agriculture and supervised experience in the curriculum, diversifying the curriculum, and fisheries education programs in Alaska. (SK)

Mapping the Terrain of Homosexually-Themed Language

PubMed Central

McCormack, Mark

2011-01-01

In this article, I present a new model for understanding homosexually-themed language. By detailing how old conceptualizations of homophobic language no longer maintain heuristic utility in explaining the social dynamics of many sport and educational settings, I situate other conceptualizations of homosexually-themed language depending on the cultural context. I argue that whether language is considered homophobic, or whether it is better conceptualized as fag discourse, gay discourse or pro-gay language, is primarily dependent on the homohysteria of a setting. This model should enable scholars and educators to understand the operation of homosexually-themed language in society and properly evaluate the homophobia of a setting. PMID:21534076

Sex- and gender-specific research priorities for the emergency management of heart failure and acute arrhythmia: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

PubMed

McGregor, Alyson J; Frank Peacock, W; Marie Chang, Anna; Safdar, Basmah; Diercks, Deborah

2014-12-01

The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in seven priority themes that are essential to the common complex clinical syndrome of heart failure for both men and women and include the areas of pathophysiology; presentation and symptomatology; and diagnostic strategies using biomarkers, treatment, and mortality, with special consideration to arrhythmia management and pregnancy. © 2014 by the Society for Academic Emergency Medicine.

Theme Parks: Program Variety and Employment Options.

ERIC Educational Resources Information Center

Samuels, Jack B.

1983-01-01

This article describes a number of privately operated theme parks, explains why the parks have been successful, and looks at career opportunities for leisure professionals in this expanding area. Implications for recreation education are pointed out, and names and addresses of major companies in the theme park business are provided. (PP)

Speech-Act and Text-Act Theory: "Theme-ing" in Freshman Composition.

ERIC Educational Resources Information Center

Horner, Winifred B.

In contrast to a speech-act theory that is limited by a simple speaker/hearer relationship, a text-act theory of written language allows for the historical or personal context of a writer and reader, both in the written work itself and in the act of reading. This theory can be applied to theme writing, essay examinations, and revision in the…

Workforce 2000 and the Mildly Handicapped. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Woodward, John

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper explores the changing nature of the workforce in relation to concurrent changes in education services for students with mild disabilities. Current trends are identified and projections for the next decade are offered, which include the…

Exploring the emerging profession of speech-language pathology in Vietnam through pioneering eyes.

PubMed

Atherton, Marie; Davidson, Bronwyn; McAllister, Lindy

2017-04-01

In September 2012, 18 Vietnamese health professionals graduated as Vietnam's first university qualified speech-language pathologists (SLPs). This study details the reflections of these pioneering health professionals at 12 months following their graduation, drawing attention to their scope of practice as SLPs and to the opportunities and challenges to progressing the practice of speech-language pathology (SLP) in Vietnam. Thirteen graduates participated in small group interviews where they described their work and their perceptions of their emerging practice. Thematic analysis of the interview transcripts was employed to identify key concepts and themes within the data. Four overarching themes were identified-scope of practice, establishing identity, confidence to practise and progressing the profession. Overall analysis revealed evolving professional practice characterised by new learning, fluctuations in confidence and an active forging of professional identity. Mentoring and support by international colleagues and advancing professional recognition were identified as critical to the profession's progression and to the development of context-specific and culturally appropriate services. Participants' reflections draw focus to an important role for the international SLP community as it works in partnership with colleagues to enhance awareness of and services for people with communication disabilities in under-served communities such as Vietnam.

Culture Writ Electronic: Themes in Television Advertising.

ERIC Educational Resources Information Center

Cheney, Michael R.

A content analysis was made of the advertisements broadcast during a half-hour of prime-time television, in an effort to discern the overt (obvious) and covert (underlying) themes present in television advertising. The analysis revealed an overt theme of a world view of individual determination, initiative, self-confidence and self-reliance, and…

Themes to Emphasize in the Geography Curriculum

ERIC Educational Resources Information Center

Ediger, Marlow

2005-01-01

There are major themes in geography, which all teachers should incorporate into the social studies. These themes assist students to organize information and relate relevant ideas. Teachers need to study and experiment with using a set of structural ideas to facilitate student learning. Otherwise, learning may comprise of isolated facts, concepts,…

Surveillance of Washington OSHA exposure data to identify uncharacterized or emerging occupational health hazards.

PubMed

Lofgren, Don J; Reeb-Whitaker, Carolyn K; Adams, Darrin

2010-07-01

Chemical substance exposure data from the Washington State Occupational Safety and Health Administration (OSHA) program were reviewed to determine if inspections conducted as a result of a report of a hazard from a complainant or referent may alert the agency to uncharacterized or emerging health hazards. Exposure and other electronically stored data from 6890 health inspection reports conducted between April 2003 and August 2008 were extracted from agency records. A total of 515 (7%) inspections with one or more personal airborne chemical substance samples were identified for further study. Inspections by report of a hazard and by targeting were compared for the following: number of inspections, number and percentage of inspections with workers exposed to substances above an agency's permissible exposure limit, types of industries inspected, and number and type of chemical substances assessed. Report of a hazard inspections documented work sites with worker overexposure at the same rate as agency targeted inspections (approximately 35% of the time), suggesting that complainants and referents are a credible pool of observers capable of directing the agency to airborne chemical substance hazards. Report of a hazard inspections were associated with significantly broader distribution of industries as well as a greater variety of chemical substance exposures than were targeted inspections. Narrative text that described business type and processes inspected was more useful than NAICS codes alone and critical in identifying processes and industries that may be associated with new hazards. Finally, previously identified emerging hazards were found among the report of a hazard data. These findings indicate that surveillance of OSHA inspection data can be a valid tool to identify uncharacterized and emerging health hazards. Additional research is needed to develop criteria for objective review and prioritization of the data for intervention. Federal OSHA and other state

Using Philosophical Liberalism and Philosophical Conservatism as an Organizing Theme in the First Half of the American History Survey

ERIC Educational Resources Information Center

Morris, Richard J.

2009-01-01

Since approximately 1970, many historians have been seeking a unifying theme for the American History Survey. Early in the twentieth century, Progressive historians identified class conflict as the main theme in American History, but during the 1950s and 1960s, this view was challenged by the Consensus Schools' assertion that Americans have always…

Identifying Preschool Children At-Risk of Later Reading Difficulties: Evaluation of two Emergent Literacy Screening Tools

PubMed Central

Wilson, Shauna B.; Lonigan, Christopher J.

2012-01-01

Emergent literacy skills are predictive of children’s early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to good emergent literacy interventions. In this study, 176 preschoolers were administered two screening tools, the Revised Get Ready to Read! (GRTR-R) and the Individual Growth and Development Indicators (IGDIs), and a diagnostic measure at two time points. Receiver operating characteristic curve analyses revealed that at optimal cut scores, GRTR-R provided more accurate classification of children’s overall emergent literacy skills than did IGDIs. However, neither measure was particularly good at classifying specific emergent literacy skills. PMID:19822699

The use of negative themes in television food advertising.

PubMed

Pettigrew, Simone; Roberts, Michele; Chapman, Kathy; Quester, Pascale; Miller, Caroline

2012-04-01

The ability of food advertising to trigger food consumption and influence social norms relating to food consumption has resulted in increasing attention being given to the prevalence and nature of food advertising. The present study investigated the use of negative themes in food advertisements aired on Australian television to determine the prevalence of depictions of violence/aggression, mocking, nagging, boredom, loneliness, food craving, mood enhancement, and the emotional use of food across 61 days of programming time. The results suggest that advertisers are using negative themes to capture attention and invoke an emotional response in the target audience. Sixteen percent (14,611) of the 93,284 food advertisements contained negative themes, with mood enhancement and food craving being the most commonly depicted negative themes. Advertisements with negative themes were more likely to be for non-core foods and to be aired during children's popular viewing times than at other times. The potential for negative themes in food advertising to promote unhealthy food consumption behaviors among children is likely to be of concern to policy makers. Building on this exploratory study, further research is needed to investigate how nutrition-related decision making is affected by exposure to food advertisements employing negative emotional themes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Interprofessional communication supporting clinical handover in emergency departments: An observation study.

PubMed

Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

2017-08-01

Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Instruction and Delight: Theme Parks and Education.

ERIC Educational Resources Information Center

King, Margaret J.

Education continues to operate as an enclave of elite culture and is battling for interest and respect with the mass media, technology, and the popular arts. These cultures must be brought together. Using the creative ideas generated by theme parks is an effective method of importing popular culture into the schools. Theme parks provide a total…

An investigation into drug-related problems identifiable by commercial medication review software.

PubMed

Curtain, Colin; Bindoff, Ivan; Westbury, Juanita; Peterson, Gregory

2013-01-01

Accredited pharmacists conduct home medicines reviews (HMRs) to detect and resolve potential drug-related problems (DRPs). A commercial expert system, Medscope Review Mentor (MRM), has been developed to assist pharmacists in the detection and resolution of potential DRPs. This study compares types of DRPs identified with the commercial system which uses multiple classification ripple down rules (MCRDR) with the findings of pharmacists. HMR data from 570 reviews collected from accredited pharmacists was entered into MRM and the DRPs were identified. A list of themes describing the main concept of each DRP identified by MRM was developed to allow comparison with pharmacists. Theme types, frequencies, similarity and dissimilarity were explored. The expert system was capable of detecting a wide range of potential DRPs: 2854 themes; compared to pharmacists: 1680 themes. The system identified the same problems as pharmacists in many patient cases. Ninety of 119 types of themes identifiable by pharmacists were also identifiable by software. MRM could identify the same problems in the same patients as pharmacists for 389 problems, resulting in a low overlap of similarity with an averaged Jaccard Index of 0.09. MRM found significantly more potential DRPs than pharmacists. MRM identified a wide scope of DRPs approaching the range of DRPs that were identified by pharmacists. Differences may be associated with system consistency and perhaps human oversight or human selective prioritisation. DRPs identified by the system were still considered relevant even though the system identified a larger number of problems.

The Tree Theme Method in psychosocial occupational therapy: a case study.

PubMed

Gunnarsson, A Birgitta; Jansson, Jan-Ake; Eklund, Mona

2006-12-01

This study aimed to describe the Tree Theme Method (TTM) as a method for intervention in psychosocial occupational therapy. The TTM is based on theories concerning creative activities and occupational storytelling and story making. In order to exemplify the method a case study of a treatment process with follow up was undertaken. The participant was a female client suffering from anxiety and depression. During an interview the client painted symbolic trees on five different occasions with specific variations of the tree theme: a tree symbolizing her present life, her childhood, adolescence, adulthood, and, finally, a tree representing her future. The trees were used as starting points for the client to tell her life story. The intention was that she would find new strategies for how to change her daily life. Three years later there was a follow up stage where the client painted new trees and told her story. Some life themes were identified. The TTM appears suitable for intervention in psychosocial occupational therapy. In future studies the TTM should be subjected to evaluation research based on several clients in order to develop a deeper understanding of the process and what kind of results changes in the TTM intervention may provide.

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

ERIC Educational Resources Information Center

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Global Emergency Medicine Journal Club: A Social Media Discussion About the Lack of Association Between Press Ganey Scores and Emergency Department Analgesia.

PubMed

Westafer, Lauren; Hensley, Justin; Shaikh, Sameed; Lin, Michelle

2016-01-01

Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host a public discussion featuring the 2014 Annals article on the association between Press Ganey scores and emergency department (ED) analgesia by Schwartz et al. The objective was to curate a 14-day (December 1 through 14, 2014) worldwide academic dialogue among clinicians in regard to preselected questions about the article. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions. Engagement was tracked through Web analytic tools and analysis of tweets. Blog comments, tweets, and video expert commentary involving the featured article are summarized and reported. The dialogue resulted in 978 page views from 342 cities in 33 countries on the ALiEM Web site, 464,345 Twitter impressions, and 83 views of the video interview with experts. Of the unique 169 identified tweets, discussion (53.3%) and learning points (32.5%) were the most common category of tweets identified. Common themes that arose in the open-access multimedia discussions included Press Ganey data validity and the utility of patient satisfaction in determining pain treatment efficacy. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide scholarly discourse. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Current and emerging screening methods to identify post-head-emergence frost adaptation in wheat and barley.

PubMed

Frederiks, T M; Christopher, J T; Harvey, G L; Sutherland, M W; Borrell, A K

2012-09-01

Cereal crops can suffer substantial damage if frosts occur at heading. Identification of post-head-emergence frost (PHEF) resistance in cereals poses a number of unique and difficult challenges. Many decades of research have failed to identify genotypes with PHEF resistance that could offer economically significant benefit to growers. Research and breeding gains have been limited by the available screening systems. Using traditional frost screening systems, genotypes that escape frost injury in trials due to spatial temperature differences and/or small differences in phenology can be misidentified as resistant. We believe that by improving techniques to minimize frost escapes, such 'false-positive' results can be confidently identified and eliminated. Artificial freezing chambers or manipulated natural frost treatments offer many potential advantages but are not yet at the stage where they can be reliably used for frost screening in breeding programmes. Here we describe the development of a novel photoperiod gradient method (PGM) that facilitates screening of genotypes of different phenology under natural field frosts at matched developmental stages. By identifying frost escapes and increasing the efficiency of field screening, the PGM ensures that research effort can be focused on finding genotypes with improved PHEF resistance. To maximize the likelihood of identifying PHEF resistance, we propose that the PGM form part of an integrated strategy to (i) source germplasm;(ii) facilitate high throughput screening; and (iii) permit detailed validation. PGM may also be useful in other studies where either a range of developmental stages and/or synchronized development are desired.

The Theme's The Thing!

ERIC Educational Resources Information Center

Zaidel, Lisa Brusman

1991-01-01

Presents suggestions to help elementary teachers organize learning centers and activities around the themes of Peter Rabbit (Grade 1), weather (Grade 3), and bees (Grade 5). Suggestions are given for activities in centers for listening/reading, language arts, computers, math, science, cooperative learning, research, and writing. (SM)

Theme: Staying Current--Horticulture.

ERIC Educational Resources Information Center

Shry, Carroll L., Jr.; And Others

1986-01-01

This theme issue on staying current in horticulture includes articles on sex equity in horticulture, Future Farmers of America, career opportunities in horticulture, staying current with your school district's needs, staying current in horticulture instruction, staying current with landscape trade associations, emphasizing the basics in vocational…

Identifying the science and technology dimensions of emerging public policy issues through horizon scanning.

PubMed

Parker, Miles; Acland, Andrew; Armstrong, Harry J; Bellingham, Jim R; Bland, Jessica; Bodmer, Helen C; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D; Cope, David; Costanzo, Lucia; Dolan, James A; Doubleday, Robert; Feng, Wai Yi; Godfray, H Charles J; Good, David A; Grant, Jonathan; Green, Nick; Groen, Arnoud J; Guilliams, Tim T; Gupta, Sunjai; Hall, Amanda C; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A; Lueshi, Leila M; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P; Watkinson, Andrew R; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K A; Worts, Kim; Sutherland, William J

2014-01-01

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.

Identifying the Science and Technology Dimensions of Emerging Public Policy Issues through Horizon Scanning

PubMed Central

Parker, Miles; Acland, Andrew; Armstrong, Harry J.; Bellingham, Jim R.; Bland, Jessica; Bodmer, Helen C.; Burall, Simon; Castell, Sarah; Chilvers, Jason; Cleevely, David D.; Cope, David; Costanzo, Lucia; Dolan, James A.; Doubleday, Robert; Feng, Wai Yi; Godfray, H. Charles J.; Good, David A.; Grant, Jonathan; Green, Nick; Groen, Arnoud J.; Guilliams, Tim T.; Gupta, Sunjai; Hall, Amanda C.; Heathfield, Adam; Hotopp, Ulrike; Kass, Gary; Leeder, Tim; Lickorish, Fiona A.; Lueshi, Leila M.; Magee, Chris; Mata, Tiago; McBride, Tony; McCarthy, Natasha; Mercer, Alan; Neilson, Ross; Ouchikh, Jackie; Oughton, Edward J.; Oxenham, David; Pallett, Helen; Palmer, James; Patmore, Jeff; Petts, Judith; Pinkerton, Jan; Ploszek, Richard; Pratt, Alan; Rocks, Sophie A.; Stansfield, Neil; Surkovic, Elizabeth; Tyler, Christopher P.; Watkinson, Andrew R.; Wentworth, Jonny; Willis, Rebecca; Wollner, Patrick K. A.; Worts, Kim; Sutherland, William J.

2014-01-01

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security. PMID:24879444

Using spatial statistics to identify emerging hot spots of forest loss

NASA Astrophysics Data System (ADS)

Harris, Nancy L.; Goldman, Elizabeth; Gabris, Christopher; Nordling, Jon; Minnemeyer, Susan; Ansari, Stephen; Lippmann, Michael; Bennett, Lauren; Raad, Mansour; Hansen, Matthew; Potapov, Peter

2017-02-01

As sources of data for global forest monitoring grow larger, more complex and numerous, data analysis and interpretation become critical bottlenecks for effectively using them to inform land use policy discussions. Here in this paper, we present a method that combines big data analytical tools with Emerging Hot Spot Analysis (ArcGIS) to identify statistically significant spatiotemporal trends of forest loss in Brazil, Indonesia and the Democratic Republic of Congo (DRC) between 2000 and 2014. Results indicate that while the overall rate of forest loss in Brazil declined over the 14-year time period, spatiotemporal patterns of loss shifted, with forest loss significantly diminishing within the Amazonian states of Mato Grosso and Rondônia and intensifying within the cerrado biome. In Indonesia, forest loss intensified in Riau province in Sumatra and in Sukamara and West Kotawaringin regencies in Central Kalimantan. Substantial portions of West Kalimantan became new and statistically significant hot spots of forest loss in the years 2013 and 2014. Similarly, vast areas of DRC emerged as significant new hot spots of forest loss, with intensified loss radiating out from city centers such as Beni and Kisangani. While our results focus on identifying significant trends at the national scale, we also demonstrate the scalability of our approach to smaller or larger regions depending on the area of interest and specific research question involved. When combined with other contextual information, these statistical data models can help isolate the most significant clusters of loss occurring over dynamic forest landscapes and provide more coherent guidance for the allocation of resources for forest monitoring and enforcement efforts.

Nursing Perceptions of the Emergency Severity Index as a Triage Tool in the United Arab Emirates: A Qualitative Analysis.

PubMed

Mistry, Binoy; Balhara, Kamna S; Hinson, Jeremiah S; Anton, Xavier; Othman, Iman Yassin; E'nouz, Maysoon Abdel Latif; Avila, Norman Agustin; Henry, Sophia; Levin, Scott; De Ramirez, Sarah Stewart

2017-11-19

With emergency department crowding becoming an increasing problem across the globe, nursing triage to prioritize patients receiving care is ever more important. ESI is the most common triage system used in the United States and is increasingly used worldwide. This qualitative study that explores emergency nursing perceptions of the ESI identifies strengths, weaknesses, and barriers to implementation of the ESI internationally. We conducted a cross-sectional qualitative analysis using semistructured interviews of 27 emergency triage nurses. Content analysis was performed by 2 independent coders, using NVivo software to identify and analyze important themes. Interview coding revealed 7 core themes related to use of the ESI (frequencies indicated in parentheses): ease of use (90), speed and efficiency (135), patient safety (12), accuracy and reliability (30), challenging patient characteristics (123), subjectivity and variability (173), and effect of triage system on team dynamics (100). Intercoder agreement was excellent (Cohen's unweighted kappa = 0.84). Subjectivity and variability in ESI score assignment consistently emerged in all interviews and included variability in number and use of resources, definition of "high risk," nursing experience, and subjectivity in pain assessment. Although emergency nurses perceive the ESI as easy to use, there are concerns about the subjectivity and variability inherent in the ESI that can lead to a functional lack of triage and a burden of undifferentiated ESI level 3 patients. These limitations in separating critically ill patients and in stratifying patients based on anticipated required resources points to the need for improvement in the ESI algorithm or a more objective triage system that can predict patient outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

FY17 Strategic Themes.

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

Leland, Robert W.

2017-03-01

I am pleased to present this summary of the FY17 Division 1000 Science and Technology Strategic Plan. As this plan represents a continuation of the work we started last year, the four strategic themes (Mission Engagement, Bold Outcomes, Collaborative Environment, and Safety Imperative) remain the same, along with many of the goals. You will see most of the changes in the actions listed for each goal: We completed some actions, modified others, and added a few new ones. As I’ve stated previously, this is not a strategy to be pursued in tension with the Laboratory strategic plan. The Division 1000more » strategic plan is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming months.« less

A systematic review and thematic synthesis of qualitative studies on maternal emergency transport in low- and middle-income countries.

PubMed

Wilson, Amie; Hillman, Sarah; Rosato, Mikey; Skelton, John; Costello, Anthony; Hussein, Julia; MacArthur, Christine; Coomarasamy, Arri

2013-09-01

Most maternal deaths are preventable with emergency obstetric care; therefore, ensuring access is essential. There is little focused information on emergency transport of pregnant women. The literature on emergency transport of pregnant women in low- and middle-income countries (LMICs) was systematically reviewed and synthesized to explore current practices, barriers, and facilitators for transport utilization. MEDLINE, EMBASE, BNI, Cochrane Library, CINAHL, African Index Medicus, ASSIA, QUALIDATA, RHL, and Science Citation Index (inception to April 2012) were searched without language restriction. Studies using qualitative methodology and reporting on emergency transportation in LMICs were included. Thematic framework and synthesis through examination and translation of common elements were used to analyze and synthesize the data. Twenty-nine articles were included. Eight major themes were identified: time for transport; transport options; geography; local support; autonomy; culture; finance; and ergonomics. Key issues were transport availability; transport speed; terrain; meteorology; support; dependence for decision making; cultural issues; cost; and lack of safe, comfortable positioning during transport. Themes should be appreciated within local contexts to illuminate barriers and facilitators. Potential solutions include motorcycle ambulance programs, collaboration with taxi services, community education, subsidies, and vehicle maintenance. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Freedom to explore the self: How emerging adults use leisure to develop identity

PubMed Central

Layland, Eric K.; Hill, Brian J.; Nelson, Larry J.

2017-01-01

During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries (Mage=23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time. PMID:29276528

Freedom to explore the self: How emerging adults use leisure to develop identity.

PubMed

Layland, Eric K; Hill, Brian J; Nelson, Larry J

2018-01-01

During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries ( M age =23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time.

[Mercosur's regional health agenda: architecture and themes].

PubMed

Queiroz, Luisa Guimaraes; Giovanella, Ligia

2011-08-01

This article describes the shaping of institutional health spaces in the Mercosur, with analysis of themes and results and considerations on the construction of the regional agenda and on the effects of regional economic integration processes on health policies and systems. We discuss the organization, operation, focus topics, and results achieved in specific health forums (Meeting of Ministers of Health and Sub-Working Group 11), seeking to analyze the architecture and issues addressed by the regional agenda and drawing parallels with the European experience. The aim of this reflection is to identify how the work done by Mercosur structures contributes to building a regional agenda, with the expectation that the integration can contribute to reducing inequalities in access to health care in the region.

The HEART Pathway randomized trial: identifying emergency department patients with acute chest pain for early discharge.

PubMed

Mahler, Simon A; Riley, Robert F; Hiestand, Brian C; Russell, Gregory B; Hoekstra, James W; Lefebvre, Cedric W; Nicks, Bret A; Cline, David M; Askew, Kim L; Elliott, Stephanie B; Herrington, David M; Burke, Gregory L; Miller, Chadwick D

2015-03-01

The HEART Pathway is a decision aid designed to identify emergency department patients with acute chest pain for early discharge. No randomized trials have compared the HEART Pathway with usual care. Adult emergency department patients with symptoms related to acute coronary syndrome without ST-elevation on ECG (n=282) were randomized to the HEART Pathway or usual care. In the HEART Pathway arm, emergency department providers used the HEART score, a validated decision aid, and troponin measures at 0 and 3 hours to identify patients for early discharge. Usual care was based on American College of Cardiology/American Heart Association guidelines. The primary outcome, objective cardiac testing (stress testing or angiography), and secondary outcomes, index length of stay, early discharge, and major adverse cardiac events (death, myocardial infarction, or coronary revascularization), were assessed at 30 days by phone interview and record review. Participants had a mean age of 53 years, 16% had previous myocardial infarction, and 6% (95% confidence interval, 3.6%-9.5%) had major adverse cardiac events within 30 days of randomization. Compared with usual care, use of the HEART Pathway decreased objective cardiac testing at 30 days by 12.1% (68.8% versus 56.7%; P=0.048) and length of stay by 12 hours (9.9 versus 21.9 hours; P=0.013) and increased early discharges by 21.3% (39.7% versus 18.4%; P<0.001). No patients identified for early discharge had major adverse cardiac events within 30 days. The HEART Pathway reduces objective cardiac testing during 30 days, shortens length of stay, and increases early discharges. These important efficiency gains occurred without any patients identified for early discharge suffering MACE at 30 days. URL: http://www.clinicaltrials.gov. Unique Identifier: NCT01665521. © 2015 American Heart Association, Inc.

Overview of chytrid emergence and impacts on amphibians

PubMed Central

2016-01-01

Chytridiomycosis is an emerging infectious disease of amphibians that affects over 700 species on all continents where amphibians occur. The amphibian–chytridiomycosis system is complex, and the response of any amphibian species to chytrid depends on many aspects of the ecology and evolutionary history of the amphibian, the genotype and phenotype of the fungus, and how the biological and physical environment can mediate that interaction. Impacts of chytridiomycosis on amphibians are varied; some species have been driven extinct, populations of others have declined severely, whereas still others have not obviously declined. Understanding patterns and mechanisms of amphibian responses to chytrids is critical for conservation and management. Robust estimates of population numbers are needed to identify species at risk, prioritize taxa for conservation actions, design management strategies for managing populations and species, and to develop effective measures to reduce impacts of chytrids on amphibians. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080989

Theme: Parents and Reading.

ERIC Educational Resources Information Center

Jund, Suzanne, Ed.

1977-01-01

This journal issue concentrates on the theme "Parents and Reading." It presents articles on sharing books with young children, using public relations in a reading program, guiding preschool learning, assessing language readiness, working with reading problems, and teaching reading readiness in Wisconsin kindergartens. Resources and a review of…

Engineering Resistors: Engineering Latina/o Students and Emerging Resistant Capital

ERIC Educational Resources Information Center

Revelo, Renata A.; Baber, Lorenzo D.

2018-01-01

This qualitative study examined how Latina/o engineering students, members of a student organization, used their emergent resistant capital in their academic trajectories. Their emergent resistant capital, as evident by three main themes, was characterized as a movement from conformist resistance toward transformative resistance. This study finds…

Perspectives on Bullying Among Children Who Present to the Emergency Department With Behavioral Misconduct

PubMed Central

Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C.

2015-01-01

The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Objectives Our objective was to explore children's perspective of bullying and their views of potential solutions. Methods A qualitative study was conducted in a cohort of 50 children (age, 8–17 years),who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. Results We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8–17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Conclusions Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what

EMSL Geochemistry, Biogeochemistry and Subsurface Science-Science Theme Advisory Panel Meeting

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

Brown, Gordon E.; Chaka, Anne; Shuh, David K.

2011-08-01

This report covers the topics of discussion and the recommendations of the panel members. On December 8 and 9, 2010, the Geochemistry, Biogeochemistry, and Subsurface Science (GBSS) Science Theme Advisory Panel (STAP) convened for a more in-depth exploration of the five Science Theme focus areas developed at a similar meeting held in 2009. The goal for the fiscal year (FY) 2011 meeting was to identify potential topical areas for science campaigns, necessary experimental development needs, and scientific members for potential research teams. After a review of the current science in each of the five focus areas, the 2010 STAP discussionsmore » successfully led to the identification of one well focused campaign idea in pore-scale modeling and five longer-term potential research campaign ideas that would likely require additional workshops to identify specific research thrusts. These five campaign areas can be grouped into two categories: (1) the application of advanced high-resolution, high mass accuracy experimental techniques to elucidate the interplay between geochemistry and microbial communities in terrestrial ecosystems and (2) coupled computation/experimental investigations of the electron transfer reactions either between mineral surfaces and outer membranes of microbial cells or between the outer and inner membranes of microbial cells.« less

Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a Focus Group and Decision Support Tool Development Project

PubMed Central

Tanabe, Paula; Reddin, Christopher; Thornton, Victoria L.; Todd, Knox H.; Wun, Ted; Lyons, John S.

2010-01-01

Objectives A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of sickle cell disease. Methods Qualitative methods using a series of focus groups and grounded theory were used. Eligible participants included adult clients with SCD, and emergency physicians and nurses with a minimum of one year of experience providing care to patients with SCD in the ED. Patients were recruited in conjunction with annual SCD meetings, and providers included clinicians who were and were not affiliated with sickle cell centers. Groups were conducted until saturation was reached, and included a total of two patient groups, three physician groups, and two nurse groups. Focus groups were held in New York, Durham, Chicago, New Orleans, and Denver. Clinician participants were asked the following three questions to guide the discussion: 1) what information would be important to know about patients with SCD in the ED setting to effectively care for them and help you identify patient analgesic, treatment, and referral needs? 2) what treatment decisions would you make with this information? and 3) what characteristics would a decision support tool need to have to make it meaningful and useful? Client participants were asked the same questions with re-wording to reflect what they believed providers should know to provide the best care, and what they should do with the information. All focus groups were audio taped and transcribed. The constant comparative method was used to analyze the data. Two coders independently coded participant responses and identified focal themes based on the key questions. An investigator and assistant independently reviewed the

Characteristics of Effective Simulation (Preclinical) Teachers as Identified by Dental Students: A Qualitative Study.

PubMed

McAndrew, Maureen; Mucciolo, Thomas W; Jahangiri, Leila

2016-11-01

The aim of this qualitative research study was to identify and categorize criteria for simulation teacher quality preferences as reported by dental students. Second-year dental students at New York University College of Dentistry in 2015 were given a two-question, open-ended survey asking what qualities they liked most and least in a simulation or preclinical teacher. Responses were collected until data saturation was reached. Key words in the responses were identified and coded based on similar relationships and then were grouped into defined categories. A total of 168 respondents out of the target group of 363 students (46.3%) provided 1,062 written comments. Three core themes-character, competence, and communication-emerged from 16 defined categories, which were validated using references from the educational literature. The theme of character encompassed eight of the defined categories (motivation, available, caring, patience, professionalism, empathy, fairness, and happiness) and accounted for 50% of the total student responses. The theme of competence comprised five categories (expertise, knowledgeable, efficient, skillful, and effective) and represented 34% of all responses. The communication theme covered the remaining three categories (feedback, approachable, and interpersonal communication) and contained 17% of the responses. Positive and negative comments in the category of motivation accounted for 11.2% of all student responses. Expertise was the next highest category with 9.3% of the responses, followed closely by 9.1% in the category of available. Among these students, the top five attributes of simulation teachers were motivation, expertise, available, caring, and feedback. While the study did not attempt to correlate these findings with improved student performance, the results can be used in the development of assessment tools for faculty and targeted faculty development programs.

CAEP 2016 Academic Symposium: How to have an impact as an emergency medicine educator and scholar.

PubMed

Frank, Jason R; Cheung, Warren J; Sherbino, Jonathan; Primavesi, Robert; Woods, Robert A; Bandiera, Glen; LeBlanc, Constance

2017-05-01

In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear. To describe how to prepare EM educators for a high-impact career. The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an "Education Impact" working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. "High impact educators" were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations. Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio. We describe a unique set of

VLSI Technology: Impact and Promise. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Bayoumi, Magdy

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the implications of very large scale integrated (VLSI) technology. The first section reviews the development of educational technology, particularly microelectronics technology, from the 1950s to the present. The implications…

Exploring Key Sustainable Development Themes through Learning Activities

ERIC Educational Resources Information Center

Cruickshank, Heather; Fenner, Richard

2012-01-01

Purpose: The purpose of the paper is to examine how a number of key themes are introduced in the Master's programme in Engineering for Sustainable Development, at Cambridge University, through student-centred activities. These themes include dealing with complexity, uncertainty, change, other disciplines, people, environmental limits, whole life…

Theme Unit. Horse Sense.

ERIC Educational Resources Information Center

Flagg, Ann

1999-01-01

This integrated, cross-curricular theme unit has children become immersed in the equine world as they broaden their vocabulary, participate in hands-on science and math, explore art, become aware of the horse's important role in history, and learn about good grooming. A student reproducible, a poetry poster, and a poster on the coloring of horses…

Incredible Years Parent and Teacher Programmes: Emerging Themes and Issues

ERIC Educational Resources Information Center

Wetherall, Michelle

2014-01-01

This paper examines the Incredible Years Parent and Teacher Programmes that have originated from the work of Webster-Stratton. It provides a brief background on the programmes and a critical analysis of the issues as identified in current literature. The issues can be grouped into four main categories, the first being government decision-making…

Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

PubMed Central

2012-01-01

Background The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. PMID:22894551

Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

PubMed

Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

2012-08-15

The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

Emerging oomycete threats to plants and animals

PubMed Central

Chaparro-Garcia, Angela

2016-01-01

Oomycetes, or water moulds, are fungal-like organisms phylogenetically related to algae. They cause devastating diseases in both plants and animals. Here, we describe seven oomycete species that are emerging or re-emerging threats to agriculture, horticulture, aquaculture and natural ecosystems. They include the plant pathogens Phytophthora infestans, Phytophthora palmivora, Phytophthora ramorum, Plasmopara obducens, and the animal pathogens Aphanomyces invadans, Saprolegnia parasitica and Halioticida noduliformans. For each species, we describe its pathology, importance and impact, discuss why it is an emerging threat and briefly review current research activities. This article is part of the themed issue ‘Tackling emerging fungal threats to animal health, food security and ecosystem resilience’. PMID:28080985

Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data

PubMed Central

Lee, David C; Gallagher, Mary Pat; Gopalan, Anjali; Osorio, Marcela; Vinson, Andrew J; Wall, Stephen P; Ravenell, Joseph E; Sevick, Mary Ann; Elbel, Brian

2018-01-01

Abstract Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency claims data from 2009 to 2013, we identified unique New York City residents with diabetes and geocoded their location using home addresses. Geospatial analysis was performed to estimate diabetes prevalence by New York City Census tract. We also used multivariable regression to identify neighborhood-level factors associated with higher diabetes prevalence. We estimated type 1 and type 2 diabetes prevalence at 0.23% and 10.5%, respectively, among adults and 0.20% and 0.11%, respectively, among children in New York City. Pediatric type 1 diabetes was associated with higher income (P = 0.001), whereas adult type 2 diabetes was associated with lower income (P < 0.001). Areas with a higher proportion of nearby restaurants categorized as fast food had a higher prevalence of all types of diabetes (P < 0.001) except for pediatric type 2 diabetes. Type 2 diabetes among children was only higher in neighborhoods with higher proportions of African American residents (P < 0.001). Our findings identify geographic disparities in diabetes prevalence that may require special attention to address the specific needs of adults and children living in these areas. Our results suggest that the food environment may be associated with higher type 1 diabetes prevalence. However, our analysis did not find a robust association with the food environment and pediatric type 2 diabetes, which was predominantly focused in African American neighborhoods. PMID:29719877

The Sweet Tooth of Bacteria: Common Themes in Bacterial Glycoconjugates

PubMed Central

Tytgat, Hanne L. P.

2014-01-01

SUMMARY Humans have been increasingly recognized as being superorganisms, living in close contact with a microbiota on all their mucosal surfaces. However, most studies on the human microbiota have focused on gaining comprehensive insights into the composition of the microbiota under different health conditions (e.g., enterotypes), while there is also a need for detailed knowledge of the different molecules that mediate interactions with the host. Glycoconjugates are an interesting class of molecules for detailed studies, as they form a strain-specific barcode on the surface of bacteria, mediating specific interactions with the host. Strikingly, most glycoconjugates are synthesized by similar biosynthesis mechanisms. Bacteria can produce their major glycoconjugates by using a sequential or an en bloc mechanism, with both mechanistic options coexisting in many species for different macromolecules. In this review, these common themes are conceptualized and illustrated for all major classes of known bacterial glycoconjugates, with a special focus on the rather recently emergent field of glycosylated proteins. We describe the biosynthesis and importance of glycoconjugates in both pathogenic and beneficial bacteria and in both Gram-positive and -negative organisms. The focus lies on microorganisms important for human physiology. In addition, the potential for a better knowledge of bacterial glycoconjugates in the emerging field of glycoengineering and other perspectives is discussed. PMID:25184559

An open dialogue on the draft focus and themes for the next ITS strategic research plan : engaging stakeholders in their discussion and development.

DOT National Transportation Integrated Search

2012-12-01

The purpose of this document is to identify the focus and themes for the next installment of the ITS Strategic Research Plan and to invite stakeholders to participate in their discussion. The goal of presenting themes is to enable continuity of the c...

The role of play themes in non-directive play therapy.

PubMed

Ryan, Virginia; Edge, Andrew

2012-07-01

Describing the processes underlying play therapy is important for evidence based practice in child therapy. Employing play themes to describe children's play session contents is in widespread use by practitioners, but an adequate classification of these themes for non-directive play therapy practice has not yet been established. This article sets out to fill this gap by first describing how themes can be distinguished and distilled from the contents of play therapy contents. Second, a classification of main themes and sub-themes with exemplars to illustrate these concepts which is compatible with non-directive play therapy practice is set out. Finally a pilot project with experienced play therapists to test this classification in practice is suggested, along with the research questions that will need to be investigated in the shorter and longer terms.

Exploring staff willingness to attend work during a disaster: a study of nurses employed in four Australian emergency departments.

PubMed

Arbon, Paul; Cusack, Lynette; Ranse, Jamie; Shaban, Ramon Z; Considine, Julie; Kako, Mayumi; Woodman, Richard J; Mitchell, Belinda; Bahnisch, Laura; Hammad, Karen

2013-08-01

Much of the literature about emergency nurses willingness to work during disasters has been from a non-Australian perspective. Despite the many recent disasters, little is known of Australian nurse's willingness to participate in disaster response. This paper presents findings from a study that explored nurses willingness to attend work during a disaster and the factors that influenced this decision. Data were collected consecutively using a combination of focus group and interview methods. Participants in this study, registered nurses from emergency departments, were recruited through convenience sampling from four hospitals in Australia. Participant narrative was electronically recorded, transcribed and thematically analysed. The participants for both the focus groups and interviews compromised a mix of ages, genders and years of experience as emergency nurses from across four jurisdictions within Australia. Three major themes that influenced willingness emerged with a number of subthemes. Theme one reflected the uncertainty of the situation such as the type of disaster. The second theme surrounded the preparedness of the workplace, emergency nurse and colleagues, and the third theme considered personal and professional choice based on home and work circumstances and responsibilities. The decision to attend work or not during a disaster, includes a number of complex personal, work-related and professional factors that can change, depending on the type of disaster, preparedness of the work environment and the emergency nurses' personal responsibilities at that time. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

International Emergency Medical Teams Training Workshop Special Report.

PubMed

Albina, Anthony; Archer, Laura; Boivin, Marlène; Cranmer, Hilarie; Johnson, Kirsten; Krishnaraj, Gautham; Maneshi, Anali; Oddy, Lisa; Redwood-Campbell, Lynda; Russell, Rebecca

2018-04-26

The World Health Organization's (WHO; Geneva, Switzerland) Emergency Medical Team (EMT) Initiative created guidelines which define the basic procedures to be followed by personnel and teams, as well as the critical points to discuss before deploying a field hospital. However, to date, there is no formal standardized training program established for EMTs before deployment. Recognizing that the World Association of Disaster and Emergency Medicine (WADEM; Madison, Wisconsin USA) Congress brings together a diverse group of key stakeholders, a pre-Congress workshop was organized to seek out collective expertise and to identify key EMT training competencies for the future development of training programs and protocols. The future of EMT training should include standardization of curriculum and the recognition or accreditation of selected training programs. The outputs of this pre-WADEM Congress workshop provide an initial contribution to the EMT Training Working Group, as this group works on mapping training, competencies, and curriculum. Common EMT training themes that were identified as fundamental during the pre-Congress workshop include: the ability to adapt one's professional skills to low-resource settings; context-specific training, including the ability to serve the needs of the affected population in natural disasters; training together as a multi-disciplinary EMT prior to deployment; and the value of simulation in training. AlbinaA, ArcherL, BoivinM, CranmerH, JohnsonK, KrishnarajG, ManeshiA, OddyL, Redwood-CampbellL, RussellR. International Emergency Medical Teams training workshop special report.

Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?

PubMed

Hope, Kirsty; Durrheim, David N; Muscatello, David; Merritt, Tony; Zheng, Wei; Massey, Peter; Cashman, Patrick; Eastwood, Keith

2008-08-01

To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance. Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status. Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days. If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response. By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.

Accessing Transgenerational Themes Through Dreamwork.

ERIC Educational Resources Information Center

Andrews, Jennifer; And Others

1988-01-01

Proposes use of dreamwork to evoke historical patterns or transgenerational themes. Describes new variant of dreamwork which combines aspects of both gestalt and family systems therapies. Implications of therapeutic dramatization for couple therapy are suggested. Examples are included. (Author/NB)

Comparison of the h-Index Scores Among Pathogens Identified as Emerging Hazards in North America.

PubMed

Cox, R; McIntyre, K M; Sanchez, J; Setzkorn, C; Baylis, M; Revie, C W

2016-02-01

Disease surveillance must assess the relative importance of pathogen hazards. Here, we use the Hirsch index (h-index) as a novel method to identify and rank infectious pathogens that are likely to be a hazard to human health in the North American region. This bibliometric index was developed to quantify an individual's scientific research output and was recently used as a proxy measure for pathogen impact. Analysis of more than 3000 infectious organisms indicated that 651 were human pathogen species that had been recorded in the North American region. The h-index of these pathogens ranged from 0 to 584. The h-index of emerging pathogens was greater than non-emerging pathogens as was the h-index of frequently pathogenic pathogens when compared to non-pathogenic pathogens. As expected, the h-index of pathogens varied over time between 1960 and 2011. We discuss how the h-index can contribute to pathogen prioritization and as an indicator of pathogen emergence. © 2014 Blackwell Verlag GmbH.

CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

PubMed

Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

2015-05-01

We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

PubMed

Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

[Evaluation standards and application for photography of schistosomiasis control theme].

PubMed

Chun-Li, Cao; Qing-Biao, Hong; Jing-Ping, Guo; Fang, Liu; Tian-Ping, Wang; Jian-Bin, Liu; Lin, Chen; Hao, Wang; You-Sheng, Liang; Jia-Gang, Guo

2018-02-26

To set up and apply the evaluation standards for photography of schistosomiasis control theme, so as to offer the scientific advice for enriching the health information carrier of schistosomiasis control. Through the literature review and expert consultation, the evaluation standard for photography of schistosomiasis control theme was formulated. The themes were divided into 4 projects, such as new construction, natural scenery, working scene, and control achievements. The evaluation criteria of the theme photography were divided into the theme (60%), photographic composition (15%), focus exposure (15%), and color saturation (10%) . A total of 495 pictures (sets) from 59 units with 77 authors were collected from schistosomiasis epidemic areas national wide. After the first-step screening and second-step evaluation, the prizes of 3 themes of control achievements and new construction, working scene, and natural scenery were selected, such as 6 pictures of first prize, 12 pictures of second prize, 18 pictures of third prize, and 20 pictures of honorable prize. The evaluation standards of theme photography should be taken into the consideration of the technical elements of photography and the work specification of schistosomiasis prevention and control. In order to improve the ability of records for propaganda purpose of schistosomiasis control and better play a role of guiding correct propaganda, the training and guidance of photography of professionals should be carried out.

Implementation of a model of emergency care in an Australian hospital.

PubMed

Millichamp, Tracey; Bakon, Shannon; Christensen, Martin; Stock, Kate; Howarth, Sarah

2017-11-10

Emergency departments are characterised by a fast-paced, quick turnover and high acuity workload, therefore appropriate staffing is vital to ensure positive patient outcomes. Models of care are frameworks in which safe and effective patient-to-nurse ratios can be ensured. The aim of this study was to implement a supportive and transparent model of emergency nursing care that provides structure - regardless of nursing staff profile, business or other demands; improvement to nursing workloads; and promotes individual responsibility and accountability for patient care. A convergent parallel mixed-method approach was used. Quantitative data were analysed using descriptive statistics and the qualitative data used a thematic analysis to identify recurrent themes. Data post-implementation of the model of emergency nursing care indicate improved staff satisfaction in relation to workload, patient care and support structures. The development and implementation of a model of care in an emergency department improved staff workload and staff's perception of their ability to provide care. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Common themes in microbial pathogenicity revisited.

PubMed Central

Finlay, B B; Falkow, S

1997-01-01

Bacterial pathogens employ a number of genetic strategies to cause infection and, occasionally, disease in their hosts. Many of these virulence factors and their regulatory elements can be divided into a smaller number of groups based on the conservation of similar mechanisms. These common themes are found throughout bacterial virulence factors. For example, there are only a few general types of toxins, despite a large number of host targets. Similarly, there are only a few conserved ways to build the bacterial pilus and nonpilus adhesins used by pathogens to adhere to host substrates. Bacterial entry into host cells (invasion) is a complex mechanism. However, several common invasion themes exist in diverse microorganisms. Similarly, once inside a host cell, pathogens have a limited number of ways to ensure their survival, whether remaining within a host vacuole or by escaping into the cytoplasm. Avoidance of the host immune defenses is key to the success of a pathogen. Several common themes again are employed, including antigenic variation, camouflage by binding host molecules, and enzymatic degradation of host immune components. Most virulence factors are found on the bacterial surface or secreted into their immediate environment, yet virulence factors operate through a relatively small number of microbial secretion systems. The expression of bacterial pathogenicity is dependent upon complex regulatory circuits. However, pathogens use only a small number of biochemical families to express distinct functional factors at the appropriate time that causes infection. Finally, virulence factors maintained on mobile genetic elements and pathogenicity islands ensure that new strains of pathogens evolve constantly. Comprehension of these common themes in microbial pathogenicity is critical to the understanding and study of bacterial virulence mechanisms and to the development of new "anti-virulence" agents, which are so desperately needed to replace antibiotics. PMID

Promising Themes for Antismoking Campaigns Targeting Youth and Young Adults.

PubMed

Brennan, Emily; Gibson, Laura A; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert C

2017-01-01

Behavior change campaigns typically try to change beliefs that influence behaviors, with targeted beliefs comprising the campaign theme. We present an empirical approach for choosing among a large number of potential themes, and results from the implementation of this approach for campaigns aimed at 4 behavioral targets: (1) preventing smoking initiation among youth, and (2) preventing initiation, (3) stopping progression to daily smoking and (4) encouraging cessation among young adults. An online survey of 13- to 17-year-olds and 18- to 25-year-olds in the United States (US), in which 20 potential campaign themes were represented by 154 beliefs. For each behavioral target, themes were ranked based on the strength of belief-intention and belief-behavior associations and size of the population not already endorsing the beliefs. The most promising themes varied across behavioral targets but 3 were consistently promising: consequences of smoking for mood, social acceptance and social popularity. Using a robust and systematic approach, this study provides campaign developers with empirical data to inform their selection of promising themes. Findings related to the campaign to prevent initiation among youth informed the development of the US Food and Drug Administration's "The Real Cost" campaign.

Italian Adolescents and Emergency Contraception: A Focus Group Study.

PubMed

Olivari, Maria Giulia; Cuccì, Gaia; Confalonieri, Emanuela

2017-02-01

Using a qualitative method, the purpose of this study was to: (1) obtain information directly from the adolescents on their attitudes and knowledge regarding emergency contraception; and (2) investigate the presence of differences between male and female participants' attitudes and knowledge. This study consisted of 24 single-sex focus groups with 160 adolescents (male = 46.3% (74 of 160); female = 53.7% (86 of 160)) aged 15-19 years conducted among high schools in 3 regions of Italy. Data were analyzed through thematic analysis taking into account gender differences and 2 main themes emerged. The first was labeled "Adolescents' attitudes toward emergency contraception" and it was divided into 3 subthemes: You should be aware; It's a life line; and Everything but a child. The second theme was labeled "Adolescents' knowledge toward emergency contraception" and it was divided into 3 subthemes: False myths; Baseline information; and Just take it. Italian adolescents believed it is important to prevent the risk of unprotected sex by using contraceptive methods and their motivation to use emergency contraception is related to critical attitudes toward the consequences of irresponsible/ineffective contraception. Although adolescents have an awareness of emergency contraception, more comprehensive knowledge is needed. These findings can inform specific interventions aimed at educating adolescents in need of emergency contraception. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Clinical Research Informatics: Challenges, Opportunities and Definition for an Emerging Domain

PubMed Central

Embi, Peter J.; Payne, Philip R.O.

2009-01-01

Objectives Clinical Research Informatics, an emerging sub-domain of Biomedical Informatics, is currently not well defined. A formal description of CRI including major challenges and opportunities is needed to direct progress in the field. Design Given the early stage of CRI knowledge and activity, we engaged in a series of qualitative studies with key stakeholders and opinion leaders to determine the range of challenges and opportunities facing CRI. These phases employed complimentary methods to triangulate upon our findings. Measurements Study phases included: 1) a group interview with key stakeholders, 2) an email follow-up survey with a larger group of self-identified CRI professionals, and 3) validation of our results via electronic peer-debriefing and member-checking with a group of CRI-related opinion leaders. Data were collected, transcribed, and organized for formal, independent content analyses by experienced qualitative investigators, followed by an iterative process to identify emergent categorizations and thematic descriptions of the data. Results We identified a range of challenges and opportunities facing the CRI domain. These included 13 distinct themes spanning academic, practical, and organizational aspects of CRI. These findings also informed the development of a formal definition of CRI and supported further representations that illustrate areas of emphasis critical to advancing the domain. Conclusions CRI has emerged as a distinct discipline that faces multiple challenges and opportunities. The findings presented summarize those challenges and opportunities and provide a framework that should help inform next steps to advance this important new discipline. PMID:19261934

Review article: A systematic review of emergency department incident classification frameworks.

PubMed

Murray, Matthew; McCarthy, Sally

2018-06-01

As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an 'ideal' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

An environmental scan of academic pediatric emergency medicine at Canadian medical schools: Identifying variability across Canada.

PubMed

Artz, Jennifer D; Meckler, Garth; Argintaru, Niran; Lim, Roderick; Stiell, Ian G

2018-01-28

To complement our environmental scan of academic emergency medicine departments, we conducted a similar environmental scan of the academic pediatric emergency medicine programs offered by the Canadian medical schools. We developed an 88-question form, which was distributed to pediatric academic leaders at each medical school. The responses were validated via email to ensure that the questions were answered completely and consistently. Fourteen of the 17 Canadian medical schools have some type of pediatric emergency medicine academic program. None of the pediatric emergency medicine units have full departmental status, while nine are divisions, two are sections, and three have no status. Canadian academic pediatric emergency medicine is practised at 13 major teaching hospitals and one specialized pediatric emergency department. There are 394 pediatric emergency medicine faculty members, including 13 full professors and 64 associate professors. Eight sites regularly take pediatric undergraduate clinical clerks, and all 14 provide resident education. Fellowship training is offered at 10 sites, with five offering advanced pediatric emergency medicine fellowship training. Half of the sites have at least one physician with a Master's degree in education, totalling 18 faculty members across Canada. There are 31 clinical researchers with salary support at nine universities. Eleven sites have published peer-reviewed papers (n=423) in the past five years, ranging from two to 102 per site. Annual academic budgets range from $10,000 to $2,607,515. This comprehensive review of academic activities in pediatric emergency medicine across Canada identifies the variability across the country, including the recognition of sites above and below the national average, which may prompt change at individual sites. Sharing these academic practices may inspire sites to provide more support to teachers, educators, and researchers.

Challenging Discourse Themes Reproducing Gender in Heterosexual Dating: An Analog Study.

ERIC Educational Resources Information Center

Gilbert, Lucia Albino; Walker, Sarah J.; McKinney, Sherry; Snell, Jessica L.

1999-01-01

Investigated whether male sexual drive discourse themes in heterosexual dating could be reproduced in a laboratory and whether those themes could be disrupted via laboratory intervention. Single, heterosexual college students role played various dating scenarios under differing conditions (dominant discourse themes and disrupted dominant discourse…

Theme Courses for Community Colleges.

ERIC Educational Resources Information Center

Conway, Diana

1986-01-01

Discusses organization of community college Spanish courses around themes, such as geography, life sciences, arts, holidays, in conjunction with techniques such as the Natural Approach and Total Physical Response. The discussion includes examples of class activities, suggestions for materials, and notes on accommodating different levels. (SED)

Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

PubMed

Plint, Amy C; Stang, Antonia S; Calder, Lisa A

2015-01-01

Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

Informing a Canadian paramedic profile: framing concepts, roles and crosscutting themes.

PubMed

Tavares, Walter; Bowles, Ron; Donelon, Becky

2016-09-07

Paramedicine is a rapidly evolving health profession with increasing responsibilities and contributions to healthcare. This rapid growth has left the profession with unclear professional and clinical boundaries. Existing defining frameworks may no longer align with the practice of paramedicine or expectations of the public. The purpose of this study was to explore the roles paramedics in Canada are to embody and that align with or support the rapid and ongoing evolution of the profession. We used a concurrent mixed methods study design involving a focused discourse analysis (i.e., analysis of language used to describe paramedics and paramedicine) of peer reviewed and grey literature (Phase 1) and in-depth one-on-one semi-structured interviews with key informants in Canadian paramedicine (Phase 2). Data from both methods were analyzed simultaneously throughout and after being merged using inductive thematic analysis. Saturation was reached after 99 national and international grey and peer reviewed publications and 20 in depth interviews with stakeholders representing six provinces, seven different service/agency types, 11 operational roles and seven provider roles. After merging both data sets three framing concepts, six roles and four crosscutting themes emerged that may be significant to both present-day practice and aspirational. Framing concepts, which provide context, include variable contexts or practice, embedded relationships and a health and social continuum. Roles include clinician, health and social advocate, team member, educator, professional and reflective practitioner. Crosscutting themes including patient safety, adaptability, compassion and communication appear to exist in all roles. The paramedic profession is experiencing a shift that appears to deviate or at least place a tension on traditional views or models of practice. Underlying and evolving notions of practice are resulting in intended or actual clinical and professional boundaries that may

Identifying Preschool Children at Risk of Later Reading Difficulties: Evaluation of Two Emergent Literacy Screening Tools

ERIC Educational Resources Information Center

Wilson, Shauna B.; Lonigan, Christopher J.

2010-01-01

Emergent literacy skills are predictive of children's early reading success, and literacy achievement in early schooling declines more rapidly for children who are below-average readers. It is therefore important for teachers to identify accurately children at risk for later reading difficulty so children can be exposed to effective emergent…

Promising Themes for Antismoking Campaigns Targeting Youth and Young Adults

PubMed Central

Brennan, Emily; Gibson, Laura A.; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert C.

2017-01-01

Objectives Behavior change campaigns typically try to change beliefs that influence behaviors, with targeted beliefs comprising the campaign theme. We present an empirical approach for choosing among a large number of potential themes, and results from the implementation of this approach for campaigns aimed at 4 behavioral targets: (1) preventing smoking initiation among youth, and (2) preventing initiation, (3) stopping progression to daily smoking and (4) encouraging cessation among young adults. Methods An online survey of 13- to 17-year-olds and 18- to 25-year-olds in the United States (US), in which 20 potential campaign themes were represented by 154 beliefs. For each behavioral target, themes were ranked based on the strength of belief-intention and belief-behavior associations and size of the population not already endorsing the beliefs. Results The most promising themes varied across behavioral targets but 3 were consistently promising: consequences of smoking for mood, social acceptance and social popularity. Conclusions Using a robust and systematic approach, this study provides campaign developers with empirical data to inform their selection of promising themes. Findings related to the campaign to prevent initiation among youth informed the development of the US Food and Drug Administration’s “The Real Cost” campaign. PMID:28989949

Between life and death: women's experiences of coming close to death, and surviving a severe postpartum haemorrhage and emergency hysterectomy.

PubMed

Elmir, Rakime; Schmied, Virginia; Jackson, Debra; Wilkes, Lesley

2012-04-01

to describe women's experiences of having an emergency hysterectomy following a severe postpartum haemorrhage. a qualitative research approach was used to guide this study. Data were collected through semi-structured, tape recorded face to face, email internet and telephone interviews. three States in Australia: New South Wales, Victoria and Western Australia. twenty-one Australian women who experienced a severe post partum followed by an emergency hysterectomy participated in the study. The median age of participants at time of interview was 42 years and the median time since having the hysterectomy was four years. a process of inductive analysis revealed the major theme, 'between life and death' and three sub-themes, 'being close to death: bleeding and fear', 'having a hysterectomy: devastation and realisation' and 'reliving the trauma: flashbacks and memories'. formulating a plan of care for women identifiably at risk of PPH and ensuring appropriate follow-up counselling is made, is key to help reduce the emotional and psychological symptoms experienced by these women in the aftermath of severe postpartum haemorrhage and hysterectomy. Copyright © 2011 Elsevier Ltd. All rights reserved.

Perspectives on bullying among children who present to the emergency department with behavioral misconduct: a qualitative study.

PubMed

Waseem, Muhammad; Boutin-Foster, Carla; Robbins, Laura; Gonzalez, Rita; Vargas, Steven; Peterson, Janey C

2014-11-01

The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem. Our objective was to explore children's perspective of bullying and their views of potential solutions. A qualitative study was conducted in a cohort of 50 children (age, 8-17 years), who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified. We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8-17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying. Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what these children feel adults should do to

The Importance of Multicultural Themes in Writing and Teaching

ERIC Educational Resources Information Center

Wartski, Maureen Crane

2005-01-01

Maureen Crane Wartski uses the themes like race and ancestry in her writings, as she believes that these themes are important parts of identity. Through multicultural literature it can be shown that there is a great deal to be learned from people who have different cultural experiences.

Identifying common values among seven health professions: An interprofessional analysis.

PubMed

Grace, Sandra; Innes, Ev; Joffe, Beverly; East, Leah; Coutts, Rosanne; Nancarrow, Susan

2017-05-01

This article reviews the competency frameworks of seven Australian health professions to explore relationships among health professions of similar status as reflected in their competency frameworks and to identify common themes and values across the professions. Frameworks were compared using a constructivist grounded theory approach to identify key themes, against which individual competencies for each profession were mapped and compared. The themes were examined for underlying values and a higher order theoretical framework was developed. In contrast to classical theories of professionalism that foreground differentiation of professions, our study suggests that the professions embrace a common structure and understanding, based on shared underpinning values. We propose a model of two core values that encompass all identified themes: the rights of the client and the capacity of a particular profession to serve the healthcare needs of clients. Interprofessional practice represents the intersection of the rights of the client to receive the best available healthcare and the recognition of the individual contribution of each profession. Recognising that all health professions adhere to a common value base, and exploring professional similarities and differences from that value base, challenges a paradigm that distinguishes professions solely on scope of practice.

Themes of rural health and aging from a program of research.

PubMed

Congdon, J G; Magilvy, J K

2001-01-01

The culture and diversity of rural life and limitations of rural health systems to meet the changing health needs of an aging population lead to problems of obtaining appropriate care in rural America. In a program of nursing research involving three ethnographic studies in rural Colorado, transitions of older adults across differing levels of heath care were explored. The sample totaled 425 participants, of whom 25% were Hispanic. Five major themes emerged: circles of formal and informal care; integration of faith, spirituality, and family with health status; crisis nature of health care transitions; nursing homes as a housing option; and changing spirit of traditional rural nursing. Recommendations for providers included making their practices congruent with rural culture, being fully informed of available resources, facilitating acceptable health care decisions, and integrating physical, mental, and spiritual health care for elders and their families.

Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

PubMed

Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

2013-08-01

The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas.

PubMed

Van Osch, Mary; Scarborough, Kathy; Crowe, Sarah; Wolff, Angela C; Reimer-Kirkham, Sheryl

2018-03-01

To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area. Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance. This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years. Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes. Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout. Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas. To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings. © 2017 John Wiley & Sons Ltd.

Modelling Creativity: Identifying Key Components through a Corpus-Based Approach

PubMed Central

2016-01-01

Creativity is a complex, multi-faceted concept encompassing a variety of related aspects, abilities, properties and behaviours. If we wish to study creativity scientifically, then a tractable and well-articulated model of creativity is required. Such a model would be of great value to researchers investigating the nature of creativity and in particular, those concerned with the evaluation of creative practice. This paper describes a unique approach to developing a suitable model of how creative behaviour emerges that is based on the words people use to describe the concept. Using techniques from the field of statistical natural language processing, we identify a collection of fourteen key components of creativity through an analysis of a corpus of academic papers on the topic. Words are identified which appear significantly often in connection with discussions of the concept. Using a measure of lexical similarity to help cluster these words, a number of distinct themes emerge, which collectively contribute to a comprehensive and multi-perspective model of creativity. The components provide an ontology of creativity: a set of building blocks which can be used to model creative practice in a variety of domains. The components have been employed in two case studies to evaluate the creativity of computational systems and have proven useful in articulating achievements of this work and directions for further research. PMID:27706185

Modelling Creativity: Identifying Key Components through a Corpus-Based Approach.

PubMed

Jordanous, Anna; Keller, Bill

2016-01-01

Creativity is a complex, multi-faceted concept encompassing a variety of related aspects, abilities, properties and behaviours. If we wish to study creativity scientifically, then a tractable and well-articulated model of creativity is required. Such a model would be of great value to researchers investigating the nature of creativity and in particular, those concerned with the evaluation of creative practice. This paper describes a unique approach to developing a suitable model of how creative behaviour emerges that is based on the words people use to describe the concept. Using techniques from the field of statistical natural language processing, we identify a collection of fourteen key components of creativity through an analysis of a corpus of academic papers on the topic. Words are identified which appear significantly often in connection with discussions of the concept. Using a measure of lexical similarity to help cluster these words, a number of distinct themes emerge, which collectively contribute to a comprehensive and multi-perspective model of creativity. The components provide an ontology of creativity: a set of building blocks which can be used to model creative practice in a variety of domains. The components have been employed in two case studies to evaluate the creativity of computational systems and have proven useful in articulating achievements of this work and directions for further research.

Theme Issue on Classroom Communication.

ERIC Educational Resources Information Center

Anapol, Malthon M., Ed.

1979-01-01

The first article in this journal issue offers a diffuse definition of instructional communication, the theme of the issue, and reviews literature that points out the ill-defined parameters of communication and the classroom. The following articles discuss the development of a rhetorical perspective on teaching, the parental role in facilitating…

Alarming Prevalence of Emergency Hypertension Levels in the General Public Identified by a Hypertension Awareness Campaign.

PubMed

Caligiuri, Stephanie P B; Austria, Jose Alejandro; Pierce, Grant N

2017-03-01

Hypertension is a major cause of mortality and morbidity today. The "silent" nature of hypertension makes it critical to determine its prevalence and its severity in the general public and to identify strategies to identify people unaware of its presence. A mobile hypertension awareness campaign was created to: (i) determine the prevalence and types of hypertension in an urban North American center, (ii) increase hypertension awareness, and (iii) identify reasons for lack of therapy adherence. Mobile clinics were provided at shopping malls, workplaces, hospitals, and community centres to measure blood pressure in the public. Blood pressure recordings were done on a voluntary basis. Of 1097 participants, 50% presented with high blood pressure which was higher than expected. Of particular clinical significance, an unexpectedly large number of participants (2%) exhibited a hypertensive urgency/emergency. Most of these people were not adherent to medications (if their hypertension was detected previously), were unaware of their hypertensive state, and/or unwilling to acknowledge or ignored the clinical significance of the extremely high blood pressure readings. Reasons for lack of adherence included: denial, being unaware of health consequences, and proper management of hypertension. A relatively large segment of an urban population lives unaware of severe emergency levels of hypertension. A public mobile hypertension clinic provides a valuable strategy for identifying hypertension in the general public and for knowledge translation of hypertension management. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The Initiation Theme in Adolescent Literature.

ERIC Educational Resources Information Center

Ramsey, Joseph; Thompson, C. Lamar

1979-01-01

A Package of classroom activities is presented on the theme of initiation, with suggestions of many titles from adolescent literature. Ideas for including rock music, movies, and television programs are also given. (SJL)

Theme: What Teaching Is Really Like.

ERIC Educational Resources Information Center

Deeds, Jacquelyn P.; And Others

1993-01-01

With agriculture teaching as its theme, this issue looks at teaching horticulture, team teaching, the ups and downs of teaching, integrating students with disabilities, and why people choose teaching as a career. (JOW)

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders.

PubMed

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-06-04

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders.

Prayerful Teaching in Higher Education: A Survey of Themes

ERIC Educational Resources Information Center

Lynn, Monty L.

2004-01-01

Prayer is a primary spiritual discipline for Christians. Nonetheless, few contemporary scholarly discussions have ventured into exploring the role of prayer in college teaching. This paper extends the conversation by reviving three themes in writings about prayer and academics and making application of those themes to teaching and learning today.…

Exploring the practical themes for medical education social accountability in Iran.

PubMed

Ahmady, Soleiman; Akbari Lakeh, Maryam

2015-01-01

The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. For this qualitative study, along with the 14(th)national conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries.

Providing long-acting reversible contraception services in Seattle school-based health centers: key themes for facilitating implementation.

PubMed

Gilmore, Kelly; Hoopes, Andrea J; Cady, Janet; Amies Oelschlager, Anne-Marie; Prager, Sarah; Vander Stoep, Ann

2015-06-01

The purpose of this study was to describe the implementation of a program that provides long-acting reversible contraception (LARC) services within school-based health centers (SBHCs) and to identify barriers and facilitators to implementation as reported by SBHC clinicians and administrators, public health officials, and community partners. We conducted 14 semistructured interviews with key informants involved in the implementation of LARC services. Key informants included SBHC clinicians and administrators, public health officials, and community partners. We used a content analysis approach to analyze interview transcripts for themes. We explored barriers to and facilitators of LARC service delivery across and within key informant groups. The most cited barriers across key informant groups were as follows: perceived lack of provider procedural skills and bias and negative attitudes about LARC methods. The most common facilitators identified across groups were as follows: clear communication strategies, contraceptive counseling practice changes, provider trainings, and stakeholder engagement. Two additional barriers emerged in specific key informant groups. Technical and logistical barriers to LARC service delivery were cited heavily by SBHC administrative staff, community partners, and public health officials. Expense and billing was a major barrier to SBHC administrative staff. LARC counseling and procedural services can be implemented in an SBHC setting to promote access to effective contraceptive options for adolescent women. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Perspectives of South American physicians hosting foreign rotators in emergency medicine

PubMed Central

2014-01-01

Background Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives (IHEs) during residency training. The impact on host institutions, however, has not been adequately investigated. The objective of this study is to assess the experience of several South American hospitals hosting foreign EM residents completing IHEs. Methods Anonymous, semi-structured one-on-one interviews were conducted with physicians working in Emergency Departments in three hospitals in Lima, Peru and one hospital in Buenos Aires, Argentina. All participants reported previously working with EM foreign rotators. Interviews were analyzed qualitatively and coded for common themes. Results Three department chairs, six residents, and 15 attending physicians were interviewed (total = 24). After qualitative analysis of interviews, two broad theme categories emerged: Benefits and Challenges. Most commonly reported benefits were knowledge sharing about emergency medical systems (78%), medical knowledge transfer (58%), and long-term relationship formation (42%). Top challenges included rotator Spanish language proficiency (70%) lack of reciprocity (58%), and level of training and rotation length (25%). Spanish proficiency related directly to how involved rotators became in patient care (e.g., taking a history, participating in rounds) but was not completely prohibitive, as a majority of physicians interviewed felt comfortable speaking in English. Lack of reciprocity refers to the difficulty of sending host physicians abroad as well as failed attempts at building long-lasting relationships with foreign institutions. Lastly, 25% preferred rotators to stay for at least 1 month and rotate in the last year of EM residency. This latter preference increased knowledge transfer from rotator to host. Conclusions Our research identified benefits and challenges

Perspectives of South American physicians hosting foreign rotators in emergency medicine.

PubMed

O'Donnell, Steve; Adler, David H; Inboriboon, Pholaphat Charles; Alvarado, Hermenegildo; Acosta, Raul; Godoy-Monzon, Daniel

2014-01-01

Emergency Medicine (EM) is increasingly becoming an international field. The number of fellowships in International EM in the USA is growing along with opportunities to complete international health electives (IHEs) during residency training. The impact on host institutions, however, has not been adequately investigated. The objective of this study is to assess the experience of several South American hospitals hosting foreign EM residents completing IHEs. Anonymous, semi-structured one-on-one interviews were conducted with physicians working in Emergency Departments in three hospitals in Lima, Peru and one hospital in Buenos Aires, Argentina. All participants reported previously working with EM foreign rotators. Interviews were analyzed qualitatively and coded for common themes. Three department chairs, six residents, and 15 attending physicians were interviewed (total = 24). After qualitative analysis of interviews, two broad theme categories emerged: Benefits and Challenges. Most commonly reported benefits were knowledge sharing about emergency medical systems (78%), medical knowledge transfer (58%), and long-term relationship formation (42%). Top challenges included rotator Spanish language proficiency (70%) lack of reciprocity (58%), and level of training and rotation length (25%). Spanish proficiency related directly to how involved rotators became in patient care (e.g., taking a history, participating in rounds) but was not completely prohibitive, as a majority of physicians interviewed felt comfortable speaking in English. Lack of reciprocity refers to the difficulty of sending host physicians abroad as well as failed attempts at building long-lasting relationships with foreign institutions. Lastly, 25% preferred rotators to stay for at least 1 month and rotate in the last year of EM residency. This latter preference increased knowledge transfer from rotator to host. Our research identified benefits and challenges of IHEs in Emergency Medicine from the

Emerging Science and Research Opportunities for Metals and Metallic Nanostructures

NASA Astrophysics Data System (ADS)

Handwerker, Carol A.; Pollock, Tresa M.

2014-07-01

During the next decade, fundamental research on metals and metallic nanostructures (MMNs) has the potential to continue transforming metals science into innovative materials, devices, and systems. A workshop to identify emerging and potentially transformative research areas in MMNs was held June 13 and 14, 2012, at the University of California Santa Barbara. There were 47 attendees at the workshop (listed in the Acknowledgements section), representing a broad range of academic institutions, industry, and government laboratories. The metals and metallic nanostructures (MMNs) workshop aimed to identify significant research trends, scientific fundamentals, and recent breakthroughs that can enable new or enhanced MMN performance, either alone or in a more complex materials system, for a wide range of applications. Additionally, the role that MMN research can play in high-priority research and development (R&D) areas such as the U.S. Materials Genome Initiative, the National Nanotechnology Initiative, the Advanced Manufacturing Initiative, and other similar initiatives that exist internationally was assessed. The workshop also addressed critical issues related to materials research instrumentation and the cyberinfrastructure for materials science research and education, as well as science, technology, engineering, and mathematics (STEM) workforce development, with emphasis on the United States but with an appreciation that similar challenges and opportunities for the materials community exist internationally. A central theme of the workshop was that research in MMNs has provided and will continue to provide societal benefits through the integration of experiment, theory, and simulation to link atomistic, nanoscale, microscale, and mesoscale phenomena across time scales for an ever-widening range of applications. Within this overarching theme, the workshop participants identified emerging research opportunities that are categorized and described in more detail in the

Emerging themes in the ecology and management of North American forests

USGS Publications Warehouse

Sharik, Terry L.; Adair, William; Baker, Fred A.; Battaglia, Michael; Comfort, Emily J.; D'Amato, Anthony W.; Delong, Craig; DeRose, R. Justin; Ducey, Mark J.; Harmon, Mark; Levy, Louise; Logan, Jesse A.; O'Brien, Joseph; Palik, Brian J.; Roberts, Scott D.; Rogers, Paul C.; Shinneman, Douglas J.; Spies, Thomas; Taylor, Sarah L.; Woodall, Christopher; Youngblood, Andrew

2010-01-01

The 7th North American Forest Ecology Workshop, consisting of 149 presentations in 16 oral sessions and a poster session, reflected a broad range of topical areas currently under investigation in forest ecology and management. There was an overarching emphasis on the role of disturbance, both natural and anthropogenic, in the dynamics of forest ecosystems, and the recognition that legacies from past disturbances strongly influence future trajectories. Climate was invoked as a major driver of ecosystem change. An emphasis was placed on application of research findings for predicting system responses to changing forest management initiatives. Several “needs” emerged from the discussions regarding approaches to the study of forest ecosystems, including (1) consideration of variable spatial and temporal scales, (2) long-term monitoring, (3) development of universal databases more encompassing of time and space to facilitate meta-analyses, (4) combining field studies and modeling approaches, (5) standardizing methods of measurement and assessment, (6) guarding against oversimplification or overgeneralization from limited site-specific results, (7) greater emphasis on plant-animal interactions, and (8) better alignment of needs and communication of results between researchers and managers.

Perceptions of Unprofessional Social Media Behavior Among Emergency Medicine Physicians.

PubMed

Soares, William; Shenvi, Christina; Waller, Nikki; Johnson, Reuben; Hodgson, Carol S

2017-02-01

Use of social media (SM) by physicians has exposed issues of privacy and professionalism. While guidelines have been created for SM use, details regarding specific SM behaviors that could lead to disciplinary action presently do not exist. To compare State Medical Board (SMB) directors' perceptions of investigation for specific SM behaviors with those of emergency medicine (EM) physicians. A multicenter anonymous survey was administered to physicians at 3 academic EM residency programs. Surveys consisted of case vignettes, asking, "If the SMB were informed of the content, how likely would they be to initiate an investigation, possibly leading to disciplinary action?" (1, very unlikely, to 4, very likely). Results were compared to published probabilities using exact binomial testing. Of 205 eligible physicians, 119 (58%) completed the survey. Compared to SMB directors, EM physicians indicated similar probabilities of investigation for themes involving identifying patient images, inappropriate communication, and discriminatory speech. Participants indicated lower probabilities of investigation for themes including derogatory speech (32%, 95% confidence interval [CI] 24-41 versus 46%, P  < .05); alcohol intoxication (41%, 95% CI 32-51 versus 73%, P  < .05); and holding alcohol without intoxication (7%, 95% CI 3-13 versus 40%, P  < .05). There were no significant associations with position, hospital site, years since medical school, or prior SM professionalism training. Physicians reported a lower likelihood of investigation for themes that intersect with social identity, compared to SMB directors, particularly for images of alcohol and derogatory speech.

Characteristics of emerging adulthood and e-cigarette use: Findings from a pilot study.

PubMed

Allem, Jon-Patrick; Forster, Myriam; Neiberger, Adam; Unger, Jennifer B

2015-11-01

Emerging adults (ages 18 to 25) are more likely to use e-cigarettes compared to other age groups, but little is known about their risk and protective factors. A next step to understanding e-cigarette use among emerging adults may involve examining how transition-to-adulthood themes are associated with e-cigarette use. It may also be important to know which specific transitions, and how the accumulated number of role transitions experienced in emerging adulthood, are associated with e-cigarette use. Emerging adults completed surveys indicating their identification with transition-to-adulthood themes, role transitions in the past year, and e-cigarette use. Logistic regression models examined the associations between transition-to-adulthood themes and e-cigarette use. Separate logistic regression models explored the association between individual role transitions, as well as the accumulated number of role transitions experienced, and e-cigarette use, controlling for age, gender, and ethnicity. Among the participants (n = 555), 21% were male, the average age was 22, 45% reported lifetime, and 12% reported past-month, e-cigarette use. Participants who felt emerging adulthood was a time of experimentation/possibility were more likely to report e-cigarette use. Several role transitions were found to be associated with e-cigarette use such as loss of a job, dating someone new, and experiencing a breakup. The relationship between the accumulated number of role transitions and e-cigarette use was curvilinear. Findings from this pilot study can be a point of departure for future studies looking to understand the risk and protective factors of e-cigarettes among emerging adults. Copyright © 2015. Published by Elsevier Ltd.

Moral Virtue and Practical Wisdom: Theme Comprehension in Children, Youth and Adults

PubMed Central

Narvaez, Darcia; Gleason, Tracy; Mitchell, Christyan

2010-01-01

Three hypotheses were tested about the relation of moral comprehension to prudential comprehension by contrasting comprehension of themes in moral stories with comprehension of themes in prudential stories among third grade, fifth grade and college students (n = 168) in Study 1, and among college students, young and middle aged adults, and older adults (n = 96) in Study 2. In both studies, all groups were statistically significantly better at moral theme comprehension than prudential theme comprehension, suggesting that moral comprehension may develop prior to prudential comprehension. In Study 2, all groups performed equally on moral theme generation whereas both adult groups were significantly better than college students on prudential theme generation. Overall, the findings of these studies provide modest evidence that moral and prudential comprehension each develop separately, and that the latter may develop more slowly. PMID:21171549

Communication and Influencing for ED Professionals: A training programme developed in the emergency department for the emergency department.

PubMed

Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony

2016-08-01

The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Conservation and Education: Prominent Themes in Zoo Mission Statements

ERIC Educational Resources Information Center

Patrick, Patricia G.; Matthews, Catherine E.; Ayers, David Franklin; Tunnicliffe, Sue Dale

2007-01-01

In this study, the authors examine the mission statements of 136 zoos in the United States that the American Zoo and Aquarium Association (AZA) has accredited, and report on the predominant themes of education and conservation in the statements. To explore the relation between these two themes, the authors present a literature review of the roles…

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness

PubMed Central

Dettinger, Julia; Calkins, Kimberly; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

2018-01-01

Background Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. Objective-method We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. Findings Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. Significance Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade’s intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of

Emergency nurses' perceptions of emergency department preparedness for an ebola outbreak: A qualitative descriptive study.

PubMed

Pincha Baduge, Mihirika Sds; Moss, Cheryle; Morphet, Julia

2017-05-01

Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak. A qualitative descriptive design was used to collect and analyse data in one metropolitan emergency department in Victoria, Australia. Four focus groups were conducted with 13 emergency nurses. Data were thematically analysed. Major themes emerged from the data: organisational, personal and future preparedness. Participants' believed that both the organisation and themselves had achieved desirable and appropriate preparedness for ebola in their emergency setting. Participants trusted their organisation to prepare and protect them for ebola. Appropriate policies, procedures, and equipment infrastructure were reportedly in place. Nurses' decisions to care for a patient with ebola were informed by professional commitment, and personal responsibilities. Participants were concerned about transmitting ebola to their families, and suggested that more regular training in personal protective equipment would increase confidence and skill in self-protection. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Composing the theme of city to be diverse and sustainable

NASA Astrophysics Data System (ADS)

Wiranegara, H. W.

2018-01-01

To give a path for developing a city needs a theme. City’s goal stated in a document of a spatial plan were too broad and insufficient detail in giving a direction. To make more detail and precise, every city has to compose a city theme. It is developed based on the potential, the uniqueness, the excellence, and the sustainability of its human resources, natural resources, and man-made resources. An integration among the three of resources which have the highest score become a theme of the city. The aim of this research was to formulate the conceptual framework to compose a city theme. The research design was the interview survey in Banda Aceh, Banjarmasin, and Kupang. Informants were the government officials, academics, figures, the private sector and public who considered related to the intended information being collected. Having set the conceptual framework, the interview directed to check the implementation in realities. The result was that the conceptual framework could accommodate the phenomenon of composing the theme of the city. Yet, it was a preliminary in nature and needed more research to get a complete result.

STEPS: lean thinking, theory of constraints and identifying bottlenecks in an emergency department.

PubMed

Ryan, A; Hunter, K; Cunningham, K; Williams, J; O'Shea, H; Rooney, P; Hickey, F

2013-04-01

This study aimed to identify the bottlenecks in patients' journeys through an emergency department (ED). For each stage of the patient journey, the average times were compared between two groups divided according to the four hour time frame and disproportionate delays were identified using a significance test These bottlenecks were evaluated with reference to a lean thinking value-stream map and the five focusing steps of the theory of constraints. A total of 434 (72.5%) ED patients were tracked over one week. Logistic regression showed that patients who had radiological tests, blood tests or who were admitted were 4.4, 4.1 and 7.7 times more likely, respectively, to stay over four hours in the ED than those who didn't The stages that were significantly delayed were the time spent waiting for radiology (p = 0.001), waiting for the in-patient team (p = 0.004), waiting for a bed (p < 0.001) and ED doctor turnaround time (p < 0.001).

Approaches to Identifying the Emerging Innovative Water Technology Industry in the United States

PubMed Central

WOOD, ALLISON R.; HARTEN, TERESA; GUTIERREZ, SALLY C.

2018-01-01

Clean water is vital to sustaining our natural environment, human health, and our economy. As infrastructure continues to deteriorate and water resources become increasingly threatened, new technologies will be needed to ensure safe and sustainable water in the future. Though the US water industry accounts for approximately 1% gross domestic product and regional “clusters” for water technology exist throughout the country, this emerging industry has not been captured by recent studies. As use of the term “cluster” becomes more prevalent, regional mapping efforts have revealed international differences in definition yet showcase this industry’s economic impact. In reality, institutional processes may inhibit altering industry coding to better describe water technology. Forgoing the benefits of national economic tracking, alternative data sets are available, which may support new ways of identifying these clusters. This work provides cluster definitions; summarizes current approaches to identifying industry activity using data, interviews, and literature; and sets a foundation for future research. PMID:29937546

Approaches to Identifying the Emerging Innovative Water Technology Industry in the United States.

PubMed

Wood, Allison R; Harten, Teresa; Gutierrez, Sally C

2018-04-25

Clean water is vital to sustaining our natural environment, human health, and our economy. As infrastructure continues to deteriorate and water resources become increasingly threatened, new technologies will be needed to ensure safe and sustainable water in the future. Though the US water industry accounts for approximately 1% gross domestic product and regional "clusters" for water technology exist throughout the country, this emerging industry has not been captured by recent studies. As use of the term "cluster" becomes more prevalent, regional mapping efforts have revealed international differences in definition yet showcase this industry's economic impact. In reality, institutional processes may inhibit altering industry coding to better describe water technology. Forgoing the benefits of national economic tracking, alternative data sets are available, which may support new ways of identifying these clusters. This work provides cluster definitions; summarizes current approaches to identifying industry activity using data, interviews, and literature; and sets a foundation for future research.

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

PubMed

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Barriers to conducting research: A survey of trainees in emergency medicine.

PubMed

Olaussen, Alexander; Jennings, Paul A; O'Reilly, Gerard; Mitra, Biswadev; Cameron, Peter A

2017-04-01

Research underpins evidence-based practice, but there are significant barriers to conducting research relevant to each clinical discipline. Understanding these barriers could allow strategies to reduce their impact. The present study was undertaken to understand specific barriers to research for emergency medicine (EM) trainees. EM trainees attending research short courses were surveyed. Free-text responses were classified into themes and a list of pre-specified potential barriers was used for ranking purposes. The responders (n = 61/90; 67.8%) were young, mostly male with low confidence in leading a research project and limited previous research experience. There were 155 unique barriers identified from 55 respondents, which fitted into nine categories. The most frequently perceived barrier was time (29%), followed by skills (22.6%) and cultural factors (19.4%). Most trainees (n = 54/56, 96.4%) believed that the barriers could be overcome. Strategies suggested included protection of time, mentoring and education, as well as top-down improved research culture. Barriers to research in EM are similar to other specialities and were perceived to be manageable. Reorganisation and refocus of the Australasian College for Emergency Medicine training curriculum may be an option to foster an environment to promote research. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Strategic Moments: IDENTIFYING OPPORTUNITIES TO ENGAGE CLIENTS IN ATTENDING CARDIAC REHABILITATION AND MAINTAINING LIFESTYLE CHANGES.

PubMed

Fletcher, Susan Marilyn; McBurney, Helen

2016-01-01

There has been extensive investigation of attendance rates at cardiac rehabilitation (CR) but little attention to client reasoning around attendance. This study explored decision-making drivers for attendance or nonattendance at CR programs in rural Victoria, Australia. All new patients referred to the CR programs at either the local hospital or community health service over a 6-month period were invited to participate and were interviewed before, after, and at 6 months post-CR. Content analysis was used to identify and group common themes that emerged from the semistructured interviews. Eighty-four of the 114 patients referred agreed to participate in the study. Multiple barriers or facilitators affected the decisions of all clients. Three themes were identified that reflected the participant decision-making experience: (1) invitation and information about participation in CR; (2) person-centered approach to CR provision; and (3) ongoing support needs. Significant decision-making points identified were after the cardiac event; before and after hospital-based CR; before and after community-based CR; and at 6 months after the cardiac event. At any time there is a risk that the client can become lost or disengaged in the service system, but providing contact at these points can allow them to reengage. This study provided the opportunity to hear participant voices, describing their decisions around CR attendance after a cardiac event. They highlighted the complexity of issues confronting them and suggested improvements to optimize their attendance and to maintain lifestyle changes.

The nursing shortage: dynamics and solutions. Reflections on a recurring theme.

PubMed

Abdellah, F G

1990-09-01

The passage of individual state nurse practice acts in the 1900s sharpened and focused attention on the practice and function of professional nurses. However, this had little effect on increasing the demand for nurses. In the 1930s student nurses were in ample supply. They staffed units in hospitals, and seniors served as charge or head nurses. It was World War II when one finally began to see the theme of nursing shortage emerge with a vengeance. The demand far exceeded the supply, creating a severe imbalance. The intervening next 4 decades brought forth many excellent models to minimize the shortage. Even the federal government contributed to the nursing shortage by offering opportunities for better-educated practitioners, teachers, and supervisors. Thus, as the nurse became better prepared, the demand for services increased. Several milestone studies are referenced during the 1970s and 1980s that attempted to balance the nursing shortage equation. The US objectives for the year 2000 provide specific guidelines as to what demands will be placed upon the nurse practitioner and educator. Can we meet those demands? Yes--with the full utilization of information technology to prepare the student and nurse practitioner to take advantage of this enormous information explosion. Will the nursing shortage continue to be a recurring theme? Yes! As nurses become better educated and ready for practice and patient-client problem solving, and as they provide strong voices in health policy formulation, the demands for their services will continue to far exceed the supply.

"We Are Strangers Walking Into Their Life-Changing Event": How Prehospital Providers Manage Emergency Calls at the End of Life.

PubMed

Waldrop, Deborah P; Clemency, Brian; Lindstrom, Heather A; Clemency Cordes, Colleen

2015-09-01

Emergency 911 calls are often made when the end stage of an advanced illness is accompanied by alarming symptoms and substantial anxiety for family caregivers, particularly when an approaching death is not anticipated. How prehospital providers (paramedics and emergency medical technicians) manage emergency calls near death influences how and where people will die, if their end-of-life choices are upheld and how appropriately health care resources are used. The purpose of this study was to explore and describe how prehospital providers assess and manage end-of-life emergency calls. In-depth and in-person interviews were conducted with 43 prehospital providers. Interviews were audiotaped, transcribed, and entered into ATLAS.ti for data management and coding. Qualitative data analysis involved systematic and axial coding to identify and describe emergent themes. Four themes illustrate the nature and dynamics of emergency end-of-life calls: 1) multifocal assessment (e.g., of the patient, family, and environment), 2) family responses (e.g., emotional, behavioral), 3) conflicts (e.g., missing do-not-resuscitate order, patient-family conflicts), and 4) management of the dying process (e.g., family witnessed resuscitation or asking family to leave, decisions about hospital transport). After a rapid comprehensive multifocal assessment, family responses and the existence of conflicts mediate decision making about possible interventions. The importance of managing symptom crises and stress responses that accompany the dying process is particularly germane to quality care at life's end. The results suggest the importance of increasing prehospital providers' abilities to uphold advance directives and patients' end-of-life wishes while managing family emotions near death. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Nuffield Secondary Science, Theme 1, Interdependence of Living Things.

ERIC Educational Resources Information Center

Marson, J. Eric

Nuffield Secondary Science is a set of tested materials from which teachers can prepare courses for students in grades 9-11 (approximately) who do not intend to major in science. The materials are designed for British secondary schools. The Teachers' Guide to the entire set of Themes is described in SE 015 440. Each Theme is a teachers' guide to a…

Identifying Factors Associated with Risk Assessment Competencies of Public Health Emergency Responders

PubMed Central

Hao, Jiejing; Ren, Jiaojiao; Wu, Qunhong; Hao, Yanhua; Sun, Hong; Ning, Ning; Ding, Ding

2017-01-01

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as “relatively low”, contrasting with 21.4% rated as “relatively high”. Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders. PMID:28587226

Understanding public responses to chemical, biological, radiological and nuclear incidents--driving factors, emerging themes and research gaps.

PubMed

Krieger, Kristian; Amlôt, Richard; Rogers, M Brooke

2014-11-01

This paper discusses the management of public responses to incidents involving chemical, biological, radiological and nuclear materials (CBRN). Given the extraordinary technical and operational challenges of a response to a CBRN release including, but not limited to, hazard detection and identification, casualty decontamination and multi-agency co-ordination, it is not surprising that public psychological and behavioural responses to such incidents have received limited attention by scholars and practitioners alike. As a result, a lack of understanding about the role of the public in effective emergency response constitutes a major gap in research and practice. This limitation must be addressed as a CBRN release has the potential to have wide-reaching psychological and behavioural impacts which, in turn, impact upon public morbidity and mortality rates. This paper addresses a number of key issues: why public responses matter; how responses have been conceptualised by practitioners; what factors have been identified as influencing public responses to a CBRN release and similar extreme events, and what further analysis is needed in order to generate a better understanding of public responses to inform the management of public responses to a CBRN release. Copyright © 2014 Elsevier Ltd. All rights reserved.

Barriers and Facilitators to Implementing the HEADS-ED: A Rapid Screening Tool for Pediatric Patients in Emergency Departments.

PubMed

MacWilliams, Kate; Curran, Janet; Racek, Jakub; Cloutier, Paula; Cappelli, Mario

2017-12-01

This study sought to identify barriers and facilitators to the implementation of the HEADS-ED, a screening tool appropriate for use in the emergency department (ED) that facilitates standardized assessments, discharge planning, charting, and linking pediatric mental health patients to appropriate community resources. A qualitative theory-based design was used to identify barriers and facilitators to implementing the HEADS-ED tool. Focus groups were conducted with participants recruited from 6 different ED settings across 2 provinces (Ontario and Nova Scotia). The Theoretical Domains Framework was used as a conceptual framework to guide data collection and to identify themes from focus group discussions. The following themes spanning 12 domains were identified as reflective of participants' beliefs about the barriers and facilitators to implementing the HEADS-ED tool: knowledge, skills, beliefs about capabilities, social professional role and identity, optimism, beliefs about consequences, reinforcement, environmental context and resources, social influences, emotion, behavioral regulation and memory, and attention and decision process. The HEADS-ED has the potential to address the need for better discharge planning, complete charting, and standardized assessments for the increasing population of pediatric mental health patients who present to EDs. This study has identified potential barriers and facilitators, which should be considered when developing an implementation plan for adopting the HEADS-ED tool into practice within EDs.

Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

PubMed

Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard

2009-03-01

ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

NCI Think Tank Concerning the Identifiability of Biospecimens and “-Omic” Data

PubMed Central

Weil, Carol J.; Mechanic, Leah E.; Green, Tiffany; Kinsinger, Christopher; Lockhart, Nicole C.; Nelson, Stefanie A.; Rodriguez, Laura L.; Buccini, Laura D.

2014-01-01

On June 11 and 12, 2012, the National Cancer Institute (NCI) hosted a think tank concerning the identifiability of biospecimens and “omic” Data in order to explore challenges surrounding this complex and multifaceted topic. The think tank brought together forty-six leaders from several fields, including cancer genomics, bioinformatics, human subject protection, patient advocacy, and commercial genetics. The first day involved presentations regarding the state of the science of re-identification; current and proposed regulatory frameworks for assessing identifiability; developments in law, industry and biotechnology; and the expectations of patients and research participants. The second day was spent by think tank participants in small break-out groups designed to address specific sub-topics under the umbrella issue of identifiability, including considerations for the development of best practices for data sharing and consent, and targeted opportunities for further empirical research. We describe the outcomes of this two day meeting, including two complimentary themes that emerged from moderated discussions following the presentations on Day 1, and ideas presented for further empirical research to discern the preferences and concerns of research participants about data sharing and individual identifiability. PMID:23579437

Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

PubMed

Connelly, Lynne M; Peltzer, Jill N

2016-01-01

In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

Emergency Department Staff Beliefs About Self-Harm: A Thematic Framework Analysis.

PubMed

Koning, Kate Louise; McNaught, Angela; Tuffin, Keith

2017-11-03

To explore the beliefs and attitudes of emergency department staff about self-harm behaviour. Existing studies looking at views regarding self-harm rely solely on the information provided by medical and nursing staff using a questionnaire format. No studies currently consider ancillary staff members' beliefs about self-harm, even though they also work with these patients. A thematic framework analysis of interview transcripts was carried out. Individual semi-structured interviews were conducted from December 2015 to February 2016. Fifteen medical, nursing, and ancillary staff members from a large, tertiary emergency department participated. There were 5 major themes identified-causes of self-harm are multifactorial; beliefs about self-harm can change over time; emergency departments should only focus on the physical; self-harm occurs on a spectrum; and the system has failed. The results suggest participants felt ill-prepared and lacking in appropriate training to help patients that self-harm, and furthermore they have little faith in the mental health system. Staff beliefs and attitudes may change over time with exposure to patients who self-harm, possibly becoming more positive in response to a greater understanding of why the self-harm behaviour is occurring.

An analysis of narratives to identify critical thinking contexts in psychiatric clinical practice.

PubMed

Mun, Mi Suk

2010-02-01

The development of students' critical thinking abilities is one of the greatest challenges facing contemporary nursing educators. Nursing educators should know about what kind of contents or situations need critical thinking. The research was undertaken to identify the critical thinking contexts that nursing students confront in psychiatric clinical practices. Students were asked to document their everyday experience. The narratives were analysed and interpreted from the philosophical notion of hermeneutics. Four themes emerged as critical thinking contexts: anxiety, conflict, hyper-awareness, dilemmas. Writing narratives appear to provide opportunities for reflection in addition to facilitating critical thinking and communicative skills in students. Also, for the instructor, students' clinical narratives could provide insight to understand how students are thinking and to share student's personal difficulties.

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2017-12-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

Process mapping as a framework for performance improvement in emergency general surgery.

PubMed

DeGirolamo, Kristin; D'Souza, Karan; Hall, William; Joos, Emilie; Garraway, Naisan; Sing, Chad Kim; McLaughlin, Patrick; Hameed, Morad

2018-02-01

Emergency general surgery conditions are often thought of as being too acute for the development of standardized approaches to quality improvement. However, process mapping, a concept that has been applied extensively in manufacturing quality improvement, is now being used in health care. The objective of this study was to create process maps for small bowel obstruction in an effort to identify potential areas for quality improvement. We used the American College of Surgeons Emergency General Surgery Quality Improvement Program pilot database to identify patients who received nonoperative or operative management of small bowel obstruction between March 2015 and March 2016. This database, patient charts and electronic health records were used to create process maps from the time of presentation to discharge. Eighty-eight patients with small bowel obstruction (33 operative; 55 nonoperative) were identified. Patients who received surgery had a complication rate of 32%. The processes of care from the time of presentation to the time of follow-up were highly elaborate and variable in terms of duration; however, the sequences of care were found to be consistent. We used data visualization strategies to identify bottlenecks in care, and they showed substantial variability in terms of operating room access. Variability in the operative care of small bowel obstruction is high and represents an important improvement opportunity in general surgery. Process mapping can identify common themes, even in acute care, and suggest specific performance improvement measures.

The New Nuffield Combined Science Themes for the Middle Years

ERIC Educational Resources Information Center

Bingham, C. D.

1976-01-01

Described are the development, materials, and use of English developed science activities for junior high schools, the Nuffield Combined Science Themes for the Middle Years. The program, when completed will present 24 themes including: color, water, air, plastics, metals, insects, food, light, and electricity. (SL)

The Perceived Role of Spirituality in the Academic Persistence of Self-Identifying African-American Emerging Adult Learners in Higher Education

ERIC Educational Resources Information Center

Cummings, Arturo M.

2017-01-01

Little research has been done regarding the role of spirituality from the perceptive of self-identifying African-American emerging adult learners and how it contributes to their academic persistence, even though isolation, lack of peer support, and identity issues can decrease motivation of self-identifying African-American students. This study…

Complex, Dynamic Systems: A New Transdisciplinary Theme for Applied Linguistics?

ERIC Educational Resources Information Center

Larsen-Freeman, Diane

2012-01-01

In this plenary address, I suggest that Complexity Theory has the potential to contribute a transdisciplinary theme to applied linguistics. Transdisciplinary themes supersede disciplines and spur new kinds of creative activity (Halliday 2001 [1990]). Investigating complex systems requires researchers to pay attention to system dynamics. Since…

Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct.

PubMed

Whitson, Heather E; Duan-Porter, Wei; Schmader, Kenneth E; Morey, Miriam C; Cohen, Harvey J; Colón-Emeric, Cathleen S

2016-04-01

Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to characterize the emerging construct of resilience as it pertains to physical health in older adults, and to identify gaps and opportunities to advance research in this area. We conducted a systematic review to identify English language papers published through January 2015 that apply the term "resilience" in relation to physical health in older adults. We applied a modified framework analysis to characterize themes in implicit or explicit definitions of physical resilience. Of 1,078 abstracts identified, 49 articles met criteria for inclusion. Sixteen were letters or concept papers, and only one was an intervention study. Definitions of physical resilience spanned cellular to whole-person levels, incorporated many outcome measures, and represented three conceptual themes: resilience as a trait, trajectory, or characteristic/capacity. Current biomedical literature lacks consensus on how to define and measure physical resilience. We propose a working definition of physical resilience at the whole person level: a characteristic which determines one's ability to resist or recover from functional decline following health stressor(s). We present a conceptual framework that encompasses the related construct of physiologic reserve. We discuss gaps and opportunities in measurement, interactions across contributors to physical resilience, and points of intervention. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

Themes of Suicide in the Kalevala.

ERIC Educational Resources Information Center

Achte, Kalle; And Others

1988-01-01

The Kalevala, Finland's national epic, is a crucial element of Finnish cultural identity and important to Finnish culture. Violence, death, and suicide are often repeated themes in Finnish folklore. The Kalevala provides insight into past attitudes toward death. Traditions passed through generations have influenced people's attitudes toward…

Themes in fibrosis and gastrointestinal inflammation

PubMed Central

Lund, P. Kay

2011-01-01

Wound healing is an appropriate response to inflammation and tissue injury in the gastrointestinal tract. If wound healing responses are excessive, perpetuated, or prolonged, they lead to fibrosis, distortion of tissue architecture, and loss of function. This introductory editorial and the minireviews or reviews in this themes series highlight the diversity in severity and location of fibrosis in response to gastrointestinal inflammation. The multiplicity of cellular and molecular mediators and new players, including stem cells or extracellular matrix-producing cells derived from nonmesenchymal cell types, is reviewed. Comparisons of inflammation-induced fibrosis across organ systems and the need for integrated and systems-based molecular approaches, new imaging modalities, well-characterized animal models, cell culture models, and improved diagnostic or predictive markers are reviewed. To date, intestinal fibrosis has received much less attention than inflammation in terms of defining mechanisms and underlying causes. This themes series aims to illustrate the importance of research in this area in gastrointestinal health and disease. PMID:21415411

Supernatural Themes in Selected Children's Stories of Isaac Bashevis Singer.

ERIC Educational Resources Information Center

Schlessinger, June H.; Vanderryst, June D.

1989-01-01

Discusses the impact of the traditional folklore theme of good versus evil on children's development and analyzes the development of this theme using magical and supernatural situations in the work of Isaac Bashevis Singer. A selected bibliography of work by and literary criticisms of Singer's writings is provided. (five references) (CLB)

Provider perceptions of barriers to the emergency use of tPA for Acute Ischemic Stroke: A qualitative study

PubMed Central

2011-01-01

Background Only 1-3% of ischemic stroke patients receive thrombolytic therapy. Provider barriers to adhering with guidelines recommending tPA delivery in acute stroke are not well known. The main objective of this study was to describe barriers to thrombolytic use in acute stroke care. Methods Twenty-four hospitals were randomly selected and matched into 12 pairs. Barrier assessment occurred at intervention sites only, and utilized focus groups and structured interviews. A pre-specified taxonomy was employed to characterize barriers. Two investigators independently assigned themes to transcribed responses. Seven facilitators (three emergency physicians, two nurses, and two study coordinators) conducted focus groups and interviews of emergency physicians (65), nurses (62), neurologists (15), radiologists (12), hospital administrators (12), and three others (hospitalists and pharmacist). Results The following themes represented the most important external barriers: environmental and patient factors. Important barriers internal to the clinician included familiarity with and motivation to adhere to the guidelines, lack of self-efficacy and outcome expectancy. The following themes were not substantial barriers: lack of awareness of the existence of acute stroke guidelines, presence of conflicting guidelines, and lack of agreement with the guidelines. Conclusions Healthcare providers perceive environmental and patient-related factors as the primary barriers to adherence with acute stroke treatment guidelines. Interventions focused on increasing physician familiarity with and motivation to follow guidelines may be of highest yield in improving adherence. Improving self-efficacy in performing guideline concordant care may also be useful. Trial Registration ClinicalTrials.gov identifier: NCT00349479 PMID:21548943

Campus and Community Connections: The Evolving IUPUI Common Theme Project

ERIC Educational Resources Information Center

Hanna, Kathleen A.

2013-01-01

In 2009, IUPUI launched the Common Theme Project, designed to "promote campus unity, conversation, and collaboration on timely issues that connect IUPUI to central Indiana and the world." This paper briefly discusses the evolution of the Common Theme Project, from its roots as a freshman common reader to the current campus focus on…

Global Organizing Themes for Biology Students.

ERIC Educational Resources Information Center

LoPresti, Vin; Garafalo, Fred

1994-01-01

Discusses how the use of organizing themes can help to convey to students a sense of internal continuity within the discipline of biology and at the same time emphasize to them that viewing the study of biology as merely applied chemistry and physics is inaccurate and overly simplistic. (ZWH)

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…

Using Timely Survey-Based Information Networks to Collect Data on Best Practices for Public Health Emergency Preparedness and Response: Illustrative Case From the American College of Emergency Physicians' Ebola Surveys.

PubMed

Abir, Mahshid; Moore, Melinda; Chamberlin, Margaret; Koenig, Kristi L; Hirshon, Jon Mark; Singh, Cynthia; Schneider, Sandra; Cantrill, Stephen

2016-08-01

Using the example of surveys conducted by the American College of Emergency Physicians (ACEP) regarding the management of Ebola cases in the United States, we aimed to demonstrate how survey-based information networks can provide timely data to inform best practices in responding to public health emergencies. ACEP conducted 3 surveys among its members in October to November 2014 to assess the state of Ebola preparedness in emergency departments. We analyzed the surveys to illustrate the types of information that can be gleaned from such surveys. We analyzed qualitative data through theme extraction and collected quantitative results through cross-tabulations and logistic regression examining associations between outcomes and potential contributing factors. In the first survey, most respondents perceived their hospital as being reasonably prepared for Ebola. The second survey revealed significant associations between a hospital's preparedness and its perceived ability to admit Ebola patients. The third survey identified 3 hospital characteristics that were significantly and independently associated with perceived ability to admit Ebola patients: large size, previous Ebola screening experience, and physician- and nurse-led hospital preparedness. Professional associations can use their member networks to collect timely survey data to inform best practices during and immediately after public health emergencies. (Disaster Med Public Health Preparedness. 2016;10:681-690).

"It's a Burden You Carry": Describing Moral Distress in Emergency Nursing.

PubMed

Wolf, Lisa A; Perhats, Cydne; Delao, Altair M; Moon, Michael D; Clark, Paul R; Zavotsky, Kathleen E

2016-01-01

Moral distress in nursing has been studied in many settings, but there is a paucity of research on moral distress as it manifests in the emergency department. One study suggests a correlation between moral distress and aspects of burnout, and other researchers report that nurses have considered leaving their position or even their profession because of moral distress. Further exploration of these issues may provide insight into their effects on ED patient care and the emergency nursing profession. The purpose of this study was to explore the nature of moral distress as it is experienced and described by emergency nurses. A qualitative, exploratory design was employed using semi-structured focus groups for data collection. Using an iterative process, transcripts were analyzed for emerging themes by the research team. Six researchers analyzed the transcripts using a thematic analysis approach. Themes from the data included dysfunctional practice arena, being overwhelmed, and adaptive/maladaptive coping. Participants described, overall, a profound feeling of not being able to provide patient care as they wanted to. Causes of moral distress in emergency nurses are environment driven, not incident driven, as is described in other settings, and include a high-acuity, high-demand, technical environment with insufficient resources. Interventions should be targeted to improve environmental factors that contribute to the moral distress of emergency nurses. Future research should focus on the development and validation of an instrument to measure moral distress in this setting. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs

PubMed Central

Jardine, Jocelyn Leonie; Mavumengwana, Vuyo

2017-01-01

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria, Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment. PMID:28914802

Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs.

PubMed

Jardine, Jocelyn Leonie; Abia, Akebe Luther King; Mavumengwana, Vuyo; Ubomba-Jaswa, Eunice

2017-09-15

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria , Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment.

[Emerging infectious diseases: complex, unpredictable processes].

PubMed

Guégan, Jean-François

2016-01-01

In the light of a double approach, at first empirical, later theoretical and comparative, illustrated by the example of the Buruli ulcer and its mycobacterial agent Mycobacterium ulcerans on which I focused my research activity these last ten years by studying determinants and factors of emerging infectious or parasitic diseases, the complexity of events explaining emerging diseases will be presented. The cascade of events occurring at various levels of spatiotemporal scales and organization of life, which lead to the numerous observed emergences, nowadays requires better taking into account the interactions between host(s), pathogen(s) and the environment by including the behavior of both individuals and the population. In numerous research studies on emerging infectious diseases, microbial hazard is described rather than infectious disease risk, the latter resulting from the confrontation between an association of threatening phenomena, or hazards, and a susceptible population. Beyond, the theme of emerging infectious diseases and its links with global environmental and societal changes leads to reconsider some well-established knowledge in infectiology and parasitology. © Société de Biologie, 2017.

Transformative Processes in Marriage: An Analysis of Emerging Trends

ERIC Educational Resources Information Center

Fincham, Frank D.; Stanley, Scott M.; Beach, Steven R. H.

2007-01-01

The study of conflict has dominated psychological research on marriage. This article documents its move from center stage, outlining how a broader canvas accommodates a richer picture of marriage. A brief sampling of new constructs such as forgiveness and sacrifice points to an organizing theme of transformative processes in emerging marital…

Strategies Identified as Effective by Mothers During Occupational Performance Coaching.

PubMed

Graham, Fiona; Rodger, Sylvia; Ziviani, Jenny; Jones, Virginia

2016-08-01

This study examined strategies mothers reported as effective in facilitating children's successful performance in activities they identified as goals during Occupational Performance Coaching (OPC). Twenty-nine mothers of children with occupational performance issues engaged in OPC. A random sample of 44 /157 (28%) coaching sessions were video-recorded from which the audio recording was analyzed using a general inductive approach to explore the nature of strategies reported as effective by mothers. Two major themes emerged: (1) Context-focused; or (2) Child-focused. Context-focused strategies were characterized by mothers' actions that made the performance context more conducive to children's success. The emphasis of mothers' intention in Context-focused strategies was achievement of the task with minimal stress. Context-focused strategies included subthemes of Adjust Manner, Create Distance, Add Structure and Routine, and Teach. Child-focused strategies required higher levels of engagement with children in the application of strategies and were focused on children's skill development. Subthemes included Collaboration and Offer Choice. Mothers engaged in coaching identified strategies which they found supported children's performance, attesting to the existing capacity of mothers in identifying and evaluating effective ways of enhancing children's performance. Findings suggest the potential of coaching as a capacity-building, context-based intervention to improve children's performance.

Identifying and Prioritizing Information Needs and Research Priorities of Public Health Emergency Preparedness and Response Practitioners.

PubMed

Siegfried, Alexa L; Carbone, Eric G; Meit, Michael B; Kennedy, Mallory J; Yusuf, Hussain; Kahn, Emily B

2017-10-01

This study describes findings from an assessment conducted to identify perceived knowledge gaps, information needs, and research priorities among state, territorial, and local public health preparedness directors and coordinators related to public health emergency preparedness and response (PHPR). The goal of the study was to gather information that would be useful for ensuring that future funding for research and evaluation targets areas most critical for advancing public health practice. We implemented a mixed-methods approach to identify and prioritize PHPR research questions. A web survey was sent to all state, city, and territorial health agencies funded through the Public Health Emergency Preparedness (PHEP) Cooperative Agreement program and a sample of local health departments (LHDs). Three focus groups of state and local practitioners and subject matter experts from the Centers for Disease Control and Prevention (CDC) were subsequently conducted, followed by 3 meetings of an expert panel of PHPR practitioners and CDC experts to prioritize and refine the research questions. We identified a final list of 44 research questions that were deemed by study participants as priority topics where future research can inform PHPR programs and practice. We identified differences in perceived research priorities between PHEP awardees and LHD survey respondents; the number of research questions rated as important was greater among LHDs than among PHEP awardees (75%, n=33, compared to 24%, n=15). The research questions identified provide insight into public health practitioners' perceived knowledge gaps and the types of information that would be most useful for informing and advancing PHPR practice. The study also points to a higher level of information need among LHDs than among PHEP awardees. These findings are important for CDC and the PHPR research community to ensure that future research studies are responsive to practitioners' needs and provide the information

Gender- and sex-specific sports-related injury research in emergency medicine: a consensus on future research direction and focused application.

PubMed

Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E

2014-12-01

Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.

Riparian area management: themes and recommendations

Treesearch

David J. Welsch; James W. Hornbeck; Elon S. Verry; Andrew Dolloff; John G. Greis

2000-01-01

The end results of most of our management actions are reflected by the health of our rivers, streams, and lakes." Michael Dombeck, Chief, USDA Forest ServiceIn this final chapter [of Riparian Management in Forests of the Continental Eastern United States], we consider the overriding themes of riparian area management and list...

Exploring physiotherapists' experiences of implementing a cognitive behavioural approach for managing low back pain and identifying barriers to long-term implementation.

PubMed

Richmond, Helen; Hall, Amanda M; Hansen, Zara; Williamson, Esther; Davies, David; Lamb, Sarah E

2018-03-01

Our objectives were two-fold: (i) to describe physiotherapists' experiences of implementing a cognitive behavioural approach (CBA) for managing low back pain (LBP) after completing an extensive online training course (iBeST), and (ii) to identify how iBeST could be enhanced to support long-term implementation before scale up for widespread use. We conducted semi-structured interviews with 11 physiotherapists from six National Health Service departments in the Midlands, Oxfordshire and Derbyshire. Questions centred on (i) using iBeST to support implementation, (ii) what barriers they encountered to implementation and (iii) what of information or resources they required to support sustained implementation. Interviews were transcribed and thematically analysed using NVivo. Themes were categorised using the Theoretical Domains Framework (TDF). Evidence-based techniques were identified using the behaviour change technique taxonomy to target relevant TDF domains. Three themes emerged from interviews: anxieties about using a CBA, experiences of implementing a CBA, and sustainability for future implementation of a CBA. Themes crossed multiple TDF domains and indicated concerns with knowledge, beliefs about capabilities and consequences, social and professional roles, social influences, emotion, and environmental context and resources. We identified evidence-based strategies that may support sustainable implementation of a CBA for LBP in a physiotherapy setting. This study highlighted potential challenges for physiotherapists in the provision of evidence-based LBP care within the current UK NHS. Using the TDF provided the foundation to develop a tailored, evidence-based, implementation intervention to support long term use of a CBA by physiotherapists managing LBP within UK NHS outpatient departments. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

Gender role models in fictional novels for emerging adult lesbians.

PubMed

Cook, Jennifer R; Rostosky, Sharon S; Riggle, Ellen D B

2013-01-01

Novels provide role models for young adult lesbians and thus may influence their identity development. This study focused on 16 lesbian protagonists identified in 11 young adult novels that received 2011 Lambda Literary Award nominations. Content analyses revealed six themes. Three themes defied traditional gender stereotypes: Asserting Oneself, Pursuing Intimacy with Another Woman, and Breaking Free of Constraints to Authentic Self-Expression. Three themes reinforced gender stereotypes: Negative Emotional Experiences Associated with Lesbian Identity, Traditional Masculine Gender Expression, and Traditional Gender Role-Based Sexual Scripts. Each theme is discussed in light of its possible contribution to lesbian identity development.

The effects of gender, ethnicity, and a close relationship theme on perceptions of persons introducing a condom.

PubMed

Castaneda, D M; Collins, B E

1998-09-01

Perceptions of persons who introduce condoms in an ongoing sexual interaction, and the effects of gender and ethnicity on these perceptions, were explored in a study involving 243 students at a large, urban university in the western US. 133 of these students identified themselves as Mexican American; the remaining students indicated they were White. A vignette methodology was used to elicit perceptions of condom introducers on six scales (Nice, Exciting, Sexually Attractive, Promiscuous, Good Relationship Partner, Unpersonable/Personable). Data were analyzed in a 2 (gender of participant) x 2 (gender of condom introducer) x 3 (low acculturated Mexican American, high acculturated Mexican American, White) x 2 (presence/absence of close relationship theme) analysis of variance and covariance. In terms of the Nice Scale, women rated condom introducers significantly higher than men, female condom introducers were rated significantly higher than male introducers, and condom introducers who expressed a care and responsibility theme while introducing a condom were rated significantly higher than those who expressed no theme. On the Exciting Scale, women condom introducers were rated significantly higher than men. Condom introducers who expressed a care and responsibility theme were rated significantly higher than those who expressed no theme on the Good Relationship Partner scale. Men rated the female condom introducer significantly higher than women on the Promiscuous scale. Low acculturated Mexicans rated the female condom introducer significantly higher than the male introducer on the Promiscuous scale and rated the condom introducer significantly higher than Whites on the Sexually Attractive scale. These findings attest that many often contradictory interpersonal gender- and ethnicity-related perceptions operate in sexual encounters.

Emerging themes in radical SAM chemistry

PubMed Central

Shisler, Krista A; Broderick, Joan B

2014-01-01

Enzymes in the radical SAM (RS) superfamily catalyze a wide variety of reactions through unique radical chemistry. The characteristic markers of the superfamily include a [4Fe–4S] cluster coordinated to the protein via a cysteine triad motif, typically CX3CX2C, with the fourth iron coordinated by S-adenosylmethionine (SAM). The SAM serves as a precursor for a 5′-deoxyadenosyl radical, the central intermediate in nearly all RS enzymes studied to date. The SAM-bound [4Fe–4S] cluster is located within a partial or full triosephosphate isomerase (TIM) barrel where the radical chemistry occurs protected from the surroundings. In addition to the TIM barrel and a RS [4Fe–4S] cluster, many members of the superfamily contain additional domains and/or additional Fe–S clusters. Recently characterized superfamily members are providing new examples of the remarkable range of reactions that can be catalyzed, as well as new structural and mechanistic insights into these fascinating reactions. PMID:23141873

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Social Media: Portrait of an Emerging Tool in Medical Education.

PubMed

Roy, Durga; Taylor, Jacob; Cheston, Christine C; Flickinger, Tabor E; Chisolm, Margaret S

2016-02-01

The authors compare the prevalence of challenges and opportunities in commentaries and descriptive accounts versus evaluative studies of social media use in medical education. A previously published report of social media use in medical education provided an in-depth discussion of 14 evaluative studies, a small subset of the total number of 99 articles on this topic. This study used the full set of articles identified by that review, including the 58 commentaries and 27 descriptive accounts which had not been previously reported, to provide a glimpse into how emerging tools in medical education are initially perceived. Each commentary, descriptive account, and evaluative study was identified and compared on various characteristics, including discussion themes regarding the challenges and opportunities of social media use in medical education. Themes related to the challenges of social media use in medical education were more prevalent in commentaries and descriptive accounts than in evaluative studies. The potential of social media to affect medical professionalism adversely was the most commonly discussed challenge in the commentaries (53%) and descriptive accounts (63%) in comparison to technical issues related to implementation in the evaluative studies (50%). Results suggest that the early body of literature on social media use in medical education-like that of previous innovative education tools-comprises primarily commentaries and descriptive accounts that focus more on the challenges of social media than on potential opportunities. These results place social media tools in historical context and lay the groundwork for expanding on this novel approach to medical education.

Defining European preparedness and research needs regarding emerging infectious animal diseases: results from a Delphi expert consultation.

PubMed

Wentholt, M T A; Cardoen, S; Imberechts, H; Van Huffel, X; Ooms, B W; Frewer, L J

2012-02-01

Emerging and major infectious animal diseases can have significant international impact on social, economic and environmental level, and are being driven by various factors. Prevention and control measures should be prepared at both national and international level to mitigate these disease risks. Research to support such policy development is mostly carried out at national level and dedicated transnational research programmes are still in its infancy. This research reports on part of a process to develop a common strategic research agenda on emerging and major infectious diseases of livestock in Europe, covering a 5-15-year time span. A two round online Delphi study was conducted to explore the views of experts on issues relating to research needs on emerging infectious diseases of livestock in Europe. Drivers that may influence the incidence of emerging infectious animal diseases in both the short (next 5 years) and medium term (10-15 years) were identified. Drivers related to regulatory measures and biological science developments were thought to decrease the incidence, and socio-economic factors to increase the incidence of emerging infectious animal diseases. From the first round a list of threats to animal health was compiled and participants combined these threats with relevant drivers in the second round. Next to identifying threats to animal health, also possible mitigatory actions to reduce the negative impact of these threats were identified. Participants emphasised that interdisciplinary research is needed to understand drivers of emerging infectious animal diseases, as well as to develop prevention and control measures which are both socio-economic and technical. From this it can be concluded that interdisciplinary research combining both natural and social research themes is required. Some of the European member states research budget needs to be allocated so that effective prevention and mitigation strategies can be developed. Copyright © 2011

Determining Student Competency in Field Placements: An Emerging Theoretical Model

ERIC Educational Resources Information Center

Salm, Twyla L.; Johner, Randy; Luhanga, Florence

2016-01-01

This paper describes a qualitative case study that explores how twenty-three field advisors, representing three human service professions including education, nursing, and social work, experience the process of assessment with students who are struggling to meet minimum competencies in field placements. Five themes emerged from the analysis of…

Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

PubMed

Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

2015-10-01

Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

Degree Progress of Women Doctoral Students: Factors that Constrain, Facilitate, and Differentiate

ERIC Educational Resources Information Center

Maher, Michelle A.; Ford, Martin E.; Thompson, Candace M.

2004-01-01

Using survey and qualitative data, this study identified emergent themes that remain consistent across or differentiate among reports of women earning their doctoral degree relatively quickly ("early-finishers") and those taking considerably longer ("late-finishers"). Emergent themes included commitment to timely degree completion, faculty…

StrengthsFinder Signature Themes of Talent in Doctor of Pharmacy Students in Five Midwestern Pharmacy Schools.

PubMed

Janke, Kristin K; Farris, Karen B; Kelley, Katherine A; Marshall, Vincent D; Plake, Kimberly S; Scott, Steven A; Sorensen, Todd D; Yee, Gary C

2015-05-25

To describe student pharmacists' Signature Themes from the Clifton StrengthsFinder across 5 Midwestern pharmacy institutions and to compare themes by gender, institution, and undergraduate population. Student pharmacists completed the StrengthsFinder 2.0 assessment and received their top 5 Signature Themes. Themes were organized and examined by domains (Executing, Influencing, Relationship Building, Strategic Thinking). The distribution of the themes was compared between student pharmacists and undergraduates and themes and domains were compared by institution and gender. Although results varied by institution, the top 5 themes among the 1244 of 1250 students (99.5%) who completed the assessment were: Achiever, Harmony, Learner, Responsibility, and Empathy. Female student pharmacists had more themes in Executing and Relationship Building, while males had more themes in Influencing and Strategic Thinking. Pharmacy students exhibit more Executing domain talents and fewer Influencing domain talents compared with undergraduates. Signature Themes were consistent among student pharmacists across 5 Midwestern colleges of pharmacy.

Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

PubMed

Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

2017-10-31

The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

The Animadora Project: Identifying factors related to the promotion of physical activity among Mexican Americans with diabetes

PubMed Central

Ingram, Maia; Ruis, Maricruz; Mayorga, Maria Theresa; Rosales, Cecilia

2015-01-01

Purpose There is a dearth of information about factors related to physical activity among Mexican Americans with diabetes. Self efficacy and social support are associated with physical activity, however little is known about their role within different cultural groups. Design Focus groups were used to identify factors that motivate walking. Setting Two Mexican American communities located in Tucson, Arizona. Subjects Individuals who attended diabetes education. Intervention A community-based provider organized walking groups with people who previously attended diabetes classes. Walkers participated in focus groups exploring themes related to their experience. Measures Self efficacy, social support, and collective efficacy. Grounded theory was used to analyze focus group results using two rounds of analysis; the first identifying references to self efficacy and social support and the second adding collective efficacy as a theoretical basis for walking. Results Among 43 eligible participants, 20 participated in focus groups. Social support was expressed as commitment and companionship. Walkers demonstrated a high level of self efficacy for walking. Development of group identity/social cohesion was also a motivator to walk. Collective efficacy emerged as an applicable theoretical model encompassing these themes and their interrelationship. Conclusion Collective efficacy, or the belief that the group can improve their lives through collective effort, is a viable theoretical construct in the development of physical activity interventions targeting Mexican Americans with diabetes. PMID:19601479

Comparison of StrengthsQuest Signature Themes in Student Pharmacists and Other Health Care Profession Students.

PubMed

Bloom, Timothy J

2018-02-01

Objective. To determine whether there is a distinctive pattern of StrengthsQuest Signature Themes or leadership domains for Doctor of Pharmacy students compared to students in other health care professional programs. Methods. Students in Doctor of Pharmacy (PharmD), Master of Physician Assistant (PA), Doctor of Physical Therapy (DPT), and Doctor of Osteopathic Medicine (DO) programs at Campbell University completed the online Clifton StrengthsQuest assessment and received their Signature Themes. The frequency of individual themes and the leadership domains into which they are sorted by Gallup was analyzed for each program. Results were compared between programs and with national frequencies among undergraduate students. Results. The most common themes in the total population were Learner, Relator, Responsibility, Harmony, and Achiever. Learner and Relator were among the five most frequent themes for all four individual programs while Responsibility and Harmony were among the top five for three programs. The most frequently reported themes in PharmD and PA students (39% and 38% of all themes, respectively) are grouped by Gallup into the executing domain, and into the relationship-building domain for DO and DPT students (35% and 33% of all themes, respectively). The least frequent themes in PharmD, DO and PA students were those grouped into the influencing domain, reported by 10% or fewer students. Conclusion. Numerous similarities were found in theme frequencies among students in four different health care professions, suggesting there is not a distinctive Doctor of Pharmacy Signature Theme profile.

Patterns and Themes in Afro-American Literature.

ERIC Educational Resources Information Center

Liebman, Arthur

1970-01-01

An historical survey of the themes, directions, trends, and artistic techniques of black writers in America provides insight into the works of such artists as Phyllis Wheatley, Paul Lawrence Dunbar, Langston Hughes, Richard Wright, Ralph Ellison, James Baldwin, and LeRoi Jones. (MF)

Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

PubMed Central

Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

2015-01-01

Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

Growing pains: understanding the needs of emerging adults with chronic pain

PubMed Central

Twiddy, Hannah; Hanna, Julie; Haynes, Louise

2017-01-01

Background: Emerging adulthood (18–30 years), in the Western world, is often a time of identity development and exploration, focusing on areas of work, relationships and education. Individuals with chronic illnesses, such as chronic pain, may be more vulnerable to facing challenges during this time. This study aims to investigate the needs of young adults (YAs) attending a tertiary level National Health Service (NHS) Pain Management Programme (PMP) Service in the United Kingdom; exploring how these needs may translate on to clinical assessment and the delivery of rehabilitation interventions. Method: This is a descriptive qualitative study influenced by phenomenological approaches. YA with a diagnosis of chronic pain were recruited and assigned to one of four focus groups facilitated by a clinical psychologist and occupational therapist. A semi-structured interview guide was used to help facilitate the group discussion. Results: Qualitative analysis identified four key themes in understanding the needs of YAs with chronic pain: (1) thwarted opportunities, (2) peer separation, (3) perceived illness validity in the context of age and (4) dependency/parental enmeshment. Conclusions: The emerging adulthood literature provides a valuable framework for examining a normal developmental trajectory and highlights the relevance of age-related processes in YAs with chronic pain. The idealisation of opportunity and the role of perception in this developmental phase both appear relevant. It is significant that emotional stability is not yet established in emerging adulthood and links to unhelpful management strategies that may be differentiated from older populations are identified. PMID:28785407

Foreword to the theme issue on geospatial computer vision

NASA Astrophysics Data System (ADS)

Wegner, Jan Dirk; Tuia, Devis; Yang, Michael; Mallet, Clement

2018-06-01

Geospatial Computer Vision has become one of the most prevalent emerging fields of investigation in Earth Observation in the last few years. In this theme issue, we aim at showcasing a number of works at the interface between remote sensing, photogrammetry, image processing, computer vision and machine learning. In light of recent sensor developments - both from the ground as from above - an unprecedented (and ever growing) quantity of geospatial data is available for tackling challenging and urgent tasks such as environmental monitoring (deforestation, carbon sequestration, climate change mitigation), disaster management, autonomous driving or the monitoring of conflicts. The new bottleneck for serving these applications is the extraction of relevant information from such large amounts of multimodal data. This includes sources, stemming from multiple sensors, that exhibit distinct physical nature of heterogeneous quality, spatial, spectral and temporal resolutions. They are as diverse as multi-/hyperspectral satellite sensors, color cameras on drones, laser scanning devices, existing open land-cover geodatabases and social media. Such core data processing is mandatory so as to generate semantic land-cover maps, accurate detection and trajectories of objects of interest, as well as by-products of superior added-value: georeferenced data, images with enhanced geometric and radiometric qualities, or Digital Surface and Elevation Models.

Chaotic Careers: A Narrative Analysis of Career Transition Themes and Outcomes Using Chaos Theory as a Guiding Metaphor

ERIC Educational Resources Information Center

Peake, Sharon; McDowall, Almuth

2012-01-01

In a rapidly changing world of work, little research exists on mid-career transitions. We investigated these using the open-systems approach of chaos theory as a guiding metaphor and conducted interviews with seven mid-career individuals chosen for their experience of a significant mid-career transition. Four common themes were identified through…

Identifying sources of emerging organic contaminants in a mixed use watershed using principal components analysis.

PubMed

Karpuzcu, M Ekrem; Fairbairn, David; Arnold, William A; Barber, Brian L; Kaufenberg, Elizabeth; Koskinen, William C; Novak, Paige J; Rice, Pamela J; Swackhamer, Deborah L

2014-01-01

Principal components analysis (PCA) was used to identify sources of emerging organic contaminants in the Zumbro River watershed in Southeastern Minnesota. Two main principal components (PCs) were identified, which together explained more than 50% of the variance in the data. Principal Component 1 (PC1) was attributed to urban wastewater-derived sources, including municipal wastewater and residential septic tank effluents, while Principal Component 2 (PC2) was attributed to agricultural sources. The variances of the concentrations of cotinine, DEET and the prescription drugs carbamazepine, erythromycin and sulfamethoxazole were best explained by PC1, while the variances of the concentrations of the agricultural pesticides atrazine, metolachlor and acetochlor were best explained by PC2. Mixed use compounds carbaryl, iprodione and daidzein did not specifically group with either PC1 or PC2. Furthermore, despite the fact that caffeine and acetaminophen have been historically associated with human use, they could not be attributed to a single dominant land use category (e.g., urban/residential or agricultural). Contributions from septic systems did not clarify the source for these two compounds, suggesting that additional sources, such as runoff from biosolid-amended soils, may exist. Based on these results, PCA may be a useful way to broadly categorize the sources of new and previously uncharacterized emerging contaminants or may help to clarify transport pathways in a given area. Acetaminophen and caffeine were not ideal markers for urban/residential contamination sources in the study area and may need to be reconsidered as such in other areas as well.

Emergency Medicine and Critical Care Blogs and Podcasts: Establishing an International Consensus on Quality.

PubMed

Thoma, Brent; Chan, Teresa M; Paterson, Quinten S; Milne, W Kenneth; Sanders, Jason L; Lin, Michelle

2015-10-01

This study identified the most important quality indicators for online educational resources such as blogs and podcasts. A modified Delphi process that included 2 iterative surveys was used to build expert consensus on a previously defined list of 151 quality indicators divided into 3 themes: credibility, content, and design. Aggregate social media indicators were used to identify an expert population of editors from a defined list of emergency medicine and critical care blogs and podcasts. Survey 1 consisted of the quality indicators and a 7-point Likert scale. The mean score for each quality indicator was included in survey 2, which asked participants whether to "include" or "not include" each quality indicator. The cut point for consensus was defined at greater than 70% "include." Eighty-three percent (20/24) of bloggers and 90.9% (20/22) of podcasters completed survey 1 and 90% (18/20) of bloggers and podcasters completed survey 2. The 70% inclusion criteria were met by 44 and 80 quality indicators for bloggers and podcasters, respectively. Post hoc, a 90% cutoff was used to identify a list of 14 and 26 quality indicators for bloggers and podcasters, respectively. The relative importance of quality indicators for emergency medicine blogs and podcasts was determined. This will be helpful for resource producers trying to improve their blogs or podcasts and for learners, educators, and academic leaders assessing their quality. These results will inform broader validation studies and attempts to develop user-friendly assessment instruments for these resources. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand.

PubMed

Yuwanich, Nuttapol; Sandmark, Hélène; Akhavan, Sharareh

2015-10-30

Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. This study aimed to explore nurses' perceptions of occupational stress in an emergency department. A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

NASA Structure and Evolution of the Universe Theme: Science Overview

NASA Technical Reports Server (NTRS)

White, Nicholas E.; Margon, Bruce

2001-01-01

The NASA Office of Space Science Structure and Evolution of the Universe (SEU) theme covers a wide variety of scientific investigations, from the nearest bodies to the farthest observable distances just after the time of the Big Bang. SEU supports experiments that sense radiation of all wavelengths, together with particle and gravitational wave detection. Recently completed road mapping and strategic planning exercises have identified a number of near- and medium-term space initiatives for the 2003-2023 time frame. Each of these experiments pushes the state of the art technically, but will return incredible new insights on the formation and evolution of the universe, as well as probe fundamental laws of physics in regimes never before tested. The scientific goals and technological highlights of each mission are described.

OAST Space Theme Workshop. Volume 3: Working Group Summary. 5: Propulsion (P-1). A. Summary Statement. B. Technology Needs (Form 1). C. Priority Assessments (Form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

All themes require some form of advanced propulsion capabilities to achieve their stated objectives. Requirements cover a broad spectrum ranging from a new generation of heavy lift launch vehicles to low thrust, long lift system for on-orbit operations. The commonality extant between propulsive technologies was established and group technologies were grouped into vehicle classes by functional capability. The five classes of launch vehicles identified by the space transportation theme were augmented with a sixth class, encompassing planetary and on-orbit operations. Propulsion technologies in each class were then ranked, and assigned priority numbers. Prioritized technologies were matched to theme requirements.

Identifying the Categories of Spiritual Experience Encountered by Therapists in Their Clinical Work

ERIC Educational Resources Information Center

Ross, Alistair

2016-01-01

Spirituality has replaced religion in popular culture and its presence is being felt in the therapeutic world. Using a questionnaire completed by 104 people utilising six descriptive definitions of spirituality and 36 categories of spiritual experience, three meta-themes of forms of spirituality emerged through a thematic analysis. These are…

Beyond a Moral Obligation: A Legal Framework for Emergency and Essential Surgical Care and Anesthesia.

PubMed

Chawla, Kashmira S; Rutkow, Lainie; Garber, Kent; Kushner, Adam L; Stewart, Barclay T

2017-05-01

Access to quality and timely emergency and essential surgical care and anesthesia (EESCA) is an integral component of the right to health as reinforced by the ratification of the World Health Assembly Resolution 68.15. However, this resolution is merely a guideline and has not been able to bolster the necessary political will to promote EESCA. Our objective was to evaluate international treaties, which carry legal obligations, for EESCA-related text, and develop a human rights-based framework to support EESCA advancement and advocacy. We conducted a comprehensive review of all the UN Treaty Collection-Certified True Copies (CTCs) of multilateral treaties database from December 2015 to April 2016. The relevant text was manually searched to abstract and analyze to identify major themes supporting a human rights-based approach to EESCA. Multiple treaties in the UN database addressed EESCA in the areas of human rights, refugees and stateless persons, health, penal matters, and disarmament. A total of 13 treaties containing 23 articles had language that endorsed aspects of EESCA. The three major themes, supported by the phraseology in the treaties, included: (1) equal access to EESCA (eight articles); (2) timely care of injured and those with emergency surgical conditions (eight articles); and (3) protection, rehabilitation, psychosocial support, and social security (seven articles). A number of United Nations multilateral treaties support available and equitable EESCA. These findings can be used to galvanize support and encourage signatory Member States to promote and implement EESCA development initiatives.

Nursing management of aggression in a Singapore emergency department: A qualitative study.

PubMed

Tan, Mei Fen; Lopez, Violeta; Cleary, Michelle

2015-09-01

In Singapore, anecdotal evidence suggests that nurses are concerned about managing aggressive incidents in the emergency department. In this study, registered nurses' perceptions of managing aggressive patients in an emergency department were explored. Ten registered nurses from the emergency department of an acute public hospital in Singapore were interviewed. Four overarching themes emerged from the thematic analysis: (i) impact of aggressive patients on nurses; (ii) nursing assessment of aggressive behaviors; (iii) nursing management of aggressive behaviors; and (iv) organizational support and responsiveness. Further research is required to better support nurses to deliver optimal care for aggressive patients and achieve positive and effective outcomes. © 2015 Wiley Publishing Asia Pty Ltd.

The Blackberry Image: Self-Identified Perceptions and Motivations Associated with College Student Blackberry Use

ERIC Educational Resources Information Center

Firmin, Michael W.; Firmin, Ruth L.; Orient, Katlyn M.; Edwards, Anna J.; Cunliff, Jennifer M.

2012-01-01

We report the results of a qualitative research study conducted with university students regarding their phenomenological perspectives of BlackBerry use. Three key themes inductively emerged throughout the interview and analysis process regarding self-perceptions college students reported regarding their own BlackBerry use. First, students offered…

Teaching Spiritual Themes to African American Children: A Picture Book Approach

ERIC Educational Resources Information Center

Harris, Demetrius B.

2017-01-01

"Teaching Spiritual Themes to African American Children: A Picture Book Approach" is a research project that used picture books to teach the four spiritual themes, 1.) love, 2.) forgiveness, 3.) kindness, and 4.) perseverance. This project was conducted in an after school program at Fifth Baptist Church, on Cary St. in Richmond, VA. The…

Recruitment and retention of emergency medical technicians: a qualitative study.

PubMed

Patterson, P Daniel; Probst, Janice C; Leith, Katherine H; Corwin, Sara J; Powell, M Paige

2005-01-01

Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Information was drawn from three focus groups of EMT-Basic, EMT-Intermediate, and EMT-Paramedic personnel recruited from participants at an annual conference. Thoughts and feelings of EMTs and paramedics were investigated using eight questions designed to explore entry into emergency medical services, what it is like to be an EMT or paramedic, and the EMT educational process. Data were analyzed at the group level for common themes using NVivo. For a majority of respondents, emergency medical services was not a primary career path. Most respondents entered the industry as an alternate or replacement for a nursing career or as a second career following military medic service. The majority of respondents believed the job was stressful yet rewarding, and although it negatively affected their personal lives, the occupation gave them a sense of accomplishment and belonging. Respondents expressed a preference for EMT education resulting in college credit or licensure versus professional certification. Job-related stress produced by numerous factors appears to be a likely contributor to low employee retention. Recruitment and retention efforts should address study findings, incorporating key findings into educational, evaluation, and job enhancement programs.

Key health themes and reporting of numerical cigarette-waterpipe equivalence in online news articles reporting on waterpipe tobacco smoking: a content analysis.

PubMed

Jawad, Mohammed; Bakir, Ali M; Ali, Mohammed; Jawad, Sena; Akl, Elie A

2015-01-01

There is anecdotal evidence that health messages interpreted from waterpipe tobacco smoking (WTS) research are inconsistent, such as comparing the health effects of one WTS session with that of 100 cigarettes. This study aimed to identify key health themes about WTS discussed by online news media, and how numerical cigarette-waterpipe equivalence (CWE) was being interpreted. We identified 1065 online news articles published between March 2011 and September 2012 using the 'Google Alerts' service. We screened for health themes, assessed statements mentioning CWE and reported differences between countries. We used logistic regression to identify factors associated with articles incorrectly reporting a CWE equal to or greater than 100 cigarettes, in the absence of any comparative parameter ('CWE ≥100 cigarettes'). Commonly mentioned health themes were the presence of tobacco (67%) and being as bad as cigarettes (49%), and we report on differences between countries. While 10.8% of all news articles contained at least one positive health theme, 22.9% contained a statement about a CWE. Most of these (18.6% total) were incorrectly a CWE ≥100 cigarettes, a quarter of which were made by healthcare professionals/organisations. Compared with the Middle East, articles from the USA and the UK were the most significant predictors to contain a CWE ≥100 cigarettes statement. Those wishing to write or publish information related to WTS may wish to avoid comparing WTS to cigarettes using numerical values as this is a major source of confusion. Future research is needed to address the impact of the media on the attitudes, initiation and cessation rates of waterpipe smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical handover of patients arriving by ambulance to the emergency department - a literature review.

PubMed

Bost, Nerolie; Crilly, Julia; Wallis, Marianne; Patterson, Elizabeth; Chaboyer, Wendy

2010-10-01

To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes. From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED. Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies. Copyright © 2009 Elsevier Ltd. All rights reserved.

Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

PubMed Central

Neri, P.M.; Redden, L.; Poole, S.; Pozner, C.N.; Horsky, J.; Raja, A.S.; Poon, E.; Schiff, G.

2015-01-01

Summary Objective To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. Methods We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Results Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. Conclusion We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to

Identifying research priorities for public health research to address health inequalities: use of Delphi-like survey methods.

PubMed

Turner, S; Ollerhead, E; Cook, A

2017-10-09

In the funding of health research and public health research it is vital that research questions posed are important and that funded research meets a research need or a gap in evidence. Many methods are used in the identification of research priorities, however, these can be resource intensive, costly and logistically challenging. Identifying such research priorities can be particularly challenging for complex public health problems as there is a need to consult a number of experts across disciplines and with a range of expertise. This study investigated the use of Delphi-like survey methods in identifying important research priorities relating to health inequalities and framing tractable research questions for topic areas identified. The study was conducted in two phases, both using Delphi-like survey methods. Firstly, public health professionals with an interest in health inequalities were asked to identify research priorities. Secondly academic researchers were asked to frame tractable research questions relating to the priorities identified. These research priorities identified using Delphi-like survey methods were subsequently compared to those identified using different methods. A total of 52 public health professionals and 21 academics across the United Kingdom agreed to take part. The response rates were high, from public health professionals across three survey rounds (69%, 50% and 40%) and from academics across one round (52%), indicating that participants were receptive to the method and motivated to respond. The themes identified as encompassing the most important research priorities were mental health, healthy environment and health behaviours. Within these themes, the topic areas that emerged most strongly included community interventions for prevention of mental health problems and the food and alcohol environment. Some responses received from academic researchers were (as requested) in the form of tractable research questions, whereas others

"It was pretty scary": the theme of fear in young adult women's descriptions of a history of adolescent dating abuse.

PubMed

Burton, Candace W; Halpern-Felsher, Bonnie; Rehm, Roberta S; Rankin, Sally; Humphreys, Janice C

2013-11-01

The mental health impact of abusive adolescent dating relationships has not been well described, but fear related to abuse has been reported. We elaborate the theme of fear in women's descriptions of a history of adolescent dating abuse. A sample of community-based women, ages 19-34, who experienced an abusive dating relationship during adolescence (ages 11-20) was used. Data were analyzed via thematic analysis. Fear was a consistent and resonant theme. Three types of fear were identified: fear for self, fear for other relationships, and fearful expectation. These results offer important insights into the impact of abusive adolescent relationships on women's mental health.

Using peptide array to identify binding motifs and interaction networks for modular domains.

PubMed

Li, Shawn S-C; Wu, Chenggang

2009-01-01

Specific protein-protein interactions underlie all essential biological processes and form the basis of cellular signal transduction. The recognition of a short, linear peptide sequence in one protein by a modular domain in another represents a common theme of macromolecular recognition in cells, and the importance of this mode of protein-protein interaction is highlighted by the large number of peptide-binding domains encoded by the human genome. This phenomenon also provides a unique opportunity to identify protein-protein binding events using peptide arrays and complementary biochemical assays. Accordingly, high-density peptide array has emerged as a useful tool by which to map domain-mediated protein-protein interaction networks at the proteome level. Using the Src-homology 2 (SH2) and 3 (SH3) domains as examples, we describe the application of oriented peptide array libraries in uncovering specific motifs recognized by an SH2 domain and the use of high-density peptide arrays in identifying interaction networks mediated by the SH3 domain. Methods reviewed here could also be applied to other modular domains, including catalytic domains, that recognize linear peptide sequences.

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Profile of Students’ Critical Thinking Skill Measured by Science Virtual Test on Living Things and Environmental Sustainability Theme

NASA Astrophysics Data System (ADS)

Maulida, N. I.; Firman, H.; Rusyati, L.

2017-02-01

The aims of this study are: (1) to investigate the level of students’ critical thinking skill on living things and environmental sustainability theme for each Inch’ critical thinking elements and overall, (2) to investigate the level of students’ critical thinking skill on living things characteristic, biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics. The research was conducted due to the important of critical thinking measurement to get the current skill description as the basic consideration for further critical thinking skill improvement in lower secondary science. The research method used was descriptive. 331 seventh grade students taken from five lower secondary schools in Cirebon were tested to get the critical thinking skill data by using Science Virtual Test as the instrument. Generally, the mean scores on eight Inch’ critical thinking elements and overall score from descriptive statistic reveals a moderate attainments level. Students’ critical thinking skill on biodiversity, energy resources, ecosystem, environmental pollution, and global warming topics are in moderate level. While students’ critical thinking skill on living things characteristic is identified as high level. Students’ experience in thinking critically during science learning process and the characteristic of the topic are emerged as the reason behind the students’ critical thinking skill level on certain science topic.

Meeting the needs of new graduates in the emergency department: a qualitative study evaluating a new graduate internship program.

PubMed

Glynn, Penelope; Silva, Sheila

2013-03-01

The purpose of this study was to explore the experiences of new graduate emergency nurses participating in a structured internship program. In order to meet the needs of new graduate nurses in emergency departments, these departments have developed a variety of orientation programs, some more successful than others. One type of program involves a combination of didactic content and hands-on clinical experience. This study examines the experiences of new graduate nurses in an internship program at a 200-bed community hospital. A qualitative design was used. Interviews with 8 of 9 nurses who participated in the new graduate internship program between 2006 and 2007 were conducted. Content analysis was used to analyze the data. Three themes were identified from the experiences and expectations reported in the interviews: (1) the acquisition of new knowledge and skills in a specialty area, (2) becoming more proficient, and (3) assistance with role transition. The significant role and importance of the unit-base clinical nurse specialist (CNS) and the nurse preceptors were also identified. The findings of this study suggest that a structured internship program is helpful to new graduate nurses when orienting to a critical care area such as the emergency department. Furthermore, the combination of didactic and clinical content, and the roles of the preceptor and unit-base CNS appear to be key factors in the successful transition from new graduate to emergency nurse. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Using Multiple Sources of Data to Gauge Outcome Differences between Academic-Themed and Transition-Themed First-Year Seminars

ERIC Educational Resources Information Center

Zerr, Ryan J.; Bjerke, Elizabeth

2016-01-01

Students in two different types of first-year experience seminar courses at a moderately sized public university were compared using a large variety of measures--both direct and indirect. One of these first-year experience types was a three-credit academic-themed course offered in sections with variable content; the other was a two-credit…

Public Health System Research in Public Health Emergency Preparedness in the United States (2009-2015): Actionable Knowledge Base.

PubMed

Savoia, Elena; Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P; Guicciardi, Stefano

2017-09-01

In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across segments of the population as well as evidence on specific

Endangered Species & Biodiversity: A Classroom Project & Theme

ERIC Educational Resources Information Center

Lauro, Brook

2012-01-01

Students discover the factors contributing to species losses worldwide by conducting a project about endangered species as a component of a larger classroom theme of biodiversity. Groups conduct research using online endangered- species databases and present results to the class using PowerPoint. Students will improve computer research abilities…

Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis.

PubMed

Golding, Sarah E; Horsfield, Claire; Davies, Annette; Egan, Bernadette; Jones, Martyn; Raleigh, Mary; Schofield, Patricia; Squires, Allison; Start, Kath; Quinn, Tom; Cropley, Mark

2017-01-01

The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: 'Organisational and Operational Factors' and 'Interactions with Others'. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. CRD42014010806.

Pilot Study of Kano "Attractive Quality" Techniques to Identify Change in Emergency Department Patient Experience.

PubMed

Bellamkonda, Venkatesh R; Kumar, Rishi; Scanlan-Hanson, Lori N; Hess, Jennifer J; Hellmich, Thomas R; Bellamkonda, Erica; Campbell, Ronna L; Hess, Erik P; Nestler, David M

2016-11-01

We describe the use of the Kano Attractive Quality analytic tool to improve an identified patient experience gap in perceived compassion by emergency department (ED) providers. In phase 1, point-of-service surveying assessed baseline patient perception of ED provider compassion. Phase 2 deployed Kano surveys to predict the effect of 4 proposed interventions on patient perception. Finally, phase 3 compared patients receiving standard care versus the Kano-identified intervention to assess the actual effect on patient experience. In phase 1, 193 of 200 surveys (97%) were completed, showing a baseline median score of 4 out of 5 (interquartile range [IQR] 3 to 5), with top box percentage of 33% for patients' perception of receiving compassionate care. In phase 2, 158 of 180 surveys (88%) using Kano-formatted questions were completed, and the data predicted that increasing shared decisionmaking would cause the greatest improvement in the patient experience. Finally, in phase 3, 45 of 49 surveys (92%) were returned and demonstrated a significant improvement in perceived concern and sensitivity, 5 (IQR 5 to 5) versus 4 (IQR 3 to 5) with a difference of 1 (95% CI 0.1-1.9) and a top box rating of 79% versus 35% with a difference of 44% (95% CI 12-66) by patients who received dedicated shared decisionmaking interventions versus those receiving standard of care. Kano analysis is likely predictive of change in patient experience. Kano methods may prove as useful in changing management of the health care industry as it has been in other industries. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

The Schizophrenic Theme in Science Fiction

DTIC Science & Technology

1965-06-01

science fiction, that certain themes such as super powers, telepathy , being influenced by external agencies, conspiracy, etc., bear only a...prohibition. This war of the instinctual drives (pleasure principle) with the reality principle was manifested in very aspect of the personality. Dreams , F. D...2. Somniomorph: Literary productions depicting events of such a nature and connected in such a manner as they typically occur in dreams . Much of the

Emergency Nurses Association

MedlinePlus

... medications to treat a medical emergency. Study: Workplace bullying is underestimated driver of nurse and patient outcomes ... Emergency Nurses Association theory helps identify and correct bullying behavior. Join the Emergency Nurses Week Celebration Led ...

Attitudes toward Tobacco, Alcohol, and Non-Alcoholic Beverage Advertisement Themes among Adolescent Boys.

PubMed

Friedman, Katherine L; Roberts, Megan E; Keller-Hamilton, Brittney; Yates, Katherine A; Paskett, Electra D; Berman, Micah L; Slater, Michael D; Lu, Bo; Ferketich, Amy K

2018-02-13

Previous studies have examined what adolescents find appealing in tobacco and alcohol advertisements and how different themes in advertisements are used to manipulate consumer behaviors. Yet, we know little about the relationship between the themes portrayed in advertisements and youth attitudes towards those themes. This study compared attitudes towards advertisements for different consumer products in a sample of urban and rural adolescent boys in order to examine how key marketing themes impact adolescent attitudes towards those advertisements. Participants were 11- to 16-year-old boys (N = 1220) residing in either urban or rural Ohio Appalachian counties. Each participant viewed five print advertisements (one each for cigarettes, electronic cigarettes (e-cigarettes), smokeless tobacco (SLT), non-alcoholic beverages, and alcohol), presented in a random order, for eight seconds each. All advertisements had appeared in magazines that adolescent males commonly read. Attitudes towards each of the five advertisements were assessed. The advertisements were then coded for the presence of various themes, including social acceptance and masculinity. Analyses were conducted to determine associations between advertisement type and the attitude measure, and between the presence of a theme and the attitude measure. Overall, participants preferred non-tobacco advertisements to tobacco advertisements, rural participants had less positive attitudes and participants who had peers who used tobacco had more positive attitudes. Social acceptance and entertainment themes increased the appeal of SLT advertisements, and sex appeal increased the appeal of e-cigarette advertisements. Conclusions/Importance: Findings suggest that advertisements that promote the social nature of use in SLT advertisements may be of particular concern for their influence on adolescent boys.

Spirit of Prophecy Perspectives: Education's Grand Theme.

ERIC Educational Resources Information Center

Douglass, Herbert E.

2001-01-01

Presents a fictional interview with Ellen White, founder of the Seventh-day Adventist Church, regarding the theological principle upon which the Adventist educational philosophy is based. This theme focuses on restoring the image of God in the human soul. The paper addresses teacher selection and training, teaching methodology, and how the…

NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies.

PubMed

D'Onofrio, Gail; Jauch, Edward; Jagoda, Andrew; Allen, Michael H; Anglin, Deirdre; Barsan, William G; Berger, Rachel P; Bobrow, Bentley J; Boudreaux, Edwin D; Bushnell, Cheryl; Chan, Yu-Feng; Currier, Glenn; Eggly, Susan; Ichord, Rebecca; Larkin, Gregory L; Laskowitz, Daniel; Neumar, Robert W; Newman-Toker, David E; Quinn, James; Shear, Katherine; Todd, Knox H; Zatzick, Douglas

2010-11-01

The Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (2003) identified a need to enhance the research base for emergency care. As a result, a National Institutes of Health (NIH) Task Force on Research in Emergency Medicine was formed to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. We identify key research questions essential to advancing the science of emergency care and discuss the barriers and strategies to advance research by exploring the collaboration between NIH and the emergency care community. Experts from emergency medicine, neurology, psychiatry, and public health assembled to review critical areas in need of investigation, current gaps in knowledge, barriers, and opportunities. Neurologic emergencies included cerebral resuscitation, pain, stroke, syncope, traumatic brain injury, and pregnancy. Mental health topics included suicide, agitation and delirium, substances, posttraumatic stress, violence, and bereavement. Presentations and group discussion firmly established the need for translational research to bring basic science concepts into the clinical arena. A coordinated continuum of the health care system that ensures rapid identification and stabilization and extends through discharge is necessary to maximize overall patient outcomes. There is a paucity of well-designed, focused research on diagnostic testing, clinical decisionmaking, and treatments in the emergency setting. Barriers include the limited number of experienced researchers in emergency medicine, limited dedicated research funding, and difficulties of conducting research in chaotic emergency environments stressed by crowding and limited resources. Several themes emerged during the course of the roundtable discussion, including the need

Measuring the operational efficiency of individual theme park attractions.

PubMed

Kim, Changhee; Kim, Soowook

2016-01-01

This study assesses the operation efficiency of theme park attractions using the data envelopment analysis, utilizing actual data on 15 attractions at Samsung Everland located in Yongin-si, Republic of Korea. In particular, this study identifies crowding and waiting time as one of the main causes of visitor's satisfaction, and analyzes the efficiency of individual attractions in terms of waiting time. The installation area, installation cost, and annual repair cost are set as input factors and the number of annual users and customer satisfaction as output factors. The results show that the roller coaster-type attractions were less efficient than other types of attractions while rotating-type attractions were relatively more efficient. However, an importance performance analysis on individual attraction's efficiency and satisfaction showed that operational efficiency should not be the sole consideration in attraction installation. In addition, the projection points for input factors for efficient use of attractions and the appropriate reference set for benchmarking are provided as guideline for attraction efficiency management.

The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

PubMed

Leggio, William Joseph

2014-10-01

This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

Intern as Patient: A Patient Experience Simulation to Cultivate Empathy in Emergency Medicine Residents.

PubMed

Nelson, Sara W; Germann, Carl A; MacVane, Casey Z; Bloch, Rebecca B; Fallon, Timothy S; Strout, Tania D

2018-01-01

Prior work links empathy and positive physician-patient relationships to improved healthcare outcomes. The objective of this study was to analyze a patient experience simulation for emergency medicine (EM) interns as a way to teach empathy and conscientious patient care. We conducted a qualitative descriptive study on an in situ, patient experience simulation held during EM residency orientation. Half the interns were patients brought into the emergency department (ED) by ambulance and half were family members. Interns then took part in focus groups that discussed the experience. Data collected during these focus groups were coded by two investigators using a grounded theory approach and constant comparative methodology. We identified 10 major themes and 28 subthemes in the resulting qualitative data. Themes were in three broad categories: the experience as a patient or family member in the ED; application to current clinical practice; and evaluation of the exercise itself. Interns experienced firsthand the physical discomfort, emotional stress and confusion patients and families endure during the ED care process. They reflected on lessons learned, including the importance of good communication skills, frequent updates on care and timing, and being responsive to the needs and concerns of patients and families. All interns felt this was a valuable orientation experience. Conducting a patient experience simulation may be a practical and effective way to develop empathy in EM resident physicians. Additional research evaluating the effect of participation in the simulation over a longer time period and assessing the effects on residents' actual clinical care is warranted.

Emergence of a New Lineage of Dengue Virus Type 2 Identified in Travelers Entering Western Australia from Indonesia, 2010-2012

PubMed Central

Ernst, Timo; McCarthy, Suzi; Chidlow, Glenys; Luang-Suarkia, Dagwin; Holmes, Edward C.; Smith, David W.; Imrie, Allison

2015-01-01

Dengue virus (DENV) transmission is ubiquitous throughout the tropics. More than 70% of the current global dengue disease burden is borne by people who live in the Asia-Pacific region. We sequenced the E gene of DENV isolated from travellers entering Western Australia between 2010–2012, most of whom visited Indonesia, and identified a diverse array of DENV1-4, including multiple co-circulating viral lineages. Most viruses were closely related to lineages known to have circulated in Indonesia for some time, indicating that this geographic region serves as a major hub for dengue genetic diversity. Most notably, we identified a new lineage of DENV-2 (Cosmopolitan genotype) that emerged in Bali in 2011–2012. The spread of this lineage should clearly be monitored. Surveillance of symptomatic returned travellers provides important and timely information on circulating DENV serotypes and genotypes, and can reveal the herald wave of dengue and other emerging infectious diseases. PMID:25635775

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

PubMed

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

Virtual Reality and Its Potential Use in Special Education. Identifying Emerging Issues and Trends in Technology for Special Education.

ERIC Educational Resources Information Center

Woodward, John

As part of a 3-year study to identify emerging issues and trends in technology for special education, this paper addresses the possible contributions of virtual reality technology to educational services for students with disabilities. An example of the use of virtual reality in medical imaging introduces the paper and leads to a brief review of…

Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

PubMed Central

Blake, Denise; Lyons, Antonia

2016-01-01

Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely “health and wellbeing”, “developing an emergency management plan”, and “stock, dose verification, and scripts” which led to an overarching concept of “service continuity in OST preparedness planning”. Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive. PMID:27834915

On Emerging from Autism and into the Terror of Relationships

ERIC Educational Resources Information Center

Holloway, Robin

2013-01-01

Aspects are outlined of the psychotherapy of two adolescents who were starting to emerge from a previous state of chronic (though high-functioning) autism. A central theme is the difficulty these adolescents had in tolerating the separateness of others (and thus the possibility that others could be lost) and at the same time being unable to remain…

Public Health System Research in Public Health Emergency Preparedness in the United States (2009–2015): Actionable Knowledge Base

PubMed Central

Lin, Leesa; Bernard, Dottie; Klein, Noah; James, Lyndon P.; Guicciardi, Stefano

2017-01-01

Background. In 2008, the Institute of Medicine released a letter report identifying 4 research priority areas for public health emergency preparedness in public health system research: (1) enhancing the usefulness of training, (2) improving timely emergency communications, (3) creating and maintaining sustainable response systems, and (4) generating effectiveness criteria and metrics. Objectives. To (1) identify and characterize public health system research in public health emergency preparedness produced in the United States from 2009 to 2015, (2) synthesize research findings and assess the level of confidence in these findings, and (3) describe the evolution of knowledge production in public health emergency preparedness system research. Search Methods and Selection Criteria. We reviewed and included the titles and abstracts of 1584 articles derived from MEDLINE, EMBASE, and gray literature databases that focused on the organizational or financial aspects of public health emergency preparedness activities and were grounded on empirical studies. Data Collection and Analysis. We included 156 articles. We appraised the quality of the studies according to the study design. We identified themes during article analysis and summarized overall findings by theme. We determined level of confidence in the findings with the GRADE-CERQual tool. Main Results. Thirty-one studies provided evidence on how to enhance the usefulness of training. Results demonstrated the utility of drills and exercises to enhance decision-making capabilities and coordination across organizations, the benefit of cross-sector partnerships for successfully implementing training activities, and the value of integrating evaluation methods to support training improvement efforts. Thirty-six studies provided evidence on how to improve timely communications. Results supported the use of communication strategies that address differences in access to information, knowledge, attitudes, and practices across

Using the Five Themes of Geography To Teach about Venezuela and Mexico.

ERIC Educational Resources Information Center

Sunal, Cynthia Szymanski; Christensen, Lois

Activities that employ the five themes of geography--location, place, relationships within places, movement, and regions--to teach about Venezuela and Mexico are described in this document. Each theme has objectives, a list of materials, and three types of activities--exploration, invention, and expansion. Background information on Venezuela and…

Trends in Themes of African American Family Research 1939-1989: A Synopsis.

ERIC Educational Resources Information Center

Davis, Lenwood G.

1990-01-01

Themes in research on African-American families between 1939 and 1989 are discussed, and the following recently developed themes are highlighted: (1) stress, (2) aging, (3) adoption, (4) prison, (5) polygamy, and (6) violence. Much more research is needed to provide better understanding of the African-American family. (SLD)

Pseudologia Fantastica in the Emergency Department: A Case Report and Review of the Literature

PubMed Central

Teslyar, Polina; Friedman, Rohn

2017-01-01

Psychiatrists commonly encounter deception in the emergency department. This article presents the case of a patient who presents to the emergency department with an unusual and elaborate web of deceptions along multiple themes including feigning medical illness, multiple losses, and grandiose academic and athletic achievements. We review the clinical characteristics of pseudologia fantastica and discuss how this patient's constellation of malingering, factitious disorder, and personality disorder suggests this diagnosis. PMID:28573061

Using action research to plan a violence prevention program for emergency departments.

PubMed

Gates, Donna; Gillespie, Gordon; Smith, Carolyn; Rode, Jennifer; Kowalenko, Terry; Smith, Barbara

2011-01-01

Although there are numerous studies that show that emergency department (ED) violence is a prevalent and serious problem for healthcare workers, there is a lack of published evaluations of interventions aimed at reducing this alarming trend. Using an action research model, the authors partnered with six hospitals to plan, implement and evaluate a violence prevention and management intervention. Phase one of this project involved gathering information from employees, managers and patients using focus groups. Ninety-seven persons participated in one of twelve focus groups. The Haddon matrix was used to develop focus group questions aimed at gathering data about the pre-assault, during assault, and post-assault time frames and to compare these findings to planned strategies. Analysis consisted of identification of themes related to intervention strategies for patients/visitors, employees, managers, and the work environment. Thematic analysis results supported the relevance, feasibility, and saliency of the planned intervention strategies. With the exception of a few items, employees and managers from the different occupational groups agreed on the interventions needed to prevent and manage violence against ED workers. Patients focused on improved staff communication and comfort measures. Results support that violence in the emergency department is increasing, that violence is a major concern for those who work in and visit emergency departments, and that interventions are needed to reduce workplace violence. The Haddon matrix along with an action research method was useful to identify intervention strategies most likely to be successfully implemented and sustained by the emergency departments. Copyright © 2011 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

PubMed

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

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

Sex Differences and/in the Self: Classic Themes, Feminist Variations, Postmodern Challenges

ERIC Educational Resources Information Center

Bohan, Janis S.

2002-01-01

This article examines perspectives on and intersections between two recurrent themes in the history of American psychology: sex differences and theories of self. These themes and certain connections between them are considered in three eras: early American psychology, feminist psychology coincident with the second wave of feminism, and the recent…

Life Themes and Interpersonal Motivational Systems in the Narrative Self-construction

PubMed Central

Veglia, Fabio; Di Fini, Giulia

2017-01-01

What makes unique and unrepeatable individuals is their ability to write their own story attributing meaning, sharing it through narration, giving coherence to the information related to the interpersonal motivational systems, and creating alternative hierarchies to those biologically provided by the genetic code. Through clinical narratives and narrative literature, we can observe the recurrence of specific topics, across time and different cultures. Hence, we wondered whether there are some evolutionary suggestions that guide us in the construction of the narrative-autobiographical contents. In this article we proposed a theoretical-clinical hypothesis about the existence of a biological disposition to identify as fundamental six Life Themes (LTs) that contribute to defining the image of the self and the world: Love, Personal Value, Power, Justice, Truth, and Freedom. Besides the innumerable narratives dependent upon context, there may be many ways of telling stories that, instead, would be reported to these few essential themes. A narrative review of the literature about these concepts follows the systematic explanation of the perspective about the LTs as attractors of meaning. The manuscript considers also the process of co-construction of meanings within the interpersonal relationships and the influences of these on the narratives. In particular, we focused on the importance of episodic and autobiographical memory related to the attachment and significant figures, in the construction of the personal story and the LTs. We also explained the possible clinical implications of the theoretical hypothesis of LTs. Within clinical conversations, the LTs could be expressed rigidly or, otherwise, in a confused way. The lack of narrative integration may lead to the dominance of chaos or rigidity that generates suffering. A better comprehension of the LTs in patients’ narrations could be useful to identify a narrative profile about the areas of greatest suffering

Theme: Staying Current--Small Animals and Specialty Crops.

ERIC Educational Resources Information Center

Knight, James A.; And Others

1986-01-01

Six theme articles examine ways that vocational agriculture teachers can keep current, including related hobbies, resource persons, beekeeping as a supervised occupational experience, specialty crops such as fruits and nuts, an inservice poultry project, and trade and industry organizations. (SK)

What do emergency medicine learners want from their teachers? A multicenter focus group analysis.

PubMed

Thurgur, Lisa; Bandiera, Glen; Lee, Shirley; Tiberius, Richard

2005-09-01

To the best of the authors' knowledge, there are no reports describing what learners believe are good emergency medicine (EM) teaching practices. EM faculty developers are compromised by this lack of knowledge about what EM learners appreciate in their teachers. To determine what Canadian EM learners consider to be good prerequisites and strategies for effective teaching in the emergency department (ED). Clinical clerks and residents from the Canadian College of Family Physicians, Emergency Medicine certification [CCFP(EM)] fellowship program, the Royal College of Physicians and Surgeons of Canada, Emergency Medicine certification [FRCP(EM)] fellowship program, and off-service programs from all five Ontario medical schools participated in monitored focus-group sessions. Conversations were recorded, transcribed by a third party, and coded by two independent assessors using standard grounded theory methods. The text was categorized based on the final code into basic themes and specific qualifiers, which were then sorted by frequency of mention in the focus groups. Results are presented in descriptive fashion. Twenty-eight learners participated. They identified 14 major principles for good EM teaching, and a further 30 specific qualifiers. The top five principles were: "has a positive teacher attitude," "takes time to teach," "uses teachable moments well," "tailors teaching to the learner," and "gives appropriate feedback." Agreement on classification of ideas was 86%. Learners are sensitive to the constraints of the ED teaching environment, and have consistent views about good ED teaching practices. Among 14 general principles identified, "takes time to teach," "gives feedback," "tailors teaching to the learner," "uses teachable moments," and "has a good teacher attitude" were the most commonly reported.

Theme issue on e-mental health: a growing field in internet research.

PubMed

Riper, Heleen; Andersson, Gerhard; Christensen, Helen; Cuijpers, Pim; Lange, Alfred; Eysenbach, Gunther

2010-12-19

This theme issue on e-mental health presents 16 articles from leading researchers working on systems and theories related to supporting and improving mental health conditions and mental health care using information and communication technologies. In this editorial, we present the background of this theme issue, and highlight the content of this issue.

Designing a clinical dashboard to fill information gaps in the emergency department.

PubMed

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

Plant cell surface receptor-mediated signaling - a common theme amid diversity.

PubMed

He, Yunxia; Zhou, Jinggeng; Shan, Libo; Meng, Xiangzong

2018-01-29

Sessile plants employ a diverse array of plasma membrane-bound receptors to perceive endogenous and exogenous signals for regulation of plant growth, development and immunity. These cell surface receptors include receptor-like kinases (RLKs) and receptor-like proteins (RLPs) that harbor different extracellular domains for perception of distinct ligands. Several RLK and RLP signaling pathways converge at the somatic embryogenesis receptor kinases (SERKs), which function as shared co-receptors. A repertoire of receptor-like cytoplasmic kinases (RLCKs) associate with the receptor complexes to relay intracellular signaling. Downstream of the receptor complexes, mitogen-activated protein kinase (MAPK) cascades are among the key signaling modules at which the signals converge, and these cascades regulate diverse cellular and physiological responses through phosphorylation of different downstream substrates. In this Review, we summarize the emerging common theme that underlies cell surface receptor-mediated signaling pathways in Arabidopsis thaliana : the dynamic association of RLKs and RLPs with specific co-receptors and RLCKs for signal transduction. We further discuss how signaling specificities are maintained through modules at which signals converge, with a focus on SERK-mediated receptor signaling. © 2018. Published by The Company of Biologists Ltd.

Collaborative practices in unscheduled emergency care: role and impact of the emergency care practitioner—qualitative and summative findings

PubMed Central

Cooper, Simon; O'Carroll, Judith; Jenkin, Annie; Badger, Beryl

2007-01-01

Objective To identify collaborative instances and hindrances and to produce a model of collaborative practice. Methods A 12‐month (2005–2006) mixed methods clinical case study was carried out in a large UK ambulance trust. Collaboration was measured through direct observational ratings of communication skills, teamwork and leadership with 24 multi‐professional emergency care practitioners (ECPs), interviews with 45 ECPs and stakeholders, and an audit of 611 patients Results Using a generic qualitative approach, observational records and interviews showed that ECPs' numerous links with other professions were influenced by three major themes as follows. (i) The ECP role: for example, “restricted transport codes” of communication, focus on reducing admissions, frustrations about patient tasking and conflicting views about leadership and team work. (ii) Education and training: drivers for multi‐professional clinically focussed graduate level education, requirements for skill development in minor injury units (MIUs) and general practice, and the need for clinical supervision/mentorship. (iii) Cultural perspectives: a “crew room” blue collar view of inter‐professional working versus emerging professional white collar views, power and communication conflicts, and a lack of understanding of the ECPs' role. The quantitative findings are reported elsewhere. Conclusions The final model of collaborative practice suggests that ECPs are having an impact on patient care, but that improvements can be made. We recommend the appointment of ECP clinical leads, degree level clinically focussed multi‐professional education, communication skills training, clinical supervision and multi‐professional ECP appointments. PMID:17711937

Privacy Attitudes among Early Adopters of Emerging Health Technologies.

PubMed

Cheung, Cynthia; Bietz, Matthew J; Patrick, Kevin; Bloss, Cinnamon S

2016-01-01

Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters. This study sought to understand privacy attitudes of early adopters of emerging health technologies. Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis. Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science. Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research.

Privacy Attitudes among Early Adopters of Emerging Health Technologies

PubMed Central

Cheung, Cynthia; Bietz, Matthew J.; Patrick, Kevin; Bloss, Cinnamon S.

2016-01-01

Introduction Advances in health technology such as genome sequencing and wearable sensors now allow for the collection of highly granular personal health data from individuals. It is unclear how people think about privacy in the context of these emerging health technologies. An open question is whether early adopters of these advances conceptualize privacy in different ways than non-early adopters. Purpose This study sought to understand privacy attitudes of early adopters of emerging health technologies. Methods Transcripts from in-depth, semi-structured interviews with early adopters of genome sequencing and health devices and apps were analyzed with a focus on participant attitudes and perceptions of privacy. Themes were extracted using inductive content analysis. Results Although interviewees were willing to share personal data to support scientific advancements, they still expressed concerns, as well as uncertainty about who has access to their data, and for what purpose. In short, they were not dismissive of privacy risks. Key privacy-related findings are organized into four themes as follows: first, personal data privacy; second, control over personal information; third, concerns about discrimination; and fourth, contributing personal data to science. Conclusion Early adopters of emerging health technologies appear to have more complex and nuanced conceptions of privacy than might be expected based on their adoption of personal health technologies and participation in open science. Early adopters also voiced uncertainty about the privacy implications of their decisions to use new technologies and share their data for research. Though not representative of the general public, studies of early adopters can provide important insights into evolving attitudes toward privacy in the context of emerging health technologies and personal health data research. PMID:27832194

Interdisciplinarity and Undergraduate Psychology Education

ERIC Educational Resources Information Center

Goodwin-Smith, Ian; Pearson, Elissa; Ranzijn, Rob; Campbell, Alan; Lushington, Kurt

2013-01-01

This work identifies the human service sector as an important and growing destination for psychology graduates. It further identifies a number of key themes which flow from that observation and which are important to configuring psychology education in a way which takes account of emerging trends. The major theme identified in the research is the…

Teachers Working Cooperatively with Parents and Caregivers when Implementing LGBT Themes in the Elementary Classroom

ERIC Educational Resources Information Center

Flores, Gabriel

2014-01-01

Many teachers are interested in having a more inclusive multicultural education that includes lesbian, gay, bisexual, and transgender (LGBT) themes and gay-themed children's literature; unfortunately, research has found that many teachers do not implement gay themes in their multicultural education curriculum because of fear of criticism from…

In a Cultural Vortex: Theme Parks, Experience, and Opportunities for Art Education

ERIC Educational Resources Information Center

Jeffers, Carol S.

2004-01-01

Theme parks can have educational value for students and teachers when these cultural sites within the range of visual culture are understood as sites of experiential learning and as processes of mediation between visitors and park designers. Worthy of serious study, the theme park can be explored as a cultural vortex whose swirling forces…

Aligning Theme and Information Structure to Improve the Readability of Technical Writing

ERIC Educational Resources Information Center

Moore, N. A. J.

2006-01-01

The readability of technical writing, and technical manuals in particular, especially for second language readers, can be noticeably improved by pairing Theme with Given and Rheme with New. This allows for faster processing of text and easier access to the "method of development" of the text. Typical Theme-Rheme patterns are described, and the…

OAST Space Theme Workshop. Volume 3: Working group summary. 1: Navigation, guidance, control (E-1) A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

The six themes identified by the Workshop have many common navigation guidance and control needs. All the earth orbit themes have a strong requirement for attitude, figure and stabilization control of large space structures, a requirement not currently being supported. All but the space transportation theme have need for precision pointing of spacecraft and instruments. In addition all the themes have requirements for increasing autonomous operations for such activities as spacecraft and experiment operations, onboard mission modification, rendezvous and docking, spacecraft assembly and maintenance, navigation and guidance, and self-checkout, test and repair. Major new efforts are required to conceptualize new approaches to large space antennas and arrays that are lightweight, readily deployable, and capable of precise attitude and figure control. Conventional approaches offer little hope of meeting these requirements. Functions that can benefit from increasing automation or autonomous operations are listed.

Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

PubMed

Ek, Bosse; Svedlund, Marianne

2015-04-01

To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

PubMed

Bank, Ilana; Snell, Linda; Bhanji, Farhan

2014-12-01

Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

Emergency medical services responders’ perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study

PubMed Central

Hansen, Matthew; O'Brien, Kerth; Dickinson, Caitlin; Meckler, Garth; Engle, Phil; Lambert, William; Jui, Jonathan

2017-01-01

Objective Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. Setting This was a nationwide study of EMS providers from 44 of 50 (88%) US states. Participants A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports. Primary and secondary outcome measures Outcomes included responses to: (1) clinical situations where heightened stress or anxiety was likely to contribute to safety events, (2) aspects of these clinical situations that cause stress or anxiety and (3) how stress or anxiety may lead to paediatric safety events. Results EMS providers reported that the clinical situations where stress and anxiety were more likely to contribute to paediatric patient safety events were trauma, respiratory distress and cardiac issues. Key themes were: (1) provider sympathy or identification with children, (2) difficulty seeing an innocent child hurt and the inherent value of children and (3) insufficient exposure to paediatric emergencies. Conclusions Caring for paediatric emergencies creates unique stresses on providers that may affect patient safety. Many of the factors reported to cause provider stress and anxiety are inherent attributes of children and therefore not modifiable. Tools that support care during stressful conditions such as cognitive aids may help to mitigate anxiety in the prehospital care of children. Further research is needed to identify opportunities for and attributes of interventions. PMID:28246139

[Psychiatric emergencies in the elderly].

PubMed

Zinetti, Jacqueline; Daraux, Jacques; Ploskas, Fabienne

2003-06-01

If it is common place to claim that old age is not a disease, however the losses and mournings related to that stage of life generate the production of acute psychopathological disorders. A few of them will be approached and treated as emergencies and required from the physician a good command of their existence and of specificities: atypical depressive disorders stressed by the risk of suicide, sits of delusions some themes of which are typical of senesence, excitement and aggressiveness inherent to dementia. As to the ill-treatment of the elderly often under-diagnosed, it requires urgent interventions both clinical and even juridical.

The emerging use of social media for health-related purposes in low and middle-income countries: A scoping review.

PubMed

Hagg, Emily; Dahinten, V Susan; Currie, Leanne M

2018-07-01

Social media allows for instant access to, and dissemination of, information around the globe. Access to social media in low- and middle-income countries has increased exponentially in recent years due to technological advances. Despite this growth, the use of social media in low- and middle-income countries is less well-researched than in high-income countries. To identify, explore and summarize the current state of the literature on the use of social media for health in low- and middle-income countries. A scoping review was conducted on literature available to December 2017. Six databases were searched, and grey literature was identified through the Google and Google Scholar search engines. Literature was considered for inclusion if it (1) was published in English, (2) was conducted in or in relation to a low or middle-income country, (3) reported on as least one type of social media or social media use generally for health purposes, and (4) reported on at least one aspect of human health. Content analysis was performed to identify themes. Forty articles met the inclusion criteria. Thirty-one were research articles, and nine were review/discussion/descriptive and evaluative reports. Since 2010, when the first article was published, most of the literature has focused on Asian (n = 15) and African (n = 12) countries. Twitter (n = 11) and Facebook (n = 10) were the most frequently discussed individual social media platforms. Four themes were identified: (1) use for health education and influence (sub-themes were health behaviour and health education); (2) use within infectious disease and outbreak situations; (3) use within natural disaster, terrorism, crisis and emergency response situations; and (4) producers and consumers of social media for health (sub-themes were misinformation, organizational challenges, users' expectations, and challenges of unique sub-populations). Most studies addressed more than one theme. Social media has the ability to

Relationships that Emerged through Participation in a Year 9 Experiential Education Program

ERIC Educational Resources Information Center

Robinson, Tony

2013-01-01

Outdoor Education (OE) and Experiential Education (EE) programs are becoming increasingly popular in Victorian schools. This article is derived from findings that emerged through the interpretation of case study data gathered for my doctoral thesis of a three-phased, non-residential, EE program. This interpretation process highlighted five themes,…

Drug Themes in Fiction. National Institute on Drug Abuse Research Issues 10.

ERIC Educational Resources Information Center

Diehl, Digby

This essay is a survey of selected literary works of fiction with drug-related thematic content. The themes represented in the survey reflect popular American attitudes toward drugs from pre-World War II through the 1970's. The roots of these themes, beginning with 17th century French cultural attitudes are explained. The subject has been treated…

The themes, institutions, and people of medical education research 1988-2010: content analysis of abstracts from six journals.

PubMed

Rotgans, Jerome I

2012-10-01

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

CAEP 2015 Academic Symposium: Recommendations for University Governance and Administration for Emergency Medicine.

PubMed

Petrie, David; Chopra, Anil; Chochinov, Alecs; Artz, Jennifer D; Schull, Michael; Tallon, John; Jones, Gordon; MacPhee, Shannon; Ackerman, Margaret; Stiell, Ian G; Christenson, Jim

2016-04-05

1) To identify the strengths and challenges of governance structures in academic emergency medicine (EM), and 2) to make recommendations on principles and approaches that may guide improvements. Over the course of 9 months, eight established EM leaders met by teleconference, reviewed the literature, and discussed their findings and experiences to arrive at recommendations on governance in academic units of EM. The results and recommendations were presented at the annual Canadian Association of Emergency Physicians (CAEP) Academic Symposium, where attendees provided feedback. The updated recommendations were subsequently distributed to the CAEP Academic Section for further input, and the final recommendations were decided by consensus. The panel identified four governance areas of interest: 1) the elements of governance; 2) the relationships between emergency physicians and academic units of EM, and between the academic units of EM and faculty of medicine; 3) current status of governance in Canadian academic units of EM; and 4) essential elements of good governance. Six recommendations were developed around three themes, including 1) the importance of good governance; 2) the purposes of an academic unit of EM; and 3) essential elements for better governance for academic units of EM. Recommendations included identifying the importance of good governance, recognizing the need to adapt to the different models depending on the local environment; seeking full departmental status, provided it is mutually beneficial to EM and the faculty of medicine (and health authority); using a consultation service to learn from the experience of other academic units of EM; and establishing an annual forum for EM leaders. Although governance of academic EM is complex, there are ways to iteratively improve the mission of academic units of EM: providing exceptional patient care through research and education. Although there is no one-size-fits-all guide, there are practical recommended

Nuffield Secondary Science, Theme 4, Harnessing Energy.

ERIC Educational Resources Information Center

Howard, Edgar

Nuffield Secondary Science is a set of tested materials from which teachers can prepare courses for students in grades 9-11 (approximately) who do not intend to major in science. The materials are designed for British secondary schools but are adaptable to other countries. The Teachers' Guide to the entire set of Themes is described in SE 015 440…

Theme: Physical Science in Agriscience--The New Ag Mech.

ERIC Educational Resources Information Center

Buriak, Phil; And Others

1992-01-01

Seven theme articles discuss strategies for teaching mechanics, physical sciences in the study of foods, scientific principles in the agricultural curriculum, environmental issues in agriculture, and applied physical sciences. (SK)

Identifying and overcoming implementation challenges: Experience of 59 noninstitutional long-term services and support pilot programs in the Veterans Health Administration.

PubMed

Sullivan, Jennifer L; Adjognon, Omonyêlé L; Engle, Ryann L; Shin, Marlena H; Afable, Melissa K; Rudin, Whitney; White, Bert; Shay, Kenneth; Lukas, Carol VanDeusen

From 2010 to 2013, the Department of Veterans Affairs (VA) funded a large pilot initiative to implement noninstitutional long-term services and supports (LTSS) programs to support aging Veterans. Our team evaluated implementation of 59 VA noninstitutional LTSS programs. The specific objectives of this study are to (a) examine the challenges influencing program implementation comparing active sites that remained open and inactive sites that closed during the funding period and (b) identify ways that active sites overcame the challenges they experienced. Key informant semistructured interviews occurred between 2011 and 2013. We conducted 217 telephone interviews over four time points. Content analysis was used to identify emergent themes. The study team met regularly to define each challenge, review all codes, and discuss discrepancies. For each follow-up interview with the sites, the list of established challenges was used as a priori themes. Emergent data were also coded. The challenges affecting implementation included human resources and staffing issues, infrastructure, resources allocation and geography, referrals and marketing, leadership support, and team dynamics and processes. Programs were able to overcome challenges by communicating with team members and other areas in the organization, utilizing information technology solutions, creative use of staff and flexible schedules, and obtaining additional resources. This study highlights several common challenges programs can address during the program implementation. The most often mentioned strategy was effective communication. Strategies also targeted several components of the organization including organizational functions and processes (e.g., importance of coordination within a team and across disciplines to provide good care), infrastructure (e.g., information technology and human resources), and program fit with priorities in the organization (e.g., leadership support). Anticipating potential pitfalls of

Bio-power, Agamben, and emerging nursing knowledge.

PubMed

Georges, Jane M

2008-01-01

This philosophical article posits that an emerging theme in contemporary nursing epistemology is bio-power and proposes the use of philosopher Giorgio Agamben's perspectives as a useful approach for the future investigation of bio-power in nursing knowledge. Building upon Meleis' characterization of diversity as the most recent "milestone" of contemporary theoretical development of the nursing discipline, selected recent texts from the nursing literature are analyzed, and implications for future nursing knowledge in the context of Agamben's work are explored.

Nursing models in a special hospital: cybernetics, hyperreality and beyond.

PubMed

Mason, T; Chandley, M

1992-11-01

Two emerging themes that resulted from research carried out in a special hospital on the use of nursing models are identified. The first theme to emerge was the tendency of the subjects to perceive the models as concrete entities thus undergoing a process of reification. The second theme identified was the adherence to the models outside the contextual nature of the setting which limited their effectiveness. A theoretical framework in which to locate the results of the study is explored using cybernetic learning theory and the notion of hyperreality, using the works of Jean Baudrillard. A method for innovation and changing practice in the special hospital setting is suggested.

From themes to hypotheses: following up with quantitative methods.

PubMed

Morgan, David L

2015-06-01

One important category of mixed-methods research designs consists of quantitative studies that follow up on qualitative research. In this case, the themes that serve as the results from the qualitative methods generate hypotheses for testing through the quantitative methods. That process requires operationalization to translate the concepts from the qualitative themes into quantitative variables. This article illustrates these procedures with examples that range from simple operationalization to the evaluation of complex models. It concludes with an argument for not only following up qualitative work with quantitative studies but also the reverse, and doing so by going beyond integrating methods within single projects to include broader mutual attention from qualitative and quantitative researchers who work in the same field. © The Author(s) 2015.

Post-head-emergence frost in wheat and barley: defining the problem, assessing the damage, and identifying resistance.

PubMed

Frederiks, T M; Christopher, J T; Sutherland, M W; Borrell, A K

2015-06-01

Radiant frost is a significant production constraint to wheat (Triticum aestivum) and barley (Hordeum vulgare), particularly in regions where spring-habit cereals are grown through winter, maturing in spring. However, damage to winter-habit cereals in reproductive stages is also reported. Crops are particularly susceptible to frost once awns or spikes emerge from the protection of the flag leaf sheath. Post-head-emergence frost (PHEF) is a problem distinct from other cold-mediated production constraints. To date, useful increased PHEF resistance in cereals has not been identified. Given the renewed interest in reproductive frost damage in cereals, it is timely to review the problem. Here we update the extent and impacts of PHEF and document current management options to combat this challenge. We clarify terminology useful for discussing PHEF in relation to chilling and other freezing stresses. We discuss problems characterizing radiant frost, the environmental conditions leading to PHEF damage, and the effects of frost at different growth stages. PHEF resistant cultivars would be highly desirable, to both reduce the incidence of direct frost damage and to allow the timing of crop maturity to be managed to maximize yield potential. A framework of potential adaptation mechanisms is outlined. Clarification of these critical issues will sharpen research focus, improving opportunities to identify genetic sources for improved PHEF resistance. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Identification and characteristics of victims of violence identified by emergency physicians, triage nurses, and the police

PubMed Central

Howe, A; Crilly, M

2002-01-01

Objectives: The objectives of the study were threefold—to evaluate the identification and characteristics of victims of assault who attend an accident and emergency (A&E) department; to compare the total number of assaults recorded in the A&E department with the number recorded by the police; and to assess a system for collecting the location and method of assault. Setting: The A&E department of Chorley and South Ribble Hospital Trust, Lancashire, England. Methods: A three month prospective study was performed. Victims of violence recorded on computer by doctors at discharge were compared with those identified at initial nurse triage. A comparison of police data with the A&E data relating to Chorley residents was performed. Additional information on the method and location of assault was also collected. Results: During the period 305 (2.6%) of the patients attending A&E were identified as having been assaulted. Of the 305 individuals, 236 (77%) were identified by a doctor while 173 (57%) such patients were identified by a triage nurse. A&E identified twice the number of assaults involving Chorley residents as the police. Both men and women were most likely to have been injured on the street (44% and 37% respectively), although a greater proportion of women were injured at home (24%) than men (10%). The majority of injuries were sustained by blows from fists, feet, and heads (73%). Conclusions: A&E doctors identify significantly more patients as the victims of violence than do nurses at triage. Using A&E data identifies assaulted individuals not identified by the police. Computer systems can be used in A&E to provide a more complete picture of the occurrence of violence in the community. PMID:12460971

The information needs of patients receiving procedural sedation in a hospital emergency department.

PubMed

Revell, Sue; Searle, Judy; Thompson, Shona

2017-07-01

This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation. They identified very few gaps in terms of specific information they needed pertaining to procedural sedation and rejected the need for receiving information in a written format. Their information needs related to a central concern for safety and trust. Focus groups, reflecting on the findings from patients, were conducted with five ED nurses and four emergency medicine consultants/registrars who regularly provided procedural sedation. Themes that emerged from the analysis of data from all three groups identified the issues concerning patient information needs as being: competence and efficiency of staff; explanations of procedures and progress; support person presence; and medico-legal issues. The research confirms that the quality of the patient's ED experience, specifically related to procedural sedation, is enhanced by ED staff, especially nurses, providing them with ongoing and repeated verbal information relevant to their circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis

PubMed Central

Davies, Annette; Egan, Bernadette; Jones, Martyn; Raleigh, Mary; Schofield, Patricia; Squires, Allison; Start, Kath; Quinn, Tom

2017-01-01

Background The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. Methods Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis. Results A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: ‘Organisational and Operational Factors’ and ‘Interactions with Others’. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress. Discussion EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health. PROSPERO Registration Number CRD42014010806. PMID:29062596

Through the Eyes of Nurse Managers in Long-Term Care: Identifying Perceived Competencies and Skills.

PubMed

Dever, Kathleen H

2018-05-01

Nurse managers (NMs) in long-term care supervise health care services for individuals with high acuity levels and numerous comorbidities. There is minimal research identifying NMs' skills and competencies as unit leaders within the long-term care environment. The current mixed-methods study identified NMs' leadership skills and competencies. Nineteen NMs with ≥5 years' long-term care management experience completed the Nurse Manager Inventory Tool and were individually interviewed. They rated their clinical skills at the competent level and their financial/strategic management skills at the novice level. All other skill categories, including leadership reflective practice, diversity, human resource leadership/management, relationship management, performance improvement, and problem solving, were rated at a competent level. Emergent interview qualitative themes included their visibility on the unit, trial and error learning, a sense of "aloneness" due to the absence of other RNs, NM position being a tough job, need for peer support, role modeling, and importance of supporting the resident through their "final journey." [Journal of Gerontological Nursing, 44(5), 32-38.]. Copyright 2018, SLACK Incorporated.

Advancing the literature on designing audit and feedback interventions: identifying theory-informed hypotheses.

PubMed

Colquhoun, Heather L; Carroll, Kelly; Eva, Kevin W; Grimshaw, Jeremy M; Ivers, Noah; Michie, Susan; Sales, Anne; Brehaut, Jamie C

2017-09-29

Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions. Using purposive sampling, semi-structured 60-90-min telephone interviews were conducted with experts in theories related to A&F from a range of fields (e.g., cognitive, health and organizational psychology, medical decision-making, economics). Guided by detailed descriptions of A&F interventions from the health care literature, interviewees described how they would approach the problem of designing improved A&F interventions. Specific, theory-informed hypotheses about the conditions for effective design and delivery of A&F interventions were elicited from the interviews. The resulting hypotheses were assigned by three coders working independently into themes, and categories of themes, in an iterative process. We conducted 28 interviews and identified 313 theory-informed hypotheses, which were placed into 30 themes. The 30 themes included hypotheses related to the following five categories: A&F recipient (seven themes), content of the A&F (ten themes), process of delivery of the A&F (six themes), behavior that was the focus of the A&F (three themes), and other (four themes). We have identified a set of testable, theory-informed hypotheses from a broad range of behavioral and social science that suggest conditions for more effective A&F interventions. This work demonstrates the breadth of perspectives about A&F from non

OAST Space Theme Workshop. Volume 3: Working group summary. 7: Material (M-1). A. Statement. B. Technology needs (form 1). C. Priority assessment (form 2)

NASA Technical Reports Server (NTRS)

1976-01-01

The approach of matching technology areas with various themes needs was not effective for the materials and thermal control discipline because of the diversity of requirements for each. Top priorities were evolved from the advanced space transportation system and the space power platform because these are essential building blocks in fulfilling some of the other themes. Important needs identified include life long-life cryogenic cooling systems for sensors, masers, and other devices and the needs for lightweight nuclear shielding materials for nuclear electric propulsion.

Perspectives of Social Justice Activists: Advocating against Native-Themed Mascots, Nicknames, and Logos

ERIC Educational Resources Information Center

Steinfeldt, Jesse A.; Foltz, Brad D.; LaFollette, Julie R.; White, Mattie R.; Wong, Y. Joel; Steinfeldt, Matthew Clint

2012-01-01

This study investigated perspectives of social justice activists who directly advocate for eliminating Native-themed mascots, nicknames, and logos. Using consensual qualitative research methodology, the research team analyzed transcripts of interviews conducted with 11 social justice activists to generate themes, categories, and domains within the…

"Sometimes You Feel Like the Freak Show": A Qualitative Assessment of Emergency Care Experiences Among Transgender and Gender-Nonconforming Patients.

PubMed

Samuels, Elizabeth A; Tape, Chantal; Garber, Naomi; Bowman, Sarah; Choo, Esther K

2018-02-01

Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care. A survey and 4 focus groups were conducted with trans individuals older than 18 years who had been to an ED in the last 5 years. Participants were recruited by trans e-mail listservs; outreach to local trans organizations; and lesbian, gay, bisexual, and transgender periodical advertisements. The interview guide was reviewed by qualitative research and trans health content experts. Deidentified participant demographic information was collected with a standardized instrument. All discussions were captured on digital audio recorders and professionally transcribed. Interview coding and thematic analysis were conducted with a grounded theory approach. Among 32 participants, 71.9% were male identified and 78.1% were white. Nearly half (43.8%) reported avoiding the ED when they needed acute care. The factors that had the greatest influence on ED avoidance were fear of discrimination, length of wait, and negative previous experiences. There were 4 overarching discussion themes: system structure, care competency, discrimination and trauma, and avoidance of emergency care. Improvement recommendations focused on staff and provider training about gender and trans health, assurance of private gender identity disclosure, and accurate capture of sex, gender, and sexual orientation information in the electronic medical record. Efforts to improve trans ED experiences should focus on provider competency and communication training, electronic medical record modifications, and assurance of private means

44 CFR 5.27 - Deletion of identifying details.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Deletion of identifying details. 5.27 Section 5.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY..., FEMA may delete identifying details when making available or publishing an opinion, statement of policy...

Understanding movement data and movement processes: current and emerging directions.

PubMed

Schick, Robert S; Loarie, Scott R; Colchero, Fernando; Best, Benjamin D; Boustany, Andre; Conde, Dalia A; Halpin, Patrick N; Joppa, Lucas N; McClellan, Catherine M; Clark, James S

2008-12-01

Animal movement has been the focus on much theoretical and empirical work in ecology over the last 25 years. By studying the causes and consequences of individual movement, ecologists have gained greater insight into the behavior of individuals and the spatial dynamics of populations at increasingly higher levels of organization. In particular, ecologists have focused on the interaction between individuals and their environment in an effort to understand future impacts from habitat loss and climate change. Tools to examine this interaction have included: fractal analysis, first passage time, Lévy flights, multi-behavioral analysis, hidden markov models, and state-space models. Concurrent with the development of movement models has been an increase in the sophistication and availability of hierarchical bayesian models. In this review we bring these two threads together by using hierarchical structures as a framework for reviewing individual models. We synthesize emerging themes in movement ecology, and propose a new hierarchical model for animal movement that builds on these emerging themes. This model moves away from traditional random walks, and instead focuses inference on how moving animals with complex behavior interact with their landscape and make choices about its suitability.

Designing a Clinical Dashboard to Fill Information Gaps in the Emergency Department

PubMed Central

Swartz, Jordan L.; Cimino, James J.; Fred, Matthew R.; Green, Robert A.; Vawdrey, David K.

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties. PMID:25954420

A whole community approach to emergency management: Strategies and best practices of seven community programs.

PubMed

Sobelson, Robyn K; Wigington, Corinne J; Harp, Victoria; Bronson, Bernice B

2015-01-01

In 2011, the Federal Emergency Management Agency (FEMA) published the Whole Community Approach to Emergency Management: Principles, Themes, and Pathways for Action, outlining the need for increased individual preparedness and more widespread community engagement to enhance the overall resiliency and security of communities. However, there is limited evidence of how to build a whole community approach to emergency management that provides real-world, practical examples and applications. This article reports on the strategies and best practices gleaned from seven community programs fostering a whole community approach to emergency management. The project team engaged in informal conversations with community stakeholders to learn about their programs during routine monitoring activities, site visits, and during an in-person, facilitated workshop. A total of 88 community members associated with the programs examples contributed. Qualitative analysis was conducted. The findings highlighted best practices gleaned from the seven programs that other communities can leverage to build and maintain their own whole community programs. The findings from the programs also support and validate the three principles and six strategic themes outlined by FEMA. The findings, like the whole community document, highlight the importance of understanding the community, building relationships, empowering action, and fostering social capital to build a whole community approach.

Use of a forensic technique to identify blood contamination of emergency department and ambulance trauma equipment.

PubMed

Lee, J B; Levy, M; Walker, A

2006-01-01

Using a Kastle-Meyer (KM) technique, the following equipment from the emergency departments of six UK hospitals (four trusts) and three regional ambulance services was tested for blood contamination: extrication ("spinal") boards, cervical collars, straps, box splints, head blocks, and headboards. Only equipment ready for patient use was tested. Over half of trauma equipment (57%) tested positive for blood, including 15% of equipment that was visibly stained with blood. There have been no recorded cases of infection from contaminated trauma equipment but our study has identified the potential risk. Disposable covers for boards, disposable straps, and disposable radiolucent head blocks which are currently available provide a solution but have resource implications.

Nurses' Perceptions of Victims of Human Trafficking in an Urban Emergency Department: A Qualitative Study.

PubMed

Long, Elizabeth; Dowdell, Elizabeth B

2017-12-15

Human trafficking is estimated to surpass the drug trade as the leading illegal industry in the world. According to a recent study, over 87.8% of trafficking survivors came into contact with a healthcare professional while they were enslaved and were not identified as a victim of human trafficking. The aims of this study are to understand the perceptions of emergency nurses about human trafficking, victims of violence, and prostitution. A qualitative, descriptive study using a semi-structured interview approach was done with ten registered nurses in a large, urban Emergency Department in the northeastern U.S. Interviews were recorded and transcribed; thematic analysis was performed. Six themes emerged from the interviews including, "human trafficking exists in the patient population" yet no nurse has screened or treated a victim; human trafficking victims are perceived to be "young, female, and foreign born"; all of the emergency nurses reported having worked with or screened a victim of violence; victims of violence were viewed as patients who present as "sad and grieving"; prostitutes are seen as "hard and tough"; and emergency nurses did not have education on human trafficking victims' needs or resources. Emergency nurses should be more aware about victims of human trafficking. The media portrayal of human trafficking victims had influenced the nurses' perceptions of this population. Victims of violence are perceived to be very different from prostitutes, but there is a desire for education about violence as well as information about specific resources open to victims. Copyright © 2017 Elsevier Inc. All rights reserved.

Themes from variation: probing the commonalities of symbiotic associations.

PubMed

Saffo, Mary Beth

2002-04-01

Research on symbiosis (including antagonistic and mutualistic associations) wrestles, directly or indirectly, with the paradox: why are symbiotic associations so prevalent in the biosphere in the face of ubiquitous immune or antibiotic defenses among organisms? The symposium "Living Together: the Dynamics of Symbiotic Interactions" considered several questions: 1. How do symbiotic species partners come together? Do symbioses share similar patterns of signal recognition and response? 2. What roles do nutrients and metabolites play in symbiotic interactions, and how are metabolic exchanges affected by environmental changes? 3. In what ways do the dynamics of multispecies symbioses differ from two-species associations? 4. How do antagonistic (parasitic, pathogenic) symbioses differ from mutualistic ones? In what ways do changes in the biotic and physical environment affect the evolutionary balance of symbiotic associations? 5. What are the coevolutionary patterns of symbiotic associations? 6. Which research techniques, and strategies of experimental design, might be useful across a broad range of symbiotic associations?Two themes emerged from the symposium. First, all the participants have incorporated multiple techniques and perspectives into their work, approaches which facilitate the understanding of symbiotic dynamics at several levels of biological organization. Secondly, many of the papers addressed genetic and environmental variation in symbiotic interactions. Such approaches are useful tools for analysis of the mechanics of interspecies interactions and for characterization of the most important factors which influence them. They provide us with the tools to evaluate symbioses in a world of complexity, variation and change.

A Grounded Theory for Identifying Students with Emotional Disturbance: Promising Practices for Assessment, Intervention, and Service Delivery

ERIC Educational Resources Information Center

Barnett, Dori

2012-01-01

A qualitative grounded theory study examined how practicing professionals involved in the ED identification process reconstructed the category of "emotional disturbance" as it applied to students in an alternative educational setting. A grounded theory integrates six emergent themes and essentially reframes the existing ED criteria in contemporary…

OAST Space Theme Workshop 1976

NASA Technical Reports Server (NTRS)

Sadin, S. R.

1977-01-01

Papers that provide a technical foundation including research and technology base candidates for each of six space themes - space power, space industrialization, search for extraterrestrial intelligence, exploration of the solar system, global service, and advanced transportation systems - are presented. The material is mainly intended for further use by workshop participants and NASA elements concerned with space research and technology. While the data presented do not represent official plans or positions, they are part of the process of evolving such plans and positions. The information contained reflects the efforts of workshop participants and should be an aid in the successful implementation and execution of the Agency's near- and far-term advanced technology program.

Understanding Overuse of Computed Tomography for Minor Head Injury in the Emergency Department: A Triangulated Qualitative Study.

PubMed

Melnick, Edward R; Shafer, Katherine; Rodulfo, Nayeli; Shi, Joyce; Hess, Erik P; Wears, Robert L; Qureshi, Rija A; Post, Lori A

2015-12-01

Overuse of computed tomography (CT) for minor head injury continues despite developed and rigorously validated clinical decision rules like the Canadian CT Head Rule (CCHR). Adherence to this sensitive and specific rule could decrease the number of CT scans performed in minor head injury by 35%. But in practice, the CCHR has failed to reduce testing, despite its accurate performance. The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of CT in patients presenting to the emergency department (ED) with minor head injury. This was a qualitative study in three phases, each with interview guides developed by a multidisciplinary team. Subjects were recruited from patients treated and released with minor head injuries and providers in an urban academic ED and a satellite community ED. Focus groups of patients (four groups, 22 subjects total) and providers (three groups, 22 subjects total) were conducted until thematic saturation was reached. The findings from the focus groups were triangulated with a cognitive task analysis, including direct observation in the ED (>150 hours), and individual semistructured interviews using the critical decision method with four senior physician subject matter experts. These experts are recognized by their peers for their skill in safely minimizing testing while maintaining patient safety and engagement. Focus groups and interviews were audio recorded and notes were taken by two independent note takers. Notes were entered into ATLAS.ti and analyzed using the constant comparative method of grounded theory, an iterative coding process to determine themes. Data were double-coded and examined for discrepancies to establish consensus. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations. Key themes within these domains included patient engagement, provider confidence

Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

ERIC Educational Resources Information Center

Herlihy, Barbara; Dufrene, Roxane L.

2011-01-01

A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

Improving access to emergent spinal care through knowledge translation: an ethnographic study.

PubMed

Webster, Fiona; Fehlings, Michael G; Rice, Kathleen; Malempati, Harsha; Fawaz, Khaled; Nicholls, Fred; Baldeo, Navindra; Reeves, Scott; Singh, Anoushka; Ahn, Henry; Ginsberg, Howard; Yee, Albert J

2014-04-14

For patients and family members, access to timely specialty medical care for emergent spinal conditions is a significant stressor to an already serious condition. Timing to surgical care for emergent spinal conditions such as spinal trauma is an important predictor of outcome. However, few studies have explored ethnographically the views of surgeons and other key stakeholders on issues related to patient access and care for emergent spine conditions. The primary study objective was to determine the challenges to the provision of timely care as well as to identify areas of opportunities to enhance care delivery. An ethnographic study of key administrative and clinical care providers involved in the triage and care of patients referred through CritiCall Ontario was undertaken utilizing standard methods of qualitative inquiry. This comprised 21 interviews with people involved in varying capacities with the provision of emergent spinal care, as well as qualitative observations on an orthopaedic/neurosurgical ward, in operating theatres, and at CritiCall Ontario's call centre. Several themes were identified and organized into categories that range from inter-professional collaboration through to issues of hospital-level resources and the role of relationships between hospitals and external organizations at the provincial level. Underlying many of these issues is the nature of the medically complex emergent spine patient and the scientific evidentiary base upon which best practice care is delivered. Through the implementation of knowledge translation strategies facilitated from this research, a reduction of patient transfers out of province was observed in the one-year period following program implementation. Our findings suggest that competing priorities at both the hospital and provincial level create challenges in the delivery of spinal care. Key stakeholders recognized spinal care as aligning with multiple priorities such as emergent/critical care, medical through

Architecture. Intermediate ThemeWorks. An Integrated Activity Bank.

ERIC Educational Resources Information Center

Stewart, Kelly

This resource book offers an activity bank of learning experiences related to the theme of architecture. The activities, which are designed for use with students in grades 4-6, require active engagement of the students and integrate language arts, mathematics, science, social studies, and art experiences. Activities exploring the architectural…

Measuring Frailty Can Help Emergency Departments Identify Independent Seniors at Risk of Functional Decline After Minor Injuries

PubMed Central

Griffith, Lauren; Perry, Jeffrey; Daoust, Raoul; Veillette, Nathalie; Lee, Jacques; Pelletier, Mathieu; Wilding, Laura; Émond, Marcel

2017-01-01

Background. This study aims to (i) describe frailty in the subgroup of independent community-dwelling seniors consulting emergency departments (EDs) for minor injuries, (ii) examine the association between frailty and functional decline 3 months postinjury, (iii) ascertain the predictive accuracy of frailty measures and emergency physicians’ for functional decline. Method. Prospective cohort in 2011–2013 among 1,072 seniors aged 65 years or older, independent in basic daily activities, evaluated in Canadian EDs for minor injuries. Frailty was assessed at EDs using the Canadian Study of Health and Aging-Clinical Frailty scale (CSHA-CFS) and the Study of Osteoporotic Fracture frailty index (SOF). Functional decline was defined as a loss ≥2/28 on the Older American Resources Services scale 3 months postinjury. Generalized mixed models were used to explore differences in functional decline across frailty levels. Areas under the receiver operating characteristic curve were used to ascertain the predictive accuracy of frailty measures and emergency physicians’ clinical judgment. Results. The SOF and CSHA-CFS were available in 342 and 1,058 participants, respectively. The SOF identified 55.6%, 32.7%, 11.7% patients as robust, prefrail, and frail. These CSHA-CFS (n = 1,058) proportions were 51.9%, 38.3%, and 9.9%. The 3-month incidence of functional decline was 12.1% (10.0%−14.6%). The Areas under the receiver operating characteristic curves of the CSHA-CFS and the emergency physicians’ were similar (0.548–0.777), while the SOF was somewhat higher (0.704–0.859). Conclusion. Measuring frailty in community-dwelling seniors with minor injuries in EDs may enhance current risk screening for functional decline. However, before implementation in usual care, feasibility issues such as inter-rater reliability and acceptability of frailty tools in the EDs have to be addressed. PMID:26400735

Common Themes in the Experiences of Mother-Daughter Incest Survivors: Implications for Counseling.

ERIC Educational Resources Information Center

Ogilvie, Beverly; Daniluk, Judith

1995-01-01

Studied mother-daughter incest. Common themes were extracted from in-depth interviews with survivors of mother-perpetrated sexual abuse, some of which parallel the experience of survivors of other forms of child sexual abuse, and some of which are more specific to mother-daughter incest. Discusses themes and counseling implications. (JBJ)

One Health, emerging infectious diseases and wildlife: two decades of progress?

PubMed

Cunningham, Andrew A; Daszak, Peter; Wood, James L N

2017-07-19

Infectious diseases affect people, domestic animals and wildlife alike, with many pathogens being able to infect multiple species. Fifty years ago, following the wide-scale manufacture and use of antibiotics and vaccines, it seemed that the battle against infections was being won for the human population. Since then, however, and in addition to increasing antimicrobial resistance among bacterial pathogens, there has been an increase in the emergence of, mostly viral, zoonotic diseases from wildlife, sometimes causing fatal outbreaks of epidemic proportions. Concurrently, infectious disease has been identified as an increasing threat to wildlife conservation. A synthesis published in 2000 showed common anthropogenic drivers of disease threats to biodiversity and human health, including encroachment and destruction of wildlife habitat and the human-assisted spread of pathogens. Almost two decades later, the situation has not changed and, despite improved knowledge of the underlying causes, little has been done at the policy level to address these threats. For the sake of public health and wellbeing, human-kind needs to work better to conserve nature and preserve the ecosystem services, including disease regulation, that biodiversity provides while also understanding and mitigating activities which lead to disease emergence. We consider that holistic, One Health approaches to the management and mitigation of the risks of emerging infectious diseases have the greatest chance of success.This article is part of the themed issue 'One Health for a changing world: zoonoses, ecosystems and human well-being'. © 2017 The Authors.

Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

PubMed

Nilsson, Tomas; Lindström, Veronica

2016-07-01

The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services. Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation. A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis. The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses. The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN. Copyright © 2015 Elsevier Ltd. All rights reserved.

Themes from a NASA workshop on gene regulatory processes in development and evolution

NASA Technical Reports Server (NTRS)

Davidson, E. H.; Ruvkun, G.; Davidowicz, L. (Principal Investigator)

1999-01-01

A memorable workshop, focused on causal mechanisms in metazoan evolution and sponsored by NASA, was held in early June 1998, at MBL. The workshop was organized by Mike Levine and Eric H. Davidson, and it included the PI and associates from 12 different laboratories, a total of about 30 people. Each laboratory had about two and one half hours in which to represent its recent research and cast up its current ideas for an often intense discussion. In the following we have tried to enunciate some of the major themes that emerged, and to reflect on their implications. The opinions voiced are our own. We would like to tender apologies over those contributions we have not been able to include, but this is not, strictly speaking, a meeting review. Rather we have focused on those topics that bear more directly on evolutionary mechanisms, and have therefore slighted some presentations (including some of our own), that were oriented mainly toward developmental processes. J. Exp. Zool. (Mol. Dev. Evol. ) 285:104-115, 1999. Copyright 1999 Wiley-Liss, Inc.

Feasibility Testing of an Emergency Department Screening Tool To Identify Older Adults Appropriate for Palliative Care Consultation.

PubMed

Ouchi, Kei; Block, Susan D; Schonberg, Mara A; Jamieson, Emily S; Aaronson, Emily L; Pallin, Daniel J; Tulsky, James A; Schuur, Jeremiah D

2017-01-01

Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. To assess the performance and determine the acceptability of a content-validated palliative care screening tool. We surveyed Emergency Medicine (EM) attending physicians at the end of their shifts using the screening tool and asked them to retrospectively apply it to all patients ≥65 years whom they had cared for. We conducted the survey for three consecutive weeks in October 2015. EM attending physicians at an urban, university-affiliated ED. Patient characteristics, acceptability rating, and time per patient screened. We approached 38 attending physicians to apply the screening tool for 69 eligible shifts. Physicians agreed to participate during 55 shifts (80%) and screened 207 patients. On 14 shifts (20%), physicians declined to participate. Mean age of the screened patients was 75 years, 51% were male, and 45% had at least one life-limiting illness. Overall, 67 patients (32%) screened positive for palliative care needs. Seventy percent of physicians (n = 33) found the screening tool acceptable to use and the average time of completion was 1.8 minutes per patient screened. A rapid screen of older adults for palliative care needs was acceptable to a majority of EM physicians and identified a significant number of patients who may benefit from palliative care referral. Further research is needed to improve acceptability and determine the appropriate care pathway for patients with palliative care needs.

Tackling emerging fungal threats to animal health, food security and ecosystem resilience.

PubMed

Fisher, Matthew C; Gow, Neil A R; Gurr, Sarah J

2016-12-05

Emerging infections caused by fungi have become a widely recognized global phenomenon. Their notoriety stems from their causing plagues and famines, driving species extinctions, and the difficulty in treating human mycoses alongside the increase of their resistance to antifungal drugs. This special issue comprises a collection of articles resulting from a Royal Society discussion meeting examining why pathogenic fungi are causing more disease now than they did in the past, and how we can tackle this rapidly emerging threat to the health of plants and animals worldwide.This article is part of the themed issue 'Tackling emerging fungal threats to animal health, food security and ecosystem resilience'. © 2016 The Author(s).

Traffic Accident Investigation: A Suitable Theme for Teaching Mechanics.

ERIC Educational Resources Information Center

Tao, P. K.

1987-01-01

Suggests the development of curriculum materials on the applications of physics to traffic accident investigations as a theme for teaching mechanics. Describes several standard investigation techniques and the physics principles involved, along with some sample exercises. (TW)

Rock and Roll! Using Classic Rock as a Guide to Fantasy-Theme Analysis

ERIC Educational Resources Information Center

Waite, Lisa

2008-01-01

This article presents an activity which makes use of Don McLean's song "American Pie," to engage students in fantasy-theme analysis. This discussion ultimately demonstrates how reality is constructed to satisfy the views shared by groups and individuals. Fantasy-theme analysis argues that audiences frequently shape their own connotation of an…

Review article: Emergency department models of care in the context of care quality and cost: a systematic review.

PubMed

Wylie, Kate; Crilly, Julia; Toloo, Ghasem Sam; FitzGerald, Gerry; Burke, John; Williams, Ged; Bell, Anthony

2015-04-01

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers. Articles published between 1998 and 2013 in the English language were included for initial review by three of the authors. Studies in underdeveloped countries and not addressing the objectives of the present study were excluded. Relevant details were extracted from the retrieved literature, and analysed for relevance and impact. The literature was synthesised around the study's main themes. Models described within the literature mainly focused on addressing issues at the input, throughput or output stages of ED care delivery. Models often varied to account for site specific characteristics (e.g. onsite inpatient units) or to suit staffing profiles (e.g. extended scope physiotherapist), ED geographical location (e.g. metropolitan or rural site), and patient demographic profile (e.g. paediatrics, older persons, ethnicity). Only a few studies conducted cost-effectiveness analysis of service models. Although various models of delivering emergency healthcare exist, further research is required in order to make accurate and reliable assessments of their safety, clinical effectiveness and cost-effectiveness. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Shutoff of Host Gene Expression in Influenza A Virus and Herpesviruses: Similar Mechanisms and Common Themes

PubMed Central

Rivas, Hembly G.; Schmaling, Summer K.; Gaglia, Marta M.

2016-01-01

The ability to shut off host gene expression is a shared feature of many viral infections, and it is thought to promote viral replication by freeing host cell machinery and blocking immune responses. Despite the molecular differences between viruses, an emerging theme in the study of host shutoff is that divergent viruses use similar mechanisms to enact host shutoff. Moreover, even viruses that encode few proteins often have multiple mechanisms to affect host gene expression, and we are only starting to understand how these mechanisms are integrated. In this review we discuss the multiplicity of host shutoff mechanisms used by the orthomyxovirus influenza A virus and members of the alpha- and gamma-herpesvirus subfamilies. We highlight the surprising similarities in their mechanisms of host shutoff and discuss how the different mechanisms they use may play a coordinated role in gene regulation. PMID:27092522

Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

PubMed

Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

2017-11-01

Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] < 1.3), which identified patients who were low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%-100%) and 49% specificity (95% CI = 44%-53%). Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of <1.3 may be at very low risk for a variceal source of their upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

Emergency medical services responders' perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study.

PubMed

Guise, Jeanne-Marie; Hansen, Matthew; O'Brien, Kerth; Dickinson, Caitlin; Meckler, Garth; Engle, Phil; Lambert, William; Jui, Jonathan

2017-02-28

Prehospital emergency medical services (EMS) providers report anxiety as the second most common contributor to paediatric patient safety events. The objective of this study was to understand how EMS providers perceive the effect of stress and anxiety on paediatric out-of-hospital patient safety. This was a nationwide study of EMS providers from 44 of 50 (88%) US states. A total of 753 eligible EMS professionals, including emergency medical technicians, emergency department physicians and nurses (general and paediatric), and respiratory therapists who participate in out-of-hospital transports. Outcomes included responses to: (1) clinical situations where heightened stress or anxiety was likely to contribute to safety events, (2) aspects of these clinical situations that cause stress or anxiety and (3) how stress or anxiety may lead to paediatric safety events. EMS providers reported that the clinical situations where stress and anxiety were more likely to contribute to paediatric patient safety events were trauma, respiratory distress and cardiac issues. Key themes were: (1) provider sympathy or identification with children, (2) difficulty seeing an innocent child hurt and the inherent value of children and (3) insufficient exposure to paediatric emergencies. Caring for paediatric emergencies creates unique stresses on providers that may affect patient safety. Many of the factors reported to cause provider stress and anxiety are inherent attributes of children and therefore not modifiable. Tools that support care during stressful conditions such as cognitive aids may help to mitigate anxiety in the prehospital care of children. Further research is needed to identify opportunities for and attributes of interventions. 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/.

77 FR 43117 - Meeting of the Cold War Advisory Committee for the Cold War Theme Study

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... the Cold War Advisory Committee for the Cold War Theme Study AGENCY: National Park Service, Interior... Committee Act, 5 U.S.C. Appendix, that the Cold War Advisory Committee for the Cold War Theme Study will... National Park Service (NPS) concerning the Cold War Theme Study. DATES: The teleconference meeting will be...

Reflections on a community and university research collaboration.

PubMed

Mayo, Kevin; Tsey, Komla

2009-08-01

This paper reflects on the collaborative research relationship between university and community researchers. It identifies emergent themes expressed in the words of researchers and recommends strategies to assist with other research collaborations. Emergent themes included: Initial reticence by community members followed by positive experiences; the value of empowerment frameworks in research; building trust between community and university researchers; capacity building, management, and workloads; and community politics, misunderstandings and wealth disparity. The paper recommends strategies for successful research collaborations and identifies challenges to research collaborations.

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom.

PubMed

Sharrock, A E; Gokani, V J; Harries, R L; Pearce, L; Smith, S R; Ali, O; Chu, H; Dubois, A; Ferguson, H; Humm, G; Marsden, M; Nepogodiev, D; Venn, M; Singh, S; Swain, C; Kirkby-Bott, J

2015-01-01

The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? The aim was to address both training requirements for the acquisition of necessary emergency general surgery skills, and the formation of job plans for trainee and consultant posts to meet the current and future requirements of the NHS. Twenty nine trainees and a consultant emergency general surgeon convened as a Working Group at The Association of Surgeons in Training Conference, 2015, to generate a united consensus statement to the training requirement and delivery of emergency general surgery provision by future general surgeons. Unscheduled general surgical care provision, emergency general surgery, trauma competence, training to meet NHS requirements, consultant job planning and future training challenges arose as key themes. Recommendations have been made from these themes in light of published evidence. Careful workforce planning, education, training and fellowship opportunities will provide well-trained enthusiastic individuals to meet public and societal need.

Theme: Innovative Curriculum Ideas and Practices in Agricultural Education.

ERIC Educational Resources Information Center