Some Comments on Key Themes and Issues in the Practice of Educational Administration. Practice, Problems and Trends in the Field: An Overview.

ERIC Educational Resources Information Center

Walker, William G.

This paper summarizes and analyzes the views presented in the preceding group of five papers, focusing on important issues in educational administration in four countries. The author notes that the developed countries discussed (England, Canada, and Australia) all face the problems of declining student numbers, decreasing birth rates, public…

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

PubMed

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

2008-04-01

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

Mexican Americans' Educational Barriers and Progress: Is the Magic Key within Reach? PERSPECTIVAS: Issues in Higher Education Policy and Practice. Issue No. 5, Spring 2016

ERIC Educational Resources Information Center

Zambrana, Ruth Enid; Hurtado, Sylvia

2016-01-01

This policy brief is based on the edited book "The Magic Key: The Educational Journey of Mexican Americans from K-12 to College and Beyond" (Zambrana & Hurtado, 2015a), which focuses on the experiences of Mexican Americans in education. Drawing from an interdisciplinary corpus of work, the authors move beyond the rhetoric of progress…

Literacy as Social Practice: Primary Voices K-6

ERIC Educational Resources Information Center

National Council of Teachers of English, 2004

2004-01-01

Based on a view of literacy as social practice, this book highlights the ways in which classroom teachers and educators have practiced and imagined teaching literacy in everyday classrooms. The twelve essays published here originally appeared in the NCTE journal Primary Voices K-6 and highlight four key issues essential to literacy practice in…

Understanding Cost-Effectiveness of Energy Efficiency Programs: Best Practices, Technical Methods, and Emerging Issues for Policy-Makers

EPA Pesticide Factsheets

Reviews the issues and approaches involved in considering and adopting cost-effectiveness tests for energy efficiency, including discussing each perspective represented by the five standard cost-effectiveness tests and clarifying key terms.

Towards a Theory of Leadership Practice: A Distributed Perspective

ERIC Educational Resources Information Center

Spillane, James; Halverson, Richard; Diamond, John

2004-01-01

School-level conditions and school leadership, in particular, are key issues in efforts to change instruction. While new organizational structures and new leadership roles matter to instructional innovation, what seems most critical is how leadership practice is undertaken. Yet, the practice of school leadership has received limited attention in…

Effectiveness of Key Knowledge Spreader Identification in Online Communities of Practice: A Simulation Study from Network Perspective

ERIC Educational Resources Information Center

Cao, Yu

2017-01-01

With the rapid development of online communities of practice (CoPs), how to identify key knowledge spreader (KKS) in online CoPs has grown up to be a hot issue. In this paper, we construct a network with variable clustering based on Holme-Kim model to represent CoPs, a simple dynamics of knowledge sharing is considered. Kendall's Tau coefficient…

Facilities removal working group

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

NONE

This working group`s first objective is to identify major economic, technical, and regulatory constraints on operator practices and decisions relevant to offshore facilities removal. Then, the group will try to make recommendations as to regulatory and policy adjustments, additional research, or process improvements and/or technological advances, that may be needed to improve the efficiency and effectiveness of the removal process. The working group will focus primarily on issues dealing with Gulf of Mexico platform abandonments. In order to make the working group sessions as productive as possible, the Facilities Removal Working Group will focus on three topics that address amore » majority of the concerns and/or constraints relevant to facilities removal. The three areas are: (1) Explosive Severing and its Impact on Marine Life, (2) Pile and Conductor Severing, and (3) Deep Water Abandonments This paper will outline the current state of practice in the offshore industry, identifying current regulations and specific issues encountered when addressing each of the three main topics above. The intent of the paper is to highlight potential issues for panel discussion, not to provide a detailed review of all data relevant to the topic. Before each panel discussion, key speakers will review data and information to facilitate development and discussion of the main issues of each topic. Please refer to the attached agenda for the workshop format, key speakers, presentation topics, and panel participants. The goal of the panel discussions is to identify key issues for each of the three topics above. The working group will also make recommendations on how to proceed on these key issues.« less

Practical Issues of Conducting a Q Methodology Study: Lessons Learned From a Cross-cultural Study.

PubMed

Stone, Teresa Elizabeth; Maguire, Jane; Kang, Sook Jung; Cha, Chiyoung

This article advances nursing research by presenting the methodological challenges experienced in conducting a multination Q-methodology study. This article critically analyzes the relevance of the methodology for cross-cultural and nursing research and the challenges that led to specific responses by the investigators. The use of focus groups with key stakeholders supplemented the Q-analysis results. The authors discuss practical issues and shared innovative approaches and provide best-practice suggestions on the use of this flexible methodology. Q methodology has the versatility to explore complexities of contemporary nursing practice and cross-cultural health research.

Teaching and Learning Communication, Language and Literacy

ERIC Educational Resources Information Center

Browne, Ann

2007-01-01

In this book, Ann Browne draws on research findings and good practice to provide practical and guidance about working with young children aged 3-5 years in nursery and reception classes. The author covers all of the key theoretical issues, providing a wealth of classroom examples. Practical suggestions for activities and resources include ways of…

School Leadership in the Caribbean: Perceptions, Practices, Paradigms

ERIC Educational Resources Information Center

Miller, Paul, Ed.

2013-01-01

Successful school leadership is an issue currently being debated up and down Caribbean territories. Key issues in the ongoing debate include: students' outcomes and participation in the regional Caribbean Secondary Examinations (CSEC); teacher recruitment and retention; teacher training and continuing professional development (upgrading); and…

Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

ERIC Educational Resources Information Center

von Kuster, Thomas, Jr.

Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

National Cultures, Performance Appraisal Practices, and Organizational Absenteeism and Turnover: A Study across 21 Countries

ERIC Educational Resources Information Center

Peretz, Hilla; Fried, Yitzhak

2012-01-01

Performance appraisal (PA) is a key human resource activity in organizations. However, in this global economy, we know little about how societal cultures affect PA practices. In this study, we address this gap by focusing on 2 complementary issues: (a) the influence of societal (national) cultural practices on PA practices adopted by organizations…

Users/consumers differences regarding ergonomics and design theory and practice.

PubMed

Dejean, Pierre-Henri; Wagstaff, Peter

2012-01-01

This paper presents the concept of direct and indirect users, a key issue to cooperation between ergonomists, designers and managers involved in a sustainable approach to design. What issues for Ergonomics and Design are launched by this concept? User/consumer differences should be approached taking into account Ergonomics and Design theory and practice. What dialogue and tools could help the ergonomist/designer/manager to respond to all the requirements of the future clients of the product?

International and cross-cultural issues: six key challenges for our professions.

PubMed

Marshall, Julie

2003-01-01

This paper discusses a number of key challenges facing professionals who work with people who have communication disabilities. The challenges are related to working internationally and in a cross-culturally competent way. Each challenge is discussed, drawing on material from a range of sources, including the papers in the final 2003 edition of FOLIA PHONIATRICA ET LOGOPAEDICA ('International and Cross-Cultural Issues'). The challenges discussed cover how experiences from majority world countries can be used to benefit services elsewhere, 'mainstreaming' commitment to cross-cultural competence, learning from relationships with other professionals, influencing research practice, responding to requests to work internationally and finally, dealing with cultural differences that challenge working practices. Some solutions are suggested and additional questions posed. Copyright 2003 S. Karger AG, Basel

The Practice-Research Relationship in Educational Administration: Potion or Poison?

ERIC Educational Resources Information Center

Lutz, Frank W.

1979-01-01

Written in response to a paper by Wayne K. Hoy on theory and practice in educational administration, this paper maintains that research and practice must be coordinated if educational administration is to progress. The author outlines Hoy's key points, agreeing with many but taking issue with Hoy's central thesis, which the author perceives as…

A Practice-Based Critique of English as a Lingua Franca

ERIC Educational Resources Information Center

Park, Joseph Sung-Yul; Wee, Lionel

2011-01-01

This paper identifies several key issues that have emerged through the debate over English as a Lingua Franca (ELF), and suggests a practice-based perspective--which treats language not as a fixed system but as an emergent product of speakers' practices--as a guide for reconsidering some fundamental assumptions of the ELF research project. In…

Observing Teaching. SEDA Paper 79.

ERIC Educational Resources Information Center

Brown, Sally, Ed.; And Others

This publication offers practical support to those in British higher education implementing the Observation of Teaching governmental directives. It provides discussion of key issues as well as a range of materials on how to carry out teaching observation including 23 checklists. The materials are grouped in four main areas: general issues, self…

Invited Commentary on "Issues in Differential Response"

ERIC Educational Resources Information Center

Vaughan-Eden, Viola; Vandervort, Frank E.

2013-01-01

Ronald Hughes and his colleagues have written a groundbreaking article on child welfare's use of differential response. Their research addresses the matter from a "lessons learned" and "ways to improve" approach. Our comments focused on three key issues: (1) the importance of evidence-based practice; (2) the recognition…

Trends in Inclusive Education at Regional and Interregional Levels: Issues and Challenges

ERIC Educational Resources Information Center

Opertti, Renato; Belalcazar, Carolina

2008-01-01

The UNESCO International Bureau of Education (IBE), through the Community of Practice (COP) in Curriculum Development, organized eight Regional Preparatory Workshops on Inclusive Education in 2007. These workshops had the overall goal of initiating a participatory, consultative process in order to highlight key issues and challenges regarding…

EDJJ Notes. Volume 3, Number 2

ERIC Educational Resources Information Center

Gagnon, Joe, Ed.

2004-01-01

This issue of "EDJJ Notes" contains the following articles: (1) "In the News: The Policy of Prosecuting Juvenile Offenders as Adults: A Summary of Key Issues" (Jeffrey M. Poirier); (2) "Youth Transition from a Secure Care Facility" (Megan McGlynn); and (3) "Research to Practice: Self-Management" (Part II of…

To pray or not to pray: a question of ethics.

PubMed

French, Charlotte; Narayanasamy, Aru

There is a widespread belief that nurses have a duty to provide spiritual care. However, many feel there is still a need for debate surrounding the ethical use of prayer in both nursing research and practice. By using critical reflections and evidence-based literature, this paper develops a discourse on the ethics of prayer as a spiritual intervention in nursing and health care practice. Several key ethical issues are highlighted. In regards to research, lack of informed consent is a major concern in both research and nursing practice. Key ethical issues in practice include questions around intention and authority, e.g. despite the religious beliefs of the nurse, intentions to proselytize must be avoided to protect patient autonomy and avoid abuse of the nurse's authority. Furthermore, prayer has unknown side effects and implications. This paper concludes that, in practice, nurses must reconcile their personal, spiritual beliefs with their professional duties, and while this may be a delicate balance, it is not yet appropriate to encourage or dissuade a patient from their beliefs until appropriate research evidence is produced.

Public lands - from concept to practice

Treesearch

John J. Vrablec

1977-01-01

Intensive timber management can and is practiced on National Forest lands in the Northeast. There are, however many constraints and limitations which are placed upon the public lands manager. The key issue here is that the National Forests are PUBLIC lands which must be managed for the public.

Selected Studies on Math Placement.

ERIC Educational Resources Information Center

Akst, Geoffrey; Hirsch, Lewis

1991-01-01

Drawing from a review of the literature and direct experience, this paper discusses key issues in developmental mathematics placement. First, the controversial practice of mandatory placement is examined, citing research results that support the practice and those that do not. Next, the diversity of developmental math placement standards is…

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

Not Available

This report contains papers on the following topics: NREN Security Issues: Policies and Technologies; Layer Wars: Protect the Internet with Network Layer Security; Electronic Commission Management; Workflow 2000 - Electronic Document Authorization in Practice; Security Issues of a UNIX PEM Implementation; Implementing Privacy Enhanced Mail on VMS; Distributed Public Key Certificate Management; Protecting the Integrity of Privacy-enhanced Electronic Mail; Practical Authorization in Large Heterogeneous Distributed Systems; Security Issues in the Truffles File System; Issues surrounding the use of Cryptographic Algorithms and Smart Card Applications; Smart Card Augmentation of Kerberos; and An Overview of the Advanced Smart Card Access Control System.more » Selected papers were processed separately for inclusion in the Energy Science and Technology Database.« less

Social Work Practice with Latinos: Key Issues for Social Workers

PubMed Central

Furman, Rich; Negi, Nalini Junko; Iwamoto, Derek Kenji; Rowan, Diana; Shukraft, Allison; Gragg, Jennifer

2010-01-01

The Latino population is the fastest growing group in the United States; thus, it is imperative that social workers and other mental health practitioners be knowledgeable about the current literature on how to effectively serve this population. This article elucidates key issues and knowledge, such as immigration and migration concerns; discusses how to assess for levels of acculturation; examines cultural values; and highlights salient work issues and health disparities that Latinos experience. Recommendations on how agencies and universities can recruit and promote bilingual practitioners are introduced. Finally, culturally responsive strategies for professional use of self and fostering the therapeutic alliance are discussed. PMID:19366165

Independent assessment is key to financial well-being.

PubMed

Karling, J; Pyper, T

1999-02-01

Both traditional group practices and IPAs have felt the impact of changes brought about by managed care. Group practices need to ensure that their financial reporting and cost-accounting methods capture information that is key to decision making. An independent assessment of financial procedures helps identify any outstanding issues and maintain financial well-being. This assessment should be conducted at least quarterly so that potential problems can be resolved, income opportunities explored, and cost-saving measures adopted in a timely manner.

Student Services and the Law: A Handbook for Practitioners.

ERIC Educational Resources Information Center

Barr, Margaret J.; And Others

An overview is provided of issues influencing student affairs practice, designed to assist practitioners in applying legal principles in their daily work. The following chapters are presented in three sections (legal foundations and student affairs practice; key areas of legal responsibility and liability; and strengthening the legal basis of…

Best Practices for Mental Health in Child Welfare: Screening, Assessment, and Treatment Guidelines

ERIC Educational Resources Information Center

Romanelli, Lisa Hunter; Landsverk, John; Levitt, Jessica Mass; Leslie, Laurel K.; Hurley, Maia M.; Bellonci, Christopher; Gries, Leonard T.; Pecora, Peter J.; Jensen, Peter S.

2009-01-01

The Best Practices for Mental Health in Child Welfare Consensus Conference focused on developing guidelines in five key areas (screening and assessment, psychosocial interventions, psychopharmacologic treatment, parent engagement, and youth empowerment) related to children's mental health. This paper provides an overview of issues related to the…

A qualitative exploration of the factors influencing the job satisfaction and career development of physiotherapists in private practice.

PubMed

Davies, J M; Edgar, S; Debenham, J

2016-09-01

The aim of this study was to investigate factors contributing to job satisfaction at different career stages, among private practice physiotherapists in Australia. Qualitative case study design utilising focus groups. Sixteen participants allocated to 3 focus groups: new graduates (n = 6), post graduates (n = 5) and practice owners (n = 5). Focus groups were transcribed verbatim and a thematic analysis was undertaken to determine themes and subthemes from each focus group. The key themes identified within each focus group included the role of peer support and mentoring, professional development, professional relationships, new graduate employment issues and career pathways within private practice. In particular, issues surrounding the new graduate experience in private practice were explored, with all groups noting lack of support and financial pressures were of concern. Findings demonstrated that new graduates are underprepared to work in private practice and modifications to the delivery of peer support, mentoring and professional development is required. Key recommendations include physiotherapy undergraduate program reform to reflect industry requirements in private practice, an increase in private practice clinical placement numbers, as well as streamlining the physiotherapy profession to improve career development pathways. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practical issues in quantum-key-distribution postprocessing

NASA Astrophysics Data System (ADS)

Fung, Chi-Hang Fred; Ma, Xiongfeng; Chau, H. F.

2010-01-01

Quantum key distribution (QKD) is a secure key generation method between two distant parties by wisely exploiting properties of quantum mechanics. In QKD, experimental measurement outcomes on quantum states are transformed by the two parties to a secret key. This transformation is composed of many logical steps (as guided by security proofs), which together will ultimately determine the length of the final secret key and its security. We detail the procedure for performing such classical postprocessing taking into account practical concerns (including the finite-size effect and authentication and encryption for classical communications). This procedure is directly applicable to realistic QKD experiments and thus serves as a recipe that specifies what postprocessing operations are needed and what the security level is for certain lengths of the keys. Our result is applicable to the BB84 protocol with a single or entangled photon source.

Learning Spaces, Agency and Notions of Improvement: What Influences Thinking and Practices about Teaching and Learning in Higher Education? An Interpretive Meta-Ethnography

ERIC Educational Resources Information Center

Savin-Baden, Maggi; McFarland, Lorraine; Savin-Baden, John

2008-01-01

This review sought to locate key themes in the literature on teaching and learning thinking and practices, by examining areas of influence and mapping ideas about the themes of practice, transfer and communities in higher education or related contexts. The findings indicate that issues of pedagogical stance, disjunction, learning spaces, agency,…

A Study of State Tax Appropriations for Capital Needs in U.S. Public Higher Education

ERIC Educational Resources Information Center

Harris, Delphine; Manns, Derrick; Katsinas, Stephen

2012-01-01

This study investigated the relationship of key issues related to capital and operating budget practices of state tax appropriations and policies at the state level, including new facilities construction, renovation, replacement and renewal which may exist between and among states by governance structure. Recognized "good practices" in…

Religious Diversity and Inclusion: Policy and Accommodation Practices in British Columbia's Secular School System

ERIC Educational Resources Information Center

Jacquet, Marianne; D'Amico, Laura

2016-01-01

The religious diversity of students and staff within a secular school system may sometimes create tensions. To better understand the possible issues generated by and practical accommodations made with respect to these tensions, interviews were conducted at the district level with key administrators in metropolitan school districts in British…

Evaluating Remote Reference Service: A Practical Guide to Problems and Solutions

ERIC Educational Resources Information Center

Pomerantz, Jeffrey; Mon, Lorri; McClure, Charles R.

2008-01-01

This paper identifies key methodological issues affecting quality of data in the evaluation of remote reference services. Despite a growing number of studies in this area, no comprehensive effort has been made to identify potential problems and suggest solutions. The strategies proposed in this paper offer practical ways in which libraries can…

National Culture in Practice: Its Impact on Knowledge Sharing in Global Virtual Collaboration

ERIC Educational Resources Information Center

Wei, Kangning

2009-01-01

Issues concerning global virtual collaboration have received considerable attention in both the academic and practical world; however, little research has been conducted on knowledge-sharing activities in global virtual collaboration, which is a key process to achieve collaboration effectiveness. Due to national culture having been seen as one of…

Racial Microaggressions: A Primer with Implications for Counseling Practice

ERIC Educational Resources Information Center

Houshmand, Sara; Spanierman, Lisa B.; De Stefano, Jack

2017-01-01

Given their societal toll and ubiquitous nature, counselors and other mental health professionals inevitably will encounter clients who have experienced racial microaggressions in their practice. In this primer, we examine key issues relative to racial microaggressions and their impact on the lives of members of racial and ethnic minority groups.…

Stakeholder attitudes and needs regarding cell-free fetal DNA testing.

PubMed

Hill, Melissa; Lewis, Celine; Chitty, Lyn S

2016-04-01

To explore stakeholder views on cell-free DNA testing and highlight findings important for successful implementation and the provision of best practice in counseling. Noninvasive tests based on the analysis of cell-free fetal DNA are now widely available in clinical practice and applications are expanding rapidly. It is essential that stakeholder views are considered in order to identify and address any ethical and social issues. We provide an overview of stakeholder viewpoints and then focus on the key issues of informed decision making, test uptake, service delivery and information sources. Stakeholders are positive about the introduction of cell-free fetal DNA testing into clinical practice. They describe both practical and psychological benefits arising from tests that are safe and can potentially be performed earlier in pregnancy. Key concerns, which include the potential for these tests to have a negative impact on informed decision making and increased societal pressure to have testing, can be addressed through careful parent-directed counseling. As applications for these tests expand it is increasingly important to develop innovative approaches to facilitate good understanding for parents who are offered noninvasive prenatal testing.

Cutting Your Losses: Could Best-Practice Pedagogy Involve Acknowledging that Even Robust Hope May Be Vain?

ERIC Educational Resources Information Center

Schuurmans-Stekhoven, James

2009-01-01

A recent special issue of "Asia-Pacific Journal of Teacher Education" (Vol. 35, Issue 3, 2007) championed "robust hope" as fundamental to achieving educational utopias, and yet key features of hope were largely overlooked. Although hope feels good and has utility in some circumstances, in other situations different…

Introduction: attachment theory and psychotherapy.

PubMed

Levy, Kenneth N

2013-11-01

In this introduction to the JCLP: In Session 69(11) issue on attachment theory and psychotherapy, the key points of attachment theory (Bowlby, , , 1981) and its relevance to psychotherapy are briefly described. The aim of this issue is to provide case illustrations of how an attachment theory perspective and principles can expand our understanding of psychotherapy practice. © 2013 Wiley Periodicals, Inc.

What Is Next for Functional Requirements for Bibliographic Records? A Delphi Study

ERIC Educational Resources Information Center

Zhang, Yin; Salaba, Athena

2009-01-01

This article reports on a Delphi study conducted to determine key issues and challenges facing Functional Requirements for Bibliographic Records (FRBR) research and practice. The Delphi panel consisted of thirty-three experts in the field who participated in a three-round issue-raising and consensus-building process via a Web-based survey…

Effects of food marketing to kids: I'm lovin' it?

PubMed

Salinsky, Eileen

2006-08-15

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children;discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

A clinical education and practice placements in the allied health professions: an international perspective.

PubMed

Rodger, Sylvia; Webb, Gillian; Devitt, Lorraine; Gilbert, John; Wrightson, Pat; McMeeken, Joan

2008-01-01

This report describes the outcomes of extensive discussions surrounding clinical education and practice placement issues undertaken by an international group of allied health educators (in audiology, occupational therapy, physiotherapy, and speech pathology) who have met since 2001 as part of Universitas 21 Health Sciences annual meetings. The report outlines key issues associated with clinical education and practice placements from an international perspective and across these four allied health professions. The allied health practice context is described in terms of the range of allied health educational programs in Universitas 21 and recent changes in health and tertiary education sectors in represented countries. Some issues and benefits related to supervision during allied health students' practice placements are addressed. A new approach is proposed through partnership such that frameworks for the provision of practice placements can be created to facilitate student learning and educate and support clinical educators. A set of guidelines that can enhance partnerships and collaborative practice for the benefit of clinical education within complex and changing health/human service and educational environments is proposed.

Update in perioperative medicine: practice changing evidence published in 2016.

PubMed

Regan, Dennis W; Kashiwagi, Deanne; Dougan, Brian; Sundsted, Karna; Mauck, Karen

2017-10-01

This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change. We integrated the new evidence into the existing body of medical knowledge and identified practical implications for real world patient care. The articles address issues related to anticoagulation, transfusion threshold, immunosuppressive medications, postoperative delirium, myocardial injury after noncardiac surgery, postoperative pain management, perioperative management of antihypertensives, perioperative fasting, and perioperative diabetic control.

Need for "conflict version" of primary surgery: war surgery in the era of low-intensity conflicts.

PubMed

Morikawa, Masahiro J

2006-01-01

The conventional wars between nations have widely been replaced by low-intensity conflicts within nations today, resulting in different patterns of injuries and practice of surgical care. A blurred front line, protracted durations of violence, indiscriminant fighting, and the emergence of specific surgical problems characterize low-intensity conflicts. In protracted conflicts with limited resources, surgical outcomes depend on many factors other than surgical skills, such as social/cultural values and economical feasibility. This paper examines how the characteristics of current conflicts affect surgical practice and will address key issues to evolve care to adapt to these changes. Key issues are (1) need for comprehensive surgical skills, (2) importance of improving local capacities, (3) long-term impact of trauma, and (4) limited access to information required to improve surgical skills.

A strategy for the implementation of a quality indicator system in German primary care.

PubMed

van den Heuvel, Henricus

2011-01-01

The Quality and Outcomes Framework (QOF) has had a major impact on the quality of care in British general practice. It is seen as a major innovation amongst quality indicator systems and as a result various countries are looking at whether such initiatives could be used in their primary care. In Germany also the development of similar schemes has started. To propose a strategy indicating key issues for the implementation of a quality indicator scheme in German primary care. Literature review with a focus on the QOF and German quality indicator literature. There are major differences between the German and British healthcare and primary care systems. The development of quality indicator systems for German general practice is in progress and there is a net force for the implementation of such systems. The following ten key factors are suggested for the successful implementation of such a system in German primary care: involvement of general practitioners (GPs) at all levels of the development, a clear implementation process, investment in practice information technology (IT) systems, an accepted quality indicator set, a quality indicator setting institution and data collection organisation, clear financial and non-financial incentives, a 'practice registration' structure, an exception reporting mechanism, delegation of routine clinical data collection tasks to practice assistants, a stepped implementation approach and adequate evaluation processes. For the successful implementation of a quality indicator system in German primary care a number of key issues, as presented in this article, need to be taken into account.

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

ERIC Educational Resources Information Center

Dagkas, Symeon

2007-01-01

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

Teacher Evaluation: Current Practices in OECD Countries and a Literature Review. OECD Education Working Papers, No. 23

ERIC Educational Resources Information Center

Isore, Marlene

2009-01-01

This paper discusses the most relevant issues concerning teacher evaluation in primary and secondary education by reviewing the recent literature and analysing current practices within the OECD countries. First, it provides a conceptual framework highlighting key features of teacher evaluation schemes. In particular, it emphasises the importance…

Your EHR license agreement: critical issues.

PubMed

Shay, Daniel F

2014-01-01

This article discusses several key provisions and concepts in software license agreements for electronic health records. It offers insight into what physician practices can expect to find in their license agreements, as well as practical advice on beneficial provisions. The article examines contractual language relating to term and termination, technical specifications and support, and compliance with governmental programs.

YoungStar in Wisconsin: Analysis of Data as of July 2014. Executive Summary: Key Findings and Analysis

ERIC Educational Resources Information Center

Wisconsin Council on Children and Families, 2014

2014-01-01

YoungStar is a five-star quality rating system for child care providers based on education, learning environment, business methods, and practices around child health and well-being. Through this rating system, the state is addressing several key issues in Wisconsin's child care system. The rating system will: (1) Improve the overall quality of…

FHWA LTBP Bridge Performance Primer

DOT National Transportation Integrated Search

2014-02-01

This TechBrief defines bridge performance and discusses the importance of measuring performance and current practices for doing so. It identifies key issues to improving performance measures and the role the Long-Term Bridge Performance (LTBP) Progra...

Telecommunications in transportation : key issues & best practices

DOT National Transportation Integrated Search

1996-09-01

Over the past several years, many states and local communities have been dealing with the need to substantially increase their usage of telecommunications. This is the result of the deployment of more surveillance capability, specifically television ...

Cause-effect relationships in analytical surveys: An illustration of statistical issues

Treesearch

Gary L. Gadbury; Hans T. Schreuder

2003-01-01

Establishing cause-effect is critical in the field of natural resources where one may want to know the impact of management practices, wildfires, drought, etc. on water quality and quantity, wildlife, growth and survival of desirable trees for timber production, etc. Yet, key obstacles exist when trying to establish cause-effect in such contexts. Issues involved with...

What's Hot, What's Not 2009: What Experts Say about Literacy Issues

ERIC Educational Resources Information Center

National Literacy Trust, 2009

2009-01-01

In December 2008, 35 professionals from research, policy, practice and the media participated in an online survey about a range of key literacy issues. This is the second time that this annual survey has been carried out in the in UK. Participants were asked to indicate whether a certain topic was "hot" (i.e. currently a topic of debate…

Qualitative Educational Research in Developing Countries: Current Perspectives. Reference Books in International Education, Volume 35. Garland Reference Library of Social Science, Volume 927.

ERIC Educational Resources Information Center

Crossley, Michael, Ed.; Vulliamy, Graham, Ed.

This book contains 11 essays that offer in-depth accounts of qualitative research in developing countries. Each chapter focuses upon a specific method and considers related theoretical and practical issues with reference to recent experiences in selected developing countries. Key issues addressed include: (1) the identification of appropriate…

Key issues and challenges in developing a pedagogical intervention in the simulation skills center--an action research study.

PubMed

Reierson, Inger Åse; Hvidsten, Anne; Wighus, Marianne; Brungot, Solvor; Bjørk, Ida Torunn

2013-07-01

Simulation skills centers (SSC) are considered important learning arenas for preparing and qualifying nursing students. Limited clinical placements and claims of diminished learning opportunities raise concerns that newly educated nurses lack proficiency in many psychomotor skills. Accordingly, there is an increased focus on learning in the SSC. However, it has been questioned if the pedagogical underpinning of teaching and learning in the SSC is missing or unclear. At a bachelor nursing education in Norway, there was a desire to change practice and enhance learning in the SSC by systematic use of The Model of Practical Skill Performance (Bjørk and Kirkevold, 2000). A participatory action research design was chosen. A pedagogical intervention was developed and implemented in 2010 in a cohort of eighty-seven first year bachelor nursing students during their basic nursing skill course. The intervention is shortly described. This article reports key issues and challenges that emerged during development of the new intervention. Data to inform the study were collected via thorough meeting minutes and the project leader's logbook, and analyzed using fieldnotes analysis. Six key issues and challenges were identified. These are presented and discussed consecutively in light of their importance for development and implementation of the new intervention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Understanding the essential elements of work-based learning and its relevance to everyday clinical practice.

PubMed

Williams, Caroline

2010-09-01

To critically review the work-based learning literature and explore the implications of the findings for the development of work-based learning programmes. With NHS budgets under increasing pressure, and challenges to the impact of classroom-based learning on patient outcomes, work-based learning is likely to come under increased scrutiny as a potential solution. Evidence from higher education institutions suggests that work-based learning can improve practice, but in many cases it is perceived as little more than on-the-job training to perform tasks. The CINAHL database was searched using the keywords work-based learning, work-place learning and practice-based learning. Those articles that had a focus on post-registration nursing were selected and critically reviewed. Using the review of the literature, three key issues were explored. Work-based learning has the potential to change practice. Learning how to learn and critical reflection are key features. For effective work-based learning nurses need to take control of their own learning, receive support to critically reflect on their practice and be empowered to make changes to that practice. A critical review of the literature has identified essential considerations for the implementation of work-based learning. A change in culture from classroom to work-based learning requires careful planning and consideration of learning cultures. To enable effective work-based learning, nurse managers need to develop a learning culture in their workplace. They should ensure that skilled facilitation is provided to support staff with critical reflection and effecting changes in practice. CONTRIBUTION TO NEW KNOWLEDGE: This paper has identified three key issues that need to be considered in the development of work-based learning programmes. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

New Stark regulations: Key issues for health care decision-makers.

PubMed

Johnson, B A; Niederman, G A; Bowman, L E; McCullough, A C

1998-01-01

On Jan. 9, 1998, The Health Care Financing Administration (HCFA) issued long-awaited Proposed Regulations for what has become known as Stark II. The regulations are subject to a comment period and later refinement. However, they lay out HCFA's basic understanding of what kinds of practices constitute an illegal kickback. In general terms, the law prohibits physicians from referring Medicare or Medicaid patients to entities with which they (or an immediate family member) have a "financial relationship" for the delivery of a specific list of designated health services. There are, however, exceptions also included in the new proposal. Group practices will want to pay special attention to HCFA's new definition of group practice.

Ethically-based clinical decision-making in physical therapy: process and issues.

PubMed

Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

2005-01-01

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

Monitoring of continuous-variable quantum key distribution system in real environment.

PubMed

Liu, Weiqi; Peng, Jinye; Huang, Peng; Huang, Duan; Zeng, Guihua

2017-08-07

How to guarantee the practical security of continuous-variable quantum key distribution (CVQKD) system has been an important issue in the quantum cryptography applications. In contrast to the previous practical security strategies, which focus on the intercept-resend attack or the Gaussian attack, we investigate the practical security strategy based on a general attack, i.e., an arbitrated individual attack or collective attack on the system by Eve in this paper. The low bound of intensity disturbance of the local oscillator signal for eavesdropper successfully concealing herself is obtained, considering all noises can be used by Eve in the practical environment. Furthermore, we obtain an optimal monitoring condition for the practical CVQKD system so that legitimate communicators can monitor the general attack in real-time. As examples, practical security of two special systems, i.e., the Gaussian modulated coherent state CVQKD system and the middle-based CVQKD system, are investigated under the intercept-resend attacks.

Social Work Practice with LGBT Elders at End of Life: Developing Practice Evaluation and Clinical Skills Through a Cultural Perspective.

PubMed

Arthur, Darren P

2015-01-01

This article focuses on culturally sensitive clinical issues related to best practices with lesbian, gay, bisexual, transgender (LGBT) elder patients at end-of-life (EOL) at key points in the therapeutic relationship. Vital concepts, including practice evaluation and clinical skills, are presented through a cultural and oncology lens. There is a paucity of LGBT research and literature as well as a shortfall of MSW graduate school education specific to social work palliative and end-of-life care (PELC) practice with LGBT elders. The content of this article is designed to be adapted and used as an educational tool for institutions, agencies, graduate programs, medical professions, social work, and students. Learning the unique elements of LGBT cultural history and their implications on EOL care can improve social work practice. This article provides an examination from assessment and engagement basics to advance care planning incorporating specific LGBT EOL issues.

Safe and inclusive research practices for qualitative research involving people with dementia: A review of key issues and strategies.

PubMed

Novek, Sheila; Wilkinson, Heather

2017-01-01

Aim Developing strategies to ensure the safe participation of people with dementia in research is critical to support their wider inclusion in research and to advance knowledge in the areas of dementia policy and practice. Objectives This literature review synthesizes and critically appraises different approaches to promote the safe participation of people with dementia in qualitative research. Methods Two databases were searched for articles that discuss the methodological or ethical aspects of qualitative research involving people with dementia. We did not focus on informed consent or ethical review processes as these have been reviewed elsewhere. Findings Key issues that impact participant safety include: language, gatekeepers, the research relationship, communication, dealing with distress, knowledge dissemination, and researcher skills. Conclusion By synthesizing different approaches to safety and highlighting areas of debate, we hope to advance discussion and to contribute to the development of inclusive research methods.

The policy context of patient centered medical homes: perspectives of primary care providers.

PubMed

Alexander, Jeffrey A; Cohen, Genna R; Wise, Christopher G; Green, Lee A

2013-01-01

Interest in the patient centered medical home (PCMH) model has increased significantly in recent years. Despite this attention, information is limited regarding the influence of policy context on implementation of the PCMH model. Using comparative, qualitative data, we identify several key policy impediments to PCMH implementation, and propose practical guidelines for addressing these issues. Qualitative, semi-structured in-person interviews with representatives of physician organizations and primary care practices pursuing PCMH. Practitioners and staff at 16 physician practices in Michigan, as well as key leaders of physician organizations. We identified five primary policy issues cited by physicians and physician organization leaders as most impactful on their efforts to adopt PCMH: misalignment of current reimbursement schemes, administrative burden, conflicting criteria for PCMH designation, workforce policy issues, and uncertainty of health care reform. These policies were largely seen as barriers to their ability to implement PCMH. Providers' motivation to embrace PCMH, and their level of confidence regarding the results of such change, are greatly influenced by their perception of the external environment and the control they believe they have over this environment. Having policies in place that shape the path to PCMH in a manner that makes it as easy as possible for providers to accomplish the desired changes could well make the difference in whether successful transformation is achieved.

Elder Abuse: Research, Practice, and Health Policy. The 2012 GSA Maxwell Pollack Award Lecture

PubMed Central

Dong, Xinqi

2014-01-01

Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults. PMID:24270215

Elder abuse: research, practice, and health policy. The 2012 GSA Maxwell Pollack award lecture.

PubMed

Dong, Xinqi

2014-04-01

Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults.

Understanding Evidence-Based Information for the Early Childhood Field: Tips from RAND's Promising Practices Network

ERIC Educational Resources Information Center

Mattox, Teryn; Kilburn, M. Rebecca

2012-01-01

With the growing and diverse use of the term "evidence-based practice" it can be difficult for policymakers, funders, program officers, and other professionals to separate the good evidence from the flawed. Furthermore, once good evidence has been identified, it can be difficult to know how to use it. This article discusses key issues to consider…

Towards the Development of a New Model for Best Practice and Knowledge Construction in Virtual Campuses

ERIC Educational Resources Information Center

Cartelli, Antonio; Stansfield, Mark; Connolly, Thomas; Jimoyiannis, Athanassios; Magalhaes, Hugo; Maillet, Katherine

2008-01-01

This paper reports on the work of a European Commission DG Education and Culture co-financed project PBP-VC, Promoting Best Practice in Virtual Campuses, which is aimed at providing a deeper understanding of the key issues and critical success factors underlying the implementation of virtual campuses. The paper outlines a tentative model of issues…

Best practices for interacting with the public about wildland fire: Key findings from interviews

Treesearch

Daniel Berkman

2012-01-01

Interviews were conducted with public information and line officers about wildland fire communications with the public. The goal of these interviews was to determine the best practices and most useful content and format for an annotated bibliography about external wildland fire communications, i.e., does the current literature reviewed address the issues of greatest...

Investigating Factors That Contribute to Effective Teaching-Learning Practices: EFL/ESL Classroom Context

ERIC Educational Resources Information Center

Islam, Rukaia

2017-01-01

This paper seeks to address some key issues, which can influence as well as determine the nature of teaching and learning practices in an ELT classroom directly or indirectly. This paper views an EFL or ESL classroom as a dynamic and multi-dimensional platform open to different interpretations of teaching and learning. Factors like teachers'…

Framing Pre-Service Teachers' Professional Learning Using Web2.0 Tools: Positioning Pre-Service Teachers as Agents of Cultural and Technological Change

ERIC Educational Resources Information Center

Kidd, Warren

2013-01-01

This article addresses key issues in pre-service teachers' professional learning. The argument explores pre-service teachers' learning and practice, which is both informed by technology and which uses technologically enhanced practices in classrooms as learning and teaching strategies. The article is contextualized by current…

Best Practices for Mental Health in Child Welfare: Parent Support and Youth Empowerment Guidelines

ERIC Educational Resources Information Center

Romanelli, Lisa Hunter; Hoagwood, Kimberly E.; Kaplan, Sandra J.; Kemp, Susan P.; Hartman, Robert L.; Trupin, Casey; Soto, Wilfredo; Pecora, Peter J.; LaBarrie, Theresa L.; Jensen, Peter S.

2009-01-01

This paper, the second in a series of two guideline papers emerging from the 2007 Best Practices for Mental Health in Child Welfare Consensus Conference, provides an overview of the key issues related to parent support and youth empowerment in child welfare and presents consensus guidelines in these important areas. The paper also discusses some…

Ethical practice in Telehealth and Telemedicine.

PubMed

Chaet, Danielle; Clearfield, Ron; Sabin, James E; Skimming, Kathryn

2017-10-01

This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code). CEJA reports are developed through an iterative process of deliberation with input from multiple stakeholders; report recommendations, once adopted by the AMA House of Delegates, become ethics policy of the AMA and are issued as Opinions in the Code. To provide enduring guidance for the medical profession as a whole, CEJA strives to articulate expectations for conduct that are as independent of specific technologies or models of practice as possible. The present report, developed at the request of the House of Delegates, provides broad guidance for ethical conduct relating to key issues in telehealth/telemedicine. The report and recommendations were debated at meetings of the House in June and November 2015; recommendations were adopted in June 2016 and published as Opinion E-1.2.12, Ethical Practice in Telemedicine, in November 2016. A summary of the key points of the recommendations can be found in Appendix A (online), and the full text of the opinion can be found in Appendix B (online).

Issues and Challenges Facing Flexible Lithium-Ion Batteries for Practical Application.

PubMed

Cha, Hyungyeon; Kim, Junhyeok; Lee, Yoonji; Cho, Jaephil; Park, Minjoon

2017-12-27

With the advent of flexible electronics, lithium-ion batteries have become a key component of high performance energy storage systems. Thus, considerable effort is made to keep up with the development of flexible lithium-ion batteries. To date, many researchers have studied newly designed batteries with flexibility, however, there are several significant challenges that need to be overcome, such as degradation of electrodes under external load, poor battery performance, and complicated cell preparation procedures. In addition, an in-depth understanding of the current challenges for flexible batteries is rarely addressed in a systematical and practical way. Herein, recent progress and current issues of flexible lithium-ion batteries in terms of battery materials and cell designs are reviewed. A critical overview of important issues and challenges for the practical application of flexible lithium-ion batteries is also provided. Finally, the strategies are discussed to overcome current limitations of the practical use of flexible lithium-based batteries, providing a direction for future research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Human Rights: Its Meaning and Practice in Social Work Field Settings.

PubMed

Steen, Julie A; Mann, Mary; Restivo, Nichole; Mazany, Shellene; Chapple, Reshawna

2017-01-01

The goal of the study reported in this article was to explore the conceptualizations of human rights and human rights practice among students and supervisors in social work field settings. Data were collected from 35 students and 48 supervisors through an online survey system that featured two open-ended questions regarding human rights issues in their agency and human rights practice tasks. Responses suggest that participants encountered human rights issues related to poverty, discrimination, participation/self-determination/autonomy, violence, dignity/respect, privacy, and freedom/liberty. They saw human rights practice as encompassing advocacy, service provision, assessment, awareness of threats to clients' rights, and the nature of the worker-client relationship. These results have implications for the social work profession, which has an opportunity to focus more intently on change efforts that support clients' rights. The study points to the possibilities of expanding the scope of the human rights competency within social work education and addressing the key human rights issues in field education. © 2016 National Association of Social Workers.

Industry and water security: overarching conclusions.

PubMed

Stigson, B

2001-01-01

Fresh water is key to sustainable development. World Business Council for Sustainable Development members are addressing fresh water use "within the corporate fenceline". However, to address water issues "outside the corporate fenceline" will require creative new public-private partnerships. Government's role is to provide sound framework conditions that will encourage businesses to invest time, staff and resources to address vital fresh water issues. Industry is committed to best practice within its internal operations and is ready to enter into partnerships to address broader fresh water issues.

Team deliberate practice in medicine and related domains: a consideration of the issues.

PubMed

Harris, Kevin R; Eccles, David W; Shatzer, John H

2017-03-01

A better understanding of the factors influencing medical team performance and accounting for expert medical team performance should benefit medical practice. Therefore, the aim here is to highlight key issues with using deliberate practice to improve medical team performance, especially given the success of deliberate practice for developing individual expert performance in medicine and other domains. Highlighting these issues will inform the development of training for medical teams. The authors first describe team coordination and its critical role in medical teams. Presented next are the cognitive mechanisms that allow expert performers to accurately interpret the current situation via the creation of an accurate mental "model" of the current situation, known as a situation model. Following this, the authors propose that effective team performance depends at least in part on team members having similar models of the situation, known as a shared situation model. The authors then propose guiding principles for implementing team deliberate practice in medicine and describe how team deliberate practice can be used in an attempt to reduce barriers inherent in medical teams to the development of shared situation models. The paper concludes with considerations of limitations, and future research directions, concerning the implementation of team deliberate practice within medicine.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives

PubMed Central

Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

2014-01-01

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from “a good idea” to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. PMID:25018637

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.

PubMed

Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

2014-01-01

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.

Understanding men's health and illness: a gender-relations approach to policy, research, and practice.

PubMed

Schofield, T; Connell, R W; Walker, L; Wood, J F; Butland, D L

2000-05-01

Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.

Measuring competition in health care markets.

PubMed Central

Baker, L C

2001-01-01

OBJECTIVE: Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS: Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data. PMID:11327175

Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice.

PubMed

Murray, Maureen M; Southerland, Dannia; Farmer, Elizabeth M; Ballentine, Kess

2010-01-01

Evidence-based practices to improve outcomes for children with severe behavioral and emotional problems have received a great deal of attention in children's mental health. Therapeutic Foster Care (TFC), a residential intervention for youth with emotional or behavioral problems, is one of the few community-based programs that is considered to be evidence-based. However, as for most treatment approaches, the vast majority of existing programs do not deliver the evidence-based version. In an attempt to fill this gap and improve practice across a wide range of TFC agencies, we developed an enhanced model of TFC based on input from both practice and research. It includes elements associated with improved outcomes for youth in "usual care" TFC agencies as well as key elements from Chamberlain's evidence-based model. The current manuscript describes this "hybrid" intervention - Together Facing the Challenge - and discusses key issues in implementation. We describe the sample and settings, highlight key implementation strategies, and provide "lessons learned" to help guide others who may wish to change practice in existing agencies.

Emerging issues in biodiversity & conservation management: The need for a palaeoecological perspective

NASA Astrophysics Data System (ADS)

Froyd, C. A.; Willis, K. J.

2008-09-01

The study of Quaternary environmental change is directly applicable to on-going issues of global conservation. Palaeoecological research techniques provide the tools to address some of the key questions presently being asked by conservation ecologists and land management organizations. But is this type of analysis currently being utilized to its full potential? Are the results of palaeoenvironmental analyses routinely applied to practical issues of natural resource management, and if not what can be done to expand the application of this research within the conservation community? This paper reviews recent developments in the application of the analysis of late Quaternary environmental change to key environmental issues of biodiversity and conservation management and examines areas which could be strengthened in the future including: (i) determination of baselines and natural ecosystem variability; (ii) understanding ecological thresholds and resilience; (iii) climate change conservation strategies; (iv) biological invasions; and (v) conservation and culture.

Surrogacy in modern obstetric practice.

PubMed

Burrell, Celia; Edozien, Leroy C

2014-10-01

Surrogacy is rising in profile and prevalence, which means that perinatal care providers face an increasing likelihood of encountering a case in their clinical practice. Rapidly expanding scientific knowledge (for example, fetal programming) and technological advances (for example, prenatal screening and diagnosis) pose challenges in the management of the surrogate mother; in particular, they could exacerbate conflict between the interests of the baby, the surrogate mother, and the intending parent(s). Navigating these often-tranquil-but-sometimes-stormy waters is facilitated if perinatal care providers are aware of the relevant ethical, legal, and service delivery issues. This paper describes the ethical and legal context of surrogacy, and outlines key clinical practice issues in management of the surrogate mother. Copyright © 2014 Elsevier Ltd. All rights reserved.

Biotechnology: Impact on sugarcane agriculture and industry

USDA-ARS?s Scientific Manuscript database

Of the nine key technology issues that affect the sustainability of the sugar- or bio-energy- cane industry, namely: land, fertility, water, variety, planting density, crop protection, cultural practices, harvesting and processing, and lately, information technology, growing the right varieties rema...

Impact of biotechnology on sugarcane agriculture and industry

USDA-ARS?s Scientific Manuscript database

There are nine key issues that can influence the productivity and sustainability of the sugarcane industry. These include land, soil fertility, water, variety, planting density, crop protection, cultural practices, harvesting and processing, and information technology. To all sugarcane farmers, it r...

Practice management: observations, issues, and empirical evidence.

PubMed

Wong, H M; Braithwaite, J

2001-02-01

The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

What Ethical Issues Really Arise in Practice at an Academic Medical Center? A Quantitative and Qualitative Analysis of Clinical Ethics Consultations from 2008 to 2013.

PubMed

Wasson, Katherine; Anderson, Emily; Hagstrom, Erika; McCarthy, Michael; Parsi, Kayhan; Kuczewski, Mark

2016-09-01

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male (55.8 %), white (57.1 %), between 50 and 69 years old (38.5 %), of non-Hispanic origin (85.9 %), and of Roman Catholic faith (43.6 %). Nearly half (47.4 %) were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making (93.6 %), goals of care/treatment (80.8 %), and end-of-life (73.1 %). More specifically, capacity (57.1 %), patient's wishes/autonomy (54.5 %), and surrogate decision maker (51.3 %) were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment (12.8 %), patient wishes/autonomy (12.2 %), and capacity (11.5 %). Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field.

Beyond STS: A research-based framework for socioscientific issues education

NASA Astrophysics Data System (ADS)

Zeidler, Dana L.; Sadler, Troy D.; Simmons, Michael L.; Howes, Elaine V.

2005-05-01

An important distinction can be made between the science, technology, and society (STS) movement of past years and the domain of socioscientific issues (SSI). STS education as typically practiced does not seem embedded in a coherent developmental or sociological framework that explicitly considers the psychological and epistemological growth of the child, nor the development of character or virtue. In contrast, the SSI movement focuses on empowering students to consider how science-based issues reflect, in part, moral principles and elements of virtue that encompass their own lives, as well as the physical and social world around them. The focus of this paper is to describe a research-based framework of current research and practice that identifies factors associated with reasoning about socioscientific issues and provide a working model that illustrates theoretical and conceptual links among key psychological, sociological, and developmental factors central to SSI and science education.

Key Issue: Enhancing Teacher Leadership

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2007

2007-01-01

"Teachers are leaders when they function in professional communities to affect student learning; contribute to school improvement; inspire excellence in practice; and empower stakeholders to participate in educational improvement" (Childs-Bowen, Moller, & Scrivner, 2000, p. 28). Enhancing teacher leadership can help schools and districts reach the…

Assessing the Impact of Educational Differences in HCI Design Practice

ERIC Educational Resources Information Center

Antunes, Pedro; Xiao, Lu; Pino, Jose A.

2014-01-01

Human-computer interaction (HCI) design generally involves collaboration from professionals in different disciplines. Trained in different design education systems, these professionals can have different conceptual understandings about design. Recognizing and identifying these differences are key issues for establishing shared design practices…

Building Better Buildings: Sustainable Building Activities in California Higher Education Systems.

ERIC Educational Resources Information Center

Sowell, Arnold; Eichel, Amanda; Alevantis, Leon; Lovegreen, Maureen

2003-01-01

This article outlines the activities and recommendations of California's sustainable building task force, discusses sustainable building activities in California's higher education systems, and highlights key issues that California is grappling with in its implementation of sustainable building practices. (EV)

REHABILITATION OF AGING WATER INFRASTRUCTURE SYSTEMS: KEY CHALLENGES AND ISSUES

EPA Science Inventory

Presented in this paper are the results of a state-of-the-practice survey on the rehabilitation of water distribution and wastewater collection systems. The survey identified several needs, including the need for rational and common design approaches for rehabilitation systems, ...

Community psychology practice: expanding the impact of psychology's work.

PubMed

Wolff, Tom

2014-11-01

This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Using Eight Key Questions as an Inquiry-Based Framework for Ethical Reasoning Issues in a General Education Earth Systems and Climate Change Course

NASA Astrophysics Data System (ADS)

Johnson, E. A.; Ball, T. C.

2014-12-01

An important objective in general education geoscience courses is to help students evaluate social and ethical issues based upon scientific knowledge. It can be difficult for instructors trained in the physical sciences to design effective ways of including ethical issues in large lecture courses where whole-class discussions are not practical. The Quality Enhancement Plan for James Madison University, "The Madison Collaborative: Ethical Reasoning in Action," (http://www.jmu.edu/mc/index.shtml) has identified eight key questions to be used as a framework for developing ethical reasoning exercises and evaluating student learning. These eight questions are represented by the acronym FOR CLEAR and are represented by the concepts of Fairness, Outcomes, Responsibilities, Character, Liberty, Empathy, Authority, and Rights. In this study, we use the eight key questions as an inquiry-based framework for addressing ethical issues in a 100-student general education Earth systems and climate change course. Ethical reasoning exercises are presented throughout the course and range from questions of personal behavior to issues regarding potential future generations and global natural resources. In the first few exercises, key questions are identified for the students and calibrated responses are provided as examples. By the end of the semester, students are expected to identify key questions themselves and justify their own ethical and scientific reasoning. Evaluation rubrics are customized to this scaffolding approach to the exercises. Student feedback and course data will be presented to encourage discussion of this and other approaches to explicitly incorporating ethical reasoning in general education geoscience courses.

The Implications of the National Minimum Wage for Training Practices and Skill Utilisation in the United Kingdom Hospitality Industry

ERIC Educational Resources Information Center

Norris, Gill; Williams, Steve; Adam-Smith, Derek

2003-01-01

Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…

Women's Health at Work Program: musculoskeletal pain experienced by women of Chinese background working on market gardens in the Sydney Basin.

PubMed

Innes, Ev; Crowther, Amber; Fonti, Fiona; Quayle, Leonie

2010-01-01

OBJECTIVE/PARTICIPANTS: This report describes a project undertaken by three final (4th) year occupational therapy undergraduate students from the University of Sydney, Australia, in their final fieldwork placement. The project involved women from a Chinese background who worked on market gardens across the Sydney Basin. Its purpose was to identify musculoskeletal risks in the work environment and work practices of a selected group of seven Cantonese-speaking women working on market gardens in the Western Sydney region. The approaches used in the project reflected a risk management approach, and involved background research, initial interviews, task analysis, hazard identification, risk assessment, data analysis, identification of key issues, and developing recommendations, in collaboration with participants and consultation with professionals. The key issues identified as contributing factors to musculoskeletal pain and injuries were: (1) work practices (long work hours, repetitive work); (2) biomechanical factors (repetitive and sustained work postures, poor manual handling practices) and limited training; (3) ergonomics of the equipment used; (4) fatigue. Two priority areas for intervention were identified: (1) pain management, and (2) preventative strategies (improving both the work environment and work practices). Recommendations were made in collaboration with the women, and in consultation with health professionals.

Inernational research in health care management: its need in the 21st century, methodological challenges, ethical issues, pitfalls, and practicalities.

PubMed

Buttigieg, Sandra C; Rathert, Cheryl; D'Aunno, Thomas A; Savage, Grant T

2015-01-01

This commentary argues in favor of international research in the 21st century. Advances in technology, science, communication, transport, and infrastructure have transformed the world into a global village. Industries have increasingly adopted globalization strategies. Likewise, the health sector is more internationalized whereby comparisons between diverse health systems, international best practices, international benchmarking, cross-border health care, and cross-cultural issues have become important subjects in the health care literature. The focus has now turned to international, collaborative, cross-national, and cross-cultural research, which is by far more demanding than domestic studies. In this commentary, we explore the methodological challenges, ethical issues, pitfalls, and practicalities within international research and offer possible solutions to address them. The commentary synthesizes contributions from four scholars in the field of health care management, who came together during the annual meeting of the Academy of Management to discuss with members of the Health Care Management Division the challenges of international research. International research is worth pursuing; however, it calls for scholarly attention to key methodological and ethical issues for its success. This commentary addresses salient issues pertaining to international research in one comprehensive account.

Guidelines clarify managed care accounting procedures.

PubMed

Cheramy, S J; Garner, M

1989-08-01

Two new documents offer guidance for accounting issues involved in managed care programs. The American Institute of Certified Public Accountants' Statement of Position 89-5 and HFMA's Principles and Practices Board Statement No. 11 address risk contracting from the perspective of the managed care program and the healthcare provider, respectively. One key issue addressed in the documents is the timing of expense recognition of the costs of providing health services to members of managed care plans.

Recent Trends in Robotics Research

NASA Astrophysics Data System (ADS)

Ejiri, Masakazu

My views on recent trends in the strategy and practice of Japan's robotics research are briefly introduced. To meet ever-increasing public expectations, robotics researchers and engineers have to be more seriously concerned about robots' intrinsic weaknesses. Examples of these are power-related and reliability issues. Resolving these issues will increase the feasibility of creating successful new industry, and the likelihood of robotics becoming a key technology for providing a safe and stress-free society in the future.

Eliminating extravasation events: a multidisciplinary approach.

PubMed

Coyle, Christine E; Griffie, Julie; Czaplewski, Lynn M

2014-01-01

Administration of chemotherapy agents can give rise to many safety issues. Extravasation of a vesicant agent causes tissue blistering and necrosis. This complication of chemotherapy administration causes additional pain and suffering in patients who are already suffering with a diagnosis of cancer. Nurses hold key responsibilities for educating patients about administration issues and following practice standards to minimize the risk of extravasation. Defining a path of shared responsibilities among team members is a critical step in assuring the safe administration of drugs classified as vesicants. This article describes a clinical practice change that is used at a large midwestern academic medical cancer center. This practice and policy change has resulted in a 90% reduction in the administration of vesicant agents peripherally, with no occurrence of extravasations in the first 6 months of implementation.

Eliminating Extravasation Events: A Multidisciplinary Approach.

PubMed

Coyle, Christine E; Griffie, Julie; Czaplewski, Lynn M

2015-01-01

Administration of chemotherapy agents can give rise to many safety issues. Extravasation of a vesicant agent causes tissue blistering and necrosis. This complication of chemotherapy administration causes additional pain and suffering in patients who are already suffering with a diagnosis of cancer. Nurses hold key responsibilities for educating patients about administration issues and following practice standards to minimize the risk of extravasation. Defining a path of shared responsibilities among team members is a critical step in assuring the safe administration of drugs classified as vesicants. This article describes a clinical practice change that is used at a large midwestern academic medical cancer center. This practice and policy change has resulted in a 90% reduction in the administration of vesicant agents peripherally, with no occurrence of extravasations in the first 6 months of implementation.

Professional Ethics in Teaching: Towards the Development of a Code of Practice.

ERIC Educational Resources Information Center

Campbell, Elizabeth

2000-01-01

Provides a theoretical discussion about the process of creating a professional code of ethics for educators. Discusses six key issues and questions, introducing the development of a code of professional ethics and the complexities the code should address. Includes references. (CMK)

Family-Centered Service Delivery.

ERIC Educational Resources Information Center

Higgins, Cindy, Ed.

1997-01-01

This theme issue focuses on family-centered practices and policies for service delivery. The first article, "Family-Centered Service Delivery," reports on a study of 130 published sources in education, social work, nursing, psychology, occupational therapy, and related disciplines, which found that the key components of family-centered…

Independence as a practice issue in occupational therapy: the safety clause.

PubMed

Russell, Cherry; Fitzgerald, Maureen H; Williamson, Peter; Manor, Debra; Whybrow, Samantha

2002-01-01

This article reports findings from interviews that explored the meanings occupational therapists attach to independence as a value and a therapeutic goal in interactions with elderly clients. Through a historical review of the literature, we trace the changing use of this term and identify two analytically distinct concepts associated with it: independence as self-reliance in activity and independence as autonomy, self-determination, or choice. We show how the latter has emerged in contemporary service contexts to represent an ideal of client-centered practice for persons with chronic disabilities, such as frail elderly clients. Using a "critical incident" interview approach with 12 Australian occupational therapists, we identified the therapists' explicit and implicit understandings of independence as a value concept and practice issue. Our findings suggest that a mismatch often exists between idealized and practice-based talk about independence and that therapists narrativize this opposition around what we call "the safety clause." That is, therapists invoke concerns about safety and duty of care as a caveat to implementing their independence ideals and justifying the retention of professional control. We identify key issues that therapists need to address if the rhetoric of independence-related client-centered practice is to be achieved in reality.

Practice teaching and the importance of feedback.

PubMed

Lally, Sheila

2013-01-01

Practice teachers play a key role in ensuring health visitors, school nurses and occupational health nurses are capable of delivering safe and effective practice to the public. The practice teacher is a significant member of the learning team during the specialist community public health nursing programme. This paper discusses the role of feedback in facilitating students' learning while in practice. Its purpose is to raise awareness for those working as practice teachers to the issues they may experience when giving feedback and discusses the theories of transactional analysis, transference and counter-transference and the impact these may have on the practice teachers' ability to give constructive feedback to specialist community public health nursing students.

Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia.

PubMed

Laws, R; Campbell, K J; van der Pligt, P; Ball, K; Lynch, J; Russell, G; Taylor, R; Denney-Wilson, E

2015-01-01

Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported. This mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0-5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles. Although nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation. While MCH nurses are well placed to address obesity prevention in early life, there is currently a missed public health opportunity. Improving nurse skills in behaviour change counseling will be key to increasing their confidence in raising sensitive lifestyle issues with parents to better integrate obesity prevention practices into normal MCH service delivery.

Theory and Practice on Teacher Performance Evaluation

ERIC Educational Resources Information Center

Yonghong, Cai; Chongde, Lin

2006-01-01

Teacher performance evaluation plays a key role in educational personnel reform, so it has been an important yet difficult issue in educational reform. Previous evaluations on teachers failed to make strict distinction among the three dominant types of evaluation, namely, capability, achievement, and effectiveness. Moreover, teacher performance…

Globalization of Science Education: Comment and a Commentary

ERIC Educational Resources Information Center

Fensham, Peter J.

2011-01-01

The globalized nature of modern society has generated a number of pressures that impact internationally on countries' policies and practices of science education. Among these pressures are key issues of health and environment confronting global science, global economic control through multi-national capitalism, comparative and competitive…

Technological Literacy. Research into Practice Series No. 4.

ERIC Educational Resources Information Center

Luke, Carmen

This booklet, which was written for adult literacy practitioners in Australia, examines some key issues currently being raised about new information technologies and technological literacy. The following are among the topics discussed in the booklet's nine sections: innovation and dissemination (effects of videocassette recorders, computers, and…

Community Psychology, Evaluation, and Social Critique

ERIC Educational Resources Information Center

Miller, Robin Lin

2015-01-01

Community psychology blends psychological science, a community-level perspective on social issues, and a social justice orientation. Despite important difference between community psychology and program evaluation, program evaluation is a key component of many community psychologists' practice and holds a central place in my own. In this…

Technological Innovations and Intervention Practices for Children with Cochlear Implants.

ERIC Educational Resources Information Center

Ertmer, David J.

2002-01-01

This epilogue to a forum on children with hearing impairments who have cochlear implants discusses innovation in implant technology and considers intervention issues. Key factors influencing outcomes are discussed, including educational programming, amount and length of communication intervention, and the targeting of both developmental and…

ASR Application in Climate Change Adaptation: The Need, Issues and Research Focus

EPA Science Inventory

This presentation will focus on four key points: (a) Aquifer storage and recovery: a long-held practice offering a potential tool for climate change adaptation, (b) The drivers: 1) hydrological perturbations related to climate change, 2) water imbalance in both Qand Vbetween wat...

GOALS AND CURRENT RESEARCH OF EPA'S STREAM RESTORATION RESEARCH PROGRAM

EPA Science Inventory

The US EPA is involved in ongoing research on stream and riparian restoration. This presentation is designed to discuss current EPA research efforts, identify key issues in the science and practice of stream restoration, and to help frame a future National Research Council study...

Transforming care: medical practice design and information technology.

PubMed

Kilo, Charles M

2005-01-01

The transformation of the medical practice is possible today because of the advancement of system design knowledge coupled with innovations in information technology (IT). Examples of such transformed care are present today, and they are creating a roadmap for others. Those efforts are also elucidating critical issues in the use of IT to advance health care quality. Connectivity, electronic integration, and knowledge management are the key functionalities emerging as levers to promote this transformation.

Stigma of People with Epilepsy in China: Views of health professionals, teachers, employers and community leaders

PubMed Central

Yang, Rongrong; Wang, Wenzhi; Snape, Dee; Chen, Gong; Zhang, Lei; Wu, Jianzhong; Baker, Gus A; Zheng, Xiaoying; Jacoby, Ann

2011-01-01

To identify the possible sources of stigma of epilepsy in key informant groups, “mini-ethnographic” studies were conducted in rural and urban locations in China. Data from 45 semi-structured interviews and 8 focus group discussions (6 persons each) were analysed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include: Practical Level issues: attitudes to risk, attitudes towards costs of epilepsy; and Cultural Level issues: the contrast between rurality and tradition and urbanization and modernity in the Chinese context. The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice. PMID:21606005

The face, the future, and dental practice: how research in craniofacial biology will influence patient care.

PubMed

Townsend, G C; Brook, A H

2014-06-01

It has been a privilege to assemble a group of Australian and international researchers to produce a special issue of the Australian Dental Journal that reflects the cutting edge of research in different aspects of craniofacial biology, and also considers how these advances will influence future education and practice within dentistry. The aim of this special issue is to provide a collection of concept papers and critical reviews on key topics that cover both fundamental and applied research in craniofacial biology and to consider the clinical implications. To do this, four questions have been addressed that lead to the four sections of this issue. These are: How have we come to the present exciting position in craniofacial biology with breakthroughs over the past 50 years? What are current fundamental research topics that are helping us to understand more about craniofacial and general development, possibly leading to future clinical developments? What are the current applied research topics that will influence future clinical practice? Looking forward, what new developments in craniofacial biology may come about that will change the face of dental education and practice? The refereed papers in this special issue are grouped into the four sections that seek to respond to these demanding questions. © 2014 Australian Dental Association.

Integrating Variable Renewable Energy into the Grid: Key Issues, Greening the Grid (Spanish Version)

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

This is the Spanish version of 'Greening the Grid - Integrating Variable Renewable Energy into the Grid: Key Issues'. To foster sustainable, low-emission development, many countries are establishing ambitious renewable energy targets for their electricity supply. Because solar and wind tend to be more variable and uncertain than conventional sources, meeting these targets will involve changes to power system planning and operations. Grid integration is the practice of developing efficient ways to deliver variable renewable energy (VRE) to the grid. Good integration methods maximize the cost-effectiveness of incorporating VRE into the power system while maintaining or increasing system stability andmore » reliability. When considering grid integration, policy makers, regulators, and system operators consider a variety of issues, which can be organized into four broad topics: New Renewable Energy Generation, New Transmission, Increased System Flexibility, and Planning for a High RE Future.« less

The core competency movement in marriage and family therapy: key considerations from other disciplines.

PubMed

Miller, John K; Todahl, Jeff L; Platt, Jason J

2010-01-01

There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines. Professions such as education, law, and medicine have made strides toward addressing the complex issue of competency standards in their respective fields. This article describes some ways in which the issue of competency has been approached in other professions, as well as some common dilemmas posed by adopting a competency-based orientation, to shed light on the process of defining competency in MFT. Moreover, this article identifies some of the more useful conceptualizations, modes of pedagogy, and evaluative practices found in other professions.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions.

PubMed

Becker, Sara J

2015-03-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.

Practice Parameter for Child and Adolescent Forensic Evaluations

ERIC Educational Resources Information Center

Journal of the American Academy of Child & Adolescent Psychiatry, 2011

2011-01-01

This Parameter addresses the key concepts that differentiate the forensic evaluation of children and adolescents from a clinical assessment. There are ethical issues unique to the forensic evaluation, because the forensic evaluator's duty is to the person, court, or agency requesting the evaluation, rather than to the patient. The forensic…

Aging Family Caregivers: Policies and Practices

ERIC Educational Resources Information Center

Heller, Tamar; Caldwell, Joe; Factor, Alan

2007-01-01

This review examines later life family support for adults with developmental disabilities from a life course perspective that takes into account social trends and changes in service patterns and in attitudes of families. Key issues addressed include: (1) trends affecting family caregiving, (2) health and social outcomes of life-long caregiving,…

Women Surviving an Abusive Relationship: Grief and the Process of Change.

ERIC Educational Resources Information Center

Russell, Bonnie; Uhlemann, Max R.

1994-01-01

Surveys literature regarding women in abusive relationships focusing on key issues related to the change process that are consistent with the grieving process. Examines constructs of depression, guilt, and decision-making difficulty by comparing them within perspective of normal grieving. Discusses implications for counseling practice. Includes 35…

Practical Literacy Matters: Teacher Confidence Is Key

ERIC Educational Resources Information Center

Santamaria, Laura A.; Taylor, Marissa K.; Park, Travis D.; Keene, Barrett L.; van der Mandele, Elizabeth

2010-01-01

Literacy is important to career and technical education (CTE) teachers, who strive to integrate core academic and cognitive skills and knowledge into their classrooms. There is little question that educators need to continually address literacy within CTE. Rather, the issue for many CTE teachers and administrators becomes how to effectively…

Acceptance and Commitment Therapy (ACT): An Overview for Practitioners

ERIC Educational Resources Information Center

Bowden, Tim; Bowden, Sandra

2012-01-01

Acceptance and Commitment Therapy (ACT) offers school counsellors a practical and meaningful approach to helping students deal with a range of issues. This is achieved through encouraging psychological flexibility through the application of six key principles. This article describes our introduction to ACT, ACT's application to children and…

Personalized Instruction: The Key to Student Achievement, Second Edition

ERIC Educational Resources Information Center

Keefe, James W.; Jenkins, John M.

2008-01-01

Personalization of learning and instruction is the most critical issue facing contemporary education--not state testing or vouchers or even aging schools. Personalization is an attempt on the part of a school to take into account individual student characteristics and needs and flexible instructional practices in organizing the learning…

Desiring Development? Psychoanalytic Contributions to Antidevelopmental Psychology

ERIC Educational Resources Information Center

Burman, Erica

2013-01-01

This paper explores how psychoanalytic ideas might support a project of critiquing the developmental paradigm as it influences, and links, models of economic and individual development on which educational policy and practice rely. After outlining the conceptual domain and questions at issue, the paper rereads some key claims about Enlightenment…

Personal and Intergenerational Narratives in Relation to Adolescents' Well-Being

ERIC Educational Resources Information Center

Fivush, Robyn; Bohanek, Jennifer G.; Zaman, Widaad

2011-01-01

Narratives of the self are embedded within families in which narrative interaction is a common practice. Especially in adolescence, when issues of identity and emotional regulation become key, narratives provide frameworks for understating self and emotion. The authors' research on family narratives suggests that adolescents' personal narratives…

Best Practices, Best Thinking, and Emerging Issues in School Leadership.

ERIC Educational Resources Information Center

Owings, William A., Ed.; Kaplan, Leslie S., Ed.

This collection of writings presents leading research and key considerations to assist educational leaders in making decisions about new programs and new directions for their schools. Twenty-six chapters make up the book: (1) "Changing Demographics: A Call for Leadership" (Bud Hodgkinson); (2) "Media and Political Misrepresentation of Public…

Teacher Evaluations in Leisure Studies Programs: An Old Issue with a New Slant.

ERIC Educational Resources Information Center

Butts, Frank B.; Swearingen, Tommy

1994-01-01

This paper examines teacher evaluation practices in leisure studies programs, noting the perceived effectiveness of rating instruments. Surveys of leisure studies professors nationwide indicated many institutions used evaluation instruments and processes that were not statistically validated; key decisions were often made on the basis of these…

Theorising Knowledge Practices: A Missing Piece of the Educational Technology Puzzle

ERIC Educational Resources Information Center

Howard, Sarah; Maton, Karl

2011-01-01

Educational technology research has been characterised as lacking theoretical frameworks that can enable cumulative knowledge-building across the field. This article explores the value of Legitimation Code Theory (LCT) for addressing these issues by discussing research into the key of integration of information and communication technologies in…

Harvard Education Letter. Volume 25, Number 3, May-June 2009

ERIC Educational Resources Information Center

Chauncey, Caroline T., Ed.

2009-01-01

"Harvard Education Letter" is published bimonthly by the Harvard Graduate School of Education. This issue of "Harvard Education Letter" contains the following articles: (1) Improving Teaching and Learning through Instructional Rounds (Lee Teitel); (2) Developmentally Appropriate Practice in the Age of Testing: New Reports Outline Key Principles…

Implementing Positive Behavior Support with Chinese American Families: Enhancing Cultural Competence

ERIC Educational Resources Information Center

Wang, Mian; McCart, Amy; Turnbull, Ann P.

2007-01-01

In positive behavior support (PBS) practices, one critical issue involves helping professionals understand and respect the values of families from culturally diverse backgrounds. This article summarizes embedded cultural values of PBS represented in four key features of the PBS process: collaborative partnerships, functional assessment, contextual…

The Logic of Equity Practice in "Queensland State Education"--2010

ERIC Educational Resources Information Center

Taylor, Sandra; Singh, Parlo

2005-01-01

This paper reports on an interview-based study which explored the implementation of a major policy initiative in Queensland, Australia, with particular attention to social justice issues. Interviews were conducted with key policy actors in three sections of the bureaucracy: strategic directions, performance and measurement; curriculum and…

When Lightning Strikes: Reexamining Creativity in Psychotherapy

ERIC Educational Resources Information Center

Carson, David K.; Becker, Kent W.

2004-01-01

Creativity is paramount to the therapeutic process. This article explored the role of creativity in counseling and psychotherapy through a critical analysis of several key articles in a special issue of The Journal of Clinical Activities, Assignments, & Handouts in Psychotherapy Practice (L. L. Hecker, 2002). Implications for counselors/therapists…

Staff awareness of food and fluid care needs for older people with dementia in residential care: A qualitative study.

PubMed

Lea, Emma J; Goldberg, Lynette R; Price, Andrea D; Tierney, Laura T; McInerney, Fran

2017-12-01

To examine awareness of aged care home staff regarding daily food and fluid care needs of older people with dementia. Older people in residential care frequently are malnourished, and many have dementia. Staff knowledge of the food and fluid needs of people with dementia is limited. Qualitative research on this topic is scarce but can provide insight into how nutrition and hydration care may be improved. Qualitative, interview-based study. Eleven staff in a range of positions at one care home were interviewed regarding their perceptions of current and potential food/fluid care practices. Transcripts were coded and analysed thematically. Key food and fluid issues reported by these staff members were weight loss and malnutrition, chewing and swallowing difficulties (dysphagia), and inadequate hydration. Staff identified a number of current care practices that they felt to be effective in facilitating older people's food and fluid intake, including responsiveness to their needs. Staff suggestions to facilitate food and fluid intake centred on improved composition and timing of meals, enhanced physical and social eating environment, and increased hydration opportunities. Staff commented on factors that may prevent changes to care practices, particularly the part-time workforce, and proposed changes to overcome such barriers. Staff were aware of key food and fluid issues experienced by the older people in their care and of a range of beneficial care practices, but lacked knowledge of many promising care practices and/or how to implement such practices. Staff need to be supported to build on their existing knowledge around effective food and fluid care practices. The numerous ideas staff expressed for changing care practices can be leveraged by facilitating staff networking to work and learn together to implement evidence-based change. © 2017 John Wiley & Sons Ltd.

The architecture of smart surveys: core issues in why and how to collect patient and referring physician satisfaction data.

PubMed

Lexa, Frank J; Berlin, Jonathan W

2009-02-01

Radiology practices are facing challenges on many fronts. As the field becomes more competitive, leaders must pay more attention to the quality of the service that groups provide to their customers. This need is also being driven by higher expectations from customers, particularly patients, who will likely act much more like consumers in the 21st century. For practices to succeed in providing exemplary service, they must pay attention to the voices of their key customer groups. It is dismaying to see practices that are struggling or even dissolving over issues created by poor service. As much as we are experts in imaging, we are unlikely to be able to provide superlative service by reading books, talking among ourselves, or hiring consultants. Rather, we must do what should be obvious, which is to actually ask our customers how we are doing. Surveys are one of the important tools that can be brought to bear on this issue. For many groups, surveying is the starting point for understanding what their patients, referring physicians, and other key stakeholders want. Groups can also find out what customers like and dislike about their experiences, and how groups compare with their competitors. This article provides a guide on how to get off to a good start in designing and deploying surveys that can help optimize the way groups take care of their patients and help their referring physicians.

Contemporary nurse executive practice: one framework, one dozen cautions.

PubMed

Fralic, Maryann F

2010-03-01

How does today's nurse executive function effectively within an incredibly complex health care environment? Does it require different skills, new competencies, new behaviors? Can nurse executives, irrespective of setting, who have always been successful in the past, move forward with the same strategic and operational behaviors? Is there "new work" associated with a new context for executive practice? To answer these questions, this article considers key contemporary issues. Copyright 2010 Elsevier Inc. All rights reserved.

ST-segment monitoring: putting standards into practice.

PubMed

Flanders, Sonya A

2007-01-01

ST-segment monitoring is one key reason that continuous electrocardiographic monitoring is performed in hospitals, and can help with early detection of myocardial ischemia for at-risk patients. Although ST-segment monitoring research, guidelines, and expert consensus statements have been published, ST-segment monitoring has not been implemented in all appropriate clinical areas. The purpose of this article is to present relevant research, review the latest practice standards, and discuss issues important to nurses wishing to implement ST-segment monitoring.

Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses

PubMed Central

Gutmanis, Iris; Beynon, Charlene; Tutty, Leslie; Wathen, C Nadine; MacMillan, Harriet L

2007-01-01

Background Intimate partner violence against women (IPV) has been identified as a serious public health problem. Although the health care system is an important site for identification and intervention, there have been challenges in determining how health care professionals can best address this issue in practice. We surveyed nurses and physicians in 2004 regarding their attitudes and behaviours with respect to IPV, including whether they routinely inquire about IPV, as well as potentially relevant barriers, facilitators, experiential, and practice-related factors. Methods A modified Dillman Tailored Design approach was used to survey 1000 nurses and 1000 physicians by mail in Ontario, Canada. Respondents were randomly selected from professional directories and represented practice areas pre-identified from the literature as those most likely to care for women at the point of initial IPV disclosure: family practice, obstetrics and gynecology, emergency care, maternal/newborn care, and public health. The survey instrument had a case-based scenario followed by 43 questions asking about behaviours and resources specific to woman abuse. Results In total, 931 questionnaires were returned; 597 by nurses (59.7% response rate) and 328 by physicians (32.8% response rate). Overall, 32% of nurses and 42% of physicians reported routinely initiating the topic of IPV in practice. Principal components analysis identified eight constructs related to whether routine inquiry was conducted: preparedness, self-confidence, professional supports, abuse inquiry, practitioner consequences of asking, comfort following disclosure, practitioner lack of control, and practice pressures. Each construct was analyzed according to a number of related issues, including clinician training and experience with woman abuse, area of practice, and type of health care provider. Preparedness emerged as a key construct related to whether respondents routinely initiated the topic of IPV. Conclusion The present study provides new insight into the factors that facilitate and impede clinicians' decisions to address the issue of IPV with their female patients. Inadequate preparation, both educational and experiential, emerged as a key barrier to routine inquiry, as did the importance of the "real world" pressures associated with the daily context of primary care practice. PMID:17250771

Satellite-instrument system engineering best practices and lessons

NASA Astrophysics Data System (ADS)

Schueler, Carl F.

2009-08-01

This paper focuses on system engineering development issues driving satellite remote sensing instrumentation cost and schedule. A key best practice is early assessment of mission and instrumentation requirements priorities driving performance trades among major instrumentation measurements: Radiometry, spatial field of view and image quality, and spectral performance. Key lessons include attention to technology availability and applicability to prioritized requirements, care in applying heritage, approaching fixed-price and cost-plus contracts with appropriate attention to risk, and assessing design options with attention to customer preference as well as design performance, and development cost and schedule. A key element of success either in contract competition or execution is team experience. Perhaps the most crucial aspect of success, however, is thorough requirements analysis and flowdown to specifications driving design performance with sufficient parameter margin to allow for mistakes or oversights - the province of system engineering from design inception to development, test and delivery.

Wheelchair transportation safety on school buses: stakeholder recommendations for priority issues and actions.

PubMed

Buning, Mary Ellen; Karg, Patricia E

2011-01-01

This paper presents results from and provides discussion of a state-of-the-science workshop in which highly informed stakeholders in wheelchair transportation safety for students on school buses were participants. The Nominal Group Technique was used to create a process in which the main issues preventing safe transportation of wheelchair-seated students and key strategies to overcome these issues were identified and ranked. These results, along with a synthesis of group discussion and recommendations for action, are presented along with consideration of current policies, regulations, and political realities. Critical safety shortcomings exist in this highly specialized enterprise that varies from state to state. Recommended strategies include implementing wheelchair requirements in federal transportation safety standards, creation of a clearinghouse for wheelchair transportation best practices and education, creation of national standards for training, practices, and monitoring, and increased "buy-in" to voluntary wheelchair standards by wheelchair manufacturers.

Studying disability and disability studies: shifting paradigms of LDA synthesis of responses to Reid and Valle.

PubMed

Connor, David J

2005-01-01

In this article, I discuss the 11 diverse responses to Reid and Valle's work on the discursive practice of learning disabilities (LD), implications for instruction, and parent-school relations. I highlight key ideas from each article and then focus on three common areas of interest shared by most respondents: the unacceptable status quo of schooling practices; desired changes in schooling practices; and knowledge production in the field of special education and its relation to schooling practices. In light of the many issues raised, I urge the need for a reflective turn in the field of LD and for openness toward diversification of thought.

Development of AACAP practice parameters for gender nonconformity and gender discordance in children and adolescents.

PubMed

Adelson, Stewart L

2011-10-01

The American Academy of Child and Adolescent Psychiatry (AACAP) is preparing a publication, Practice Parameter on Gay, Lesbian or Bisexual Sexual Orientation, Gender-Nonconformity, and Gender Discordance in Children and Adolescents. This article discusses the development of the part of the parameter related to gender nonconformity and gender discordance and describes the practice parameter preparation process,rationale, key scientific evidence, and methodology. Also discussed are terminology considerations, related clinical issues and practice skills, and overall organization of information including influences on gender development, gender role behavior, gender nonconformity and gender discordance, and their relationship to the development of sexual orientation.

Prescriptive authority for advanced practice nurses: current and future perspectives.

PubMed

McDermott, K C

1995-09-01

To present an overview of the issues related to prescriptive authority and advanced practice nurses (APNs) in oncology. Professional journals and books, print media, and professional and government releases. Discussion of issues related to complex political, educational, economic, and healthcare environmental factors. Strategies to achieve increased recognition for APN prescriptive authority include increasing APNs' knowledge about the effects of the political process on prescriptive authority, educating legislators and consumers, promoting standardization of pharmacology curricula, and encouraging formation of coalitions. Failure to pass a national healthcare plan, escalating managed-care markets, and the reform efforts of individual states to forge their own healthcare initiatives will challenge the APN's ability to practice and prescribe. The subject of prescriptive authority highlights the controversies and debates that APNs encounter in a dynamic healthcare environment. These include the complexity of state-to-state regulations, non-nursing professions making key decisions regarding scope of practice and prescriptive authority, and the challenge for APNs to carve out new roles while overcoming state regulatory inconsistencies and market-reform barriers. If not resolved, these issues will continue to prevent qualified APNs from providing appropriate and comprehensive care to patients with cancer.

National cultures, performance appraisal practices, and organizational absenteeism and turnover: a study across 21 countries.

PubMed

Peretz, Hilla; Fried, Yitzhak

2012-03-01

Performance appraisal (PA) is a key human resource activity in organizations. However, in this global economy, we know little about how societal cultures affect PA practices. In this study, we address this gap by focusing on 2 complementary issues: (a) the influence of societal (national) cultural practices on PA practices adopted by organizations and (b) the contribution of the level of congruence between societal cultural practices and the characteristics of organizational PA practices to absenteeism and turnover. The results, based on a large data set across multiple countries and over 2 time periods, support the hypothesized effects of societal (national) cultural practices on particular PA practices and the interactive effects of societal cultural practices and PA practices on absenteeism and turnover. We discuss theoretical and practical implications of our findings.

The Dawning of the Ethics of Environmental Robots.

PubMed

van Wynsberghe, Aimee; Donhauser, Justin

2017-10-23

Environmental scientists and engineers have been exploring research and monitoring applications of robotics, as well as exploring ways of integrating robotics into ecosystems to aid in responses to accelerating environmental, climatic, and biodiversity changes. These emerging applications of robots and other autonomous technologies present novel ethical and practical challenges. Yet, the critical applications of robots for environmental research, engineering, protection and remediation have received next to no attention in the ethics of robotics literature to date. This paper seeks to fill that void, and promote the study of environmental robotics. It provides key resources for further critical examination of the issues environmental robots present by explaining and differentiating the sorts of environmental robotics that exist to date and identifying unique conceptual, ethical, and practical issues they present.

Assessment and E-Learning: Current Issues and Future Trends

ERIC Educational Resources Information Center

Cowie, Neil; Sakui, Keiko

2015-01-01

This paper describes different ways in which digital technology can be used for language learning. It then identifies some key trends connecting assessment and technology in language learning and higher education: the use of automated systems to enhance traditional assessment practices; the use of Web 2.0 tools to facilitate new assessment…

Finding Traction for Social Justice Practices through the Student Teaching Socialization Transition

ERIC Educational Resources Information Center

Morrison, Jennifer D.

2014-01-01

A key issue continuing to plague current educational systems is the intransigent racial and socio-economic achievement gaps for students. Using narrative inquiry and Harré and van Langenhove's (1999) six modes of positioning theory, this study considered preservice teachers' construction of socially just pedagogy within their public school…

Rethinking Professional Standards to Promote Professional Learning

ERIC Educational Resources Information Center

Forde, Christine; McMahon, Margery Anne; Hamilton, Gillian; Murray, Rosa

2016-01-01

This article explores some of the key issues that emerged in the revision of the professional standards in Scottish education. The revision of the professional standards was part of a wider project to build teacher professional learning in ways that had an impact on practice and on pupil learning. The article begins by examining the international…

Identifying Research Priorities for School Improvement in the Developing World

ERIC Educational Resources Information Center

Read, Robyn; Fernandez-Hermosilla, Magdalena; Anderson, Stephen; Mundy, Karen

2016-01-01

This paper discusses a research agenda setting project conducted for an international non-governmental organization which aims to help create a regionally relevant, high-quality knowledge base on key education issues of policy and practice. Specifically, we illustrate how our team adapted the Child Health and Nutrition Research Initiative (CHRNI)…

International Students and American University Culture: Adjustment Issues.

ERIC Educational Resources Information Center

Robinson, Jennifer

This paper discusses two types of adjustments that foreign students face when they encounter university culture in the United States. The central section lists and describes four key groups of underlying principles, values, and practices in American education and discusses the reasons why these may be difficult for foreign students to understand.…

Key Issues in Minority Education. Research Directions and Practical Implications.

ERIC Educational Resources Information Center

Ward, Wanda E., Ed.; Cross, Mary M., Ed.

A collection of 10 papers on minority education is presented, with sections on legal aspects of access for minorities, minority faculty and staff, minority graduate education, and standardized testing in the admission of minority students. Papers are as follows: "The Legal Obligation to Secure Access for Minority Students in Higher Education"…

Soil-profile distribution of organic C and N at the end of 6 years of tillage and grazing management

USDA-ARS?s Scientific Manuscript database

Stocks of soil organic carbon (SOC) and total soil nitrogen (TSN) are key determinants for evaluating agricultural management practices to address climate change, environmental quality, and soil productivity issues. We determined SOC, TSN, and particulate organic C and N depth distributions and cum...

Pedagogical Renewal: Improving the Quality of Classroom Interaction in Nigerian Primary Schools

ERIC Educational Resources Information Center

Hardman, Frank; Abd-Kadir, Jan; Smith, Fay

2008-01-01

This study reports on an investigation of classroom interaction and discourse practices in Nigerian primary schools. Its purpose was to identify key issues affecting patterns of teacher-pupil interaction and discourse as research suggests managing the quality of classroom interaction will play a central role in improving the quality of teaching…

Research Information Management: How the Library Can Contribute to the Campus Conversation

ERIC Educational Resources Information Center

Day, Annette

2018-01-01

This article describes a project undertaken as part of a cross-campus strategic planning effort. The project documented current campus practices and systems in use for collecting, analyzing and reporting key research metrics. The project identified organizational issues around siloed data collection and lack of clarity on data stewards, data…

Empowerment of Women through Education in Twenty First Century

ERIC Educational Resources Information Center

Moradi Sheykhjan, Tohid; Rajeswari, K.; Jabari, Kamran

2014-01-01

This article explores theoretical and practical issues related to the impact of women's education in their empowerment. The development of women's education is discussed in this study. As women's education has become one of the key development objectives in the recent decades, the concept of empowerment has been tied to the range of activities…

Does Government Funding Alter Nonprofit Governance? Evidence from New York City Nonprofit Contractors

ERIC Educational Resources Information Center

O'Regan, Katherine; Oster, Sharon

2002-01-01

Government contracting has raised a collection of issues with respect to adequate oversight and accountability. This paper explores one avenue through which contracting agencies may achieve these tasks: through the governance practices of the contractor's board. Oversight and monitoring are a board's key responsibilities, and influencing a board's…

An Analysis of Communication as a Key Component in Leadership with Diverse School Populations

ERIC Educational Resources Information Center

Cagle, Jo E.; Wiley, Sandy T.

2012-01-01

"Effective Communication as an Essential Element of Leaders with Diverse School Populations" describes a problem based learning project focused on issues related to practices used by principals to address diverse school populations. The team found that communication between principals and diverse populations in schools was a challenge.…

Flexible Learning, Human Resource and Organisational Development: Putting Theory To Work.

ERIC Educational Resources Information Center

Jakupec, Viktor, Ed.; Garrick, John, Ed.

This book addresses contemporary contexts of flexible learning and its practices and provides insights about directions that education and training providers may be required to follow to implement flexible learning in a variety of settings. Key issues and debates include the following: social and economic dimensions of flexible learning and…

Every Child Matters: Every Challenge Met?

ERIC Educational Resources Information Center

Straker, Katherine; Foster, Rob

2009-01-01

This article explores the impact of the Every Child Matters agenda on a group of multi-agency professionals with regard to a number of key issues--such as leadership, multi-agency collaboration, and individual practice. One of the main challenges concerning the successful implementation of the ECM agenda is to ensure that effective training is…

Collaboration, Integration and Change in Children's Services: Critical Issues and Key Ingredients

ERIC Educational Resources Information Center

Horwath, Jan; Morrison, Tony

2007-01-01

Background: Government and state policy, irrespective of jurisdiction, increasingly require and indeed specify the nature of collaboration with regard to the delivery of child welfare services for maltreated children. The rationale for collaboration appears obvious in as much as it is aimed at promoting multidisciplinary practice in order to meet…

Improving the Validity of Quantitative Measures in Applied Linguistics Research

ERIC Educational Resources Information Center

Purpura, James E.; Brown, James Dean; Schoonen, Rob

2015-01-01

In empirical applied linguistics research it is essential that the key variables are operationalized in a valid and reliable way, and that the scores are treated appropriately, allowing for a proper testing of the hypotheses under investigation. The current article addresses several theoretical and practical issues regarding the use of measurement…

Reflections on Practical Approaches to Involving Children and Young People in the Data Analysis Process

ERIC Educational Resources Information Center

Coad, Jane; Evans, Ruth

2008-01-01

This article reflects on key methodological issues emerging from children and young people's involvement in data analysis processes. We outline a pragmatic framework illustrating different approaches to engaging children, using two case studies of children's experiences of participating in data analysis. The article highlights methods of…

Effective Computer-Aided Assessment of Mathematics; Principles, Practice and Results

ERIC Educational Resources Information Center

Greenhow, Martin

2015-01-01

This article outlines some key issues for writing effective computer-aided assessment (CAA) questions in subjects with substantial mathematical or statistical content, especially the importance of control of random parameters and the encoding of wrong methods of solution (mal-rules) commonly used by students. The pros and cons of using CAA and…

Key Issues in the Practice of College Student Personnel: A Commitment to Excellence.

ERIC Educational Resources Information Center

Creamer, Don G.

The first "Student Personnel Point of View" (1937) still stands as the premiere statement of excellence for the student personnel profession. Several propositions are requisites to achieving the goal of development in students. Students, professional staff, and institutions must all achieve their goals. The environment must be…

Microscale Synthesis of Chiral Alcohols via Asymmetric Catalytic Transfer Hydrogenation

ERIC Educational Resources Information Center

Peeters, Christine M.; Deliever, Rik; De Vos, Dirk

2009-01-01

Synthesis of pure enantiomers is a key issue in industry, especially in areas connected to life sciences. Catalytic asymmetric synthesis has emerged as a powerful and practical tool. Here we describe an experiment on racemic reduction and asymmetric reduction via a catalytic hydrogen transfer process. Acetophenone and substituted acetophenones are…

Looking Backwards to Reach Forward: A Strategic Architecture for Professional Development in Music Education

ERIC Educational Resources Information Center

Schmidt, Patrick; Robbins, Janet

2011-01-01

The article analyzes professional development in music education considering the ways in which policy change depends on conditions where renewed practice can become self supporting. The authors situate professional development amid the current politico-educational climate while offering an interpretive framework based on key issues and actions…

Assisting Laid-Off Workers in a Changing Economy. Issue Brief.

ERIC Educational Resources Information Center

National Governors' Association, Washington, DC. Employment and Social Services Policy Studies Div.

Faced with worker displacement stemming from a changing economy, states are acting to soften the economic impact of displacement on affected individuals and businesses. Key strategies and practices are as follows: (1) anticipating layoffs by analyzing economic and labor market trends (using data to anticipate layoffs; developing an early warning…

Ethnic Label Use in Adolescents from Traditional and Non-Traditional Immigrant Communities

ERIC Educational Resources Information Center

Kiang, Lisa; Perreira, Krista M.; Fuligni, Andrew J.

2011-01-01

Understanding adolescents' use of ethnic labels is a key developmental issue, particularly given the practical significance of identity and self-definition in adolescents' lives. Ethnic labeling was examined among adolescents in the traditional immigrant receiving area of Los Angeles (Asian n = 258, Latino n = 279) and the non-traditional…

Debates in Religious Education. The Debates in Subject Teaching Series

ERIC Educational Resources Information Center

Barnes, L. Philip, Ed.

2011-01-01

What are the key debates in Religious Education teaching today? "Debates in Religious Education" explores the major issues all RE teachers encounter in their daily professional lives. It encourages critical reflection and aims to stimulate both novice and experienced teachers to think more deeply about their practice, and link research…

Summoning Spectres: Crises and Their Construction

ERIC Educational Resources Information Center

Clarke, John; Newman, Janet

2010-01-01

The construction of crises is a key analytical and political issue. This paper examines what is at stake in the processes and practices of construction, responding to the arguments made in Andrew Gamble's "The spectres at the feast" (2009). We suggest that there are three areas of critical concern: first, that too little attention has…

Toward Successful School Crisis Intervention: 9 Key Issues

ERIC Educational Resources Information Center

Jaksec, Charles M., III

2007-01-01

Despite their best and frequently heroic efforts, school crisis intervention teams often find themselves unprepared for the many types of tragedies they face. This timely text prompts crisis intervention team members to reevaluate their beliefs and practices and consider a new approach to dealing with school crises. The author, a longtime school…

Digitizing a Cultural Heritage--The Key Issue for Preservation and Electronic Publishing.

ERIC Educational Resources Information Center

Bogen, Manfred; Bonkowski, Christian; Borowski, Marion; Loffler, Jobst

This paper describes a realization approach to evaluate the best fitting service provider in the context of "The Digital Beethoven House" pilot project, involving the digitizing of a composer-referred collection of colored manuscripts and other sources at the Beethoven House Association (Germany). Practical hints for museums are provided…

How Can We Improve School Safety Research?

ERIC Educational Resources Information Center

Astor, Ron Avi; Guerra, Nancy; Van Acker, Richard

2010-01-01

The authors of this article consider how education researchers can improve school violence and school safety research by (a) examining gaps in theoretical, conceptual, and basic research on the phenomena of school violence; (b) reviewing key issues in the design and evaluation of evidence-based practices to prevent school violence; and (c)…

The Fail-Safe Micro Research Paper.

ERIC Educational Resources Information Center

Saunders, Mary Anne

A key element in a research paper writing assignment modified for students of English as a second language to assure their success is teacher control over most of the process. A chronological plan for action for the micro research project includes these steps: creating an awareness of current events and controversial issues, practicing necessary…

Development and Evaluation of Computer-Based Laboratory Practical Learning Tool

ERIC Educational Resources Information Center

Gandole, Y. B.

2006-01-01

Effective evaluation of educational software is a key issue for successful introduction of advanced tools in the curriculum. This paper details to developing and evaluating a tool for computer assisted learning of science laboratory courses. The process was based on the generic instructional system design model. Various categories of educational…

Military Reading Assessment: What Theory Tells Us.

ERIC Educational Resources Information Center

Oxford-Carpenter, Rebecca L.; Schultz-Shiner, Linda J.

This paper addresses practical Army problems in reading assessment from a theory base reflecting the most recent research on reading comprehension. Military and occupational research shows that reading proficiency is related to job performance. Reading assessment is a key issue in the Army due to changes in the reading ability levels of the Army…

Advising on Career Image: Perspectives, Practice and Politics

ERIC Educational Resources Information Center

Yates, Julia; Hooley, Tristram

2018-01-01

This article analyses qualitative data gathered from a survey of career practitioners on the issue of career image (n = 355, 75% female, 89% white and 78% from the UK). Findings reveal three key themes which represent how career image relates to practitioners' values and beliefs, how practitioners make decisions about whether to address the topic…

New Developments in ESP Teaching and Learning Research

ERIC Educational Resources Information Center

Sarré, Cédric, Ed.; Whyte, Shona, Ed.

2017-01-01

This volume intends to address key issues related to research in English for Specific Purposes (ESP) teaching and learning by bringing together current research at the intersection of the theoretical and practical dimensions of ESP. Readers will discover a treasury of information they will find useful to their own understanding of research into…

What Puzzles Teachers in Rio de janeiro, and What Keeps Them Going?

ERIC Educational Resources Information Center

Lyra, Isolina; Fish, Solange; Braga, Walewska Gomes

2003-01-01

Focuses on the key mechanism of "puzzling" in Exploratory Practice (EP), a form of practitioner research, and the critical issue of sustainability in the context of volunteer teacher development work in Rio de Janeiro, Brazil. Investigated puzzles (concerns) of language teachers and grouped them into six categories; motivation, anxiety,…

"What Works": Recommendations on Improving Academic Experiences and Outcomes for Black Males

ERIC Educational Resources Information Center

Howard, Tyrone C.; Douglas, Ty-Ron, M. O.; Warren, Chezare A.

2016-01-01

This brief presents the most significant recommendations based on a review of key findings from research presented in this special issue. The authors offer what they believe to be the most important considerations of what works for improving Black male school achievement in the domains of research, practice, and policy.

Ecological Knowledge Among Communities, Managers and Scientists: Bridging Divergent Perspectives to Improve Forest Management Outcomes

NASA Astrophysics Data System (ADS)

Rist, Lucy; Shackleton, Charlie; Gadamus, Lily; Chapin, F. Stuart; Gowda, C. Made; Setty, Siddappa; Kannan, Ramesh; Shaanker, R. Uma

2016-04-01

Multiple actors are typically involved in forest management, namely communities, managers and researchers. In such cases, suboptimal management outcomes may, in addition to other factors, be symptomatic of a divergence in perspectives among these actors driven by fundamental differences in ecological knowledge. We examine the degree of congruence between the understandings of actors surrounding key issues of management concern in three case studies from tropical, subtropical and boreal forests. We identify commonly encountered points of divergence in ecological knowledge relating to key management processes and issues. We use these to formulate seven hypotheses about differences in the bodies of knowledge that frequently underlie communication and learning failures in forest management contexts where multiple actors are involved and outcomes are judged to be suboptimal. Finally, we present a set of propositions to acknowledge and narrow these differences. A more complete recognition of the full triangulation between all actors involved, and of the influence that fundamental differences in ecological knowledge can exert, may help lead to a more fruitful integration between local knowledge and practice, manager knowledge and practice, and contemporary science in forest management.

The feminist/emotionally focused therapy practice model: an integrated approach for couple therapy.

PubMed

Vatcher, C A; Bogo, M

2001-01-01

Emotionally focused therapy (EFT) is a well-developed, empirically tested practice model for couple therapy that integrates systems, experiential, and attachment theories. Feminist family therapy theory has provided a critique of biased assumptions about gender at play in traditional family therapy practice and the historical absence of discussions of power in family therapy theory. This article presents an integrated feminist/EFT practice model for use in couple therapy, using a case from practice to illustrate key concepts. Broadly, the integrated model addresses gender roles and individual emotional experience using a systemic framework for understanding couple interaction. The model provides practitioners with a sophisticated, comprehensive, and relevant practice approach for working with the issues and challenges emerging for contemporary heterosexual couples.

Large-Eddy Simulation: Current Capabilities, Recommended Practices, and Future Research

NASA Technical Reports Server (NTRS)

Georgiadis, Nicholas J.; Rizzetta, Donald P.; Fureby, Christer

2009-01-01

This paper presents the results of an activity by the Large Eddy Simulation (LES) Working Group of the AIAA Fluid Dynamics Technical Committee to (1) address the current capabilities of LES, (2) outline recommended practices and key considerations for using LES, and (3) identify future research needs to advance the capabilities and reliability of LES for analysis of turbulent flows. To address the current capabilities and future needs, a survey comprised of eleven questions was posed to LES Working Group members to assemble a broad range of perspectives on important topics related to LES. The responses to these survey questions are summarized with the intent not to be a comprehensive dictate on LES, but rather the perspective of one group on some important issues. A list of recommended practices is also provided, which does not treat all aspects of a LES, but provides guidance on some of the key areas that should be considered.

Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation.

PubMed

Malone, J; Guleria, R; Craven, C; Horton, P; Järvinen, H; Mayo, J; O'reilly, G; Picano, E; Remedios, D; Le Heron, J; Rehani, M; Holmberg, O; Czarwinski, R

2012-05-01

The Radiation Protection of Patients Unit of the International Atomic Energy Agency (IAEA) is concerned about the effectiveness of justification of diagnostic medical exposures. Recent published work and the report of an initial IAEA consultation in the area gave grounds for such concerns. There is a significant level of inappropriate usage, and, in some cases, a poor level of awareness of dose and risk among some key groups involved. This article aims to address this. The IAEA convened a second group of experts in November 2008 to review practical and achievable actions that might lead to more effective justification. This report summarises the matters that this group considered and the outcome of their deliberations. There is a need for improved communication, both within professions and between professionals on one hand, and between professionals and the patients/public on the other. Coupled with this, the issue of consent to imaging procedures was revisited. The need for good evidence-based referral guidelines or criteria of acceptability was emphasised, as was the need for their global adaptation and dissemination. Clinical audit was regarded as a key tool in ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice. In summary, justification would be facilitated by the "3 As": awareness, appropriateness and audit.

Teaching professionalism in the digital age on the psychiatric consultation-liaison service.

PubMed

Baer, Wendy; Schwartz, Ann C

2011-01-01

The rapid emergence of social media, including Facebook and YouTube, have added a new dimension to defining, teaching, and role modeling professionalism in the medical field. Explicit and consistent role modeling of professional behaviors are needed to encourage the development of professional physicians. The purpose of this article is to investigate the challenges and opportunities at the interface of professionalism and social media for physicians. The medical literature via PubMed was reviewed with key words including "Facebook," "YouTube," "social media," "digital media," and key issues are discussed. Our residency program was surveyed regarding their experiences with digital media in medical practice and the findings are discussed. Sample topics and relevant, thought provoking questions generated from our practices are outlined. Case vignettes are offered to exemplify issues with regard to professionalism raised by digital and social media in medical practice. Social media sites offer great opportunity to widely distribute valuable health care information as well as provide physicians with a venue to de-stress. In this new digital age, trainees and lifelong learners must learn to be mindful of professionalism while using social media in order to protect their privacy as well as the image of physicians. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Looking Back to the Future: Current Issues Facing Nursing Education From the Reflections of a Member of the Silent Generation.

PubMed

Keating, Sarah B

2016-07-01

As a member of the Silent Generation, the author, through her lived experiences, reflects upon the successes and challenges facing nursing education in the mid-20th to 21st centuries. The author looks "back to the future" and reviews current issues that surround four key nursing education milestones. From the early entry-level baccalaureate programs in the 1950s to the current growth of the Doctor of Nursing Practice as entry into advanced practice, milestones in nursing education are linked to the cultural changes and healthcare system demands that took place at the time and their influence on nursing education and the profession. Looking to the future, the author speaks of the implications from the forecasted changes in the healthcare system that will demand interdisciplinary education and practice and the continued need for nursing research to increase the body of scientific knowledge in practice, education, and technology. Keating. © 2015 Wiley Periodicals, Inc.

Value of community pharmacy residency programs: college of pharmacy and practice site perspectives.

PubMed

Schommer, Jon C; Bonnarens, Joseph K; Brown, Lawrence M; Goode, Jean-Venable Kelly R

2010-01-01

To describe and compare perceptions of key informants representing U.S. colleges/schools of pharmacy and community pharmacy practice sites regarding (1) value associated with community pharmacy residency programs (CPRPs) and (2) barriers to offering CPRPs . Descriptive, non-experimental, cross-sectional study. United States, June 13, 2009, through July 13, 2009. 554 respondents to a Web-based survey. Key informants representing the following four organizational groups were surveyed: (1) colleges/schools of pharmacy participating in CPRPs, (2) colleges/schools of pharmacy not participating in CPRPs, (3) CPRP community pharmacy practice sites, and (4) non-CPRP community pharmacy practice sites. Value of CPRPs to participating pharmacies, value of CPRPs to participating colleges/schools of pharmacy, and barriers to offering CPRPs. Overall, 267 key informants from colleges/schools of pharmacy and 287 key informants from pharmacy practice sites responded to the survey (n = 554 total respondents). Of these, 334 responders provided data that were usable for analysis. The most important types of value to the respondents were altruistic in nature (e.g., pharmacy education development, pharmacy profession development, community engagement). However, barriers to offering CPRPs were more practical and included challenges related to accreditation and operational issues. Further, evidence indicated that (1) lack of leadership, (2) lack of revenue generated from such programs, and (3) the cost of reimbursement for residents may be fundamental, multidimensional barriers to implementing CPRPs. Guidelines for starting and continuing CPRPs, "industry norms" that would require CPRP training for certain types of employment, and creation of models for patient care revenue would help develop and position CPRPs in the future.

A social-ecological systems approach for environmental management.

PubMed

Virapongse, Arika; Brooks, Samantha; Metcalf, Elizabeth Covelli; Zedalis, Morgan; Gosz, Jim; Kliskey, Andrew; Alessa, Lilian

2016-08-01

Urgent environmental issues are testing the limits of current management approaches and pushing demand for innovative approaches that integrate across traditional disciplinary boundaries. Practitioners, scholars, and policy-makers alike call for increased integration of natural and social sciences to develop new approaches that address the range of ecological and societal impacts of modern environmental issues. From a theoretical perspective, social-ecological systems (SES) science offers a compelling approach for improved environmental management through the application of transdisciplinary and resilience concepts. A framework for translating SES theory into practice, however, is lacking. In this paper, we define the key components of an SES-based environmental management approach. We offer recommendations for integrating an SES approach into existing environmental management practices. Results presented are useful for management professionals that seek to employ an SES environmental management approach and scholars aiming to advance the theoretical foundations of SES science for practical application. Published by Elsevier Ltd.

How to write a surgical clinical research protocol: literature review and practical guide.

PubMed

Rosenthal, Rachel; Schäfer, Juliane; Briel, Matthias; Bucher, Heiner C; Oertli, Daniel; Dell-Kuster, Salome

2014-02-01

The study protocol is the core document of every clinical research project. Clinical research in studies involving surgical interventions presents some specific challenges, which need to be accounted for and described in the study protocol. The aim of this review is to provide a practical guide for developing a clinical study protocol for surgical interventions with a focus on methodologic issues. On the basis of an in-depth literature search of methodologic literature and on some cardinal published surgical trials and observational studies, the authors provides a 10-step guide for developing a clinical study protocol in surgery. This practical guide outlines key methodologic issues important when planning an ethically and scientifically sound research project involving surgical interventions, with the ultimate goal of providing high-level evidence relevant for health care decision making in surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions

PubMed Central

Becker, Sara J.

2014-01-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710

Mathematics lecturing in the digital age

NASA Astrophysics Data System (ADS)

Trenholm, Sven; Alcock, Lara; Robinson, Carol L.

2012-09-01

In this article, we consider the transformation of tertiary mathematics lecture practice. We undertake a focused examination of the related research with two goals in mind. First, we document this research, reviewing the findings of key studies and noting that reflective pieces on individual practice as well as surveys are more prevalent than empirical studies. Second, we investigate issues related to the transformation of lecture practice by the emergence of e-lectures. We discuss the latter in terms of claims about the efficiencies offered by new technologies and contrast these with possible disadvantages in terms of student engagement in a learning community. Overall findings indicate that while survey results appear to trumpet the value of e-lecture provision, empirical study results appear to call that value into question. Two explanatory theoretical frameworks are presented. Issues concerning the instructional context (e.g. the nature of mathematical thinking), inherent complexities and recommendations for implementation are discussed.

Methane Storage in Biosilica-Supported Semiclathrates at Ambient Temperature and Pressure

NASA Astrophysics Data System (ADS)

Li, Liang; Wang, Suying; Wang, Weixing

2018-01-01

Two key issues regarding the use of clathrates and semiclathrates for practical gas storage and transport is the pressure-temperature stability of the material and very low formation kinetics. For many practical applications, the avoidance of cooling, gas overpressure, and mechanical mixing would be very desirable. Here, we show that biosilica supports from rice husks greatly enhance gases uptake kinetics in tetra-iso-amyl ammonium bromide semiclathrates without introducing complex mixing technologies. These systems show excellent thermal stability and good recyclability.

An Independent Scientific Assessment of Well Stimulation in California Volume III

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

Jane C.S. Long; Laura C. Feinstein; Birkholzer, Jens

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, issued in July 2015, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, this volume, presents case studies that assess environmental issues and qualitative risks for specificmore » geographic regions. The Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

An Independent Scientific Assessment of Well Stimulation in California Volume II

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

Jane C.S. Long; Laura C. Feinstein; Corinne E. Bachmann

This study is issued in three volumes. Volume I, issued in January 2015, describes how well stimulation technologies work, how and where operators deploy these technologies for oil and gas production in California, and where they might enable production in the future. Volume II, the present volume, discusses how well stimulation could affect water, atmosphere, seismic activity, wildlife and vegetation, and human health. Volume II reviews available data, and identifies knowledge gaps and alternative practices that could avoid or mitigate these possible impacts. Volume III, also issued in July 2015, presents case studies that assess environmental issues and qualitative risksmore » for specific geographic regions. A final Summary Report summarizes key findings, conclusions and recommendations of all three volumes.« less

Industry challenge to best practice risk communication.

PubMed

McEntire, J; Boateng, A

2012-04-01

Effective food safety and food defense risk communication helps to inform consumers without causing panic and alarm. The Risk Communication Team of the Natl. Center for Food Protection and Defense has developed a list of 11 best practices recommended for effective risk communication. These practices, designed for a food defense crisis, are currently applied to food safety issues, since fortunately a food defense crisis has yet to occur. IFT examined the utility of these best practices and the limitations on their use during food safety and food defense crises by academics, trade associations, and the government. It was hypothesized that legal and business considerations as well as the nature of the event would determine the implementation of the best practices. Through the use of focus group meetings, it was discovered that there was a low level of awareness of the best practices. However, stakeholders practiced some aspects of the recommended practices. Participants felt some of the practices were related and could be consolidated. They also agreed that a food defense event will increase the urgency of the communication and include players not typically involved in food safety issues. The challenges reported by the stakeholders varied, but legal liability, as well as the impact their communications could have on an industry, were often cited. From the government perspective, their need to act within their authorities drove some of their actions with respect to communication. Determining the differences in communication limitations during food safety against food defense events can provide key information to further developing and refining risk communications and specific messages targeted for a food defense incident. Effective food safety and food defense risk communication helps to inform consumers without causing panic and alarm. Determining the differences in communication limitations during food safety against food defense events can provide key information to further developing and refining risk communications and specific messages targeted for a food defense incident. © 2012 Institute of Food Technologists®

Denied Access: Using African American Children's Literature to Examine the Anatomy of Social Justice

ERIC Educational Resources Information Center

Stewart, Loraine Moses; Marshall, Jacqueline

2009-01-01

Cynthia Tyson and Sung Choon Park's powerful article, "From Theory to Practice: Teaching for Social Justice," addressed many key points for educators to consider when discussing issues of social justice and injustice. They offered a variety of multicultural children's books and strategies for using them that can be helpful to educators.…

School-Based Physical Activity Interventions: Effectiveness, Trends, Issues, Implications and Recommendations for Practice

ERIC Educational Resources Information Center

Cale, Lorraine; Harris, Jo

2006-01-01

The promotion of physical activity within schools and physical education (PE) has attracted growing interest in recent years. Schools have been acknowledged as the primary institution with responsibility for promoting activity in young people and more specifically, school PE has been recognized as having a key role to play. Given this, and based…

Technology in New York's Classrooms: One Key To Improving Educational Outcomes.

ERIC Educational Resources Information Center

Public Policy Inst., Albany, NY.

This report discusses the potential for computers and other educational technologies to aid in school restructuring in New York State. Issues involved in such a restructuring are examined and include: (1) the need for a common effort in creating a state program; (2) current practices and current realities in the classroom; (3) current uses of such…

Beyond Instruction. Comprehensive Program Planning for Business and Education. Jossey-Bass Business and Management Series.

ERIC Educational Resources Information Center

Rothwell, William J.; Cookson, Peter S.

This book introduces key issues in program planning as practiced in business and educational settings. Two chapters in part 1 introduce two foundational models--Lifelong Education Program Planning (LEPP) model and Contingency-Based Program Planning--and provide background on models designed by Houle, Knowles, Boyle, and Nadler. Parts 2-5 focus on…

Working with Second Language Learners: Answers to Teachers' Top Ten Questions.

ERIC Educational Resources Information Center

Cary, Stephen

This book aims to provide practical, research-informed answers to the questions most frequently asked by teachers of second language learners. Every question targets one of the key instructional issues teachers must address to ensure success for their second language students. Included among the questions are: How do I assess a student's English?…

Computing the Average Square: An Agent-Based Introduction to Aspects of Current Psychometric Practice

ERIC Educational Resources Information Center

Stroup, Walter M.; Hills, Thomas; Carmona, Guadalupe

2011-01-01

This paper summarizes an approach to helping future educators to engage with key issues related to the application of measurement-related statistics to learning and teaching, especially in the contexts of science, mathematics, technology and engineering (STEM) education. The approach we outline has two major elements. First, students are asked to…

Key issues in diagnosing and treating hepatitis C infection.

PubMed

Hainsworth, Terry

A strategy and action plan is in place for the management of hepatitis C. However, recent evidence suggests that this is not being implemented and hepatitis C remains a significant public health concern. This article summarises the condition and potential problems, highlights data from the recent audit of practice and outlines the latest recommendations for managing hepatitis C.

Overview. Good Policy and Practice in HIV & AIDS and Education. Booklet 1

ERIC Educational Resources Information Center

Attawell, Kathy; Elder, Katharine

2006-01-01

This booklet is the first in a series of publications that address key themes of UNESCO's work on HIV & AIDS and the education sector. It provides an overview of why HIV and AIDS are important issues for the education sector, identifies weaknesses in current policy and programming responses, and highlights evidence gaps. Intended mainly for…

Perspectives on Student Development. New Directions for Community Colleges, Number 67.

ERIC Educational Resources Information Center

Deegan, William L., Ed.; O'Banion, Terry, Ed.

1989-01-01

This collection of articles examines the history of student development practices, reviews key issues that have emerged in the field, and proposes paths of action for the future. The volume includes: (1) "Student Development Philosophy: A Perspective on the Past and Future," by Terry O'Banion, which reviews the history of student development; (2)…

On Teaching Abstraction in Computer Science to Novices

ERIC Educational Resources Information Center

Armoni, Michal

2013-01-01

Abstraction is a key concept in CS, one of the most fundamental ideas underlying CS and its practice. However, teaching this soft concept to novices is a very difficult task, as discussed by many CSE experts. This paper discusses this issue, and suggests a general framework for teaching abstraction in CS to novices, a framework that would fit into…

Significance of Marketing Practices for Work Force Preparation. National Marketing Education Research Conference (Key West, Florida, May 19-21, 1995).

ERIC Educational Resources Information Center

University of West Florida, Pensacola.

The following papers are included: "Concepts on Marketing Issues in the Czech Republic" (Anne Mills); "Requiring More of Teacher Preparation: Authentic Assessment as a Vehicle to Reform" (Laura J. Wyant); "A Delphi Study of Professional Competencies for the Secondary Marketing Educator" (Trellys A. Morris); "The…

Competencies of Front-Line Managers in Supported Accommodation: Issues for Practice and Future Research

ERIC Educational Resources Information Center

Clement, Tim; Bigby, Christine

2012-01-01

Background: Front-line managers of supported accommodation for people with intellectual disability are assumed to have a key role in the realisation of outcomes for service users. Yet, their job has been little researched. A job analysis from Minnesota that identified 142 competencies required of effective front-line managers was used to examine…

Effective Consultation in Educational and Child Psychology Practice: Professional Training for Both Competence and Capability

ERIC Educational Resources Information Center

Kennedy, Emma Kate; Cameron, R. J.; Monsen, Jeremy

2009-01-01

How should applied psychology practitioners be prepared to meet an increasingly challenging and unpredictable working context? This article explores some of the key current issues for educational and child psychology practitioners and their professional trainers in the UK with regard to the topic of effective consultation. The article argues that…

Key Issues in an International Clinical Experience for Graduate Students in Education: Implications for Policy and Practice

ERIC Educational Resources Information Center

Gaudino, Ann C.; Moss, David M.; Wilson, Eleanor V.

2012-01-01

This study examines international clinical experiences in England with graduate education students from The University of Connecticut (UConn) and The University of Virginia (UVA) in the United States of America. Limited research available about international clinical experiences in the field of Education focuses primarily to only describe programs…

Qualities of an Effective Successor: the Role of Education and Training

ERIC Educational Resources Information Center

Ibrahim, A.B.; Soufani, K.; Poutziouris, P.; Lam, J.

2004-01-01

Small family firms represent the predominant organizational form in Canada. They are perceived to be crucial to the development and growth of the Canadian economy. Despite this, scant attention is given to the study of human resource management practices in the specialist family business literature. A key human resource issue in family firms,…

Linking Costs and Postsecondary Degrees: Key Issues for Policymakers. Working Paper 2011-03

ERIC Educational Resources Information Center

Johnson, Nate

2011-01-01

In this paper the author offers practical advice for decision-makers who are struggling to rein in college costs while improving productivity. He provides a step-by-step guide to different approaches for calculating costs, highlights the tremendous variability in cost across programs within institutions, and documents some of the "hidden costs" of…

Mapping Trends and Framing Issues in Higher Music Education: Changing Minds/Changing Practices

ERIC Educational Resources Information Center

Minors, Helen Julia; Burnard, Pamela; Wiffen, Charles; Shihabi, Zaina; van der Walt, J. Simon

2017-01-01

This article presents five case studies from within music in higher education programmes that collectively explore key questions concerning how we look at the challenges and trends, and the need for change to react to the recent higher education (HE) climate, through reference to teaching musicians the skills, knowledge and diverse career…

The Development and Implementation of a Teaching and Learning Strategy at a Modern Military Academy

ERIC Educational Resources Information Center

Thain, Richard Holman; McDonough, Ambrose; Priestley, Alan Duncan

2008-01-01

A strategy for teaching and learning was developed at Britannia Royal Naval College during 2006 in order to address several key issues. These included improving professional knowledge and skills retention, enhancing pedagogical practices to increase levels of student motivation, and adapting the training and educational package to an extremely…

Understanding Bullying Behavior: What Educators Should Know and Can Do

ERIC Educational Resources Information Center

Englander, Elizabeth Kandel

2017-01-01

The purpose of this article is to help educators sort through some thorny issues that complicate efforts to understand bullying and cyberbullying, and to suggest practical and realistic ways to address these behaviors effectively. The author starts with a few key points that are often not well understood but can really help clarify everything that…

Dancing with the Web: Students Bring Meaning to the Semantic Web

ERIC Educational Resources Information Center

Brooks, Pauline

2012-01-01

This article will discuss the issues concerning the storage, retrieval and use of multimedia technology in dance, and how semantic web technologies can support those requirements. It will identify the key aims and outcomes of four international telematic dance projects, and review the use of reflective practice to engage students in their learning…

Designing Year 12 Strategy Training in Listening and Writing: From Theory to Practice

ERIC Educational Resources Information Center

Graham, Suzanne; Macaro, Ernesto

2007-01-01

This article outlines some of the key issues involved in developing a programme of strategy training for learners of French, in listening and in writing. It highlights the theoretical perspectives and research findings on listening and writing that informed the selection of strategies to teach learners and thence the development of appropriate…

Using Insider Research in MEd Final Projects to Bridge the Theory/Practice Gap

ERIC Educational Resources Information Center

Arar, Khalid

2018-01-01

This paper aims to identify key issues involved in MEd final project supervision and to highlight the potential of supervision from an academic institution to change educational reality through the postgraduate student-teachers' work-based final project as insider researchers in Israeli schools. It draws on analysis of case-study data from two…

Identifying and Supporting English Learner Students with Learning Disabilities: Key Issues in the Literature and State Practice. REL 2015-086

ERIC Educational Resources Information Center

Burr, Elizabeth; Haas, Eric; Ferriere, Karen

2015-01-01

While the literature on learning disabilities and on second-language acquisition is relatively extensive within the field of education, less is known about the specific characteristics and representation of English learner students with learning disabilities. Because there are no definitive resources and processes for identifying and determining…

Research ethics consultation: ethical and professional practice challenges and recommendations.

PubMed

Sharp, Richard R; Taylor, Holly A; Brinich, Margaret A; Boyle, Mary M; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-05-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical and Translational Science Award Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: (1) managing multiple institutional roles and responsibilities, (2) managing sensitive information, and (3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services.

Developing longitudinal qualitative designs: lessons learned and recommendations for health services research.

PubMed

Calman, Lynn; Brunton, Lisa; Molassiotis, Alex

2013-02-06

Longitudinal qualitative methods are becoming increasingly used in the health service research, but the method and challenges particular to health care settings are not well described in the literature.We reflect on the strategies used in a longitudinal qualitative study to explore the experience of symptoms in cancer patients and their carers, following participants from diagnosis for twelve months; we highlight ethical, practical, theoretical and methodological issues that need to be considered and addressed from the outset of a longitudinal qualitative study. Key considerations in undertaking longitudinal qualitative projects in health research, include the use of theory, utilizing multiple methods of analysis and giving consideration to the practical and ethical issues at an early stage. These can include issues of time and timing; data collection processes; changing the topic guide over time; recruitment considerations; retention of staff; issues around confidentiality; effects of project on staff and patients, and analyzing data within and across time. As longitudinal qualitative methods are becoming increasingly used in health services research, the methodological and practical challenges particular to health care settings need more robust approaches and conceptual improvement. We provide recommendations for the use of such designs. We have a particular focus on cancer patients, so this paper will have particular relevance for researchers interested in chronic and life limiting conditions.

Research Ethics Consultation: Ethical and Professional Practice Challenges and Recommendations

PubMed Central

Sharp, Richard R.; Taylor, Holly A.; Brinich, Margaret A.; Boyle, Mary M.; Cho, Mildred; Coors, Marilyn; Danis, Marion; Havard, Molly; Magnus, David; Wilfond, Benjamin

2015-01-01

The complexity of biomedical research has increased considerably in the last decade, as has the pace of translational research. This complexity has generated a number of novel ethical issues for clinical investigators, institutional review boards (IRBs), and other oversight committees. In response, many academic medical centers have created formal research ethics consultation (REC) services to help clinical investigators and IRBs navigate ethical issues in biomedical research. Key functions of a REC service include: assisting with research design and implementation, providing a forum for deliberative exploration of ethical issues, and supplementing regulatory oversight. As increasing numbers of academic research institutions establish REC services, there is a pressing need for consensus about the primary aims and policies that should guide these activities. Establishing clear expectations about the aims and policies of REC services is important if REC programs are to achieve their full potential. Drawing on the experiences of a Clinical Translational Science Award (CTSA) Research Ethics Consultation Working Group, this article describes three major ethical and professional practice challenges associated with the provision of REC: 1) managing multiple institutional roles and responsibilities, 2) managing sensitive information, and 3) communicating with consultation requestors about how these issues are managed. The paper also presents several practical strategies for addressing these challenges and enhancing the quality of REC services. PMID:25607942

The Practical Implementation of Non-Contacting Laser Strain Measurements Systems

NASA Technical Reports Server (NTRS)

Yunis, Isam; Quinn, roger D.; Kadambi, Jaikrishnan R.

2000-01-01

Measurement of stress and strain in rotating turbomachinery is critical to many industries. The search for a non-contacting, non-interfering, non-degrading measurement system is on going and extensive. While several methods seem promising in theory, implementation has proven troublesome. This work uncovers and quantifies these implementation issues in the context of a laser measurement system. Both a Laser Doppler Velocimeter system and a displacement laser system are utilized. It is found that the key issues are signal to noise ratio, rigid body compensation, measurement location, and conversion of intermittent measurements to a continuous signal. Accounting for these factors leads to successful measurements. These results should lead to better ideas and more practical solutions to the non-contacting, non-degrading, non-interfering strain measurement system problem.

Exploring work-life issues in provincial corrections settings.

PubMed

Almost, Joan; Doran, Diane; Ogilvie, Linda; Miller, Crystal; Kennedy, Shirley; Timmings, Carol; Rose, Don N; Squires, Mae; Lee, Charlotte T; Bookey-Bassett, Sue

2013-01-01

Correctional nurses hold a unique position within the nursing profession as their work environment combines the demands of two systems, corrections and health care. Nurses working within these settings must be constantly aware of security issues while ensuring that quality care is provided. The primary role of nurses in correctional health care underscores the importance of understanding nurses' perceptions about their work. The purpose of this study was to examine the work environment of nurses working in provincial correctional facilities. A mixed-methods design was used. Interviews were conducted with 13 nurses and healthcare managers (HCMs) from five facilities. Surveys were distributed to 511 nurses and HCMs in all provincial facilities across the province of Ontario, Canada. The final sample consisted of 270 nurses and 27 HCMs with completed surveys. Participants identified several key issues in their work environments, including inadequate staffing and heavy workloads, limited control over practice and scope of practice, limited resources, and challenging workplace relationships. Work environment interventions are needed to address these issues and subsequently improve the recruitment and retention of correctional nurses.

Global Nursing Issues and Development: Analysis of World Health Organization Documents.

PubMed

Wong, Frances Kam Yuet; Liu, Huaping; Wang, Hui; Anderson, Debra; Seib, Charrlotte; Molasiotis, Alex

2015-11-01

To analyze World Health Organization (WHO) documents to identify global nursing issues and development. Qualitative content analysis. Documents published by the six WHO regions between 2007 and 2012 and with key words related to nurse/midwife or nursing/midwifery were included. Themes, categories, and subcategories were derived. The final coding reached 80% agreement among three independent coders, and the final coding for the discrepant coding was reached by consensus. Thirty-two documents from the regions of Europe (n = 19), the Americas (n = 6), the Western Pacific (n = 4), Africa (n = 1), the Eastern Mediterranean (n = 1), and Southeast Asia (n = 1) were examined. A total of 385 units of analysis dispersed in 31 subcategories under four themes were derived. The four themes derived (number of unit of analysis, %) were Management & Leadership (206, 53.5), Practice (75, 19.5), Education (70, 18.2), and Research (34, 8.8). The key nursing issues of concern at the global level are workforce, the impacts of nursing in health care, professional status, and education of nurses. International alliances can help advance nursing, but the visibility of nursing in the WHO needs to be strengthened. Organizational leadership is important in order to optimize the use of nursing competence in practice and inform policy makers regarding the value of nursing to promote people's health. © 2015 Sigma Theta Tau International.

An investigation of how university sports team athletic therapists and physical therapists experience ethical issues.

PubMed

Riendeau, Catherine; Parent-Houle, Valérie; Lebel-Gabriel, Marie Eve; Gauvin, Patrick; Liu, Le Yu; Pearson, Isabelle; Hunt, Matthew R

2015-03-01

Qualitative study using interpretive description methodology. The purpose of this study was to better understand how ethical issues are experienced by university sports team athletic therapists and physical therapists. In clinical practice, sports teams are associated with a range of ethical issues. Issues commonly reported in the literature include confidentiality, return-to-play decisions, conflicts of interest, advertising, doping, and use of local anesthetic. To date, there has been limited examination of how athletic therapists and physical therapists involved with sports teams experience these ethical issues, and limited exploration of how these ethical issues, when encountered, are shaped by therapists' professional roles and responsibilities. Semi-structured interviews were conducted with 11 athletic or physical therapists working with sports teams in 5 Canadian provinces. The data were analyzed inductively, using a recursive approach and constant comparative techniques. Four key themes were developed relating to the participants' experiences of ethical issues: establishing and maintaining professional boundaries, striving for respectful and effective collaboration, seeking answers to ethical concerns, and living with the repercussions of challenging decisions. While many ethical issues reported by participants resemble those faced by sports medicine physicians, they are experienced in distinctive ways, due to differences in professional roles and identities. Issues concerning professional boundaries were also more prominent for the study participants than the literature has reported them to be for sports medicine physicians. Effective communication and enhanced collaboration appear to be key elements in managing these ethical challenges.

The persistence and challenges of homebirths: perspectives of traditional birth attendants in urban Kenya.

PubMed

Izugbara, Chimaraoke; Ezeh, Alex; Fotso, Jean-Christophe

2009-01-01

Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants' (TBAs) accounts of the persistence of homebirths and the key challenges they present. TBAs associated the continued demand for homebirths with the wide-ranging character and quality of their services. They did not consider their lack of formal training on matters of pregnancy and birthing to be a particular challenge to their work. Rather, they identified the non-cooperative and disrespectful attitudes of their counterparts in hospital settings as the most important issue. Further efforts are needed to make TBAs realize how much better their services could become if they adopted more modern ways of assisting in deliveries, unlearnt their belief in the superiority of their particular type of practice, and understood how their lack of formal training is a key issue.

When trust defies common security sense.

PubMed

Williams, Patricia A H

2008-09-01

Primary care medical practices fail to recognize the seriousness of security threats to their patient and practice information. This can be attributed to a lack of understanding of security concepts, underestimation of potential threats and the difficulty in configuration of security technology countermeasures. To appreciate the factors contributing to such problems, research into general practitioner security practice and perceptions of security was undertaken. The investigation focused on demographics, actual practice, issues and barriers, and practitioner perception. Poor implementation, lack of relevant knowledge and inconsistencies between principles and practice were identified as key themes. Also the results revealed an overwhelming reliance on trust in staff and in computer information systems. This clearly identified that both cultural and technical attributes contribute to the deficiencies in information security practice. The aim of this research is to understand user needs and problems when dealing with information security practice.

[Clinical ethics consultation - an integrative model for practice and reflection].

PubMed

Reiter-Theil, Stella

2008-07-01

Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

Current issues in diagnostic breast pathology.

PubMed

Walker, Rosemary A; Hanby, Andy; Pinder, Sarah E; Thomas, Jeremy; Ellis, Ian O

2012-09-01

On behalf of the NHS Breast Screening Programme Pathology Coordinating Group we present recommendations for terminology and diagnostic criteria for a number of key areas of practice in breast pathology where terminology can be confusing and where accurate communication will ensure appropriate clinical management. These recommendations cover columnar cell lesions and the spectrum of changes that can be seen in these epithelial proliferations, lobular neoplasia, micrometastases and isolated tumour cells in axillary lymph nodes, the use of basal/myoepithelial markers in diagnostic practice and oestrogen receptor testing in ductal carcinoma in situ.

Theory and Theorizing in Nursing Science: Commentary from the Nursing Research Special Issue Editorial Team.

PubMed

Jairath, Nalini N; Peden-McAlpine, Cynthia J; Sullivan, Mary C; Vessey, Judith A; Henly, Susan J

Articles from three landmark symposia on theory for nursing-published in Nursing Research in 1968-1969-served as a key underpinning for the development of nursing as an academic discipline. The current special issue on Theory and Theorizing in Nursing Science celebrates the 50th anniversary of publication of these seminal works in nursing theory. The purpose of this commentary is to consider the future of nursing theory development in light of articles published in the anniversary issue. The Editorial Team for the special issue identified core questions about continued nursing theory development, as related to the nursing metaparadigm, practice theory, big data, and doctoral education. Using a dialogue format, the editors discussed these core questions. The classic nursing metaparadigm (health, person, environment, nursing) was viewed as a continuing unifying element for the discipline but is in need of revision in today's scientific and practice climates. Practice theory and precision healthcare jointly arise from an emphasis on individualization. Big data and the methods of e-science are challenging the assumptions on which nursing theory development was originally based. Doctoral education for nursing scholarship requires changes to ensure that tomorrow's scholars are prepared to steward the discipline by advancing (not reifying) past approaches to nursing theory. Ongoing reexamination of theory is needed to clarify the domain of nursing, guide nursing science and practice, and direct and communicate the unique and essential contributions of nursing science to the broader health research effort and of nursing to healthcare.

Suicide prevention in primary care: General practitioners' views on service availability

PubMed Central

2010-01-01

Background Primary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision. Findings During the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care services Conclusions Health professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care. PMID:20920302

Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation

PubMed Central

Malone, J; Guleria, R; Craven, C; Horton, P; Järvinen, H; Mayo, J; O’reilly, G; Picano, E; Remedios, D; Le Heron, J; Rehani, M; Holmberg, O; Czarwinski, R

2012-01-01

Objectives The Radiation Protection of Patients Unit of the International Atomic Energy Agency (IAEA) is concerned about the effectiveness of justification of diagnostic medical exposures. Recent published work and the report of an initial IAEA consultation in the area gave grounds for such concerns. There is a significant level of inappropriate usage, and, in some cases, a poor level of awareness of dose and risk among some key groups involved. This article aims to address this. Methods The IAEA convened a second group of experts in November 2008 to review practical and achievable actions that might lead to more effective justification. Results This report summarises the matters that this group considered and the outcome of their deliberations. There is a need for improved communication, both within professions and between professionals on one hand, and between professionals and the patients/public on the other. Coupled with this, the issue of consent to imaging procedures was revisited. The need for good evidence-based referral guidelines or criteria of acceptability was emphasised, as was the need for their global adaptation and dissemination. Conclusion Clinical audit was regarded as a key tool in ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice. In summary, justification would be facilitated by the “3 As”: awareness, appropriateness and audit. PMID:21343316

Framing the issues: moral distress in health care.

PubMed

Pauly, Bernadette M; Varcoe, Colleen; Storch, Jan

2012-03-01

Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care.

Research challenges in municipal solid waste logistics management.

PubMed

Bing, Xiaoyun; Bloemhof, Jacqueline M; Ramos, Tania Rodrigues Pereira; Barbosa-Povoa, Ana Paula; Wong, Chee Yew; van der Vorst, Jack G A J

2016-02-01

During the last two decades, EU legislation has put increasing pressure on member countries to achieve specified recycling targets for municipal household waste. These targets can be obtained in various ways choosing collection methods, separation methods, decentral or central logistic systems, etc. This paper compares municipal solid waste (MSW) management practices in various EU countries to identify the characteristics and key issues from a waste management and reverse logistics point of view. Further, we investigate literature on modelling municipal solid waste logistics in general. Comparing issues addressed in literature with the identified issues in practice result in a research agenda for modelling municipal solid waste logistics in Europe. We conclude that waste recycling is a multi-disciplinary problem that needs to be considered at different decision levels simultaneously. A holistic view and taking into account the characteristics of different waste types are necessary when modelling a reverse supply chain for MSW recycling. Copyright © 2015 Elsevier Ltd. All rights reserved.

Representations of Linguistic and Ethnocultural Diversity in Poland's Education Policy, National School Curricula and Textbooks

ERIC Educational Resources Information Center

Kowalski, Ewa

2008-01-01

With its recent entry into the European Union (EU) and the adoption of multiethnic democracy as a national policy, a key challenge for Poland is to transform its education policy and practice in ways that are consistent with multicultural and pluralist values. This paper examines Poland's efforts to address these issues by exploring changes in the…

Developing and Establishing School-Based Sexual Health Services: Issues for School Nursing Practice

ERIC Educational Resources Information Center

Hayter, Mark; Owen, Jenny; Cooke, Jo

2012-01-01

School-based sexual health clinics are emerging as one of the key ways to promote sexual health among young people, and school nurses play an important role in developing and delivering these services. This study used a qualitative design to explore the experiences of health professionals and policy makers involved in setting up such services in…

Opening a Gateway to College Access: Algebra at the Right Time. Research Brief

ERIC Educational Resources Information Center

Snipes, Jason; Finkelstein, Neal

2015-01-01

Four years of math in high school, with a strong foundation in algebra that builds from middle school, is key to higher education access. Therefore, ensuring that middle and high school students succeed in math--and in algebra in particular--is an important issue for policy and practice. This research brief examines three recent Regional…

Research Trends in Mobile Learning in Higher Education: A Systematic Review of Articles (2011-2015)

ERIC Educational Resources Information Center

Krull, Greig; Duart, Josep M.

2017-01-01

The potential and use of mobile devices in higher education has been a key issue for educational research and practice since the widespread adoption of these devices. Due to the evolving nature and affordances of mobile technologies, it is an area that requires ongoing investigation. This study aims to identify emerging trends in mobile learning…

A Framework for K-12 Science Education: Practices, Crosscutting Concepts, and Core Ideas

ERIC Educational Resources Information Center

National Academies Press, 2012

2012-01-01

Science, engineering, and technology permeate nearly every facet of modern life and hold the key to solving many of humanity's most pressing current and future challenges. The United States' position in the global economy is declining, in part because U.S. workers lack fundamental knowledge in these fields. To address the critical issues of U.S.…

Strategies for integrating computer-based activities into your educational environment: a practical guide.

PubMed Central

Miller, J G; Wolf, F M

1996-01-01

Strategies for implementing instructional technology are based on recent experiences at the University of Michigan Medical Center. The issues covered include 1) addressing facilities, hardware, and staffing needs, 2) determining learners' skill requirements and appropriate training activities, and 3) selecting and customizing educational software. Many examples are provided, and nine key points for success are emphasized. PMID:8653447

APA Summit on Medical Student Education Task Force on Informatics and Technology: Learning about Computers and Applying Computer Technology to Education and Practice

ERIC Educational Resources Information Center

Hilty, Donald M.; Hales, Deborah J.; Briscoe, Greg; Benjamin, Sheldon; Boland, Robert J.; Luo, John S.; Chan, Carlyle H.; Kennedy, Robert S.; Karlinsky, Harry; Gordon, Daniel B.; Yager, Joel; Yellowlees, Peter M.

2006-01-01

Objective: This article provides a brief overview of important issues for educators regarding medical education and technology. Methods: The literature describes key concepts, prototypical technology tools, and model programs. A work group of psychiatric educators was convened three times by phone conference to discuss the literature. Findings…

Some Key Issues in Creating Inquiry-Based Instructional Practices that Aim at the Understanding of Simple Electric Circuits

ERIC Educational Resources Information Center

Kock, Zeger-Jan; Taconis, Ruurd; Bolhuis, Sanneke; Gravemeijer, Koeno

2013-01-01

Many students in secondary schools consider the sciences difficult and unattractive. This applies to physics in particular, a subject in which students attempt to learn and understand numerous theoretical concepts, often without much success. A case in point is the understanding of the concepts current, voltage and resistance in simple electric…

Toward Ubiquitous BCIs

NASA Astrophysics Data System (ADS)

Allison, Brendan Z.

The preceding chapters in this book described modern BCI systems. This concluding chapter instead discusses future directions. While there are some specific predictions, I mainly analyze key factors and trends relating to practical mainstream BCI development. While I note some disruptive technologies that could dramatically change BCIs, this chapter focuses mainly on realistic, incremental progress and how progress could affect user groups and ethical issues.

Some Reflections on "Going beyond the Consensus View" of the Nature of Science in K-12 Science Education

ERIC Educational Resources Information Center

Berkovitz, Joseph

2017-01-01

Hodson and Wong (2017, this issue) argue that, though the nature of science (NOS) is now an established focus of school science education and a key element in defining scientific literacy, "the consensus view" of NOS misrepresents contemporary scientific practice. They then propose a number of alternative approaches to science curriculum…

Educating (More and More) Students Experiencing Homelessness: An Analysis of Recession-Era Policy and Practice

ERIC Educational Resources Information Center

Miller, Peter M.

2013-01-01

Rates of student homelessness have increased dramatically throughout the United States in recent years, yet there has been a dearth of scholarly analysis devoted to key organizations' engagement of the issue. Given that the federal McKinney-Vento Homeless Assistance Act has taken on a central, but underexamined role in shaping this engagement,…

Adult Education as a Human Right: The Latin American Context and the Ecopedagogic Perspective

ERIC Educational Resources Information Center

Gadotti, Moacir

2011-01-01

This article presents the concept and practice of adult education as a key issue for Brazil and other Latin American countries, both for formal and non-formal education in the public and private sectors. It includes citizen education focused on democratisation of society and sustainable development. The concept is pluralist and ideological as well…

"What Do I Teach for 90 Minutes?" Creating a Successful Block-Scheduled English Classroom.

ERIC Educational Resources Information Center

Porter, Carol

The story of the process that Mundelein High School (located in a northwest suburb of Chicago, Illinois) as it moved from a traditional schedule to a block schedule is described throughout this book as a way to blend theory with practice. The book addresses types of block schedules; key issues for effective preparation; professional development…

Best Practice Irrigation Management and Extension in Peri-Urban Landscapes--Experiences and Insights from the Hawkesbury-Nepean Catchment, Australia

ERIC Educational Resources Information Center

Maheshwari, B. L.; Plunkett, M.

2015-01-01

Purpose: The aim of this article to examine key irrigation management issues and their implications for future research and extension developments. Design/Methodology/Approach: Peri-urban landscapes are important as they supply fresh fruit, vegetables, turf, ornamental plants and other farm products to the cities. In this study, the…

Constructing a New KS3 Curriculum at Brooke Weston CTC: A Review and Commentary

ERIC Educational Resources Information Center

Campbell, Andrew; Kerry, Trevor

2004-01-01

This paper reviews changes to the key stage 3 curriculum at a leading comprehensive school. The nature and practical concerns of the changes are described. These move beyond a fresh approach to content; they include issues about engaging students actively in learning for the future, planning around the school's distinctive ethos and expertise in…

Diagnosis and predictive molecular analysis of non-small-cell lung cancer in the Africa-Middle East region: challenges and strategies for improvement.

PubMed

Slavik, Tomas; Asselah, Fatima; Fakhruddin, Najla; El Khodary, Ahmed; Torjman, Fairouz; Anis, Elia; Quinn, Martin; Khankan, Azzam; Kerr, Keith M

2014-11-01

The identification of tumor biomarkers provides information on the prognosis and guides the implementation of appropriate treatment in patients with many different cancer types. In non-small cell lung cancer (NSCLC), targeted treatment plans based on biomarker identification have already been used in the clinic. However, such predictive molecular testing is not currently a universally used practice. This is the case, in particular, in developing countries where lung cancer is increasingly prevalent. In September 2012 and November 2013, a committee of 16 lung cancer experts from Africa and the Middle East met to discuss key issues related to diagnosis and biomarker testing in NSCLC and the implementation of personalized medicine in the region. The committee identified current challenges for effective diagnosis and predictive analysis in Africa and the Middle East. Moreover, strategies to encourage the implementation of biomarker testing were discussed. A practical approach for the effective diagnosis and predictive molecular testing of NSCLC in these regions was derived. We present the key issues and recommendations arising from the meetings. Copyright © 2014 Elsevier Inc. All rights reserved.

Making communities safer from crime: An undervalued element in impact assessment

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

Glasson, John, E-mail: jglasson@brookes.ac.u; Curtin University, Perth; Cozens, Paul

Crime and safety are significant issues for individuals, communities and businesses but they have tended to be undervalued elements in the consideration of social impacts in impact assessment theory and practice. It has been argued that crime is a form of pollution and an externality of development. In principle, the precautionary impact assessment family of approaches should be very useful here. The paper explores first the coverage of crime and safety issues in both the longer history of EIA, followed by the much shorter history of SEA and Sustainability Appraisal (SA). It then considers several key issues for advancing bettermore » practice. These include: the recognition of the lifecycles of projects and plans and the relevant dimensions of the local safety and crime baseline; the need to employ meaningful data, including 'fear of crime' considerations; and the consideration of innovative approaches to the use of indicators. Evidence and theories from the field of environmental criminology are presented as crucial to understanding crime and its association with land-use. The paper concludes with an exploration of appropriate mitigation measures for anticipating and designing out crime. Examples draw in particular on evolving practice in the UK and Australia.« less

From theory to 'measurement' in complex interventions: methodological lessons from the development of an e-health normalisation instrument.

PubMed

Finch, Tracy L; Mair, Frances S; O'Donnell, Catherine; Murray, Elizabeth; May, Carl R

2012-05-17

Although empirical and theoretical understanding of processes of implementation in health care is advancing, translation of theory into structured measures that capture the complex interplay between interventions, individuals and context remain limited. This paper aimed to (1) describe the process and outcome of a project to develop a theory-based instrument for measuring implementation processes relating to e-health interventions; and (2) identify key issues and methodological challenges for advancing work in this field. A 30-item instrument (Technology Adoption Readiness Scale (TARS)) for measuring normalisation processes in the context of e-health service interventions was developed on the basis on Normalization Process Theory (NPT). NPT focuses on how new practices become routinely embedded within social contexts. The instrument was pre-tested in two health care settings in which e-health (electronic facilitation of healthcare decision-making and practice) was used by health care professionals. The developed instrument was pre-tested in two professional samples (N=46; N=231). Ratings of items representing normalisation 'processes' were significantly related to staff members' perceptions of whether or not e-health had become 'routine'. Key methodological challenges are discussed in relation to: translating multi-component theoretical constructs into simple questions; developing and choosing appropriate outcome measures; conducting multiple-stakeholder assessments; instrument and question framing; and more general issues for instrument development in practice contexts. To develop theory-derived measures of implementation process for progressing research in this field, four key recommendations are made relating to (1) greater attention to underlying theoretical assumptions and extent of translation work required; (2) the need for appropriate but flexible approaches to outcomes measurement; (3) representation of multiple perspectives and collaborative nature of work; and (4) emphasis on generic measurement approaches that can be flexibly tailored to particular contexts of study.

Conference on "Multidisciplinary approaches to nutritional problems". Symposium on "Performance, exercise and health". Practical aspects of nutrition in performance.

PubMed

Gilbert, Nicky

2009-02-01

The importance of nutrition in sport has been recognised since the ancient Olympians, and its role in improving both health and sports performance has widespread acceptance. However, in sporting circles nutritional knowledge, beliefs and practices are extremely varied. Within any sporting organisation the sports dietitian or nutritionist must be able to work with athletes, their family, coaches and other support staff to develop and monitor realistic and practical strategies that work best for each performer, contributing to a positive and sustained outcome on performance. The present review examines the practical application of current key issues in performance nutrition, highlighting the advantages of early intervention in youth development and comprehensive and integrated nutrition services.

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review

PubMed Central

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors’ (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care. PMID:26257520

Ongoing ethical issues concerning authorship in biomedical journals: an integrative review.

PubMed

Kornhaber, Rachel Anne; McLean, Loyola M; Baber, Rodney J

2015-01-01

Health professionals publishing within the field of health sciences continue to experience issues concerning appropriate authorship, which have clinical, ethical, and academic implications. This integrative review sought to explore the key issues concerning authorship from a bioethical standpoint, aiming to explore the key features of the authorship debate. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases of peer-reviewed research, published between 2009 and 2014, limited to English language research, with search terms developed to reflect the current issues of authorship. From among the 279 papers identified, 20 research papers met the inclusion criteria. Findings were compiled and then arranged to identify themes and relationships. The review incorporated a wide range of authorship issues encompassing equal-credited authors, honorary (guest/gift) and ghost authorship, perception/experiences of authorship, and guidelines/policies. This review suggests that the International Committee of Medical Journal Editors' (ICMJE) recommended guidelines for authorship are not reflected in current authorship practices within the domain of health sciences in both low-and high-impact-factor journals. This devaluing of the true importance of authorship has the potential to affect the validity of authorship, diminish the real contributions of the true authors, and negatively affect patient care.

Psychometrics in action, science as practice.

PubMed

Pearce, Jacob

2017-07-27

Practitioners in health sciences education and assessment regularly use a range of psychometric techniques to analyse data, evaluate models, and make crucial progression decisions regarding student learning. However, a recent editorial entitled "Is Psychometrics Science?" highlighted some core epistemological and practical problems in psychometrics, and brought its legitimacy into question. This paper attempts to address these issues by applying some key ideas from history and philosophy of science (HPS) discourse. I present some of the conceptual developments in HPS that have bearing on the psychometrics debate. Next, by shifting the focus onto what constitutes the practice of science, I discuss psychometrics in action. Some incorrectly conceptualize science as an assemblage of truths, rather than an assemblage of tools and goals. Psychometrics, however, seems to be an assemblage of methods and techniques. Psychometrics in action represents a range of practices using specific tools in specific contexts. This does not render the practice of psychometrics meaningless or futile. Engaging in debates about whether or not we should regard psychometrics as 'scientific' is, however, a fruitless enterprise. The key question and focus should be whether, on what grounds, and in what contexts, the existing methods and techniques used by psychometricians can be justified or criticized.

Global quality imaging: emerging issues.

PubMed

Lau, Lawrence S; Pérez, Maria R; Applegate, Kimberly E; Rehani, Madan M; Ringertz, Hans G; George, Robert

2011-07-01

Quality imaging may be described as "a timely access to and delivery of integrated and appropriate procedures, in a safe and responsive practice, and a prompt delivery of an accurately interpreted report by capable personnel in an efficient, effective, and sustainable manner." For this article, radiation safety is considered as one of the key quality elements. The stakeholders are the drivers of quality imaging. These include those that directly provide or use imaging procedures and others indirectly supporting the system. Imaging is indispensable in health care, and its use has greatly expanded worldwide. Globalization, consumer sophistication, communication and technological advances, corporatization, rationalization, service outsourcing, teleradiology, workflow modularization, and commoditization are reshaping practice. This article defines the emerging issues; an earlier article in the May 2011 issue described possible improvement actions. The issues that could threaten the quality use of imaging for all countries include workforce shortage; increased utilization, population radiation exposure, and cost; practice changes; and efficiency drive and budget constraints. In response to these issues, a range of quality improvement measures, strategies, and actions are used to maximize the benefits and minimize the risks. The 3 measures are procedure justification, optimization of image quality and radiation protection, and error prevention. The development and successful implementation of such improvement actions require leadership, collaboration, and the active participation of all stakeholders to achieve the best outcomes that we all advocate. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Why eyewitnesses fail

PubMed Central

Albright, Thomas D.

2017-01-01

Eyewitness identifications play an important role in the investigation and prosecution of crimes, but it is well known that eyewitnesses make mistakes, often with serious consequences. In light of these concerns, the National Academy of Sciences recently convened a panel of experts to undertake a comprehensive study of current practice and use of eyewitness testimony, with an eye toward understanding why identification errors occur and what can be done to prevent them. The work of this committee led to key findings and recommendations for reform, detailed in a consensus report entitled Identifying the Culprit: Assessing Eyewitness Identification. In this review, I focus on the scientific issues that emerged from this study, along with brief discussions of how these issues led to specific recommendations for additional research, best practices for law enforcement, and use of eyewitness evidence by the courts. PMID:28739937

Accounting for Parcel-Allocation Variability in Practice: Combining Sources of Uncertainty and Choosing the Number of Allocations.

PubMed

Sterba, Sonya K; Rights, Jason D

2016-01-01

Item parceling remains widely used under conditions that can lead to parcel-allocation variability in results. Hence, researchers may be interested in quantifying and accounting for parcel-allocation variability within sample. To do so in practice, three key issues need to be addressed. First, how can we combine sources of uncertainty arising from sampling variability and parcel-allocation variability when drawing inferences about parameters in structural equation models? Second, on what basis can we choose the number of repeated item-to-parcel allocations within sample? Third, how can we diagnose and report proportions of total variability per estimate arising due to parcel-allocation variability versus sampling variability? This article addresses these three methodological issues. Developments are illustrated using simulated and empirical examples, and software for implementing them is provided.

Market mature 1998 hybrid electric vehicles

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

Wyczalek, F.A.

Beginning in 1990, the major automotive passenger vehicle manufacturers once again re-evaluated the potential of the battery powered electric vehicle (EV). This intensive effort to reduce the battery EV to commercial practice focused attention on the key issue of limited vehicle range, resulting from the low energy density and high mass characteristics of batteries, in comparison to the high energy density of liquid hydrocarbon (HC) fuels. Consequently, by 1995, vehicle manufacturers turned their attention to hybrid electric vehicles (HEV). This redirection of EV effort was highlighted finally, in 1997, at the 57th Frankfurt Motor Show, the Audi Duo parallel typemore » hybrid was released for the domestic market as a 1998 model vehicle. Also at the 1997 32nd Tokyo Motor Show, the Toyota Hybrid System (THS) Prius was released for the domestic market as a 1998 model vehicle. This paper presents a comparative analysis of the key features of these two 1998 model year production hybrid propulsion systems. Among the conclusions, two issues are evident: one, the major manufacturers have turned to the hybrid concept in their search for solutions to the key EV issues of limited range and heating/air conditioning; and, two, the focus is now on introducing hybrid EV for test marketing domestically.« less

Journal of Air Transportation World Wide, Volume 2, No. 1. Volume 2

NASA Technical Reports Server (NTRS)

Bowen, Brent (Editor)

1997-01-01

The Journal of Air Transportation World Wide's (JATWW) mission is to provide the global community immediate key resource information in all areas of air transportation. Our goal is to be recognized as the preeminent scholarly journal in the aeronautical aspects of transportation. As an international and interdisciplinary journal, the JATWW will provide a forum for peer-reviewed articles in all areas of aviation and space transportation research, policy, theory, case study, practice, and issues. While maintaining a broad scope, a key focal point of the journal will be in the area of aviation administration and policy.

Evaluating the use of key performance indicators to evidence the patient experience.

PubMed

McCance, Tanya; Hastings, Jack; Dowler, Hilda

2015-11-01

To test eight person-centred key performance indicators and the feasibility of an appropriate measurement framework as an approach to evidencing the patient experience. The value of measuring the quality of patient care is undisputed in the international literature, however, the type of measures that can be used to generate data that is meaningful for practice continues to be debated. This paper offers a different perspective to the 'measurement' of the nursing and midwifery contribution to the patient experience. Fourth generation evaluation was the methodological approach used to evaluate the implementation of the key performance indicators and measurement framework across three participating organisations involving nine practice settings. Data were collected by repeated use of claims, concerns and issues with staff working across nine participating sites (n = 18) and the senior executives from the three partner organisations (n = 12). Data were collected during the facilitated sessions with stakeholders and analysed in conjunction with the data generated from the measurement framework. The data reveal the inherent value placed on the evidence generated from the implementation of the key performance indicators as reflected in the following themes: measuring what matters; evidencing the patient experience; engaging staff; a focus for improving practice; and articulating and demonstrating the positive contribution of nursing and midwifery. The implementation of the key performance indicators and the measurement framework has been effective in generating evidence that demonstrates the patient experience. The nature of the data generated not only privileges the patient voice but also offers feedback to nurses and midwives that can inform the development of person-centred cultures. The use of these indicators will produce evidence of patient experience that can be used by nurse and midwives to celebrate and further inform person-centred practice. © 2015 John Wiley & Sons Ltd.

Building Acoustics

NASA Astrophysics Data System (ADS)

Cowan, James

This chapter summarizes and explains key concepts of building acoustics. These issues include the behavior of sound waves in rooms, the most commonly used rating systems for sound and sound control in buildings, the most common noise sources found in buildings, practical noise control methods for these sources, and the specific topic of office acoustics. Common noise issues for multi-dwelling units can be derived from most of the sections of this chapter. Books can be and have been written on each of these topics, so the purpose of this chapter is to summarize this information and provide appropriate resources for further exploration of each topic.

Development of a practice tool for community-based nurses: the Heart Failure Palliative Approach to Care (HeFPAC).

PubMed

Strachan, Patricia H; Joy, Cathy; Costigan, Jeannine; Carter, Nancy

2014-04-01

Patients living with advanced heart failure (HF) require a palliative approach to reduce suffering. Nurses have described significant knowledge gaps about the disease-specific palliative care (PC) needs of these patients. An intervention is required to facilitate appropriate end-of-life care for HF patients. The purpose of this study was to develop a user-friendly, evidence-informed HF-specific practice tool for community-based nurses to facilitate care and communication regarding a palliative approach to HF care. Guided by the Knowledge to Action framework, we identified key HF-specific issues related to advanced HF care provision within the context of a palliative approach to care. Informed by current evidence and subsequent iterative consultation with community-based and specialist PC and HF nurses, a pocket guide tool for community-based nurses was created. We developed the Heart Failure Palliative Approach to Care (HeFPAC) pocket guide to promote communication and a palliative approach to care for HF patients. The HeFPAC has potential to improve the quality of care and experiences for patients with advanced HF. It will be piloted in community-based practice and in a continuing education program for nurses. The HeFPAC pocket guide offers PC nurses a concise, evidence-informed and practical point-of care tool to communicate with other clinicians and patients about key HF issues that are associated with improving disease-specific HF palliative care and the quality of life of patients and their families. Pilot testing will offer insight as to its utility and potential for modification for national and international use.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

Stakeholder views on pharmacogenomic testing.

PubMed

Patel, Haridarshan N; Ursan, Iulia D; Zueger, Patrick M; Cavallari, Larisa H; Pickard, A Simon

2014-02-01

Pharmacogenomics has an important role in the evolution of personalized medicine, and its widespread uptake may ultimately depend on the interests and perspectives of key players in health care. Our aim was to summarize studies on stakeholder perspectives and attitudes toward pharmacogenomic testing. Thus, we conducted a review of original research studies that reported stakeholder views on pharmacogenomic testing using a structured approach in PubMed, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and EMBASE. A standardized data abstraction form was developed that included stakeholder group of interest-patients, general public, providers, and payers. Stakeholder views regarding barriers to pharmacogenetic implementation were organized into the following themes: ancillary information-related, clinical, economic, educational, ethical or legal, medical mistrust, and practicality. Of 34 studies that met our inclusion criteria, 37 perspectives were reported (15 on providers, 9 on the general public, 9 on patients, and 4 on payers). The most common topics that arose in studies of providers related to clinical usefulness of genetic data (n=11) and educational needs (n=11). Among the general public, the most common concerns were medical mistrust (n=5), insufficient education (n=5), and practicality (n=5). The most prevalent issues from the patient perspective were ethical or legal (n=6) and economic (n=5) issues. Among payers, leading issues were practicality (n=4) and clinical usefulness (n=3). There was overlap in the topics and concerns across stakeholder perspectives, including lack of knowledge about pharmacogenomic testing. Views on issues related to privacy, cost, and test result dissemination varied by stakeholder perspective. Limited research had been conducted in underrepresented groups. Efforts to address the issues raised by stakeholders may facilitate the implementation of pharmacogenomic testing into clinical practice. © 2013 American College of Clinical Pharmacy.

Examining the Role of Mental Health and Clinical Issues within Talent Development

PubMed Central

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2016-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general “warning signs” such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools—coupled with appropriate training and signposting—could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors. PMID:26793153

Examining the Role of Mental Health and Clinical Issues within Talent Development.

PubMed

Hill, Andy; MacNamara, Áine; Collins, Dave; Rodgers, Sheelagh

2015-01-01

Although significant research supports the association between physical activity and mental wellbeing, current literature acknowledges that athletes are no less susceptible to mental illness than the general population. Despite welcomed initiatives aimed at improving mental health within elite sport, these programs often fail to target young athletes; an important concern given that the genesis of many mental illnesses are recognized to occur during this critical period. Given the importance of early intervention and effective treatment, and the potentially devastating consequences of clinical issues going undiagnosed, the implications for talent identification and development (TID) become obvious. With this in mind, this study sought to examine the range of mental health issues that may impact upon developing athletes and potential consequences for the development process, specific risk and protective factors associated with talent development, along with an examination of current practices concerning the identification of mental health issues in such environments. Qualitative interviews were conducted with purposively sampled clinicians (n = 8) experienced in working with adolescents and/or young athletes. Inductive content analysis was undertaken, identifying four main themes: key behavioral indicators; associated risk factors; associated protective factors; and issues around identification and diagnosis. Key behavioral indicators included behavioral change, along with behaviors associated with eating disorders, anxiety and depression. Risk factors centered on family background, the performance environment, and issues surrounding adolescence. Protective factors were primarily social in nature. Finally, a lack of awareness and understanding of clinical issues, multiple causes of symptoms, non-disclosure and the need for triangulation of assessment were identified. The need for improved identification and intervention strategies was apparent, with coaches identified as well placed to detect general "warning signs" such as behavioral change. Short of integrating trained clinicians into talent development environments, as part of a triangulation process, ecologically validated assessment tools-coupled with appropriate training and signposting-could offer a practical way of flagging potential issues in developing athletes. The need for the development of such an instrument is therefore apparent. Finally, education around the influential role of family is also recommended in order to promote the protective elements and mitigate risk factors.

Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study.

PubMed

Ghosh, Abhijeet; McCarthy, Sandra; Halcomb, Elizabeth

2016-04-26

Technological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable. We aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken. Five key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff. The move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health status and health needs within the community. However, this study has reinforced the importance of human factors in the maintenance of such datasets. To achieve optimal benefits of electronic health and medical records for patient care and for population health planning purposes, it is extremely essential to address the barriers that clinicians and other staff face in maintaining complete and correct primary care patient electronic health and medical information.

Schools as Vehicles to Assess Experiences, Improve Outcomes, and Effect Social Change.

PubMed

McMahon, Susan Dvorak

2018-06-01

Schools are important settings that can be utilized to yield a positive impact on youth and the many issues our society faces. In this Presidential Address, I identify key issues and directions for the field, advocating that we need to expand our ecological focus, improve school climate, and collaborate with schools to effect change. To illustrate these key themes, findings from four projects with k-12 youth and educators in the United States are described, and these projects have the following foci: protective factors for youth exposed to violence, teacher-directed violence as part of an APA Task Force, school climate and neighborhood factors in relation to academic outcomes, and school transitions for students with disabilities. Challenges and future directions to build upon community psychology theory, research, practice, and policy are discussed. © Society for Community Research and Action 2018.

Gender perspectives in resilience, vulnerability and adaptation to global environmental change.

PubMed

Ravera, Federica; Iniesta-Arandia, Irene; Martín-López, Berta; Pascual, Unai; Bose, Purabi

2016-12-01

The main goal of this special issue is to offer a room for interdisciplinary and engaged research in global environmental change (GEC), where gender plays a key role in building resilience and adaptation pathways. In this editorial paper, we explain the background setting, key questions and core approaches of gender and feminist research in vulnerability, resilience and adaptation to GEC. Highlighting the interlinkages between gender and GEC, we introduce the main contributions of the collection of 11 papers in this special issue. Nine empirical papers from around the globe allow to understand how gendered diversity in knowledge, institutions and everyday practices matters in producing barriers and options for achieving resilience and adaptive capacity in societies. Additionally, two papers contribute to the theoretical debate through a systematic review and an insight on the relevance of intersectional framings within GEC research and development programming.

Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

PubMed

Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

2010-01-01

Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

Behavioral medicine and clinical health psychology: introduction to the special issue.

PubMed

Christensen, Alan J; Nezu, Arthur M

2013-04-01

This issue represents the 4th Journal of Consulting and Clinical Psychology special issue on behavioral medicine and clinical health psychology over the past 4 decades. Recent developments in health care policy, as well as in the maturation of the science, make a special issue in this area particularly timely. This collection includes state of the clinical science reviews, reports of clinical trials, and articles addressing theory and methods in behavioral medicine and clinical health psychology. A multilevel, ecological perspective that considers multiple levels of influences (e.g., cultural influences on behavior-health linkages, individual differences) is salient throughout many of the articles. Our hope is that this sampling of this broad field, and coverage of some key issues and areas, will play a role in stimulating the next 10 years of research, practice, and policy implementation in behavioral medicine and clinical health psychology.

Defining and describing capacity issues in U.S. Doctor of Nursing Practice programs.

PubMed

Minnick, Ann F; Norman, Linda D; Donaghey, Beth

2013-01-01

Recent calls to expand the number of U.S. Doctors of Nursing Practice (DNPs) raises questions about programs' capacities, content and requirements, and their ability to expand. This paper aims to describe (1) key aspects of DNP program capacities that may provide direction for DNP program expansion plans, the timing of such expansion and program QI efforts; and (2) the impact of the DNP on faculty resources for research doctoral programs. A survey of all U.S. DNP programs (n = 130; response rate 72%) was conducted in 2011 based on previously tested items. Reviews of Web sites of nonresponding schools provided some data from all programs. Ratios of students to faculty active in advanced practice (AP) and in QI (QI) were high (AP 11.0:1, SD 10.1; QI 20.2:1, SD 17.0 respectively). There was wide variation in scholarly requirements (0-4: 50% of program had none) and program committee composition (1-5; mode=2). Almost all responding schools that offered PhD and DNP programs reported assigning research-active or potentially research-active faculty in both programs. The ability to expand programs while maintaining quality may be compromised by capacity issues. Addressing demand issues through the alignment of program requirements with societal and employment requirements may provide directions for addressing current DNP capacity issues. Copyright © 2013 Elsevier Inc. All rights reserved.

Engaging participants in a complex intervention trial in Australian General Practice

PubMed Central

Perkins, David; Harris, Mark F; Tan, Jocelyn; Christl, Bettina; Taggart, Jane; Fanaian, Mahnaz

2008-01-01

Background The paper examines the key issues experienced in recruiting and retaining practice involvement in a large complex intervention trial in Australian General Practice. Methods Reflective notes made by research staff and telephone interviews with staff from general practices which expressed interest, took part or withdrew from a trial of a complex general practice intervention. Results Recruitment and retention difficulties were due to factors inherent in the demands and context of general practice, the degree of engagement of primary care organisations (Divisions of General Practice), perceived benefits by practices, the design of the trial and the timing and complexity of data collection. Conclusion There needs to be clearer articulation to practices of the benefits of the research to participants and streamlining of the design and processes of data collection and intervention to fit in with their work practices. Ultimately deeper engagement may require additional funding and ongoing participation through practice research networks. Trial Registration Current Controlled Trials ACTRN12605000788673 PMID:18700984

Advancing practice relating to SEA alternatives

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

González, Ainhoa, E-mail: agonzal@tcd.ie; Thérivel, Riki, E-mail: levett-therivel@phonecoop.coop; Fry, John, E-mail: john.fry@ucd.ie

Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues havemore » resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.« less

[Driving and dementia : An issue for general practice?!

PubMed

Leve, Verena; Ilse, Katharina; Ufert, Marie; Wilm, Stefan; Pentzek, Michael

2017-05-01

With most forms of dementia, the risk of road traffic accidents increases with disease progression. Addressing the issue of fitness to drive at an early stage can help to reduce driving-related risks and simultaneously preserve mobility. General practitioners (GPs) are central contact persons for dementia patients and their relatives in medical and psychosocial matters, and also play a key role in addressing the issue of driving safety. Identification of relevant aspects of managing fitness to drive in dementia, as well as of support requirements for German general practice. Seven focus groups with dementia patients, family caregivers and GPs were conducted in order to define the different requirements for counselling in the general practice setting. The transcribed discussions were analysed by a multiprofessional research team using content analysis. For people with dementia, declining mobility and driving cessation is related to a loss of autonomy. Addressing fitness to drive in dementia is thus a subject of conflict and uncertainty for both family caregivers and GPs. The difficulties include the assessment of fitness to drive in the general practice setting, concerns about compromising the patient-physician relationship by raising the issue of driving fitness, as well as uncertainties about the GP's own role. GPs consider the involvement of caregivers to be important to successfully address the topic of driving safety and organise alternative transport. Support is required in the form of criteria defining the time point at which fitness to drive should be assessed, information on compensation possibilities and mobility alternatives. Resource-oriented and patient-centred development of management strategies for limited mobility is needed in general practice. Finding the correct balance between documentation, adequately informing the patient and establishing patient-centred strategies represents a challenge.

Scientific-practical and legal problems of implementation of the personalized medicine.

PubMed

Bezdieniezhnykh, N O; Reznikova, V V; Rossylna, O V

2017-09-01

The article is devoted to the comprehensive analysis of scientific, practical and legal issues of personalized medicine that is a rapidly developing science-driven approach to healthcare. It is concluded that there is lack of general legal framework for the encouragement of scientific researches and practical implementation in this field. The article shows foreign experience and prospects for the introduction of personalized medicine as a key concept of healthcare system, which is based on a selection of diagnostic, therapeutic and preventive measures that would be the most effective for a particular person in view of individual characteristics. The conclusions and proposals to improve the current legislation and development of personalized medicine in Ukraine are suggested.

Transfer-of-Care Communication: Nursing Best Practices.

PubMed

Chard, Robin; Makary, Martin A

2015-10-01

The successful and safe transfer of the patient from one phase of care to another is contingent on optimal communication by all team members. Nurses are often in a natural leadership position to improve safe practices during hand overs. A holistic understanding of the patient allows the perioperative nurse the opportunity to identify issues and choose a nursing diagnosis based on key elements of a patient's needs and goals--information that should be relayed during patient transfers. This article reviews best practices in transfer-of-care communication to enable perioperative RNs to take an active, leading role in hand-over processes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Supporting work practices through telehealth: impact on nurses in peripheral regions.

PubMed

Gagnon, Marie-Pierre; Paré, Guy; Pollender, Hugo; Duplantie, Julie; Côté, José; Fortin, Jean-Paul; Labadie, Rita; Duplàa, Emmanuel; Thifault, Marie-Claude; Courcy, François; McGinn, Carrie Anna; Ly, Birama Apho; Trépanier, Amélie; Malo, François-Bernard

2011-02-04

In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs) are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately fifty semi-structured interviews with key stakeholders. Data from both parts of this research project will be jointly analysed using triangulation of researchers, theoretical approaches, methods, and results. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the nursing recruitment and retention.

Patient Access Study

DTIC Science & Technology

1998-03-01

guidelines. 14. SUBJECT TERMS Efficiency, health care issues, medical services, military medicine, military standards, Navy, patients , scheduling...Rev. 2-89) Prescribed by ANSI Std. 239-18 299-01 Patient Access Study Sponsor: Assistant Chief for Health Care Operations (MED 03) March 1998...Michelle Dolfini-Reed Derek Shia In today’s highly competitive health care market, patient access to care is the key ingredient to a practice’s

Resource Integration Strategies for Elder Education Organizations: A Case Study in Taichung, Taiwan

ERIC Educational Resources Information Center

Tien, Chi Hu; Tsai, Wen Chi

2013-01-01

Dealing with the aging problem has been a global issue. One of the keys to help successful aging is to implement elder education. The government in Taiwan has invested a lot of budget in elder education, but in practice, there are two independent and diversified elder education systems in Taiwan, which had led to a lack of resource integration, in…

National Implications for Urban School Systems: Strategic Planning in the Human Resource Management Department in a Large Urban School District

ERIC Educational Resources Information Center

Johnson, Clarence; Kritsonis, William Allan

2007-01-01

This article addresses several key ongoing issues in a large urban school district. Literature focuses on what make a large urban school district effective in Human Resource Management. The effectiveness is addressed through recruitment and retention practices. A comparison of the school district with current research is the main approach to the…

Responding to Poverty and Its Complex Challenges: The Importance of Policy Fluency for Educational Leaders

ERIC Educational Resources Information Center

Miller, Peter; Pavlakis, Alexandra; Lac, Van; Hoffman, Deborah

2014-01-01

We present a case example of a school leader whose understanding of both in- and out-of-school policies and issues supported 2 students who experienced severe trauma. We describe some of the principal's key beliefs and practices that led to the development of a justice-oriented school, and then contextualize her work in a "social…

Developing core outcome sets for clinical trials: issues to consider

PubMed Central

2012-01-01

The selection of appropriate outcomes or domains is crucial when designing clinical trials in order to compare directly the effects of different interventions in ways that minimize bias. If the findings are to influence policy and practice then the chosen outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set, which should be measured and reported, as a minimum, in all trials for a specific clinical area. Accumulating work in this area has identified the need for general guidance on the development of core outcome sets. Key issues to consider in the development of a core outcome set include its scope, the stakeholder groups to involve, choice of consensus method and the achievement of a consensus. PMID:22867278

Engaging Underrepresented Group Youth in Environmental Science Research Activities: Catalyst for Change

NASA Astrophysics Data System (ADS)

Cuff, K.; Cannady, M.; Dorph, R.; Rodriguez, V. A.; Romero, V.

2016-12-01

The UC Berkeley East Bay Academy for Young Scientists (EBAYS) program provides youth from non-dominant communities in the East San Francisco Bay Area with unique opportunities to develop deeper understanding of environmental science content, as well as fundamental scientific practice skills. A key component of EBAYS programming is collaborative research projects that generate information useful in addressing critical environmental issues. This important component also provides opportunities for youth to present results of their investigations to other community members and to the scientific community at large. Inclusion of the environmental science research component is intended to help address the following program goals: A) increasing appreciation for the value of scientific practices as a tool for addressing important community-based issues; B) helping raise community awareness of important issues; C) sparking interest in other forms of community activism; D) increasing understanding of key science concepts; and E) generating valuable environmental quality data. In an effort to assess the degree to which EBAYS programming accomplishes these goals, as well as to evaluate its capacity to be effectively replicated on a broader scale, EBAYS staff has engaged in an investigation of associated learning and youth development outcomes. In this regard a research strategy has been developed that includes the use of assessment tools that will help foster a deeper understanding of the ways in which EBAYS programming increases the extent to which participants value the application of science, affects their overall occupational trajectory, and inspires them to consider careers in STEM.

Australian blue-collar men's health and well-being: contextual issues for workplace health promotion interventions.

PubMed

Du Plessis, Karin; Cronin, David; Corney, Tim; Green, Emma

2013-09-01

In Australia, blue-collar workers are predominantly male and form a unique and large (approximately 30%) subset of the Australian workforce. They exhibit particular health-related issues and, in comparison to other groups, often a lack of health promoting behavior. This article briefly discusses the Australian context and some of the key health issues blue-collar men face, in particular as it relates to construction workers. It reviews the impact of gender and socioeconomic factors in designing workplace health promotion interventions. This article considers practice strategies for health promoters in a specific workplace setting: it looks at meta-factors and industry-based contextual factors, including barriers to implementation and participation, while addressing common misconceptions about Australian blue-collar workers.

Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders.

PubMed

Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F

2011-05-01

A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

Where civics meets science: building science for the public good through Civic Science.

PubMed

Garlick, J A; Levine, P

2017-09-01

Public understanding of science and civic engagement on science issues that impact contemporary life matter more today than ever. From the Planned Parenthood controversy, to the Flint water crisis and the fluoridation debate, societal polarization about science issues has reached dramatic levels that present significant obstacles to public discussion and problem solving. This is happening, in part, because systems built to support science do not often reward open-minded thinking, inclusive dialogue, and moral responsibility regarding science issues. As a result, public faith in science continues to erode. This review explores how the field of Civic Science can impact public work on science issues by building new understanding of the practices, influences, and cultures of science. Civic Science is defined as a discipline that considers science practice and knowledge as resources for civic engagement, democratic action, and political change. This review considers how Civic Science informs the roles that key participants-scientists, public citizens and institutions of higher education-play in our national science dialogue. Civic Science aspires to teach civic capacities, to inform the responsibilities of scientists engaged in public science issues and to inspire an open-minded, inclusive dialogue where all voices are heard and shared commitments are acknowledged. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Endangered species and nature conservation: science issues and challenges.

PubMed

Szaro, Robert C

2008-06-01

The issues and challenges facing us in ensuring the survival of as many species and ecosystems as possible call for a renewed research focus to address how to improve management strategies and policy making now and into the future. The key issues to be addressed by activities of the International Union of Forest Research Organization's (IUFRO) Task Force on Endangered Species and Nature Conservation include such issues as: (i) preventing species from being listed by maintaining species populations at sufficient levels that they do not require listing; (ii) recovering threatened and endangered species; (iii) developing management practices and strategies; (iv) balancing actions affecting suites of threatened or endangered species; (v) developing conservation strategies for species without definitive taxonomic treatments; (vi) dealing with global change; (vii) dealing with invasive species; and (viii) restoring critical habitats. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

Selective perceptions of hydraulic fracturing.

PubMed

Sarge, Melanie A; VanDyke, Matthew S; King, Andy J; White, Shawna R

2015-01-01

Hydraulic fracturing (HF) is a focal topic in discussions about domestic energy production, yet the American public is largely unfamiliar and undecided about the practice. This study sheds light on how individuals may come to understand hydraulic fracturing as this unconventional production technology becomes more prominent in the United States. For the study, a thorough search of HF photographs was performed, and a systematic evaluation of 40 images using an online experimental design involving N = 250 participants was conducted. Key indicators of hydraulic fracturing support and beliefs were identified. Participants showed diversity in their support for the practice, with 47 percent expressing low support, 22 percent high support, and 31 percent undecided. Support for HF was positively associated with beliefs that hydraulic fracturing is primarily an economic issue and negatively associated with beliefs that it is an environmental issue. Level of support was also investigated as a perceptual filter that facilitates biased issue perceptions and affective evaluations of economic benefit and environmental cost frames presented in visual content of hydraulic fracturing. Results suggested an interactive relationship between visual framing and level of support, pointing to a substantial barrier to common understanding about the issue that strategic communicators should consider.

Nurses attitudes and practices towards provision of survivorship care for people with a haematological cancer on completion of treatment.

PubMed

Chan, Raymond Javan; Button, Elise; Thomas, Alison; Gates, Priscilla; Yates, Patsy

2018-05-01

The purpose of this study is to assess cancer nurses' perceptions of responsibility, confidence levels and practice in relation to survivorship care for people with a haematological malignancy on completion of treatment. A prospective cross-sectional survey was conducted. An online survey was distributed to members of two Australian professional bodies. A total of 310 cancer nurses participated in the study, representing a response rate of 28%. The participants generally agreed that all survivorship care items were part of their role. Of the 17 survivorship care items, the three items receiving the lowest confidence scores were discussing fertility issues, discussing employment and financial issues and discussing how to identify signs of cancer recurrence. The least performed survivorship care items were discussing fertility issues, communicating survivorship care with primary healthcare team (i.e. general practitioners) and discussing sexuality issues. Older age, more years of experience, having a post-graduate qualification and working in non-metropolitan area were associated with higher levels of perception of responsibilities and confidence (p < 0.05). The top ranked barriers to survivorship care were reported to be lack of end-of-treatment consultation dedicated to survivorship care, time and an appropriate physical space for delivering care. Cancer nurses perceive key aspects of survivorship care to be part of their role, however there remains variations in practice and confidence with respect to implementation of survivorship care practices. Interventions that focus on enhancing the capability of cancer nurses and eliminating barriers identified in this study have the potential to improve quality survivorship care provision.

Factors impacting on psychological wellbeing of international students in the health professions: A scoping review.

PubMed

McKenna, Lisa; Robinson, Eddie; Penman, Joy; Hills, Danny

2017-09-01

There are increasing numbers of international students undertaking health professional courses, particularly in Western countries. These courses not only expose students to the usual stresses and strains of academic learning, but also require students to undertake clinical placements and practice-based learning. While much is known about general issues facing international students, less is known about factors that impact on those studying in the health professions. To explore what is known about factors that influence the psychological wellbeing of international students in the health professions. A scoping review. A range of databases were searched, including CINAHL, Medline, Scopus, Proquest and ERIC, as well as grey literature, reference lists and Google Scholar. The review included qualitative or quantitative primary peer reviewed research studies that focused on international undergraduate or postgraduate students in the health professions. The core concept underpinning the review was psychological issues, with the outcome being psychological and/or social wellbeing. Thematic analysis across studies was used to identify key themes emerging. A total of 13 studies were included in the review, from the disciplines of nursing, medicine and speech-language pathology. Four key factor groups emerged from the review: negotiating structures and systems, communication and learning, quality of life and self-care, and facing discrimination and social isolation. International health professional students face similar issues to other international students. The nature of their courses, however, also requires negotiating different health care systems, and managing a range of clinical practice issues including with communication, and isolation and discrimination from clinical staff and patients. Further research is needed to specifically explore factors impacting on student well-being and how international students can be appropriately prepared and supported for their encounters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effective Monitoring and Control of Outsourced Software Development Projects

NASA Astrophysics Data System (ADS)

Ponisio, Laura; Vruggink, Peter

In our study of four outsourcing projects we discover mechanisms to support managerial decision making during software development processes. We report on Customer Office, a framework used in practice that facilitates reasoning about projects by highlighting information paths and making co-ordination issues explicit. The results suggest a key role of modularisation and standardisation to assist in value creation, by facilitating information flow and keeping the overview of the project. The practical implications of our findings are guidelines for managing outsourcing projects such as to have a modularised view of the project based on knowledge domains and to standardise co-ordination operations.

Object extraction in photogrammetric computer vision

NASA Astrophysics Data System (ADS)

Mayer, Helmut

This paper discusses state and promising directions of automated object extraction in photogrammetric computer vision considering also practical aspects arising for digital photogrammetric workstations (DPW). A review of the state of the art shows that there are only few practically successful systems on the market. Therefore, important issues for a practical success of automated object extraction are identified. A sound and most important powerful theoretical background is the basis. Here, we particularly point to statistical modeling. Testing makes clear which of the approaches are suited best and how useful they are for praxis. A key for commercial success of a practical system is efficient user interaction. As the means for data acquisition are changing, new promising application areas such as extremely detailed three-dimensional (3D) urban models for virtual television or mission rehearsal evolve.

What factors influence physiotherapy service provision in rural communities? A pilot study.

PubMed

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

Practical Application of Sociology in Systems Engineering

NASA Technical Reports Server (NTRS)

Watson, Michael D.; Andrews, James G.; Eckley, Jeri Cassel; Culver, Michael L.

2017-01-01

Systems engineering involves both the integration of the system and the integration of the disciplines which develop and operate the system. Integrating the disciplines is a sociological effort to bring together different groups, who often have different terminology, to achieve a common goal, the system. The focus for the systems engineer is information flow through the organization, between the disciplines, to ensure the system is developed and operated will all relevant information informing system decisions. The practical application of the sociology in systems engineering brings in various organizational development concepts including the principles of planned renegotiation and the application of principles to address information barriers created by organizational culture. Concepts such as specification of ignorance, consistent terminology, opportunity structures, role-sets, and the reclama (reconsideration) process are all important sociological approaches that help address the organizational social structure (culture). In bringing the disciplines together, the systems engineer must also be wary of social ambivalence, social anomie, social dysfunction, and insider-outsider behavior. Unintended consequences can result when these social issues are present. These issues can occur when localized subcultures shift from the overarching organizational culture, or when the organizational culture prevents achievement of system goals. These sociological principles provide the systems engineer with key approaches to manage the information flow through the organization as the disciplines are integrated and share their information and provides key sociological barriers to information flow through the organization. This paper will discuss the practical application of sociological principles to systems engineering.

Implementing an intravenous insulin protocol in your practice: practical advice to overcome clinical, administrative, and financial barriers.

PubMed

Kelly, Janet L; Hirsch, Irl B; Furnary, Anthony P

2006-01-01

Diabetes mellitus is the fourth most common comorbid condition among hospitalized patients, and 30% of patients undergoing open-heart surgery have diabetes. The link between hyperglycemia and poor outcome has been well described, and large clinical trials have shown that aggressive control of blood glucose with an insulin infusion can improve these outcomes. The barriers to implementing an insulin infusion protocol are numerous, despite the fact that doing so is paramount to clinical success. Barriers include safety concerns, such as fear of hypoglycemia, insufficient nursing staff to patient ratios, lack of administrative and physician support, various system and procedural issues, and resistance to change. Key steps to overcome the barriers include building support with multidisciplinary champions, involving key staff, educating staff, and administrators of the clinical and economic benefits of improving glycemic control, setting realistic goals, selecting a validated insulin infusion protocol, and internally marketing the success of the protocol.

APA Summit on Medical Student Education Task Force on Informatics and Technology: learning about computers and applying computer technology to education and practice.

PubMed

Hilty, Donald M; Hales, Deborah J; Briscoe, Greg; Benjamin, Sheldon; Boland, Robert J; Luo, John S; Chan, Carlyle H; Kennedy, Robert S; Karlinsky, Harry; Gordon, Daniel B; Yager, Joel; Yellowlees, Peter M

2006-01-01

This article provides a brief overview of important issues for educators regarding medical education and technology. The literature describes key concepts, prototypical technology tools, and model programs. A work group of psychiatric educators was convened three times by phone conference to discuss the literature. Findings were presented to and input was received from the 2005 Summit on Medical Student Education by APA and the American Directors of Medical Student Education in Psychiatry. Knowledge of, skills in, and attitudes toward medical informatics are important to life-long learning and modern medical practice. A needs assessment is a starting place, since student, faculty, institution, and societal factors bear consideration. Technology needs to "fit" into a curriculum in order to facilitate learning and teaching. Learning about computers and applying computer technology to education and clinical care are key steps in computer literacy for physicians.

Ambulatory surgery center joint ventures involving tax-exempt entities.

PubMed

Becker, S; Pristave, R J; McConnell, W

1999-01-01

This article provides an overview of the tax-exempt related issues for ambulatory surgery center joint ventures involving tax-exempt entities. The article analyzes the key points of analysis of the guidance released by the IRS, in particular General Counsel Memorandum 39862, Revenue Ruling 98-15, and Redlands Surgical Services v. Commissioner of the Internal Revenue Service. These key points include whether the venture results in private inurement to insiders and whether the venture furthers the charitable purposes of the tax-exempt entity. The article also provides practical guidance to analyze the documents and structure of the joint venture to ensure compliance with the IRS guidance. These practical considerations include, among other things, whether the charitable purposes of the tax-exempt entity are clearly expressed in the documents and whether the tax-exempt entity has sufficient control over the joint venture to ensure the charitable purposes are being adhered to.

Key Value Considerations for Consultant Pharmacists.

PubMed

Meyer, Lee; Perry, Ronald G; Rhodus, Susan M; Stearns, Wendy

2016-07-01

Managing the efficiency and costs of residents' drug regimens outside the acute-care hospital and through transitions of care requires a toolbox filled with cost-control tools and careful collaboration among the pharmacy provider(s), facility staff, and the consultant/senior care pharmacist. This article will provide the reader with key long-term care business strategies that affect the profitability of the pharmacy provider in various care settings while, at the same time, ensuring optimal therapy for residents as they transition across levels of care. Readers can take away ideas on how to access critical information, what they can do with this information, and how they can improve the overall care process. Four experts in various aspects of pharmacy management share their insights on pharmacy practice issues including formulary management, performance metrics, short-cycle dispensing challenges/solutions, cost-control measures, facility surveys, billing practices, medication reconciliation, prospective medication reviews, and transitions of care.

Treating Substance Use Disorders in the Criminal Justice System

PubMed Central

Hiller, Matthew; Hamilton, Leah

2013-01-01

The large number of individuals with substance use disorders involved in the nation’s criminal justice system (CJS) represents a unique opportunity, as well as challenges, in addressing the dual concerns of public safety and public health. Unfortunately, a low proportion of those who could benefit from treatment actually receive it while involved in the CJS. This article presents a review of recent research on the effectiveness of major substance abuse treatment interventions used at different possible linkage points during criminal justice case processing, including diversion, jail, prison, and community supervision. This is followed by a discussion of key research and practice issues, including low rates of treatment access and under-utilization of medication-assisted treatment. Concluding comments discuss principles of effective treatment for offenders and identify key gaps in research and practice that need to be addressed to improve and expand provision of effective treatment for offenders. PMID:24132733

Cultural relativism: occupation and independence reconsidered.

PubMed

Whiteford, G E; Wilcock, A A

2000-12-01

In this article, findings from a qualitative study of a cohort of occupational therapy students in Auckland, New Zealand are presented. The study focussed on the experiences of students as they learned to work with people from different social and cultural backgrounds over a 3-year period. As well as identifying curriculum and teaching/learning processes that enhance intercultural competence development, the data that emerged from the study also highlight important issues about how occupation and independence are conceptualised across cultures. A review of the trans-disciplinary and occupational therapy literature dealing with theoretical, conceptual and educational issues relating to cross-cultural practice is followed by a presentation of narrative extracts that address the key concepts of occupation and independence. These are then discussed with reference to relevant occupational therapy literature. In conclusion, implications for future research and practice are explored focussing on a need for occupation and independence to be reconsidered as culturally relative constructions.

The relevance of the Goudge inquiry to the practice of child protection/forensic paediatrics.

PubMed

Skellern, Catherine; Donald, Terence

2014-10-01

In 2008 Ontario, Canada the Goudge Inquiry arose following increasing concerns about practices surrounding forensic pathology and the investigation of paediatric deaths. Some of the considerations and recommendations have relevance to child protection/forensic paediatricians, particularly in relation to their responsibilities in opinion formulation and as expert witnesses. By examining the Inquiry recommendations, this paper applies them in relation to child protection/forensic paediatrics by discussing forensic medicine and its legal context, how interpretation of published reports and data should be used in opinion formulation; issues of 'diagnosis' versus 'opinion'; issues specific to child protection paediatrics; quality control; aspects of report writing and terminological considerations. It concludes with an adaptation of key recommendations directly from those of Goudge, applied to the context of paediatric forensic medicine undertaken in child protection assessments. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A novel and lightweight system to secure wireless medical sensor networks.

PubMed

He, Daojing; Chan, Sammy; Tang, Shaohua

2014-01-01

Wireless medical sensor networks (MSNs) are a key enabling technology in e-healthcare that allows the data of a patient's vital body parameters to be collected by the wearable or implantable biosensors. However, the security and privacy protection of the collected data is a major unsolved issue, with challenges coming from the stringent resource constraints of MSN devices, and the high demand for both security/privacy and practicality. In this paper, we propose a lightweight and secure system for MSNs. The system employs hash-chain based key updating mechanism and proxy-protected signature technique to achieve efficient secure transmission and fine-grained data access control. Furthermore, we extend the system to provide backward secrecy and privacy preservation. Our system only requires symmetric-key encryption/decryption and hash operations and is thus suitable for the low-power sensor nodes. This paper also reports the experimental results of the proposed system in a network of resource-limited motes and laptop PCs, which show its efficiency in practice. To the best of our knowledge, this is the first secure data transmission and access control system for MSNs until now.

Consensus Development from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014)

PubMed Central

Hsu, Chiun; Chen, Bang-Bin; Chen, Chien-Hung; Ho, Ming-Chih; Cheng, Jason Chia-Hsien; Kokudo, Norihiro; Murakami, Takamichi; Yeo, Winnie; Seong, Jinsil; Jia, Ji-Dong; Han, Kwan-Hyub; Cheng, Ann-Lii

2015-01-01

A key mission of the Asia-Pacific Primary Liver Cancer Expert (APPLE) Association is to ensure a coherent view for management of hepatocellular carcinoma (HCC) and to advance new treatment for this difficult disease. At the 5th APPLE meeting, held in July 2014 in Taipei, Taiwan, an APPLE consensus development program was established to facilitate discussion among experts in the Asia-Pacific region on pertinent issues for HCC management, including (1) surgery for intermediate/advanced-stage disease, (2) prevention of HCC recurrence after curative treatment, (3) optimizing imaging diagnosis, (4) radiotherapy: current practice and future clinical trials, and (5) the role of cytotoxic chemotherapy. A pre-congress questionnaire was undertaken with the consensus development committee members to help understand the current practice patterns for HCC in the Asia-Pacific region and to identify issues relating to optimal patient care and further clinical trials for which consensus needs to be developed. In this report, the results of the questionnaire are presented, and the pertinent issues identified by each consensus group for further discussion and consensus development are summarized. PMID:26020032

Evidence-based interventions in pediatric psychology: progress over the decades.

PubMed

Palermo, Tonya M

2014-09-01

This introduction to the special issue on Evidence-Based Interventions in Pediatric Psychology provides background on the process used to develop the special issue, a summary of the key findings from the series of reviews, and discussion of the implications for evidence-based practice. Authors followed a three-phase approach to develop their systematic reviews using rigorous systematic review methodology drawn heavily from the Cochrane Collaboration. The strength of the evidence for each pediatric psychology intervention was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The introduction discusses the progress that has been made in the evidence base for pediatric psychology interventions since the first special series published in 1999. Recommendations to stimulate further research and expand and strengthen the quality of the evidence base are described. The introduction concludes with implications from the special issue for pediatric psychology training in evidence-based practice. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Alternative Paths to Diversity: Exploring and Implementing Effective College Admissions Policies. Policy Information Report and ETS Research Report Series No. RR-17-40

ERIC Educational Resources Information Center

Orfield, Gary

2017-01-01

The Supreme Court has established the parameters within which universities can practice race-conscious affirmative action for college admissions in a series of decisions beginning in l978. The key issues concern the educational impact of campus diversity and whether or not it is necessary to give some consideration to students' race into order to…

Analysis of small crack behavior for airframe applications

NASA Technical Reports Server (NTRS)

Mcclung, R. C.; Chan, K. S.; Hudak, S. J., Jr.; Davidson, D. L.

1994-01-01

The small fatigue crack problem is critically reviewed from the perspective of airframe applications. Different types of small cracks-microstructural, mechanical, and chemical-are carefully defined and relevant mechanisms identified. Appropriate analysis techniques, including both rigorous scientific and practical engineering treatments, are briefly described. Important materials data issues are addressed, including increased scatter in small crack data and recommended small crack test methods. Key problems requiring further study are highlighted.

Changing Concepts of Equity in Transforming UK Higher Education: Implications for Future Pedagogies and Practices in Global Higher Education

ERIC Educational Resources Information Center

David, Miriam E.

2011-01-01

This paper is about changing concepts of equity in UK higher education. In particular, it charts the moves from concepts about gender equality as about women's education as a key issue in twentieth century higher education to questions of men's education in the twenty-first century. These changing concepts of equity are linked to wider social and…

Fire Safety in Extraterrestrial Environments

NASA Technical Reports Server (NTRS)

Friedman, Robert

1998-01-01

Despite rigorous fire-safety policies and practices, fire incidents are possible during lunar and Martian missions. Fire behavior and hence preventive and responsive safety actions in the missions are strongly influenced by the low-gravity environments in flight and on the planetary surfaces. This paper reviews the understanding and key issues of fire safety in the missions, stressing flame spread, fire detection, suppression, and combustion performance of propellants produced from Martian resources.

Joint Forces Command - Operation United Assistance Case Study: Lessons and Best Practices

DTIC Science & Technology

2016-07-01

additional and prioritized computers and access in the operations center for these mission requirements are essential. 127 JFC-OUA CASE STUDY Issue...this publication is welcomed and highly encouraged. Joint Forces Command – Operation United Assistance Case Study JFC-OUA CASE STUDY iii Foreword...Based on information drawn from various sources including after action reports, lessons learned, case studies , umbrella-week visits, and key-leader

Reporting Physical Activity: Perceptions and Practices of Australian Media Professionals.

PubMed

Smith, Ben J; Bonfiglioli, Catriona M F

2015-08-01

Advocacy informed by scientific evidence is necessary to influence policy and planning to address physical inactivity. The mass media is a key arena for this advocacy. This study investigated the perceptions and practices of news media professionals reporting physical activity and sedentariness to inform strategic communication about these issues. We interviewed media professionals working for major television, radio, newspaper and online news outlets in Australia. The interviews explored understandings of physical activity and sedentariness, attributions of causality, assignment of responsibility, and factors affecting news reporting on these topics. Data were thematically analyzed using NVivo. Physical inactivity was recognized as pervasive and important, but tended to be seen as mundane and not newsworthy. Sedentariness was regarded as more novel than physical activity, and more likely to require organizational and environment action. Respondents identified that presenting these issues in visual and engaging ways was an ongoing challenge. Physical activity researchers and advocates need to take account of prevailing news values and media practices to improve engagement with the news media. These include understanding the importance of novelty, narratives, imagery, and practical messages, and how to use these to build support for environmental and policy action.

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes.

PubMed

Frazer, Kate; Connolly, Michael; Naughton, Corina; Kow, Veronica

2014-07-01

Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports. The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme. Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students. The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Defining Neuromarketing: Practices and Professional Challenges

PubMed Central

Fisher, Carl Erik; Chin, Lisa; Klitzman, Robert

2011-01-01

Neuromarketing has recently generated controversies concerning the involvement of medical professionals, and many key questions remain—ones that have potentially important implications for the field of psychiatry. Conflicting definitions of neuromarketing have been proposed, and little is known about the actual practices of companies, physicians, and scientists involved in its practice. This article reviews the history of neuromarketing and uses an exploratory survey of neuromarketing Web sites to illustrate ethical issues raised by this new field. Neuromarketing, as currently practiced, is heterogeneous, as companies are offering a variety of technologies. Many companies employ academicians and professionals, but few list their clients or fees. Media coverage of neuromarketing appears disproportionately high compared to the paucity of peer-reviewed reports in the field. Companies may be making premature claims about the power of neuroscience to predict consumer behavior. Overall, neuromarketing has important implications for academic-industrial partnerships, the responsible conduct of research, and the public understanding of the brain. We explore these themes to uncover issues relevant to professional ethics, research, and policy. Of particular relevance to psychiatry, neuromarketing may be seen as an extension of the search for quantification and certainty in previously indefinite aspects of human behavior. PMID:20597593

Defining neuromarketing: practices and professional challenges.

PubMed

Fisher, Carl Erik; Chin, Lisa; Klitzman, Robert

2010-01-01

Neuromarketing has recently generated controversies concerning the involvement of medical professionals, and many key questions remain-ones that have potentially important implications for the field of psychiatry. Conflicting definitions of neuromarketing have been proposed, and little is known about the actual practices of companies, physicians, and scientists involved in its practice. This article reviews the history of neuromarketing and uses an exploratory survey of neuromarketing Web sites to illustrate ethical issues raised by this new field. Neuromarketing, as currently practiced, is heterogeneous, as companies are offering a variety of technologies. Many companies employ academicians and professionals, but few list their clients or fees. Media coverage of neuromarketing appears disproportionately high compared to the paucity of peer-reviewed reports in the field. Companies may be making premature claims about the power of neuroscience to predict consumer behavior. Overall, neuromarketing has important implications for academic-industrial partnerships, the responsible conduct of research, and the public understanding of the brain. We explore these themes to uncover issues relevant to professional ethics, research, and policy. Of particular relevance to psychiatry, neuromarketing may be seen as an extension of the search for quantification and certainty in previously indefinite aspects of human behavior.

Hiring and Retention: Key Factors in Increasing Gender Diversity in the Geosciences

NASA Astrophysics Data System (ADS)

Holmes, M.; O'Connell, S.; Frey, C.

2004-12-01

Graduation and hiring data of geoscientists over the last ten years indicate that the largest leak in the academic pipeline for women geoscientists is at hiring into tenure-track positions. Anecdotal explanations for this leak generally cite a lack of females in the applicant pool, but women in tenure-track positions anecdotally cite a lack of family-friendly practices by academic departments. Both ideas are currently being tested via surveys of geoscience departments. Is there a way to attract more women to the field to increase the applicant pool? Results of focus groups of geoscientists indicate that both men and women are attracted into the field of geosciences by the same types of events: over one-third became a geoscientist by randomly walking into an undergraduate class and finding themselves captivated by the topic and/or a dynamic instructor. The subject matter itself attracts another one-fourth, and family members encourage another one-fifth of geoscientists to initially enter the field. Slightly more women cite the first attractor of undergraduate class, but the principal draw for our future workforce, male and female, is good instruction of freshman courses. Retention of women in academia is another key issue. The proportion that considers leaving after working towards one or more degrees is highly skewed by gender: one-half of female and only one-third of male geoscientists considered leaving the field at some time in their career. The reasons for considering leaving also differ by gender. Males cite financial issues, including an uncertain job market. Females cite two principal reasons for considering leaving: family issues and difficulties with a graduate advisor. Strategies currently exist for "family issues", including stop-the-clock (of tenure for family needs), assignment shift, on-campus daycare facilities, and unflinching administrative support for such practices. Graduate advising is a learnable skill, and more attention needs to be paid to this critical issue for female retention in the geosciences.

Medication adherence monitoring: implications for patients and providers.

PubMed

Gheorghiu, Bobby; Nayani, Seema

2018-05-01

Non-adherence to medication is a key worldwide issue and can lead to adverse patient outcomes and increased health system costs. Would a process facilitating notification of non-adherence infringe upon the autonomy of individuals or breach expectations of privacy? In contrast, patients who are not taking their medication could unknowingly be putting themselves at risk and all the while prescribers are unaware and without the opportunity to intervene. With the advent of electronic methods of medication adherence monitoring, this ethical dilemma now involves a new layer of complexity. We present two scenarios encountered in clinical practice that reflect issues occurring regularly in the Canadian healthcare system.

Averting a pandemic health crisis in Europe by 2020: what physicians need to know regarding cholesterol management.

PubMed

Catapano, Alberico L; Pedersen, Terje R; de Backer, Guy

2007-04-01

Cardiovascular disease (CVD) represents a major cause of premature death, disability, and escalating healthcare costs throughout Europe. According to a recent report by the Stockholm Network (an independent European 'think tank'), major political, economic, social, and medical changes are urgently needed with respect to cholesterol management to help prevent CVD. To identify key cholesterol management issues that practitioners should consider to help prevent an impending European health crisis, our collective experience of policies and practices relating to CVD and cholesterol management in our respective countries was consolidated and used to develop this commentary. Physicians and healthcare workers are uniquely positioned to make immediate and meaningful improvements in preventing and treating CVD if they recognize and address a handful of key clinical issues pertaining to cholesterol management. These issues include utilizing newer combination therapies and realizing the limitations of statins, improving compliance with cholesterol-lowering therapies, promoting a healthy lifestyle and diet, making treatment decisions based on patients' total CVD risk, fostering communication between primary and secondary providers, and soliciting governmental funding to implement disease management programmes. By promptly and effectively addressing these cholesterol management issues, physicians and other healthcare professionals have an unprecedented opportunity to help reduce CVD in Europe to lessen the personal, social, and economic impact of this devastating disease.

Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia

PubMed Central

Doughty, Amanda K.; Coleman, Grahame J.; Hinch, Geoff N.; Doyle, Rebecca E.

2017-01-01

Simple Summary This survey was designed as the first step in the development of a welfare assessment framework with the aim of identifying potential causes of welfare compromise and useful indicators for sheep in extensive Australian production systems. We asked the general public, sheep producers, service providers and sheep industry related scientists to provide their thoughts on the importance of a range of sheep welfare issues and possible key indicators. All respondents thought sheep welfare was adequate but that improvement was desired. Issues perceived to cause the most risk to sheep related to factors influenced by the environment (i.e., nutrition and food supply), heat stress and lameness while key indicators useful to assess welfare were nutrition and food availability, mortality/management issues, pain and fear related indicators, and numbers of illness/injuries. Women and the general public perceived all issues and indicators to be more important than other groups of respondents. These results highlight the need to consult a wide range of stakeholders in order to develop a broadly acceptable assessment system. Abstract An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents (p < 0.05). Environmental issues were considered to pose the greatest risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p < 0.01) and indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns. PMID:28333110

Measurement-Device-Independent Quantum Key Distribution Over a 404 km Optical Fiber.

PubMed

Yin, Hua-Lei; Chen, Teng-Yun; Yu, Zong-Wen; Liu, Hui; You, Li-Xing; Zhou, Yi-Heng; Chen, Si-Jing; Mao, Yingqiu; Huang, Ming-Qi; Zhang, Wei-Jun; Chen, Hao; Li, Ming Jun; Nolan, Daniel; Zhou, Fei; Jiang, Xiao; Wang, Zhen; Zhang, Qiang; Wang, Xiang-Bin; Pan, Jian-Wei

2016-11-04

Measurement-device-independent quantum key distribution (MDIQKD) with the decoy-state method negates security threats of both the imperfect single-photon source and detection losses. Lengthening the distance and improving the key rate of quantum key distribution (QKD) are vital issues in practical applications of QKD. Herein, we report the results of MDIQKD over 404 km of ultralow-loss optical fiber and 311 km of a standard optical fiber while employing an optimized four-intensity decoy-state method. This record-breaking implementation of the MDIQKD method not only provides a new distance record for both MDIQKD and all types of QKD systems but also, more significantly, achieves a distance that the traditional Bennett-Brassard 1984 QKD would not be able to achieve with the same detection devices even with ideal single-photon sources. This work represents a significant step toward proving and developing feasible long-distance QKD.

Selecting and starting an orthopaedic surgery practice.

PubMed

Mishra, Allan; Urquhart, Andrew G; Anders, Geoffrey T

2008-01-01

Every new surgeon is faced with the same question as their residency or fellowship draws to a close: What is next? Few residents or fellows are as well prepared to answer that question as they could be. Most programs do not teach residents how to choose a practice type and location. After formal orthopaedic training, new surgeons must make decisions about their careers that can be nearly as complex and difficult as the decisions they make in the operating room. Career choices have both significant and long-term effects on the physician's financial situation, career satisfaction, and personal life. The physician should be aware of key non academic issues that arise when completing a residency program or just beginning the practice of orthopaedic surgery.

Principles for research on ethnicity and health: the Leeds Consensus Statement.

PubMed

Mir, Ghazala; Salway, Sarah; Kai, Joe; Karlsen, Saffron; Bhopal, Raj; Ellison, George Th; Sheikh, Aziz

2013-06-01

There is substantial evidence that health and health-care experiences vary along ethnic lines and the need to understand and tackle ethnic health inequalities has repeatedly been highlighted. Research into ethnicity and health raises ethical, theoretical and methodological issues and, as the volume of research in this area grows, so too do concerns regarding its scientific rigour and reporting, and its contribution to reducing inequalities. Guidance may be helpful in encouraging researchers to adopt standard practices in the design, conduct and reporting of research. However, past efforts at introducing such guidance have had limited impact on research practice, and the diversity of disciplinary perspectives on the key challenges and solutions may undermine attempts to derive and promote guiding principles. A consensus building Delphi exercise--the first of its kind in this area of research practice--was undertaken with leading academics, practitioners and policymakers from a broad range of disciplinary backgrounds to assess whether consensus on key principles could be achieved. Ten key principles for conducting research on ethnicity and health emerged, covering: the aims of research in this field; how such research should be framed and focused; key design-related considerations; and the direction of future research. Despite some areas of dispute, participants were united by a common concern that the generation and application of research evidence should contribute to better health-care experiences and health outcomes for minority ethnic people. The principles provide a strong foundation to guide future ethnicity-related research and build a broader international consensus.

Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

PubMed

Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

2015-03-01

The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

Seven Foundational Principles of Population Health Policy.

PubMed

Bhattacharya, Dru; Bhatt, Jay

2017-10-01

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

The norm and the text: Denzin and Lincoln's handbooks of qualitative method.

PubMed

Fielding, N G

1999-09-01

Qualitative methods have lately enjoyed enhanced legitimacy and are increasingly used in academic and applied social research. Yet the field is marked by controversy about virtually every key tenet of qualitative inquiry, from matters of epistemology to purely practical matters of relations with research subjects. Not only is the practice of qualitative research hotly contested, consensus is lacking about the purpose of qualitative research and whether it has a distinctive role to play relative to other approaches to the study of social phenomena. Against this context, the handbooks of qualitative method edited by Norman Denzin and Yvonna Lincoln represent a significant attempt to capture the breadth of contemporary approaches to qualitative method. The article examines key contributions from the handbooks, drawing on these to develop a view of qualitative method from a pragmatic, realist perspective. Among the issues considered are the significance of relativism, subjectivity, post-modernism and feminist method, the politicization of the purposes of qualitative research, the debate over criteria of validity, and the move to treat qualitative research as an entertainment rather than a scientific practice.

The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform

PubMed Central

Mechanic, David

2001-01-01

The focus on managed care and the managed care backlash divert attention from more important national health issues, such as insurance coverage and quality of care. The ongoing public debate often does not accurately convey the key issues or the relevant evidence. Important perceptions of reduced encounter time with physicians, limitations on physicians' ability to communicate options to patients, and blocked access to inpatient care, among others, are either incorrect or exaggerated. The public backlash reflects a lack of trust resulting from cost constraints, explicit rationing, and media coverage. Inevitable errors are now readily attributed to managed care practices and organizations. Some procedural consumer protections may help restore the eroding trust and refocus public discussion on more central issues. PMID:11286094

Freedom of movement across the EU: legal and ethical issues for children with chronic disease.

PubMed

Mercieca, Cecilia; Aquilina, Kevin; Pullicino, Richard; Borg, Andrew A

2012-11-01

While freedom of movement has been one of the most highly respected human right across the EU, there are various aspects which come into play which still need to be resolved for this to be achieved in practice. One of these key issues is cross border health care. Indeed, there is an increasing awareness of standardisation of health service provision and cross border collaboration in the EU. However, certain groups particularly children may be at risk of suboptimal treatment as a result. We present the case of a child patient which highlights the complexity of this matter spanning family law, health law, social security law as well as ethical issues. EU legislation needs to ensure that children patients have access to high quality care across the EU borders.

Knowledge translation at the macro level: legal and ethical considerations.

PubMed

Larkin, Gregory Luke; Hamann, Cara J; Monico, Edward P; Degutis, Linda; Schuur, Jeremiah; Kantor, Walter; Graffeo, Charles S

2007-11-01

Macro-level legal and ethical issues play a significant role in the successful translation of knowledge into practice. The medicolegal milieu, in particular, can promote clinical inertia and stifle innovation. Embracing new clinical practice guidelines and best practice models has not protected physicians from superfluous torts; in some cases, emerging evidence has been used as the dagger of trial lawyers rather than the scalpel of physicians. Beyond the legal challenges are overarching justice issues that frame the broad goals of knowledge translation (KT) and technology diffusion. Optimal implementation of the latest evidence requires attention to be paid to the context of the candidate community and the key opinion leaders therein, characterized by the "8Ps" (public, patients, press, physicians, policy makers, private sector, payers, and public health). Ethical and equitable KT also accounts for the global burdens and benefits of implementing innovation such that disparities and gaps in health experienced by the least advantaged are prioritized. Researchers and thought leaders must attend to questions of fairness, economics, and legal risk when investigating ways to promote equity-oriented KT.

The foundational principles as psychological lodestars: Theoretical inspiration and empirical direction in rehabilitation psychology.

PubMed

Dunn, Dana S; Ehde, Dawn M; Wegener, Stephen T

2016-02-01

Historically, the Foundational Principles articulated by Wright (1983) and others guided theory development, research and scholarship, and practice in rehabilitation psychology. In recent decades, these principles have become more implicit and less explicit or expressive in the writings and work of rehabilitation professionals. We believe that the Foundational Principles are essential lodestars for working with people with disabilities that can guide inquiry, practice, and service. To introduce this special issues, this commentary identifies and defines key Foundational Principles, including, for example, Lewin's (1935) person-environment relation, adjustment to disability, the malleability of self-perceptions of bodily states, and the importance of promoting dignity for people with disabilities. We then consider the role the Foundational Principles play in the articles appearing in this special issue. We close by considering some new principles and their potential utility in rehabilitation settings. Readers in rehabilitation psychology and aligned areas (e.g., social-personality psychology, health psychology, rehabilitation therapist, psychiatry, and nursing) are encouraged to consider how the Foundational Principles underlie and can shape their research and practice. (c) 2016 APA, all rights reserved).

Assessment of positive functioning in clinical psychology: theoretical and practical issues.

PubMed

Joseph, Stephen; Wood, Alex

2010-11-01

Positive psychology has led to an increasing emphasis on the promotion of positive functioning in clinical psychology research and practice, raising issues of how to assess the positive in clinical setting. Three key considerations are presented. First, existing clinical measures may already be assessing positive functioning, if positive and negative functioning exist on a single continuum (such as on bipolar dimensions from happiness to depression, and from anxiety to relaxation). Second, specific measures of positive functioning (e.g., eudemonic well-being) could be used in conjunction with existing clinical scales. Third, completely different measures would be needed depending on whether well-being is defined as emotional or medical functioning, or as humanistically orientated growth (e.g., authenticity). It is important that clinical psychologists introduce positive functioning into their research and practice in order to widen their armoury of therapeutic interventions, but in doing so researchers and practitioners need also to be aware that they are shifting the agenda of clinical psychology. As such, progress in clinical psychology moving toward the adoption of positive functioning requires reflection on epistemological foundations. Copyright © 2010 Elsevier Ltd. All rights reserved.

Improving ethical and participatory practice for marginalized populations in biomedical HIV prevention trials: lessons from Thailand.

PubMed

Allman, Dan; Ditmore, Melissa Hope; Kaplan, Karyn

2014-01-01

This paper presents findings from a qualitative investigation of ethical and participatory issues related to the conduct of biomedical HIV prevention trials among marginalized populations in Thailand. This research was deemed important to conduct, as several large-scale biomedical HIV prevention trials among marginalized populations had closed prematurely in other countries, and a better understanding of how to prevent similar trial closures from occurring in the future was desired. In-depth key informant interviews were held in Bangkok and Chiang Mai, Thailand. Interviews were audio recorded, transcribed, translated and thematically analyzed. The Good Participatory Practice Guidelines for Biomedical HIV Prevention Trials (GPP) guided this work. Fourteen interviews were conducted: 10 with policymakers, academic and community-based researchers and trial staff and four with representatives of non-governmental organizations (NGOs). Suggested ways to improve ethical and participatory practice centered on standards of HIV prevention, informed consent, communication and human rights. In particular, the need to overcome language and literacy differences was identified. Key informants felt communication was the basis of ethical understanding and trust within biomedical HIV prevention trial contexts, and thus fundamental to trial participants' ability to exercise free will. Biomedical HIV prevention trials present opportunities for inclusive and productive ethical and participatory practice. Key informants suggested that efforts to improve practice could result in better relationships between research stakeholders and research investigative teams and by extension, better, more ethical participatory trials. This research took place in Thailand and its findings apply primarily to Thailand. However, given the universality of many ethical considerations, the results of this study can inform the improvement of ethical and participatory practice in other parts of the world where biomedical HIV prevention trials occur, and where clinical trials in marginalized populations continue.

Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

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

McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca; Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3; Ollson, Christopher A., E-mail: collson@intrinsik.com

Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout themore » process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.« less

Is EIA part of the wind power planning problem?

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

Smart, Duncan Ewan; Stojanovic, Timothy A., E-mail: tas21@st-andrews.ac.uk; Warren, Charles R.

2014-11-15

This research evaluates the importance and effectiveness of Environmental Impact Assessment (EIA) within wind farm planning debates, drawing on insights from case studies in Scotland. Despite general public support for renewable energy on the grounds that it is needed to tackle climate change and implement sustainable development, many proposed wind farms encounter significant resistance. The importance of planning issues and (EIA) processes has arguably been overlooked within recent wind farm social acceptability discourse. Through semi-structured interviews with key stakeholders and textual analysis of EIA documents, the characteristics of EIA are assessed in terms of its perceived purpose and performance. Themore » data show that whilst respondents perceive EIA to be important, they express concerns about bias and about the inability of EIA to address climate change and wind farm decommissioning issues adequately. Furthermore, the research identifies key issues which impede the effectiveness of EIA, and reveals differences between theoretical and practical framings of EIA. The paper questions the assumption that EIA is a universally applicable tool, and argues that its effectiveness should be analysed in the context of specific development sectors. The article concludes by reviewing whether the recently amended EIA Directive (2014/52/EU) could resolve identified problems within national EIA practice. - Highlights: • Evaluation of EIA for onshore wind farm planning in Scotland. • EIA is important for multiple aspects of onshore wind farm planning. • Multiple substantive deficiencies of relevance to wind farm planning exist in EIA. • Further research into EIA effectiveness for specific development types is required. • Directive 2014/52/EU may improve EIA effectiveness within wind farm planning.« less

What's gender got to do with it? Examining masculinities, health and safety and return to work in male dominated skilled trades.

PubMed

Stergiou-Kita, Mary; Mansfield, Elizabeth; Colantonio, Angela; Moody, Joel; Mantis, Steve

2016-06-16

Electrical injuries are a common cause of work-related injury in male dominated skilled trades. In this study we explored how issues of gender, masculinities and institutional workplace practices shape expectations of men and their choices when returning to work following a workplace electrical injury. Twelve workers, who suffered an electrical injury, and twelve employer representatives, completed semi-structured interviews. Using thematic analysis we identified key themes related to how masculinities influenced men's health and safety during the return to work process. Strong identification with worker roles can influence injured workers decisions to return to work 'too early'. A desire to be viewed as a strong, responsible, resilient worker may intersect with concerns about job loss, to influence participants' decisions to not report safety issues and workplace accidents, to not disclose post-injury work challenges, and to not request workplace supports. Institutionalized workplace beliefs regarding risk, de-legitimization of the severity of injuries, and the valorization of the "tough" worker can further re-enforce dominant masculine norms and influence return to work processes and health and safety practices. Workplaces are key sites where gender identities are constructed, affirmed and institutionalized. Further research is warranted to examine how established masculine norms and gendered workplace expectations can influence workplace health and safety in male dominated high risk occupations. Future research should also evaluate strategies that encourage men to discuss post-injury work challenges and request supports when work performance or health and safety issues arise during the return to work process.

Investing in nursing research in practice settings: a blueprint for building capacity.

PubMed

Jeffs, Lianne; Smith, Orla; Beswick, Susan; Maoine, Maria; Ferris, Ella

2013-12-01

Engaging clinical nurses in practice-based research is a cornerstone of professional nursing practice and a critical element in the delivery of high-quality patient care. Practising staff nurses are well suited to identify the phenomena and issues that are clinically relevant and appropriate for research. In response to the need to invest in and build capacity in nursing research, hospitals have developed creative approaches to spark interest in nursing research and to equip clinical nurses with research competencies. This paper outlines a Canadian hospital's efforts to build research capacity as a key strategy to foster efficacious, safe and cost-effective patient care practices. Within a multi-pronged framework, several strategies are described that collectively resulted in enhanced research and knowledge translation productivity aimed at improving the delivery of safe and high-quality patient care.

Issuing and Responding to Unusual Questions: A Conversation Analytic Account of Tom Andersen's Therapeutic Practice.

PubMed

Smoliak, Olga; Le Couteur, Amanda; Quinn-Nilas, Christopher

2018-03-08

Tom Andersen is considered one of the key contributors to the development of postmodern practice. Little is known, however, about the ways in which his ideas and practices are routinely carried out in situ. We used Conversation Analysis (CA) to investigate a session of couple therapy facilitated by Andersen. We show how Andersen and client participants oriented to and addressed problems of understanding that occurred between them. The source of this trouble was Andersen's use of unusual question formulations. We offer preliminary evidence that such unusual formulations served particular interactional and institutional (i.e., therapeutic) functions in their local contexts of use. We conclude by considering some implications of this analysis-and of conversation analytic inquiry more generally-for the practice of family therapy. © 2018 American Association for Marriage and Family Therapy.

Women's oral health: growing evidence for enhancing perspectives.

PubMed

Halpern, Leslie R; Kaste, Linda M; Briggs, Charlotte; DiPietro, Luisa A; Erwin, Katherine; Frantsve-Hawley, Julie; Gordon, Sara; Heaton, Brenda; Henshaw, Michelle M; Joskow, Renée; Reisine, Susan T; Sinkford, Jeanne C

2013-04-01

Women's health, including oral health, is an evolving science with foundation knowledge from many disciplines. Key milestones, particularly in the last decade, provide a roadmap towards the necessary inclusion of gender into dental practice. Such focus is especially important for the evolving role of oral health care providers as primary health care providers. Continued progress of the vibrant incorporation of evidence-based women's oral health into the standard practice of oral health care is encouraged. This expanded preface provides an introduction to this DCNA issue, a brief history and timeline of major women's oral health events, and resources for further consideration. Copyright © 2013. Published by Elsevier Inc.

Working with the Mental Capacity Act: findings from specialist palliative and neurological care settings.

PubMed

Wilson, Eleanor; Seymour, Jane E; Perkins, Paul

2010-06-01

Since October 2007 staff across health and social care services in England and Wales have been guided by the Mental Capacity Act (2005) in the provision of care for those who may lack capacity to make some decisions for themselves. This paper reports on the findings from a study with 26 staff members working in three palliative and three neurological care centres. Semistructured interviews were used to gain an understanding of their knowledge of the Mental Capacity Act, the issue of capacity itself and the documentation processes associated with the introduction of the Act and in line with advance care planning. Within this setting advance care planning is a key part of care provision and the mental capacity of service users is a regular issue. Findings show that staff generally had a good understanding of issues around capacity but felt unclear about some of the terminology related to the Mental Capacity Act, impacting on their confidence to discuss issues with service users and complete the documentation. Many felt the Act and its associated documentation had aided record-keeping in an area staff already delivered well in practice. Advance care planning in the context of the Mental Capacity Act is not as well embedded in practice as providers would like and consideration needs to be given to how and when staff should approach these issues with service users.

Diversity management: an imperative for healthcare organizations.

PubMed

Gathers, Daryl

2003-01-01

Historically, white males have represented the ideal manager in appearance, values, and behaviors, resulting in overt or subtle discrimination in selection, evaluation, and promotion practices in corporate America. Because women and minorities could not meet this ideal, they were often passed over for advancement. The author discusses key areas of diversity management for healthcare administrators to consider: the elements of diversity, the reasons behind diversity management, and solutions for addressing many of the issues involved.

Considerations to Enhance the Florida Domestic Security Strategic Plan

DTIC Science & Technology

2011-03-01

In his book, Implementing your Strategic Plan How to Turn “Intent” Into Effective Action for Sustainable Change, C. Davis Fogg suggests that...companies that are long-term, strategic winners faithfully practice 18 keys to strategy implementation (1999). Fogg states to begin, a company must have a...this small group of strategic priority issues will lead one toward an envisioned future ( Fogg , 1999, p. 6). Fogg suggests that it is important

From Cases to Capacity? A Critical Reflection on the Role of ‘Ethical Dilemmas’ in the Development of Dual-Use Governance

PubMed Central

Edwards, Brett; Revill, James; Bezuidenhout, Louise

2016-01-01

The dual-use issue is often framed as a series of paralyzing ‘dilemmas’ facing the scientific community as well as institutions which support innovation. While this conceptualization of the dual-use issue can be useful in certain contexts (such as in awareness-raising and as part of educational activities directed at the scientific community) its usefulness is more limited when reflecting on the governance and politics of the dual-use issue. Within this paper, key shortcomings of the dilemma framing are outlined. It is argued that many of the issues raised in the most recent debates about ‘dual-use’ bird flu research remain unresolved. This includes questions about the trajectories of certain lines of research, as well as broader trends in the practice and governance of science. This leads to difficult questions about current approaches to the dual-use issue within the US, as well as internationally. PMID:23703451

Does Evidence Matter? How Middle School Students Make Decisions About Socioscientific Issues

NASA Astrophysics Data System (ADS)

Emery, Katherine Beth

People worldwide are faced with making decisions daily. While many decisions are quick (e.g., what clothes to wear), others, such as those about environmental issues (e.g., overfishing), require more thought and have less immediate outcomes. How one makes such decisions depends on how one interprets, evaluates, and uses evidence. The central objective of this thesis was to investigate environmental science literacy in general, and specifically, to understand how evidence and other factors impact decision-making. I conducted three main studies: First, I provide an example of how decision-making practices affect environmental systems and services through a descriptive case study of Atlantic bluefin tuna overfishing. I reviewed the scientific, historical and cultural factors contributing to a paradox of marine preservation in the Mediterranean and highlighted the need for education and informed decision-making about such social and ecological issues. This study motivated me to investigate how people make decisions about environmental issues. Second, I interviewed middle school students to understand how they describe and evaluate evidence hypothetically and in practice about environmental issues---a key component of environmental literacy. Students discussed how they would evaluate evidence and then were then given a packet containing multiple excerpts of information from conflicting stakeholders about an environmental issue and asked how they would make voting or purchasing decisions about these issues. Findings showed that students' ideas about evaluating evidence (e.g., by scientific and non-scientific criteria) match their practices in part. This study was unique in that it investigated how students evaluate evidence that (1) contradicts other evidence and (2), conflicts with the student's prior positions. Finally, I investigated whether middle school students used evidence when making decisions about socioscientific issues. I hypothesized that holding a strong opinion would decrease the likelihood of changing decisions when presented with additional information. Findings indicated that most students do not change their stance after reading additional evidence. Students were more likely to change their decisions about issues that they cared least about than about issues that they cared most about. Implications for science teaching and learning are discussed.

Health workers who ask about social determinants of health are more likely to report helping patients: Mixed-methods study.

PubMed

Naz, Anila; Rosenberg, Ellen; Andersson, Neil; Labonté, Ronald; Andermann, Anne

2016-11-01

To assess the feasibility of implementing a clinical decision aid called the CLEAR Toolkit that helps front-line health workers ask their patients about social determinants of health, refer to local support resources, and advocate for wider social change. A mixed-methods study using quantitative (online self-completed questionnaires) and qualitative (in-depth interviews, focus groups, and key informant interviews) methods. A large, university-affiliated family medicine teaching centre in Montreal, Que, serving one of the most ethnically diverse populations in Canada. Fifty family doctors and allied health workers responded to the online survey (response rate of 50.0%), 15 completed in-depth interviews, 14 joined 1 of 2 focus groups, and 3 senior administrators participated in key informant interviews. Our multimethod approach included an online survey of front-line health workers to assess current practices and collect feedback on the tool kit; in-depth interviews to understand why they consider certain patients to be more vulnerable and how to help such patients; focus groups to explore barriers to asking about social determinants of health; and key informant interviews with high-level administrators to identify organizational levers for changing practice. Senior administrators consider asking about social determinants to be part of the mandate of health workers. However, barriers perceived by front-line clinicians include insufficient training in social history taking, uncertainty about how to address these issues in clinical practice, and a lack of knowledge of local referral resources. Health workers with specific ways of asking patients about their social challenges were more likely to report having helped their patients as compared with those who did not know how to ask (93.8% vs 52.9%; P = .003). While health workers recognize the importance of social determinants, many are unsure how to ask about these often sensitive issues or where to refer patients. The CLEAR Toolkit can be easily adapted to local contexts to help front-line health workers initiate dialogue around social challenges and better support patients in clinical practice. Copyright© the College of Family Physicians of Canada.

Conceptual parameters of acculturation within the Asian and Pacific Islander American populations: applications for nursing practice and research.

PubMed

Baker, Dian

2011-01-01

Asian and Pacific Islander Americans (A&PIAs) are experiencing health inequities. For example, A&PIA is the only racial/ethnic group in America to experience cancer as their leading cause of death. Several studies within the A&PIA population have pointed to acculturation as a significant variable to explain their health and health-seeking behaviors. Acculturation is a key construct in understanding the health of the A&PIA population. The purpose of this concept analysis is to provide a current conceptual understanding of the relationship between acculturation and health, especially within the A&PIA populations, which will serve as a pragmatic guideline for nursing practice and research. Understanding the contemporary issues surrounding the conceptual application of acculturation will aid in the development of appropriate programs to reduce health inequities. Acculturation was explored using the Morse method of concept analysis. An iterative historical and contemporary literature review across the disciplines of anthropology, sociology, psychology, medicine, and nursing was completed. Analytical questions asked of the resultant data provided the theoretical definition, antecedents, key attributes, outcomes, and implications. The concept analysis resulted in a new theoretical definition that includes multidimensional concepts of acculturation. Dilemmas in the measurement of key attributes of acculturation include unidirectional and bidirectional analysis, psychometric issues, and the appropriateness of proxy measurements. Outcomes of acculturation on health can be positive or negative and depend on an individual's or group's ability to navigate freely with necessary supports. Results of the conceptual analysis resulted in recommendations for nursing practice and future acculturation research. While debate continues about the appropriate use and definition of acculturation, researchers agree that it is an important construct in understanding the health of migrating individuals and groups. Currently there is no testable framework that delineates the role of acculturation in health. Further research is indicated to clarify the relationship between acculturation and health. © 2011 Wiley Periodicals, Inc.

Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

PubMed

Buse, Chris G; Smith, Maxwell; Silva, Diego S

2018-06-04

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

Preface to the special issue on "Integrated Microwave Photonic Signal Processing"

NASA Astrophysics Data System (ADS)

Azaña, José; Yao, Jianping

2016-08-01

As Guest Editors, we are pleased to introduce this special issue on ;Integrated Microwave Photonic Signal Processing; published by the Elsevier journal Optics Communications. Microwave photonics is a field of growing importance from both scientific and practical application perspectives. The field of microwave photonics is devoted to the study, development and application of optics-based techniques and technologies aimed to the generation, processing, control, characterization and/or distribution of microwave signals, including signals well into the millimeter-wave frequency range. The use of photonic technologies for these microwave applications translates into a number of key advantages, such as the possibility of dealing with high-frequency, wide bandwidth signals with minimal losses and reduced electromagnetic interferences, and the potential for enhanced reconfigurability. The central purpose of this special issue is to provide an overview of the state of the art of generation, processing and characterization technologies for high-frequency microwave signals. It is now widely accepted that the practical success of microwave photonics at a large scale will essentially depend on the realization of high-performance microwave-photonic signal-processing engines in compact and integrated formats, preferably on a chip. Thus, the focus of the issue is on techniques implemented using integrated photonic technologies, with the goal of providing an update of the most recent advances toward realization of this vision.

Physics Matters: An Introduction to Conceptual Physics

NASA Astrophysics Data System (ADS)

Trefil, James; Hazen, Robert M.

2003-12-01

From amusement park rides to critical environmental issues such as energy generation-physics affects almost every aspect of our world. In PHYSICS MATTERS, James Trefil and Robert Hazen examine the fundamental physics principles at work behind the many practical applications that fuel our society and individual lives. Their goal is to promote a deeper understanding of how the great ideas of physics connect to form a much larger understanding of the universe in which we live. Highlights Helps readers build a general knowledge of key ideas in physics and their connection to technology and other areas of science. Promotes an appreciation of what science is, how scientific knowledge is developed, and how it differs from other intellectual activities. Examines modern technologies, including GPS, the Internet, and information technologies, as well as medical technologies, such as MRI, PET scans, CAT scans, and radioisotope tracers. Explores key issues facing the world today, such as global warning, nuclear waste, and government funding for research.

Physics Matters: An Introduction to Conceptual Physics, Activity Book

NASA Astrophysics Data System (ADS)

Trefil, James; Hazen, Robert M.

2004-02-01

From amusement park rides to critical environmental issues such as energy generation-physics affects almost every aspect of our world. In PHYSICS MATTERS, James Trefil and Robert Hazen examine the fundamental physics principles at work behind the many practical applications that fuel our society and individual lives. Their goal is to promote a deeper understanding of how the great ideas of physics connect to form a much larger understanding of the universe in which we live. Highlights Helps readers build a general knowledge of key ideas in physics and their connection to technology and other areas of science. Promotes an appreciation of what science is, how scientific knowledge is developed, and how it differs from other intellectual activities. Examines modern technologies, including GPS, the Internet, and information technologies, as well as medical technologies, such as MRI, PET scans, CAT scans, and radioisotope tracers. Explores key issues facing the world today, such as global warning, nuclear waste, and government funding for research.

A review on the key issues for lithium-ion battery management in electric vehicles

NASA Astrophysics Data System (ADS)

Lu, Languang; Han, Xuebing; Li, Jianqiu; Hua, Jianfeng; Ouyang, Minggao

2013-03-01

Compared with other commonly used batteries, lithium-ion batteries are featured by high energy density, high power density, long service life and environmental friendliness and thus have found wide application in the area of consumer electronics. However, lithium-ion batteries for vehicles have high capacity and large serial-parallel numbers, which, coupled with such problems as safety, durability, uniformity and cost, imposes limitations on the wide application of lithium-ion batteries in the vehicle. The narrow area in which lithium-ion batteries operate with safety and reliability necessitates the effective control and management of battery management system. This present paper, through the analysis of literature and in combination with our practical experience, gives a brief introduction to the composition of the battery management system (BMS) and its key issues such as battery cell voltage measurement, battery states estimation, battery uniformity and equalization, battery fault diagnosis and so on, in the hope of providing some inspirations to the design and research of the battery management system.

The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices

PubMed Central

Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

2014-01-01

Context Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. Methods We used key informant interviews, supplemented by document analysis. Findings The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. Conclusions In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. PMID:25199899

The dynamics of community health care consolidation: acquisition of physician practices.

PubMed

Christianson, Jon B; Carlin, Caroline S; Warrick, Louise H

2014-09-01

Health care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems. We used key informant interviews, supplemented by document analysis. The acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single-specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future. In the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices. © 2014 Milbank Memorial Fund.

Developing the practice context to enable more effective pain management with older people: an action research approach

PubMed Central

2011-01-01

Background This paper, which draws upon an Emancipatory Action Research (EAR) approach, unearths how the complexities of context influence the realities of nursing practice. While the intention of the project was to identify and change factors in the practice context that inhibit effective person-centred pain management practices with older people (65 years or older), reflective critical engagement with the findings identified that enhancing pain management practices with older people was dependent on cultural change in the unit as a whole. Methods An EAR approach was utilised. The project was undertaken in a surgical unit that conducted complex abdominal surgery. Eighty-five percent (n = 48) of nursing staff participated in the two-year project (05/NIR02/107). Data were obtained through the use of facilitated critical reflection with nursing staff. Results Three key themes (psychological safety, leadership, oppression) and four subthemes (power, horizontal violence, distorted perceptions, autonomy) were found to influence the way in which effective nursing practice was realised. Within the theme of 'context,' effective leadership and the creation of a psychologically safe environment were key elements in the enhancement of all aspects of nursing practice. Conclusions Whilst other research has identified the importance of 'practice context' and models and frameworks are emerging to address this issue, the theme of 'psychological safety' has been given little attention in the knowledge translation/implementation literature. Within the principles of EAR, facilitated reflective sessions were found to create 'psychologically safe spaces' that supported practitioners to develop effective person-centred nursing practices in complex clinical environments. PMID:21284857

Undergraduate Training in Human Sexuality-Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation.

PubMed

Clegg, Mary; Pye, Joanne; Wylie, Kevan R

2016-09-01

It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty and exposure to issues related to sexual health affected this opinion. One hundred seventy doctors maintaining contact with the University of Sheffield Medical School Alumni Office after qualifying in 2004 were sent self-completion postal questionnaires. Space was allocated for supplementary comments to their answers. Self-completion postal questionnaire. Although the response rate was low, there appeared to be an impact of the teaching of human sexuality on the clinical practice of doctors. More than two-thirds of respondents rated the teaching as useful and more than 70% felt more confident in diagnosing and managing male and female sexual issues. The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A safe way to talk about death.

PubMed

2016-11-09

Could a learning disability-specific death cafe be the key to initiating conversations about death and dying in a safe way? Paula Hopes writes in Learning Disability Practice about a conference on breaking bad news and noted that while some people with learning disabilities were ready to deal with the issues, healthcare professionals were not. Reasons varied from protecting people with learning disabilities to the assumption that they cannot cope with or understand the information. Ms Hopes says nurses should be advocates for people with learning disabilities and provide them with information to engage them in the process of dying. A learning disability-specific death cafe could support nurses to develop confidence in discussing this sensitive issue.

A Survey of Usability Practices in Free/Libre/Open Source Software

NASA Astrophysics Data System (ADS)

Paul, Celeste Lyn

A review of case studies about usability in eight Free/Libre/Open Source Software (FLOSS) projects showed that an important issue regarding a usability initiative in the project was the lack of user research. User research is a key component in the user-centered design (UCD) process and a necessary step for creating usable products. Reasons why FLOSS projects suffered from a lack of user research included poor or unclear project leadership, cultural differences between developer and designers, and a lack of usability engineers. By identifying these critical issues, the FLOSS usability community can begin addressing problems in the efficacy of usability activities and work towards creating more usable FLOSS products.

Making meaningful improvements to direct care worker training through informed policy: Understanding how care setting structure and culture matter.

PubMed

Kemeny, M Elizabeth; Mabry, J Beth

2017-01-01

Well-intentioned policy governing the training of direct care workers (DCWs) who serve older persons, in practice, may become merely a compliance issue for organizations rather than a meaningful way to improve quality of care. This study investigates the relationships between best practices in DCW training and the structure and culture of long term support service (LTSS) organizations. Using a mixed-methods approach to analyzing data from 328 licensed LTSS organizations in Pennsylvania, the findings suggest that public policy should address methods of training, not just content, and consider organizational variations in size, training evaluation practices, DCW integration, and DCW input into care planning. Effective training also incorporates support for organizations and supervisors as key aspects of DCWs' learning and working environment.

Developing a research agenda for cardiovascular disease prevention in high-risk rural communities.

PubMed

Melvin, Cathy L; Corbie-Smith, Giselle; Kumanyika, Shiriki K; Pratt, Charlotte A; Nelson, Cheryl; Walker, Evelyn R; Ammerman, Alice; Ayala, Guadalupe X; Best, Lyle G; Cherrington, Andrea L; Economos, Christina D; Green, Lawrence W; Harman, Jane; Hooker, Steven P; Murray, David M; Perri, Michael G; Ricketts, Thomas C

2013-06-01

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.

Blood pressure monitoring: theory and practice. European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability Teaching Course Proceedings.

PubMed

Stergiou, George S; Palatini, Paolo; Asmar, Roland; Bilo, Grzegorz; de la Sierra, Alejandro; Head, Geoff; Kario, Kazuomi; Mihailidou, Anastasia; Wang, Jiguang; Mancia, Giuseppe; O'Brien, Eoin; Parati, Gianfranco

2018-02-01

The European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring and Cardiovascular Variability organized a Teaching Course on 'Blood Pressure Monitoring: Theory and Practice' during the 2017 ESH Meeting in Milan, Italy. This course performed by 11 international BP monitoring experts covered key topics of BP monitoring, including office BP measurement, ambulatory BP monitoring, home BP monitoring, ambulatory versus home BP, white-coat and masked hypertension, cuff use, and BP variability. This article presents a summary of the proceedings of the ESH BP Monitoring Teaching Course, including essential information, practical issues, and recommendations on the clinical application of BP monitoring methods, aiming to the optimal management of patients with suspected or diagnosed hypertension.

Eleven essential steps to purchasing or selling a medical practice.

PubMed

Barrett, William

2014-01-01

Based on our experience in representing more than 100 doctors and medical specialists in practice sales and acquisitions, we have identified 11 key considerations important to a deal. There are several issues to consider while going through the process of buying or selling a practice including the implementation of a "letter of intent" as a first step rather than drafting a contract, securing a lease, and verifying the property is not in violation of the local zoning requirements. There are also considerations with regard to the patients, which range from how will the accounts receivable at the time of the closing be handled to who is responsible for the handling of continued treatment in an ongoing case after a deal is finalized. This article details these considerations and more.

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

PubMed

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

2010-11-01

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

Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities

PubMed Central

Corbie-Smith, Giselle; Kumanyika, Shiriki K.; Pratt, Charlotte A.; Nelson, Cheryl; Walker, Evelyn R.; Ammerman, Alice; Ayala, Guadalupe X.; Best, Lyle G.; Cherrington, Andrea L.; Economos, Christina D.; Green, Lawrence W.; Harman, Jane; Hooker, Steven P.; Murray, David M.; Perri, Michael G.; Ricketts, Thomas C.

2013-01-01

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas. PMID:23597371

Managing water resources infrastructure in the face of different values

NASA Astrophysics Data System (ADS)

Mostert, Erik

Water resources infrastructure (WRI) plays a key role in water management. It can serve or negatively affect some seven to ten different and sometimes conflicting values. WRI management is therefore not a purely technical issue. Economic analyses can help to some extent, but only for values related to current human use. Multi-criteria analysis can cover all values, but in the end WRI management is not an analytical issue, but a governance issue. Different governance paradigms exist: markets, hierarchies and “third alternatives”, such as common pool resources management and network management. This article presents social learning as the most promising paradigm. Positive experiences with social learning have been described and guidance on putting social learning into practice exists. Nonetheless, there are no magic solutions for managing WRI in the face of different values.

Academic physicians' opinions on preliminary reporting of echocardiographic data.

PubMed

McDonald, R W; Rice, M J; Reller, M D; Silberbach, G M; Imus, R L; Marcella, C P; Brazee, R B; Pantely, G A

1993-01-01

Preliminary reporting of echocardiographic data by cardiac sonographers has become a key issue in the echocardiography community. A survey on this issue was sent to 248 academic physicians and 89 (35.8%) were returned. In response to a question in the survey, 76 physicians stated that they had at least a limited amount of knowledge in echocardiography. For the group, 62% wanted a written or verbal preliminary report and 52% concluded that this report should be a part of the cardiac sonographer's position. If cardiac abnormalities are suspected, 65% wanted the results before the cardiologist reviewed the study, but only 42% of the physicians wanted a diagnostic versus a descriptive type of report. About 49% stated that if necessary they would attempt to influence the cardiac sonographer to give them a preliminary report, whereas 67% of the physicians would possibly use this information to medically manage the patient. Fifty percent believed that it was legal for a cardiac sonographer to give a preliminary report. Another 70% said that the cardiac sonographer would NOT be "practicing medicine without a license" and 66% concluded that they would NOT be "aiding and abetting the unauthorized practice of medicine" if given this information. These data have important potential ramifications for both cardiac sonographers as well as for the practice of cardiology regarding the issue of preliminary echocardiographic reports.

Introduction to special issue: moving forward in pediatric neuropsychology.

PubMed

Daly, Brian P; Giovannetti, Tania; Zabel, T Andrew; Chute, Douglas L

2011-08-01

This special issue of The Clinical Neuropsychologist focuses on advances in the emerging subspecialty of pediatric neuropsychology. The national and international contributions in this issue cover a range of key clinical, research, training, and professional issues specific to pediatric neuropsychology. The genesis for this project developed out of a series of talks at the Philadelphia Pediatric Neuropsychology Symposium in 2010, hosted by the Stein Family Fellow, the Department of Psychology of the College of Arts and Sciences at Drexel University, and the Philadelphia Neuropsychology Society. Articles that explore clinical practice issue focus on the assessment of special medical populations with congenital and/or acquired central nervous system insults. Research articles investigate the core features of developmental conditions, the use of technology in neuropsychological research studies, and large sample size genomic, neuropsychological, and imaging studies of under-represented populations. The final series of articles examine new considerations in training, advocacy, and subspecialty board certification that have emerged in pediatric neuropsychology. This introductory article provides an overview of the articles in this special issue and concluding thoughts about the future of pediatric neuropsychology.

What nurses and midwives want: Findings from the national survey on workplace climate and well-being.

PubMed

Holland, Peter J; Tham, Tse Leng; Gill, Fenella J

2018-06-01

A discussion of the findings from a nationwide study of workplace and well-being issues of Australian nurses and midwives. Current discourse only provides a fragmented understanding of a multifaceted nature of working conditions and well-being, necessitating a more holistic investigation to identify critical workplace issues within these professions. Discussion paper. A national survey conducted in July 2016 involving Australian Nursing and Midwifery Federation members. The literature supporting this paper focuses on the nursing and midwifery workforce and studies on attraction and retention issues. Workplace policies and practices in place in health care organizations that are within the control of management are key factors in the negative issues associated with the profession from the survey. Proactive and targeted interventions particularly aimed at salient issues of work intensification, declining engagement, and effective voice mechanisms are needed to address these crucial issues if the attrition of individuals from nursing and midwifery occupations is going to be ameliorated. To alleviate workforce issues pushing nurses and midwives to the tipping point of exiting the professions, health care organizations need to take a proactive stance in addressing issues under the control of management. © 2018 John Wiley & Sons Australia, Ltd.

Public health nutrition practice in Canada: a situational assessment.

PubMed

Fox, Ann; Chenhall, Cathy; Traynor, Marie; Scythes, Cindy; Bellman, Jane

2008-08-01

Renewed focus on public health has brought about considerable interest in workforce development among public health nutrition professionals in Canada. The present article describes a situational assessment of public health nutrition practice in Canada that will be used to guide future workforce development efforts. A situational assessment is a planning approach that considers strengths and opportunities as well as needs and challenges, and emphasizes stakeholder participation. This situational assessment consisted of four components: a systematic review of literature on public health nutrition workforce issues; key informant interviews; a PEEST (political, economic, environmental, social, technological) factor analysis; and a consensus meeting. Information gathered from these sources identified key nutrition and health concerns of the population; the need to define public health nutrition practice, roles and functions; demand for increased training, education and leadership opportunities; inconsistent qualification requirements across the country; and the desire for a common vision among practitioners. Findings of the situational assessment were used to create a three-year public health nutrition workforce development strategy. Specific objectives of the strategy are to define public health nutrition practice in Canada, develop competencies, collaborate with other disciplines, and begin to establish a new professional group or leadership structure to promote and enhance public health nutrition practice. The process of conducting the situational assessment not only provided valuable information for planning purposes, but also served as an effective mechanism for engaging stakeholders and building consensus.

Legal issues surrounding consent and capacity: the key to autonomy.

PubMed

Griffith, Richard; Tengnah, Cassam

2011-12-01

With campaigns from the RCN, Nursing Times and Patients' Association promoting dignity and choice in healthcare district nurses need to be aware of the legal principle that lie at the heart of autonomy, consent. In the first of a series of articles on the principles of patient consent Richard Griffith and Cassam Tengnah outline the elements of a valid consent and how important obtaining consent is to the propriety of a district nurse's practice.

Homeland security challenges in nursing practice.

PubMed

Boatright, Connie; McGlown, K Joanne

2005-09-01

Nurses need a comprehensive knowledge of doctrine, laws, regulations,programs, and processes that build the operational framework for health care preparedness. Key components of this knowledge base reside in the areas of: evolution of homeland security: laws and mandates affecting health care and compliance and regulatory issues for health care organizations. This article addresses primary components in both of these areas, after first assessing the status of nursing's involvement (in homeland security), as portrayed in the professional literature.

A Welcome for Every Child--How France Achieves Quality in Child Care: Practical Ideas for the United States. The Report of the Child Care Study Panel of the French-American Foundation.

ERIC Educational Resources Information Center

Richardson, Gail; Marx, Elisabeth

Seven principles underlying the impressive achievements of the French child care system are especially relevant to concerns and issues in the United States. First, the primary mission of child care is to help meet young children's integrated needs for education and care. Second, skilled staff is the key to program quality. Third, incentives and…

Proceedings of the seventh Northern region paediatric colloquium.

PubMed

Barkla, Xanthe; Kaplan, Carole

2014-01-01

Ethical and legal dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are relevant to both the medical and legal professions. To this end, senior figures from the medical and legal professions in the Northern region have met on a regular basis in order to discuss anonymised case material. We report on the proceedings of the seventh such meeting. Six cases are described and key points arising from the subsequent discussion are presented.

What are they thinking? Facilitating clinical reasoning through longitudinal patient exposure in rural practice.

PubMed

Campbell, David; Walters, Lucie; Couper, Ian; Greacen, Jane

2017-12-01

  This article reports the findings from an international research workshop, held over 2 days in October 2014 in Bairnsdale, Australia, which brought together 19 clinician teachers and medical educators who work in rural primary care. The objectives of the workshop were to clarify and identify the key aspects of the development of clinical reasoning in students and junior doctors, particularly as a result of longitudinal immersion in rural community practice.   Delegates were asked to prepare a 55-word vignette related to their experience of teaching clinical reasoning, and these case studies formed the basis of identification of key issues, further refined via a modified Delphi process.   The workshop identified four key themes: the patient’s story, the learner’s reasoning, the context of learning, and the role of the supervisor. Exposure to undifferentiated patient presentations is increasingly common in medical education, particularly in longitudinal integrated placements.   This research explored clinicians’ perspectives of how students develop their clinical reasoning: by learning from patients, from their supervisors and by understanding the context of their clinical interactions.  .

Hybrid electric vehicles in Europe and Japan

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

Wyczalek, F.A.

Beginning in 1990, the major automotive passenger vehicle manufacturers once again reexamined the battery powered electric vehicle (EV). This intensive effort to reduce the battery EV to commercial practice focused attention on the key issue of limited vehicle range, resulting from the low energy density and high mass characteristics of batteries, in comparison to liquid hydrocarbon fuels. Consequently, by 1995, vehicle manufacturers turned their attention to hybrid electric vehicles (HEV). This redirection of EV effort is highlighted by the focus on experimental hybrid EV displayed at the 1995 Frankfurt Motor Show and the Tokyo Motor Show in Japan. In Europemore » the 56th IAA in Frankfurt included twelve or more EV designed for personnel transportation, and among them, two featured hybrid-electric (HEV) systems: the Peugeot turboelectric HEV, and the Opel Ermscher Selectra HEV. In Japan, at the 31st Tokyo Motor Show, among the twenty or more EV on display, seven were hybrid HEV by: Daihatsu, Mitsubishi, Toyota: and, the Suburu, Suzuki, and the Kia KEV4 parallel type HEV. This paper presents a comparative analysis of the key features of these hybrid propulsion systems. Among the conclusions, two issues are evident: one, the focus is on series-type hybrid systems, with the exception of the parallel Suburu and Suzuki HEV, and, two, the major manufacturers are turning to the hybrid concept in their search for solutions to two key EV Issues: limited driving range; and, heating and air conditioning, associated with the low energy density characteristic of batteries.« less

Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

PubMed

Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

2017-04-01

A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues

PubMed Central

Goligher, Ewan C.; Ely, E. Wesley; Sulmasy, Daniel P.; Bakker, Jan; Raphael, John; Volandes, Angelo E.; Patel, Bhavesh M.; Payne, Kate; Hosie, Annmarie; Churchill, Larry; White, Douglas B.; Downar, James

2016-01-01

Objective Many patients are admitted to the intensive care unit at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia (PAS/E) holds implications for the practice of critical care medicine. The objective of this manuscript is to explore core ethical issues related to PAS/E from the perspective of healthcare professionals and ethicists on both sides of the debate. Synthesis We identified four issues highlighting the key areas of ethical tension central to evaluating PAS/E in medical practice: (1) the benefit or harm of death itself, (2) the relationship between PAS/E and withholding or withdrawing life support, (3) the morality of a physician deliberately causing death, and (4) the management of conscientious objection related to PAS/E in the critical care setting. We present areas of common ground as well as important unresolved differences. Conclusions We reached differing positions on the first three core ethical questions and achieved significant agreement on how critical care clinicians should manage conscientious objections related to PAS/E. The alternative positions presented in this paper may serve to promote open and informed dialogue within the critical care community. PMID:28098622

Physician-Assisted Suicide and Euthanasia in the ICU: A Dialogue on Core Ethical Issues.

PubMed

Goligher, Ewan C; Ely, E Wesley; Sulmasy, Daniel P; Bakker, Jan; Raphael, John; Volandes, Angelo E; Patel, Bhavesh M; Payne, Kate; Hosie, Annmarie; Churchill, Larry; White, Douglas B; Downar, James

2017-02-01

Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting. We present areas of common ground and important unresolved differences. We reached differing positions on the first three core ethical questions and achieved unanimity on how critical care clinicians should manage conscientious objections related to physician-assisted suicide and euthanasia. The alternative positions presented in this article may serve to promote open and informed dialogue within the critical care community.

When Does Decisional Impairment Become Decisional Incompetence? Ethical and Methodological Issues in Capacity Research in Schizophrenia

PubMed Central

Kim, Scott Y H

2006-01-01

Most decision-making capacity (DMC) research has focused on measuring the decision-making abilities of patients, rather than on how such persons may be categorized as competent or incompetent. However, research ethics policies and practices either assume that we can differentiate or attempt to guide the differentiation of the competent from the incompetent. Thus there is a need to build on the recent advances in capacity research by conceptualizing and studying DMC as a categorical concept. This review discusses why there is a need for such research and addresses challenges and obstacles, both practical and theoretical. After a discussion of the potential obstacles and suggesting ways to overcome them, it discusses why clinicians with expertise in capacity assessments may be the best source of a provisional “gold standard” for criterion validation of categorical capacity status. The review provides discussions of selected key methodological issues in conducting research that treats DMC as a categorical concept, such as the issue of the optimal number of expert judges needed to generate a criterion standard and the kinds of information presented to the experts in obtaining their judgments. Future research needs are outlined. PMID:16177276

Standardization of quantum key distribution and the ETSI standardization initiative ISG-QKD

NASA Astrophysics Data System (ADS)

Länger, Thomas; Lenhart, Gaby

2009-05-01

In recent years, quantum key distribution (QKD) has been the object of intensive research activities and of rapid progress, and it is now developing into a competitive industry with commercial products. Once QKD systems are transferred from the controlled environment of physical laboratories into a real-world environment for practical use, a number of practical security, compatibility and connectivity issues need to be resolved. In particular, comprehensive security evaluation and watertight security proofs need to be addressed to increase trust in QKD. System interoperability with existing infrastructures and applications as well as conformance with specific user requirements have to be assured. Finding common solutions to these problems involving all actors can provide an advantage for the commercialization of QKD as well as for further technological development. The ETSI industry specification group for QKD (ISG-QKD) offers a forum for creating such universally accepted standards and will promote significant leverage effects on coordination, cooperation and convergence in research, technical development and business application of QKD.

An exploration of the assessment experiences of new academics as they engage with a community of practice in higher education.

PubMed

Garrow, Amanda; Tawse, Stephen

2009-08-01

This paper considers a phenomenological research study that attempted to explore how new academics were introduced to the assessment process within a Higher Education context. Two key educational perspectives have shaped the interpretation of the studies findings. These are Nonaka and Takeuchi's [Nonaka, I., Takeuchi, H., 1995. The Knowledge Creating Company: How Japanese Companies Create the Dynamics of Innovation. Oxford University Press, New York] model of knowledge conversion and Lave and Wenger's work on communities of practice (1991, 2002). Three key findings emerged from this work. Firstly, the study highlights a number of issues relating to the types of support and guidance that new academics receive. These were divided into formal and informal types that either promoted conformity or facilitated challenge. Secondly, the study suggests that the ways in which experienced academic staff communicate their assessment knowledge and interact with new academics may require further consideration. Finally, the study raises questions about the type of academic that the organisation would wish to develop.

Management of adults with paediatric-onset chronic liver disease: strategic issues for transition care.

PubMed

Vajro, Pietro; Ferrante, Lorenza; Lenta, Selvaggia; Mandato, Claudia; Persico, Marcello

2014-04-01

Advances in the management of children with chronic liver disease have enabled many to survive into adulthood with or without their native livers, so that the most common of these conditions are becoming increasingly common in adult hepatology practice. Because the aetiologies of chronic liver disease in children may vary significantly from those in adulthood, adults with paediatric-onset chronic liver disease may often present with clinical manifestations unfamiliar to their adulthood physician. Transition of medical care to adult practice requires that the adulthood medical staff (primary physicians and subspecialists) have a comprehensive knowledge of childhood liver disease and their implications, and of the differences in caring for these patients. Pending still unavailable Scientific Society guidelines, this article examines causes, presentation modes, evaluation, management, and complications of the main paediatric-onset chronic liver diseases, and discusses key issues to aid in planning a program of transition from paediatric to adult patients. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Acceptability of the 6-PACK falls prevention program: A pre-implementation study in hospitals participating in a cluster randomized controlled trial

PubMed Central

Hill, Keith D.; Brand, Caroline A.; Livingston, Patricia M.; Botti, Mari

2017-01-01

There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; ‘falls alert’ signs; supervision of patients in the bathroom; ensuring patients’ walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients’ walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan. PMID:28199376

Ad hoc supervision of general practice registrars as a 'community of practice': analysis, interpretation and re-presentation.

PubMed

Clement, T; Brown, J; Morrison, J; Nestel, D

2016-05-01

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ('communities of practice') guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

PubMed

Malatzky, Christina; Bourke, Lisa

2018-05-25

To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

Issues and approaches for ensuring effective communication on acceptable daily exposure (ADE) values applied to pharmaceutical cleaning.

PubMed

Olson, Michael J; Faria, Ellen C; Hayes, Eileen P; Jolly, Robert A; Barle, Ester Lovsin; Molnar, Lance R; Naumann, Bruce D; Pecquet, Alison M; Shipp, Bryan K; Sussman, Robert G; Weideman, Patricia A

2016-08-01

This manuscript centers on communication with key stakeholders of the concepts and program goals involved in the application of health-based pharmaceutical cleaning limits. Implementation of health-based cleaning limits, as distinct from other standards such as 1/1000th of the lowest clinical dose, is a concept recently introduced into regulatory domains. While there is a great deal of technical detail in the written framework underpinning the use of Acceptable Daily Exposures (ADEs) in cleaning (for example ISPE, 2010; Sargent et al., 2013), little is available to explain how to practically create a program which meets regulatory needs while also fulfilling good manufacturing practice (GMP) and other expectations. The lack of a harmonized approach for program implementation and communication across stakeholders can ultimately foster inappropriate application of these concepts. Thus, this period in time (2014-2017) could be considered transitional with respect to influencing best practice related to establishing health-based cleaning limits. Suggestions offered in this manuscript are intended to encourage full and accurate communication regarding both scientific and administrative elements of health-based ADE values used in pharmaceutical cleaning practice. This is a large and complex effort that requires: 1) clearly explaining key terms and definitions, 2) identification of stakeholders, 3) assessment of stakeholders' subject matter knowledge, 4) formulation of key messages fit to stakeholder needs, 5) identification of effective and timely means for communication, and 6) allocation of time, energy, and motivation for initiating and carrying through with communications. Copyright © 2016 Elsevier Inc. All rights reserved.

Regulatory framework in assisted reproductive technologies, relevance and main issues.

PubMed

Merlet, Françoise

2009-01-01

Assisted reproductive technologies (ART) have changed life for the past 25 years and many ethical and social issues have emerged following this new method of conception. In order to protect individuals against scientific and ethical abuses without inhibiting scientific progress, a specific legal framework is necessary. The first French law on Bioethics was voted after an extensive debate in 1994 then reviewed in 2004. This review previously scheduled every five years is currently being discussed. Legal provisions applying to ART are part of a large framework including the protection of the patients' rights and biomedical research. The key principles consist of respect for human life and ban on commercial practices of human body parts, eugenic practices and any kind of cloning. These key principles apply to ART. Donation is anonymous and free. Created in 2004, the Agence de la biomédecine is a government agency and one of the main tools of the French regulations. The missions focus on improving the quality and the safety of the management of ART. Evaluation of activities is available to all from the annual report. The agency represents the French competent authority for medical and scientific aspects of ART. Substantial differences in European legislations exist from the open-up "laissez faire" to the most restrictive one. As a consequence a large reproductive tourism has developed particularly for egg donation or surrogacy. The medical and ethical conditions of management of patients and donors represent the main critical points. In order to avoid ethical abuses, homogenization regarding the key principles is necessary in Europe. It is an opportunity to reassert that human body parts should not be a source of financial gain.

Client Centeredness and Health Reform: Key Issues for Occupational Therapy

PubMed Central

Pitonyak, Jennifer S.; Fogelberg, Donald; Leland, Natalie E.

2015-01-01

Health reform promotes the delivery of patient-centered care. Occupational therapy’s rich history of client-centered theory and practice provides an opportunity for the profession to participate in the evolving discussion about how best to provide care that is truly patient centered. However, the growing emphasis on patient-centered care also poses challenges to occupational therapy’s perspectives on client-centered care. We compare the conceptualizations of client-centered and patient-centered care and describe the current state of measurement of client-centered and patient-centered care. We then discuss implications for occupational therapy’s research agenda, practice, and education within the context of patient-centered care, and propose next steps for the profession. PMID:26356651

Psychotherapy-based supervision models in an emerging competency-based era: a commentary.

PubMed

Falender, Carol A; Shafranske, Edward P

2010-03-01

As psychology engages in a cultural shift to competency-based education and training supervision practice is being transformed to the use of competency frames and the application of benchmark competencies. In this issue, psychotherapy-based models of supervision are conceptualized in a competency framework. This paper reflects on the translation of key components of each psychotherapy-based supervision approach in terms of foundational and functional competencies articulated in the Competencies Benchmarks (Fouad et al., 2009). The commentary concludes with a discussion of implications for supervision practice and identifies directions for future articulation and development, including evidence-based psychotherapy supervision. PsycINFO Database Record (c) 2010 APA, all rights reserved

Poetry therapy, men and masculinities.

PubMed

Furman, Rich; Dill, LeConté

2012-04-01

Therapists have long utilized poetry with various at risk male populations. Yet, in spite of its use, therapists have also been aware of the dilemmas associated with using poetry in a population whose behavior and identity may at times run counter to the core tenants of poetry therapy. However, the literature of poetry therapy does not fully explore what therapists need to know about men and masculinities in order to work with them. This article helps prepare therapists using poetry to become more sensitive to gender issues and utilize this understanding in their practice with men. It explores some of the key concepts from gender and masculinities studies and provides examples for how these concepts can be used in practice.

Advanced rural skills training - the value of an addiction medicine rotation.

PubMed

Allan, Julaine

2011-11-01

General practitioners are ideally placed to address drug and alcohol problems in the Australian population. Lack of adequate undergraduate and postgraduate training has been suggested as a key barrier limiting their involvement in addiction medicine. This article describes the establishment and operations of an advanced rural skills training program at the Lyndon Community - a rural drug and alcohol treatment organisation in New South Wales. An addiction medicine rotation offers general practice registrars the opportunity to develop skills and experience in psychosocial interventions as well as physical and mental health issues common in the treatment population. Registrars participating in the Lyndon Community program perceived that the training period had influenced and enhanced their future practice.

Clinical practice guideline: allergic rhinitis executive summary.

PubMed

Seidman, Michael D; Gurgel, Richard K; Lin, Sandra Y; Schwartz, Seth R; Baroody, Fuad M; Bonner, James R; Dawson, Douglas E; Dykewicz, Mark S; Hackell, Jesse M; Han, Joseph K; Ishman, Stacey L; Krouse, Helene J; Malekzadeh, Sonya; Mims, James Whit W; Omole, Folashade S; Reddy, William D; Wallace, Dana V; Walsh, Sandra A; Warren, Barbara E; Wilson, Meghan N; Nnacheta, Lorraine C

2015-02-01

The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the new Clinical Practice Guideline: Allergic Rhinitis. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 14 recommendations developed address the evaluation of patients with allergic rhinitis, including performing and interpretation of diagnostic testing and assessment and documentation of chronic conditions and comorbidities. It will then focus on the recommendations to guide the evaluation and treatment of patients with allergic rhinitis, to determine the most appropriate interventions to improve symptoms and quality of life for patients with allergic rhinitis. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Toward a cognitive-affective model of goal-setting in rehabilitation: is self-regulation theory a key step?

PubMed

Siegert, Richard J; McPherson, Kathryn M; Taylor, William J

2004-10-21

The aim of this article is to argue that self-regulation theory might offer a useful model for clinical practice, theory-building and empirical research on goal-setting in rehabilitation. Relevant literature on goal-setting and motivation in rehabilitation is considered and some problematic issues for current practice and future research are highlighted. Carver and Scheier's self-regulation theory and its application to rehabilitation research is examined. It is argued that self-regulation theory offers a robust theoretical framework for goal-setting and one in which the salient concepts of motivation and emotion are prominent. Self-regulation theory offers a potentially useful heuristic framework for rehabilitation research.

Some practical aspects of lossless and nearly-lossless compression of AVHRR imagery

NASA Technical Reports Server (NTRS)

Hogan, David B.; Miller, Chris X.; Christensen, Than Lee; Moorti, Raj

1994-01-01

Compression of Advanced Very high Resolution Radiometers (AVHRR) imagery operating in a lossless or nearly-lossless mode is evaluated. Several practical issues are analyzed including: variability of compression over time and among channels, rate-smoothing buffer size, multi-spectral preprocessing of data, day/night handling, and impact on key operational data applications. This analysis is based on a DPCM algorithm employing the Universal Noiseless Coder, which is a candidate for inclusion in many future remote sensing systems. It is shown that compression rates of about 2:1 (daytime) can be achieved with modest buffer sizes (less than or equal to 2.5 Mbytes) and a relatively simple multi-spectral preprocessing step.

Poetry therapy, men and masculinities

PubMed Central

Furman, Rich; Dill, LeConté

2016-01-01

Therapists have long utilized poetry with various at risk male populations. Yet, in spite of its use, therapists have also been aware of the dilemmas associated with using poetry in a population whose behavior and identity may at times run counter to the core tenants of poetry therapy. However, the literature of poetry therapy does not fully explore what therapists need to know about men and masculinities in order to work with them. This article helps prepare therapists using poetry to become more sensitive to gender issues and utilize this understanding in their practice with men. It explores some of the key concepts from gender and masculinities studies and provides examples for how these concepts can be used in practice. PMID:27134327

The manned transportation system study - Defining human pathways into space

NASA Technical Reports Server (NTRS)

Lance, Nick; Geyer, Mark S.; Gaunce, Michael T.; Anson, H. W.; Bienhoff, D. G.; Carey, D. A.; Emmett, B. R.; Mccandless, B.; Wetzel, E. D.

1992-01-01

Substantiating data developed by a NASA-industry team (NIT) for subsequent NASA decisions on the 'right' set of manned transportation elements needed for human access to space are discussed. Attention is given to the framework for detailed definition of these manned transportation elements. Identifying and defining architecture evaluation criteria, i.e., attributes, specified the amount and type of data needed for each concept under consideration. Several architectures, each beginning with today's transportation systems, were defined using representative systems to explore future options and address specific questions currently being debated. The present solutions emphasize affordability, safety, routineness, and reliability. Key issues associated with current business practices were challenged and the impact associated with these practices quantified.

Practical aspects of modern interferometry for optical manufacturing quality control: Part 2

NASA Astrophysics Data System (ADS)

Smythe, Robert

2012-07-01

Modern phase shifting interferometers enable the manufacture of optical systems that drive the global economy. Semiconductor chips, solid-state cameras, cell phone cameras, infrared imaging systems, space based satellite imaging and DVD and Blu-Ray disks are all enabled by phase shifting interferometers. Theoretical treatments of data analysis and instrument design advance the technology but often are not helpful towards the practical use of interferometers. An understanding of the parameters that drive system performance is critical to produce useful results. Any interferometer will produce a data map and results; this paper, in three parts, reviews some of the key issues to minimize error sources in that data and provide a valid measurement.

Practical aspects of modern interferometry for optical manufacturing quality control, Part 3

NASA Astrophysics Data System (ADS)

Smythe, Robert A.

2012-09-01

Modern phase shifting interferometers enable the manufacture of optical systems that drive the global economy. Semiconductor chips, solid-state cameras, cell phone cameras, infrared imaging systems, space-based satellite imaging, and DVD and Blu-Ray disks are all enabled by phase-shifting interferometers. Theoretical treatments of data analysis and instrument design advance the technology but often are not helpful toward the practical use of interferometers. An understanding of the parameters that drive the system performance is critical to produce useful results. Any interferometer will produce a data map and results; this paper, in three parts, reviews some of the key issues to minimize error sources in that data and provide a valid measurement.

Use and interpretation of climate envelope models: a practical guide

USGS Publications Warehouse

Watling, James I.; Brandt, Laura A.; Mazzotti, Frank J.; Romañach, Stephanie S.

2013-01-01

This guidebook is intended to provide a practical overview of climate envelope modeling for conservation professionals and natural resource managers. The material is intended for people with little background or experience in climate envelope modeling who want to better understand and interpret models developed by others and the results generated by such models, or want to do some modeling themselves. This is not an exhaustive review of climate envelope modeling, but rather a brief introduction to some key concepts in the discipline. Readers interested in a more in-depth treatment of much of the material presented here are referred to an excellent book, Mapping Species Distributions: Spatial Inference and Prediction by Janet Franklin. Also, a recent review (Araújo & Peterson 2012) provides an excellent, though more technical, discussion of many of the issues dealt with here. Here we treat selected topics from a practical perspective, using minimal jargon to explain and illustrate some of the many issues that one has to be aware of when using climate envelope models. When we do introduce specialized terminology in the guidebook, we bold the term when it is first used; a glossary of these terms is included at the back of the guidebook.

Using a communication audit to improve communication on clinical placement in pre-registration nursing.

PubMed

Hogard, Elaine; Ellis, Roger; Ellis, Jackie; Barker, Chris

2005-02-01

This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.

Potential of best practice to reduce impacts from oil and gas projects in the Amazon.

PubMed

Finer, Matt; Jenkins, Clinton N; Powers, Bill

2013-01-01

The western Amazon continues to be an active and controversial zone of hydrocarbon exploration and production. We argue for the urgent need to implement best practices to reduce the negative environmental and social impacts associated with the sector. Here, we present a three-part study aimed at resolving the major obstacles impeding the advancement of best practice in the region. Our focus is on Loreto, Peru, one of the largest and most dynamic hydrocarbon zones in the Amazon. First, we develop a set of specific best practice guidelines to address the lack of clarity surrounding the issue. These guidelines incorporate both engineering-based criteria and key ecological and social factors. Second, we provide a detailed analysis of existing and planned hydrocarbon activities and infrastructure, overcoming the lack of information that typically hampers large-scale impact analysis. Third, we evaluate the planned activities and infrastructure with respect to the best practice guidelines. We show that Loreto is an extremely active hydrocarbon front, highlighted by a number of recent oil and gas discoveries and a sustained government push for increased exploration. Our analyses reveal that the use of technical best practice could minimize future impacts by greatly reducing the amount of required infrastructure such as drilling platforms and access roads. We also document a critical need to consider more fully the ecological and social factors, as the vast majority of planned infrastructure overlaps sensitive areas such as protected areas, indigenous territories, and key ecosystems and watersheds. Lastly, our cost analysis indicates that following best practice does not impose substantially greater costs than conventional practice, and may in fact reduce overall costs. Barriers to the widespread implementation of best practice in the Amazon clearly exist, but our findings show that there can be great benefits to its implementation.

Ethical Issues in Transnational Eye Banking.

PubMed

Martin, Dominique E; Kelly, Richard; Jones, Gary L A; Machin, Heather; Pollock, Graeme A

2017-02-01

To review ethical issues that may arise in the setting of transnational eye banking activities, such as when exporting or importing corneal tissue for transplantation. A principle-based normative analysis of potential common dilemmas in transnational eye banking activities was performed. Transnational activities in eye banking, like those in other fields involving procurement and use of medical products of human origin, may present a number of ethical issues for policy makers and professionals. Key ethical concerns include the potential impact of export or import activities on self-sufficiency of corneal tissue supply within exporting and importing countries; potential disclosure requirements when obtaining consent or authorization for ocular tissue donation when donations may be exported; and difficulties inherent in assuring equity in the allocation of tissues available for export and in establishing and respecting standards of safety and quality across different jurisdictions. Further analysis of specific ethical issues in eye banking is necessary to inform development of guidelines and other governance tools that will assist policy makers and professionals to support ethical practice.

Infusing Sustainability Across Disciplines to Build Student Engagement

NASA Astrophysics Data System (ADS)

Bruckner, M. Z.; O'Connell, K.; McDaris, J. R.; Kirk, K. B.; Larsen, K.; Kent, M.; Manduca, C. A.; Egger, A. E.; Blockstein, D.; Mogk, D. W.; Taber, J.

2014-12-01

Establishing relevance and effective communication are key mechanisms for building student and community engagement in a topic and can be used to promote the importance of working across disciplines to solve problems. Sustainability, including the impacts of and responses to climate change, is an inherently interdisciplinary issue and can be infused across courses and curricula in a variety of ways. Key topics such as climate change, hazards, and food, water, and energy production and sustainability are relevant to a wide audience and can be used to build student engagement. Using real-world examples, service learning, and focusing on the local environment may further boost engagement by establishing relevance between sustainability issues and students' lives. Communication plays a key role in the exchange of information across disciplines and allows for a more holistic approach to tackling the complex climate and sustainability issues our society faces. It has the power to bridge gaps, break down disciplinary silos, and build connections among diverse audiences with a wide range of expertise, including scientists, policy-makers, stakeholders, and the general public. It also aids in planning and preparation for, response to, and mitigation of issues related to sustainability, including the impacts of climate change, to lessen the detrimental effects of unavoidable events such as sea level rise and extreme weather events. Several workshops from the InTeGrate and On the Cutting Edge projects brought together educators and practitioners from a range of disciplines including geoscience, engineering, social science, and more to encourage communication and collaboration across disciplines. They supported networking, community-building, and sharing of best practices for preparing our students for a sustainable future, both in and out of the workplace, and across disciplines. Interdisciplinary teams are also working together to author curricular materials that highlight societal issues. The InTeGrate Teaching Materials web pages highlight major outcomes from the workshops and feature community-contributed resources and pedagogic guidance designed to enhance teaching about sustainability across disciplines. Explore these materials at: serc.carleton.edu/integrate/teaching_materials/

Assessing and managing breast cancer risk: clinicians' current practice and future needs.

PubMed

Collins, Ian M; Steel, Emma; Mann, G Bruce; Emery, Jon D; Bickerstaffe, Adrian; Trainer, Alison; Butow, Phyllis; Pirotta, Marie; Antoniou, Antonis C; Cuzick, Jack; Hopper, John; Phillips, Kelly-Anne; Keogh, Louise A

2014-10-01

Decision support tools for the assessment and management of breast cancer risk may improve uptake of prevention strategies. End-user input in the design of such tools is critical to increase clinical use. Before developing such a computerized tool, we examined clinicians' practice and future needs. Twelve breast surgeons, 12 primary care physicians and 5 practice nurses participated in 4 focus groups. These were recorded, coded, and analyzed to identify key themes. Participants identified difficulties assessing risk, including a lack of available tools to standardize practice. Most expressed confidence identifying women at potentially high risk, but not moderate risk. Participants felt a tool could especially reassure young women at average risk. Desirable features included: evidence-based, accessible (e.g. web-based), and displaying absolute (not relative) risks in multiple formats. The potential to create anxiety was a concern. Development of future tools should address these issues to optimize translation of knowledge into clinical practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluation of Return to Practice: the views of nurse returnees from three NHS Hospital Trusts.

PubMed

Barriball, K Louise; Coopamah, Vinoda; Roberts, Julia; Watts, Suzanne

2007-05-01

Exploration of the views and experiences of returnees on a Return to Practice programme based in three NHS Hospital Trusts. In the light of nursing shortages in Britain, there is an ongoing need to encourage nurses to re-enter the profession through Return to Practice programmes. In order to maximize returnees' participation in the nursing workforce; however, evaluation of the effectiveness of Return to Practice programmes is necessary. 17 returnees were recruited to the study completing self-report questionnaires at programme commencement and participating in focus group discussions on programme completion. Three key issues emerged from the data: the varied personal circumstances and professional histories of returnees; the challenge of providing adequate support in practice that reflected returnees' individual needs and aspirations and the importance of flexible employment opportunities to meet returnees' expectations of an appropriate work life balance. It is important that any schemes to attract nurses back to the profession are targeted at their specific needs.

Networks as systems.

PubMed

Best, Allan; Berland, Alex; Greenhalgh, Trisha; Bourgeault, Ivy L; Saul, Jessie E; Barker, Brittany

2018-03-19

Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders. Sampling was purposive and at a senior level, focusing on board members, executive directors, funders, and academics. Data were analyzed thematically with reference to systems theory and Shiffman's theory of network development. Findings Five key lessons emerged: effective management and leadership are critical; networks need to balance "tight" and "loose" approaches to their structure and processes; an active communication strategy is key to create and maintain support; the goals, priorities, and membership must be carefully focused; and the network needs to support shared measurement of progress on agreed-upon goals. Shiffman's middle-range network theory is a useful tool when guided by the principles of complex systems that illuminate dynamic situations and shifting interests as global alliances evolve. Research limitations/implications This study was implemented at the end of the ten-year funding cycle. A more continuous evaluation throughout the term would have provided richer understanding of issues. Experience and perspectives at the country level were not assessed. Practical implications Design and management of large, complex networks requires ongoing attention to key issues like leadership, and flexible structures and processes to accommodate the dynamic reality of these networks. Originality/value This case study builds on growing interest in the role of networks to foster large-scale change. The particular value rests on the longitudinal perspective on the evolution of a large, complex global network, and the use of theory to guide understanding.

Enabling and enacting 'practical action' in catchments: responding to the 'wicked problem' of nonpoint source pollution in coastal subtropical Australia.

PubMed

Patterson, James J; Smith, Carl; Bellamy, Jennifer

2015-02-01

Enabling and enacting 'practical action' (i.e., purposeful and concerted collective action) in catchments is a key challenge in responding to a wide range of pressing catchment and natural resource management (NRM) issues. It is particularly a challenge in responding to 'wicked problems,' where generating action is not straightforward and cannot be brought about solely by any single actor, policy or intervention. This paper responds to the critical need to better understand how practical action can be generated in catchments, by conducting an in-depth empirical case study of efforts to manage nonpoint source (NPS) pollution in South East Queensland (SEQ), Australia. SEQ has seen substantial concerted efforts to manage waterway and catchment issues over two decades, yet NPS pollution remains a major problem for waterway health. A novel framework was applied to empirically analyze practical action in three local catchment cases embedded within the broader SEQ region. The analysis focuses on 'enabling capacities' underpinning practical action in catchments. Findings reveal that capacities manifested in different ways in different cases, yet many commonalities also occurred across cases. Interplay between capacities was critical to the emergence of adaptive and contextual forms of practical action in all cases. These findings imply that in order to enable and enact practical action in catchments, it is vital to recognize and support a diversity of enabling capacities across both local and regional levels of decision making and action. This is likely to have relevance for other 'wicked' catchment and NRM problems requiring local responses within broader multiscalar regional problem situations.

Re-Form: FPGA-Powered True Codesign Flow for High-Performance Computing In The Post-Moore Era

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

Cappello, Franck; Yoshii, Kazutomo; Finkel, Hal

Multicore scaling will end soon because of practical power limits. Dark silicon is becoming a major issue even more than the end of Moore’s law. In the post-Moore era, the energy efficiency of computing will be a major concern. FPGAs could be a key to maximizing the energy efficiency. In this paper we address severe challenges in the adoption of FPGA in HPC and describe “Re-form,” an FPGA-powered codesign flow.

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

Buchanan, J.R.; Keilholtz, G.W.

This report discusses the current status of liquid-metal fast breeder (LMFBR) development and one of the principal safety issues, a hypothetical core-disruptive accident (HCDA). Bibliographic information on worldwide LMFBRs relative to the development of the breeder reactor as a safe source of nuclear power is presented for the period 1960 through 1969. The bibliography consists of 1560 abstracts covering early research and development and operating experiences leading up to the present design practices that are necessary for the licensing of breeder reactors. Key-word, author, and permuted-title indexes are included for completeness.

Requirements Document for Development of a Livermore Tomography Tools Interface

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

Seetho, I. M.

In this document, we outline an exercise performed at LLNL to evaluate the user interface deficits of a LLNL-developed CT reconstruction software package, Livermore Tomography Tools (LTT). We observe that a difficult-to-use command line interface and the lack of support functions compound to generate a bottleneck in the CT reconstruction process when input parameters to key functions are not well known. Through the exercise of systems engineering best practices, we generate key performance parameters for a LTT interface refresh, and specify a combination of back-end (“test-mode” functions) and front-end (graphical user interface visualization and command scripting tools) solutions to LTT’smore » poor user interface that aim to mitigate issues and lower costs associated with CT reconstruction using LTT. Key functional and non-functional requirements and risk mitigation strategies for the solution are outlined and discussed.« less

Simplifying the negotiating process with physicians: critical elements in negotiating from private practice to employed physician.

PubMed

Gallucci, Armen; Deutsch, Thomas; Youngquist, Jaymie

2013-01-01

The authors attempt to simplify the key elements to the process of negotiating successfully with private physicians. From their experience, the business elements that have resulted in the most discussion center on the compensation including the incentive plan. Secondarily, how the issue of malpractice is handled will also consume a fair amount of time. What the authors have also learned is that the intangible issues can often be the reason for an unexpectedly large amount of discussion and therefore add time to the negotiation process. To assist with this process, they have derived a negotiation checklist, which seeks to help hospital leaders and administrators set the proper framework to ensure successful negotiation conversations. More importantly, being organized and recognizing these broad issues upfront and remaining transparent throughout the process will help to ensure a successful negotiation.

Continuing education in physical rehabilitation and health issues of agricultural workers.

PubMed

Wilhite, Carla S; Jaco, Linda

2014-01-01

Limited attention has been devoted to the cultural and practice competencies needed by occupational therapy and physical therapy professionals who provide services to farming families impacted by chronic health or disability issues. Agricultural occupational safety and health should represent a continuum of services responsive to individuals, families, and agricultural communities across a life span and range of health status changes. Physical rehabilitation professionals have a key role in impacting an agricultural producer's sense of self-efficacy and capacities for returning to agricultural living and work. However, demonstration of competency is essential in providing person-centered rehabilitation services of assessment, evaluation, treatment planning, interventions, referrals, and discharge issues. The paper highlights methods utilized by a state AgrAbility program and a former National AgrAbility Project to develop a model of continuing education programming for occupational and physical therapists that evaluate and treat agricultural workers after acute injury or exacerbation of chronic health conditions.

Adolescents' as active agents in the socialization process: legitimacy of parental authority and obligation to obey as predictors of obedience.

PubMed

Darling, Nancy; Cumsille, Patricio; Martínez, M Loreto

2007-04-01

Adolescents' agreement with parental standards and beliefs about the legitimacy of parental authority and their own obligation to obey were used to predict adolescents' obedience, controlling for parental monitoring, rules, and rule enforcement. Hierarchical linear models were used to predict both between-adolescent and within-adolescent, issue-specific differences in obedience in a sample of 703 Chilean adolescents (M age=15.0 years). Adolescents' global agreement with parents and global beliefs about their obligation to obey predicted between-adolescent obedience, controlling for parental monitoring, age, and gender. Adolescents' issue-specific agreement, legitimacy beliefs, and obligation to obey predicted issue-specific obedience, controlling for rules and parents' reports of rule enforcement. The potential of examining adolescents' agreement and beliefs about authority as a key link between parenting practices and adolescents' decisions to obey is discussed.

Salbutamol in paediatrics: pharmacology, prescribing and controversies.

PubMed

Andrzejowski, Paul; Carroll, Will

2016-08-01

Salbutamol has become a key drug in respiratory medicine since it was first developed by Sir David Jack et al in 1968, 5000 years after the β agonist ephedrine was first used in its raw form, as the Ma Huang herb in Chinese medicine to treat asthma. It is one of the most commonly encountered medicines in paediatric practice and the authors have found that an understanding of its pharmacology in clinical practice is incredibly helpful. In this article, we discuss its pharmacology and pharmacodynamics, practical prescribing points and some unresolved issues surrounding its use, which should serve to provide an essential working knowledge for the busy paediatrician. 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/

Disassembling archeology, reassembling the modern world.

PubMed

Carruthers, William; Van Damme, Stéphane

2017-09-01

This article provides a substantive discussion of the relevance of the history of archeology to the history of science. At the same time, the article introduces the papers contained in this special issue as exemplars of this relevance. To make its case, the article moves through various themes in the history of archeology that overlap with key issues in the history of science. The article discusses the role and tension of regimes of science in antiquarian and archeological practices, and also considers issues of scale and place, particularly in relation to the field. Additionally, the piece attends to issues of professionalization and the constitution of an archeological public, at the same time as discussing issues of empire, colonialism, and the circulation of knowledge. Meanwhile, enriching discussions within and beyond the history of science, the article discusses the history of archeology and its relationship with museums, collecting, and material culture and materiality. Finally, the piece discusses the relationship of the history of archeology with wider discussions about scientific ethics. In conclusion, the article questions whether we should speak of 'the history of archeology' at all.

Genecialist manifesto: overcoming the “class struggle” in medicine

PubMed Central

Iwata, Kentaro

2013-01-01

Generalists and specialists are often considered two completely distinct species, which culminates in the establishment of a concept of dichotomy. However, these dichotomy can at times fuel tension and even erupt into open conflict. In order to resolve this issue, the author herein proposes the concept of a “genecialist.” The genecialist refers to a hybrid comprising elements inherent to both generalists and specialists. This potentially overcomes the multitude of issues associated with both generalists and specialists in the practical aspects of medicine. The coalescence of these two contrarieties may hold the key to improving the future of health care. Mediating and integrating both categories into one consolidated entity carries the potential to stem the tide of class warfare between generalists and specialists. PMID:23596354

Overview of research addressing ethical dimensions of participation in traumatic stress studies: autonomy and beneficence.

PubMed

Newman, Elana; Kaloupek, Danny

2009-12-01

One element of the design of human research studies is ethically informed decision-making. Key issues include the safety, costs, and benefits of participation. Historically, much of this decision-making was based on opinion rather than formal evidence. Recently, however, investigators in the traumatic stress field have begun to collect data that are relevant to these decisions. In this article, the authors focus on issues emanating from the ethical concepts of autonomy and respect for persons and beneficence and nonmaleficence, and then summarize relevant evidence from studies with trauma-exposed individuals. Discussion addresses implications of this evidence for research practice and policy, and identifies some potentially informative data collections opportunities for future trauma studies.

Educator Preparedness for Mental Health in Adolescents: Opportunities for School Nurse Leadership.

PubMed

Smith-Fromm, Tiffany; Evans-Agnew, Robin A

2017-11-01

One in five adolescents will experience a mental health event in their lifetime. If left untreated, depression, anxiety, attention-deficit/hyperactivity, and anorexia/bulimia can elevate the risk of dropping out of high school. As a key principle of 21st-century nursing practice, school nurses must provide leadership in educating school staff in identifying and responding to mental health issues in high school settings. This article describes the results of an online survey assessing secondary educators' knowledge of and experience with mental health issues in one school district. Resources are suggested to assist nurses in educating school staff, providing them with ways to decrease stigma in the classroom, and partnering with the community to improve services.

An introduction to exemplar research: a definition, rationale, and conceptual issues.

PubMed

Bronk, Kendall Cotton; King, Pamela Ebstyne; Matsuba, M Kyle

2013-01-01

The exemplar methodology represents a useful yet underutilized approach to studying developmental constructs. It features an approach to research whereby individuals, entities, or programs that exemplify the construct of interest in a particularly intense or highly developed manner compose the study sample. Accordingly, it reveals what the upper ends of development look like in practice. Utilizing the exemplar methodology allows researchers to glimpse not only what is but also what is possible with regard to the development of a particular characteristic. The present chapter includes a definition of the exemplar methodology, a discussion of some of key conceptual issues to consider when employing it in empirical studies, and a brief overview of the other chapters featured in this volume. © Wiley Periodicals, Inc.

Dating Violence among College Students: Key Issues for College Counselors

ERIC Educational Resources Information Center

Murray, Christine E.; Kardatzke, Kerrie N.

2007-01-01

The authors present a review of literature examining dating violence among college students. They describe 6 key issues related to dating violence among college students that affect college counselors' work. These key issues relate to the incidence and prevalence of physical, sexual, and psychological violence in college students' dating…

Keys to career satisfaction: insights from a survey of women pediatric surgeons.

PubMed

Caniano, Donna A; Sonnino, Roberta E; Paolo, Anthony M

2004-06-01

Declining interest in the field of surgery is attributed to lifestyle issues, more women per class, high debt, and long residency. To maintain surgery as a premier career choice, female students must find surgery to be professionally and personally rewarding. A 35-item questionnaire was mailed to 95 women pediatric surgeons (WPS), assessing multiple professional and personal factors. Responses were entered into a confidential database and analyzed by chi2 or t tests. Seventy-nine percent of surveys were returned; practice was identified as academic (60%) and private (40%). Respondents were grouped by age: A, less than 44 years (41%); B, 45 to 54 years (37%); and C, greater than 55 years (22%). For academic WPS, 81% are on timeline for promotion. Insufficient protected time was a significant obstacle for a successful academic career in groups A and B (P =.001). Clinical load, on-call responsibilities, lack of mentorship, and departmental support were major obstacles in all groups (P =.05). Seventy-three percent of WPS in private practice were satisfied with their role in practice management; poor practice conditions were cited as the most frequent reason for job relocation. Sixty-one percent of WPS are married, and 46% are raising children. WPS had statistically significant more responsibilities for child care and household tasks in comparison with their partners. Eighty-three percent report career satisfaction but desire more time with family and for personal interests. Part-time and flexible work schedules were identified as attractive ways to achieve career-family balance. Eighty-four percent believe that quality-of-life issues are the dominant reason that fewer medical students choose surgical fields. WPS express career satisfaction but share the concerns of their female colleagues in other surgical disciplines. Quality of life is viewed as central to career choice for the current generation of medical students; female role models are key to recruiting women into pediatric surgery.

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

PubMed

Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy.

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures

PubMed Central

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures’ psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy. PMID:24834111

European consensus conference on faecal microbiota transplantation in clinical practice

PubMed Central

Cammarota, Giovanni; Ianiro, Gianluca; Tilg, Herbert; Rajilić-Stojanović, Mirjana; Kump, Patrizia; Satokari, Reetta; Sokol, Harry; Arkkila, Perttu; Pintus, Cristina; Hart, Ailsa; Segal, Jonathan; Aloi, Marina; Masucci, Luca; Molinaro, Antonio; Scaldaferri, Franco; Gasbarrini, Giovanni; Lopez-Sanroman, Antonio; Link, Alexander; de Groot, Pieter; de Vos, Willem M; Högenauer, Christoph; Malfertheiner, Peter; Mattila, Eero; Milosavljević, Tomica; Nieuwdorp, Max; Sanguinetti, Maurizio; Simren, Magnus; Gasbarrini, Antonio

2017-01-01

Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements. PMID:28087657

Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health.

PubMed

Galway, Lindsay P; Parkes, Margot W; Allen, Diana; Takaro, Tim K

2016-01-01

The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i) the need for frameworks that facilitate integration; (ii) emphasize learning-by-doing; (iii) the benefits of examining issues at multiple scales; (iv) make the implicit, explicit; and (v) the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly.

Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health

PubMed Central

Galway, Lindsay P.; Parkes, Margot W.; Allen, Diana; Takaro, Tim K.

2016-01-01

The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i) the need for frameworks that facilitate integration; (ii) emphasize learning-by-doing; (iii) the benefits of examining issues at multiple scales; (iv) make the implicit, explicit; and (v) the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly. PMID:29546171

Drinking water and health research: a look to the future in the United States and globally.

PubMed

Sobsey, Mark D

2006-01-01

Drinking water supplies continue to be a major source of human disease and death globally because many of them remain unsafe and vulnerable. Greater efforts are needed to address the key issues and questions which influence the provision of safe drinking water. Efforts are needed to re-evaluate and set new and better priorities for drinking water research and practice. More stakeholders need to be included in the processes of identifying key issues and setting priorities for safe drinking water. The overall approach to drinking water research and the provision of safe drinking water needs to become more rational and scientific, and become more visionary and anticipatory of the ever-present and emerging risks to drinking water safety. Collectively, we need to do a better job of making safe water available, accessible and affordable for all. One such approach to safe water for all is household water treatment and safe storage, which is being promoted globally by the World Health Organization and many other stakeholders and partners to reduce the global burden of waterborne disease.

Microorganisms: Good or Evil, MIRRI Provides Biosecurity Awareness.

PubMed

Smith, David; Martin, Dunja; Novossiolova, Tatyana

2017-03-01

The life-science community is a key stakeholder in the effort to ensure that the advances in biotechnology are not misused. Unfortunately, to date, the engagement of life scientists with issues of biosecurity has been limited. Microorganisms have been harnessed for the benefit of humankind but in the wrong hands could be used in direct or indirect acts against humans, livestock, crops, food, water infrastructure and other economically valuable entities. The Microbial Resources Research Infrastructure in its preparatory phase has addressed the topic implementing a code of conduct as part of its programme of prevention of malicious use and continues to work with the international community to raise awareness of best practice to avoid misuse of microorganisms. Biosecurity has become a major concern for several countries creating numerous activities to put in place counter measures, risk assessment, legislation and emergency response. The goal is to implement measures to protect us against malicious use of microorganisms, their products, information and technology transfer. Through this paper, we wish to discuss some of the activities that are underway, mention key educational tools and provide scientists with information on addressing biosecurity issues.

Digital Traces of Behaviour Within Addiction: Response to Griffiths (2017).

PubMed

Ellis, David A; Kaye, Linda K; Wilcockson, Thomas D W; Ryding, Francesca C

2018-01-01

Griffiths' (2017) response to the recent commentary piece by Ryding and Kaye (2017) on "Internet Addiction: A conceptual minefield" provided a useful critique and extension of some key issues. We take this opportunity to further build upon on one of these issues to provide some further insight into how the field of "internet addiction" (IA) or technological addictions more generally, may benefit from capitalising on behavioural data. As such, this response extends Griffiths' (2007) points surrounding the efficacy of behavioural data previously used in studies on problematic gambling, to consider its merit for future research on IA or associated topics such as Internet Gaming Disorder (IGD) or "Smartphone addiction". Within this, we highlight the challenges associated with utilising behavioural data but provide some practical solutions which may support researchers and practitioners in this field. These recent developments could, in turn, advance our understanding and potentially validate such concepts by establishing behavioural correlates, conditions and contexts. Indeed, corroborating behavioural metrics alongside self-report measures presents a key opportunity if scholars and practitioners are to move the field forward.

Improving the use of crop models for risk assessment and climate change adaptation.

PubMed

Challinor, Andrew J; Müller, Christoph; Asseng, Senthold; Deva, Chetan; Nicklin, Kathryn Jane; Wallach, Daniel; Vanuytrecht, Eline; Whitfield, Stephen; Ramirez-Villegas, Julian; Koehler, Ann-Kristin

2018-01-01

Crop models are used for an increasingly broad range of applications, with a commensurate proliferation of methods. Careful framing of research questions and development of targeted and appropriate methods are therefore increasingly important. In conjunction with the other authors in this special issue, we have developed a set of criteria for use of crop models in assessments of impacts, adaptation and risk. Our analysis drew on the other papers in this special issue, and on our experience in the UK Climate Change Risk Assessment 2017 and the MACSUR, AgMIP and ISIMIP projects. The criteria were used to assess how improvements could be made to the framing of climate change risks, and to outline the good practice and new developments that are needed to improve risk assessment. Key areas of good practice include: i. the development, running and documentation of crop models, with attention given to issues of spatial scale and complexity; ii. the methods used to form crop-climate ensembles, which can be based on model skill and/or spread; iii. the methods used to assess adaptation, which need broadening to account for technological development and to reflect the full range options available. The analysis highlights the limitations of focussing only on projections of future impacts and adaptation options using pre-determined time slices. Whilst this long-standing approach may remain an essential component of risk assessments, we identify three further key components: 1.Working with stakeholders to identify the timing of risks. What are the key vulnerabilities of food systems and what does crop-climate modelling tell us about when those systems are at risk?2.Use of multiple methods that critically assess the use of climate model output and avoid any presumption that analyses should begin and end with gridded output.3.Increasing transparency and inter-comparability in risk assessments. Whilst studies frequently produce ranges that quantify uncertainty, the assumptions underlying these ranges are not always clear. We suggest that the contingency of results upon assumptions is made explicit via a common uncertainty reporting format; and/or that studies are assessed against a set of criteria, such as those presented in this paper.

Advancing antimicrobial stewardship: Summary of the 2015 CIDSC Report.

PubMed

Khan, F; Arthur, J; Maidment, L; Blue, D

2016-11-03

Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment. The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective. To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions. Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship. The information was reviewed and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada. The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research. Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels. Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals. ​: Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs. Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.

Fast and simple high-capacity quantum cryptography with error detection

PubMed Central

Lai, Hong; Luo, Ming-Xing; Pieprzyk, Josef; Zhang, Jun; Pan, Lei; Li, Shudong; Orgun, Mehmet A.

2017-01-01

Quantum cryptography is commonly used to generate fresh secure keys with quantum signal transmission for instant use between two parties. However, research shows that the relatively low key generation rate hinders its practical use where a symmetric cryptography component consumes the shared key. That is, the security of the symmetric cryptography demands frequent rate of key updates, which leads to a higher consumption of the internal one-time-pad communication bandwidth, since it requires the length of the key to be as long as that of the secret. In order to alleviate these issues, we develop a matrix algorithm for fast and simple high-capacity quantum cryptography. Our scheme can achieve secure private communication with fresh keys generated from Fibonacci- and Lucas- valued orbital angular momentum (OAM) states for the seed to construct recursive Fibonacci and Lucas matrices. Moreover, the proposed matrix algorithm for quantum cryptography can ultimately be simplified to matrix multiplication, which is implemented and optimized in modern computers. Most importantly, considerably information capacity can be improved effectively and efficiently by the recursive property of Fibonacci and Lucas matrices, thereby avoiding the restriction of physical conditions, such as the communication bandwidth. PMID:28406240

Fast and simple high-capacity quantum cryptography with error detection.

PubMed

Lai, Hong; Luo, Ming-Xing; Pieprzyk, Josef; Zhang, Jun; Pan, Lei; Li, Shudong; Orgun, Mehmet A

2017-04-13

Quantum cryptography is commonly used to generate fresh secure keys with quantum signal transmission for instant use between two parties. However, research shows that the relatively low key generation rate hinders its practical use where a symmetric cryptography component consumes the shared key. That is, the security of the symmetric cryptography demands frequent rate of key updates, which leads to a higher consumption of the internal one-time-pad communication bandwidth, since it requires the length of the key to be as long as that of the secret. In order to alleviate these issues, we develop a matrix algorithm for fast and simple high-capacity quantum cryptography. Our scheme can achieve secure private communication with fresh keys generated from Fibonacci- and Lucas- valued orbital angular momentum (OAM) states for the seed to construct recursive Fibonacci and Lucas matrices. Moreover, the proposed matrix algorithm for quantum cryptography can ultimately be simplified to matrix multiplication, which is implemented and optimized in modern computers. Most importantly, considerably information capacity can be improved effectively and efficiently by the recursive property of Fibonacci and Lucas matrices, thereby avoiding the restriction of physical conditions, such as the communication bandwidth.

Fast and simple high-capacity quantum cryptography with error detection

NASA Astrophysics Data System (ADS)

Lai, Hong; Luo, Ming-Xing; Pieprzyk, Josef; Zhang, Jun; Pan, Lei; Li, Shudong; Orgun, Mehmet A.

2017-04-01

Quantum cryptography is commonly used to generate fresh secure keys with quantum signal transmission for instant use between two parties. However, research shows that the relatively low key generation rate hinders its practical use where a symmetric cryptography component consumes the shared key. That is, the security of the symmetric cryptography demands frequent rate of key updates, which leads to a higher consumption of the internal one-time-pad communication bandwidth, since it requires the length of the key to be as long as that of the secret. In order to alleviate these issues, we develop a matrix algorithm for fast and simple high-capacity quantum cryptography. Our scheme can achieve secure private communication with fresh keys generated from Fibonacci- and Lucas- valued orbital angular momentum (OAM) states for the seed to construct recursive Fibonacci and Lucas matrices. Moreover, the proposed matrix algorithm for quantum cryptography can ultimately be simplified to matrix multiplication, which is implemented and optimized in modern computers. Most importantly, considerably information capacity can be improved effectively and efficiently by the recursive property of Fibonacci and Lucas matrices, thereby avoiding the restriction of physical conditions, such as the communication bandwidth.

When courts intervene: public health, legal and ethical issues surrounding HIV, pregnant women, and newborn infants.

PubMed

Tessmer-Tuck, Jennifer A; Poku, Joseph K; Burkle, Christopher M

2014-11-01

Ninety-three percent of pediatric AIDS cases are the result of perinatal HIV transmission, a disease that is almost entirely preventable with early intervention, which reduces the risk of perinatal HIV infection from 25% to <2%. The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics both recommend routine HIV testing of all pregnant women and at-risk newborn infants. When pregnant women decline HIV testing and/or treatment, public health, legal, and ethical dilemmas can result. Federal courts consistently uphold a woman's right to refuse medical testing and treatment, even though it may benefit her fetus/newborn infant. Federal courts also reliably respect the rights of parents to make health care decisions for their newborn infants, which may include declining medical testing and treatment. Confusing the issue of HIV testing and treatment, however, is the fact that there is no definitive United States Supreme Court ruling on the issue. State laws and standards vary widely and serve as guiding principles for practicing clinicians, who must be vigilant of ongoing legal challenges and changes in the states in which they practice. We present a case of an HIV-positive pregnant woman who declined treatment and then testing or treatment of her newborn infant. Ultimately, the legal system intervened. Given the rarity of such cases, we use this as a primer for the practicing clinician to highlight the public health, legal, and ethical issues surrounding prenatal and newborn infant HIV testing and treatment in the United States, including summarizing key state-to-state regulatory differences. Copyright © 2014 Elsevier Inc. All rights reserved.

Justification of radiographic examinations: What are the key issues?

PubMed

Vom, Jason; Williams, Imelda

2017-09-01

Justification of radiographic examinations is the practice of evaluating requested radiological examinations to assess for clinical merit and appropriateness based on clinical notes and patient information. This implies that justification in radiography requires the evaluation of requested examinations, the justification of exposures being applied and determining whether patients fit the recommended criteria for the procedure. Medico-legal requirements by the professional registration body, the Medical Radiation Practice Board of Australia (MRPBA), identify justification as an advocated and obligatory practice for radiographers. Yet, justification remains an inconsistent practice implemented amongst Australian radiographers. This review aims to identify associated barriers inhibiting the consistent practice of justification and the hesitance by radiographers in practicing justification responsibilities. It also recommends a change in workplace culture which encourages radiographers to accept a more autonomous role that cultivates critical thinking, reflection and research-informed decision making as justification will ultimately benefit patients. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Perspectives of San Juan healthcare practitioners on the detection deficit in oral premalignant and early cancers in Puerto Rico: a qualitative research study

PubMed Central

2011-01-01

Background In Puerto Rico, relative to the United States, a disparity exists in detecting oral precancers and early cancers. To identify factors leading to the deficit in early detection, we obtained the perspectives of San Juan healthcare practitioners whose practice could be involved in the detection of such oral lesions. Methods Key informant (KI) interviews were conducted with ten clinicians practicing in or around San Juan, Puerto Rico. We then triangulated our KI interview findings with other data sources, including recent literature on oral cancer detection from various geographic areas, current curricula at the University of Puerto Rico Schools of Medicine and Dental Medicine, as well as local health insurance regulations. Results Key informant-identified factors that likely contribute to the detection deficit include: many practitioners are deficient in knowledge regarding oral cancer and precancer; oral cancer screening examinations are limited regarding which patients receive them and the elements included. In Puerto Rico, specialists generally perform oral biopsies, and patient referral can be delayed by various factors, including government-subsidized health insurance, often referred to as Reforma. Reforma-based issues include often inadequate clinician knowledge regarding Reforma requirements/provisions, diagnostic delays related to Reforma bureaucracy, and among primary physicians, a perceived financial disincentive in referring Reforma patients. Conclusions Addressing these issues may be useful in reducing the deficit in detecting oral precancers and early oral cancer in Puerto Rico. PMID:21612663

Integrating postgraduate and undergraduate general practice education: qualitative study.

PubMed

O'Regan, Andrew; Culhane, Aidan; Dunne, Colum; Griffin, Michael; McGrath, Deirdre; Meagher, David; O'Dwyer, Pat; Cullen, Walter

2013-05-01

Educational activity in general practice has increased considerably in the past 20 years. Vertical integration, whereby practices support students and trainees at different stages, may enhance general practices' capacity to fulfil this role. To explore the potential for vertical integration in undergraduate and postgraduate education in general practice, by describing the experience of (and attitudes towards) 'vertical integration in general practice education' among key stakeholder groups. Qualitative study of GPs, practice staff, GPs-in-training and medical students involving focus groups which were thematically analysed. We identified four overarching themes: (1) Important practical features of vertical integration are interaction between learners at different stages, active involvement in clinical teams and interagency collaboration; (2) Vertical integration may benefit GPs/practices, students and patients through improved practice systems, exposure to team-working and multi-morbidity and opportunistic health promotion, respectively; (3) Capacity issues may challenge its implementation; (4) Strategies such as recognising and addressing diverse learner needs and inter-agency collaboration can promote vertical integration. Vertical integration, whereby practices support students and trainees at different stages, may enhance general practices' teaching capacity. Recognising the diverse educational needs of learners at different stages and collaboration between agencies responsible for the planning and delivery of specialist training and medical degree programmes would appear to be important.

Intervention against excessive alcohol consumption in primary health care: a survey of GPs' attitudes and practices in England 10 years on.

PubMed

Wilson, Graeme B; Lock, Catherine A; Heather, Nick; Cassidy, Paul; Christie, Marilyn M; Kaner, Eileen F S

2011-01-01

To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier. In total, 282 (73%) of 419 GPs surveyed in East Midlands, UK, completed a postal questionnaire, measuring practices and attitudes, including the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). GPs reported lower levels of post-graduate education or training on alcohol-related issues (<4 h for the majority) than in 1999 but not significantly so (P = 0.031). In the last year, GPs had most commonly requested more than 12 blood tests and managed 1-6 patients for alcohol. Reports of these preventive practices were significantly increased from 1999 (P < 0.001). Most felt that problem or dependent drinkers' alcohol issues could be legitimately (88%, 87%) and adequately (78%, 69%) addressed by GPs. However, they had low levels of motivation (42%, 35%), task-related self-esteem (53%, 49%) and job satisfaction (15%, 12%) for this. Busyness (63%) and lack of training (57%) or contractual incentives (48%) were key barriers. Endorsement for government policies on alcohol was very low. Among GPs, there still appears to be a gap between actual practice and potential for preventive work relating to alcohol problems; they report little specific training and a lack of support. Translational work on understanding the evidence-base supporting screening and brief intervention could incentivize intervention against excessive drinking and embedding it into everyday primary care practice.

Food parenting measurement issues: working group consensus report.

PubMed

Hughes, Sheryl O; Frankel, Leslie A; Beltran, Alicia; Hodges, Eric; Hoerr, Sharon; Lumeng, Julie; Tovar, Alison; Kremers, Stef

2013-08-01

Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent-child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.

Food Parenting Measurement Issues: Working Group Consensus Report

PubMed Central

Frankel, Leslie A.; Beltran, Alicia; Hodges, Eric; Hoerr, Sharon; Lumeng, Julie; Tovar, Alison; Kremers, Stef

2013-01-01

Abstract Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent–child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models. PMID:23944928

The effects of fatigue and dissatisfaction on how physicians perceive their social responsibilities.

PubMed

O'Donnell, Erin P; Humeniuk, Katherine M; West, Colin P; Tilburt, Jon C

2015-02-01

To examine how fatigue and dissatisfaction with practicing medicine relate to US physicians' perceptions of their professional responsibilities in a time of upheaval in health care. From May 30, 2012, through September 1, 2012, we mailed an 8-page paper survey, including measures of perceived social responsibility, fatigue, and satisfaction, to a random sample of 3897 physicians selected from the American Medical Association Physician Masterfile. We performed bivariate tests and multivariable logistic regression to examine associations between key predictors (fatigue and satisfaction) and 3 dependent variables: obligations to care for the uninsured and underinsured, obligations to address policy issues, and agreement with cost-containment. A total of 2556 physicians (65.6%) responded to the survey. Nearly half of physicians (1160 [45.4%]) reported high levels of fatigue, whereas most (1810 [70.8%]) expressed satisfaction with practicing medicine. Dissatisfaction in practicing medicine proved to be a significant predictor in how physicians perceive their professional responsibilities and in medical decision-making. Overall, physicians who rated themselves as very dissatisfied had a significantly reduced likelihood of favoring limiting reimbursement to expand basic coverage (odds ratio, 0.5; 95% CI, 0.3-0.7), recognizing an obligation to care for the uninsured (odds ratio, 0.5; 95% CI, 0.3-0.7), and addressing societal health policy issues (OR, 0.7; 95% CI, 0.5-0.9). Although fatigue and satisfaction are strongly associated, only satisfaction appears to correlate with physicians' perceived social responsibilities. Physicians who are dissatisfied with their profession may be less inclined to address health policy issues, embrace charity care, or practice cost containment. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Ethics and Childhood Vaccination Policy in the United States

PubMed Central

Sturm, Lynne A.; Zimet, Gregory D.; Meslin, Eric M.

2016-01-01

Childhood immunization involves a balance between parents’ autonomy in deciding whether to immunize their children and the benefits to public health from mandating vaccines. Ethical concerns about pediatric vaccination span several public health domains, including those of policymakers, clinicians, and other professionals. In light of ongoing developments and debates, we discuss several key ethical issues concerning childhood immunization in the United States and describe how they affect policy development and clinical practice. We focus on ethical considerations pertaining to herd immunity as a community good, vaccine communication, dismissal of vaccine-refusing families from practice, and vaccine mandates. Clinicians and policymakers need to consider the nature and timing of vaccine-related discussions and invoke deliberative approaches to policymaking. PMID:26691123

Accelerating the translation of research into practice in long term services and supports: a critical need for federal infrastructure at the nexus of aging and disability.

PubMed

Washko, Michelle M; Campbell, Margaret; Tilly, Jane

2012-01-01

The nexus of aging and disability, characterized by the phenomenon of aging with a disability, will become more visible as the population ages and the number of people with disabilities surviving to midlife increases. This article addresses 3 interrelated issues critical to the fields of aging and disability: increasing demand for community-based long-term services and supports, a paucity of evidence-based programs demonstrating effectiveness in facilitating independence for those aging with a disability, and lack of a federal infrastructure to support coordinated investments in research-to-practice for this population. Suggestions for federal interagency collaborations are given, along with roles for key stakeholders.

[Good practice in occupational health services: prophylactic care and occupational activation of people with disabilities due to respiratory diseases].

PubMed

Wiszniewska, Marta; Tymoszuk, Diana; Lipińska-Ojrzanowska, Agnieszka; Wagrowska-Koski, Ewa; Walusiak-Skorupa, Jolanta

2013-01-01

Respiratory diseases are a cause of long-term sickness absence, and even of partial or complete inability to work. This paper presents the first in Poland description of principles of good practice in occupational health service provided for people with respiratory diseases. The issues concerning the certification of the ability to work in this group of patients are discussed. The key-principles of preventive care of workers with obstructive and interstitial lung diseases with particular attention paid to the control of major risk factors are also presented. The importance of possible contraindications for job performance by workers affected by these diseases, as well as the responsibilities of occupational health physicians were highlighted. M

Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities.

PubMed

Rosenbaum, Marcy E

2017-11-01

The purpose of this paper, based on a 2016 Heidelberg International Conference on Communication in Healthcare (ICCH) plenary presentation, is to examine a key problem in communication skills training for health professional learners. Studies have pointed to a decline in medical students' communication skills and attitudes as they proceed through their education, particularly during their clinical workplace training experiences. This paper explores some of the key factors in this disintegration, drawing on selected literature and highlighting some curriculum efforts and research conducted at the University of Iowa Carver College of Medicine as a case study of these issues. Five key factors contributing to the disintegration of communication skills and attitudes are presented including: 1) lack of formal communication skills training during clinical clerkships; 2) informal workplace teaching failing to explicitly address learner clinical communication skills; 3) emphasizing content over process in relation to clinician-patient interactions; 4) the relationship between ideal communication models and the realities of clinical practice; and 5) clinical teachers' lack of knowledge and skills to effectively teach about communication in the clinical workplace. Within this discussion, potential practical responses by individual clinical teachers and broader curricular and faculty development efforts to address each of these factors are presented. Copyright © 2017 Elsevier B.V. All rights reserved.

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2011-05-06

... report entitled ``SAB Review of EPA's Reanalysis of Key Issues Related to Dioxin Toxicity and Response to... of EPA's Reanalysis of Key Issues Related to Dioxin Toxicity and Response to NAS Comments.'' The SAB... Reanalysis of Key Issues Related to Dioxin Toxicity and Response to NAS Comments.'' To conduct this review...

Education of advanced practice nurses in Canada.

PubMed

Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

2010-12-01

In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

Exploring barriers to assessment of bereavement risk in palliative care: perspectives of key stakeholders.

PubMed

Sealey, Margaret; O'Connor, Moira; Aoun, Samar M; Breen, Lauren J

2015-10-14

Palliative care standards advocate support for grieving caregivers, given that some bereaved people fail to integrate their loss, experience ongoing emotional suffering and adverse health outcomes. Research shows that bereavement support tends to be delivered on an ad hoc basis without formal assessment of risk or need. To align support with need, assessment of bereavement risk is necessary. The overall aim is to develop a bereavement risk assessment model, based on a three-tiered public health model, congruent with palliative care bereavement standards for use in palliative care in Western Australia. The specific aim of this phase of the study was to explore the perspectives of key stakeholders and to highlight issues in relation to the practice of bereavement risk assessment in palliative care. Action research, a cyclical process that involves working collaboratively with stakeholders, was considered as the best method to effect feasible change in practice. The nine participants were multidisciplinary health professionals from five palliative care services, and a bereaved former caregiver. Data were obtained from participants via three 90 min group meetings conducted over five weeks. An inductive thematic analysis approach was used to analyse data following each meeting until saturation was reached, and the research team was satisfied that the themes were congruent with research aims. Existing measures were found unsuitable to assess bereavement risk in palliative care. Assessment following the patient's death presented substantial barriers, directing assessment to the pre-death period. Four themes were identified relating to issues in need of consideration to develop a risk assessment model. These were systems of care, encompassing logistics of contact with caregivers; gatekeeping; conflation between caregiver stress, burden and grief; and a way forward. These group discussions provide a data-driven explanation of the issues affecting bereavement risk assessment in palliative care settings. A number of barriers will need to be overcome before assessment can become routine practice. We recommend the development of a brief, pre-death caregiver self-report measure of bereavement risk that may empower caregivers, lead to early intervention, and allow staff to remain focused on patient care, reducing burden on staff and palliative care services.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

PubMed

Jackson, Debra; Hickman, Louise D; Hutchinson, Marie; Andrew, Sharon; Smith, James; Potgieter, Ingrid; Cleary, Michelle; Peters, Kath

2014-10-27

Abstract Aim To summarise and critique the research literature about whistleblowing and nurses. Background Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. Method An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'whistleblow*', 'nurs*'. In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. Findings Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Conclusions Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

PubMed

Jackson, Debra; Hickman, Louise D; Hutchinson, Marie; Andrew, Sharon; Smith, James; Potgieter, Ingrid; Cleary, Michelle; Peters, Kath

2014-01-01

Abstract Aim: To summarise and critique the research literature about whistleblowing and nurses. Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the data-based literature has not been undertaken. An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: 'Whistleblow*,' 'nurs*.' In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007-2013 were selected for inclusion. Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

The use of virtual communities of practice to improve interprofessional collaboration and education: findings from an integrated review.

PubMed

McLoughlin, Clodagh; Patel, Kunal D; O'Callaghan, Tom; Reeves, Scott

2018-03-01

The recent growth in online technology has led to a rapid increase in the sharing of health related information globally. Health and social care professionals are now using a wide range of virtual communities of practice (VCoPs) for learning, support, continuing professional education, knowledge management and information sharing. In this article, we report the findings from a review of the literature that explored the use of VCoPs by health and social care professionals to determine their potential for interprofessional education and collaboration. We employed integrated review methods to search and identify relevant VCoP articles. We undertook searches of PubMed and Google Scholar from 2000, which after screening, resulted in the inclusion of 19 articles. A thematic analysis generated the following key issues related to the use of VCoPs: 'definitions and approaches', 'technological infrastructure', 'reported benefits', 'participation issues', 'trust and privacy and 'technical ability'. Based on the findings from this review, there is some evidence that VCoPs can offer an informal method of professional and interprofessional development for clinicians, and can decrease social and professional isolation. However, for VCoPs to be successful, issues of privacy, trust, encouragement and technology need to be addressed.

Community-university partnerships in occupational therapy education: a preliminary exploration of practice in a European context.

PubMed

McGrath, Margaret; Moldes, Ines Viana; Fransen, Hetty; Hofstede-Wessels, Saskia; Lilienberg, Karin

2014-01-01

To explore community-university partnerships in occupational therapy education in Europe. Educators from Europe were invited to participate in the study. Data were collected using a questionnaire designed for the study. Eleven completed questionnaires were included. Descriptive statistics were generated from quantitative data while qualitative data were analyzed using inductive content analysis. The majority of participants reported that community-university partnerships were part of the third year of undergraduate occupational therapy studies. Partners were from a broad range of sectors. The activities undertaken were typically focused on specific target groups within the community. Three main themes emerged from the qualitative analysis (i) instigating community-university partnerships, (ii) processes of creating and sustaining partnerships and (iii) perceived outcomes of community-university partnerships. This is the first study of community-university partnerships in Europe generating some useful findings. Clarification is needed regarding the use of the term community-university partnership. Educators are called upon to consider how partnerships are embedded into curricula and to address issues of sustainability. Healthcare education should prepare rehabilitation professionals to collaborate with diverse communities. Community--university collaborations appear to offer opportunities to support students to develop competences for future community orientated practice. Key issues to be considered include choice of pedagogical approach, issues of reciprocity and sustainability.

Making sense in a complex landscape: how the Cynefin Framework from Complex Adaptive Systems Theory can inform health promotion practice.

PubMed

Van Beurden, Eric K; Kia, Annie M; Zask, Avigdor; Dietrich, Uta; Rose, Lauren

2013-03-01

Health promotion addresses issues from the simple (with well-known cause/effect links) to the highly complex (webs and loops of cause/effect with unpredictable, emergent properties). Yet there is no conceptual framework within its theory base to help identify approaches appropriate to the level of complexity. The default approach favours reductionism--the assumption that reducing a system to its parts will inform whole system behaviour. Such an approach can yield useful knowledge, yet is inadequate where issues have multiple interacting causes, such as social determinants of health. To address complex issues, there is a need for a conceptual framework that helps choose action that is appropriate to context. This paper presents the Cynefin Framework, informed by complexity science--the study of Complex Adaptive Systems (CAS). It introduces key CAS concepts and reviews the emergence and implications of 'complex' approaches within health promotion. It explains the framework and its use with examples from contemporary practice, and sets it within the context of related bodies of health promotion theory. The Cynefin Framework, especially when used as a sense-making tool, can help practitioners understand the complexity of issues, identify appropriate strategies and avoid the pitfalls of applying reductionist approaches to complex situations. The urgency to address critical issues such as climate change and the social determinants of health calls for us to engage with complexity science. The Cynefin Framework helps practitioners make the shift, and enables those already engaged in complex approaches to communicate the value and meaning of their work in a system that privileges reductionist approaches.

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

PubMed

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-01-01

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

Child rights and Child and Adolescent Mental Health Services (CAMHS) in Ireland.

PubMed

Damodaran, J; Sherlock, C

2013-12-01

This paper explores children's rights in the child and adolescent mental health arena in Ireland. It begins by outlining the legal and policy contexts of both children's services and mental health policy and practice. It specifically focuses on the notion of participation as a key factor in addressing rights-based approaches in the provision of services. The article explores current practice in Child and Adolescent Mental Health Services, highlights some of the disparities in services, which result in questions about human rights. Mainly reflective in its approach, it does, however, provide data from a small scale qualitative study carried out in relation to young people diagnosed with ADHD and their perceptions of psychopharmacological approach. The issue of consent is explored as an example of how current practice approaches fall short of a rights-based framework. It concludes with recommendations for changes incorporating a more participatory and collaborative approach.

The new caring: financial asset management and older people.

PubMed

Tilse, Cheryl; Wilson, Jill; Setterlund, Deborah; Rosenman, Linda

2007-10-01

Increasing longevity and the growing proportion of the aged in the population in most countries have served to focus on the question of how governments and older people can finance living, health, and care options in retirement. Prudent management of income and assets is an increasingly complex and important aspect of aging as assets and expectations of self-financing increase. Although many informal caregivers act as asset managers and/or substitute decision-makers for older people, little attention has been paid to this increasingly important aspect of care. This paper summaries key findings of a broad research program exploring family involvement in the management of older people's assets and the practices that constitute good practice as well as financial mismanagement and abuse. It identifies multi-level and multi-strategy responses needed to address the issues raised by the research and outlines an innovative community demonstration project aimed at improving financial management practices in relation to older people's assets.

SAFETY: an integrated clinical reasoning and reflection framework for undergraduate nursing students.

PubMed

Hicks Russell, Bedelia; Geist, Melissa J; House Maffett, Jenny

2013-01-01

Nurse educators can no longer focus on imparting to students knowledge that is merely factual and content specific. Activities that provide students with opportunities to apply concepts in real-world scenarios can be powerful tools. Nurse educators should take advantage of student-patient interactions to model clinical reasoning and allow students to practice complex decision making throughout the entire curriculum. In response to this change in nursing education, faculty in a pediatric course designed a reflective clinical reasoning activity based on the SAFETY template, which is derived from the National Council of State Boards of Nursing RN practice analysis. Students were able to prioritize key components of nursing care, as well as integrate practice issues such as delegation, Health Insurance Portability and Accountability Act violations, and questioning the accuracy of orders. SAFETY is proposed as a framework for integration of content knowledge, clinical reasoning, and reflection on authentic professional nursing concerns. Copyright 2012, SLACK Incorporated.

The Evolution of Gero-Oncology Nursing

PubMed Central

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

2016-01-01

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

Bringing New PET Drugs to Clinical Practice - A Regulatory Perspective

PubMed Central

Hung, Joseph C.

2013-01-01

The regulatory framework for radioactive drugs, in particular those used in positron emission tomography (PET) scans, has been gradually established since the release of the Food and Drug Administration Modernization Act in 1997. Various guidances specially tailored to accommodate special properties of PET drugs have been issued by the Food and Drug Administration (FDA) in order to ensure this valuable technology (i.e., PET molecular imaging) will continue to be available to patients and yet the safety and efficacy of PET drugs are well regulated so that public health will be protected. This article presents several key elements of this regulatory framework for PET drugs. New regulatory avenues proposed by the FDA to facilitate the research and development process to bring more new PET drugs to clinical practice, as well as to foster the opportunity of using “orphan” PET drugs in clinical practice are also discussed in this paper. PMID:24312157

Adherence policy, education and practice - an international perspective.

PubMed

Marie-Schneider, Paule; Aslani, Parisa

2010-10-01

Nonadherence to chronic therapy has become a large burden on the healthcare system of many countries. Community pharmacists are well positioned to address nonadherence as part of their overall patient care activities, and contribute to patients' quality use of medicines. Between 2008 and 2010, a series of narrative, peer-reviewed articles were published in Pharmacy Practice which focused on community pharmacists' activities in medication adherence, specifically in the areas of the education they receive, their practice, the research conducted and national or local policies. This editorial aims to summarise the key findings presented in the series, and highlight the pertinent issues and gaps in the literature. There is a need to implement global and long-term objectives focussing on enhancing the quality of education and competencies of community pharmacists and the research conducted in medication adherence, to develop guidelines for pharmacists and enhance the uptake of adherence promoting services in routine care.

Advance directives in the UK: legal, ethical, and practical considerations for doctors.

PubMed

Kessel, A S; Meran, J

1998-05-01

In the United Kingdom (UK), advance directives have recently received considerable attention from professional and voluntary organizations as well as medical journals and the media. However, despite such exposure, many doctors remain uncertain of the importance or relevance of advance directives with regard to their own clinical practice. This paper addresses these uncertainties by first explaining what advance directives are and then describing the current legal status of such directives in the UK. Examination of the cases underpinning this status reveals several key elements: competence, information, anticipation, applicability, and freedom from duress. Each is discussed. Although this paper focuses on legal issues, it is important that medical law does not dominate medical ethics. Accordingly, the paper also discusses some important philosophical and sociological considerations that have remained largely unexplored in the medical press. Finally, the paper deals with practical matters, including how the general practitioner might be involved.

Supporting self-care in general practice

PubMed Central

Greaves, Colin J; Campbell, John L

2007-01-01

There is both a clear need and a political will to improve self-care in long-term conditions: demand for self-care support interventions is rising. This article discusses current approaches to supporting self-care in primary care, evidence in favour of self-care support, and issues for GPs to consider in planning self-care support systems. In planning care pathways, important choices need to be made about whether to use individual or group-based approaches and what intensity of intervention is appropriate to match patient needs. Investment may also be needed in both health professional competences and practice systems to optimise their ability to support patient self-care. Self-care support is a key approach for the future of UK health care. Practices that are well trained and well organised to support self-care will respond better to the complex challenges of achieving improvements in the outcomes of long-term conditions. PMID:17925140

The Australian Pharmaceutical Benefits Scheme data collection: a practical guide for researchers.

PubMed

Mellish, Leigh; Karanges, Emily A; Litchfield, Melisa J; Schaffer, Andrea L; Blanch, Bianca; Daniels, Benjamin J; Segrave, Alicia; Pearson, Sallie-Anne

2015-11-02

The Pharmaceutical Benefits Scheme (PBS) is Australia's national drug subsidy program. This paper provides a practical guide to researchers using PBS data to examine prescribed medicine use. Excerpts of the PBS data collection are available in a variety of formats. We describe the core components of four publicly available extracts (the Australian Statistics on Medicines, PBS statistics online, section 85 extract, under co-payment extract). We also detail common analytical challenges and key issues regarding the interpretation of utilisation using the PBS collection and its various extracts. Research using routinely collected data is increasing internationally. PBS data are a valuable resource for Australian pharmacoepidemiological and pharmaceutical policy research. A detailed knowledge of the PBS, the nuances of data capture, and the extracts available for research purposes are necessary to ensure robust methodology, interpretation, and translation of study findings into policy and practice.

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

PubMed

Morrow, Nathan; Nkwake, Apollo M

2016-12-01

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

Children's nursing research: toward development, drudgery or demise?

PubMed

Long, Tony

This paper, based on a presentation to the UK Association of Chief Children's Nurses, is the author's personal reflection on the nature and future of children's nursing research. Key constitutive elements of this concept are considered to arrive at the conclusion that children's nursing research is research undertaken by children's nurses into questions of relevance to children's nursing practice and services, or wider issues in which children's nursing has a vital role. Three possible futures are presented, of which only the last is positive and desirable: development in line with the reality of practice and population needs. An integrated approach is necessary, with responsibilities both for those in positions of authority in the service and for researchers themselves. In particular, this partnership is essential for children's nursing to evidence the impact of research and for children and young people to reap the greatest benefit from evidence-based practice.

But is this really the ‘parent’ or ‘guardian’? Practical strategies for consent to child research in South Africa

PubMed Central

Slack, C M; Strode, A E

2018-01-01

Research ethics committees (RECs) in South Africa may require consent from a parent or legal guardian for child research. In instances where an REC determines that parental or guardianship consent is required, how far should researchers go to establish if the accompanying adult is in fact the parent or guardian? Should researchers accept disclosures at face value, probe assertions that are made, or even call for supporting documentation? In this article we set out the facts research staff should possess, propose key questions they could ask, and recommend practical steps for uncertain cases. We recognise that a parental/guardianship consent strategy may not be appropriate in all instances, but do not debate that issue in this article. This article is confined to practical advice for researchers wishing to implement a parental or guardianship consent approach. PMID:29887973

Added value of involving patients in the first step of multidisciplinary guideline development: a qualitative interview study among infertile patients.

PubMed

den Breejen, Elvira M E; Hermens, Rosella P M G; Galama, Wienke H; Willemsen, Wim N P; Kremer, Jan A M; Nelen, Willianne L D M

2016-06-01

Patient involvement in scoping the guideline is emphasized, but published initiatives actively involving patients are generally limited to the writing and reviewing phase. To assess patients' added value to the scoping phase of a multidisciplinary guideline on infertility. Qualitative interview study. We conducted interviews among 12 infertile couples and 17 professionals. We listed and compared the couples' and professionals' key clinical issues (=care aspects that need improvement) to be addressed in the guideline according to four domains: current guidelines, professionals, patients and organization of care. Main key clinical issues suggested by more than three quarters of the infertile couples and/or at least two professionals were identified and compared. Overall, we identified 32 key clinical issues among infertile couples and 23 among professionals. Of the defined main key clinical issues, infertile couples mentioned eight issues that were not mentioned by the professionals. These main key clinical issues mainly concerned patient-centred (e.g. poor information provision and poor alignment of care) aspects of care on the professional and organizational domain. Both groups mentioned two main key clinical issues collectively that were interpreted differently: the lack of emotional support and respect for patients' values. Including patients from the first phase of the guideline development process leads to valuable additional main key clinical issues for the next step of a multidisciplinary guideline development process and broadens the scope of the guideline, particularly regarding patient-centredness and organizational issues from a patients' perspective. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Dietary supplement labeling and advertising claims: are clinical studies on the full product required?

PubMed

Villafranco, John E; Bond, Katie

2009-01-01

Whether labeling and advertising claims for multi-ingredient dietary supplements may be based on the testing of individual, key ingredients--rather than the actual product--has caused a good deal of confusion. This confusion stems from the dearth of case law and the open-endedness of Federal Trade Commission (FTC) and Food and Drug Administration (FDA) guidance on this issue. Nevertheless, the relevant regulatory guidance, case law and self-regulatory case law--when assessed together--indicate that the law allows and even protects "key ingredient claims" (i.e., claims based on efficacy testing of key ingredients in the absence of full product testing). This article provides an overview of the relevant substantiation requirements for dietary supplement claims and then reviews FTC's and FDA's guidance on key ingredient claims; relevant case law; use of key ingredient claims in the advertising of other consumer products; and the National Advertising Division of the Better Business Bureau, Inc.'s (NAD's) approach to evaluating key ingredient claims for dietary supplements. This article concludes that key ingredient claims--provided they are presented in a truthful and non-deceptive manner--are permissible, and should be upheld in litigation and cases subject to industry self-regulation. This article further concludes that the NAD's approach to key ingredient claims provides practical guidance for crafting and substantiating dietary supplement key ingredient claims.

Design for reliability: NASA reliability preferred practices for design and test

NASA Technical Reports Server (NTRS)

Lalli, Vincent R.

1994-01-01

This tutorial summarizes reliability experience from both NASA and industry and reflects engineering practices that support current and future civil space programs. These practices were collected from various NASA field centers and were reviewed by a committee of senior technical representatives from the participating centers (members are listed at the end). The material for this tutorial was taken from the publication issued by the NASA Reliability and Maintainability Steering Committee (NASA Reliability Preferred Practices for Design and Test. NASA TM-4322, 1991). Reliability must be an integral part of the systems engineering process. Although both disciplines must be weighed equally with other technical and programmatic demands, the application of sound reliability principles will be the key to the effectiveness and affordability of America's space program. Our space programs have shown that reliability efforts must focus on the design characteristics that affect the frequency of failure. Herein, we emphasize that these identified design characteristics must be controlled by applying conservative engineering principles.

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

PubMed

Stillwell, Devon

2016-02-01

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

Assessing the impacts of sustainable agricultural practices for water quality improvements in the Vouga catchment (Portugal) using the SWAT model.

PubMed

Rocha, João; Roebeling, Peter; Rial-Rivas, María Ermitas

2015-12-01

The extensive use of fertilizers has become one of the most challenging environmental issues in agricultural catchment areas. In order to reduce the negative impacts from agricultural activities and to accomplish the objectives of the European Water Framework Directive we must consider the implementation of sustainable agricultural practices. In this study, we assess sustainable agricultural practices based on reductions in N-fertilizer application rates (from 100% to 0%) and N-application methods (single, split and slow-release) across key agricultural land use classes in the Vouga catchment, Portugal. The SWAT model was used to relate sustainable agricultural practices, agricultural yields and N-NO3 water pollution deliveries. Results show that crop yields as well as N-NO3 exportation rates decrease with reductions in N-application rates and single N-application methods lead to lower crop yields and higher N-NO3 exportation rates as compared to split and slow-release N-application methods. Copyright © 2015 Elsevier B.V. All rights reserved.

SPECT detectors: the Anger Camera and beyond

PubMed Central

Peterson, Todd E.; Furenlid, Lars R.

2011-01-01

The development of radiation detectors capable of delivering spatial information about gamma-ray interactions was one of the key enabling technologies for nuclear medicine imaging and, eventually, single-photon emission computed tomography (SPECT). The continuous NaI(Tl) scintillator crystal coupled to an array of photomultiplier tubes, almost universally referred to as the Anger Camera after its inventor, has long been the dominant SPECT detector system. Nevertheless, many alternative materials and configurations have been investigated over the years. Technological advances as well as the emerging importance of specialized applications, such as cardiac and preclinical imaging, have spurred innovation such that alternatives to the Anger Camera are now part of commercial imaging systems. Increased computing power has made it practical to apply advanced signal processing and estimation schemes to make better use of the information contained in the detector signals. In this review we discuss the key performance properties of SPECT detectors and survey developments in both scintillator and semiconductor detectors and their readouts with an eye toward some of the practical issues at least in part responsible for the continuing prevalence of the Anger Camera in the clinic. PMID:21828904

Affirming our commitment to research: the Medical Library Association's research policy statement: the process and findings.

PubMed

Grefsheim, Suzanne F; Rankin, Jocelyn A; Perry, Gerald J; McKibbon, K Ann

2008-04-01

Building on its 1995 research policy statement, the Medical Library Association (MLA) has issued a new research policy, The Research Imperative. This paper shares the background research that informed the new policy. Semi-structured interviews were conducted with fifty-one key informants representing various library types, functions, geographic locations, ages, and ethnicities. The grounded theory approach was used to analyze the resulting textual database. Additionally, to gather input from the membership as a whole, two open forums were held at MLA annual meetings. Key informant data indicated that the policy should provide roles for MLA in leadership, advocacy, collaboration, services, education, publishing, and development of a research agenda. Evidence-based library and information practice was emphasized. Six themes emerged to center the new policy: creation of a research culture, challenges, domains of research, research skills set, roles of stakeholders, and measurement of progress. Reflecting the interests and beliefs of the membership, The Research Imperative challenges MLA members to build a supportive culture that values and contributes to a research base that is recognized as an essential tool for future practice.

Models of Integrating Physical Therapists into Family Health Teams in Ontario, Canada: Challenges and Opportunities

PubMed Central

Mandoda, Shilpa; Landry, Michel D.

2011-01-01

ABSTRACT Purpose: To explore the potential for different models of incorporating physical therapy (PT) services within the emerging network of family health teams (FHTs) in Ontario and to identify challenges and opportunities of each model. Methods: A two-phase mixed-methods qualitative descriptive approach was used. First, FHTs were mapped in relation to existing community-based PT practices. Second, semi-structured key-informant interviews were conducted with representatives from urban and rural FHTs and from a variety of community-based PT practices. Interviews were digitally recorded, transcribed verbatim, and analyzed using a categorizing/editing approach. Results: Most participants agreed that the ideal model involves embedding physical therapists directly into FHTs; in some situations, however, partnering with an existing external PT provider may be more feasible and sustainable. Access and funding remain the key issues, regardless of the model adopted. Conclusion: Although there are differences across the urban/rural divide, there exist opportunities to enhance and optimize existing delivery models so as to improve client access and address emerging demand for community-based PT services. PMID:22654231

Australian primary school communities' understandings of SunSmart: a qualitative study.

PubMed

Winslade, Matthew; Wright, Bradley; Dudley, Dean; Cotton, Wayne; Brown, Alexandra

2017-10-01

Skin cancer represents a major health issue for Australia. Childhood sun exposure is an important risk factor and evidence suggests the use of sun protection measures by Australian school children could be improved. This study examines how the SunSmart Program, a school-based skin cancer prevention resource, can be supported to further increase sun protection behaviours to assist in lowering skin cancer incidence. The Health Promoting Schools (HPS) framework was adopted to select key stakeholders from a convenience sample of five school communities. Students, teaching staff and parents participated in semi-structured focus group and individual interviews. A thematic analysis was used to extract key themes from the data. Although these school communities were aware of sun protection practices and the risks associated with sun exposure, their understandings of the SunSmart Program were limited. Sun protection policy implementation was inconsistent and students were unlikely to engage in sun protection practices beyond the school setting. School communities require additional support and engagement to holistically enforce the principles of the SunSmart Program. © 2017 The Authors.

Issues concerning international comparison of free-field calibrations of acoustical standards

NASA Astrophysics Data System (ADS)

Nedzelnitsky, Victor

2002-11-01

Primary free-field calibrations of laboratory standard microphones by the reciprocity method establish these microphones as reference standard devices for calibrating working standard microphones, other measuring microphones, and practical instruments such as sound level meters and personal sound exposure meters (noise dosimeters). These primary, secondary, and other calibrations are indispensable to the support of regulatory requirements, standards, and product characterization and quality control procedures important for industry, commerce, health, and safety. International Electrotechnical Commission (IEC) Technical Committee 29 Electroacoustics produces international documentary standards, including standards for primary and secondary free-field calibration and measurement procedures and their critically important application to practical instruments. This paper addresses some issues concerning calibrations, standards activities, and the international key comparison of primary free-field calibrations of IEC-type LS2 laboratory standard microphones that is being planned by the Consultative Committee for Acoustics, Ultrasound, and Vibration (CCAUV) of the International Committee for Weights and Measures (CIPM). This comparison will include free-field calibrations by the reciprocity method at participating major national metrology laboratories throughout the world.

Interventions in randomised controlled trials in surgery: issues to consider during trial design.

PubMed

Blencowe, Natalie S; Brown, Julia M; Cook, Jonathan A; Metcalfe, Chris; Morton, Dion G; Nicholl, Jon; Sharples, Linda D; Treweek, Shaun; Blazeby, Jane M

2015-09-04

Until recently, insufficient attention has been paid to the fact that surgical interventions are complex. This complexity has several implications, including the way in which surgical interventions are described and delivered in trials. In order for surgeons to adopt trial findings, interventions need to be described in sufficient detail to enable accurate replication; however, it may be permissible to allow some aspects to be delivered according to local practice. Accumulating work in this area has identified the need for general guidance on the design of surgical interventions in trial protocols and reports. Key issues to consider when designing surgical interventions include the identification of each surgical intervention and their components, who will deliver the interventions, and where and how the interventions will be standardised and monitored during the trial. The trial design (pragmatic and explanatory), comparator and stage of innovation may also influence the extent of detail required. Thoughtful consideration of surgical interventions in this way may help with the interpretation of trial results and the adoption of successful interventions into clinical practice.

Integration of Technology-based Behavioral Health Interventions in Substance Abuse and Addiction Services

PubMed Central

Ramsey, Alex

2015-01-01

The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements—technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms—has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services—namely access, quality, and cost—is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research. PMID:26161047

Integration of Technology-based Behavioral Health Interventions in Substance Abuse and Addiction Services.

PubMed

Ramsey, Alex

2015-08-01

The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements-technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms-has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services-namely access, quality, and cost -is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research.