A case study of the knowledge transfer practices from the perspectives of highly experienced engineers in the aerospace industry

NASA Astrophysics Data System (ADS)

Martin, Deloris

Purpose. The purpose of this study was to describe the existing knowledge transfer practices in selected aerospace companies as perceived by highly experienced engineers retiring from the company. Specifically it was designed to investigate and describe (a) the processes and procedures used to transfer knowledge, (b) the systems that encourage knowledge transfer, (c) the impact of management actions on knowledge transfer, and (d) constraining factors that might impede knowledge transfer. Methodology. A descriptive case study was the methodology applied in this study. Qualitative data were gathered from highly experienced engineers from 3 large aerospace companies in Southern California. A semistructured interview was conducted face-to-face with each participant in a private or semiprivate, non-workplace setting to obtain each engineer's perspectives on his or her company's current knowledge transfer practices. Findings. The participants in this study preferred to transfer knowledge using face-to-face methods, one-on-one, through actual troubleshooting and problem-solving scenarios. Managers in these aerospace companies were observed as having knowledge transfer as a low priority; they tend not to promote knowledge transfer among their employees. While mentoring is the most common knowledge transfer system these companies offer, it is not the preferred method of knowledge transfer among the highly experienced engineers. Job security and schedule pressures are the top constraints that impede knowledge transfer between the highly experienced engineers and their coworkers. Conclusions. The study data support the conclusion that the highly experienced engineers in the study's aerospace companies would more likely transfer their knowledge to those remaining in the industry if the transfer could occur face-to-face with management support and acknowledgement of their expertise and if their job security is not threatened. The study also supports the conclusion that managers should be responsible for the leadership in developing a knowledge-sharing culture and rewarding those who do share. Recommendations. It is recommended that a quantitative study of highly experienced engineers in aerospace be conducted to determine the degree to which knowledge-sharing methods, processes, and procedures may be effective in capturing their knowledge. It is also recommended that a replication of this study be undertaken to include the perspectives of first-line managers on developing a knowledge-sharing culture for the aerospace industry.

Teaching MBA Students the Use of Web 2.0: The Knowledge Management Perspective

ERIC Educational Resources Information Center

Levy, Meira; Hadar, Irit

2010-01-01

The new concepts and technologies of Web 2.0 attract researches in a variety of fields including education, business and knowledge management. However, while the Web 2.0 potential in the education discipline has been widely studied, in the management discipline the Web 2.0 business value has not been fully acknowledged. This research suggests an…

Team knowledge representation: a network perspective.

PubMed

Espinosa, J Alberto; Clark, Mark A

2014-03-01

We propose a network perspective of team knowledge that offers both conceptual and methodological advantages, expanding explanatory value through representation and measurement of component structure and content. Team knowledge has typically been conceptualized and measured with relatively simple aggregates, without fully accounting for differing knowledge configurations among team members. Teams with similar aggregate values of team knowledge may have very different team dynamics depending on how knowledge isolates, cliques, and densities are distributed across the team; which members are the most knowledgeable; who shares knowledge with whom; and how knowledge clusters are distributed. We illustrate our proposed network approach through a sample of 57 teams, including how to compute, analyze, and visually represent team knowledge. Team knowledge network structures (isolation, centrality) are associated with outcomes of, respectively, task coordination, strategy coordination, and the proportion of team knowledge cliques, all after controlling for shared team knowledge. Network analysis helps to represent, measure, and understand the relationship of team knowledge to outcomes of interest to team researchers, members, and managers. Our approach complements existing team knowledge measures. Researchers and managers can apply network concepts and measures to help understand where team knowledge is held within a team and how this relational structure may influence team coordination, cohesion, and performance.

The Interactional Management of Claims of Insufficient Knowledge in English Language Classrooms

ERIC Educational Resources Information Center

Sert, Olcay; Walsh, Steve

2013-01-01

This paper primarily investigates the interactional unfolding and management of "claims of insufficient knowledge" (Beach and Metzger 1997) in two English language classrooms from a multi-modal, conversation-analytic perspective. The analyses draw on a close, micro-analytic account of sequential organisation of talk as well as on various…

Knowledge Management of Web Financial Reporting in Human-Computer Interactive Perspective

ERIC Educational Resources Information Center

Wang, Dong; Chen, Yujing; Xu, Jing

2017-01-01

Handling and analyzing to web financial data is becoming a challenge issue in knowledge management and education to accounting practitioners. eXtensible Business Reporting Language (XBRL), which is a type of web financial reporting, describes and recognizes financial items by tagging metadata. The goal is to make it possible for financial reports…

Managing Conflict during Divorce

MedlinePlus

... focus is on building an agreement. In the “evaluative mediation” model, the mediator, using background knowledge of ... will be sharing their unique perspectives, knowledge, and research findings in a crowdsourced effort to update our ...

Human Capital Accumulation: The Role of Human Resource Development.

ERIC Educational Resources Information Center

Garavan, Thomas N.; Morley, Michael; Gunnigle, Patrick; Collins, Eammon

2001-01-01

Presents definitions of intellectual and human capital. Examines human capital from the individual perspective (employability, performance, career development) and organization perspective (investment, ownership, knowledge management). Reviews papers in the theme issue. (Contains 117 references.) (SK)

Perspectives to Performance of Environment and Health Assessments and Models—From Outputs to Outcomes?

PubMed Central

Pohjola, Mikko V.; Pohjola, Pasi; Tainio, Marko; Tuomisto, Jouni T.

2013-01-01

The calls for knowledge-based policy and policy-relevant research invoke a need to evaluate and manage environment and health assessments and models according to their societal outcomes. This review explores how well the existing approaches to assessment and model performance serve this need. The perspectives to assessment and model performance in the scientific literature can be called: (1) quality assurance/control, (2) uncertainty analysis, (3) technical assessment of models, (4) effectiveness and (5) other perspectives, according to what is primarily seen to constitute the goodness of assessments and models. The categorization is not strict and methods, tools and frameworks in different perspectives may overlap. However, altogether it seems that most approaches to assessment and model performance are relatively narrow in their scope. The focus in most approaches is on the outputs and making of assessments and models. Practical application of the outputs and the consequential outcomes are often left unaddressed. It appears that more comprehensive approaches that combine the essential characteristics of different perspectives are needed. This necessitates a better account of the mechanisms of collective knowledge creation and the relations between knowledge and practical action. Some new approaches to assessment, modeling and their evaluation and management span the chain from knowledge creation to societal outcomes, but the complexity of evaluating societal outcomes remains a challenge. PMID:23803642

Asthma Management in New York City Schools: a Classroom Teacher Perspective

PubMed Central

Cain, Agnieszka; Reznik, Marina

2016-01-01

Objective Classroom teachers play an important role in facilitating asthma management in school but little is known about their perspectives around asthma management. We examined the perspectives of classroom teachers around barriers to school asthma management. Methods We conducted key informant interviews with 21 inner-city classroom teachers from 3rd to 5th grades in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. We used thematic and content review to analyze interview data. Results Seven themes representing teachers’ perspectives on in-school asthma management emerged: (1) the problematic process of identifying students with asthma; (2) poor familiarity with the city health department’s asthma initiative and poor general knowledge of school policies on asthma management (3) lack of competency in managing an acute asthma attack in the classroom and poor recognition of symptoms of an asthma attack; (4) lack of confidence in dealing with a hypothetical asthma attack in the classroom; (5) lack of quick access to asthma medication in school; (6) limited communication between school staff; and (7) enthusiasm about learning more about asthma management. Conclusions Our results revealed several barriers contributing to suboptimal in-school asthma management: ineffective ways of identifying students with asthma, lack of teacher knowledge of guidelines on asthma management, lack of comfort in managing students’ asthma, inadequate access to asthma medication in school, and limited communication between school staff. These issues should be considered in the design of interventions to improve in-school asthma management. PMID:27031532

Knowledge Management in Consultancies and High-Tech Companies: A Social Systems Perspective

ERIC Educational Resources Information Center

Kasper, Helmut; Muhlbacher, Jurgen; Muller, Barbara

2008-01-01

In dealing with Knowledge Management (KM) literature, we have to diagnose three essential points: first, we have detected a lack of comprehensive theoretical models based on "grand theories", secondly, we have discovered an overemphasis of "good" values, like openness and trust, that help organisations to learn. And thirdly, we have to recognise…

Ecological research and environmental management: We need different interfaces based on different knowledge types.

PubMed

Gosselin, Frédéric; Cordonnier, Thomas; Bilger, Isabelle; Jappiot, Marielle; Chauvin, Christophe; Gosselin, Marion

2018-04-25

The role of ecological science in environmental management has been discussed by many authors who recognize that there is a persistent gap between ecological science and environmental management. Here we develop theory through different perspectives based on knowledge types, research categories and research-management interface types, which we combine into a common framework. To draw out insights for bridging this gap, we build our case by:We point out the complementarities as well as the specificities and limitations of the different types of ecological research, ecological knowledge and research-management interfaces, which is of major importance for environmental management and research policies. Copyright © 2018 Elsevier Ltd. All rights reserved.

The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study.

PubMed

Heckemann, Birgit; Breimaier, Helga Elisabeth; Halfens, Ruud J G; Schols, Jos M G A; Hahn, Sabine

2016-09-01

Aggression management training for nurses is an important part of a comprehensive strategy to reduce patient and visitor aggression in healthcare. Although training is commonplace, few scientific studies examine its benefits. To explore and describe, from a nurse's perspective, the learning gained from attending aggression management training. This was a descriptive qualitative interview study. We conducted semi-structured individual interviews with seven nurses before (September/October 2012) and after they attended aggression management training (January/February 2013). Interview transcripts were content-analysed qualitatively. The study plan was reviewed by the responsible ethics committees. Participants gave written informed consent. Aggression management training did not change nurses' attitude. Coping emotionally with the management of patient and visitor aggression remained a challenge. Nurses' theoretical knowledge increased, but they did not necessarily acquire new strategies for managing patient/visitor aggression. Instead, the course refreshed or activated existing knowledge of prevention, intervention and de-escalation strategies. The training increased nurses' environmental and situational awareness for early signs of patient and visitor. They also acquired some strategies for emotional self-management. Nurses became more confident in dealing with (potentially) aggressive situations. While the training influenced nurses' individual clinical practice, learning was rarely shared within teams. Aggression management training increases skills, knowledge and confidence in dealing with patient or visitor aggression, but the emotional management remains a challenge. Future research should investigate how aggression management training courses can strengthen nurses' ability to emotionally cope with patient and visitor aggression. More knowledge is needed on how the theoretical and practical knowledge gained from the training may be disseminated more effectively within teams and thus contributed to the creation of low-conflict ward cultures. © 2016 Nordic College of Caring Science.

Self-Centered Management Skills and Knowledge Appropriation by Students in High Schools and Private Secondary Schools of the City of Maroua

ERIC Educational Resources Information Center

Oyono, Tadjuidje Michel

2016-01-01

Knowledge in its process of appropriation necessitates on the part of the learner, the mobilization of an efficient management strategy of adapted competencies. The present article in its problematic presents the theoretical perspective of Desaunay (1985) which estimates that three fundamental competences (relational, technical and affective) have…

Knowledge mobilisation in healthcare: a critical review of health sector and generic management literature.

PubMed

Ferlie, Ewan; Crilly, Tessa; Jashapara, Ashok; Peckham, Anna

2012-04-01

The health policy domain has displayed increasing interest in questions of knowledge management and knowledge mobilisation within healthcare organisations. We analyse here the findings of a critical review of generic management and health-related literatures, covering the period 2000-2008. Using 29 pre-selected journals, supplemented by a search of selected electronic databases, we map twelve substantive domains classified into four broad groups: taxonomic and philosophical (e.g. different types of knowledge); theoretical discourse (e.g. critical organisational studies); disciplinary fields (e.g. organisational learning and Information Systems/Information Technology); and organisational processes and structures (e.g. organisational form). We explore cross-overs and gaps between these traditionally separate literature streams. We found that health sector literature has absorbed some generic concepts, notably Communities of Practice, but has not yet deployed the performance-oriented perspective of the Resource Based View (RBV) of the Firm. The generic literature uses healthcare sites to develop critical analyses of power and control in knowledge management, rooted in neo-Marxist/labour process and Foucauldian approaches. The review generates three theoretically grounded statements to inform future enquiry, by: (a) importing the RBV stream; (b) developing the critical organisational studies perspective further; and (c) exploring the theoretical argument that networks and other alternative organisational forms facilitate knowledge sharing. Copyright © 2012 Elsevier Ltd. All rights reserved.

A transdisciplinary approach for supporting the integration of ecosystem services into land and water management

NASA Astrophysics Data System (ADS)

Fatt Siew, Tuck; Döll, Petra

2015-04-01

Transdisciplinary approaches are useful for supporting integrated land and water management. However, the implementation of the approach in practice to facilitate the co-production of useable socio-hydrological (and -ecological) knowledge among scientists and stakeholders is challenging. It requires appropriate methods to bring individuals with diverse interests and needs together and to integrate their knowledge for generating shared perspectives/understanding, identifying common goals, and developing actionable management strategies. The approach and the methods need, particularly, to be adapted to the local political and socio-cultural conditions. To demonstrate how knowledge co-production and integration can be done in practice, we present a transdisciplinary approach which has been implemented and adapted for supporting land and water management that takes ecosystem services into account in an arid region in northwestern China. Our approach comprises three steps: (1) stakeholder analysis and interdisciplinary knowledge integration, (2) elicitation of perspectives of scientists and stakeholders, scenario development, and identification of management strategies, and (3) evaluation of knowledge integration and social learning. Our adapted approach has enabled interdisciplinary and cross-sectoral communication among scientists and stakeholders. Furthermore, the application of a combination of participatory methods, including actor modeling, Bayesian Network modeling, and participatory scenario development, has contributed to the integration of system, target, and transformation knowledge of involved stakeholders. The realization of identified management strategies is unknown because other important and representative decision makers have not been involved in the transdisciplinary research process. The contribution of our transdisciplinary approach to social learning still needs to be assessed.

Perspectives, perceptions and experiences in postoperative pain management in developing countries: A focus group study conducted in Rwanda

PubMed Central

Johnson, Ana P; Mahaffey, Ryan; Egan, Rylan; Twagirumugabe, Theogene; Parlow, Joel L

2015-01-01

BACKGROUND: Access to postoperative acute pain treatment is an important component of perioperative care and is frequently managed by a multidisciplinary team of anesthesiologists, surgeons, pharmacists, technicians and nurses. In some developing countries, treatment modalities are often not performed due to scarce health care resources, knowledge deficiencies and cultural attitudes. OBJECTIVES: In advance of a comprehensive knowledge translation initiative, the present study aimed to determine the perspectives, perceptions and experiences of anesthesia residents regarding postoperative pain management strategies. METHODS: The present study was conducted using a qualitative assessment strategy in a large teaching hospital in Rwanda. During two sessions separated by seven days, a 10-participant semistructured focus group needs analysis was conducted with anesthesia residents at the Centre Hospitalier Universitaire de Kigali (Kigali, Rwanda). Field notes were analyzed using interpretative and descriptive phenomenological approaches. Participants were questioned regarding their perspectives, perceptions and experiences in pain management. RESULTS: The responses from the focus groups were related to five general areas: general patient and medical practice management; knowledge base regarding postoperative pain management; pain evaluation; institutional/system issues related to protocol implementation; and perceptions about resource allocation. Within these areas, challenges (eg, communication among stakeholders and with patients) and opportunities (eg, on-the-job training, use of protocols, routine pain assessment, participation in resource allocation decisions) were identified. CONCLUSIONS: The present study revealed the prevalent challenges residents perceive in implementing postoperative pain management strategies, and offers practical suggestions to overcoming them, primarily through training and the implementation of practice recommendations. PMID:26448971

Knowledge management impact of information technology Web 2.0/3.0. The case study of agent software technology usability in knowledge management system

NASA Astrophysics Data System (ADS)

Sołtysik-Piorunkiewicz, Anna

2015-02-01

How we can measure the impact of internet technology Web 2.0/3.0 for knowledge management? How we can use the Web 2.0/3.0 technologies for generating, evaluating, sharing, organizing knowledge in knowledge-based organization? How we can evaluate it from user-centered perspective? Article aims to provide a method for evaluate the usability of web technologies to support knowledge management in knowledge-based organizations of the various stages of the cycle knowledge management, taking into account: generating knowledge, evaluating knowledge, sharing knowledge, etc. for the modern Internet technologies based on the example of agent technologies. The method focuses on five areas of evaluation: GUI, functional structure, the way of content publication, organizational aspect, technological aspect. The method is based on the proposed indicators relating respectively to assess specific areas of evaluation, taking into account the individual characteristics of the scoring. Each of the features identified in the evaluation is judged first point wise, then this score is subject to verification and clarification by means of appropriate indicators of a given feature. The article proposes appropriate indicators to measure the impact of Web 2.0/3.0 technologies for knowledge management and verification them in an example of agent technology usability in knowledge management system.

Hospital information management system: an evolutionary knowledge management perspective.

PubMed

Wadhwa, S; Saxena, Avneet; Wadhwa, Bharat

2007-01-01

The evolving paradigm shift resulting from IT, social and technological changes has created a need for developing an innovative knowledge-based healthcare system, which can effectively meet global healthcare system demands and also cater to future trends. The Hospital Information Management System (HIMS) is developed with this sole aim in mind, which helps in processing and management of hospital information not only inside the boundary, but also beyond the hospital boundary, e.g., telemedicine or e-healthcare. The purpose of this paper is to present such kind of functional HIMS, which can efficiently satisfy the current and future system requirements by using Knowledge Management (KM) and data management systems. The HIMS is developed in a KM context, wherein users can share and use the knowledge more effectively. The proposed system is fully compatible with future technical, social, managerial and economical requirements.

Project Management Meets Change Management - A Success Story. Focus Area: Tech Perspectives TI012SN

NASA Technical Reports Server (NTRS)

Hall, Wayne

2011-01-01

Utilizing the concepts and terminology from Project Management, the process of planning and executing a Change Management (CM) Infrastructure improvement project is described. The primary audience for this presentation includes both experienced and relatively new CM administrators and their managers. It also includes anyone with an interest in the application of project management knowledge to CM administration. There are several benefits: the complexity of the CM tool technology is more manageable, CM administrators get to use project management knowledge to complete a project (not "firefighting"), improve relations with your customers (that means developers and managers), and get the opportunity to do it again.

Unleashing the power of human genetic variation knowledge: New Zealand stakeholder perspectives.

PubMed

Gu, Yulong; Warren, James Roy; Day, Karen Jean

2011-01-01

This study aimed to characterize the challenges in using genetic information in health care and to identify opportunities for improvement. Taking a grounded theory approach, semistructured interviews were conducted with 48 participants to collect multiple stakeholder perspectives on genetic services in New Zealand. Three themes emerged from the data: (1) four service delivery models were identified in operation, including both those expected models involving genetic counselors and variations that do not route through the formal genetic service program; (2) multiple barriers to sharing and using genetic information were perceived, including technological, organizational, institutional, legal, ethical, and social issues; and (3) impediments to wider use of genetic testing technology, including variable understanding of genetic test utilities among clinicians and the limited capacity of clinical genetic services. Targeting these problems, information technologies and knowledge management tools have the potential to support key tasks in genetic services delivery, improve knowledge processes, and enhance knowledge networks. Because of the effect of issues in genetic information and knowledge management, the potential of human genetic variation knowledge to enhance health care delivery has been put on a "leash."

A Case-Based Exploration of Task/Technology Fit in a Knowledge Management Context

DTIC Science & Technology

2008-03-01

have a difficult time articulating to others. Researchers who subscribe to the constructionist perspective view knowledge as an inherently social ...Acceptance Model With Task-Technology Fit Constructs. Information & Management, 36, 9-21. Dooley, D. (2001). Social Research Methods (4th ed.). Upper...L. (2006). Social Research Methods : Qualitative and Quantitative Approaches (6 ed.). Boston: Pearson Education, Inc. Nonaka, I. (1994). A Dynamic

Boeing--A Case Study Example of Enterprise Project Management from a Learning Organization Perspective.

ERIC Educational Resources Information Center

Szymczak, Conrad C.; Walker, Derek H. T.

2003-01-01

The evolution of the Boeing Company illustrates how to achieve an enterprise project management culture through organizational learning. Project management can be a survival technique for adapting to change as well as a proactive mechanism. An organizational culture that supports commitment and enthusiasm and a knowledge management infrastructure…

The Birth, Death, and Resurrection of an SPI Project

NASA Astrophysics Data System (ADS)

Carlsson, Sven; Schönström, Mikael

Commentators on contemporary themes of strategic management and firm competitiveness stress that a firm's competitive advantage flows from its unique knowledge and how it manages knowledge, and for many firms their ability to create, share, exchange, and use knowledge have a major impact on their competitiveness (Nonaka & Teece 2001). In software development, knowledge management (KM) plays an increasingly important role. It has been argued that the KM-field is an important source for creating new perspectives on the software development process (Iivari 2000). Several Software Process Improvement (SPI) approaches stress the importance of managing knowledge and experiences as a way for improving software processes (Ahem et al. 2001). Another SPI-trend is the use of ideas from process management like in the Capability Maturity Model (CMM). Unfortunately, little research on the effects of the use of process management ideas in SPI exists. Given the influx of process management ideas to SPI, the impact of these ideas should be addressed.

Experiential Learning in Hospitality Management Education

ERIC Educational Resources Information Center

Brennen, Paul George

2017-01-01

The research study recognized that, although the knowledge obtained from academic textbooks and traditional classes are important to post-secondary hospitality management curriculum as they provide numerous insights and perspectives of different methods to manage a particular avenue within the hospitality industry; it is not the only aspect of the…

A Learning Framework for Knowledge Building and Collective Wisdom Advancement in Virtual Learning Communities

ERIC Educational Resources Information Center

Gan, Yongcheng; Zhu, Zhiting

2007-01-01

This study represents an effort to construct a learning framework for knowledge building and collective wisdom advancement in a virtual learning community (VLC) from the perspectives of system wholeness, intelligence wholeness and dynamics, learning models, and knowledge management. It also tries to construct the zone of proximal development (ZPD)…

What should men living with severe haemophilia need to know? The perspectives of Canadian haemophilia health care providers.

PubMed

Lane, S; Arnold, E; Webert, K E; Chan, A; Walker, I; Heddle, N M

2013-07-01

Haemophilia is a complex disease to manage. Home-based management of haemophilia has placed greater responsibility for disease management on individuals with haemophilia, heightening the individual's need for knowledge, particularly among individuals with severe haemophilia. The aim of this study was to identify and understand the knowledge needs and gaps of Canadian men with severe haemophilia from the perspectives of health care providers. A qualitative approach was undertaken. Data were collected using semi-structured focus groups and interviews with health care providers from Haemophilia Treatment Centres (HTCs) across Canada; data were analysed using thematic analysis. Three focus groups and two interviews were conducted; 13 individuals participated in this study. Health care providers identified the following areas of knowledge required by men with severe haemophilia: disease pathology, causes and consequences of bleeds, bleed prevention, recognition, treatment, how and when to access support, activity selection and risk reduction, benefits of exercise, genetic inheritance patterns, impact on career selection, travel and ageing. Knowledge gaps and challenges to knowledge provision were highlighted. In addition, providers emphasized the influences of timing, rapport and context on readiness to receive and assimilate information and recommended tailoring education to the individual and creating a developmental curriculum and knowledge assessment tool. Provision and uptake of disease knowledge is essential to patient self-management. To effectively receive, retain and assimilate information, individuals with severe haemophilia require the right information, from the right source, at the right time. Education should be tailored to the needs of the individual, provided throughout the lifespan. © 2013 John Wiley & Sons Ltd.

Science in the Public Sphere: Greater Sage-grouse Conservation Planning from a Transdisciplinary Perspective

USGS Publications Warehouse

Torregrosa, Alicia; Casazza, Michael L.; Caldwell, Margaret R.; Mathiasmeier, Teresa A.; Morgan, Peter M.; Overton, Cory T.

2010-01-01

Integration of scientific data and adaptive management techniques is critical to the success of species conservation, however, there are uncertainties about effective methods of knowledge exchange between scientists and decisionmakers. The conservation planning and implementation process for Greater Sage-grouse (Centrocercus urophasianus; ) in the Mono Basin, Calif. region, was used as a case study to observe the exchange of scientific information among stakeholders with differing perspectives; resource manager, scientist, public official, rancher, and others. The collaborative development of a risk-simulation model was explored as a tool to transfer knowledge between stakeholders and inform conservation planning and management decisions. Observations compiled using a transdisciplinary approach were used to compare the exchange of information during the collaborative model development and more traditional interactions such as scientist-led presentations at stakeholder meetings. Lack of congruence around knowledge needs and prioritization led to insufficient commitment to completely implement the risk-simulation model. Ethnographic analysis of the case study suggests that further application of epistemic community theory, which posits a strong boundary condition on knowledge transfer, could help support application of risk simulation models in conservation-planning efforts within similarly complex social and bureaucratic landscapes.

A research perspective on white-tailed deer overabundance in the northeastern United States

Treesearch

William M. Healy; David S. deCalesta; Susan L. Stout

1997-01-01

Resolving issues of deer (Odocoileus spp.) over-abundance will require gaining more reliable knowledge about their role in ecosystem dynamics. Science can contribute by advancing knowledge in 4 overlapping spheres of research: model development, measurement techniques, population management, and human behavior.

General practitioners' perspectives on management of early-stage chronic kidney disease: a focus group study.

PubMed

van Dipten, Carola; van Berkel, Saskia; de Grauw, Wim J C; Scherpbier-de Haan, Nynke D; Brongers, Bouke; van Spaendonck, Karel; Wetzels, Jack F M; Assendelft, Willem J J; Dees, Marianne K

2018-06-06

Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care. Qualitative focus group study with 27 GPs in the Netherlands. Three analysts open-coded and comparatively analysed the data. Mind-mapping sessions were performed after data-saturation. Five themes emerged: defining CKD, knowledge and awareness, patient-physician interaction, organisation of CKD care and value of the guideline. A key finding was the abstractness of the CKD concept. The GPs expressed various perspectives about defining CKD and interpreting estimated glomerular filtration rates. Views about clinical relevance influenced the decision-making, although factual knowledge seems lacking. Striving to inform well enough without creating anxiety and to explain suitably for the intellectual ability of the patient caused tension in the patient-physician interaction. Integration with cardiovascular disease-management programmes was mentioned as a way of implementing CKD care in the future. The guideline was perceived as a rough guide rather than a leading document. CKD is perceived as an abstract rather than a clinical concept. Abstractness plays a role in all formulated themes. Management of CKD patients in primary care is complex and is influenced by physician-bound considerations related to individual knowledge and perception of the importance of CKD. Strategies are needed to improve GPs' understanding of the concept of CKD by education, a holistic approach to guidelines, and integration of CKD care into cardiovascular programmes. Not applicable.

Distributed Information System Development: Review of Some Management Issues

NASA Astrophysics Data System (ADS)

Mishra, Deepti; Mishra, Alok

Due to the proliferation of the Internet and globalization, distributed information system development is becoming popular. In this paper we have reviewed some significant management issues like process management, project management, requirements management and knowledge management issues which have received much attention in distributed development perspective. In this literature review we found that areas like quality and risk management issues could get only scant attention in distributed information system development.

Integrative management of commercialized wild mushroom: a case study of Thelephora ganbajun in Yunnan, southwest China.

PubMed

He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

2011-07-01

The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

Integrative Management of Commercialized Wild Mushroom: A Case Study of Thelephora ganbajun in Yunnan, Southwest China

NASA Astrophysics Data System (ADS)

He, Jun; Zhou, Zhimei; Yang, Huixian; Xu, Jianchu

2011-07-01

The management of wild mushroom is interdisciplinary in nature, whereby the biophysical considerations have to be incorporated into the context of a wide range of social, economic and political concerns. However, to date, little documentation exists illustrating an interdisciplinary approach to management of wild mushrooms. Moreover, the empirical case studies necessary for developing applicable and practical methods are even more rare. This paper adopted an interdisciplinary approach combining participatory methods to improve the habitat management of Thelephora ganbajun, an endemic and one of the most economically valuable mushroom species in Southwest China. The paper documents an empirical case of how an interdisciplinary approach facilitated the development of a scientific basis for policy and management practice, and built the local capacity to create, adopt and sustain the new rules and techniques of mushroom management. With this integrative perspective, a sustainable management strategy was developed, which was found not only technically feasible for farmers, but also acceptable to the government from an ecological and policy-related perspective. More importantly, this approach has greatly contributed to raising the income of farmers. The paper highlights how the integration of biophysical and socioeconomic factors and different knowledge systems provided a holistic perspective to problem diagnosis and resolution, which helped to cope with conventional scientific dilemmas. Finally, it concludes that the success of this interdisciplinary approach is significant in the context of policy decentralization and reform for incorporating indigenous knowledge and local participation in forest management.

Main Principles of the Perspective System of SNF Management in Russia - 13333

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

Baryshnikov, Mikhail

For the last several years the System of the Spent Nuclear Fuel management in Russia was seriously changed. The paper describes the main principles of the changes and the bases of the Perspective System of SNF Management in Russia. Among such the bases there are the theses with the interesting names like 'total knowledge', 'pollutant pays' and 'pay and forget'. There is also a brief description of the modern Russian SNF Management Infrastructure. And an outline of the whole System. The System which is - in case of Russia - is quite necessary to adjust SNF accumulation and to utilizemore » the nuclear heritage. (authors)« less

New knowledge network evaluation method for design rationale management

NASA Astrophysics Data System (ADS)

Jing, Shikai; Zhan, Hongfei; Liu, Jihong; Wang, Kuan; Jiang, Hao; Zhou, Jingtao

2015-01-01

Current design rationale (DR) systems have not demonstrated the value of the approach in practice since little attention is put to the evaluation method of DR knowledge. To systematize knowledge management process for future computer-aided DR applications, a prerequisite is to provide the measure for the DR knowledge. In this paper, a new knowledge network evaluation method for DR management is presented. The method characterizes the DR knowledge value from four perspectives, namely, the design rationale structure scale, association knowledge and reasoning ability, degree of design justification support and degree of knowledge representation conciseness. The DR knowledge comprehensive value is also measured by the proposed method. To validate the proposed method, different style of DR knowledge network and the performance of the proposed measure are discussed. The evaluation method has been applied in two realistic design cases and compared with the structural measures. The research proposes the DR knowledge evaluation method which can provide object metric and selection basis for the DR knowledge reuse during the product design process. In addition, the method is proved to be more effective guidance and support for the application and management of DR knowledge.

Three Generational Issues in Organizational Learning: Knowledge Management, Perspectives on Training and "Low-Stakes" Development

ERIC Educational Resources Information Center

Sprinkle, Therese A.; Urick, Michael J.

2018-01-01

Purpose: Methods for facilitating learning and knowledge transfer in multigenerational workplaces are of importance to organizations. Yet, intergenerational learning is vastly understudied in academic organizational literature. This conceptual paper aims to recommend future directions for studying intergenerational learning by examining three…

Using Ontologies for Knowledge Management: An Information Systems Perspective.

ERIC Educational Resources Information Center

Jurisica, Igor; Mylopoulos, John; Yu, Eric

1999-01-01

Surveys some of the basic concepts that have been used in computer science for the representation of knowledge and summarizes some of their advantages and drawbacks. Relates these techniques to information sciences theory and practice. Concepts are classified in four broad ontological categories: static ontology, dynamic ontology, intentional…

Knowledge Management Orientation: An Innovative Perspective to Hospital Management.

PubMed

Ghasemi, Matina; Ghadiri Nejad, Mazyar; Bagzibagli, Kemal

2017-12-01

By considering innovation as a new project in hospitals, all the project management's standard steps should be followed in execution. This study investigated the validation of a new set of measures in terms of providing a procedure for knowledge management-oriented innovation that enriches the hospital management system. The relation between innovation and all the knowledge management areas, as the main constructs of project management, was illustrated by referring to project management standard steps and previous studies. Through consultations and meetings with a committee of professional project managers, a questionnaire was developed to measure ten knowledge management areas in hospital's innovation process. Additionally, a group of experts from hospital managers were invited to comment on the applicability of the questionnaires by considering if the items are measurable in hospitals practically. A close-ended, Likert-type scale items, consisted of ten sections, were developed based on project management body of knowledge thorough Delphi technique. It enables the managers to evaluate hospitals' situation to be aware whether the organization follows the knowledge management standards in innovation process or not. By pilot study, confirmatory factor analysis and exploratory factor analysis were conducted to ensure the validity and reliability of the measurement items. The developed items seem to have a potential to help hospital managers and subsequently delivering new products/services successfully based on the standard procedures in their organization. In all innovation processes, the knowledge management areas and their standard steps help hospital managers by a new tool as questionnaire format.

ARL and Association 3.0: Ten Management Challenges

ERIC Educational Resources Information Center

Funk, Carla J.

2009-01-01

Association management in today's "association 3.0" environment presents some new challenges and new perspectives on old ones. This paper summarizes 10 such challenges including collaboration, diversity, innovation, transparency, financial stability, member benefits, knowledge-based decision-making, a demand-driven association model, pro-activity…

Indigenous Perspectives and Knowledge Informing Freshwater Management, Planning and Decision Making in Aotearoa-New Zealand

NASA Astrophysics Data System (ADS)

Harmsworth, G.

2017-12-01

Indigenous Māori have distinct cultural values and perspectives that establish their identity, responsibilities, and rights to manage and use freshwater in New Zealand. Recognition of the 1840 Treaty of Waitangi and its principles has culminated in an array of modern legislation, obligations, national policy statements, statutory requirements, holistic frameworks, and approaches that strengthens Māori participation and authority in resource management and environmental decision-making. We briefly explain indigenous Māori frameworks, knowledge, values, and perspectives used to grow indigenous research and capability, enrich western scientific research, and inform freshwater planning, policy, and management. We will discuss some important methods, indicators, and tools that Māori have developed, or are developing, to support environmental assessment and the monitoring and reporting of freshwater ecosystems, particularly to help sustain and enhance customary values and practice. These tools include, for example, the Cultural Health Index, the Wai Ora Wai Māori assessment tool, the mauri compass, the mauri model, Māori wetlands assessment, kaitiaki tools, taonga assessment, which are being used to build Māori capability and capacity in freshwater sciences and management and to provide innovative approaches based on integrative knowledge systems. Many of these indigenous-led initiatives are now being used next to science and technical approaches at local, regional, and national scale in New Zealand to guide policy and help understand complex and dynamic human-environmental interactions. Māori epistemologies provide a holistic worldview well aligned with current international thinking and approaches that stress the importance of systems thinking and understanding interconnections between sub-component parts; exploring the world and universe within holistic, integrative frameworks; taking into account different perspectives, values, and worldviews, measuring progress towards outcomes across multiple goals, i.e. cultural, social, environmental and economic; developing links between human health and ecosystems; and promoting collaborative, interdisciplinary, and transdisciplinary approaches.

Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

PubMed

Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

2014-04-01

To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

Realizing the Potential of Management and Leadership: Toward a Synthesis of Western and Indigenous Perspectives in the Modernization of Non-Western Societies.

ERIC Educational Resources Information Center

Sapre, Padmakar M.

2000-01-01

Examines the tradition/Westernization debate against the background of India's exposure to Western ideas through its higher education system. Proposes a shift from a centralized, bureaucratic educational-administration model to a managerial- professional model that synthesizes Western and indigenous perspectives. Self-knowledge and responsiveness…

The Life Course Perspective on Drug Use: A Conceptual Framework for Understanding Drug Use Trajectories

ERIC Educational Resources Information Center

Hser, Yih-Ing; Longshore, Douglas; Anglin, M. Douglas

2007-01-01

This article discusses the life course perspective on drug use, including conceptual and analytic issues involved in developing the life course framework to explain how drug use trajectories develop during an individual's lifetime and how this knowledge can guide new research and approaches to management of drug dependence. Central concepts…

Historical Perspectives: A Review and Evaluation of 76 Studies of the Defense Research Enterprise, 1945-2015

DTIC Science & Technology

2016-08-01

MANAGEMENT FELLOW U.S. DEPARTMENT OF DEFENSE This report summarizes recommendations from 76 prior studies of the Department of Defense Research...Enterprise. A brief summary and evaluation of each study is provided, and recommendations are grouped according to management areas. Enduring themes...Prominent Trends in Historical Recommendations .................................................................................. 5 Knowledge Management

Natural Resource Management based on Gender Perspectives and Integrating Traditional Ecological Knowledge of the Tepera in Jayapura, Papua

NASA Astrophysics Data System (ADS)

Rumbiak, W. A.; Wambrauw, E. V.

2018-05-01

The Tepera in Jayapura Regency have a traditional ecological concept of managing their natural resources which evolved over generations. The spatial concept of their resources management is recorded visually on mental maps. The existing conditions of the landscape, forest, coastal area, and sea are considered heritage and have economic, ecological, and cultural values. The people have their own perspectives on the relationship between the resources management, cultural values, gender perspectives, and development. Thus, this research aims to identify the gender perspective in the natural resource management and environmental services; and to analyse the sustainable pattern of the land use and cultural zoning in the resources management. The methodology comprises grounded research and Participatory Action Research. This research has three findings, i.e., the tribe named the landscape; they have developed a zoning system to manage the forest traditionally; and there is a difference in perception between men and women regarding the type of forest and landscape related to food and traditional medicine sources. Therefore, it is important to incorporate the concept of managing the environment and the cultural zones of the Tepera in the programs of the local government to direct the development in sustainable way. In addition, the female participation in managing the environment should be improved, especially related to domestic aspects.

Knowledge Mobilisation in the Polish Education System

ERIC Educational Resources Information Center

Fazlagic, Jan; Erkol, Arif

2015-01-01

Poland has made substantial progress in improving the quality of its education system in recent years. This paper aims to describe the situation of the Polish education system from a knowledge management perspective and, to some extent, through innovation policies in education. The many challenges, this paper argues, can be tackled only through…

Engaging indigenous and academic knowledge on bees in the Amazon: implications for environmental management and transdisciplinary research.

PubMed

Athayde, Simone; Stepp, John Richard; Ballester, Wemerson C

2016-06-20

This paper contributes to the development of theoretical and methodological approaches that aim to engage indigenous, technical and academic knowledge for environmental management. We present an exploratory analysis of a transdisciplinary project carried out to identify and contrast indigenous and academic perspectives on the relationship between the Africanized honey bee and stingless bee species in the Brazilian Amazon. The project was developed by practitioners and researchers of the Instituto Socioambiental (ISA, a Brazilian NGO), responding to a concern raised by a funding agency, regarding the potential impact of apiculture development by indigenous peoples, on the diversity of stingless bee species in the Xingu Park, southern Brazilian Amazon. Research and educational activities were carried out among four indigenous peoples: Kawaiwete or Kaiabi, Yudja or Juruna, Kīsêdjê or Suyá and Ikpeng or Txicão. A constructivist qualitative approach was developed, which included academic literature review, conduction of semi-structured interviews with elders and leaders, community focus groups, field walks and workshops in schools in four villages. Semi-structured interviews and on-line surveys were carried out among academic experts and practitioners. We found that in both indigenous and scientific perspectives, diversity is a key aspect in keeping exotic and native species in balance and thus avoiding heightened competition and extinction. The Africanized honey bee was compared to the non-indigenous westerners who colonized the Americas, with whom indigenous peoples had to learn to coexist. We identify challenges and opportunities for engagement of indigenous and scientific knowledge for research and management of bee species in the Amazon. A combination of small-scale apiculture and meliponiculture is viewed as an approach that might help to maintain biological and cultural diversity in Amazonian landscapes. The articulation of knowledge from non-indigenous practitioners and researchers with that of indigenous peoples might inform sustainable management practices that are, at the same time, respectful of indigenous perspectives and intellectual property rights. However, there are ontological, epistemological, political and financial barriers and constraints that need to be addressed in transdisciplinary research projects inter-relating academic, technical and indigenous knowledge systems for environmental management.

New perspectives in fire management in South American savannas: The importance of intercultural governance.

PubMed

Mistry, Jayalaxshmi; Schmidt, Isabel Belloni; Eloy, Ludivine; Bilbao, Bibiana

2018-05-11

Wildfires continue to cause damage to property, livelihoods and environments around the world. Acknowledging that dealing with wildfires has to go beyond fire-fighting, governments in countries with fire-prone ecosystems have begun to recognize the multiple perspectives of landscape burning and the need to engage with local communities and their practices. In this perspective, we outline the experiences of Brazil and Venezuela, two countries where fire management has been highly contested, but where there have been recent advances in fire management approaches. Success of these new initiatives have been measured by the reduction in wildfire extent through prescribed burning, and the opening of a dialogue on fire management between government agencies and local communities. Yet, it is clear that further developments in community participation need to take place in order to avoid the appropriation of local knowledge systems by institutions, and to better reflect more equitable fire governance.

Academic Entrepreneurship vs. Changing Governance and Institutional Management Structures at European Universities

ERIC Educational Resources Information Center

Kwiek, Marek

2008-01-01

This article discusses academic entrepreneurship in the context of ongoing changes in university management and governance in European universities. The comparative perspective is provided by the European Union (EU) research project "European Universities for Entrepreneurship: Their Role in the Europe of Knowledge" (EUEREK) comprising…

Patients' perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study.

PubMed

Islam, Sheikh Mohammed Shariful; Biswas, Tuhin; Bhuiyan, Faiz A; Mustafa, Kamrun; Islam, Anwar

2017-03-21

Patients' perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients' perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh. We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked for errors, coded and analyzed by means of a qualitative content analysis framework. The data analysis generated rich information on the participants' knowledge and perception on diabetes, its causes, self-management, medication use, adverse effects of medication use, medication adherence, and impact of diabetes, Although most of the participants demonstrated substantive knowledge on diabetes and its consequences, they also reported numerous misconceptions about the disease. Knowledge on diabetes medication, their appropriate use and side effects was rather poor. Respondents also reported non-compliance to dietary and physical activity advice by their physicians and concerns on diabetes diabetes-induced psychological stress. High cost of medications, concerns over medication side effects and forgetfulness was noted as factors for non-adherence to medication. Participants' knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management. Healthcare providers should explore to better understand patients' perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence.

Knowledge Management Orientation: An Innovative Perspective to Hospital Management

PubMed Central

GHASEMI, Matina; GHADIRI NEJAD, Mazyar; BAGZIBAGLI, Kemal

2017-01-01

Background: By considering innovation as a new project in hospitals, all the project management’s standard steps should be followed in execution. This study investigated the validation of a new set of measures in terms of providing a procedure for knowledge management-oriented innovation that enriches the hospital management system. Methods: The relation between innovation and all the knowledge management areas, as the main constructs of project management, was illustrated by referring to project management standard steps and previous studies. Through consultations and meetings with a committee of professional project managers, a questionnaire was developed to measure ten knowledge management areas in hospital’s innovation process. Additionally, a group of experts from hospital managers were invited to comment on the applicability of the questionnaires by considering if the items are measurable in hospitals practically. Results: A close-ended, Likert-type scale items, consisted of ten sections, were developed based on project management body of knowledge thorough Delphi technique. It enables the managers to evaluate hospitals’ situation to be aware whether the organization follows the knowledge management standards in innovation process or not. By pilot study, confirmatory factor analysis and exploratory factor analysis were conducted to ensure the validity and reliability of the measurement items. Conclusion: The developed items seem to have a potential to help hospital managers and subsequently delivering new products/services successfully based on the standard procedures in their organization. In all innovation processes, the knowledge management areas and their standard steps help hospital managers by a new tool as questionnaire format. PMID:29259938

Performance of nursing auxiliaries and technicians in managing piercing cutting material: a necessary study.

PubMed

Moura, Elaine Cristina Carvalho; Moreira, Maria de Fátima Santana; da Fonseca, Soraia Martins

2009-01-01

This study aimed to analyze the knowledge of nursing auxiliaries and technicians in handling and disposing of piercing-cutting material and describe their performance. This qualitative-descriptive research was carried out with three nursing auxiliaries and 12 technicians at a medium-size hospital, totaling 15 participants interviewed through a semi-structured script. Discourse was analyzed through the content analysis technique. Results appoint that, even though the participants have theoretical knowledge on the management of piercing-cutting material, they do not totally follow their knowledge, which exposes them to several biological risks, revealing reproductive knowledge and performance. Thus, we propose the implementation of continuing education programs based on constructivist methodological approach aiming at effective practices in the management and disposal of piercing-cutting material. In this perspective, research clarifying how adults apprehend knowledge can deepen the results described in the study.

The association between effectiveness of the management processes and quality of health services from the perspective of the managers in the university hospitals of Ahvaz, Iran

PubMed Central

Faraji-Khiavi, F; Ghobadian, S; Moradi-Joo, E

2015-01-01

Background and Objective: Knowledge management is introduced as a key element of quality improvement in organizations. There was no such research in university hospitals of Ahvaz. This study aimed to determine the association between the effectiveness of the processes of knowledge management and the health services quality from the managers’ view in the educational hospitals of Ahvaz city. Materials and Methods: in this correlational and research, the research population consisted of 120 managers from hospitals in University of Medical Sciences Ahvaz. Due to the limited population, the census was run. Three questionnaires were used for data collection: Demographic characteristics, the effectiveness of knowledge management processes and the quality of medical services. To analyze the data, the Spearman association analysis, The Kruskal-Wallis, the Mann–Whitney U test, were used in SPSS. Results: estimation of average scoring of the effectiveness of knowledge management processes and its components were relatively appropriate. Quality of medical services was estimated as relatively appropriate. Relationship of quality of health services with the effectiveness of knowledge management processes showed a medium and positive correlation (p < 0.001). Managers with different genders showed significant differences in knowledge development and transfer (P = 0.003). Conclusion: a significant and positive association was observed between the effectiveness of knowledge management processes and health care quality. To improve the health care quality in university hospitals, managers should pay more attention to develop the cultures of innovation, encourage teamwork, and improve communication and creative thinking in the knowledge management context PMID:28316735

Hypertension: management perspectives.

PubMed

Borghi, Claudio; Cicero, Arrigo F G

2012-10-01

The increasing worldwide prevalence of hypertension and the related increase in cost due to diagnosis, management and negative outcomes forces public health institutions and clinical researchers to find new strategies to improve blood pressure (BP) control. So what are the possible future perspectives for high BP management? Three main points are briefly discussed in this article: individualized therapy, the known genetic contribution to hypertension development and control, and the improvement of disease management, including perspectives on new antihypertensive drug development. It is likely that the integration of the best available current knowledge with recent diagnostic and therapeutic achievements for the management of hypertension prevention and treatment will lead to the early detection of at-risk conditions, early diagnosis, and individualized and efficacious treatment. The most promising antihypertensive drugs currently in development are innovative renin-angiotensin-aldosterone system modulators. Further drugs have potentially interesting mechanisms of action, but renalase analogs are in the very early phases of development, and available endothelin antagonists have a poor safety profile.

Mapping the Terrain of Educational Leadership and Management in East Asia

ERIC Educational Resources Information Center

Hallinger, Philip; Bryant, Darren

2013-01-01

Purpose: The purpose of this paper is to gain perspective on the extent to which the vision for knowledge production in East Asia set forth by Bajunid, Cheng, Hallinger, Walker, Dimmock and others almost 20 years ago has been fulfilled. The authors undertook an effort to map the terrain of knowledge production in educational leadership and…

From a social marketing perspective: a proposed customer relationship management technology transfer model

Treesearch

Delton Alderman; Kent Nakamoto; David Briberg

2007-01-01

Technology and knowledge transfer (TKT) is practiced for a plethora of causes, ranging from AIDS prevention to manufacturing competitiveness. The number of government, university, and association TKT efforts is exhausting and fraught with problems; we know anecdotally that the adoption of technology or knowledge is minimal across all contexts. There are a myriad of...

Key barriers to gout care: a systematic review and thematic synthesis of qualitative studies.

PubMed

Rai, Sharan K; Choi, Hyon K; Choi, Sally H J; Townsend, Anne F; Shojania, Kam; De Vera, Mary A

2018-04-17

Gout care remains highly suboptimal, contributing to an increased global disease burden. To understand barriers to gout care, our aim was to provide a systematic review and thematic synthesis of qualitative studies worldwide reporting provider and patient perspectives and experiences with management. We conducted a mapped search of MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, and Social Sciences Citation Index databases and selected qualitative studies of provider and patient perspectives on gout management. We used thematic synthesis to combine the included studies and identify key themes across studies. We included 20 studies that reported the experiences and perspectives of 480 gout patients and 120 providers spanning five different countries across three continents. We identified three predominant provider themes: knowledge gaps and management approaches; perceptions and beliefs about gout patients; and system barriers to optimal gout care (e.g. time constraints and a lack of incentives). We also identified four predominant themes among gout patients: limited gout knowledge; interactions with health-care providers; attitudes towards and experiences with taking medication; and practical barriers to long-term medication use. Our systematic review of worldwide literature consistently identified gaps in gout knowledge among providers, which is likely to contribute to patients' lack of appropriate education about the fundamental causes of and essential treatment approaches for gout. Furthermore, system barriers among providers and day-to-day challenges of taking long-term medications among patients are considerable. These factors provide key targets to improve the widespread suboptimal gout care.

Automated Management Of Documents

NASA Technical Reports Server (NTRS)

Boy, Guy

1995-01-01

Report presents main technical issues involved in computer-integrated documentation. Problems associated with automation of management and maintenance of documents analyzed from perspectives of artificial intelligence and human factors. Technologies that may prove useful in computer-integrated documentation reviewed: these include conventional approaches to indexing and retrieval of information, use of hypertext, and knowledge-based artificial-intelligence systems.

The Tribal Environment and Natural Resources Management Approach to Indian Education and Student Assessment.

ERIC Educational Resources Information Center

Berardi, Gigi; Burns, Dan; Duran, Phillip; Gonzalez-Plaza, Roberto; Kinley, Sharon; Robbins, Lynn; Williams, Ted; Woods, Wayne

2003-01-01

A pilot program at Northwest Indian College (Washington) teaches tribal resource management from the Native perspective. The program is built on principles of articulation of both tribal and Western knowledge, support and non-abandonment of students, and developmental education. Student assessment eliminates punitive measures and focuses on…

A Collaborative Learning Environment for Management Education Based on Experiential Learning

ERIC Educational Resources Information Center

Lidon, Ivan; Rebollar, Ruben; Moller, Charles

2011-01-01

In many areas of applied sciences, such as management and engineering, the generation and dissemination of theory and knowledge is increasingly woven into practice. This leaves teaching and research institutions with the challenge of developing and organising teaching activities that are effective from a student learning perspective. This paper…

Perspectives on prevention, assessment, and rehabilitation of low back pain in WORK.

PubMed

Ravenek, Michael J; Bryson-Campbell, Mikelle M; Shaw, Lynn; Hughes, Ian D

2010-01-01

The aim of this review was to describe the low back pain (LBP) knowledge base developed in WORK and to discuss its relevance to current perspectives in the broader literature on LBP and employment. A scoping review of the literature in WORK on LBP and employment was conducted using published articles from 1990-2009. Articles were organized into geographical regions and summarized for contributions to the domains of WORK: prevention, assessment, and rehabilitation. Methodological accordance of the articles was also assessed. Fifty articles were extracted and organized into contributions from authors within North America (n=34) and outside North America (n=16). In total there were 26 prevention, 7 assessment, and 12 rehabilitation articles in this review. Five articles were also classified as 'understanding' articles. More than half of the articles retrieved employed quantitative methodology. WORK has contributed a broad realm of publications to the knowledge base on LBP and employment. Two thirds of the articles were contributed from authors within North America, with a greater emphasis on prevention. This article highlights the similarities and differences in the international knowledge base in the management of LBP in WORK. Future directions for research are elaborated drawing on current perspectives of two experts on the management of LBP.

Patient perspectives on fluid management in chronic hemodialysis.

PubMed

Smith, Kimberly; Coston, Melinda; Glock, Kimberly; Elasy, Tom A; Wallston, Kenneth A; Ikizler, T Alp; Cavanaugh, Kerri L

2010-09-01

We sought to describe the perspectives and experiences of chronic hemodialysis (CHD) patients regarding self-care and adherence to fluid restrictions. Semistructured focus groups. Two outpatient hemodialysis centers. Nineteen patients on chronic hemodialysis. Patients were asked a series of open-ended questions to encourage discussion about the management of fluid restriction within the broad categories of general knowledge, knowledge sources or barriers, beliefs and attitudes, self-efficacy, emotion, and self-care skills. We analyzed session transcripts using the theoretical framework of content analysis to identify themes generated by the patients. Patients discussed both facilitators and barriers to fluid restriction, which we categorized into six themes: knowledge, self-assessment, psychological factors, social, physical, and environmental. Psychological factors were the most common barriers to fluid restriction adherence, predominantly involving lack of motivation. Knowledge was the most discussed facilitator with accurate self-assessment, positive psychological factors, and supportive social contacts also playing a role. Dialysis providers were most commonly described as the source of dialysis information (54%), but learning through personal experience was also frequently noted (28%). Interventions to improve fluid restriction adherence of chronic hemodialysis patients should target motivational issues, assess and improve patient knowledge, augment social support, and facilitate accurate self-assessment of fluid status. (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Informatics Observed [and] Agenda: A Tool for Agenda Setting Research [and] Telos Language Partner: Multimedia Language Learning, Authoring and Customisation [and] Towards a Consumer Perspective on Information Behaviour Research [and] The Digital Library as Access Management Facilitator [and] Knowledge and Information Management (KIM'21) [and] Perspectives of ICT in Professional Development and Education.

ERIC Educational Resources Information Center

Cawkell, Tony; Kok, Yeong Haur; Goh, Angela; Holaday, Duncan; Hoffstaedter, Petra; Kohn, Kurt; Rowley, Jennifer; van Halm, Johan; Pye, Jo

1999-01-01

The following collection of articles reprinted from "CD ROM and Online Review" include "a new way of learning." Discuses research and development funding in educational technology and recommends to offer vast sums to investigate the best way of teaching a particular topic, and through that to fund the use of computers as an incidental part of the…

Revisiting Organisational Learning in Integrated Care.

PubMed

Nuño-Solinís, Roberto

2017-08-11

Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning.

Revisiting Organisational Learning in Integrated Care

PubMed Central

2017-01-01

Progress in health care integration is largely linked to changes in processes and ways of doing. These changes have knowledge management and learning implications. For this reason, the use of the concept of organisational learning is explored in the field of integrated care. There are very limited contributions that have connected the fields of organisational learning and care integration in a systematic way, both at the theoretical and empirical level. For this reason, hybridization of both perspectives still provides opportunities for understanding care integration initiatives from a research perspective as well as potential applications in health care management and planning. PMID:28970762

Information technologies and the sharing of disaster knowledge: the critical role of professional culture.

PubMed

Marincioni, Fausto

2007-12-01

A comparative survey of a diverse sample of 96 US and Italian emergency management agencies shows that the diffusion of new information technologies (IT) has transformed disaster communications. Although these technologies permit access to and the dissemination of massive amounts of disaster information with unprecedented speed and efficiency, barriers rooted in the various professional cultures still hinder the sharing of disaster knowledge. To be effective the available IT must be attuned to the unique settings and professional cultures of the local emergency management communities. Findings show that available technology, context, professional culture and interaction are key factors that affect the knowledge transfer process. Cultural filters appear to influence emergency managers' perceptions of their own professional roles, their vision of the applicability of technology to social issues, and their perspective on the transferability of disaster knowledge. Four cultural approaches to the application of IT to disaster communications are defined: technocentric; geographic,; anthropocentric; and ecocentric.

Assessing communications effectiveness in meeting corporate goals of public health organizations.

PubMed

Brown, Gordon D; Bopp, Kenneth D; Boren, Suzanne Austin

2005-01-01

Much evaluation of health communications in public health is considered from a program perspective of smoking cessation, weight reduction, education on sexually transmitted diseases, etc. These studies have advanced the knowledge base of communications theory and evaluation and have contributed to program effectiveness. In program-based evaluation the communications process is structured as part of the program itself. This article extends program-based communications evaluation to view communications from the perspective of the consumer and how effectively public health departments respond to consumer expectations. It develops a conceptual model for evaluating elements of communications such as its importance in defining mission and goals within the community, managing strategic constituencies, and enlisting individuals and groups as customers and co-producers of health. It gives a broader perspective on how communications in public heath organizations are managed and a basis for assessing whether they are being managed effectively.

Assessing Patient Management Plans of Doctors and Medical Students: An Illness Script Perspective

ERIC Educational Resources Information Center

Monajemi, Alireza; Schmidt, Henk G.; Rikers, Remy M. J. P.

2012-01-01

Introduction: Illness script theory offers explanations for expert-novice differences in clinical reasoning. However, it has mainly focused on diagnostic (Dx) performance, while patient management (Mx) has been largely ignored. The aim of the present study was to show the role of Mx knowledge in illness script development and how it relates to…

Classroom Management and National Professional Standards for Teachers: A Review of the Literature on Theory and Practice

ERIC Educational Resources Information Center

Egeberg, Helen M.; McConney, Andrew; Price, Anne

2016-01-01

This article reviews the conceptual and empirical research on classroom management to ascertain the extent to which there is consistency between the "advice" found in the research literature and the professional standards for teachers and initial teacher education, in regards to knowledge and perspectives about effective classroom…

Managing knowledge integration in a national health-care crisis: lessons learned from combating SARS in Singapore.

PubMed

Devadoss, Paul Raj; Pan, Shan Ling; Singh, Shreyan

2005-06-01

The outbreak of Severe Acute Respiratory Syndrome is the first severe and readily transmissible disease to emerge in the 21st century. Often one new infection meant tracing of several people to monitor their health conditions as well. In Singapore, several agencies coordinated their efforts to quickly bring the outbreak under control. The current breed of health-care information systems (HCIS) was not sufficient to handle new information-sharing needs during the crisis. In this paper, we take a look at the measures taken during the crisis in Singapore through a knowledge integration perspective. This perspective reveals interesting implications for HCIS.

Managing Distributed Innovation Processes in Virtual Organizations by Applying the Collaborative Network Relationship Analysis

NASA Astrophysics Data System (ADS)

Eschenbächer, Jens; Seifert, Marcus; Thoben, Klaus-Dieter

Distributed innovation processes are considered as a new option to handle both the complexity and the speed in which new products and services need to be prepared. Indeed most research on innovation processes was focused on multinational companies with an intra-organisational perspective. The phenomena of innovation processes in networks - with an inter-organisational perspective - have been almost neglected. Collaborative networks present a perfect playground for such distributed innovation processes whereas the authors highlight in specific Virtual Organisation because of their dynamic behaviour. Research activities supporting distributed innovation processes in VO are rather new so that little knowledge about the management of such research is available. With the presentation of the collaborative network relationship analysis this gap will be addressed. It will be shown that a qualitative planning of collaboration intensities can support real business cases by proving knowledge and planning data.

Are They Really Ready to Work? Employers' Perspectives on the Basic Knowledge and Applied Skills of New Entrants to the 21st Century U.S. Workforce

ERIC Educational Resources Information Center

Casner-Lotto, Jill; Barrington, Linda

2006-01-01

In collaboration, The Conference Board, Corporate Voices for Working Families, the Partnership for 21st Century Skills, and the Society for Human Resource Management conducted an in-depth study of the corporate perspective on the readiness of new entrants into the U.S. workforce by level of educational attainment. The study includes results…

Factors Influencing the Application of a Biopsychosocial Perspective in Clinical Judgement of Chronic Pain: Interactive Management with Medical Students.

PubMed

Dwyer, Christopher P; McKenna-Plumley, Phoebe E; Durand, Hannah; Gormley, Emer M; Slattery, Brian W; Harney, Owen M; MacNeela, Padraig; McGuire, Brian E

2017-09-01

Though there is wide support for the application of biopsychosocial perspectives in clinical judgement of chronic pain cases, such perspectives are often overlooked due to either inadequate training or attitudes favoring a biomedical approach. Recent research has indicated that despite such explanations, both established general practitioners (GP) and medical students account for some psychosocial factors when making clinical judgements regarding chronic pain cases, but report not being likely to apply these in real-world, clinical settings due to numerous factors, including available time with patients. Thus, it is evident that a greater understanding of clinical judgement-making processes and the factors that affect application of these processes is required, particularly regarding chronic pain. The aims of the current study were to investigate medical students' conceptualizations of the factors that influence application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain using interactive management (IM), model the relationships among these factors, and make recommendations to chronic pain treatment policy in light of the findings. The current study used IM to identify and model factors that influence the application of a biopsychosocial approach to clinical judgement-making in cases of chronic pain, based on medical students' conceptualizations of these factors. Two university classrooms. IM is a systems thinking and action mapping strategy used to aid groups in developing outcomes regarding complex issues, through integrating contributions from individuals with diverse views, backgrounds, and perspectives. IM commonly utilizes the nominal group technique and interpretive structural modeling, which in this context were employed to help medical students identify, clarify, and model influences on the application of biopsychosocial perspectives in treating chronic pain patients. Results of IM group work revealed 7 core biopsychosocial approach application categories: GP attitudes, cost, GP knowledge, time, patient-doctor relationship, biomedical factors. and patient perception. GP attitudes was the most critical driver of all other competencies in the system, with cost and GP knowledge revealed as secondary drivers. Potential differences in level of prior biopsychosocial perspective knowledge across participants and a potentially small sample size (though consistent with past research and appropriate for an exploratory study of this nature - for purposes of achieving the depth and richness of the deliberation and qualitative insights revealed by participants using the IM methodology). Results from this study may be used to both recommend further research on the identified factors influencing application of biopsychosocial perspectives in treatment of chronic pain and support amendment to extant health care policy, particularly with respect to cost, GP attitudes, and knowledge. Though this research claims neither that the influences identified are the only influences on biopsychosocial application, nor the order of their importance, the research does contribute to an on-going effort to better understand the factors that influence doctors in their treatment of chronic pain.Key words: Chronic pain, biopsychosocial, medical education, clinical judgement, interactive management, pain management.

'On the surface': a qualitative study of GPs' and patients' perspectives on psoriasis.

PubMed

Nelson, Pauline A; Barker, Zoë; Griffiths, Christopher E M; Cordingley, Lis; Chew-Graham, Carolyn A

2013-10-20

Psoriasis is a chronic, inflammatory skin disease affecting approximately 2% of the UK population and is currently incurable. It produces profound effects on psychological wellbeing and social functioning and has significant associated co-morbidities. The majority of patients with psoriasis are managed in primary care, however in-depth patient and GP perspectives about psoriasis management in this setting are absent from the literature. This article reports an in-depth study which compares and contrasts the perspectives of people with psoriasis and of GPs on the challenges of managing psoriasis in primary care. In-depth, qualitative semi-structured interviews were conducted with a diverse sample of 29 people with psoriasis and 14 GPs. Interviews were coded using principles of Framework Analysis to enable a comparison of patient and practitioner perspectives on key issues and concepts arising from the data. Patients perceived GPs to be lacking in confidence in the assessment and management of psoriasis and both groups felt lacking in knowledge and understanding about the condition. While practitioners recognised that psoriasis has physical, emotional and social impact, they assumed patients had expertise in the condition and may not address these issues in consultations. This resulted in patient dissatisfaction and sub-optimal assessment of severity and impact of psoriasis by GPs. Patients and GPs recognised that psoriasis was not being managed as a complex long-term condition, however this appeared less problematic for GPs than for patients who desired a shared management with their GP incorporating appropriate monitoring and timely reviews. The research suggests that current routine practice for psoriasis management in primary care is mismatched with the expressed needs of patients. To address these needs, psoriasis must be recognised as a complex long-term condition involving exacting physical, psychological and social demands, co-morbidity and the development of new treatments.General practitioners need to improve both their knowledge and skills in the assessment and management of psoriasis. This in turn will facilitate management of the condition in partnership with patients. Commissioning multi-disciplinary services, which focus on long-term impacts on wellbeing and quality of life, might address current deficits in care.

Understanding effective care management implementation in primary care: a macrocognition perspective analysis.

PubMed

Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

2015-08-21

Care management in primary care can be effective in helping patients with chronic disease improve their health status. Primary care practices, however, are often challenged with its implementation. Incorporating care management involves more than a simple physical process redesign to existing clinical care routines. It involves changes to who is working with patients, and consequently such things as who is making decisions, who is sharing patient information, and how. Studying the range of such changes in "knowledge work" during implementation requires a perspective and tools designed to do so. We used the macrocognition perspective, which is designed to understand how individuals think in dynamic, messy real-world environments such as care management implementation. To do so, we used cognitive task analysis to understand implementation in terms of such thinking as decision making, knowledge, and communication. Data collection involved semi-structured interviews and observations at baseline and at approximately 9 months into implementation at five practices in one physician-owned administratively connected group of practices in the state of Michigan, USA. Practices were intervention participants in a larger trial of chronic care model implementation. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with macrocognition as a guiding framework. Seventy-four interviews and five observations were completed. There were differences in implementation success across the practices, and these differences in implementation success were well explained by macrocognition. Practices that used more macrocognition functions and used them more often were also more successful in care management implementation. Although care management can introduce many new changes into the delivery of primary care clinical practice, implementing it successfully as a new complex intervention is possible. Macrocognition is a useful perspective for illuminating the elements that facilitate new complex interventions with a view to addressing them during implementation planning.

Ethics, Collaboration, and Presentation Methods for Local and Traditional Knowledge for Understanding Arctic Change

NASA Astrophysics Data System (ADS)

Parsons, M. A.; Gearheard, S.; McNeave, C.

2009-12-01

Local and traditional knowledge (LTK) provides rich information about the Arctic environment at spatial and temporal scales that scientific knowledge often does not have access to (e.g. localized observations of fine-scale ecological change potentially from many different communities, or local sea ice and conditions prior to 1950s ice charts and 1970s satellite records). Community-based observations and monitoring are an opportunity for Arctic residents to provide ‘frontline’ observations and measurements that are an early warning system for Arctic change. The Exchange for Local Observations and Knowledge of the Arctic (ELOKA) was established in response to the growing number of community-based and community-oriented research and observation projects in the Arctic. ELOKA provides data management and user support to facilitate the collection, preservation, exchange, and use of local observations and knowledge. Managing these data presents unique ethical challenges in terms of appropriate use of rare human knowledge and ensuring that knowledge is not lost from the local communities and not exploited in ways antithetical to community culture and desires. Local Arctic residents must be engaged as true collaborative partners while respecting their perspectives, which may vary substantially from a western science perspective. At the same time, we seek to derive scientific meaning from the local knowledge that can be used in conjunction with quantitative science data. This creates new challenges in terms of data presentation, knowledge representations, and basic issues of metadata. This presentation reviews these challenges, some initial approaches to addressing them, and overall lessons learned and future directions.

Assessing Proposals for Interagency Reorganization

DTIC Science & Technology

2005-05-26

is useful to have a single entity responsible for operations. Though postmodernist theory is based on a diffusion of knowledge there is an... of knowledge …[for] the general good of mankind.”32 Their research tends to focus on technological solutions to complex information management issues...from an institutional perspective different from that of CSIS. The Markle Foundation was created in 1927 “to promote the advancement and diffusion

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

PubMed

Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012-2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training. Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services.

Normalizing suffering: A meta-synthesis of experiences of and perspectives on pain and pain management in nursing homes.

PubMed

Vaismoradi, Mojtaba; Skär, Lisa; Söderberg, Siv; Bondas, Terese E

2016-01-01

Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of "identity of pain," "recognition of pain," and "response to pain." The metaphor of "normalizing suffering" was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society-among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain-must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain.

Trials, tribulations, and triumphs of insider researchers

NASA Astrophysics Data System (ADS)

McBride, S.; Tilley, E. N.; Becker, J.; Orchiston, C.; Johnston, D. M.

2016-12-01

Is there merit in "insider" research? An insider researcher, in the social science context, is someone who conducts their research and provides their observations and perspectives on a project, sector or disaster setting which they are intimately familiar with. One strength of insider research is the unique insights and awareness that are gained as a consequence of the experience of working within the research setting. This could also be considered the most significant criticism of insider research, one that is fraught with bias and subjectivity. So, given their potential biases, can an insider develop worthwhile research? The trials and tribulations of an insider are many. Given the insider position, traditional observer empirical research is not ideal, so this research necessitates exploring different research theoretical perspectives, including the use of critical theory and constructivism. Constructivism-based research permits the researcher to use their unique perspectives and knowledge to `construct' knowledge through their research. However, using constructivist theoretical perspectives and methods may be a complex and challenging endeavor for those better acquainted with empirical methods. Further, ethical restrictions can create further complexities to insider research. Compounding the complexities of methodologies and theoretical perspective, an insiders' perspective can be difficult to manage, given their embedded viewpoint, and may include professional and emotional risks for the researcher. Given its many challenges, insider research is not a frequent pathway of academic examination, particularly in emergency management and natural hazards research. Triumphs of insider research endeavors become clear once ways to address methodological and ethical issues are resolved. I will explore these solutions in my presentation. Further, insider researchers laid the foundation for the contemporary emergency management discipline but this research has been largely been overlooked in the discourse. The triumph of insider research is how influential they may be to a sector; one historical piece of research assisted in the development of an entire sector. Finally, I explore my research pathway, as an insider, to research the communication lessons from the Canterbury Earthquake Sequence.

Unresolved pain in children: a relational ethics perspective.

PubMed

Olmstead, Deborah L; Scott, Shannon D; Austin, Wendy J

2010-11-01

It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children's pain experiences, the relationships nurses share with children who are suffering, and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end.

[Perioperative thirst: an analysis from the perspective of the Symptom Management Theory].

PubMed

Conchon, Marilia Ferrari; Nascimento, Leonel Alves do; Fonseca, Lígia Fahl; Aroni, Patrícia

2015-02-01

A theoretical study aimed to analyze the existing knowledge in the literature on the perioperative thirst symptom from the perspective of Symptom Management Theory, and supplemented with the experience of the study group and thirst research. Thirst is described as a very intense symptom occurring in the perioperative period, and for this reason it cannot be ignored. The Symptom Management Theory is adequate for understanding the thirst symptom and is a deductive theory, focused on the domains of the Person, Environment and Health / Illness Status, as well as on the dimensions of Experience, Management Strategies and Symptom Outcomes. Using the theory leads us to consider perioperative thirst in its multifactorial aspects, analyzing the interrelation of its domains and dimensions in order to draw attention to this symptom that has been insufficiently valued, recorded and treated in clinical practice.

The Regional Advisory Councils: what is their potential to incorporate stakeholder knowledge into fisheries governance?

PubMed

Linke, Sebastian; Dreyer, Marion; Sellke, Piet

2011-03-01

The protection of the Baltic Sea ecosystem is exacerbated by the social, environmental and economic complexities of governing European fisheries. Increased stakeholder participation and knowledge integration are suggested to improve the EU's Common Fisheries Policy (CFP), suffering from legitimacy, credibility and compliance problems. As a result, the CFP was revised in 2002 to involve fisheries representatives, NGOs and other stakeholders through so called Regional Advisory Councils (RACs) in the policy process. We address the RAC's task to incorporate stakeholder knowledge into the EU's fisheries governance system in empirical and theoretical perspectives. Drawing on a four-stage governance concept we subsequently suggest that a basic problem is a mismatch between participation purpose (knowledge inclusion) and the governance stage at which RACs are formally positioned (evaluation of management proposals). We conclude that, if the aim is to broaden the knowledge base of fisheries management, stakeholders need to be included earlier in the governance process.

Supporting Complex Problems: An Examination of Churchman’s Inquirers as a Knowledge Management Foundation

DTIC Science & Technology

2006-06-07

inquirers based on the underlying philosophies of Leibniz, Locke, Kant , Hegel, and Singer. These inquirers share capabilities and can work together in a...encourages and supports socially oriented knowledge development. The Kantian Inquirer Kantian systems are the archetype of multi-model, synthetic systems...Mason and Mitroff, 1973). The Kantian inquirer is designed to incorporate both multiple perspectives and facts to determine models that are

Evolving from bioinformatics in-the-small to bioinformatics in-the-large.

PubMed

Parker, D Stott; Gorlick, Michael M; Lee, Christopher J

2003-01-01

We argue the significance of a fundamental shift in bioinformatics, from in-the-small to in-the-large. Adopting a large-scale perspective is a way to manage the problems endemic to the world of the small-constellations of incompatible tools for which the effort required to assemble an integrated system exceeds the perceived benefit of the integration. Where bioinformatics in-the-small is about data and tools, bioinformatics in-the-large is about metadata and dependencies. Dependencies represent the complexities of large-scale integration, including the requirements and assumptions governing the composition of tools. The popular make utility is a very effective system for defining and maintaining simple dependencies, and it offers a number of insights about the essence of bioinformatics in-the-large. Keeping an in-the-large perspective has been very useful to us in large bioinformatics projects. We give two fairly different examples, and extract lessons from them showing how it has helped. These examples both suggest the benefit of explicitly defining and managing knowledge flows and knowledge maps (which represent metadata regarding types, flows, and dependencies), and also suggest approaches for developing bioinformatics database systems. Generally, we argue that large-scale engineering principles can be successfully adapted from disciplines such as software engineering and data management, and that having an in-the-large perspective will be a key advantage in the next phase of bioinformatics development.

Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia.

PubMed

Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha

2016-01-01

Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.

How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

PubMed

Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis

2016-07-08

In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we recommend that the procurement mechanism should integrate knowledge from clinical procedures adequately in their decision-making. Without strong guidance, organisational changes, and support by technological solutions to improve the generation and management of knowledge, procurement processes for orthopaedic high-risk medical devices will remain sub-optimal.

Critical research needs for managing coral reef marine protected areas: perspectives of academics and managers.

PubMed

Cvitanovic, C; Wilson, S K; Fulton, C J; Almany, G R; Anderson, P; Babcock, R C; Ban, N C; Beeden, R J; Beger, M; Cinner, J; Dobbs, K; Evans, L S; Farnham, A; Friedman, K J; Gale, K; Gladstone, W; Grafton, Q; Graham, N A J; Gudge, S; Harrison, P L; Holmes, T H; Johnstone, N; Jones, G P; Jordan, A; Kendrick, A J; Klein, C J; Little, L R; Malcolm, H A; Morris, D; Possingham, H P; Prescott, J; Pressey, R L; Skilleter, G A; Simpson, C; Waples, K; Wilson, D; Williamson, D H

2013-01-15

Marine protected areas (MPAs) are a primary policy instrument for managing and protecting coral reefs. Successful MPAs ultimately depend on knowledge-based decision making, where scientific research is integrated into management actions. Fourteen coral reef MPA managers and sixteen academics from eleven research, state and federal government institutions each outlined at least five pertinent research needs for improving the management of MPAs situated in Australian coral reefs. From this list of 173 key questions, we asked members of each group to rank questions in order of urgency, redundancy and importance, which allowed us to explore the extent of perceptional mismatch and overlap among the two groups. Our results suggest the mismatch among MPA managers and academics is small, with no significant difference among the groups in terms of their respective research interests, or the type of questions they pose. However, managers prioritised spatial management and monitoring as research themes, whilst academics identified climate change, resilience, spatial management, fishing and connectivity as the most important topics. Ranking of the posed questions by the two groups was also similar, although managers were less confident about the achievability of the posed research questions and whether questions represented a knowledge gap. We conclude that improved collaboration and knowledge transfer among management and academic groups can be used to achieve similar objectives and enhance the knowledge-based management of MPAs. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Experiential Approach to Benchmarking Curriculum

ERIC Educational Resources Information Center

Grandzol, John R.; Grandzol, Christian J.

2011-01-01

Continuous curriculum improvement derives from a variety of perspectives, opportunities, and approaches. In this brief, we describe a process that facilitated student participation in curriculum development. We took our Supply Chain Management students to a regional conference affiliated with APICS and had them assess their knowledge readiness…

Towards a Postmodern Research Agenda For Public Relations.

ERIC Educational Resources Information Center

Holtzhausen, Derina R.

2002-01-01

Explores the possibility of postmodernism as an alternative theoretical approach to public relations. Examines modernist public relations as a hegemonic practice that interpolates practitioners into the system to legitimize the perspectives and actions of corporate managers as objective knowledge. Concludes with suggestions for a postmodern…

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Normalizing suffering: A meta-synthesis of experiences of and perspectives on pain and pain management in nursing homes

PubMed Central

Vaismoradi, Mojtaba; Skär, Lisa; Söderberg, Siv; Bondas, Terese E.

2016-01-01

Older people who live in nursing homes commonly suffer from pain. Therefore, relieving suffering among older people that stems from pain demands knowledge improvement through an integration of international knowledge. This study aimed to integrate current international findings and strengthen the understanding of older people's experiences of and perspectives on pain and pain management in nursing homes. A meta-synthesis study using Noblit and Hare's interpretative meta-ethnography approach was conducted. Empirical research papers from journals were collected from various databases. The search process and appraisal determined six articles for inclusion. Two studies were conducted in the US and one each in Iceland, Norway, the UK, and Australia. The older people's experiences of pain as well as perspectives on pain management from all involved (older people, their family members, and healthcare staff) were integrated into a theoretical model using three themes of “identity of pain,” “recognition of pain,” and “response to pain.” The metaphor of “normalizing suffering” was devised to illustrate the meaning of pain experiences and pain management in nursing homes. Society's common attitude that pain is unavoidable and therefore acceptable in old age in society—among older people themselves as well as those who are responsible for reporting, acknowledging, and relieving pain—must change. The article emphasizes that pain as a primary source of suffering can be relieved, provided that older people are encouraged to report their pain. In addition, healthcare staff require sufficient training to take a person-centered approach towards assessment and management of pain that considers all elements of pain. PMID:27173102

Older persons' lived experiences of depression and self-management.

PubMed

Holm, Anne Lise; Lyberg, Anne; Lassenius, Erna; Severinsson, Elisabeth; Berggren, Ingela

2013-10-01

Mental ill-health, such as depression in the elderly, is a complex issue that is influenced by the life-world perspective of older persons. Their self-management ability should be strengthened based on an understanding of their situation, perspectives, and vulnerability. The aim of this study was to explore and increase understanding of old persons' lived experiences of depression and self-management using an interpretative explorative design. Understanding was developed by means of hermeneutic interpretation. One theme, Relationships and Togetherness, and four subthemes, A Sense of Carrying a Shoulder Bag, Walking on Eggshells, Holding the Reins, and Estrangement--a Loss of Togetherness, emerged. A collaborative approach can be important for empowering older persons through self-development and management. Although the findings of the present study cannot be considered conclusive or definitive, they nevertheless contribute new knowledge of older persons' lived experiences of depression in everyday life.

Engineering Quality Software: 10 Recommendations for Improved Software Quality Management

DTIC Science & Technology

2010-04-27

lack of user involvement • Inadequate Software Process Management & Control By Contractors • No “Team” of Vendors and users; little SME participation...1990 Quality Perspectives • Process Quality ( CMMI ) • Product Quality (ISO/IEC 2500x) – Internal Quality Attributes – External Quality Attributes... CMMI /ISO 9000 Assessments – Capture organizational knowledge • Identify best practices, lessons learned Know where you are, and where you need to be

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia

PubMed Central

Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Background Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012–2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. Methods This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. Results On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace environment, especially in handling human resource management matters. The smallest improvement was noted in ethics and accountability. Qualitative interviews showed improvements in the meeting culture and a greater appreciation for the importance of meetings. Shared vision, teamwork and coordination seemed to have improved more in work places where the overall manager had received ZMLA training. Conclusion Leadership and management training will be a key ingredient in health system strengthening in low-income settings. The ZMLA model was found to be acceptable and effective in improving knowledge and skills for health system managers with minimal disruption to health services. PMID:28742853

Challenges of self-management when living with multiple chronic conditions

PubMed Central

Liddy, Clare; Blazkho, Valerie; Mill, Karina

2014-01-01

Abstract Objective To explore the perspectives of patients who live with multiple chronic conditions as they relate to the challenges of self-management. Data sources On September 30, 2013, we searched MEDLINE, EMBASE, and CINAHL using relevant key words including chronic disease, comorbidity, multimorbidity, multiple chronic conditions, self-care, self-management, perspective, and perception. Study selection Three reviewers assessed and extracted the data from the included studies after study quality was rated. Qualitative thematic synthesis method was then used to identify common themes. Twenty-three articles met the inclusion criteria, with most coming from the United States. Synthesis Important themes raised by people living with multiple chronic conditions related to their ability to self-manage included living with undesirable physical and emotional symptoms, with pain and depression highlighted. Issues with conflicting knowledge, access to care, and communication with health care providers were raised. The use of cognitive strategies, including reframing, prioritizing, and changing beliefs, was reported to improve people’s ability to self-manage their multiple chronic conditions. Conclusion This study provides a unique view into patients’ perspectives of living with multiple chronic conditions, which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with patients’ perspectives on living with multiple chronic conditions. This might be achieved by ensuring a more patient-centred approach is adopted by providers and health service organizations. PMID:25642490

International HRD Perspectives.

ERIC Educational Resources Information Center

1999

The first of the four papers in this symposium, "Towards a Meaningful HRD [Human Resource Development] Function in the Post-Command Economies of Central and Eastern Europe" (Devi Jankowicz), examines the existing knowledge-base among managers who are to be trained as HRD practitioners and suggests that efforts may be constrained by…

Down Syndrome: A Cardiovascular Perspective

ERIC Educational Resources Information Center

Vis, J. C.; Duffels, M. G. J.; Winter, M. M.; Weijerman, M. E.; Cobben, J. M.; Huisman, S. A.; Mulder, B. J. M.

2009-01-01

This review focuses on the heart and vascular system in patients with Down syndrome. A clear knowledge on the wide spectrum of various abnormalities associated with this syndrome is essential for skillful management of cardiac problems in patients with Down syndrome. Epidemiology of congenital heart defects, cardiovascular aspects and…

Towards Comparative Educational Administration: Building the Case for a Cross-Cultural School-Based Approach.

ERIC Educational Resources Information Center

Dimmock, Clive; Walker, Allan

1998-01-01

Advocates a stronger comparative emphasis in the study of educational administration and management while acknowledging comparative educational administration's weak knowledge base. Clarifies the potential import of a comparative, cross-cultural perspective embracing five societal/cultural dimensions: individualism versus collectivism, power…

Alumni Perspectives Survey. 2015 Survey Report

ERIC Educational Resources Information Center

Schoenfeld, Gregg

2015-01-01

Graduate business school students worldwide typically are motivated to pursue management education to achieve three objectives: to advance their careers, to increase their earning potential, and to develop their business knowledge, skills, and abilities. Once they graduate, these business school alumni discover many paths to fulfilling careers,…

Nurses’ Experiences of Managing and Management in a Critical Care Unit

PubMed Central

Ogle, K. Robyn; Glass, Nel

2014-01-01

In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

An assessment of maintainability of elevator system to improve facilities management knowledge-base

NASA Astrophysics Data System (ADS)

Siti, N. A.; Asmone, A. S.; Chew, M. Y. L.

2018-02-01

Elevator system is a highly specialized machinery that requires technicians that have a wider array of knowledge in maintaining the system to be safe and reliable. While attaining reliable data of elevator malfunction become challenges, this study has filled the gap by gathering the management-maintenance issues and operational defects of elevator system. Forty-three types of operation defects were found and the consequence defects and their possible causes of occurrences were discussed. To respond to the prime challenges of maintaining elevator system provided by the industry players’ perspective, a theoretical framework is established as a recommendation to improve knowledge base of defects in elevator system which comprises good practices, and solutions to rectify each defects found. Hence, this research paper has theoretically improved the knowledge base of maintainability of elevator system and provide meaningful guidelines in practical senses to the industry professionals.

Isomorphic pressures, institutional strategies, and knowledge creation in the health care sector.

PubMed

Yang, Chen-Wei; Fang, Shih-Chieh; Huang, Wei-Min

2007-01-01

Health care organizations are facing surprisingly complex challenges, including new treatment and diagnostic technologies, ongoing pressures for health care institutional reform, the emergence of new organizational governance structures, and knowledge creation for the health care system. To maintain legitimacy in demanding environments, organizations tend to copy practices of similar organizations, which lead to isomorphism, and to use internal strategies to accommodate changes. A concern is that a poor fit between isomorphic pressures and internal strategies can interfere with developmental processes, such as knowledge creation. The purposes of this article are to, first, develop a set of propositions, based on institutional theory, as a theoretical framework that might explain the influence of isomorphic pressures on institutional processes through which knowledge is created within the health care sector and, second, propose that a good fit between isomorphic pressures factors and health care organizations' institutional strategic choices will enhance the health care organizations' ability to create knowledge. To develop a theoretical framework, we developed a set of propositions based on literature pertaining to the institutional theory perspective of isomorphic pressures and the response of health care organizations to isomorphic pressures. Institutional theory perspectives of isomorphic pressures and institutional strategies may provide a new understanding for health care organizations seeking effective knowledge creation strategies within institutional environment of health care sector. First, the ability to identify three forces for isomorphic change is critical for managers. Second, the importance of a contingency approach by health care managers can lead to strategies tailoring to cope with uncertainties facing their organizations.

A New Perspective on Modeling Groundwater-Driven Health Risk With Subjective Information

NASA Astrophysics Data System (ADS)

Ozbek, M. M.

2003-12-01

Fuzzy rule-based systems provide an efficient environment for the modeling of expert information in the context of risk management for groundwater contamination problems. In general, their use in the form of conditional pieces of knowledge, has been either as a tool for synthesizing control laws from data (i.e., conjunction-based models), or in a knowledge representation and reasoning perspective in Artificial Intelligence (i.e., implication-based models), where only the latter may lead to coherence problems (e.g., input data that leads to logical inconsistency when added to the knowledge base). We implement a two-fold extension to an implication-based groundwater risk model (Ozbek and Pinder, 2002) including: 1) the implementation of sufficient conditions for a coherent knowledge base, and 2) the interpolation of expert statements to supplement gaps in knowledge. The original model assumes statements of public health professionals for the characterization of the exposed individual and the relation of dose and pattern of exposure to its carcinogenic effects. We demonstrate the utility of the extended model in that it: 1)identifies inconsistent statements and establishes coherence in the knowledge base, and 2) minimizes the burden of knowledge elicitation from the experts for utilizing existing knowledge in an optimal fashion.ÿÿ

A positive deviance perspective on hospital knowledge management: analysis of Baldrige Award recipients 2002-2008.

PubMed

Griffith, John R; Fear, Kathleen M; Lammers, Eric; Banaszak-Holl, Jane; Lemak, Christy Harris; Zheng, Kai

2013-01-01

Knowledge management (KM) is emerging as an important aspect of achieving excellent organizational performance, but its use has not been widely explored for hospitals. Taking a positive deviance perspective, we analyzed the applications of nine healthcare organizations (HCOs) that received the Malcolm Baldrige National Quality Award from 2002 to 2008. Baldrige Award applications constitute a uniquely comprehensive, standardized, and audited record of HCOs achieving near-benchmark performance. Applications are organized around leadership, strategy, customers, information, workforce, and operations. We find that KM is frequently referenced in all sections, and about two thirds of each application addresses KM-related issues. Many specific KM activities, such as strategic and action plans, communications, and processes to capture internal and external knowledge, are addressed by all nine applications. We present examples illustrating these frequently appearing KM concepts. Baldrige Award-recipient HCOs apply continuous improvement to KM processes, as they do to their organizations as a whole. We conclude that these HCOs have developed sophisticated, comprehensive KM processes to align both culture and specific procedures throughout the organization. KM in these organizations is a deliberate effort to keep all relevant knowledge at the fingertips of every worker, characterized by frequent communication, careful maintenance of content accuracy, and redundant distribution. We also conclude that the extent and rigor of their KM practice distinguish them from other U.S. hospitals.

Ten Years of Net Work

ERIC Educational Resources Information Center

Anklam, Patti

2009-01-01

Purpose: The purpose of this paper is to provide a perspective on the emergence of social media and their adoption as a critical element in knowledge management strategy. Social media are defined as the collection of software tools and web-based applications that are personalized, that is, that communications identify individuals by name and…

Learner Perspectives on Fully Online Language Learning

ERIC Educational Resources Information Center

Sun, Susan Y. H.

2014-01-01

This study builds on this author's 2011 article in which the author reflects on the pedagogical challenges and resultant changes made while teaching two fully online foreign language papers over a four-year period (Y. H. S. Sun (2011). Online language teaching: The pedagogical challenges. "Knowledge Management & E-Learning: An…

Re-Conceptualizing the Organizing Circumstance of Learning

ERIC Educational Resources Information Center

Spear Ellinwood, Karen Courtenay

2011-01-01

This study explores the web-navigation practices of adult learners in higher education and re-conceptualizes the concept of the organizing circumstance of self-managed learning, originated by Spear and Mocker (1984). The theoretical framework draws on funds of knowledge theory from a cultural historical perspective and elaborates a Vygotskian…

Public perspectives on the "wildfire problem."

Treesearch

Antony S. Cheng; Dennis R. Becker

2005-01-01

Just as wildland fire managers must have a working knowledge of fire behavior, they must also understand the social dimensions of wildland fire in order to effectively engage the public.Social scientists are therefore gathering information about public attitudes toward wildland fire and wildfire mitigation. How do people see the "wildfire problem"? What...

Extending stakeholder theory to promote resource management initiatives to key stakeholders: a case study of water transfers in Alberta, Canada.

PubMed

Lafreniere, Katherine C; Deshpande, Sameer; Bjornlund, Henning; Hunter, M Gordon

2013-11-15

Many attempts to implement resource management initiatives in Canadian and international communities have been resisted by stakeholders despite inclusion of their representatives in the decision-making process. Managers' failure to understand stakeholders' perspectives when proposing initiatives is a potential cause of this resistance. Our study uses marketing thought to enhance stakeholder theory by bringing in an audience-centric perspective. We attempt to understand how stakeholders perceive their interests in an organization and consequently decide how to influence that organization. By doing so, we investigate whether a disconnect exists between the perceptions of managers and those of stakeholders. Natural resource managers can utilize this knowledge to garner stakeholder support for the organization and its activities. We support this claim with findings from a water transfer plebiscite held in the Canadian province of Alberta. Sixteen personal interviews employing narrative inquiry were conducted to document voters' (i.e., irrigators') interpretations. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Overview of Conceptual Change Theories

ERIC Educational Resources Information Center

Özdemir, Gökhan; Clark, Douglas B.

2007-01-01

Conceptual change researchers have made significant progress on two prominent but competing theoretical perspectives regarding knowledge structure coherence. These perspectives can be broadly characterized as (1) knowledge-as-theory perspectives and (2) knowledge-as-elements perspectives. These perspectives can be briefly summarized in terms of…

Gender sensitive education in watershed management to support environmental friendly city

NASA Astrophysics Data System (ADS)

Asteria, D.; Budidarmono; Herdiansyah, H.; Ni’mah, N. L.

2018-03-01

This study is about gender-sensitive perspective in watershed management education program as one of capacity building for citizens in watershed management with community-based strategy to support environmental friendly cities and security for women from flood disasters. Involving women and increasing women’s active participation in sustainable watershed management is essential in urban area. In global warming and climate change situations, city management should be integrated between social aspect and environmental planning. This study used mix method (concurrent embedded type, with quantitative as primary method) with research type is descriptive-explanatory. The result of this study is education strategies with gender approaches and affirmative action through emancipation approach and local knowledge from women’s experiences can increase women’s participation. Women’s empowerment efforts need integrated intervention and collaboration from government, NGO, and other stakeholders to optimize women’s role in watershed management for support environmental friendly city. The implication of this study is an educational strategy on watershed conservation with gender perspective to offer social engineering alternatives for decision makers to policy of sustainable watershed management in urban area related to flood mitigation efforts.

Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

NASA Astrophysics Data System (ADS)

Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

2009-04-01

Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the societal values that are driving prioritization in river management, it will only support their elicitation and rational use. This is particularly important for the assessment of micro-pollutants because of severe limitations in scientific knowledge of their effects on river ecosystems. This makes the influence of pollution by micro-pollutants on prioritization of measures strongly dependent on the weight of the precautionary principle relative to other societal objectives of river management.

Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers

PubMed Central

2011-01-01

Background Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue. Methods Concept mapping methodology was used to elicit and map statements (ideas) from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization. Results Participants generated 35 statements. Each group (LMs and HRM) sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support. Conclusions There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health researchers and planners should address in developing job retention programs for chronically ill workers. PMID:21586139

Facilitating job retention for chronically ill employees: perspectives of line managers and human resource managers.

PubMed

Haafkens, Joke A; Kopnina, Helen; Meerman, Martha G M; van Dijk, Frank J H

2011-05-17

Chronic diseases are a leading contributor to work disability and job loss in Europe. Recent EU policies aim to improve job retention among chronically ill employees. Disability and occupational health researchers argue that this requires a coordinated and pro-active approach at the workplace by occupational health professionals, line managers (LMs) and human resource managers (HRM). Little is known about the perspectives of LMs an HRM on what is needed to facilitate job retention among chronically ill employees. The aim of this qualitative study was to explore and compare the perspectives of Dutch LMs and HRM on this issue. Concept mapping methodology was used to elicit and map statements (ideas) from 10 LMs and 17 HRM about what is needed to ensure continued employment for chronically ill employees. Study participants were recruited through a higher education and an occupational health services organization. Participants generated 35 statements. Each group (LMs and HRM) sorted these statements into six thematic clusters. LMs and HRM identified four similar clusters: LMs and HRM must be knowledgeable about the impact of chronic disease on the employee; employees must accept responsibility for work retention; work adaptations must be implemented; and clear company policy. Thematic clusters identified only by LMs were: good manager/employee cooperation and knowledge transfer within the company. Unique clusters identified by HRM were: company culture and organizational support. There were both similarities and differences between the views of LMs and HRM on what may facilitate job retention for chronically ill employees. LMs perceived manager/employee cooperation as the most important mechanism for enabling continued employment for these employees. HRM perceived organizational policy and culture as the most important mechanism. The findings provide information about topics that occupational health researchers and planners should address in developing job retention programs for chronically ill workers.

Engaging teens and parents in collaborative practice: perspectives on diabetes self-management.

PubMed

Sullivan-Bolyai, Susan; Bova, Carol; Johnson, Kimberly; Cullen, Karen; Jaffarian, Carol; Quinn, Diane; Aroke, Edwin N; Crawford, Sybil; Lee, Mary M; Gupta, Olga

2014-01-01

The purpose of this exploratory focus group study was to describe the perspectives of teens and their parents about self-management knowledge, behaviors (including division of labor associated with T1D management), and resources used to manage T1D. The overall goal is to use this information to develop a teen-family transition clinic. The self and family management behaviors framework undergirded the separate teen-parent focus groups that were conducted concurrently. Note-based qualitative content analysis was used, resulting in several important messages. From the teens' perspective there was variation in interest in learning more about T1D and management. Those teens who had been diagnosed at a very young age reported not knowing anything else but diabetes, while those diagnosed later developmentally embraced the active learning process. Diabetes camp and peer group support were not seen as beneficial. All the teens were interested in "helping others" with diabetes. Parents shared the common struggle with transition of self-management, with variation in parenting styles. A small group of parents reported their "job" as a parent was to make sure their child was self-sufficient in self-management, but felt pressure from the health care providers (HCPs) to physically do the care, defeating the purpose. Parents and teens reported wanting HCPs to be less focused on "numbers" (blood glucose levels) and more on the whole person. Scheduling appointment changes and long waiting times were reported as problematic by all participants. Teen and parent perspectives are critical in designing future well-received adolescent-family transition clinics. Development from the ground up with family recommendations may contribute to high-quality health outcomes.

Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

PubMed Central

2012-01-01

Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors. PMID:22333210

Knowledge Representation and Management: a Linked Data Perspective.

PubMed

Barros, M; Couto, F M

2016-11-10

Biomedical research is increasingly becoming a data-intensive science in several areas, where prodigious amounts of data is being generated that has to be stored, integrated, shared and analyzed. In an effort to improve the accessibility of data and knowledge, the Linked Data initiative proposed a well-defined set of recommendations for exposing, sharing and integrating data, information and knowledge, using semantic web technologies. The main goal of this paper is to identify the current status and future trends of knowledge representation and management in Life and Health Sciences, mostly with regard to linked data technologies. We selected three prominent linked data studies, namely Bio2RDF, Open PHACTS and EBI RDF platform, and selected 14 studies published after 2014 (inclusive) that cited any of the three studies. We manually analyzed these 14 papers in relation to how they use linked data techniques. The analyses show a tendency to use linked data techniques in Life and Health Sciences, and even if some studies do not follow all of the recommendations, many of them already represent and manage their knowledge using RDF and biomedical ontologies. These insights from RDF and biomedical ontologies are having a strong impact on how knowledge is generated from biomedical data, by making data elements increasingly connected and by providing a better description of their semantics. As health institutes become more data centric, we believe that the adoption of linked data techniques will continue to grow and be an effective solution to knowledge representation and management.

Risk Analysis Related to Quality Management Principles

NASA Astrophysics Data System (ADS)

Vykydal, David; Halfarová, Petra; Nenadál, Jaroslav; Plura, Jiří; Hekelová, Edita

2012-12-01

Efficient and effective implementation of quality management principles asks for a responsible approach from top managers' perspectives. A study of the current state of affairs in Czech organizations discovers a lot of shortcomings in this field that can be changed to vary managerial risks. The article identifies and analyses some of them and gives short guidance for appropriate treatment. Text of the article reflects the authors' experience as well as knowledge obtained from the systematic analysis of industrial companies' environments.

Integrating Patient Concerns into Parkinson's Disease Management.

PubMed

Lim, Shen-Yang; Tan, Ai Huey; Fox, Susan H; Evans, Andrew H; Low, Soon Chai

2017-01-01

Parkinson's disease (PD) is a complex motor and non-motor disorder and management is often challenging. In this review, we explore emerging approaches to improve the care of patients, drawing from the literature regarding patient-centred care, patient and caregiver perspectives and priorities, gaps in knowledge among patients and caregivers and the need for accurate information, individual variability in disease manifestations, prognostication of disease course, new developments in health technologies and personalized medicine, specialty care, pharmacological and non-pharmacological management, financial burden, lifestyle and work-related issues, support groups and palliative care.

Developing genomic knowledge bases and databases to support clinical management: current perspectives.

PubMed

Huser, Vojtech; Sincan, Murat; Cimino, James J

2014-01-01

Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

Developing genomic knowledge bases and databases to support clinical management: current perspectives

PubMed Central

Huser, Vojtech; Sincan, Murat; Cimino, James J

2014-01-01

Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward. PMID:25276091

IMO and Internal Branding Outcomes: An Employee Perspective in UK HE

ERIC Educational Resources Information Center

Yu, Qionglei; Asaad, Yousra; Yen, Dorothy A.; Gupta, Suraksha

2018-01-01

This study extends our knowledge of internal branding in the context of employees in the higher education sector. Employing a quantitative methodology in UK universities, a conceptual model is presented and tested on 235 employees. Internal market orientation (IMO) is examined as a management tool to drive employees' university brand commitment…

The Nature of Knowledge and the Structure of the University.

ERIC Educational Resources Information Center

Thompson, Patricia J.

This paper argues that women experience two realities, a "private sphere" and a "public sphere," and the implication of this dual perspective needs to be addressed by women scholars in all disciplines. The idea behind these two spheres of reality is traced back to the ancient Greeks where household management (oikos) was the…

Performer: An Instrument for Multidisciplinary Courseware Teams to Share Knowledge and Experiences

ERIC Educational Resources Information Center

van Aalst, Jan-Willem; van der Mast, Charles

2003-01-01

One of the traditional problems in courseware development that is recognized as hard to solve, is the communication and co-operation between various disciplines in project teams that are working on a courseware product [Alber (1996) "Multimedia: a management perspective." California: Wadsworth; Boyle (1997) "Design for multimedia learning." UK:…

Taking Culture into Account: A Maori Perspective on Visual Impairment

ERIC Educational Resources Information Center

Bevan-Brown, Jill; Walker, Taingunguru

2013-01-01

The authors open this article by noting that there is substantial research evidence showing that ethnic culture affects how disability is perceived and managed, and that taking a person's culture into account maximizes the effectiveness of the person's education. Jill Bevan-Brown and Taingunguru Walker, address this gap in knowledge by describing…

Students Perspectives toward Key Personal Finance Variables

ERIC Educational Resources Information Center

Miller, Donald; Hite, Nancy Groneman; Slocombe, Tom; Railsback, Barbara

2010-01-01

Purpose: In the current economic climate, young people's attitudes and habits related to money management seem to be of great interest. The primary purpose of this study is to advance the knowledge base in the area of personal finance education. Methodology: This survey was administered by English teachers to a convenience sample population of 326…

Leading Work with Young People

ERIC Educational Resources Information Center

Harrison, Roger, Ed.; Benjamin, Cathy, Ed.; Curran, Sheila, Ed.; Hunter, Rob, Ed.

2007-01-01

"Leading Work with Young People" provides a selection of writing from a complex and dynamic field of work. The editors bring together key readings and newly commissioned material to present a variety of theoretical and practical perspectives on leading and managing work with young people. The book will equip students with the knowledge, skills,…

Managing boundaries in primary care service improvement: a developmental approach to communities of practice.

PubMed

Kislov, Roman; Walshe, Kieran; Harvey, Gill

2012-10-15

Effective implementation of change in healthcare organisations involves multiple professional and organisational groups and is often impeded by professional and organisational boundaries that present relatively impermeable barriers to sharing knowledge and spreading work practices. Informed by the theory of communities of practice (CoPs), this study explored the effects of intra-organisational and inter-organisational boundaries on the implementation of service improvement within and across primary healthcare settings and on the development of multiprofessional and multi-organisational CoPs during this process. The study was conducted within the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester-a collaborative partnership between the University of Manchester and local National Health Service organisations aiming to undertake applied health research and enhance its implementation in clinical practice. It deployed a qualitative embedded case study design, encompassing semistructured interviews, direct observation and documentary analysis, conducted in 2010-2011. The sample included practice doctors, nurses, managers and members of the CLAHRC implementation team. The study showed that in spite of epistemic and status differences, professional boundaries between general practitioners, practice nurses and practice managers co-located in the same practice over a relatively long period of time could be successfully bridged, leading to the formation of multiprofessional CoPs. While knowledge circulated relatively easily within these CoPs, barriers to knowledge sharing emerged at the boundary separating them from other groups existing in the same primary care setting. The strongest boundaries, however, lay between individual general practices, with inter-organisational knowledge sharing and collaboration between them remaining unequally developed across different areas due to historical factors, competition and strong organisational identification. Manipulated emergence of multi-organisational CoPs in the context of primary care may thus be problematic. In cases when manipulated emergence of new CoPs is problematic, boundary issues could be addressed by adopting a developmental perspective on CoPs, which provides an alternative to the analytical and instrumental perspectives previously described in the CoP literature. This perspective implies a pragmatic, situational approach to mapping existing CoPs and their characteristics and potentially modifying them in the process of service improvement through the combination of internal and external facilitation.

Cross-Cutting Risk Framework: Mining Data for Common Risks Across the Portfolio

NASA Technical Reports Server (NTRS)

Klein, Gerald A., Jr.; Ruark, Valerie

2017-01-01

The National Aeronautics and Space Administration (NASA) defines risk management as an integrated framework, combining risk-informed decision making and continuous risk management to foster forward-thinking and decision making from an integrated risk perspective. Therefore, decision makers must have access to risks outside of their own project to gain the knowledge that provides the integrated risk perspective. Through the Goddard Space Flight Center (GSFC) Flight Projects Directorate (FPD) Business Change Initiative (BCI), risks were integrated into one repository to facilitate access to risk data between projects. With the centralized repository, communications between the FPD, project managers, and risk managers improved and GSFC created the cross-cutting risk framework (CCRF) team. The creation of the consolidated risk repository, in parallel with the initiation of monthly FPD risk managers and risk governance board meetings, are now providing a complete risk management picture spanning the entire directorate. This paper will describe the challenges, methodologies, tools, and techniques used to develop the CCRF, and the lessons learned as the team collectively worked to identify risks that FPD programs projects had in common, both past and present.

An Assessment of Artificial Intelligence and Expert Systems Technology for Application to Management of Cockpit Systems.

DTIC Science & Technology

1986-09-01

expert systems will certainly find management applications a fertile field for research and practice." Elam and Henderson (1983) also discuss concepts ...Shortliffe, E.H. (1983). Expert systems research. Science, 220, 261-268, 15 Apr. * Elam, J.J. and Henderson, J.C. (1983). Knowledge engineering concepts for...Symposium on Aerospace and Electronic Systems, Advanced Concepts and Pioneering Perspectives, Dayton, OH, Sect 4, (pp 1-9), Nov 14-15. Dreyfus, H

A gender-centered ecological framework targeting Black men living with diabetes: integrating a "masculinity" perspective in diabetes management and education research.

PubMed

Jack, Leonard; Toston, Tyra; Jack, Nkenge H; Sims, Mario

2010-03-01

Blacks have traditionally experienced a disproportionate burden of diabetes in the United States. Research published from 1980 to 2008 revealed a paucity of diabetes education and management research targeting Black men. There is a paucity of published research that takes into consideration attributes of "being male," such as masculinity, and how its attributes influence diabetes self-management behaviors. This article discusses three important factors that may help explain diabetes-related disparities among Black men.These factors include absence of consistent sources of health care, lack of health insurance, and the absence of a masculinity perspective in diabetes education and management research. This article offers a gender-centered ecological framework that examines pathways between demographic factors, family functioning, knowledge and psychological health, biological health, behavioral health and medical compliance, masculinity, and diabetes-related outcomes. Recommendations for future research that consider how aspects of masculinity might lead to the identification of gender-based risk factors are presented.

Physiotherapy students' perspectives of online e-learning for interdisciplinary management of chronic health conditions: a qualitative study.

PubMed

Gardner, Peter; Slater, Helen; Jordan, Joanne E; Fary, Robyn E; Chua, Jason; Briggs, Andrew M

2016-02-16

To qualitatively explore physiotherapy students' perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL). Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore students' perspectives on the advantages and disadvantages of online e-learning, ways to enhance e-learning, and information/learning gaps in relation to interdisciplinary management of chronic health conditions, a semi-structured interview schedule was developed. Verbatim transcripts were analysed using inductive methods within a grounded theory approach to derive key themes. Twenty-three students (78 % female; 39 % with previous tertiary qualification) of mean (SD) age 23 (3.6) years participated. Students expressed a preference for a combination of both online e-learning and lecture-style learning formats for chronic disease management, citing flexibility to work at one's own pace and time, and access to comprehensive information as advantages of e-learning learning. Personal interaction and ability to clarify information immediately were considered advantages of lecture-style formats. Perceived knowledge gaps included practical application of interdisciplinary approaches to chronic disease management and developing and implementing physiotherapy management plans for people with chronic health conditions. Physiotherapy students preferred multi-modal and blended formats for learning about chronic disease management. This study highlights the need for further development of practically-oriented knowledge and skills related to interdisciplinary care for people with chronic conditions among physiotherapy students. While RAP-eL focuses on rheumatoid arthritis, the principles of learning apply to the broader context of chronic disease management.

Fishers' knowledge and seahorse conservation in Brazil

PubMed Central

Rosa, Ierecê ML; Alves, Rômulo RN; Bonifácio, Kallyne M; Mourão, José S; Osório, Frederico M; Oliveira, Tacyana PR; Nottingham, Mara C

2005-01-01

From a conservationist perspective, seahorses are threatened fishes. Concomitantly, from a socioeconomic perspective, they represent a source of income to many fishing communities in developing countries. An integration between these two views requires, among other things, the recognition that seahorse fishers have knowledge and abilities that can assist the implementation of conservation strategies and of management plans for seahorses and their habitats. This paper documents the knowledge held by Brazilian fishers on the biology and ecology of the longsnout seahorse Hippocampus reidi. Its aims were to explore collaborative approaches to seahorse conservation and management in Brazil; to assess fishers' perception of seahorse biology and ecology, in the context evaluating potential management options; to increase fishers' involvement with seahorse conservation in Brazil. Data were obtained through questionnaires and interviews made during field surveys conducted in fishing villages located in the States of Piauí, Ceará, Paraíba, Maranhão, Pernambuco and Pará. We consider the following aspects as positive for the conservation of seahorses and their habitats in Brazil: fishers were willing to dialogue with researchers; although captures and/or trade of brooding seahorses occurred, most interviewees recognized the importance of reproduction to the maintenance of seahorses in the wild (and therefore of their source of income), and expressed concern over population declines; fishers associated the presence of a ventral pouch with reproduction in seahorses (regardless of them knowing which sex bears the pouch), and this may facilitate the construction of collaborative management options designed to eliminate captures of brooding specimens; fishers recognized microhabitats of importance to the maintenance of seahorse wild populations; fishers who kept seahorses in captivity tended to recognize the condtions as poor, and as being a cause of seahorse mortality. PMID:16336660

Fishers' knowledge and seahorse conservation in Brazil.

PubMed

Rosa, Ierecê Ml; Alves, Rômulo Rn; Bonifácio, Kallyne M; Mourão, José S; Osório, Frederico M; Oliveira, Tacyana Pr; Nottingham, Mara C

2005-12-08

From a conservationist perspective, seahorses are threatened fishes. Concomitantly, from a socioeconomic perspective, they represent a source of income to many fishing communities in developing countries. An integration between these two views requires, among other things, the recognition that seahorse fishers have knowledge and abilities that can assist the implementation of conservation strategies and of management plans for seahorses and their habitats. This paper documents the knowledge held by Brazilian fishers on the biology and ecology of the longsnout seahorse Hippocampus reidi. Its aims were to explore collaborative approaches to seahorse conservation and management in Brazil; to assess fishers' perception of seahorse biology and ecology, in the context evaluating potential management options; to increase fishers' involvement with seahorse conservation in Brazil. Data were obtained through questionnaires and interviews made during field surveys conducted in fishing villages located in the States of Piauí, Ceará, Paraíba, Maranhão, Pernambuco and Pará. We consider the following aspects as positive for the conservation of seahorses and their habitats in Brazil: fishers were willing to dialogue with researchers; although captures and/or trade of brooding seahorses occurred, most interviewees recognized the importance of reproduction to the maintenance of seahorses in the wild (and therefore of their source of income), and expressed concern over population declines; fishers associated the presence of a ventral pouch with reproduction in seahorses (regardless of them knowing which sex bears the pouch), and this may facilitate the construction of collaborative management options designed to eliminate captures of brooding specimens; fishers recognized microhabitats of importance to the maintenance of seahorse wild populations; fishers who kept seahorses in captivity tended to recognize the condtions as poor, and as being a cause of seahorse mortality.

Managing the water crisis: A youth perspective

NASA Astrophysics Data System (ADS)

Simataa, Faith

2017-04-01

The youth are identified as a key group to include in effective engagement and decision-making for water security and sustainable development. An increase in severe droughts in Namibia has highlighted its destructive impacts and led to a growing concern about the societal exposure of communities. Acknowledging the benefit of access to safe drinking water to humanity, in reality a disproportionate burden of protecting environmental benefits such as clean water is borne by the poor and vulnerable sections of the society. As a result, a key consideration highlighted in the Hyogo and Sendai Frameworks is the inclusion of gender & age perspectives, and vulnerable groups in planning for disaster risk reduction. Therefore, the paper argues that empowering the youth with knowledge and skills capability in disaster risk issues becomes essential for a sustainable management approach, and a potential 'rescue' mechanism from the web of poverty. The paper also illustrates that there is indeed weak adherence to good governance and that the government needs to improve structures for youth coordination to ensure water stewardship. Realizing this gap in knowledge, innovation and education to build a culture of resilience at all levels of society, the paper offers a perspective on the role of youth in the development agenda of Namibia and how they can influence decision-making processes in addressing water insecurity in the country. Keywords: Empowerment, Namibia, Water insecurity, Youth

Experience in implementation of «Nuclear Knowledge Management» course at the National Research Nuclear University MEPhI

NASA Astrophysics Data System (ADS)

Geraskin, N. I.; Kosilov, A. N.

2017-01-01

This paper describes the experience of teaching «Nuclear Knowledge Management» course at the National Research Nuclear University MEPhI (NRNU MEPhI). Currently, the course is implemented both in engineer and master degree programs and is attended by over 50 students. Goal, objectives and syllabus of the course are discussed in detail. A special attention is paid to practical exercises and final examination options in the case of small and large student groups. The course is supported by the Cyber Learning Platform for Nuclear Education and Training (CLP4NET), developed by the IAEA. The experience of NRNU MEPhI lecturers assisting in conducting the International School of Nuclear Knowledge Management, held annually in Trieste (Italy), is described with a special attention to the fact, that the course has passed the certification process at Academic Council of NRNU MEPhI. In 2014 and 2015 the course has been recognized as one of the best ones in NRNU MEPhI. Finally, perspectives of «Nuclear Knowledge Management» course are considered. They include increase of the course duration, introduction of the course into the learning process of other departments and institutions of the university, and transferring the course to other members of the Association «Consortium of ROSATOM supporting universities».

Education, Industry and the Knowing-Doing Gap: A Knowledge Management Perspective of Business Education

ERIC Educational Resources Information Center

Nicolaidis, Christos S.; Michalopoulos, George

2004-01-01

This paper examines the evolutionary path of the university and its impact on the quality of education it provides to people, industry and society. The authors first analyse the (Kantian) paradigm of reason, the (German Idealists') paradigm of culture and the current dominant techno-bureaucratic paradigm of excellence. They then argue that the…

Gender and Management in Further Education in Scotland: An Agenda for Research

ERIC Educational Resources Information Center

Ducklin, Alan; Ozga, Jenny

2007-01-01

Research on gender and education is somewhat limited in Scotland, and research that explores the further education sector from a gender perspective is particularly lacking. This paper argues for such work, and underlines its importance given the prominence of FE in the Scottish policy context as a key contributor to the knowledge economy and…

Benefits of pre-release population genetics: a case study using Psyttalia lounsburyi, a biocontrol agent of the olive fruit fly in California

USDA-ARS?s Scientific Manuscript database

From a pest management perspective, limited knowledge on the genetics of released biocontrol agents has been repeatedly considered as one possible cause of failures in classical biological control. Introduced biocontrol agents are expected to experience a loss in genetic diversity as the result of s...

Implementing VET in New South Wales Government Schools: Investigating Implementers' Expectations and Perspectives

ERIC Educational Resources Information Center

Smyth, Robyn

2003-01-01

This paper discusses how the management of educational change can be affected by the fundamental beliefs about the formation and communication of knowledge that stakeholders bring to the process of implementing change. A curriculum change designed to embed vocational education into the senior years of secondary schooling was investigated from the…

Understanding and managing trust at the climate science-policy interface

NASA Astrophysics Data System (ADS)

Lacey, Justine; Howden, Mark; Cvitanovic, Christopher; Colvin, R. M.

2018-01-01

Climate change effects are accelerating, making the need for appropriate actions informed by sound climate knowledge ever more pressing. A strong climate science-policy relationship facilitates the effective integration of climate knowledge into local, national and global policy processes, increases society's responsiveness to a changing climate, and aligns research activity to policy needs. This complex science-policy relationship requires trust between climate science `producers' and `users', but our understanding of trust at this interface remains largely uncritical. To assist climate scientists and policymakers, this Perspective provides insights into how trust develops and operates at the interface of climate science and policy, and examines the extent to which trust can manage — or even create — risk at this interface.

Value Encounters - Modeling and Analyzing Co-creation of Value

NASA Astrophysics Data System (ADS)

Weigand, Hans

Recent marketing and management literature has introduced the concept of co-creation of value. Current value modeling approaches such as e3-value focus on the exchange of value rather than co-creation. In this paper, an extension to e3-value is proposed in the form of a “value encounter”. Value encounters are defined as interaction spaces where a group of actors meet and derive value by each one bringing in some of its own resources. They can be analyzed from multiple strategic perspectives, including knowledge management, social network management and operational management. Value encounter modeling can be instrumental in the context of service analysis and design.

Knowledge Representation and Management: A Linked Data Perspective

PubMed Central

Barros, M.

2016-01-01

Summary Introduction Biomedical research is increasingly becoming a data-intensive science in several areas, where prodigious amounts of data is being generated that has to be stored, integrated, shared and analyzed. In an effort to improve the accessibility of data and knowledge, the Linked Data initiative proposed a well-defined set of recommendations for exposing, sharing and integrating data, information and knowledge, using semantic web technologies. Objective The main goal of this paper is to identify the current status and future trends of knowledge representation and management in Life and Health Sciences, mostly with regard to linked data technologies. Methods We selected three prominent linked data studies, namely Bio2RDF, Open PHACTS and EBI RDF platform, and selected 14 studies published after 2014 (inclusive) that cited any of the three studies. We manually analyzed these 14 papers in relation to how they use linked data techniques. Results The analyses show a tendency to use linked data techniques in Life and Health Sciences, and even if some studies do not follow all of the recommendations, many of them already represent and manage their knowledge using RDF and biomedical ontologies. Conclusion These insights from RDF and biomedical ontologies are having a strong impact on how knowledge is generated from biomedical data, by making data elements increasingly connected and by providing a better description of their semantics. As health institutes become more data centric, we believe that the adoption of linked data techniques will continue to grow and be an effective solution to knowledge representation and management. PMID:27830248

What do working menopausal women want? A qualitative investigation into women's perspectives on employer and line manager support.

PubMed

Hardy, Claire; Griffiths, Amanda; Hunter, Myra S

2017-07-01

To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause. An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45-65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause. 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice. Copyright © 2017. Published by Elsevier B.V.

Biomedical Ontologies in Action: Role in Knowledge Management, Data Integration and Decision Support

PubMed Central

Bodenreider, O.

2008-01-01

Summary Objectives To provide typical examples of biomedical ontologies in action, emphasizing the role played by biomedical ontologies in knowledge management, data integration and decision support. Methods Biomedical ontologies selected for their practical impact are examined from a functional perspective. Examples of applications are taken from operational systems and the biomedical literature, with a bias towards recent journal articles. Results The ontologies under investigation in this survey include SNOMED CT, the Logical Observation Identifiers, Names, and Codes (LOINC), the Foundational Model of Anatomy, the Gene Ontology, RxNorm, the National Cancer Institute Thesaurus, the International Classification of Diseases, the Medical Subject Headings (MeSH) and the Unified Medical Language System (UMLS). The roles played by biomedical ontologies are classified into three major categories: knowledge management (indexing and retrieval of data and information, access to information, mapping among ontologies); data integration, exchange and semantic interoperability; and decision support and reasoning (data selection and aggregation, decision support, natural language processing applications, knowledge discovery). Conclusions Ontologies play an important role in biomedical research through a variety of applications. While ontologies are used primarily as a source of vocabulary for standardization and integration purposes, many applications also use them as a source of computable knowledge. Barriers to the use of ontologies in biomedical applications are discussed. PMID:18660879

Authentic science experiences as a vehicle for assessing orientation towards science and science careers relative to identity and agency: a response to ``learning from the path followed by Brad''

NASA Astrophysics Data System (ADS)

Chinn, Pauline W. U.

2009-09-01

This response draws from the literature on adaptive learning, traditional ecological knowledge, and social-ecological systems to show that Brad's choice is not a simple decision between traditional ecological knowledge and authentic science. This perspective recognizes knowledge systems as dynamic, cultural and historical activities characterized by diverse worldviews and ways of constructing and legitimizing knowledge. Brad's decision is seen as an example of adaptive learning, identity development and personal/collective agency oriented to increasing tribal influence in resource management decisions and policies. I will conclude that science literacy for all is not served by a transcendent, universal, Western modern view of science.

"Engendering" Agenda 21: gender equality and water resource management: five years after Rio.

PubMed

Hannan-andersson, C

1997-01-01

Agenda 21 acknowledges women's role in natural resources management at the local level and emphasizes the need for more women in senior positions to contribute positively to the implementation of environmental policy. This article assesses Agenda 21's approach to gender equality and its achievements. A few explicit references to women and water resource management (WRM) without consideration on the gender implications of the WRM policies and strategies were noted. The macro-oriented, technology-focused and supply-oriented approach of Agenda 21 on WRM hinders the inclusion of a gender perspective. There are two levels of implications of gender-blind intervention in relation to WRM: the issue of social justice and rights, and the negative impact of the neglect of gender inequality on overall planning and success of interventions. The inclusion of a gender perspective at policy and planning levels to facilitate the resolution of inconsistencies, as well as the importance of water sources and patterns of use knowledge for adequate policy development and planning was suggested. It is important that the WRM principle application utilize a sociocultural and gender perspective at both community and household levels before decisions are made on WRM interventions.

Engineering youth service system infrastructure: Hawaii's continued efforts at large-scale implementation through knowledge management strategies.

PubMed

Nakamura, Brad J; Mueller, Charles W; Higa-McMillan, Charmaine; Okamura, Kelsie H; Chang, Jaime P; Slavin, Lesley; Shimabukuro, Scott

2014-01-01

Hawaii's Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaii's mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the system's infrastructure.

Burning, fire prevention and landscape productions among the Pemon, Gran Sabana, Venezuela: toward an intercultural approach to wildland fire management in Neotropical Savannas.

PubMed

Sletto, Bjørn; Rodriguez, Iokiñe

2013-01-30

Wildland fire management in savanna landscapes increasingly incorporates indigenous knowledge to pursue strategies of controlled, prescriptive burning to control fuel loads. However, such participatory approaches are fraught with challenges because of contrasting views on the role of fire and the practices of prescribed burning between indigenous and state fire managers. Also, indigenous and state systems of knowledge and meanings associated with fire are not monolithic but instead characterized by conflicts and inconsistencies, which require new, communicative strategies in order to develop successful, intercultural approaches to fire management. This paper is based on long-term research on indigenous Pemon social constructs, rules and regulations regarding fire use, and traditional system of prescribed burning in the Gran Sabana, Venezuela. The authors review factors that act as constraints against successful intercultural fire management in the Gran Sabana, including conflicting perspectives on fire use within state agencies and in indigenous communities, and propose strategies for research and communicative planning to guide future efforts for more participatory and effective fire management. Copyright © 2012 Elsevier Ltd. All rights reserved.

Time perspective, optimistic bias, and self-control among different statuses of university smokers in China: a cross-sectional study.

PubMed

Xu, Ying; Yang, Yang; Ma, Xiao

2018-01-09

Risk behavior often seems 'self-defeating' to the observers. Most people understand the basic health-related knowledge, but some of them still choose to continue risk behaviors, especially for the young. This study aimed to examine time perspective, optimism bias and self control correlated with smoking behavior in Chinese college students. A cross-sectional survey enrolling 3016 university students in Chengdu City, Sichuan Province, China. Influence Factors were identified using multiple logistic regression analyses. Prevalence of current smoking was 20.92% (631 smokers), including 272 daily smokers (9.02%) and 359 non-daily smokers (11.90%). Future-oriented time perspective, general capacity for self-discipline, reliability and ethnicity were protective factors of smoking behavior. Possibility of self-suffering diseases and gender were risk factors of smoking behavior. Smoking in University of Chengdu, China is a severe problem. Results in this research have suggested that irrespective of the smoking level, improving health-related knowledge, time management awareness and self-control ability may contribute to reducing the prevalence of smoking behavior.

Patient perspectives of an individualized diabetes care management plan

PubMed Central

Saucier, Ashley N.; Ansa, Benjamin; Coffin, Janis; Akhtar, Mariam; Miller, Andre; Mahoney, Holly; Hodo, Denise M.; Duffie, Carla; Fontenot, Brittney; Andrews, Holly E.; Smith, Selina A.

2017-01-01

Purpose This cross sectional study examines patients’ knowledge, attitudes and beliefs about a diabetic care management plan (DCMP) that was developed to provide patient education on diabetes guidelines and display individual diabetic core measures. Secondary objectives included a comparison of diabetic core measures [hemoglobin A1C (HbA1C), systolic and diastolic blood pressure (SBP, DBP), low-density lipoprotein (LDL) and urine microalbumin (Um)] before and after DCMP implementation. We hypothesize this tool will contribute to patients’ awareness of current disease status, diabetes knowledge and diabetic core value improvement over time. Methods A consecutive sample of 102 adult patients with diabetes mellitus type 2 in a primary care setting participated. Patients’ perspectives on the care plan and knowledge about diabetes was collected via survey after care plan implementation. A comparison of selected diabetic core measures was conducted at baseline and post-DCMP. Descriptive statistics summarized survey response and diabetic core measures. A repeated measures ANOVA was used to assess change in diabetic core measures over time. Results Participants understood the DCMP (96%), found it important because it explained their laboratory results and medications (89%) and believed it would help them to have better diabetic control (99%). There was a significant interaction between time and being at goal pre-DCMP for HbA1c, SBP and LDL. Patients not at goal pre-DCMP for the above measures decreased significantly over time (P = <0.01 for HbA1c, SBP and LDL). Participants at goal for all diabetic core measures increased pre- to post-DCMP from 13% to 20% (P = 0.28). Conclusion Patients perceived the diabetic care management plan favorably and their diabetic core measurements improved over time. This simple and reproducible self-management intervention can enhance self-management in a patient population with diabetes mellitus type 2. PMID:28835847

Willingness to participate in accountable care organizations: health care managers' perspective.

PubMed

Wan, Thomas T H; Demachkie Masri, Maysoun; Ortiz, Judith; Lin, Blossom Y J

2014-01-01

This study examines how health care managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors, and knowledge about ACOs as predictors. Propensity score matching and analysis are used to adjust the state and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, health care managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Health care managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACO participation. The perspective of health care managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of health care managers.

The perceptions and perspectives of patients and health care providers on chronic diseases management in rural South Africa: a qualitative study.

PubMed

Maimela, Eric; Van Geertruyden, Jean-Pierre; Alberts, Marianne; Modjadji, Sewela E P; Meulemans, Herman; Fraeyman, Jesicca; Bastiaens, Hilde

2015-04-08

Preventive health care represents the future for health care delivery in South Africa to improve management of chronic diseases as this has been implemented for some time in several countries to tackle the increasing burden of chronic diseases. Individual person's health is unique, as they move in and out of chronic and acute health care phases, there is need to integrate chronic and acute care constructs to improve continuity of care and maximize health and improve wellbeing. The aim of this study was to determine the perceptions and perspectives of chronic patients' and nurses regarding chronic disease management in terms of barriers, facilitators and their experiences. To meet our aim we used qualitative methods involving the collection of information by means of focus group discussions in Dikgale Health and Demographic Surveillance System (HDSS). All data was recorded, transcribed verbatim and analysed using data-driven thematic analysis. Our study showed that chronic disease patients have a first contact with health care professionals at the primary health care level in the study area. The main barriers mentioned by both the health care workers and chronic disease patients are lack of knowledge on chronic diseases, shortage of medication and shortage of nurses in the clinics which causes patients to wait for a long periods in a clinic. Health care workers are poorly trained on the management of chronic diseases. Lack of supervision by the district and provincial health managers together with poor dissemination of guidelines has been found to be a contributing factor to lack of knowledge in nurses among the clinics within the study area. Both patients and nurses mentioned the need to involve community health workers and traditional healers and integrate their services in order to early detect and manage chronic diseases in the community. Nurses and chronic disease patients mentioned similar barriers to chronic disease management. Concerted action is needed to strengthen the delivery of medications at the clinics, improve the chronic disease knowledge for both nurses and patients by conducting in-service trainings or workshops, increase the involvement of community health workers and establish a link (through formal referral system) with traditional healers.

Perspectives on statistics education: observations from statistical consulting in an academic nursing environment.

PubMed

Hayat, Matthew J; Schmiege, Sarah J; Cook, Paul F

2014-04-01

Statistics knowledge is essential for understanding the nursing and health care literature, as well as for applying rigorous science in nursing research. Statistical consultants providing services to faculty and students in an academic nursing program have the opportunity to identify gaps and challenges in statistics education for nursing students. This information may be useful to curriculum committees and statistics educators. This article aims to provide perspective on statistics education stemming from the experiences of three experienced statistics educators who regularly collaborate and consult with nurse investigators. The authors share their knowledge and express their views about data management, data screening and manipulation, statistical software, types of scientific investigation, and advanced statistical topics not covered in the usual coursework. The suggestions provided promote a call for data to study these topics. Relevant data about statistics education can assist educators in developing comprehensive statistics coursework for nursing students. Copyright 2014, SLACK Incorporated.

[Tacit Knowledge: Characteristics in nursing practice].

PubMed

Pérez-Fuillerat, Natalia; Solano-Ruiz, M Carmen; Amezcua, Manuel

2018-01-20

Tacit knowledge can be defined as knowledge which is used intuitively and unconsciously, which is acquired through one's experience, characterized by being personal and contextual. Some terms such as 'intuition', 'know how' and 'implicit knowledge' have been used to describe tacit knowledge. Different disciplines in the fields of management or health have studied tacit knowledge, identifying it as a powerful tool to create knowledge and clinical decision-making. The aim of this review is to analyse the definition and characteristics that make up tacit knowledge and determine the role it plays in the nursing discipline. An integrative review was undertaken of the literature published up to November 2016 in the databases CUIDEN, SciELO, PubMed, Cochrane and CINAHL. The synthesis and interpretation of the data was performed by two researchers through content analysis. From a total of 819 articles located, 35 articles on tacit knowledge and nursing were chosen. There is no consensus on the name and description of results in tacit knowledge. The main characteristics of tacit knowledge have a personal and social character, which is used from an organised mental structure, called mindline. This structure relates to the use of tacit knowledge on clinical decision-making. Previous studies on tacit knowledge and nursing provide the nursing community with perspectives without going into depth. The production of a framework is suggested, as it would clarify implied concepts and its role on the management of nursing knowledge. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Iranian Language Teachers' and Students' Perspectives on Top Notch Series (2nd Edition) at Intermediate Level

ERIC Educational Resources Information Center

Azadsarv, Mehdi; Tahriri, Abdorreza

2014-01-01

As the means of transferring knowledge between teachers and students, coursebooks play a significant role in educational practices all over the world. Evaluation of coursebooks is also of great significance as it manages to a better understanding of the nature of a specific teaching/learning situation. The present study is an attempt to evaluate…

Management of female sexual pain disorders.

PubMed

Boyer, Stéphanie C; Goldfinger, Corrie; Thibault-Gagnon, Stéphanie; Pukall, Caroline F

2011-01-01

Our understanding of the sexual pain disorders vaginismus and dyspareunia has been fundamentally altered over the past two decades due to increased attention and empirically sound research in this domain. This increased knowledge base has included a shift from a dualistic view of the etiology of painful and/or difficult vaginal penetration being due to either psychological or physiological causes, to a multifactorial perspective. The present chapter reviews current classification and prevalence rates, including ongoing definitional debates. Research regarding the etiology, assessment and management of sexual pain disorders is discussed from a biopsychosocial perspective. Cyclical theories of the development and maintenance of sexual pain disorders, which highlight the complex interplay among physiological, psychological and social factors, are described. Medical/surgical treatment options, pelvic floor rehabilitation and psychological approaches are reviewed, as well as future directions in treatment research. Copyright © 2011 S. Karger AG, Basel.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

PubMed

Gok Metin, Zehra; Izgu, Nur; Karadas, Canan; Arikan Donmez, Ayse

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

The Principal and Nurse Perspective on Gaps in Asthma Care and Barriers to Physical Activity in New York City Schools: A Qualitative Study.

PubMed

Cain, Agnieszka; Reznik, Marina

2017-10-01

School officials and nurses play an important role in facilitating asthma management in schools. Little is known about their perspectives on in-school asthma management and barriers to physical activity (PA) at school. The goal of this study is to explore school officials' and nurses' perspectives on asthma care and barriers to PA in children with asthma attending New York City schools. We conducted qualitative, semistructured interviews with 10 principals, 3 assistant principals, and 9 nurses in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and coded for common themes. The thematic and content review was subsequently used to analyze interview data. Emerging themes were discussed and agreed on by both investigators. Three main categories arose from the analysis: (1) procedures and policies around asthma management in school, (2) barriers to effective medication administration in school, and (3) barriers to PA in children with asthma. Participants identified gaps to in-school asthma management and barriers to PA participation: ineffective ways of identifying students with asthma; lack of written procedures for asthma management; difficulty in meeting the administrative requirements to administer asthma medication; lack of knowledge and training on asthma management for the parents, students, and school staff; parental limitation of children's PA; and schools not meeting the state physical education requirement. Our findings suggest the need for policy reform on asthma management and PA in urban schools and should be considered in the design of future interventions.

Through the Lens of TEK - Building GeoScience Pathways for American Indian/Alaska Native Students

NASA Astrophysics Data System (ADS)

Thomas, W. J.; van Cooten, S.; Wrege, B.; Wildcat, D.

2017-12-01

Native American or American Indian/Alaska Native (AI/AN) students come from diverse communities with indigenous knowledges, perspectives and worldviews. These communities and the students they send into our nation's education systems have cultural connectivity to oral histories, documents, and artwork that details climate cycles and weather events prior to colonization through eras of forced relocation and assimilation. Today, these students are the trailblazers as tribal governments exercise their ownership rights to natural resources and the welfare of their citizens as sovereign nations. In universities, especially tribal colleges, our nation's indigenous students are bridge builders. Through the lens of Traditional Ecological Knowledge (TEK), these students have a unique yet overlooked perspective to merge mainstream research with indigenous knowledge systems to develop practical sustainable solutions for local, regional and international resource management issues. The panel will discuss barriers, such as underdeveloped geophysical science curricula at tribal colleges, that limit the pool of indigenous geoscience graduates and examine possible strategies such as entry point opportunities and partnerships, mentoring, and community relevant research experiences, to eliminate barriers that limit the influx of TEK in resiliency planning.

Behavioral medicine perspectives on the design of health information technology to improve decision-making, guideline adherence, and care coordination in chronic pain management.

PubMed

Midboe, Amanda M; Lewis, Eleanor T; Cronkite, Ruth C; Chambers, Dallas; Goldstein, Mary K; Kerns, Robert D; Trafton, Jodie A

2011-03-01

Development of clinical decision support systems (CDSs) has tended to focus on facilitating medication management. An understanding of behavioral medicine perspectives on the usefulness of a CDS for patient care can expand CDSs to improve management of chronic disease. The purpose of this study is to explore feedback from behavioral medicine providers regarding the potential for CDSs to improve decision-making, care coordination, and guideline adherence in pain management. Qualitative methods were used to analyze semi-structured interview responses from behavioral medicine stakeholders following demonstration of an existing CDS for opioid prescribing, ATHENA-OT. Participants suggested that a CDS could assist with decision-making by educating providers, providing recommendations about behavioral therapy, facilitating risk assessment, and improving referral decisions. They suggested that a CDS could improve care coordination by facilitating division of workload, improving patient education, and increasing consideration and knowledge of options in other disciplines. Clinical decision support systems are promising tools for improving behavioral medicine care for chronic pain.

International Nursing: Nurse Managers' Leadership and Management Competencies Assessed by Nursing Personnel in a Finnish Hospital.

PubMed

Lehtonen, Mia-Riitta; Roos, Mervi; Kantanen, Kati; Suominen, Tarja

The aim of this research was to describe nurse managers' leadership and management competencies (NMLMC) from the perspective of nursing personnel. Nurse managers are responsible for the management of the largest professional group in social and health care. The assessment of NMLMC is needed because of their powerful influence on organizational effectiveness. An electronic survey was conducted among the nursing personnel (n = 166) of 1 Finnish hospital in spring 2016. Nursing personnel assessed their manager using a NMLMC scale consisting of general and special competences. The data were statistically analyzed. Leadership and management competencies were assessed as being quite good by the nursing personnel. The best-assessed area of general competence was professional competence and credibility and the weakest was service initiation and innovation. The best-assessed area of special competence was substance knowledge and the weakest was research and development. The nursing personnel's assessment of their nurse manger's competencies was associated with the personnel's education level, working experience, and with their knowledge of the manager's education. Conclusion was made that nursing personnel highly value professional competence as part of nursing leadership and management. To achieve more appreciation, nurse managers have to demonstrate their education and competence. They must also work in more open and versatile ways with their nursing personnel.

Organizational Factors that Affect the Implementation of Information Technology: Perspectives of Middle Managers in Iran.

PubMed

Barzekar, Hosein; Karami, Mahtab

2014-10-01

to examine the organizational factors affecting the application of information technology in hospitals. Since the organizational factors are one of the most important determinants of successful projects, by understanding their impact and identifying them it can help planning a systematic IT implementation. In this cross-sectional descriptive study 110 middle managers were chosen from teaching hospitals. Structured questionnaire was used for the data collection. There was a significant relationship between organization resource, organizational knowledge, process, management structure and values and goals with implementation of information technology. Findings showed that organizational factors had a considerable impact on implementation of information technology. Top managers must consider the important aspects of effective organizational factors.

Managing boundaries in primary care service improvement: A developmental approach to communities of practice

PubMed Central

2012-01-01

Background Effective implementation of change in healthcare organisations involves multiple professional and organisational groups and is often impeded by professional and organisational boundaries that present relatively impermeable barriers to sharing knowledge and spreading work practices. Informed by the theory of communities of practice (CoPs), this study explored the effects of intra-organisational and inter-organisational boundaries on the implementation of service improvement within and across primary healthcare settings and on the development of multiprofessional and multi-organisational CoPs during this process. Methods The study was conducted within the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Greater Manchester—a collaborative partnership between the University of Manchester and local National Health Service organisations aiming to undertake applied health research and enhance its implementation in clinical practice. It deployed a qualitative embedded case study design, encompassing semistructured interviews, direct observation and documentary analysis, conducted in 2010–2011. The sample included practice doctors, nurses, managers and members of the CLAHRC implementation team. Findings The study showed that in spite of epistemic and status differences, professional boundaries between general practitioners, practice nurses and practice managers co-located in the same practice over a relatively long period of time could be successfully bridged, leading to the formation of multiprofessional CoPs. While knowledge circulated relatively easily within these CoPs, barriers to knowledge sharing emerged at the boundary separating them from other groups existing in the same primary care setting. The strongest boundaries, however, lay between individual general practices, with inter-organisational knowledge sharing and collaboration between them remaining unequally developed across different areas due to historical factors, competition and strong organisational identification. Manipulated emergence of multi-organisational CoPs in the context of primary care may thus be problematic. Conclusions In cases when manipulated emergence of new CoPs is problematic, boundary issues could be addressed by adopting a developmental perspective on CoPs, which provides an alternative to the analytical and instrumental perspectives previously described in the CoP literature. This perspective implies a pragmatic, situational approach to mapping existing CoPs and their characteristics and potentially modifying them in the process of service improvement through the combination of internal and external facilitation. PMID:23068016

Diabetes management in Commercial Driver License holders.

PubMed

Kerr, Jessica L; Frichtl, Kelsey D; Behnen, Erin M

2015-04-01

The purpose of this study is to evaluate diabetes management in Commercial Driver License (CDL) holders, how prescribing habits change when treating this patient population, and health care providers' knowledge of regulations concerning insulin use in CDL holders. A survey was posted on the American Association of Diabetes Educators (AADE) Communities of Interest websites and was open for 2 weeks. The anonymous survey collected demographic data and evaluated the perspectives of health care providers on diabetes management in CDL holders. Descriptive statistics were used to analyze the survey results. A total of 139 AADE members responded to the survey, and 22.2% were prescribing providers. Findings from the survey indicated an overall lack of knowledge by health care professionals regarding the current laws affecting diabetes management in CDL holders. Most participants emphasized the need for making decisions on CDL suspension on a case-by-case basis, and some expressed concern that current laws may not be appropriate. Additional diabetes education for health care providers who treat CDL holders is warranted as many health care providers were not familiar with current regulations and management strategies. © 2015 The Author(s).

Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice.

PubMed

Macdermid, Joy C; Miller, Jordan; Gross, Anita R

2013-01-01

Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain-a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.

What Case Managers Should Know About Their Roles and Functions: A National Study From the Commission for Case Manager Certification: Part 1.

PubMed

Tahan, Hussein M; Watson, Annette C; Sminkey, Patrice V

2015-01-01

The purpose of this national role and function study was to identify the essential activities and necessary knowledge areas for effective case manager practice from the perspective of those currently functioning in various care settings and across diverse professional disciplines. The national study covered all case management practices and/or work settings across the full continuum of health care. This cross-sectional descriptive study used the practice analysis method and online survey research design. It employed a purposive sample of case managers, in which 52,370 individuals received an invitation to participate. Data collection completed over a 4-week period, resulting in 7,668 useable survey responses (nearly a 15% response rate). The study identified the common activities and knowledge areas necessary for competent and effective performance of case managers, as is highlighted in this article, which is the first of a 2-part series on the role and function study. The results informed the needed update of the test specifications for the Certified Case Manager (CCM) certification examination, as will be delineated in Part 2 of the article series, to ensure that it continues to be substantiated in current practice. Of special note are the emergence of specific activity and knowledge domains in the area of case management ethical, legal, and practice standards, and an increase in the number of employers requiring certified case managers to fill vacant positions and compensating them financially for such qualifications. This study helps keep the CCM credentialing examination evidence-based and maintain its validity for evaluating competency of case managers. Specifically, the study identified essential activities and knowledge domains that define competent case management practice. Findings can be used for developing programs and curricula for the training and development of case managers. The study instrument also can be used for further research of case management practice.

Mapping discourses using Q methodology in Matang Mangrove Forest, Malaysia.

PubMed

Hugé, Jean; Vande Velde, Katherine; Benitez-Capistros, Francisco; Japay, Jan Harold; Satyanarayana, Behara; Nazrin Ishak, Mohammad; Quispe-Zuniga, Melissa; Mohd Lokman, Bin Husain; Sulong, Ibrahim; Koedam, Nico; Dahdouh-Guebas, Farid

2016-12-01

The sustainable management of natural resources requires the consideration of multiple stakeholders' perspectives and knowledge claims, in order to inform complex and possibly contentious decision-making dilemmas. Hence, a better understanding of why people in particular contexts do manage natural resources in a particular way is needed. Focusing on mangroves, highly productive tropical intertidal forests, this study's first aim is to map the diversity of subjective viewpoints among a range of stakeholders on the management of Matang Mangrove Forest in peninsular Malaysia. Secondly, this study aims to feed the reflection on the possible consequences of the diversity of perspectives for the future management of mangroves in Malaysia and beyond. The use of the semi-quantitative Q methodology allowed us to identify three main discourses on mangrove management: i. the optimization discourse, stressing the need to improve the current overall satisfactory management regime; ii. the 'change for the better' discourse, which focuses on increasingly participatory management and on ecotourism; and iii. the conservative 'business as usual' discourse. The existence of common points of connection between the discourses and their respective supporters provides opportunities for modifications of mangrove management regimes. Acknowledging this diversity of viewpoints, reflecting how different stakeholders see and talk about mangrove management, highlights the need to develop pro-active and resilient natural resource management approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2015-10-01

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

Health workers' perspectives, knowledge and skills regarding community case management of childhood diarrhoea and pneumonia: a qualitative inquiry for an implementation research project "Nigraan" in District Badin, Sindh, Pakistan.

PubMed

Rabbani, Fauziah; Perveen, Shagufta; Aftab, Wafa; Zahidie, Aysha; Sangrasi, Kashif; Qazi, Shamim Ahmad

2016-09-01

Pakistan's Lady Health Worker Programme aims to provide care to children sick with pneumonia and diarrhoea, which continues to cause 27 % under-five mortality in Pakistan. The quality of supervision received by Lady Health Workers (LHWs) in the programme influence their knowledge and skills, in turn impacting their ability to provide care. This study is part of an implementation research project titled "Nigraan" (an Urdu word meaning supervisor), and explores LHW and Lady Health Supervisor (LHS) perspectives regarding the role of supervision in improving LHWs performance and motivation in district Badin, Sindh, Pakistan. Their knowledge and skills regarding integrated community case management (iCCM) of diarrhoea and pneumonia were also assessed. Fourteen focus group discussions and 20 in-depth interviews were conducted as part of this qualitative inquiry. Analysis was done using QSR NVivo version 10. Most LHWs and LHSs identified pneumonia and diarrhoea as two major causes of death among children under-five. Poverty, illiteracy, poor hygiene and lack of clean drinking water were mentioned as underlying causes of high mortality due to diarrhoea and pneumonia. LHWs and LHSs gaps in knowledge included classification of dehydration, correctly preparing ORS and prescribing correct antibiotics in pneumonia. Lack of training, delayed salaries and insufficient medicines and other supplies were identified as major factors impeding appropriate knowledge and skill development for iCCM of childhood diarrhoea and pneumonia. LHWs considered adequate supervision and the presence of LHSs during household visits as a factor facilitating their performance. LHWs did not have a preference for written or verbal feedback, but LHSs considered written individual feedback to LHWs to be more useful than group and verbal feedback. LHWs have knowledge and skill gaps that prevent them from providing effective care for diarrhoea and pneumonia. Enhanced supportive feedback from LHSs could improve LHWs skills and performance.

Predictors and Effects of Knowledge Management in U.S. Colleges and Schools of Pharmacy

NASA Astrophysics Data System (ADS)

Watcharadamrongkun, Suntaree

Public demands for accountability in higher education have placed increasing pressure on institutions to document their achievement of critical outcomes. These demands also have had wide-reaching implications for the development and enforcement of accreditation standards, including those governing pharmacy education. The knowledge management (KM) framework provides perspective for understanding how organizations evaluate themselves and guidance for how to improve their performance. In this study, we explore knowledge management processes, how these processes are affected by organizational structure and by information technology resources, and how these processes affect organizational performance. This is done in the context of Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree (Standards 2007). Data were collected using an online census survey of 121 U.S. Colleges and Schools of Pharmacy and supplemented with archival data. A key informant method was used with CEO Deans and Assessment leaders serving as respondents. The survey yielded a 76.0% (92/121) response rate. Exploratory factor analysis was used to construct scales (and scales) describing core KM processes: Knowledge Acquisition, Knowledge Integration, and Institutionalization; all scale reliabilities were found to be acceptable. Analysis showed that, as expected, greater Knowledge Acquisition predicts greater Knowledge Integration and greater Knowledge Integration predicts greater Institutionalization. Predictive models were constructed using hierarchical multiple regression and path analysis. Overall, information technology resources had stronger effects on KM processes than did characteristics of organizational structure. Greater Institutionalization predicted better outcomes related to direct measures of performance (i.e., NAPLEX pass rates, Accreditation actions) but Institutionalization was unrelated to an indirect measure of performance (i.e., USNWR ratings). Several organizational structure characteristics (i.e., size, age, and being part of an academic health center) were significant predictors of organizational performance; in contrast, IT resources had no direct effects on performance. Findings suggest that knowledge management processes, organizational structures and IT resources are related to better performance for Colleges and Schools of Pharmacy. Further research is needed to understand mechanisms through which specific knowledge management processes translate into better performance and, relatedly, to establish how enhancing KM processes can be used to improve institutional quality.

Epidemiology and prevention of stroke: a worldwide perspective

PubMed Central

Kuklina, Elena V; Tong, Xin; George, Mary G; Bansil, Pooja

2015-01-01

This paper reviews how epidemiological studies during the last 5 years have advanced our knowledge in addressing the global stroke epidemic. The specific objectives were to review the current evidence supporting management of ten major modifiable risk factors for prevention of stroke: hypertension, current smoking, diabetes, obesity, poor diet, physical inactivity, atrial fibrillation, excessive alcohol consumption, abnormal lipid profile and psychosocial stress/depression. PMID:22288675

The Adult Student Learning Experience: A Mixed-Methods Investigation in a Marine Corps Program from a Knowledge Management Perspective

ERIC Educational Resources Information Center

Stephens, Jennifer Gray

2010-01-01

On one Marine Corps base, a minimum of 5% of adult enlisted Marines per year lack certain competencies and seek admittance into a high school competency remediation program. The lack of these competencies impedes qualification for many military occupational specialties, the ability to convert from an enlisted Marine to a Warrant Officer, or…

Course Management Systems as Tools for the Creation of Online Learning Environments: Evaluation from a Social Constructivist Perspective and Implications for Their Design

ERIC Educational Resources Information Center

Papastergiou, Marina

2006-01-01

The Internet and the Web offer academic institutions solutions for covering the massive demand for education and transition towards student-centered, social constructivist educational models, in accordance with the demands of the knowledge-based society. This article reports on an investigation aimed at presenting a synthesis of recent research on…

Shared Awareness in Times of Crisis: A Framework for Collaboration

DTIC Science & Technology

2011-06-01

also affords a “ dashboard ” perspective allowing for centralization of resources. The U.S. Army’s Knowledge Online portal is one example of a single...labor, energy, materials, information, cash and technology into outputs of higher value • Organization’s values (criteria that managers and...follows: Challenges - Disabilities Inter-Organizational Cross-Organizational Privacy and Security high security (portal) blocks information flow Trust

Building organizational supports for research-minded practitioners.

PubMed

Austin, Michael J; Dal Santo, Teresa S; Lee, Chris

2012-01-01

One of the biggest challenges facing human service organizations is the proliferation of information from inside and outside the agency that needs to be managed if it is to be of use. The concepts of tacit and explicit knowledge can inform an approach to this challenge. Tacit knowledge is stored in the minds of practitioners (often called practice wisdom) and the explicit knowledge is often found in organizational procedure manuals and educational and training materials. Building on this perspective, this analysis provides a preliminary definition of research-minded practitioners by explicating the elements of curiosity, critical reflection, and critical thinking. The organizational implications of developing a cadre of research-minded practitioners include the commitment of top management to support "link officers", evidence request services, research and development units, and service standards. The challenges include the capacity to identify/support research-minded practitioners, promote an organizational culture of evidence-informed practice, redefine staff development and training, redefine job descriptions, and specify the nature of managerial leadership. Copyright © Taylor & Francis Group, LLC

Optimal management of genital herpes: current perspectives

PubMed Central

Sauerbrei, Andreas

2016-01-01

As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease. PMID:27358569

Optimal management of genital herpes: current perspectives.

PubMed

Sauerbrei, Andreas

2016-01-01

As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease.

Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

PubMed

Bååthe, Fredrik; Ahlborg, Gunnar; Edgren, Lars; Lagström, Annica; Nilsson, Kerstin

2016-05-03

Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician's professional identity was centered. Physicians with more of a We-perspective experienced challenges with the new round, while physicians with more of an I-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians' professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians' professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Adolescents' perspectives on food literacy and its impact on their dietary behaviours.

PubMed

Ronto, Rimante; Ball, Lauren; Pendergast, Donna; Harris, Neil

2016-12-01

Food literacy has been identified as a promising approach to support healthy dietary behaviours in adolescents. However, adolescents' perspectives on food literacy and the impact it could have on their dietary behaviours are not well understood. This study explored adolescents' perspectives on the potential for food literacy to influence their dietary behaviours. Fifteen focus groups were conducted with adolescents aged 12-17 years and encompassed quantitative and qualitative questions. Adolescents were asked to rank 22 aspects of food literacy in order of importance and discuss their responses as a group. Overall, adolescents ranked food and nutrition knowledge as more important than food skills and food capacity. Although adolescents stated that food and nutrition knowledge is important for them to eat well, the majority did not apply their knowledge to practice due to low confidence in food skills. Participants demonstrated very limited knowledge about macro aspects of food literacy such as animal welfare or environmental sustainability. Food skills such as planning and managing budgets for food and time for food shopping were ranked as least important due to being presently irrelevant but recognised as important later in life. Adolescents reported being very interested in developing food skills such as food preparation but they had very limited opportunities due to lack of food literacy education in home and high school settings. The high school setting provides an ideal opportunity for adolescents to improve their food literacy in particular food skills through home economics. Future research should develop and measure adolescents' food literacy and its impact on their dietary behaviours. Copyright © 2016 Elsevier Ltd. All rights reserved.

[NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 7:] The NASA/DOD Aerospace Knowledge Diffusion Research Project: The DOD perspective

NASA Technical Reports Server (NTRS)

Pinelli, Thomas E.; Kennedy, John M.

1990-01-01

This project will provide descriptive and analytical data regarding the flow of STI at the individual, organizational, national, and international levels. It will examine both the channels used to communicate information and the social system of the aerospace knowledge diffusion process. Results of the project should provide useful information to R and D managers, information managers, and others concerned with improving access to and use of STI. Objectives include: (1) understanding the aerospace knowledge diffusion process at the individual, organizational, and national levels, placing particular emphasis on the diffusion of Federally funded aerospace STI; (2) understanding the international aerospace knowledge diffusion process at the individual and organizational levels, placing particular emphasis on the systems used to diffuse the results of Federally funded aerospace STI; (3) understanding the roles NASA/DoD technical report and aerospace librarians play in the transfer and use of knowledge derived from Federally funded aerospace R and D; (4) achieving recognition and acceptance within NASA, DoD and throughout the aerospace community that STI is a valuable strategic resource for innovation, problem solving, and productivity; and (5) providing results that can be used to optimize the effectiveness and efficiency of the Federal STI aerospace transfer system and exchange mechanism.

Clinical reasoning-embodied meaning-making in physiotherapy.

PubMed

Chowdhury, Anoop; Bjorbækmo, Wenche Schrøder

2017-07-01

This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes. One session emerged as particularly stressful for both parties and is explored in detail in this article. In our analysis, we seek to be attentive to the experiences of physiotherapy displayed and to explore their meaning, significance and uniqueness from a phenomenological perspective. Our research reveals the complexity of integrating multiple theoretical perspectives of practice in clinical decision-making and suggests that a phenomenological perspective can provide insights into clinical encounters through its recognition of embodied knowledge. We argue that good physiotherapy practice demands tactfulness, sensitivity, and the desire to build a cooperative patient-therapist relationship. Informed by theoretical and practical knowledge from multiple disciplines, patient management can evolve and unfold beyond rehearsed routines and theoretical principles.

Fuel Crime Conceptualization through Specialization of Ontology for Investigation Management System

NASA Astrophysics Data System (ADS)

Cybulka, Jolanta

We undertook the task of building the conceptual model of a particular economic offense, called "a fuel crime". This model is thought of as a part of a larger conceptualization, which comprises consensual semantics underlying the knowledge base of a system, aimed at supporting the teamwork of investigators of economic crimes. Because such a knowledge-based system represents a perspective on economic crimes, it should be carefully modeled. This can be done with the help of an expressive enough ontology. To achieve our goal we use the constructive descriptions and situations (c.DnS) design pattern, which enables us to construct an extensible, layered ontology in a top-down manner: c.DnS top layer is specialized by the reference ontology for investigation management system, that in turn, is specialized by the ontology of the fuel crime.

An integrated Pan-European perspective on coastal Lagoons management through a mosaic-DPSIR approach

PubMed Central

Dolbeth, Marina; Stålnacke, Per; Alves, Fátima L.; Sousa, Lisa P.; Gooch, Geoffrey D.; Khokhlov, Valeriy; Tuchkovenko, Yurii; Lloret, Javier; Bielecka, Małgorzata; Różyński, Grzegorz; Soares, João A.; Baggett, Susan; Margonski, Piotr; Chubarenko, Boris V.; Lillebø, Ana I.

2016-01-01

A decision support framework for the management of lagoon ecosystems was tested using four European Lagoons: Ria de Aveiro (Portugal), Mar Menor (Spain), Tyligulskyi Liman (Ukraine) and Vistula Lagoon (Poland/Russia). Our aim was to formulate integrated management recommendations for European lagoons. To achieve this we followed a DPSIR (Drivers-Pressures-State Change-Impacts-Responses) approach, with focus on integrating aspects of human wellbeing, welfare and ecosystem sustainability. The most important drivers in each lagoon were identified, based on information gathered from the lagoons’ stakeholders, complemented by scientific knowledge on each lagoon as seen from a land-sea perspective. The DPSIR cycles for each driver were combined into a mosaic-DPSIR conceptual model to examine the interdependency between the multiple and interacting uses of the lagoon. This framework emphasizes the common links, but also the specificities of responses to drivers and the ecosystem services provided. The information collected was used to formulate recommendations for the sustainable management of lagoons within a Pan-European context. Several common management recommendations were proposed, but specificities were also identified. The study synthesizes the present conditions for the management of lagoons, thus analysing and examining the activities that might be developed in different scenarios, scenarios which facilitate ecosystem protection without compromising future generations. PMID:26776151

Organizational Factors that Affect the Implementation of Information Technology: Perspectives of Middle Managers in Iran

PubMed Central

Barzekar, Hosein; Karami, Mahtab

2014-01-01

ABSTRACT Objective: to examine the organizational factors affecting the application of information technology in hospitals. Since the organizational factors are one of the most important determinants of successful projects, by understanding their impact and identifying them it can help planning a systematic IT implementation. Methods: In this cross-sectional descriptive study 110 middle managers were chosen from teaching hospitals. Structured questionnaire was used for the data collection. Results: There was a significant relationship between organization resource, organizational knowledge, process, management structure and values and goals with implementation of information technology. Conclusion: Findings showed that organizational factors had a considerable impact on implementation of information technology. Top managers must consider the important aspects of effective organizational factors. PMID:25568582

Pain experiences of patients with advanced cancer: A qualitative descriptive study.

PubMed

Erol, Ozgul; Unsar, Serap; Yacan, Lale; Pelin, Meryem; Kurt, Seda; Erdogan, Bülent

2018-04-01

Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management. Copyright © 2018 Elsevier Ltd. All rights reserved.

Knowledge communication: a key to successful crisis management.

PubMed

Johansson, Anders; Härenstam, Malin

2013-09-01

A winning concept of crisis management can be summarized in 2 words: knowledge communication. If decision makers, communicators, experts, and the public understand what the crisis is about and share their knowledge, the process of handling it will be optimized. Effective crisis communication implies the necessity of an unhindered but purposeful exchange of information within and between authorities, organizations, media, involved individuals, and groups before, during, and after a crisis. This article focuses on the importance of the before, or prevention, part of a crisis since it holds a rich possibility to enhance the chances for successful crisis management of a bioterrorism incident. An extended perspective on crisis communication efficiently links to a more thorough understanding of risk perception with various stakeholders and the public, which also will be helpful for situational awareness. Furthermore, the grounded baseline for the dialogue type of crisis communication suitable in modern society and to modern social media is achieved by linking to those risk communication efforts that are made. The link between risk and crisis should be afforded more attention since, especially in biosecurity, there would be no crisis without risk negligence and poor or malfunctioning preventive efforts.

Models for Forest Ecosystem Management: A European Perspective

PubMed Central

Pretzsch, H.; Grote, R.; Reineking, B.; Rötzer, Th.; Seifert, St.

2008-01-01

Background Forest management in Europe is committed to sustainability. In the face of climate change and accompanying risks, however, planning in order to achieve this aim becomes increasingly challenging, underlining the need for new and innovative methods. Models potentially integrate a wide range of system knowledge and present scenarios of variables important for any management decision. In the past, however, model development has mainly focused on specific purposes whereas today we are increasingly aware of the need for the whole range of information that can be provided by models. It is therefore assumed helpful to review the various approaches that are available for specific tasks and to discuss how they can be used for future management strategies. Scope Here we develop a concept for the role of models in forest ecosystem management based on historical analyses. Five paradigms of forest management are identified: (1) multiple uses, (2) dominant use, (3) environmentally sensitive multiple uses, (4) full ecosystem approach and (5) eco-regional perspective. An overview of model approaches is given that is dedicated to this purpose and to developments of different kinds of approaches. It is discussed how these models can contribute to goal setting, decision support and development of guidelines for forestry operations. Furthermore, it is shown how scenario analysis, including stand and landscape visualization, can be used to depict alternatives, make long-term consequences of different options transparent, and ease participation of different stakeholder groups and education. Conclusions In our opinion, the current challenge of forest ecosystem management in Europe is to integrate system knowledge from different temporal and spatial scales and from various disciplines. For this purpose, using a set of models with different focus that can be selected from a kind of toolbox according to particular needs is more promising than developing one overarching model, covering ecological, production and landscape issues equally well. PMID:17954471

Foundations of translational ecology

USGS Publications Warehouse

Enquist, Carolyn A. F.; Jackson, Stephen T.; Garfin, Gregg M.; Davis, Frank W.; Gerber, Leah R.; Littell, Jeremy; Tank, Jennifer L.; Terando, Adam; Wall, Tamara U.; Halpern, Benjamin S.; Morelli, Toni L.; Hiers, J. Kevin; McNie, Elizabeth; Stephenson, Nathan L.; Williamson, Matthew A.; Woodhouse, Connie A.; Yung, Laurie; Brunson, Mark W.; Hall, Kimberly R.; Hallett, Lauren M.; Lawson, Dawn M.; Moritz, Max A.; Nydick, Koren R.; Pairis, Amber; Ray, Andrea J.; Regan, Claudia M.; Safford, Hugh D.; Schwartz, Mark W.; Shaw, M. Rebecca

2017-01-01

Ecologists who specialize in translational ecology (TE) seek to link ecological knowledge to decision making by integrating ecological science with the full complement of social dimensions that underlie today's complex environmental issues. TE is motivated by a search for outcomes that directly serve the needs of natural resource managers and decision makers. This objective distinguishes it from both basic and applied ecological research and, as a practice, it deliberately extends research beyond theory or opportunistic applications. TE is uniquely positioned to address complex issues through interdisciplinary team approaches and integrated scientist–practitioner partnerships. The creativity and context‐specific knowledge of resource managers, practitioners, and decision makers inform and enrich the scientific process and help shape use‐driven, actionable science. Moreover, addressing research questions that arise from on‐the‐ground management issues – as opposed to the top‐down or expert‐oriented perspectives of traditional science – can foster the high levels of trust and commitment that are critical for long‐term, sustained engagement between partners.

Essential managerial skills for financial and budgetary management in medical universities: The top managers' perspective

PubMed Central

Javani, Ali; Abolhallaje, Masoud; Jafari, Javad; Fazl Hashemi, Seyed Mohammad Esmaeil

2017-01-01

Background: Achieving organizational objectives depends on the effectiveness of administrators. However, managerial efficacy largely depends on the knowledge and skills of managers. This study aimed at assessing the skills of financial and budget management of the Ministry of Health from the perspective of resource development assistants of universities of medical sciences nationwide. Methods: This cross- sectional study was conducted in 2012. Study participants were resource development assistants of universities of medical sciences in Iran. We adopted simple random sampling method in locating participants. Data were collected using pretested questionnaires and analyzed using descriptive statistics and Mann-Whitney test (as a non-parametric test) and Friedman test. Results: The highest mean recorded under financial management skills was technical skills (3.58±0.50), followed by human skills (3.50±.048), and perceptual skills (3.32±0.52). With regards to financial and budget management and performance monitoring, the means of technical skills, as prioritized by directors, was 3.72±0.71, followed by human skills (3.72±0.70), and perceptual skills (3.66±0.75). A significant association was found between perceptual skills of financial managers and budgeting and performance monitoring managers (p= 0.014). Conclusion: Operational level managers, such as financial and budgetary managers, need to acquire more technical skills. Therefore, we support activities that promote technical skills and awareness of managers within organizations, such as organizational training courses and distribution of educational materials like brochures.

Issues and challenges in resource management and its interaction with levels 2/3 fusion with applications to real-world problems: an annotated perspective

NASA Astrophysics Data System (ADS)

Blasch, Erik; Kadar, Ivan; Hintz, Kenneth; Biermann, Joachim; Chong, Chee-Yee; Salerno, John; Das, Subrata

2007-04-01

Resource management (or process refinement) is critical for information fusion operations in that users, sensors, and platforms need to be informed, based on mission needs, on how to collect, process, and exploit data. To meet these growing concerns, a panel session was conducted at the International Society of Information Fusion Conference in 2006 to discuss the various issues surrounding the interaction of Resource Management with Level 2/3 Situation and Threat Assessment. This paper briefly consolidates the discussion of the invited panel panelists. The common themes include: (1) Addressing the user in system management, sensor control, and knowledge based information collection (2) Determining a standard set of fusion metrics for optimization and evaluation based on the application (3) Allowing dynamic and adaptive updating to deliver timely information needs and information rates (4) Optimizing the joint objective functions at all information fusion levels based on decision-theoretic analysis (5) Providing constraints from distributed resource mission planning and scheduling; and (6) Defining L2/3 situation entity definitions for knowledge discovery, modeling, and information projection

An Investigation of Learning Efficacy, Management Difficulties and Improvements in Tertiary CLIL (Content and Language Integrated Learning) Programmes in Taiwan: A Survey of Stakeholder Perspectives

ERIC Educational Resources Information Center

Yang, Wenhsien

2016-01-01

In 2011, Taiwan's Ministry of Education conducted a national-scale appraisal of 92 CLIL programmes. However, we lack an effective model for examining by precisely how much improvement in the quality of the CLIL programmes will rise as a consequence of the increased language proficiency and the acquisition of disciplinary knowledge. To gain greater…

Research perspectives on the public and fire management: a synthesis of current social science on eight essential questions

Treesearch

Sarah M. McCaffrey; Christine S. Olsen

2012-01-01

As part of a Joint Fire Science Program project, a team of social scientists reviewed existing fire social science literature to develop a targeted synthesis of scientific knowledge on the following questions: 1. What is the public's understanding of fire's role in the ecosystem? 2. Who are trusted sources of information about fire? 3. What are the public...

California's hardwood resource: status of the industry and an ecosystem management perspective

Treesearch

Philip M. McDonald; Dean W. Huber

1994-01-01

In an earlier publication on California’s forest-zone hardwoods, 22 reasons were offered for the failure of a sustained hardwood industry to develop. This report presents knowledge developed over the past 18 years on each of these reasons. Progress is reflected in society’s shift from a negative to a positive attitude towards the hardwood industry, better estimates of...

The everyday life of adolescent coeliacs: issues of importance for compliance with the gluten-free diet.

PubMed

Olsson, C; Hörnell, A; Ivarsson, A; Sydner, Y M

2008-08-01

Noncompliance with the gluten-free diet is often reported among adolescents with coeliac disease. However, knowledge is limited regarding their own perspectives and experiences of managing the disease and the prescription of a gluten-free diet. The aim of this study was to explore how adolescents with coeliac disease perceive and manage their everyday lives in relation to a gluten-free diet. In total, 47 adolescents with coeliac disease, divided into 10 focus groups, were interviewed. In the qualitative analysis, themes emerged to illustrate and explain the adolescents' own perspectives on life with a gluten-free diet. The probability of compliance with the gluten-free diet was comprised by insufficient knowledge of significant others, problems with the availability and sensory acceptance of gluten-free food, insufficient social support and their perceived dietary deviance. Three different approaches to the gluten-free diet emerged: compliers, occasional noncompliers, and noncompliers. Each approach, as a coping strategy, was rational in the sense that it represented the adolescents' differing views of everyday life with coeliac disease and a prescription of a gluten-free diet. dolescents with coeliac disease experience various dilemmas related to the gluten-free diet. The study demonstrated unmet needs and implies empowerment strategies for optimum clinical outcomes.

[Patient Participation in Development of Quality Indicators using the Example of National Disease Management Guidelines for Chronic Heart Failure - A Qualitative Analysis of Collective Perspectives].

PubMed

Herzberg, H; Bernateck, K; Welti, F; Joos, S; Pohontsch, N J; Blozik, E; Scherer, M

2016-06-01

In this qualitative study it was investigated by group discussions with patients suffering from chronic heart failure, how relevant the existing quality indicators of the National Disease Management Guidelines for Chronic Heart Failure are being estimated. 6 group discussions were performed. The sample was formed from 4 mixed-gender groups, a male group and a female group. Participants were recruited from local heart sports groups. For the interpretation a method similar to the grounded theory was used. The main conclusion is that in principle quality indicators are accepted. However, many of these indicators neglect the everyday aspects of patients' life. Participants show a disposition of "yes - but" regarding the quality indicators. This phenomenon could be theoretically grasped using the concept of order of knowledge. While participants keep referring to an order of everyday knowledge, quality indicators make recourse to a medical order of knowledge. Both orders of knowledge may compete with each other. The professional knowledge order of medicine needs to open up to a patients' knowledge order. Patient representatives in health care bodies need to be trained to develop a reflexive point of view to different knowledge orders enabling them to represent patients' everyday knowledge more confidently. Otherwise there is danger of conformation to the professional knowledge order of medicine only for reasons of being recognised as equal partners. © Georg Thieme Verlag KG Stuttgart · New York.

Perspective on pain management in the 21st century.

PubMed

Polomano, Rosemary C; Dunwoody, Colleen J; Krenzischek, Dina A; Rathmell, James P

2008-02-01

Pain is a predictable consequence of surgery or trauma. Untreated, it is associated with significant physiological, emotional, mental, and economic consequences. Despite the vast amount of current knowledge, uncontrolled postoperative pain is reported by approximately 50% of patients. Thus, techniques for effective acute pain management (APM) represent unmet educational needs. The significance of these unmet needs is reflected in the number of journal and textbook publications dedicated to disseminating research, evidence-based guidelines, and clinical information. Acknowledging the importance of APM, health care accrediting agencies and professional societies have become increasingly focused on ensuring that patients receive prompt and acceptable pain relief.

Achieving conservation science that bridges the knowledge-action boundary.

PubMed

Cook, Carly N; Mascia, Michael B; Schwartz, Mark W; Possingham, Hugh P; Fuller, Richard A

2013-08-01

There are many barriers to using science to inform conservation policy and practice. Conservation scientists wishing to produce management-relevant science must balance this goal with the imperative of demonstrating novelty and rigor in their science. Decision makers seeking to make evidence-based decisions must balance a desire for knowledge with the need to act despite uncertainty. Generating science that will effectively inform management decisions requires that the production of information (the components of knowledge) be salient (relevant and timely), credible (authoritative, believable, and trusted), and legitimate (developed via a process that considers the values and perspectives of all relevant actors) in the eyes of both researchers and decision makers. We perceive 3 key challenges for those hoping to generate conservation science that achieves all 3 of these information characteristics. First, scientific and management audiences can have contrasting perceptions about the salience of research. Second, the pursuit of scientific credibility can come at the cost of salience and legitimacy in the eyes of decision makers, and, third, different actors can have conflicting views about what constitutes legitimate information. We highlight 4 institutional frameworks that can facilitate science that will inform management: boundary organizations (environmental organizations that span the boundary between science and management), research scientists embedded in resource management agencies, formal links between decision makers and scientists at research-focused institutions, and training programs for conservation professionals. Although these are not the only approaches to generating boundary-spanning science, nor are they mutually exclusive, they provide mechanisms for promoting communication, translation, and mediation across the knowledge-action boundary. We believe that despite the challenges, conservation science should strive to be a boundary science, which both advances scientific understanding and contributes to decision making. © 2013 Society for Conservation Biology.

The barriers and facilitators people with diabetes from a nonEnglish speaking background experience when managing their medications: a qualitative study.

PubMed

Claydon-Platt, Kate; Manias, Elizabeth; Dunning, Trisha

2014-08-01

To explore the barriers to and facilitators of effective medication management from the perspectives of people with diabetes from a nonEnglish speaking background, carers and health professionals. The barriers that people with diabetes experience managing their medications can adversely impact on health outcomes. People from nonEnglish speaking backgrounds are at risk of medication-related problems, although there is a paucity of research in this area. A qualitative research design using a purposive sampling approach. People with type 1 or type 2 diabetes from a nonEnglish speaking background, their carers, and health professionals who assisted these people and their carers to manage their medications were recruited from the diabetes outpatient clinic at an adult teaching public hospital in Melbourne, Australia. Participants were interviewed using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim and analysed using a thematic framework method. Eleven people with diabetes, 10 carers and 10 health professionals were interviewed, and four key issues were identified: diabetes knowledge, diabetes impact, medication knowledge and medication management. The cost of medications, language barriers that hinder communication, forgetfulness, and poor knowledge and understanding emerged as barriers to effective medication management. Facilitators included the use of dose administration aids to manage medications, but current medication lists were not used. Findings revealed people with diabetes experienced a multitude of barriers when managing their medications, and, despite the problems people experienced, there appeared to be poor use of support aids to assist people to effectively manage their medications. The findings can be used to develop strategies aiming at improving how people from nonEnglish speaking backgrounds manage their medicines. © 2013 John Wiley & Sons Ltd.

Perspective on Physical Therapist Management of Functional Constipation.

PubMed

George, Susan E; Borello-France, Diane F

2017-04-01

Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail to address the underlying pathophysiology and impairments contributing to this condition. Physical therapists possess the knowledge and skills to diagnose and manage a wide range of musculoskeletal and motor coordination impairments that may contribute to functional constipation. Relevant anatomic, physiologic, and behavioral contributors to functional constipation are discussed with regard to specific constipation diagnoses. A framework for physical therapist examination of impairments that can affect gastrointestinal function, including postural, respiratory, musculoskeletal, neuromuscular, and behavioral impairments, is offered. Within the context of diagnosis-specific patient cases, multifaceted interventions are described as they relate to impairments underlying functional constipation type. The current state of evidence to support these interventions and patient recommendations is summarized. This perspective article aims not only to heighten physical therapists' awareness and management of this condition, but also to stimulate clinical questioning that will open avenues for future research to improve patient care. © 2016 American Physical Therapy Association.

A perspective of adaptation in healthcare.

PubMed

Mezghani, Emna; Da Silveira, Marcos; Pruski, Cédric; Exposito, Ernesto; Drira, Khalil

2014-01-01

Emerging new technologies in healthcare has proven great promises for managing patient care. In recent years, the evolution of Information and Communication Technologies pushes many research studies to think about treatment plan adaptation in this area. The main goal is to accelerate the decision making by dynamically generating new treatment due to unexpected situations. This paper portrays the treatment adaptation from a new perspective inspired from the human nervous system named autonomic computing. Thus, the selected potential studies are classified according to the maturity levels of this paradigm. To guarantee optimal and accurate treatment adaptation, challenges related to medical knowledge and data are identified and future directions to be explored in healthcare systems are discussed.

HIV prevention through drugs and sex education in junior high schools in Bandung West Java: the teachers' perspective.

PubMed

Hinduan, Zahrotur R; Riyanti, Eka; Tasya, Irma A; Pohan, Mawar N; Sumintardja, Elmira N; Astuti, Sri R; Jabar, Bambang A; Pinxten, Lucas Wj; Hospers, Harm J

2009-07-01

to explore the teacher perspective on needs (in terms of knowledge, skills and curriculum content), attitudes, beliefs and self-efficacy related to teaching and implementation of a reproductive health (RH)/drug education (DE) program at their own junior high school. one hundred and thirty-three teachers participated in a survey, from February to April 2009, measuring: socio demographic, behavioral intention, perceived behavior control, content knowledge, school climate, reproductive health knowledge and school drug education. all teachers had a high intention to teach RH and DE, especially the younger RH teachers had a high intention to teach about teenage pregnancy and sexually transmitted infections. DE teachers had a high intention facts/effects of drugs, first-time drug use dealing with peer pressure. Perceived beliefs of teachers, parents, school management and perceived self-efficacy were strong predictors for the intention of RH teaching and DE. the high intention of the RH and DE teacher offers a great opportunity to build and implement a DE and RH curriculum in junior high school. Before a curriculum is developed and implemented there is a need to assess and strengthen the teacher's skills and effectiveness in teaching RH and DE.

Exploring patient perception of success and benefit in self-management of breast cancer-related arm lymphoedema.

PubMed

Jeffs, Eunice; Ream, Emma; Shewbridge, Amanda; Cowan-Dickie, Siobhan; Crawshaw, Diana; Huit, Martine; Wiseman, Theresa

2016-02-01

The aim of this study was to identify factors influencing patient perception of success and benefit with self-management of breast cancer-related lymphoedema (BCRL) and explore how patients decide whether their swollen limb has improved or deteriorated. This qualitative study used a Grounded Theory approach. Twenty-one women in the BCRL self-management phase participated in one in-depth interview exploring their experience and perspective on self-managing their BCRL. Seven enablers and blocks to self-management were identified: routine, recognising benefit of self-management and consequences of non-treatment, owning treatment, knowledge and understanding, problem-solving, time required for treatment and aesthetics of hosiery. Women determined treatment outcome by monitoring size, appearance, texture and internal sensations within the affected arm. Women who participated in this study showed varying degrees of acceptance and adjustment to life with lymphoedema. This appears to directly impact their ability to self-manage lymphoedema. Lymphoedema practitioners and oncology nurses have a valuable role providing knowledge and support to patients transitioning to independent self-care. A better understanding of factors facilitating patients to become experts in their condition may improve longer term outcomes and reduce cost pressures on lymphoedema services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Painful and involuntary Multiple Sclerosis

PubMed Central

Bagnato, Francesca; Centonze, Diego; Galgani, Simonetta; Grasso, Maria Grazia; Haggiag, Shalom; Strano, Stefano

2010-01-01

Importance of the field Pain, dysphagia, respiratory problems, sexual and cardiovascular dysfunctions may occur in patients with multiple sclerosis (MS). Areas covered in the field In the present review we attempt to summarize the current knowledge on the impact that pain, dysphagia, respiratory problems, sexual and cardiovascular dysfunctions have in patients with MS. What the reader will gain The current understanding on pain, dysphagia, respiratory problems, sexual and cardiovascular dysfunctions and future research perspectives to expand the knowledge of this field. Take home message To effectively manage MS it is essential that these symptoms are recognised as early as possible and treated by a rehabilitative multidisciplinary approach, based on proven scientific evidence. PMID:21323633

Chronic fatigue syndrome defies the mind-body-schism of medicine. New perspectives on a multiple realisable developmental systems disorder.

PubMed

Ulvestad, Elling

2008-09-01

The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested.

Meta-Design and the Triple Learning Organization in Architectural Design Process

NASA Astrophysics Data System (ADS)

Barelkowski, Robert

2017-10-01

The paper delves into the improvement of Meta-Design methodology being the result of implementation of triple learning organization. Grown from the concept of reflective practice, it offers an opportunity to segregate and hierarchize both criteria and knowledge management and at least twofold application. It induces constant feedback loops recharging the basic level of “design” with second level of “learning from design” and third level of “learning from learning”. While learning from design reflects the absorption of knowledge, structuralization of skills, management of information, learning from learning gives deeper understanding and provides axiological perspective which is necessary when combining cultural, social, and abstract conceptual problems. The second level involves multidisciplinary applications imported from many engineering disciplines, technical sciences, but also psychological background, or social environment. The third level confronts these applications with their respective sciences (wide extra-architectural knowledge) and axiological issues. This distinction may be represented in difference between e.g. purposeful, systemic use of participatory design which again generates experience-by-doing versus use of disciplinary knowledge starting from its theoretical framework, then narrowed down to be relevant to particular design task. The paper discusses the application in two cases: awarded competition proposal of Digital Arts Museum in Madrid and BAIRI university building. Both cases summarize the effects of implementation and expose the impact of triple-loop knowledge circles onto design, teaching the architect or helping them to learn how to manage information flows and how to accommodate paradigm shifts in the architectural design process.

Clinical reasoning and population health: decision making for an emerging paradigm of health care.

PubMed

Edwards, Ian; Richardson, Barbara

2008-01-01

Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

Exploring the use of situation awareness in behaviors and practices of health and safety leaders.

PubMed

Willmer, D R

2017-01-01

An understanding of how health and safety management systems (HSMS) reduce worksite injuries, illnesses and fatalities may be gained in studying the behaviors of health and safety leaders. These leaders bear the accountability for identifying, understanding and managing the risks of a mining operation. More importantly, they have to transfer this knowledge of perception, recognition and response to risks in the mining environment to their workers. The leaders' efforts to build and maintain a mining operation's workforce that consistently executes safe work practices may be captured through more than just lagging indicators of health and safety performance. This exploratory study interviewed six leaders in occupations such as site-level safety supervisors, mine superintendents and/or general managers at surface and underground stone, sand and gravel and metal/nonmetal mine sites throughout the United States, with employee populations ranging from 40 to 175. In exploring leaders' perspectives on how they systematically manage health and safety, examples such as approaches to task training, handling near-miss incidents, identifying future leaders and providing workers with feedback offer insights into how leaders translate their knowledge and management of site-level risks to others.

Exploring the use of situation awareness in behaviors and practices of health and safety leaders

PubMed Central

Willmer, D.R.

2018-01-01

An understanding of how health and safety management systems (HSMS) reduce worksite injuries, illnesses and fatalities may be gained in studying the behaviors of health and safety leaders. These leaders bear the accountability for identifying, understanding and managing the risks of a mining operation. More importantly, they have to transfer this knowledge of perception, recognition and response to risks in the mining environment to their workers. The leaders’ efforts to build and maintain a mining operation’s workforce that consistently executes safe work practices may be captured through more than just lagging indicators of health and safety performance. This exploratory study interviewed six leaders in occupations such as site-level safety supervisors, mine superintendents and/or general managers at surface and underground stone, sand and gravel and metal/nonmetal mine sites throughout the United States, with employee populations ranging from 40 to 175. In exploring leaders’ perspectives on how they systematically manage health and safety, examples such as approaches to task training, handling near-miss incidents, identifying future leaders and providing workers with feedback offer insights into how leaders translate their knowledge and management of site-level risks to others. PMID:29593373

Nurse-Led Competency Model for Emergency Physicians: A Qualitative Study.

PubMed

Daouk-Öyry, Lina; Mufarrij, Afif; Khalil, Maya; Sahakian, Tina; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline

2017-09-01

To develop a competency model for emergency physicians from the perspective of nurses, juxtapose this model with the widely adopted Accreditation Council for Graduate Medical Education (ACGME) model, and identify competencies that might be unique to the nurses' perspective. The study relied on secondary data originally collected as part of nurses' assessment of emergency physicians' nonclinical skills in the emergency department (ED) of an academic medical center in the Middle East. Participants were 36 registered nurses who had worked in the ED for at least 2 years and had worked for at least 2 shifts per month with the physician being evaluated. Through content analysis, a nurse-led competency model was identified, including 8 core competencies encompassing 33 subcompetencies. The 8 core competencies were emotional intelligence; problem-solving and decisionmaking skills; operations management; patient focus; patient care, procedural skills, and medical knowledge; professionalism; communication skills; and team leadership and management. When the developed model was compared with the ACGME model, the 2 models diverged more than they converged. The nurses' perspective offered distinctive insight into the competencies needed for physicians in an emergency medicine environment, indicating the value of nurses' perspective and shedding light on the need for more systematic and more methodologically sound studies to examine the issue further. The differences between the models highlighted the competencies that were unique to the nurse perspective, and the similarities were indicative of the influence of different perspectives and organizational context on how competencies manifest. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Perspectives on Pre-Service Teacher Knowledge for Teaching Early Algebra

ERIC Educational Resources Information Center

McAuliffe, Sharon; Lubben, Fred

2013-01-01

This paper examines a pre-service teacher's content knowledge for teaching early algebra from two perspectives, i.e. using "Rowland's Knowledge Quartet" theory and "Ball's framework for Mathematical Knowledge for Testing" (MKfT). The study intends to examine the differences between the influences using each framework and to…

Global Knowledge Transfer Issues. Symposium 12. [AHRD Conference, 2001].

ERIC Educational Resources Information Center

2001

This document contains three papers on global knowledge transfer issues and human resource development (HRD). "Indigenizing Knowledge Transfer" (Gary N. McLean) explores examples of HRD in which ethnocentric perspectives predominate and argues that, unless a HRD develops a global perspective, efforts to transfer knowledge within academia…

More Stable Ties or Better Structure? An Examination of the Impact of Co-author Network on Team Knowledge Creation

PubMed Central

Li, Mingze; Zhuang, Xiaoli; Liu, Wenxing; Zhang, Pengcheng

2017-01-01

This study aims to explore the influence of co-author network on team knowledge creation. Integrating the two traditional perspectives of network relationship and network structure, we examine the direct and interactive effects of tie stability and structural holes on team knowledge creation. Tracking scientific articles published by 111 scholars in the research field of human resource management from the top 8 American universities, we analyze scholars’ scientific co-author networks. The result indicates that tie stability changes the teams’ information processing modes and, when graphed, results in an inverted U-shape relationship between tie stability and team knowledge creation. Moreover, structural holes in co-author network are proved to be harmful to team knowledge sharing and diffusion, thereby impeding team knowledge creation. Also, tie stability and structural hole interactively influence team knowledge creation. When the number of structural hole is low in the co-author network, the graphical representation of the relationship between tie stability and team knowledge creation tends to be a more distinct U-shape. PMID:28993744

More Stable Ties or Better Structure? An Examination of the Impact of Co-author Network on Team Knowledge Creation.

PubMed

Li, Mingze; Zhuang, Xiaoli; Liu, Wenxing; Zhang, Pengcheng

2017-01-01

This study aims to explore the influence of co-author network on team knowledge creation. Integrating the two traditional perspectives of network relationship and network structure, we examine the direct and interactive effects of tie stability and structural holes on team knowledge creation. Tracking scientific articles published by 111 scholars in the research field of human resource management from the top 8 American universities, we analyze scholars' scientific co-author networks. The result indicates that tie stability changes the teams' information processing modes and, when graphed, results in an inverted U-shape relationship between tie stability and team knowledge creation. Moreover, structural holes in co-author network are proved to be harmful to team knowledge sharing and diffusion, thereby impeding team knowledge creation. Also, tie stability and structural hole interactively influence team knowledge creation. When the number of structural hole is low in the co-author network, the graphical representation of the relationship between tie stability and team knowledge creation tends to be a more distinct U-shape.

Identification and evaluation of scientific uncertainties related to fish and aquatic resources in the Colorado River, Grand Canyon - summary and interpretation of an expert-elicitation questionnaire

USGS Publications Warehouse

Kennedy, Theodore A.

2013-01-01

Identifying areas of scientific uncertainty is a critical step in the adaptive management process (Walters, 1986; Runge, Converse, and Lyons, 2011). To identify key areas of scientific uncertainty regarding biologic resources of importance to the Glen Canyon Dam Adaptive Management Program, the Grand Canyon Monitoring and Research Center (GCMRC) convened Knowledge Assessment Workshops in May and July 2005. One of the products of these workshops was a set of strategic science questions that highlighted key areas of scientific uncertainty. These questions were intended to frame and guide the research and monitoring activities conducted by the GCMRC in subsequent years. Questions were developed collaboratively by scientists and managers. The questions were not all of equal importance or merit—some questions were large scale and others were small scale. Nevertheless, these questions were adopted and have guided the research and monitoring efforts conducted by the GCMRC since 2005. A new round of Knowledge Assessment Workshops was convened by the GCMRC in June and October 2011 and January 2012 to determine whether the research and monitoring activities conducted since 2005 had successfully answered some of the strategic science questions. Oral presentations by scientists highlighting research findings were a centerpiece of all three of the 2011–12 workshops. Each presenter was also asked to provide an answer to the strategic science questions that were specific to the presenter’s research area. One limitation of this approach is that these answers represented the views of the handful of scientists who developed the presentations, and, as such, they did not incorporate other perspectives. Thus, the answers provided by presenters at the Knowledge Assessment Workshops may not have accurately captured the sentiments of the broader group of scientists involved in research and monitoring of the Colorado River in Glen and Grand Canyons. Yet a fundamental ingredient of resilient decisionmaking and problem-solving is incorporation of a wide range of perspectives (Carpenter and others, 2009). To ensure that a wide range of scientists had an opportunity to weigh in on the strategic science questions, the GCMRC elicited additional perspectives through written questionnaires. Independently soliciting responses from scientists through questionnaires had the added advantage of allowing all scientists to freely and openly share their views on complex and controversial topics—something which may not have occurred in the group setting of the June 2011 Knowledge Assessment Workshop because of dominance by one or more scientists. The purpose of this report is to document and interpret the questionnaire responses.

Luso-Brazilian Enlightenment and the circulation of Caribbean slavery-related knowledge: the establishment of the Brazilian coffee culture from a comparative perspective.

PubMed

Marquese, Rafael de Bivar

2009-01-01

The generation of enlightened Luso-Brazilians saw Caribbean slavery agriculture as the model to be emulated in Portuguese America. To do so, at the turn of the eighteenth to the nineteenth centuries, they translated and published some texts originally elaborated in the Antilles. In this reformist environment, the coffee culture occupied a place of prominence. To understand the role of this knowledge in establishing the Brazilian coffee culture, the Brazilian case is compared with the Cuban. The intent is to demonstrate that in the Spanish colony, the productive coffee plan of Santo Domingo was implanted, while in Brazil a plan was created, supported by new standards of agricultural management that were founded on local knowledge.

Leadership skills for the California electric utility industry: A qualitative study

NASA Astrophysics Data System (ADS)

Hubbell, Michael

The purpose of this qualitative study was to determine the skills and knowledge necessary for leaders in the California electric utility industry in 2020. With rapid industry changes, skills to effectively lead and stay competitive are undetermined. Leaders must manage an increasingly hostile social and political environment, incorporate new technology, and deal with an aging workforce and infrastructure. Methodology. This study utilized a qualitative case study design to determine the factors that influence the skills leaders will require in 2020. It incorporated the perspectives of current electric utility leaders while looking with a future lens. Findings. Interviews were conducted with transmission and distribution (T&D) directors at 3 investor-owned public electric utilities headquartered in California. The questions followed an open-ended format to gather responses as perceived by electric utility leaders for each research question category: overall skills, aging workforce, regulation, technology, and leading younger generations. The research resulted in 18 major themes: 5 for overall skills, 3 for aging workforce, 4 for regulation, 3 for technology, and 3 for leading younger generations. Conclusions. The study identified leadership skills including the ability to embrace, leverage, and stay current with technology; understand and provide a clear vision for the future; increase creativity; manage the next set of workers; motivate during a time of great change; prepare for knowledge transfer and change in workforce culture; manage regulatory expectations; expand potential utility opportunities; leverage "big data"; allow worker collaboration; and understand what drives younger generations. Recommendations. California-based electric utility leaders can remain effective by implementing key strategies identified herein. Further research could examine perspectives of additional utility leaders who lead in organizational units outside of T&D, expand the research to include additional states, and/or demonstrate how to acquire the identified skills. It is also recommended that a replication of this study be undertaken to include a perspective and analysis of union or "field" workers.

Safety in construction--a comprehensive description of the characteristics of high safety standards in construction work, from the combined perspective of supervisors and experienced workers.

PubMed

Törner, Marianne; Pousette, Anders

2009-01-01

The often applied engineering approach to safety management in the construction industry needs to be supplemented by organizational measures and measures based on how people conceive and react to their social environment. This requires in-depth knowledge of the broad preconditions for high safety standards in construction. The aim of the study was to comprehensively describe the preconditions and components of high safety standards in the construction industry from the perspective of both experienced construction workers and first-line managers. Five worker safety representatives and 19 first-line managers were interviewed, all strategically selected from within a large Swedish construction project. Phenomenographic methodology was used for data acquisition and analysis and to categorize the information. Nine informants verified the results. The study identified four main categories of work safety preconditions and components: (1) Project characteristics and nature of the work, which set the limits of safety management; (2) Organization and structures, with the subcategories planning, work roles, procedures, and resources; (3) Collective values, norms, and behaviors, with the subcategories climate and culture, and interaction and cooperation; and (4) Individual competence and attitudes, with the subcategories knowledge, ability and experience, and individual attitudes. The results comprehensively describe high safety standards in construction, incorporating organizational, group, individual, and technical aspects. High-quality interaction between different organizational functions and hierarchical levels stood out as important aspects of safety. The results are discussed in relation to previous research into safety and into the social-psychological preconditions for other desired outcomes in occupational settings. The results can guide construction companies in planning and executing construction projects to a high safety standard.

Ayurpharmacoepidemiology Perspective: Health Literacy (Knowledge and Practice) Among Older Diabetes Patients Visiting Ayurveda Teaching Hospitals in India.

PubMed

Debnath, Parikshit; Natasha, Khurshid; Ali, Liaquat; Bhaduri, Tapas; Roy, Tushar Kanti; Bera, Sayantan; Mukherjee, Debdeep; Debnath, Swati

2016-04-12

Older Indian diabetics lack proper health literacy making them vulnerable to complications. Assessment of health literacy was done by hospital-based cross-sectional study. Face-to-face interview was conducted by pretested structured questionnaires. Diabetes patients aged ≥60 years consisted of 56.22% males and 43.78% females; in addition, 34.2% respondents were without formal schooling. Diabetes was known to 63.56% respondents. Total knowledge and practice score of the respondents was good (18.9% and 35.1%), average (30.7% and 46.9%), and poor (50.4% and 18%), respectively. Knowledge and practice score was strongly associated (P< .01) with religion, educational status, and diabetes duration with positive relationship (R 2 = 0.247,P< .01) between knowledge and practice score. The study highlights lack of health literacy among older diabetics undergoing ayurveda management. Baseline statistics will pave the way toward ayurpharmacoepidemiology. © The Author(s) 2016.

Preceptors' Expectations of Nursing Students' Preparation before Placement in Psychiatry: Ability and Will to Reflect on and Exercise Knowledge.

PubMed

Kirkbakk-Fjær, Kari; Andfossen, Nina Beate; Hedelin, Birgitta

2015-04-01

Nursing students must be prepared to provide nursing care regardless of the patient's illness. This requires that nursing education, including clinical placements, strengthen knowledge and skills in mental health nursing. The aim of this qualitative study was to describe 15 preceptors' expectations of nursing students' preparedness before they entered the psychiatric field. Data was collected with focus group interviews and analysed using conventional content analysis. The findings show that preceptors are concerned about the nursing students' will and ability to reflect on and exercise knowledge for managing the student role and themselves; for adapting their perspective on humanity; for their understanding of illness and how they are interacting with persons with mental illness. The conclusion is that the preceptors expect the educators to give sufficient theoretical knowledge and assess the students' personal maturity prior to entering the psychiatric field.

Who Let the Dogs Out? Communicating First Nations Perspectives on a Canine Veterinary Intervention Through Digital Storytelling.

PubMed

Schurer, Janna M; McKenzie, Christina; Okemow, Crystal; Viveros-Guzmán, Arcadio; Beatch, Heather; Jenkins, Emily J

2015-12-01

Dog-related human injuries affect public safety and animal welfare, and occur more frequently in rural, remote, and Indigenous communities than in urban centres in Canada. Little work has been done to identify the perspectives of those people most heavily affected by this issue or to report successful dog management programs. This project was undertaken by veterinarians and public health workers with the goal of documenting First Nations perspectives on dogs, and educating other rural health workers about introducing animal management services to Indigenous communities. We recruited 10-14 residents and healthcare workers from three First Nations to take dog-related photos in their communities and participate in group interviews during the summer of 2014. Audiovisual data were synthesised into four digital stories exploring the following aspects of participant relationships with community dogs: (1) Spay/neuter clinics; (2) Role of the dog (past and present); (3) Human-animal bond; and (4) Healthy dogs as a part of healthy communities. These videos document changes in dog husbandry behaviour, new acceptance of spay/neuter, three-way knowledge transfer between residents, researchers, and policy makers, and an overall desire to sustain the positive outcomes of the pilot dog management project. This work highlights cultural beliefs and success strategies that might guide other programs providing veterinary services in First Nations communities.

Pan-European management of coastal lagoons: A science-policy-stakeholder interface perspective

NASA Astrophysics Data System (ADS)

Lillebø, Ana I.; Stålnacke, Per; Gooch, Geoffrey D.; Krysanova, Valentina; Bielecka, Małgorzata

2017-11-01

The main objective of the work carried out in the scope of a three years collaborative research project was to develop science-based strategies and a decision support framework for the integrated management of coastal lagoons and their catchments and, in this context, to enhance connectivity between research and policymaking. In this paper our main objective is to share the lessons learned from the innovative methodology used throughout the project. To achieve the proposed objectives, the multidisciplinary scientific knowledge in the project team was combined and integrated with the knowledge and views of local stakeholders of four selected European coastal lagoons, using a three step participatory approach. With this innovative approach, which included the usage of eco-hydrological and water quality-modelling tools, the team developed and analyzed integrated scenarios of possible economic development and environmental impacts in four European lagoons and their catchments. These scenarios were presented and discussed with stakeholders, giving rise to management recommendations for each case study lagoon. Results show that some management options might be transferrable to other European lagoons having similar climatic, geophysical and socio-economic settings. In management terms, the project output provides a set of policy guidelines derived from the different analyses conducted and proposes initiatives concerning management implementation in a local-regional-national-European setting.

A transdisciplinary account of water research.

PubMed

Krueger, Tobias; Maynard, Carly; Carr, Gemma; Bruns, Antje; Mueller, Eva Nora; Lane, Stuart

2016-01-01

Water research is introduced from the combined perspectives of natural and social science and cases of citizen and stakeholder coproduction of knowledge. Using the overarching notion of transdisciplinarity, we examine how interdisciplinary and participatory water research has taken place and could be developed further. It becomes apparent that water knowledge is produced widely within society, across certified disciplinary experts and noncertified expert stakeholders and citizens. However, understanding and management interventions may remain partial, or even conflicting, as much research across and between traditional disciplines has failed to integrate disciplinary paradigms due to philosophical, methodological, and communication barriers. We argue for more agonistic relationships that challenge both certified and noncertified knowledge productively. These should include examination of how water research itself embeds and is embedded in social context and performs political work. While case studies of the cultural and political economy of water knowledge exist, we need more empirical evidence on how exactly culture, politics, and economics have shaped this knowledge and how and at what junctures this could have turned out differently. We may thus channel the coproductionist critique productively to bring perspectives, alternative knowledges, and implications into water politics where they were not previously considered; in an attempt to counter potential lock-in to particular water policies and technologies that may be inequitable, unsustainable, or unacceptable. While engaging explicitly with politics, transdisciplinary water research should remain attentive to closing down moments in the research process, such as framings, path-dependencies, vested interests, researchers' positionalities, power, and scale. WIREs Water 2016, 3:369-389. doi: 10.1002/wat2.1132 For further resources related to this article, please visit the WIREs website.

Case Managers' Perspectives On What They Need To Do Their Job

PubMed Central

Eack, Shaun M.; Greeno, Catherine G.; Christian-Michaels, Stephen; Dennis, Amy; Anderson, Carol M.

2013-01-01

Objective To identify the perceived training needs of case managers working on community support teams in a community mental health center serving a semi-rural/suburban area. Methods Semi-structured interviews were conducted with 18 case managers and 3 supervisors to inquire about areas of training need in case management. Interviews were coded and analyzed for common themes regarding training needs and methods of training improvement. Results Identified training needs called for a hands-on, back to basics approach that included education on the symptoms of severe mental illness, co-morbid substance use problems, and methods of engaging consumers. A mentoring model was proposed as a potential vehicle for disseminating knowledge in these domains. Conclusions Case managers identify significant training needs that would address their basic understanding of severe mental illness. Programs targeting these needs may result in improved outcomes for case managers and the individuals with psychiatric disabilities. PMID:19346211

Knowledge Management - A Necessity For The Training Of Future Specialists Of The Sustainable Entreprises

NASA Astrophysics Data System (ADS)

Rotaru, Ionela Magdalena

2015-09-01

The world we are living in is shaped by what is a reality for years already: globalisation of economy. The lack of borders makes the impact that technology has on society to be a major one. The virtual world so accessible today is not just about new markets, access to cheaper work force, work online but also fierce competition. The common denominator of most efforts in the area of industry is performance. Limits continuously moving willingness to pay for products that delineate the performance delivered be the same range. Here too we can see the role of the education. For example, Landes shows that both knowledge and know-how are the ones that determine how well off societies are. The education of engineers is therefore critical to every nation to ensure the prosperity of its citizens. This paper here intends to approach the educational process of the engineering specific area of knowledge from the management perspective. The training process becomes sustainable in accordance with the requirements of the future: trained specialists for sustainable enterprises.

Thai district Leaders' perceptions of managing the direct observation treatment program in Trang Province, Thailand.

PubMed

Choowong, Jiraporn; Tillgren, Per; Söderbäck, Maja

2016-07-28

Thailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders' perceptions of the management of the DOT program in Trang province, Thailand. A phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories. The first descriptive category revealed a common perception of the leaders' duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines. Using the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership's perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.

Predictors of Rural Health Clinics Managers' Willingness to Join Accountable Care Organizations.

PubMed

T H Wan, Thomas; Masri, Maysoun Dimachkie; Ortiz, Judith

2014-01-01

The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care Organizations (ACOs). It is timely, to identify how health care managers in rural health clinics are responding to the ACO model. This research examines RHC managers' perceived benefits and barriers for implementing ACOs from an organizational ecology perspective. A survey was conducted in Spring of 2012 covering the present RHC network working infrastructures - 1) Organizational social network; 2) organizational care delivery structure; 3) ACO knowledge, perceived benefits, and perceived barriers; 4) quality and disease management programs; and 5) health information technology (HIT) infrastructure. One thousand one hundred sixty clinics were surveyed in the United States. They cover eight southeastern states (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) and California. A total of ninety-one responses were received. RHC managers' personal perceptions on ACO's benefits and knowledge level explained the most variance in their willingness to join ACOs. Individual perceptions appear to be more influential than organizational and context factors in the predictive analysis. The study is primarily focused in the Southeastern region of the U.S. The generalizability is limited to this region. The predictors of rural health clinics' participation in ACOs are germane to guide the development of organizational strategies for enhancing the general knowledge about the innovativeness of delivering coordinated care and containing health care costs inspired by the Affordable Care Act. Rural health clinics are lagged behind the growth curve of ACO adoption. The diffusion of new knowledge about pros and cons of ACO is essential to reinforce the health care reform in the United States.

Predictors of Rural Health Clinics Managers' Willingness to Join Accountable Care Organizations

PubMed Central

T.H.Wan, Thomas; Masri, Maysoun Dimachkie; Ortiz, Judith

2014-01-01

Purpose The implementation of the Patient Protection and Affordable Care Act has facilitated the development of an innovative and integrated delivery care system, Accountable Care Organizations (ACOs). It is timely, to identify how health care managers in rural health clinics are responding to the ACO model. This research examines RHC managers' perceived benefits and barriers for implementing ACOs from an organizational ecology perspective. Methodology/Approach A survey was conducted in Spring of 2012 covering the present RHC network working infrastructures – 1) Organizational social network; 2) organizational care delivery structure; 3) ACO knowledge, perceived benefits, and perceived barriers; 4) quality and disease management programs; and 5) health information technology (HIT) infrastructure. One thousand one hundred sixty clinics were surveyed in the United States. They cover eight southeastern states (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) and California. A total of ninety-one responses were received. Findings RHC managers' personal perceptions on ACO's benefits and knowledge level explained the most variance in their willingness to join ACOs. Individual perceptions appear to be more influential than organizational and context factors in the predictive analysis. Research limitations/implications The study is primarily focused in the Southeastern region of the U.S. The generalizability is limited to this region. The predictors of rural health clinics' participation in ACOs are germane to guide the development of organizational strategies for enhancing the general knowledge about the innovativeness of delivering coordinated care and containing health care costs inspired by the Affordable Care Act. Originality/Value of Paper Rural health clinics are lagged behind the growth curve of ACO adoption. The diffusion of new knowledge about pros and cons of ACO is essential to reinforce the health care reform in the United States. PMID:25541569

Rethinking Value in the Bio-economy: Finance, Assetization, and the Management of Value.

PubMed

Birch, Kean

2017-05-01

Current debates in science and technology studies emphasize that the bio-economy-or, the articulation of capitalism and biotechnology-is built on notions of commodity production, commodification, and materiality, emphasizing that it is possible to derive value from body parts, molecular and cellular tissues, biological processes, and so on. What is missing from these perspectives, however, is consideration of the political-economic actors, knowledges, and practices involved in the creation and management of value. As part of a rethinking of value in the bio-economy, this article analyzes three key political-economic processes: financialization, capitalization, and assetization. In doing so, it argues that value is managed as part of a series of valuation practices, it is not inherent in biological materialities.

U.S. Geological Survey activities related to American Indians and Alaska Natives: Fiscal years 2007 and 2008

USGS Publications Warehouse

Marcus, Susan M.

2010-01-01

In the late 1800s, John Wesley Powell, the second director of the U.S. Geological Survey (USGS), followed his interest in the tribes of the Great Basin and Colorado Plateau and studied their cultures, languages, and surroundings. From that early time, the USGS has recognized the importance of Native knowledge and living in harmony with nature as complements to the USGS mission to better understand the Earth. Combining traditional ecological knowledge with empirical studies allows the USGS and Native American governments, organizations, and people to increase their mutual understanding and respect for this land. The USGS is the earth and natural science bureau within the U.S. Department of the Interior (DOI) and is not responsible for regulations or land management. Climate change is a major current issue affecting Native lives and traditions throughout the United States. Climate projections for the coming century indicate an increasing probability for more frequent and more severe droughts in the Southwest, including the Navajo Nation. Erosion has claimed Native homes in Alaska. Fish have become inedible due to diseases that turn their flesh mushy. Native people who rely on or who are culturally sustained by hunting, fishing, and using local plants are living with climate change now. The traditional knowledge of Native peoples enriches and confirms the work of USGS scientists. The results are truly synergistic-greater than the sum of their parts. Traditional ecological knowledge is respected and increasingly used in USGS studies-when the holders of that knowledge choose to share it. The USGS respects the rights of Native people to maintain their patrimony of traditional ecological knowledge. The USGS studies can help Tribes, Native organizations, and natural resource professionals manage Native lands and resources with the best available unbiased data and information that can be added to their traditional knowledge. Wise Native leaders have noted that traditional ecological knowledge includes the connections between Earth and her denizens. From this perspective, it is the connections among these ?relatives? that needs to be nurtured. This perspective on nature is finding new adherents among Natives and non-Natives as understanding of climate change and other environmental conditions deepens. Although this report uses the term ?resources,? the USGS, through its interdisciplinary research, acknowledges the interconnectedness of the Earth and the things that live upon it.

Benefits from a geographers' perspective on human-water systems - the waterscape concept

NASA Astrophysics Data System (ADS)

Evers, Mariele; Höllermann, Britta; Almoradie, Adrian; Taft, Linda

2016-04-01

Recently a couple of theoretical foundations and concepts were developed such as hydro-sociology, hydro-economics and integrated water resources management in order to structure and process parameterizations of hydrological research and reflect human-water-interrelations. However, a remaining challenge in human-water-system research is that approaches like socio-hydrology still struggle to formalize hypotheses which are capable to capture the basic driving mechanisms of the dynamic human-water system beyond optimizing algorithms or the principle of optimality or entropy as the societal values and experiences may unfold diverging policy and society responses (cf. Troy et al. 2015). Another challenge that we see is the integration of physical and social sciences with regard to the different epistemologies and perspectives: positivist thinking common in natural sciences and engineering and constructivist conceptualisation common in the social sciences. Here, geographic research seeks to acknowledge multi-spatial perspectives of the different actors and entities and their integration into the physical system that needs mutual recognition of natural and social sciences concepts, theories and methods. We suggest for human-water system research a more geographic perspective, which we call waterscape concept. Water can be regarded as a key structuring element for landscape and its management and, hence, from our perspective, the dynamics in water resources and interrelation of actors and entities in its management also helps to better understand current landscape patterns, their developments and interrelations, respectively. By our definition, a waterscape includes sources and users of water, their interactions, feedbacks and external influencing factors. It is therefore not only the physical space but rather includes the arena of actors and entities interacting. Against this understanding, waterscapes are defined by reciprocal boundary conditions which allow integrating the knowledge of natural and social sciences by acknowledging their different epistemologies, concepts and methods at the same time, hereby, fostering a true integration of the disciplines. Space and time and feedback loops are the three key factors to understand human-water interactions. Especially, by recognizing the degree of feedback sensitive system parameters can be detected and allow for emerging a set of multiple framings and possible development paths. Therefore, the geographical perspective on the waterscape concept proposes a search apart from one solution or best practice as, in our assumption, there are no single best answers because the human dimension and their action and reaction are guided also beyond perceptions, preferences, benefits and costs. Our waterscape concept allows a multi-spatial and multi-disciplinary perspective on water and its projection into space by acknowledging multiple meanings, alternative framings and possible development paths, hence fostering an integrative perspective on human-water systems. It further provides a fruitful framework for transdisciplinary research approaches since it is open and supports societal co-production and reframing of knowledge and policies. Troy, T. J., Pavao-Zuckerman, M., and Evans, T. P.: Debates Perspectives on socio-hydrology: Socio-hydrologic modeling: Tradeoffs, hypothesis testing, and validation, Water Resour Res, 51, 4806-4814, 10.1002/2015WR017046, 2015

Managing clinical failure: a complex adaptive system perspective.

PubMed

Matthews, Jean I; Thomas, Paul T

2007-01-01

The purpose of this article is to explore the knowledge capture process at the clinical level. It aims to identify factors that enable or constrain learning. The study applies complex adaptive system thinking principles to reconcile learning within the NHS. The paper uses a qualitative exploratory study with an interpretative methodological stance set in a secondary care NHS Trust. Semi-structured interviews were conducted with healthcare practitioners and managers involved at both strategic and operational risk management processes. A network structure is revealed that exhibits the communication and interdependent working practices to support knowledge capture and adaptive learning. Collaborative multidisciplinary communities, whose values reflect local priorities and promote open dialogue and reflection, are featured. The main concern is that the characteristics of bureaucracy; rational-legal authority, a rule-based culture, hierarchical lines of communication and a centralised governance focus, are hindering clinical learning by generating barriers. Locally emergent collaborative processes are a key strategic resource to capture knowledge, potentially fostering an environment that could learn from failure and translate lessons between contexts. What must be addressed is that reporting mechanisms serve not only the governance objectives, but also supplement learning by highlighting the potential lessons in context. Managers must nurture a collaborative infrastructure using networks in a co-evolutionary manner. Their role is not to direct and design processes but to influence, support and create effective knowledge capture. Although the study only investigated one site the findings and conclusions may well translate to other trusts--such as the risk of not enabling a learning environment at clinical levels.

Prospective Secondary Mathematics Teachers' Perspectives and Mathematical Knowledge for Teaching

ERIC Educational Resources Information Center

Karagöz-Akar, Gülseren

2016-01-01

This study investigated the relationship between prospective secondary mathematics teachers' perspectives and their mathematical knowledge for teaching in action. Data from two prospective teachers' practice-teachings, one in geometry and one in algebra, their lesson plans and self-reflections were analyzed with Teacher Perspectives and Knowledge…

Clinical characteristics and treatment of inflammatory bowel disease: A comparison of Eastern and Western perspectives

PubMed Central

Park, Soo Jung; Kim, Won Ho; Cheon, Jae Hee

2014-01-01

Inflammatory bowel disease (IBD) is a chronic, relapsing intestinal inflammatory disorder with unidentified causes. Both environmental factors and genetic aspects are believed to be crucial to the pathogenesis of IBD. The incidence and prevalence of IBD have recently been increasing throughout Asia, presumably secondary to environmental changes. This increasing trend in IBD epidemiology necessitates specific health care planning and education in Asia. To this end, we must gain a precise understanding of the distinctive clinical and therapeutic characteristics of Asian patients with IBD. The phenotypes of IBD reportedly differ considerably between Asians and Caucasians. Thus, use of the same management strategies for these different populations may not be appropriate. Moreover, investigation of the Asian-specific clinical aspects of IBD offers the possibility of identifying causative factors in the pathogenesis of IBD in this geographical area. Accordingly, this review summarizes current knowledge of the phenotypic manifestations and management practices of patients with IBD, with a special focus on a comparison of Eastern and Western perspectives. PMID:25206259

What qualities are valued in residential direct care workers from the perspective of people with an intellectual disability and managers of accommodation services?

PubMed

Dodevska, G A; Vassos, M V

2013-07-01

To date, the descriptions of a 'good' direct care worker used to recruit workers for disability services have largely been drawn up by managerial professionals in charge of hiring supports for people with disabilities. However, previous research highlights that these professionals conceptualise a 'good' direct care worker differently from service users with an intellectual disability (ID), with professionals placing an emphasis on describing workers with a range of practical skills and knowledge and service users placing an emphasis on describing workers with interpersonal skills. The aim of this research was to replicate this finding using a methodological approach that rectifies some of the weaknesses of previous research in this field. Semi-structured interviews were conducted to explore the qualities that are valued in residential direct care workers (RDCWs) from the perspective of seven residents with ID and seven managers of accommodation services located in metropolitan Melbourne, Australia. Thematic and chi-squared analysis confirmed the findings of previous research with residents with an ID placing more of an emphasis on the interpersonal behaviours of RDCWs in their descriptions compared to the managers. The interpersonal skills of a potential worker along with their practical skills and knowledge must be considered when recruiting RDCWs. It is also implied that given the different conceptualisation of a 'good' direct care worker across service users and professionals, increased service user participation in the organisation of appropriate supports is warranted. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

PubMed

Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

2012-01-01

Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

An Anthropological Perspective: Another Dimension to Modern Dental Wear Concepts

PubMed Central

Kaidonis, John A.; Ranjitkar, Sarbin; Lekkas, Dimitra; Townsend, Grant C.

2012-01-01

For many years, research on tooth wear by dental academics has been diametrically opposite to that of anthropological research, with each discipline having a different understanding as to the nature of the wear processes. Dental focus revolved around preventive and restorative considerations while the anthropological focus was a biological understanding related to human evolution, diet, environment, form, and function and included all the craniofacial structures. Introducing the anthropological perspective into modern dentistry gives an insight into the “bigger picture” of the nature and extent of tooth wear. By combining anthropological evidence with clinical knowledge and experience, it is most likely to provide the best-informed and biologically based approach to the management of tooth wear in modern societies. PMID:23304146

Perceptions of barriers in managing diabetes: perspectives of Hispanic immigrant patients and family members.

PubMed

Hu, Jie; Amirehsani, Karen; Wallace, Debra C; Letvak, Susan

2013-01-01

Hispanics show poorer self-management of type 2 diabetes than non-Hispanic whites. Although previous studies have reported socioeconomic and cultural barriers to diabetes self-management by Hispanics, little is known about perceived barriers to diabetes self-management from the perspectives of both Hispanics and their family members. The purpose of the study was to explore perceived barriers among Hispanic immigrants with diabetes and their family members. A qualitative study using 5 focus groups was conducted. A total of 73 Hispanic immigrants with type 2 diabetes (n = 36) and family members (n = 37) were recruited in the southeastern United States for a family-based intervention study of diabetes-self management. Participants were asked to describe their perceptions of barriers to self-management. The 5 sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. Demographics, hemoglobin A1C levels, blood pressure, and body mass index (BMI) were obtained both for participants with diabetes and for their family members. Barriers to diabetes self-management identified by participants with diabetes were in 3 major themes categorized as: suffering from diabetes, difficulties in managing the disease, and lack of resources/support. Two key themes emerged pertaining to family members: we can provide support and we lack knowledge. Perceived barriers to diabetes self-management described by Hispanic immigrants with diabetes and family members indicate a lack of intervention strategies to meet their needs. Interventions should include culturally relevant resources, family support, and diabetes self-management skills education.

Theoretical developments in psychosocial work environment research.

PubMed

Johnson, J V

1989-01-01

This article introduces the fourth series of articles in the Special Section on work organization and health. The authors identify the theory of scientific management as one of the major obstacles to workplace democratization efforts. The application of this theory has led to the centralization of workplace knowledge and skill under managerial control. The articles in this issue criticize this conventional theory of job design and suggest new theoretical directions from psychological, sociological, and political-economic perspectives.

An Overview of Practice Facilitation Programs in Canada: Current Perspectives and Future Directions

PubMed Central

Liddy, Clare; Laferriere, Dianne; Baskerville, Bruce; Dahrouge, Simone; Knox, Lyndee; Hogg, William

2013-01-01

Practice facilitation has proven to be effective in improving the quality of primary care. A practice facilitator is a health professional, usually external to the practice, who regularly visits the practice to provide support in change management that targets improvements in the delivery of care. Our environmental scan shows that several initiatives across Canada utilize practice facilitation as a quality improvement method; however, many are conducted in isolation as there is a lack of coordinated effort, knowledge translation and dissemination in this field across the country. We recommend that investments be made in capacity building, knowledge exchange and facilitator training, and that partnership building be considered a priority in this field. PMID:23968627

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems

PubMed Central

2016-01-01

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what ‘participation’ means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs. This article is part of the themed issue ‘The ethical impact of data science’. PMID:28336799

Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems.

PubMed

Leonelli, Sabina

2016-12-28

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what 'participation' means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs.This article is part of the themed issue 'The ethical impact of data science'. © 2015 The Authors.

The secondary school football coach's relationship with the athletic trainer and perspectives on exertional heat stroke.

PubMed

Adams, William M; Mazerolle, Stephanie M; Casa, Douglas J; Huggins, Robert A; Burton, Laura

2014-01-01

Prior researchers have examined the first-aid knowledge and decision making among high school coaches, but little is known about their perceived knowledge of exertional heat stroke (EHS) or their relationships with an athletic trainer (AT). To examine secondary school football coaches' perceived knowledge of EHS and their professional relationship with an AT. Qualitative study. Web-based management system. Thirty-eight secondary school head football coaches (37 men, 1 woman) participated in this study. Their average age was 47 ± 10 years old, and they had 12 ± 9 years' experience as a head football coach. Participants responded to a series of online questions that were focused on their perceived knowledge of EHS and professional relationships with ATs. Data credibility was established through multiple-analyst triangulation and peer review. We analyzed the data by borrowing from the principles of a general inductive approach. Two dominant themes emerged from the data: perceived self-confidence of the secondary school coach and the influence of the AT. The first theme highlighted the perceived confidence, due to basic emergency care training, of the coach regarding management of an emergency situation, despite a lack of knowledge. The second theme illustrated the secondary school coach's positive professional relationships with ATs regarding patient care and emergency procedures. Of the coaches who participated, 89% (34 out of 38) indicated positive interactions with their ATs. These secondary school coaches were unaware of the potential causes of EHS or the symptoms associated with EHS, and they had higher perceived levels of self-confidence in management abilities than indicated by their perceived knowledge level. The secondary school football coaches valued and understood the role of the AT regarding patient and emergency care.

Exploring EFL Teachers' CALL Knowledge and Competencies: In-Service Program Perspectives

ERIC Educational Resources Information Center

Liu, Mei-Hui; Kleinsasser, Robert C.

2015-01-01

This article describes quantitative and qualitative data providing perspectives on how six English as a Foreign Language (EFL) vocational high school teachers perceived CALL knowledge and competencies in a yearlong technology-enriched professional development program. The teachers' developing technological pedagogical content knowledge (TPACK) and…

Diversity, local knowledge and use of stingless bees (Apidae: Meliponini) in the municipality of Nocupétaro, Michoacan, Mexico

PubMed Central

2014-01-01

Background Stingless bees were significant resources managed by Mesoamerican peoples during pre-Columbian times and remain important in particular areas. Our study aimed at inventorying stingless bees’ species, traditional knowledge and forms of use and management of them at the municipality of Nocupetaro, Michoacán, Mexico, a region of the Balsas River Basin. Methods We inventoried the stingless bees of the municipality of Nocupétaro, Michoacán, México, through extensive collecting of bee specimens in different vegetation types. We then conducted semi-structured interviews to local experts in order to document their knowledge and management techniques of stingless bees’ species. Results We identified a total of eight stingless bees’ species in the study area as well as three additional unidentified taxa recognized by people through the local names. Our inventory included one new record of species for the region (Lestrimelitta chamelensis Ayala, 1999). The taxa identified are all used by local people. Scaptotrigona hellwegeri Friese, 1900; Melipona fasciata Latreille, 1811; Frieseomelitta nigra Cresson, 1878 and Geotrigona acapulconis Strand, 1919 are particularly valued as food (honey), medicinal (honey and pollen), and material for handcrafts (wax). All species recorded are wild and their products are obtained through gathering. On average, local experts were able to collect 4 nests of stingless bees per year obtaining on average 6 L of honey and 4 Kg of wax but some came to collect up 10–12 hives per year (18 L of honey and 24 Kg of wax). Conclusions Local knowledge about use, management and ecological issues on stingless bees is persistent and deep in the study area. Information about this group of bees is progressively scarcer in Mexico and significant effort should be done from ethnobiological and ecological perspectives in order to complement the national inventory of bee resources and traditional knowledge and management of them. PMID:24903644

Diversity, local knowledge and use of stingless bees (Apidae: Meliponini) in the municipality of Nocupétaro, Michoacan, Mexico.

PubMed

Reyes-González, Alejandro; Camou-Guerrero, Andrés; Reyes-Salas, Octavio; Argueta, Arturo; Casas, Alejandro

2014-06-05

Stingless bees were significant resources managed by Mesoamerican peoples during pre-Columbian times and remain important in particular areas. Our study aimed at inventorying stingless bees' species, traditional knowledge and forms of use and management of them at the municipality of Nocupetaro, Michoacán, Mexico, a region of the Balsas River Basin. We inventoried the stingless bees of the municipality of Nocupétaro, Michoacán, México, through extensive collecting of bee specimens in different vegetation types. We then conducted semi-structured interviews to local experts in order to document their knowledge and management techniques of stingless bees' species. We identified a total of eight stingless bees' species in the study area as well as three additional unidentified taxa recognized by people through the local names. Our inventory included one new record of species for the region (Lestrimelitta chamelensis Ayala, 1999). The taxa identified are all used by local people. Scaptotrigona hellwegeri Friese, 1900; Melipona fasciata Latreille, 1811; Frieseomelitta nigra Cresson, 1878 and Geotrigona acapulconis Strand, 1919 are particularly valued as food (honey), medicinal (honey and pollen), and material for handcrafts (wax). All species recorded are wild and their products are obtained through gathering. On average, local experts were able to collect 4 nests of stingless bees per year obtaining on average 6 L of honey and 4 Kg of wax but some came to collect up 10-12 hives per year (18 L of honey and 24 Kg of wax). Local knowledge about use, management and ecological issues on stingless bees is persistent and deep in the study area. Information about this group of bees is progressively scarcer in Mexico and significant effort should be done from ethnobiological and ecological perspectives in order to complement the national inventory of bee resources and traditional knowledge and management of them.

Tacit Knowledge Sharing Modes of University Teachers from the Perspectives of Psychological Risk and Value

ERIC Educational Resources Information Center

Yu, Dengke; Zhou, Rong

2015-01-01

Tacit knowledge sharing (TKS) is important to improve the teaching skill and researching knowledge of university teachers. In this paper, the tacit knowledge sharing of university teachers is catalogued as four modes from perspectives of the psychological risk and psychological value which are measured by two grades--high and low. The four modes…

Towards understanding and managing the learning process in mail sorting.

PubMed

Berglund, M; Karltun, A

2012-01-01

This paper was based on case study research at the Swedish Mail Service Division and it addresses learning time to sort mail at new districts and means to support the learning process on an individual as well as organizational level. The study population consisted of 46 postmen and one team leader in the Swedish Mail Service Division. Data were collected through measurements of time for mail sorting, interviews and a focus group. The study showed that learning to sort mail was a much more complex process and took more time than expected by management. Means to support the learning process included clarification of the relationship between sorting and the topology of the district, a good work environment, increased support from colleagues and management, and a thorough introduction for new postmen. The identified means to support the learning process require an integration of human, technological and organizational aspects. The study further showed that increased operations flexibility cannot be reinforced without a systems perspective and thorough knowledge about real work activities and that ergonomists can aid businesses to acquire this knowledge.

[The impact of economics on health policy and management in Spain].

PubMed

Ortun Rúbio, Vicente; Meneu de Guillerna, Ricard

2006-01-01

Despite the intrinsic value of scientific disciplines, such as Economics, it is appropriate to gauge the impact of its applications on social welfare, or at least--Health Economics' (HE) case--its influence on health policy and management. The three relevant features of knowledge (production, diffusion and application) are analyzed, more from an 'emic' perspective--the one used in Anthropology relying on the experience of the members of a culture--than from an 'etic' approach seated on material descriptions and dubious statistics. The soundness of the principles and results of HE depends on its disciplinary foundations, whereas its relevance--than does not imply translation into practice--is more linked with the problems studied. Important contributions from Economics to the health sphere are recorded. HE in Spain ranks seventh in the world despite the relatively minor HE contents of its clinical and health services research journals. HE has in Spain more presence than influence, having failed to impregnate sufficiently the daily events. HE knowledge required by a politician, a health manager or a clinician is rather limited; the main impact of HE could be to develop their intuition and awareness.

Community engagement in the management of biosolids: lessons from four New Zealand studies.

PubMed

Goven, Joanna; Langer, E R Lisa; Baker, Virginia; Ataria, James; Leckie, Alan

2012-07-30

Biosolids management has been largely overlooked as an issue for environmental co-management, collaborative learning and public participation. This paper summarises four research projects on facilitating community involvement in biosolids management in New Zealand. The authors situate these studies both in relation to the New Zealand institutional and policy context for the management of biosolids and in relation to the themes of public participation and social learning in the literature on community involvement in environmental management. From the studies it can be concluded that: the incorporation of the knowledge and views of Māori is important from both public-participation and social-learning perspectives; both public-participation and social-learning approaches must consider the role of issue-definition in relation to willingness to participate; democratic accountability remains a challenge for both approaches; and locating biosolids management within an integrated water-and-wastewater or sustainable waste-management strategy may facilitate wider community participation as well as better-coordinated decision-making. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ayurpharmacoepidemiology Perspective

PubMed Central

Debnath, Parikshit; Natasha, Khurshid; Ali, Liaquat; Bhaduri, Tapas; Roy, Tushar Kanti; Bera, Sayantan; Mukherjee, Debdeep; Debnath, Swati

2016-01-01

Older Indian diabetics lack proper health literacy making them vulnerable to complications. Assessment of health literacy was done by hospital-based cross-sectional study. Face-to-face interview was conducted by pretested structured questionnaires. Diabetes patients aged ≥60 years consisted of 56.22% males and 43.78% females; in addition, 34.2% respondents were without formal schooling. Diabetes was known to 63.56% respondents. Total knowledge and practice score of the respondents was good (18.9% and 35.1%), average (30.7% and 46.9%), and poor (50.4% and 18%), respectively. Knowledge and practice score was strongly associated (P < .01) with religion, educational status, and diabetes duration with positive relationship (R 2 = 0.247, P < .01) between knowledge and practice score. The study highlights lack of health literacy among older diabetics undergoing ayurveda management. Baseline statistics will pave the way toward ayurpharmacoepidemiology. PMID:27074784

Agricultural Education from a Knowledge Systems Perspective: From Teaching to Facilitating Joint Inquiry and Learning.

ERIC Educational Resources Information Center

Engel, Paul G. H.; van den Bor, Wout

1995-01-01

Application of a knowledge and information systems perspective shows how agricultural innovation can be enhanced through networking. In the Netherlands, a number of alternative systems of inquiry and learning are infused with this perspective: participatory technology development, participatory rural appraisal, soft systems methodology, and rapid…

Parental concerns on disclosure of HIV status to children living with HIV: children's perspective.

PubMed

Sanjeeva, G N; Pavithra, H B; Chaitanya, S; Sunil Kumar, D R; Rewari, B B

2016-11-01

Disclosure is an important component of comprehensive management of children living with HIV infection (CLHIV). Many parental concerns are barriers for disclosure in children and only few studies addresses children's perspective on these concerns. Our study aims to understand children's perspective on parental concerns for disclosure and assess the knowledge of HIV. A questionnaire-based cross-sectional study involving CLHIV between 10 and 18 years attending HIV clinic in southern India, was conducted. Data were collected by directly interviewing only the children after obtaining consent from parents/caregivers. Initial open-ended questions were asked to assess the disclosure status and only fully disclosed children were included. Out of 362 enrolled eligible children, the prevalence of full and partial disclosure was 36.7% and 24%, respectively. The mean age of disclosure was 10.4 years (SD ± 2.6) and non-parental family members in an informal setting were the most common source of disclosure (38.3%). Forty-six percentages of parents were unaware of their child's disclosure status. Only 2% had disclosed their status to others who were not part of their care. Among disclosed children, 33.8% became upset or sad upon knowing their status, 12% faced discrimination and 41.4% had complete knowledge about their illness. Though the prevalence of disclosure among CLHIV was high, a majority of them had incomplete knowledge about HIV infection. The parental concerns as reported in literature like the child is too young to disclose, concerns about coping, fear of stigma and discrimination and child disclosing to others were not expressed by children.

Undergraduate Consumer Affairs Program Needs: Employers' Perspectives

ERIC Educational Resources Information Center

Morrison, Kathryn; Saboe-Wounded Head, Lorna; Cho, Soo Hyun

2012-01-01

Forty-six Consumer Affairs (CA) internship supervisors were surveyed to identify critical knowledge and skills demonstrated by interns and to examine the importance of knowledge and skills needed in the workplace from the supervisors' perspectives.The knowledge and skills measured were identified through program goals. Results revealed that CA…

Educating Librarians and Information Resource Managers: Differing Management Perspectives?

ERIC Educational Resources Information Center

Bouthillier, France

1993-01-01

Examines differences between library management and information resource management (IRM). Highlights include a historical perspective of library management education and IRM; the organizational perspective of library management and the emphasis of information as a resource in IRM; library management and advances in information technology; and…

"We are toothless and hanging, but optimistic": sub county managers' experiences of rapid devolution in coastal Kenya.

PubMed

Nyikuri, Mary M; Tsofa, Benjamin; Okoth, Philip; Barasa, Edwine W; Molyneux, Sassy

2017-09-15

In March 2013, Kenya transitioned from a centralized to a devolved system of governance. Within the health sector, this entailed the transfer of service provision functions to 47 newly formed semi-autonomous counties, while policy and regulatory functions were retained at the national level. The devolution process was rapid rather than progressive. We conducted qualitative research within one county to examine the early experiences of devolution in the health sector. We specifically focused on the experience of change from the perspective of sub-county managers, who form the link between county level managers and health facility managers. We collected data by observing a diverse range of management meetings, support supervision visits and outreach activities involving sub-county managers between May 2013 and June 2015, conducting informal interviews wherever we could. Informal observations and interviews were supplemented by fifteen tape recorded in depth interviews with purposively selected sub-county managers from three sub-counties. We found that sub county managers as with many other health system actors were anxious about and ill-prepared for the unexpectedly rapid devolution of health functions to the newly created county government. They experienced loss of autonomy and resources in addition to confused lines of accountability within the health system. However, they harnessed individual, team and stakeholder resources to maintain their jobs, and continued to play a central role in supporting peripheral facility managers to cope with change. Our study illustrates the importance in accelerated devolution contexts for: 1) mid-level managers to adopt new ways of working and engagement with higher and lower levels in the system; 2) clear lines of communication during reforms to these actors and 3) anticipating and managing the effect of change on intangible software issues such as trust and motivation. More broadly, we show the value of examining organisational change from the perspective of key actors within the system, and highlight the importance in times of rapid change of drawing upon and working with those already in the system. These actors have valuable tacit knowledge, but tapping into and building on this knowledge to enable positive response in times of health system shocks requires greater attention to sustained software capacity building within the health system.

Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

PubMed

Samuel, Cleo A; Turner, Kea; Donovan, Heidi A S; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-12-01

Adjuvant endocrine therapy (AET) utilization is linked to improved clinical outcomes among breast cancer survivors (BCS); yet, AET adherence rates remain suboptimal. Little is known about provider perspectives regarding barriers and facilitators to AET-related symptom management (SM). In this study, we examined provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. We conducted three focus groups (FGs) with a multidisciplinary group of healthcare providers (n = 13) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM. FGs were audiotaped, transcribed, and analyzed using qualitative software to identify key themes. Providers described patient-, provider-, and system-level barriers and facilitators to AET-related SM. At the patient-level, barriers included competing demands, limited time/resources, and possible misattribution of some symptoms to AET, while family/social relationships and insurance emerged as important facilitators. Discomfort with SM, limited time, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Provider-level facilitators included routine symptom documentation and strong provider relationships. Care fragmentation and complexity of the cancer care delivery system were described as system-level barriers; however, survivor clinics were endorsed by providers. Provider perspectives on AET-related SM can shed light on SM barriers and facilitators spanning multiple levels of the cancer care delivery system. Strategies for improving AET-related SM in BCS include increasing patients' knowledge and engagement in SM, equipping providers with efficient SM strategies, and improving coordination of symptom-related services through survivorship programs.

The private struggle of mothers with asthma: a gender perspective on illness management.

PubMed

van Mens-Verhulst, Janneke; Radtke, H Lorraine; Spence, Cheryl D

2004-07-01

Little attention has been paid to the specific problems of mothers with chronic illness. In this study of mothers with asthma, we asked the question: "how do they manage their illness"? We interviewed a purposive sample of four Dutch and four Canadian mothers living with asthma and varying in age and socio-economic class. Our analysis explored challenges the mothers face, three main strategies of non-medical illness management (prevention, normalization and mobilizing support), and the influence of age and class differences. Unhealthy cycles of living with asthma are identified and suggestions for mother-specific interventions are offered. By drawing attention to the gendered nature of chronic illness management and to patients' own experiences, a more useful frame of reference is created for professionals who do not have first hand knowledge of living with a chronic illness.

Customer quality and type 2 diabetes from the patients' perspective: a cross-sectional study.

PubMed

Tabrizi, Jafar S; Wilson, Andrew J; O'Rourke, Peter K

2010-12-18

Quality in health care can be seen as having three principal dimensions: service, technical and customer quality. This study aimed to measure Customer Quality in relation to self-management of Type 2 diabetes. A cross-sectional survey of 577 Type 2 diabetes people was carried out in Australia. The 13-item Patient Activation Measure was used to evaluate Customer Quality based on self-reported knowledge, skills and confidence in four stages of self-management. All statistical analyses were conducted using SPSS 13.0. All participants achieved scores at the level of stage 1, but ten percent did not achieve score levels consistent with stage 2 and a further 16% did not reach the actual action stage. Seventy-four percent reported capacity for taking action for self-management and 38% reported the highest Customer Quality score and ability to change the action by changing health and environment. Participants with a higher education attainment, better diabetes control status and those who maintain continuity of care reported a higher Customer Quality score, reflecting higher capacity for self-management. Specific capacity building programs for health care providers and people with Type 2 diabetes are needed to increase their knowledge and skills; and improve their confidence to self-management, to achieve improved quality of delivered care and better health outcomes.

Understanding what helps or hinders asthma action plan use: a systematic review and synthesis of the qualitative literature.

PubMed

Ring, Nicola; Jepson, Ruth; Hoskins, Gaylor; Wilson, Caroline; Pinnock, Hilary; Sheikh, Aziz; Wyke, Sally

2011-11-01

To understand better what helps and/or hinders asthma action plan use from the professionals and patients/carers perspective. Systematic review and qualitative synthesis (using meta-ethnography). Nineteen studies (20 papers) were included in an analysis of patients/carers' and professionals' views. Seven main influences on action plan implementation were identified including perceived un-helpfulness and irrelevance of the plans. Translation and synthesis of the original authors' interpretations suggested that action plan promotion and use was influenced by professional and patient/carers' asthma beliefs and attitudes and patient/carer experiences of managing asthma. Action plan use is hindered because professionals and patients/carers have different explanatory models of asthma, its management and their respective roles in the management process. Patients/carers, based on their experiential knowledge of their condition, perceive themselves as capable, effective in managing their asthma, but health professionals do not always share this view. Professionally provided medically focused action plans that do not 'fit' with and incorporate the patients'/carers' views of asthma, and their management strategies, will continue to be under-utilised. Professionals need to develop a more patient-centred, partnership-based, approach to the joint development and review of action plans, recognising the experiential asthma knowledge of patients/carers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Does the knowledge-to-action (KTA) framework facilitate physical demands analysis development for firefighter injury management and return-to-work planning?

PubMed

Sinden, Kathryn; MacDermid, Joy C

2014-03-01

Employers are tasked with developing injury management and return-to-work (RTW) programs in response to occupational health and safety policies. Physical demands analyses (PDAs) are the cornerstone of injury management and RTW development. Synthesizing and contextualizing policy knowledge for use in occupational program development, including PDAs, is challenging due to multiple stakeholder involvement. Few studies have used a knowledge translation theoretical framework to facilitate policy-based interventions in occupational contexts. The primary aim of this case study was to identify how constructs of the knowledge-to-action (KTA) framework were reflected in employer stakeholder-researcher collaborations during development of a firefighter PDA. Four stakeholder meetings were conducted with employee participants who had experience using PDAs in their occupational role. Directed content analysis informed analyses of meeting minutes, stakeholder views and personal reflections recorded throughout the case. Existing knowledge sources including local data, stakeholder experiences, policies and priorities were synthesized and tailored to develop a PDA in response to the barriers and facilitators identified by the firefighters. The flexibility of the KTA framework and synthesis of multiple knowledge sources were identified strengths. The KTA Action cycle was useful in directing the overall process but insufficient for directing the specific aspects of PDA development. Integration of specific PDA guidelines into the process provided explicit direction on best practices in tailoring the PDA and knowledge synthesis. Although the themes of the KTA framework were confirmed in our analysis, order modification of the KTA components was required. Despite a complex context with divergent perspectives successful implementation of a draft PDA was achieved. The KTA framework facilitated knowledge synthesis and PDA development but specific standards and modifications to the KTA framework were needed to enhance process structure. Flexibility for modification and integration of PDA practice guidelines were identified as assets of the KTA framework during its application.

Using Action Research and Peer Perspectives to Develop Technology That Facilitates Behavioral Change and Self-Management in COPD

PubMed Central

McCabe, Catherine; Dinsmore, John; Brady, Anne Marie; Mckee, Gabrielle; O'Donnell, Sharon; Prendergast, David

2014-01-01

Background. Behavioural change and self-management in patients with chronic illness may help to control symptoms, avoid rehospitalization, enhance quality of life, and decrease mortality and morbidity. Objective. Guided by action research principles and using mixed methods, the aim of this project was to develop peer based educational, motivational, and health-promoting peer based videos, using behavioural change principles, to support self-management in patients with COPD. Methods. Individuals (n = 32) living with COPD at home and involved in two community based COPD support groups were invited to participate in this project. Focus group/individual interviews and a demographic questionnaire were used to collect data. Results. Analysis revealed 6 categories relevant to behavioural change which included self-management, support, symptoms, knowledge, rehabilitation, and technology. Participants commented that content needed to be specific, and videos needed to be shorter, to be tailored to severity of condition, to demonstrate “normal” activities, to be positive, and to ensure that content is culturally relevant. Conclusions. This study demonstrated that detailed analysis of patient perspectives and needs for self-management is essential and should underpin the development of any framework, materials, and technology. The action research design principles provided an effective framework for eliciting the data and applying it to technology and testing its relevance to the user. PMID:24959177

Improving support for heart failure patients: a systematic review to understand patients' perspectives on self-care.

PubMed

Spaling, Melisa A; Currie, Kay; Strachan, Patricia H; Harkness, Karen; Clark, Alexander M

2015-11-01

This systematic review aimed to generate patient-focussed recommendations to enhance support of heart failure self-care by examining patients' experiences, perspectives and self-care behaviours. Despite increased recognition of the importance of heart failure self-care, patients' knowledge and practices around this self-care and interventions to improve it are inconsistent. Consequently, current guidelines focus on what the domains of heart failure self-care are, more so than the ways to improve this care. Systematic review and qualitative interpretive synthesis. A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995-2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals) that contained a qualitative research component and data on adult patients' heart failure self-care. This interpretive synthesis used a recognized approach consisting of a multi-stage analytic process; in addition, the included studies underwent quality appraisal. Findings indicate that while patients could often recall health professionals' self-care advice, they were unable to integrate this knowledge into daily life. Attempts to manage HF were based on how patients 'felt' rather than clinical indicators of worsening symptoms. Self-efficacy and learning from past management experiences facilitated favourable outcomes - these enabled patients and caregivers to adeptly apply self-care strategies into daily activities. Addressing common but basic knowledge misconceptions regarding the domains of HF self-care is insufficient to increase effective HF self-care; this should be supplemented with strategies with patients and family members to promote self-efficacy, learning and adaptation/application of recommendations to daily life. © 2015 John Wiley & Sons Ltd.

Perspectives of Frailty and Frailty Screening: Protocol for a Collaborative Knowledge Translation Approach and Qualitative Study of Stakeholder Understandings and Experiences.

PubMed

Archibald, Mandy M; Ambagtsheer, Rachel; Beilby, Justin; Chehade, Mellick J; Gill, Tiffany K; Visvanathan, Renuka; Kitson, Alison L

2017-04-17

Accompanying the unprecedented growth in the older adult population worldwide is an increase in the prevalence of frailty, an age-related clinical state of increased vulnerability to stressor events. This increased vulnerability results in lower social engagement and quality of life, increased dependency, and higher rates of morbidity, health service utilization and mortality. Early identification of frailty is necessary to guide implementation of interventions to prevent associated functional decline. Consensus is lacking on how to clinically recognize and manage frailty. It is unknown how healthcare providers and healthcare consumers understand and perceive frailty, whether or not they regard frailty as a public health concern; and information on the indirect and direct experiences of consumer and healthcare provider groups towards frailty are markedly limited. We will conduct a qualitative study of consumer, practice nurse, general practitioner, emergency department physician, and orthopedic surgeons' perspectives of frailty and frailty screening in metropolitan and non-metropolitan South Australia. We will use tailored combinations of semi-structured interviews and arts-based data collection methods depending on each stakeholder group, followed by inductive and iterative analysis of data using qualitative description. Using stakeholder driven approaches to understanding and addressing frailty and frailty screening in context is critical as the prevalence and burden of frailty is likely to increase worldwide. We will use the findings from the Perceptions of Frailty and Frailty Screening study to inform a context-driven identification, implementation and evaluation of a frailty-screening tool; drive awareness, knowledge, and skills development strategies across stakeholder groups; and guide future efforts to embed emerging knowledge about frailty and its management across diverse South Australian contexts using a collaborative knowledge translation approach. Study findings will help achieve a coordinated frailty and healthy ageing strategy with relevance to other jurisdictions in Australia and abroad, and application of the stakeholder driven approach will help illuminate how its applicability to other jurisdictions.

Collaboration Across Worldviews: Managers and Scientists on Hawai'i Island Utilize Knowledge Coproduction to Facilitate Climate Change Adaptation.

PubMed

Laursen, Scott; Puniwai, Noelani; Genz, Ayesha S; Nash, Sarah A B; Canale, Lisa K; Ziegler-Chong, Sharon

2018-05-30

Complex socio-ecological issues, such as climate change have historically been addressed through technical problem solving methods. Yet today, climate science approaches are increasingly accounting for the roles of diverse social perceptions, experiences, cultural norms, and worldviews. In support of this shift, we developed a research program on Hawai'i Island that utilizes knowledge coproduction to integrate the diverse worldviews of natural and cultural resource managers, policy professionals, and researchers within actionable science products. Through their work, local field managers regularly experience discrete land and waterscapes. Additionally, in highly interconnected rural communities, such as Hawai'i Island, managers often participate in the social norms and values of communities that utilize these ecosystems. Such local manager networks offer powerful frameworks within which to co-develop and implement actionable science. We interviewed a diverse set of local managers with the aim of incorporating their perspectives into the development of a collaborative climate change research agenda that builds upon existing professional networks utilized by managers and scientists while developing new research products. We report our manager needs assessment, the development process of our climate change program, our interactive forums, and our ongoing research products. Our needs assessment showed that the managers' primary source of information were other professional colleagues, and our in-person forums informed us that local managers are very interested in interacting with a wider range of networks to build upon their management capacities. Our initial programmatic progress suggests that co-created research products and in-person forums strengthen the capacities of local managers to adapt to change.

An Evaluation of the Implementation of Maternal Obesity Pathways of Care: A Mixed Methods Study with Data Integration

PubMed Central

Heslehurst, Nicola; Dinsdale, Sarah; Sedgewick, Gillian; Simpson, Helen; Sen, Seema; Summerbell, Carolyn Dawn; Rankin, Judith

2015-01-01

Objectives Maternal obesity has multiple associated risks and requires substantial intervention. This research evaluated the implementation of maternal obesity care pathways from multiple stakeholder perspectives. Study Design A simultaneous mixed methods model with data integration was used. Three component studies were given equal priority. 1: Semi-structured qualitative interviews explored obese pregnant women’s experiences of being on the pathways. 2: A quantitative and qualitative postal survey explored healthcare professionals’ experiences of delivering the pathways. 3: A case note audit quantitatively assessed pathway compliance. Data were integrated using following a thread and convergence coding matrix methods to search for agreement and disagreement between studies. Results Study 1: Four themes were identified: women’s overall (positive and negative) views of the pathways; knowledge and understanding of the pathways; views on clinical and weight management advice and support; and views on the information leaflet. Key results included positive views of receiving additional clinical care, negative experiences of risk communication, and weight management support was considered a priority. Study 2: Healthcare professionals felt the pathways were worthwhile, facilitated good practice, and increased confidence. Training was consistently identified as being required. Healthcare professionals predominantly focussed on women’s response to sensitive obesity communication. Study 3: There was good compliance with antenatal clinical interventions. However, there was poor compliance with public health and postnatal interventions. There were some strong areas of agreement between component studies which can inform future development of the pathways. However, disagreement between studies included a lack of shared priorities between healthcare professionals and women, different perspectives on communication issues, and different perspectives on women’s prioritisation of weight management. Conclusion The differences between healthcare professionals’ and women’s priorities and perspectives are important factors to consider when developing care pathways. Shared perspectives could help facilitate more effective implementation of the pathway interventions that have poor compliance. PMID:26018338

A transdisciplinary account of water research

PubMed Central

Maynard, Carly; Carr, Gemma; Bruns, Antje; Mueller, Eva Nora; Lane, Stuart

2016-01-01

Water research is introduced from the combined perspectives of natural and social science and cases of citizen and stakeholder coproduction of knowledge. Using the overarching notion of transdisciplinarity, we examine how interdisciplinary and participatory water research has taken place and could be developed further. It becomes apparent that water knowledge is produced widely within society, across certified disciplinary experts and noncertified expert stakeholders and citizens. However, understanding and management interventions may remain partial, or even conflicting, as much research across and between traditional disciplines has failed to integrate disciplinary paradigms due to philosophical, methodological, and communication barriers. We argue for more agonistic relationships that challenge both certified and noncertified knowledge productively. These should include examination of how water research itself embeds and is embedded in social context and performs political work. While case studies of the cultural and political economy of water knowledge exist, we need more empirical evidence on how exactly culture, politics, and economics have shaped this knowledge and how and at what junctures this could have turned out differently. We may thus channel the coproductionist critique productively to bring perspectives, alternative knowledges, and implications into water politics where they were not previously considered; in an attempt to counter potential lock‐in to particular water policies and technologies that may be inequitable, unsustainable, or unacceptable. While engaging explicitly with politics, transdisciplinary water research should remain attentive to closing down moments in the research process, such as framings, path‐dependencies, vested interests, researchers’ positionalities, power, and scale. WIREs Water 2016, 3:369–389. doi: 10.1002/wat2.1132 For further resources related to this article, please visit the WIREs website. PMID:27656284

Heboidophrenia and Pseudo-Psychopathic Schizophrenia: Current Knowledge and Critical Perspective.

PubMed

De Page, Louis; Englebert, Jérôme

2018-06-26

In this article, based on literature review, we present an integrated description of heboidophrenia and pseudo-psychopathic schizophrenia. Both diagnostic constructs describe latent psychotic processes inextricably bound with psychopathic features. Although both have been described in different eras and research threads, they are that similar that we could not find divergences. We formulated operational criteria for clinical and research purpose. The recognition of this syndrome improves risk management, treatment, and legal decisions. © 2018 S. Karger AG, Basel.

Vascular trauma: selected historical reflections from the western world.

PubMed

Rich, Norman-M; McKay, Patricia-L; Welling, David-R; Rasmussen, Todd-E

2011-04-01

In the spirit of international exchanges of knowledge with colleagues from all over the world, who are interested in the care and treatment of vascular trauma, we offer selected historical reflections from the western world on vascular trauma. Whereas there are a number of key individuals and a variety of events that are important to us in our writing, we know essentially nothing about what is written by other cultures and, particularly, the Chinese. It is well recognized around the world that Chinese surgeons are among the first to be highly successful in re-plantation of severed extremities, repairing both injured arteries and veins. Also, we recognize that there are contributions in other parts of the world, which are not well known to us collectively. Contributions from the Arabic speaking part of the world come to mind because there is periodic brief reference. We offer our perspective hoping that there will be one or more Chinese surgeons who will offer us the benefit of sharing their perspective on important historical contributions to the managing of vascular trauma outside of the western world, and, particularly, the English speaking literature. Once again, we encourage our colleagues in the Arabic speaking world to provide us with their perspective of the development and management of vascular trauma.

Plant Functional Traits: Soil and Ecosystem Services.

PubMed

Faucon, Michel-Pierre; Houben, David; Lambers, Hans

2017-05-01

Decline of ecosystem services has triggered numerous studies aiming at developing more sustainable agricultural management practices. Some agricultural practices may improve soil properties by expanding plant biodiversity. However, sustainable management of agroecosystems should be performed from a functional plant trait perspective. Advances in functional ecology, especially plant functional trait effects on ecosystem processes and services, provide pivotal knowledge for ecological intensification of agriculture; this approach acknowledges that a crop field is an agroecosystem whose ecological processes influence soil properties. We highlight the links between plant functional traits and soil properties in relation to four major ecosystem processes involved in vital ecosystem services: food production, crop protection, climate change mitigation, and soil and water conservation, aiming towards ecological intensification of sustainable agricultural and soil management. Copyright © 2017 Elsevier Ltd. All rights reserved.

[The hospital perspective: disease management and integrated health care].

PubMed

Schrappe, Matthias

2003-06-01

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

Spatio-structural granularity of biological material entities

PubMed Central

2010-01-01

Background With the continuously increasing demands on knowledge- and data-management that databases have to meet, ontologies and the theories of granularity they use become more and more important. Unfortunately, currently used theories and schemes of granularity unnecessarily limit the performance of ontologies due to two shortcomings: (i) they do not allow the integration of multiple granularity perspectives into one granularity framework; (ii) they are not applicable to cumulative-constitutively organized material entities, which cover most of the biomedical material entities. Results The above mentioned shortcomings are responsible for the major inconsistencies in currently used spatio-structural granularity schemes. By using the Basic Formal Ontology (BFO) as a top-level ontology and Keet's general theory of granularity, a granularity framework is presented that is applicable to cumulative-constitutively organized material entities. It provides a scheme for granulating complex material entities into their constitutive and regional parts by integrating various compositional and spatial granularity perspectives. Within a scale dependent resolution perspective, it even allows distinguishing different types of representations of the same material entity. Within other scale dependent perspectives, which are based on specific types of measurements (e.g. weight, volume, etc.), the possibility of organizing instances of material entities independent of their parthood relations and only according to increasing measures is provided as well. All granularity perspectives are connected to one another through overcrossing granularity levels, together forming an integrated whole that uses the compositional object perspective as an integrating backbone. This granularity framework allows to consistently assign structural granularity values to all different types of material entities. Conclusions The here presented framework provides a spatio-structural granularity framework for all domain reference ontologies that model cumulative-constitutively organized material entities. With its multi-perspectives approach it allows querying an ontology stored in a database at one's own desired different levels of detail: The contents of a database can be organized according to diverse granularity perspectives, which in their turn provide different views on its content (i.e. data, knowledge), each organized into different levels of detail. PMID:20509878

Integrating Disciplines, Sectors, and Societies to Improve the Definition and Implementation of Environmental Flows for Dammed Amazonian Rivers

NASA Astrophysics Data System (ADS)

Kaplan, D. A.; Livino, A.; Arias, M. E.; Crouch, T. D.; Anderson, E.; Marques, E.; Dutka-Gianelli, J.

2017-12-01

The Amazon River watershed is the world's largest river basin and provides US$30 billion/yr in ecosystem services to local populations, national societies, and humanity at large. The Amazon is also a relatively untapped source of hydroelectricity for Latin America, and construction of >30 large hydroelectric dams and >170 small dams is currently underway. Hydropower development will have a cascade of physical, ecological, and social effects at local to global scales. While Brazil has well-defined environmental impact assessment and mitigation programs, these efforts often fail to integrate data and knowledge across disciplines, sectors, and societies throughout the dam planning process. Resulting failures of science, policy, and management have had widespread environmental, economic, and social consequences, highlighting the need for an improved theoretical and practical framework for understanding the impacts of Amazon dams and guiding improved management that respects the needs and knowledge of diverse set of stakeholders. We present a conceptual framework that links four central goals: 1) connecting research in different disciplines (interdisciplinarity); 2) incorporating new knowledge into decision making (adaptive management); 3) including perspectives and participation of non-academic participants in knowledge generation (transdisciplinarity); and 4) extending the idea of environmental flows ("how much water does a river need?") to better consider human uses and users through the concept of fluvial anthropology ("how much water does a society need?"). We use this framework to identify opportunities for improved integration strategies within the (Brazilian) hydroelectric power plant planning and implementation "lifecycle." We applied this approach to the contentious Belo Monte dam, where compliance with regulatory requirements, including monitoring for environmental flows, exemplifies the opportunity for applying adaptive management, but also highlights an urgent need for much improved communication with and participation of affected communities.

[The dimension of the paradigm of complexity in health systems].

PubMed

Fajardo-Ortiz, Guillermo; Fernández-Ortega, Miguel Ángel; Ortiz-Montalvo, Armando; Olivares-Santos, Roberto Antonio

2015-01-01

This article presents elements to better understand health systems from the complety paradigm, innovative perspective that offers other ways in the conception of the scientific knowledge prevalent away from linear, characterized by the arise of emerging dissociative and behaviors, based on the intra and trans-disciplinarity concepts such knowledges explain and understand in a different way what happens in the health systems with a view to efficiency and effectiveness. The complexity paradigm means another way of conceptualizing the knowledge, is different from the prevalent epistemology, is still under construction does not separate, not isolated, is not reductionist, or fixed, does not solve the problems, but gives other bases to know them and study them, is a different strategy, a perspective that has basis in the systems theory, informatics and cybernetics beyond traditional knowledge, the positive logics, the newtonian physics and symmetric mathematics, in which everything is centered and balanced, joint the "soft sciences and hard sciences", it has present the Social Determinants of Health and organizational culture. Under the complexity paradigm the health systems are identified with the following concepts: entropy, neguentropy, the thermodynamic second law, attractors, chaos theory, fractals, selfmanagement and self-organization, emerging behaviors, percolation, uncertainty, networks and robusteness; such expressions open new possibilities to improve the management and better understanding of the health systems, giving rise to consider health systems as complex adaptive systems. Copyright © 2015. Published by Masson Doyma México S.A.

Patent foramen ovale and paradoxical embolization: a historical perspective.

PubMed

Lippmann, H; Rafferty, T

1993-01-01

The use of transesophageal echocardiography for intraoperative management of critically ill patients allows for routine evaluation of foramen ovale patency. The high prevalence of preoperatively unrecognized flow-patency of this structure has led investigators to emphasize the potential for paradoxical embolization in any patient undergoing anesthesia. This perspective led us to research earliest documentation of paradoxical embolization through a patent foramen ovale as a historical issue with present day relevance. This report examines the 1877 text of Julius Cohnheim in which he described a fatal case of paradoxical embolization to the middle meningeal artery. The 1880 manuscript of Moritz Litten documenting paradoxical embolization to the lower extremity is also presented. Both translations, to our knowledge, represent the first such representations of both the original 1877 edition of Cohnheim's work and Litten's journal article.

Changes in leadership styles as a function of a four-day leadership training institute for nurse managers: a perspective on continuing education program evaluation.

PubMed

Wolf, M S

1996-01-01

This study measured changes in knowledge acquisition and application of the Hersey and Blanchard model of leadership styles and leadership style adaptability among 144 registered nurses who participated in a four-day management institute. A pre- and post-institute administration of the LEAD-Self instrument was conducted. Although the findings demonstrated a significant change in the participants' leadership styles, the data revealed that outcomes were not as positive as had been assumed based on participants' self-reports. The discussion of findings reveals the complexity and the necessity of measuring learning outcomes for continuing education program improvement.

Sustainable development and next generation's health: a long-term perspective about the consequences of today's activities for food safety.

PubMed

Frazzoli, Chiara; Petrini, Carlo; Mantovani, Alberto

2009-01-01

Development is defined sustainable when it meets the needs of the present without compromising the ability of future generations to meet their own needs. Pivoting on social, environmental and economic aspects of food chain sustainability, this paper presents the concept of sustainable food safety based on the prevention of risks and burden of poor health for generations to come. Under this respect, the assessment of long-term, transgenerational risks is still hampered by serious scientific uncertainties. Critical issues to the development of a sustainable food safety framework may include: endocrine disrupters as emerging contaminants that specifically target developing organisms; toxicological risks assessment in Countries at the turning point of development; translating knowledge into toxicity indexes to support risk management approaches, such as hazard analysis and critical control points (HACCP); the interplay between chemical hazards and social determinants. Efforts towards the comprehensive knowledge and management of key factors of sustainable food safety appear critical to the effectiveness of the overall sustainability policies.

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

Conceptualising Knowledge for Access in the Sciences: Academic Development from a Social Realist Perspective

ERIC Educational Resources Information Center

Ellery, Karen

2017-01-01

Whilst arguing from a social realist perspective that knowledge matters in academic development (AD) curricula, this paper addresses the question of what knowledge types and practices are necessary for enabling epistemological access. It presents a single, in-depth, qualitative case study in which the curriculum of a science AD course is…

Toward Understanding, Managing, and Protecting Microbial Ecosystems

PubMed Central

Bodelier, Paul L. E.

2011-01-01

Microbial communities are at the very basis of life on earth, catalyzing biogeochemical reactions driving global nutrient cycles. However, unlike for plants and animals, microbial diversity is not on the biodiversity–conservation agenda. The latter, however, would imply that microbial diversity is not under any threat by anthropogenic disturbance or climate change. This maybe a misconception caused by the rudimentary knowledge we have concerning microbial diversity and its role in ecosystem functioning. This perspective paper identifies major areas with knowledge gaps within the field of environmental microbiology that preclude a comprehension of microbial ecosystems on the level we have for plants and animals. Opportunities and challenges are pointed out to open the microbial black box and to go from descriptive to predictive microbial ecology. PMID:21747797

Science education in an urban elementary school: Case studies of teacher beliefs and classroom practices

NASA Astrophysics Data System (ADS)

King, Ken; Shumow, Lee; Lietz, Stephanie

2001-03-01

Through a case study approach, the state of science education in an urban elementary school was examined in detail. Observations made from the perspective of a science education specialist, an educational psychologist, and an expert elementary teacher were triangulated to provide a set of perspectives from which elementary science instruction could be examined. Findings revealed that teachers were more poorly prepared than had been anticipated, both in terms of science content knowledge and instructional skills, but also with respect to the quality of classroom pedagogical and management skills. Particularly significant, from a science education perspective, was the inconsistency between how they perceived their teaching practice (a hands-on, inquiry-based approach) and the investigator-observed expository nature of the lessons. Lessons were typically expository in nature, with little higher-level interaction of significance. Implications for practice and the associated needs for staff development among urban elementary teachers is discussed within the context of these findings.

A practitioner's perspective on the application and research needs of membrane bioreactors for municipal wastewater treatment.

PubMed

Kraemer, Jeremy T; Menniti, Adrienne L; Erdal, Zeynep K; Constantine, Timothy A; Johnson, Bruce R; Daigger, Glen T; Crawford, George V

2012-10-01

The application of membrane bioreactors (MBRs) for municipal wastewater treatment has increased dramatically over the last decade. From a practitioner's perspective, design practice has evolved over five "generations" in the areas of biological process optimization, separating process design from equipment supply, and reliability/redundancy thereby facilitating "large" MBRs (e.g. 150,000 m(3)/day). MBR advantages and disadvantages, and process design to accommodate biological nutrient removal, high mixed liquor suspended solids concentrations, operation and maintenance, peak flows, and procurement are reviewed from the design practitioner's perspective. Finally, four knowledge areas are identified as important to practitioners meriting further research and development: (i) membrane design and performance such as improving peak flow characteristics and decreasing operating costs; (ii) process design and performance such as managing the fluid properties of the biological solids, disinfection, and microcontaminant removal; (iii) facility design such as equipment standardization and decreasing mechanical complexity; and (iv) sustainability such as anaerobic MBRs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Contemporary disease management in Quebec.

PubMed

Gogovor, Amédé; Savoie, Michelle; Moride, Yola; Krelenbaum, Marilyn; Montague, Terrence

2008-01-01

Health or disease management (DM) has emerged as a promising solution to improve the quality of healthcare and patient outcomes in a cost-efficient way. This solution is particularly relevant in the care of our increasing, and aging, patient populations with multiple chronic diseases. This article reviews the recent history and current status of DM in the province of Quebec and summarizes its evolving perspectives and future prospects. Most DM projects in Quebec have developed from a public-private partnership, and they have addressed several disease states. The results of completed programs confirmed the presence of care gaps--the differences between best and usual care in several disease states. They also identified process changes leading to improved practices and enhanced professional satisfaction among stakeholders. Priorities identified for further research include increased knowledge of the underlying causes of care gaps and greater concentration on the measurement of clinical, humanistic and fiscal outcomes and their causal links to DM structures and processes. Although still embryonic in Quebec and Canada, the available evidence suggests that DM partnerships are practical and functional vehicles to expedite knowledge creation and transfer in the care of whole populations of patients. Future projects offer the promise of updated knowledge and continuously improved care and outcomes.

Disease surveillance and private sector in the metropolitans: a troublesome collaboration.

PubMed

Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

2013-09-01

An effective response to health problems is completely dependent upon the capacities of the health system in providing timely and valid information to take action. This study was designed to identify various reasons from various perspectives for underreporting disease by physicians in the private sector in big cities in developing countries setting. In this qualitative study, we used focus group discussions (16 manager), and in-depth semi-structured interviews. Themes were classified in 6 categories: Infrastructure and legal issues, the priority of disease reporting, workflow processes, motivation and attitude, human resources and knowledge and awareness. As the main reasons of under reporting, most physicians pointed out complicacy in reporting process and inadequate attention by the public sector. Managers emphasized instituting legal incentives and penalties. Experts focused on physicians' knowledge and expressed a need for continuing medical education programs. Independent interventions will have little chance of success and sustainability. Different intervention programs should consider legal issues, attitude and knowledge of physicians in the private sector, and building a simple reporting process for physicians. Intervention programs in which the reporting process offers incentives for all stakeholders can help improving and sustaining the disease reporting system.

Disease Surveillance and Private Sector in the Metropolitans: A Troublesome Collaboration

PubMed Central

Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

2013-01-01

Background: An effective response to health problems is completely dependent upon the capacities of the health system in providing timely and valid information to take action. This study was designed to identify various reasons from various perspectives for underreporting disease by physicians in the private sector in big cities in developing countries setting. Methods: In this qualitative study, we used focus group discussions (16 manager), and in-depth semi-structured interviews Results: Themes were classified in 6 categories: Infrastructure and legal issues, the priority of disease reporting, workflow processes, motivation and attitude, human resources and knowledge and awareness. As the main reasons of under reporting, most physicians pointed out complicacy in reporting process and inadequate attention by the public sector. Managers emphasized instituting legal incentives and penalties. Experts focused on physicians’ knowledge and expressed a need for continuing medical education programs. Conclusions: Independent interventions will have little chance of success and sustainability. Different intervention programs should consider legal issues, attitude and knowledge of physicians in the private sector, and building a simple reporting process for physicians. Intervention programs in which the reporting process offers incentives for all stakeholders can help improving and sustaining the disease reporting system. PMID:24130945

Development of an expert system for assessing trumpeter swan breeding habitat in the Northern Rocky Mountains.

USGS Publications Warehouse

Sojda, Richard S.; Cornely, John E.; Howe, Adele E.

2002-01-01

A decision support system for the management of the Rocky Mountain Population of Trumpeter Swans (Cygnus buccinators) is being developed. As part of this, three expert systems are also in development: one for assessing the quality of Trumpeter Swan breeding habitat; one for making water level recommendations in montane, palustrine wetlands; and one for assessing the contribution a particular site can make towards meeting objectives from as flyway perspective. The focus of this paper is the development of the breeding habitat expert system, which currently consists of 157 rules. Out purpose is to provide decision support for issues that appear to be beyond the capability of a single persons to conceptualize and solve. We propose that by involving multiple experts in the development and use of the systems, management will be significantly improved. The knowledge base for the expert system has been developed using standard knowledge engineering techniques with a small team of ecological experts. Knowledge was then coded using production rules organized in decision trees using a commercial expert system development shell. The final system has been deployed on the world wide web.

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program.

PubMed

Kristensen, Erling; Enevoldsen, Carsten

2008-12-18

Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers' goals among veterinarians. The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers' expectations. On the other hand veterinarians did not focus enough on the major products, which farmers really wanted to buy, i.e. teamwork and animal welfare. Consequently, disciplines like sociology, economics and marketing may offer new methodological approaches to veterinarians as these disciplines have understood that accounting for individual differences is central to motivate change, i.e. 'know thy customer'.

Rethinking Soils: an under-investigated commons?

NASA Astrophysics Data System (ADS)

Short, Chrisopher; Mills, Jane; Ingram, Julie

2015-04-01

In a number of global contexts there is a re-awakening of interest in soils in both increasing the resilience of complex social-ecological systems (SES) and as a result of the threats to them, as shown by the UN International Year of Soils in 2015. Consequently the management of soils and their wider role within property regimes and natural resource management might need to be reassessed. At the heart of this is the rise in awareness regarding the connectedness of SES, and in frameworks such as the Ecosystem Approach and the identification and analysis of Ecosystem Services. Whilst not new to some, it has widened the understanding among many, that soils have a valuable role to play in complex SES because they are a slow variable crucial to underlying structure of the SES. The conventional approach that soils are linked to the ecosystem services category of provisioning services (production of food, timber and fibre) remains valid. Not surprisingly this link is strong within natural resource management and property rights regimes but soils remain at risk for a range of threats, for example soil erosion and compaction, salinization, sealing, desertification, loss of organic matter and biodiversity and contamination. However, soils are increasingly seen as a slow variable that can lead to increased resilience within a SES and have a profound importance to human life through a range of regulating services including water quality and purification, water flow and attenuation and , pest and disease control. Given the long-standing importance of soil as a natural resource there are also accompanying legal systems, property regimes, societal values, knowledge, custom and traditions. However, in the light of the wider understanding soil functions are these social frameworks appropriate and fit for purpose or would a shared resource of commons approach be more appropriate. To some extent this examination would also extend to the presence of soils within the cultural services category of ecosystem services. As a result of the increasing evidence regarding soil threats, there is concern that the knowledge relating to soils is fragmented and incomplete. This is particular true regarding the complexity and functioning of soil systems and their interaction with human activities and the effectiveness of governance arrangements to promote resilience in the management of soils. Therefore discussions concerning soils needs to be taken from an interdisciplinary perspectives that embraces both natural and social sciences. This paper will seek to examine soils from a multi-scale governance/complex commons perspective. It will also consider how a commons perspective might be useful in reducing soil threats and in the development of effective prevention, remediation and restoration measures. This often requires a change in thinking about soil, perhaps considering it as a 'slow variable', able to drive long-term change or as a 'cultural asset' and 'knowledge resource'.

Cross-domain Collaborative Research and People Interoperability: Beyond Knowledge Representation Frameworks

NASA Astrophysics Data System (ADS)

Fox, P. A.; Diviacco, P.; Busato, A.

2016-12-01

Geo-scientific research collaboration commonly faces of complex systems where multiple skills and competences are needed at the same time. Efficacy of such collaboration among researchers then becomes of paramount importance. Multidisciplinary studies draw from domains that are far from each other. Researchers also need to understand: how to extract what data they need and eventually produce something that can be used by others. The management of information and knowledge in this perspective is non-trivial. Interoperability is frequently sought in computer-to-computer environements, so-as to overcome mismatches in vocabulary, data formats, coordinate reference system and so on. Successful researcher collaboration also relies on interoperability of the people! Smaller, synchronous and face-to-face settings for researchers are knownn to enhance people interoperability. However changing settings; either geographically; temporally; or with increasing the team size, diversity, and expertise requires people-computer-people-computer (...) interoperability. To date, knowledge representation framework have been proposed but not proven as necessary and sufficient to achieve multi-way interoperability. In this contribution, we address epistemology and sociology of science advocating for a fluid perspective where science is mostly a social construct, conditioned by cognitive issues; especially cognitive bias. Bias cannot be obliterated. On the contrary it must be carefully taken into consideration. Information-centric interfaces built from different perspectives and ways of thinking by actors with different point of views, approaches and aims, are proposed as a means for enhancing people interoperability in computer-based settings. The contribution will provide details on the approach of augmenting and interfacing to knowledge representation frameworks to the cognitive-conceptual frameworks for people that are needed to meet and exceed collaborative research goals in the 21st century. A web based collaborative portal has been developed that integrates both approaches and will be presented. Reports will be given on initial tests that have encouraging results.

Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community: a mixed studies review.

PubMed

Aston, Lydia; Hilton, Andrea; Moutela, Tiago; Shaw, Rachel; Maidment, Ian

2017-10-18

Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.

A conceptual framework for understanding the perspectives on the causes of the science-practice gap in ecology and conservation.

PubMed

Bertuol-Garcia, Diana; Morsello, Carla; N El-Hani, Charbel; Pardini, Renata

2018-05-01

Applying scientific knowledge to confront societal challenges is a difficult task, an issue known as the science-practice gap. In Ecology and Conservation, scientific evidence has been seldom used directly to support decision-making, despite calls for an increasing role of ecological science in developing solutions for a sustainable future. To date, multiple causes of the science-practice gap and diverse approaches to link science and practice in Ecology and Conservation have been proposed. To foster a transparent debate and broaden our understanding of the difficulties of using scientific knowledge, we reviewed the perceived causes of the science-practice gap, aiming to: (i) identify the perspectives of ecologists and conservation scientists on this problem, (ii) evaluate the predominance of these perspectives over time and across journals, and (iii) assess them in light of disciplines studying the role of science in decision-making. We based our review on 1563 sentences describing causes of the science-practice gap extracted from 122 articles and on discussions with eight scientists on how to classify these sentences. The resulting process-based framework describes three distinct perspectives on the relevant processes, knowledge and actors in the science-practice interface. The most common perspective assumes only scientific knowledge should support practice, perceiving a one-way knowledge flow from science to practice and recognizing flaws in knowledge generation, communication, and/or use. The second assumes that both scientists and decision-makers should contribute to support practice, perceiving a two-way knowledge flow between science and practice through joint knowledge-production/integration processes, which, for several reasons, are perceived to occur infrequently. The last perspective was very rare, and assumes scientists should put their results into practice, but they rarely do. Some causes (e.g. cultural differences between scientists and decision-makers) are shared with other disciplines, while others seem specific to Ecology and Conservation (e.g. inadequate research scales). All identified causes require one of three general types of solutions, depending on whether the causal factor can (e.g. inadequate research questions) or cannot (e.g. scientific uncertainty) be changed, or if misconceptions (e.g. undervaluing abstract knowledge) should be solved. The unchanged predominance of the one-way perspective over time may be associated with the prestige of evidence-based conservation and suggests that debates in Ecology and Conservation lag behind trends in other disciplines towards bidirectional views ascribing larger roles to decision-makers. In turn, the two-way perspective seems primarily restricted to research traditions historically isolated from mainstream conservation biology. All perspectives represented superficial views of decision-making by not accounting for limits to human rationality, complexity of decision-making contexts, fuzzy science-practice boundaries, ambiguity brought about by science, and different types of knowledge use. However, joint knowledge-production processes from the two-way perspective can potentially allow for democratic decision-making processes, explicit discussions of values and multiple types of science use. To broaden our understanding of the interface and foster productive science-practice linkages, we argue for dialogue among different research traditions within Ecology and Conservation, joint knowledge-production processes between scientists and decision-makers and interdisciplinarity across Ecology, Conservation and Political Science in both research and education. © 2017 Cambridge Philosophical Society.

Evaluating a national science and technology program using the human capital and relational asset perspectives.

PubMed

Hung, Chia-Liang; Chou, Jerome Chih-Lung; Roan, Hung-Wei

2010-11-01

The purpose of this research is to evaluate the performance of the National Science and Technology Program (NSTP) by targeting the Taiwan National Telecommunication Program (NTP) initiated in 1998. The Taiwan telecommunications industry has prospered, currently occupying key positions in global markets even though NTP seldom contributes positively to patent citation performance. Hence, the authors of this study investigate the qualitative perspective of intellectual capital rather than quantitative technological indices. The current study focuses on both human capital and relational assets through surveys of 53 principal investigators of NTP projects and 63 industrial R&D managers of telecommunications corporations in the Taiwan market. Results show that NSTP member quality and the flow of employment are good indicators of human capital and that both perform better than the middle value in the case of Taiwan NTP. In addition, we find that industrial participants are more likely to share R&D resources than other academic researchers with higher intention of co-publishing, co-funding, and sharing equipment and facilities. The industrial NTP participants also have higher expectations regarding achieving advanced technology breakthroughs in contrast to non-NTP industrial interviewees. Moreover, industrial participants with greater industry-university cooperation intensity indeed obtain a particular advantage, that is, greater knowledge acquisition from other fields related to the effect of knowledge spillovers through the particular NSTP linkage. Accordingly, from the perspectives of human capital and relational assets, the authors conclude by articulating the importance of absorptive capacity resulting from good human capital and knowledge spillover contributed by relational assets within governmental technology policy and NSTP programming. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Engaging plant anatomy and local knowledge on the buriti palm ( Mauritia flexuosa L.f.: Arecaceae): the microscopic world meets the golden grass artisan's perspective

NASA Astrophysics Data System (ADS)

Viana, Rebeca V. R.; Scatena, Vera L.; Eichemberg, Mayra T.; Sano, Paulo T.

2018-03-01

Considering that both Western Science and Local Knowledge Systems share a common ground—observations of the natural world—the dialogue between them should not only be possible, but fruitful. Local communities whose livelihoods depend on traditional uses of the local biodiversity not only develop knowledge about nature, making several uses of such knowledge, but, with that process, several inquiries about nature can be raised. Here we present our experience with the engagement of Western Science with golden grass artisan's knowledge about the buriti palm ( M. flexuosa). We applied 25 semi-directive interviews, combined with field diary and participative observation, in two quilombola communities from Jalapão region (Central-Brazil). One of the inquiries that emerged from the artisan's perspectives was about the differences between male and female buriti palms' fiber. We then engaged both local and scientific perspectives regarding this issue using plant anatomy as a dialogue instrument. Here we describe this experience and resort to Paulo Freire's ideas on dialogue to argue that, to integrate Western Science and Local Knowledge Systems in a collaborative and contextualized perspective, the research should be faced as a mutual learning practice.

The Knowledge, Awareness, and Practices of Portuguese General Practitioners Regarding Multimorbidity and its Management: Qualitative Perspectives from Open-Ended Questions.

PubMed

Prazeres, Filipe; Santiago, Luiz

2016-11-08

Multimorbidity's high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics' management (consultation time, organization of care teams, clinical information) and society (media pressure, social/family support). Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.

The management of work-related asthma guidelines: a broader perspective.

PubMed

Baur, Xaver; Aasen, Tor Brøvig; Burge, P Sherwood; Heederik, Dick; Henneberger, Paul K; Maestrelli, Piero; Schlünssen, Vivi; Vandenplas, Olivier; Wilken, Dennis

2012-06-01

The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden. Several hundred occupational agents, mainly allergens but also irritants and substances with unknown pathological mechanisms, have been identified as causing work-related asthma. The essential message of these guidelines is that the management of work-related asthma can be considerably optimised based on the present knowledge of causes, risk factors, pathomechanisms, and realistic and effective interventions. To reach this goal we urgently require greatly intensified primary preventive measures and improved case management. There is now a substantial body of evidence supporting the implementation of comprehensive medical surveillance programmes for workers at risk. Those workers who fail surveillance programmes need to be referred to a clinician who can confirm or exclude an occupational cause. Once work-related asthma is confirmed, a revised risk assessment in the workplace is needed to prevent further cases. These new guidelines confirm and extend already existing statements and recommendations. We hope that these guidelines will initiate the much-needed research that is required to fill the gaps in our knowledge and to initiate substantial improvements in preventative measures.

Feasibility of health systems strengthening in South Sudan: a qualitative study of international practitioner perspectives

PubMed Central

Jones, Abigail; Legido-Quigley, Helena

2015-01-01

Objective To explore the feasibility of health systems strengthening from the perspective of international healthcare implementers and donors in South Sudan. Design A qualitative interview study, with thematic analysis using the WHO health system building blocks framework. Setting South Sudan. Participants 17 health system practitioners, working for international agencies in South Sudan, were purposively sampled for their knowledge and experiences of health systems strengthening, services delivery, health policy and politics in South Sudan. Results Participants universally reported the health workforce as insufficient and of low capacity and service delivery as poor, while access to medicines was restricted by governmental lack of commitment in undertaking procurement and supply. However, progress was clear in improved county health department governance, health management information system functionality, increased health worker salary harmonisation and strengthened financial management. Conclusions Resurgent conflict and political tensions have negatively impacted all health system components and maintaining or continuing health system strengthening has become extremely challenging. A coordinated approach to balancing humanitarian need particularly in conflict-affected areas, with longer term development is required so as not to lose improvements gained. PMID:26700280

Exposure to science, perspectives on science and religion, and religious commitment in young adulthood.

PubMed

Uecker, Jeremy E; Longest, Kyle C

2017-07-01

Social scientists know very little about the consequences of exposure to scientific knowledge and holding different perspectives on science and religion for individuals' religious lives. Drawing on secularization and post-secular theories, we develop and test several hypotheses about the relationships among exposure to scientific knowledge, perspectives on religion and science, and religious commitment using panel data from the National Study of Youth and Religion. Our findings indicate that religious faith is strongest among young adults who: (1) accommodate scientific knowledge into their religious perspective, or (2) reject scientific knowledge that directly contradicts their religious beliefs about the origins of the world. Young adults are also more likely to have lower religious commitment when they view science and religion as independent institutions, lending support to secularization ideas about how social differentiation secularizes individuals. We further find that mere exposure to scientific knowledge, in terms of majoring in biology or acknowledging conflict between the teachings of religion and science, is usually not sufficient to undermine religious commitment. Copyright © 2017 Elsevier Inc. All rights reserved.

Alcohol abuse management in primary care: an e-learning course.

PubMed

Pereira, Celina Andrade; Wen, Chao Lung; Tavares, Hermano

2015-03-01

The mental health knowledge gap challenges public health. The Alcohol Abuse Management in Primary Care (AAMPC) is an e-learning course designed to cover alcohol-related problems from the primary care perspective. The goal of this study was to verify if the AAMPC was able to enhance healthcare professionals' alcohol-related problems knowledge. One hundred subscriptions for the AAMPC were offered through the federal telehealth program. The course was instructor-led and had nine weekly classes, delivered synchronously or asynchronously, at the students' convenience, using a varied array of learning tools. At the beginning, students took a test that provided a positive score, related to critical knowledge for clinical management, and a negative score, related to misconceptions about alcohol-related problems. The test was repeated 2 months after course completion. Thirty-three students completed the course. The positive score improved significantly (p<0.001), but not the negative score. Students with previous experience with e-courses presented greater improvement on the positive score (p<0.036). Eighty-percent of the students thought the course excelled in meeting its objectives. Web conferences and video and audio recordings were the most appreciated learning tools. Course satisfaction was negatively related to frequency of Internet access (Spearman's rho=-0.455, p=0.022). E-learning was highly appreciated as a learning tool, especially by students with the least frequency of Internet use. Nonetheless, it worked better for those previously familiar with e-courses. The AAMPC e-course provided effective knowledge transmission and retention. Complementary strategies to reduce misconceptions about alcohol-related problems must be developed for the training of primary care staff.

Advancing the deliberative turn in natural resource management: an analysis of discourses on the use of local resources.

PubMed

Rodela, Romina

2012-04-15

The natural resource management literature stresses the need for public participation and community involvement in resource management and planning. Recently, some of this literature turned to the theory on deliberative democracy and demonstrated that a deliberative perspective on participation can help to challenge established practices and contribute with new ideas about how to conduct participation. The purpose of this paper is to consider the latest developments in deliberative democracy and outline the implications arising from these insights for a "deliberative turn" in resource management. A bottom-up protected area establishment, the Goričko Landscape Park, is examined. The empirical case is discussed from a discursive perspective, which relied on John Dryzek's approach to discourse analysis here used to explore the construction of discourses on the use of local natural resources. Two discourses are identified and the way these interfaced with the participatory park establishment process is considered. Findings indicate that advocates of the two discourses engaged differently with the participatory tools used and this had important implications for the park establishment. The case study suggests that, in contexts where participation has been recently introduced, knowledge of discourses on the use of local natural resources and of mobilization strategies actors may pursue could usefully assist in the design and implementation of participatory processes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Watershed management perspectives in the Southwest: Past, present, and future

Treesearch

Peter F. Ffolliott; Malchus B. Baker; Vicente L. Lopes

2000-01-01

Watershed management perspectives in the Southwest have been, are, and will be reflected by the nature of watershed management practices. Past perspectives evolved from considerations of increasing water yields and water quality concerns. Present perspectives are centered on minimizing adverse impacts to soil and water resources, sustaining high-quality water flows,...

A new perspective on optimal care for patients with COPD.

PubMed

Postma, Dirkje; Anzueto, Antonio; Calverley, Peter; Jenkins, Christine; Make, Barry J; Sciurba, Frank C; Similowski, Thomas; van der Molen, Thys; Eriksson, Göran

2011-06-01

Worldwide, clinicians face the task of providing millions of patients with the best possible treatment and management of COPD. Currently, management primarily involves short-term 'here-and-now' goals, targeting immediate patient benefit. However, although there is considerable knowledge available to assist clinicians in minimising the current impact of COPD on patients, relatively little is known about which dominant factors predict future risks. These predictors may vary for different outcomes, such as exacerbations, mortality, co-morbidities, and the long-term consequences of COPD. We propose a new paradigm to achieve 'optimal COPD care' based on the concept that here-and-now goals should be integrated with goals to improve long-term outcomes and reduce future risks. Whilst knowledge on risk factors for poorer outcomes in COPD is growing and some data exist on positive effects of pharmacological interventions, information on defining the benefits of all commonly used interventions for reducing the risk of various future disease outcomes is still scarce. Greater insight is needed into the relationships between the two pillars of optimal COPD care: 'best current control' and 'future risk reduction'. This broader approach to disease management should result in improved care for every COPD patient now and into the future.

Effective Program Management: A Cornerstone of Malaria Elimination

PubMed Central

Gosling, Jonathan; Case, Peter; Tulloch, Jim; Chandramohan, Daniel; Wegbreit, Jennifer; Newby, Gretchen; Gueye, Cara Smith; Koita, Kadiatou; Gosling, Roly

2015-01-01

Effective program management is essential for successful elimination of malaria. In this perspective article, evidence surrounding malaria program management is reviewed by management science and malaria experts through a literature search of published and unpublished gray documents and key informant interviews. Program management in a malaria elimination setting differs from that in a malaria control setting in a number of ways, although knowledge and understanding of these distinctions are lacking. Several core features of successful health program management are critical to achieve elimination, including effective leadership and supervision at all levels, sustained political and financial commitment, reliable supply and control of physical resources, effective management of data and information, appropriate incentives, and consistent accountability. Adding to the complexity, the requirements of an elimination program may conflict with those of a control regimen. Thus, an additional challenge is successfully managing program transitions along the continuum from control to elimination to prevention of reintroduction. This article identifies potential solutions to these challenges by exploring managerial approaches that are flexible, relevant, and sustainable in various cultural and health system contexts. PMID:26013372

Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.

PubMed

Mebazaa, Alexandre; Yilmaz, M Birhan; Levy, Phillip; Ponikowski, Piotr; Peacock, W Frank; Laribi, Said; Ristic, Arsen D; Lambrinou, Ekaterini; Masip, Josep; Riley, Jillian P; McDonagh, Theresa; Mueller, Christian; deFilippi, Christopher; Harjola, Veli-Pekka; Thiele, Holger; Piepoli, Massimo F; Metra, Marco; Maggioni, Aldo; McMurray, John; Dickstein, Kenneth; Damman, Kevin; Seferovic, Petar M; Ruschitzka, Frank; Leite-Moreira, Adelino F; Bellou, Abdelouahab; Anker, Stefan D; Filippatos, Gerasimos

2015-06-01

Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice. © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.

Children with chronic conditions: perspectives on condition management.

PubMed

Beacham, Barbara L; Deatrick, Janet A

2015-01-01

This qualitative study described children's (8-13 years old) perspectives of their chronic health conditions (e.g., asthma, diabetes, cystic fibrosis): how they perceived their condition, its management, and its implications for their future. The study used the family management style framework (FMSF) to examine child perspectives on the joint venture of condition management between the child and family. Children within this age group viewed condition management in ways similar to their parents and have developed their own routines around condition management. Future studies of this phenomenon comparing child and parent perspectives would further our understanding of the influence of family management. Copyright © 2015 Elsevier Inc. All rights reserved.

Analysis of Students' Conceptions of Basic Magnetism from a Complex Systems Perspective

NASA Astrophysics Data System (ADS)

Lemmer, Miriam; Kriek, Jeanne; Erasmus, Benita

2018-03-01

This study established whether 12 South African secondary school physics students had incorrect conceptions of basic magnetism and if they had, to what extent they consistently applied such conceptions. Different scenarios in the form of thought experiments were presented in a clinical interview approach. A complex systems perspective underpinned the study and was firstly used to analyze 12 students' conceptions in terms of intuitive fragments of knowledge elements, structured misconceptions, and theory-like system of knowledge elements. Secondly, coherence in each student's ideas expressed across ten themes using thought experiments was analyzed in an effort to determine variations or coherence in responses. Examples of student explanations and sketches are discussed in the paper to illustrate the conceptual structures they applied. Most of the students in this study used a variety of knowledge elements in accord with a complex systems perspective, but three students seemed to prefer a specific perspective. One student's ideas tended to be mainly fragmented, a second exposed a number of structured misconceptions, while another student's reasoning can be described as a theory-like system of knowledge elements. Accordingly, the emphasis of physics education research should no longer be on the compilation of a list of misconceptions that have to be remedied or replaced, but on the conceptual connections, students make and their associative reasoning patterns (i.e., knowledge systems revealed). It remains for the teacher to use the complex systems perspective as a framework to facilitate students' conceptual development and understanding, proceeding on their existing knowledge systems.

Ethical issues in patient safety: Implications for nursing management.

PubMed

Kangasniemi, Mari; Vaismoradi, Mojtaba; Jasper, Melanie; Turunen, Hannele

2013-12-01

The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in 'the ethical imperative' of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers' decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.

Lean healthcare from a change management perspective.

PubMed

van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk

2016-05-16

Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.

Disease self-management needs of adolescents with cancer: perspectives of adolescents with cancer and their parents and healthcare providers.

PubMed

Stinson, J N; Sung, L; Gupta, A; White, M E; Jibb, L A; Dettmer, E; Baker, N

2012-09-01

The ability for adolescents with cancer (AWC) to engage in disease self-management may result in improved cancer outcomes and quality-of-life ratings for this group. Despite this, a comprehensive self-management program for this group is yet to be developed. To ensure that self-management programming developed for AWC meets the needs of this group, discussion with key stakeholders (i.e., AWC, parents, and healthcare providers) is required. A descriptive qualitative design was used. Adolescents (n = 29) who varied in age (12 to 18 years) and type of cancer, their parents (n = 30) and their healthcare providers (n = 22) were recruited from one large tertiary-care oncology center. Audio-taped semi-structured individual and focus-group interviews were conducted with participants. Transcribed data were organized into categories that reflected emerging themes. Four major themes, which captured the self-management needs of AWC, emerged from the data. These themes were: (1) disease knowledge and cancer care skills, (2) knowledge and skills to support effective transition to adult healthcare, (3) delivery of AWC-accessible healthcare services, and (4) supports for the adolescent with cancer. In order to provide comprehensive, relevant, and acceptable self-management programs to AWC, the voices of this population, their parents, and healthcare providers should be considered. Findings from this study will be used to develop and evaluate cancer self-management programming for AWC. Self-management represents an important avenue for exploration into improving cancer outcomes and quality of life for survivors of cancers during adolescence.

Shaping the Herders' "Mental Maps": Participatory Mapping with Pastoralists' to Understand Their Grazing Area Differentiation and Characterization

NASA Astrophysics Data System (ADS)

Wario, Hussein T.; Roba, Hassan G.; Kaufmann, Brigitte

2015-09-01

Understanding the perception of environmental resources by the users is an important element in planning its sustainable use and management. Pastoralist communities manage their vast grazing territories and exploit resource variability through strategic mobility. However, the knowledge on which pastoralists' resource management is based and their perception of the grazing areas has received limited attention. To improve this understanding and to document this knowledge in a way that can be communicated with `outsiders', we adopted a participatory mapping approach using satellite imagery to explore how Borana pastoralists of southern Ethiopia differentiated and characterized their grazing areas. The Borana herders conceptualized their grazing areas as set of distinctive grazing units each having specific names and characteristics. The precise location and the borders of each grazing unit were identified on the satellite image. In naming of the grazing units, the main differentiating criteria were landforms, vegetation types, prevalence of wildlife species, and manmade features. Based on the dominant soil type, the grazing units were aggregated into seasonal grazing areas that were described using factors such as soil drainage properties, extent of woody cover, main grass species, and prevalence of ecto-parasites. Pastoralists ranking of the seasonal grazing areas according to their suitability for cattle grazing matched with vegetation assessment results on the abundance of desirable fodder varieties. Approaching grazing area differentiation from the pastoralists' perspectives improves the understanding of rangeland characteristics that pastoralists considered important in their grazing management and visualization of their mental representation in digital maps eases communication of this knowledge.

A Conceptual Framework for Studying Knowledge Utilization.

ERIC Educational Resources Information Center

Paul, Douglas

This paper, written from an organizational perspective, begins with an examination of the deficiencies of knowledge utilization and educational change literature. It suggests the explication of descriptive and heuristic conceptual dimensions as one approach for facilitating a descriptive perspective of knowldge utilization. The efficacy of three…

PERSPECTIVES ON LEARNING AND CLINICAL PRACTICE IMPROVEMENT FOR DIABETES IN THE HOSPITAL: A REVIEW OF EDUCATIONAL INTERVENTIONS FOR PROVIDERS

PubMed Central

Pichardo-Lowden, Ariana; Haidet, Paul; Umpierrez, Guillermo E.

2017-01-01

Objective The management of inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning, and clinical practice. Methods We conducted a literature search through PubMed Medical for terms related to concepts of glycemic management in the hospital and medical education and training. This search yielded 1,493 articles published between 2003 and 2016. Results The selection process resulted in 16 original articles encompassing 1,123 learners from various disciplines. We categorized findings corresponding to learning outcomes and patient care outcomes. Conclusion Based on the analysis, we propose the following perspectives, leveraging learning and clinical practice that can advance the care of patients with diabetes and/or dysglycemia in the hospital. These include: (1) application of knowledge related to inpatient glycemic management can be improved with active, situated, and participatory interactions of learners in the workplace; (2) instruction about inpatient glycemic management needs to reach a larger population of learners; (3) management of dysglycemia in the hospital may benefit from the integration of clinical decision support strategies; and (4) education should be adopted as a formal component of hospitals’ quality planning, aiming to integrate clinical practice guidelines and to optimize diabetes care in hospitals. PMID:28225312

PERSPECTIVES ON LEARNING AND CLINICAL PRACTICE IMPROVEMENT FOR DIABETES IN THE HOSPITAL: A REVIEW OF EDUCATIONAL INTERVENTIONS FOR PROVIDERS.

PubMed

Pichardo-Lowden, Ariana; Haidet, Paul; Umpierrez, Guillermo E

2017-05-01

The management of inpatient hyperglycemia and diabetes requires expertise among many health-care providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning, and clinical practice. We conducted a literature search through PubMed Medical for terms related to concepts of glycemic management in the hospital and medical education and training. This search yielded 1,493 articles published between 2003 and 2016. The selection process resulted in 16 original articles encompassing 1,123 learners from various disciplines. We categorized findings corresponding to learning outcomes and patient care outcomes. Based on the analysis, we propose the following perspectives, leveraging learning and clinical practice that can advance the care of patients with diabetes and/or dysglycemia in the hospital. These include: (1) application of knowledge related to inpatient glycemic management can be improved with active, situated, and participatory interactions of learners in the workplace; (2) instruction about inpatient glycemic management needs to reach a larger population of learners; (3) management of dysglycemia in the hospital may benefit from the integration of clinical decision support strategies; and (4) education should be adopted as a formal component of hospitals' quality planning, aiming to integrate clinical practice guidelines and to optimize diabetes care in hospitals.

Knowledge-Based Systems Approach to Wilderness Fire Management.

NASA Astrophysics Data System (ADS)

Saveland, James M.

The 1988 and 1989 forest fire seasons in the Intermountain West highlight the shortcomings of current fire policy. To fully implement an optimization policy that minimizes the costs and net value change of resources affected by fire, long-range fire severity information is essential, yet lacking. This information is necessary for total mobility of suppression forces, implementing contain and confine suppression strategies, effectively dealing with multiple fire situations, scheduling summer prescribed burning, and wilderness fire management. A knowledge-based system, Delphi, was developed to help provide long-range information. Delphi provides: (1) a narrative of advice on where a fire might spread, if allowed to burn, (2) a summary of recent weather and fire danger information, and (3) a Bayesian analysis of long-range fire danger potential. Uncertainty is inherent in long-range information. Decision theory and judgment research can be used to help understand the heuristics experts use to make decisions under uncertainty, heuristics responsible both for expert performance and bias. Judgment heuristics and resulting bias are examined from a fire management perspective. Signal detection theory and receiver operating curve (ROC) analysis can be used to develop a long-range forecast to improve decisions. ROC analysis mimics some of the heuristics and compensates for some of the bias. Most importantly, ROC analysis displays a continuum of bias from which an optimum operating point can be selected. ROC analysis is especially appropriate for long-range forecasting since (1) the occurrence of possible future events is stated in terms of probability, (2) skill prediction is displayed, (3) inherent trade-offs are displayed, and (4) fire danger is explicitly defined. Statements on the probability of the energy release component of the National Fire Danger Rating System exceeding a critical value later in the fire season can be made early July in the Intermountain West. Delphi was evaluated formally and informally. Continual evaluation and feedback to update knowledge-based systems results in a repository for current knowledge, and a means to devise policy that will augment existing knowledge. Thus, knowledge-based systems can help implement adaptive resource management.

A normative analysis of nursing knowledge.

PubMed

Zanotti, Renzo; Chiffi, Daniele

2016-03-01

This study addresses the question of normative analysis of the value-based aspects of nursing. In our perspective, values in science may be distinguished into (i) epistemic when related to the goals of truth and objectivity and (ii) non-epistemic when related to social, cultural or political aspects. Furthermore, values can be called constitutive when necessary for a scientific enterprise, or contextual when contingently associated with science. Analysis of the roles of the various forms of values and models of knowledge translation provides the ground to understand the specific role of values in nursing. A conceptual framework has been built to classify some of the classical perspectives on nursing knowledge and to examine the relationships between values and different forms of knowledge in nursing. It follows that adopting a normative perspective in the analysis of nursing knowledge provides key elements to identify its proper dimension. © 2015 John Wiley & Sons Ltd.

Thoracic perspective revisited in chronic liver disease.

PubMed

Sureka, Binit; Bansal, Kalpana; Patidar, Yashwant; Kumar, Sachin; Arora, Ankur

2015-08-01

A variety of chest manifestations are seen in patients with chronic liver diseases, namely hepatopulmonary syndrome, portopulmonary hypertension, intrathoracic portosystemic collaterals, hepatic hydrothorax, infections, drug-induced changes, manifestations of hepatocellular carcinoma, gynecomastia, acute respiratory distress syndrome, autoimmune changes, aspiration pneumonitis and changes due to α1-antitrypsin deficiency. Gastroenterologists and radiologists should be aware of these entities; knowledge of the imaging findings specific to each condition is of prime importance for managing such patients. © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

Cross-cultural nursing research.

PubMed

Suhonen, Riitta; Saarikoski, Mikko; Leino-Kilpi, Helena

2009-04-01

International cross-cultural comparative nursing research is considered important for the advancement of nursing knowledge offering a global perspective for nursing. Although this is recognised in policy statements and quality standards, international comparative studies are rare in database citations. To highlight the need for cross-cultural comparative research in nursing and to share some of the insights gained after conducting three international/cross-cultural comparative studies. These are: an examination of patients' autonomy, privacy and informed consent in nursing interventions BIOMED 1998-2001, the ICProject International Patient Study 2002-2006 and the Ethical Codes in Nursing (ECN) project 2003-2005. There are three critical issues raised here for discussion from the international cross-cultural studies. These are: the planning and formulating of an international study, the conduct of cross-cultural research including the implementation of rigorous data collection and analysis and the reporting and implementing the results. International and cross-cultural nursing research is powerful tool for the improvement of clinical nursing practise, education and management and advancement of knowledge. Such studies should be carried out in order to improve European evidence based health care development in which the patients' perspective plays an important part in the evaluation and benchmarking of services.

Female streetwalkers' perspectives on migration and HIV/STI risks in a changing economic and social environment: a qualitative study in Shanghai, China.

PubMed

Huang, Z Jennifer; Hu, Dier; Chang, Ruth; Zaccaro, Heather; Iguchi, Martin; Zheng, Huang; He, Na

2015-01-01

China's 30-year economic boom has created a unique social and economic market for commercial sex, as well as for a workforce of migrant women from rural China. This qualitative study explores the impact of the rapidly changing social and economic environment on migration patterns, knowledge of sexually transmitted infections (STIs), STI risk behaviours and health beliefs among female streetwalkers in Shanghai. Qualitative data were collected in 2010 through semi-structured in-depth interviews with 16 streetwalkers to characterise their migration passages, sexual health and behaviours, and peer networks. Many streetwalkers reported histories of childhood impoverishment, of family or partner violence or trauma, of migration consistent with the timeline and routes of economic development and of a scarcity in health, social or economic support. Their knowledge of the prevention and treatment of HIV and STIs was limited. They had little bargaining power on condom use and the majority resorted to vaginal douching and self-management with antibiotics as preventative measures. The study identifies streetwalkers' perspectives on the changing environment, their options and actions and, finally, HIV/STI risks that were unique to this hidden population.

The Secondary School Football Coach's Relationship With the Athletic Trainer and Perspectives on Exertional Heat Stroke

PubMed Central

Adams, William M.; Mazerolle, Stephanie M.; Casa, Douglas J.; Huggins, Robert A.; Burton, Laura

2014-01-01

Context: Prior researchers have examined the first-aid knowledge and decision making among high school coaches, but little is known about their perceived knowledge of exertional heat stroke (EHS) or their relationships with an athletic trainer (AT). Objective: To examine secondary school football coaches' perceived knowledge of EHS and their professional relationship with an AT. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: Thirty-eight secondary school head football coaches (37 men, 1 woman) participated in this study. Their average age was 47 ± 10 years old, and they had 12 ± 9 years' experience as a head football coach. Data Collection and Analysis: Participants responded to a series of online questions that were focused on their perceived knowledge of EHS and professional relationships with ATs. Data credibility was established through multiple-analyst triangulation and peer review. We analyzed the data by borrowing from the principles of a general inductive approach. Results: Two dominant themes emerged from the data: perceived self-confidence of the secondary school coach and the influence of the AT. The first theme highlighted the perceived confidence, due to basic emergency care training, of the coach regarding management of an emergency situation, despite a lack of knowledge. The second theme illustrated the secondary school coach's positive professional relationships with ATs regarding patient care and emergency procedures. Of the coaches who participated, 89% (34 out of 38) indicated positive interactions with their ATs. Conclusions: These secondary school coaches were unaware of the potential causes of EHS or the symptoms associated with EHS, and they had higher perceived levels of self-confidence in management abilities than indicated by their perceived knowledge level. The secondary school football coaches valued and understood the role of the AT regarding patient and emergency care. PMID:24933433

Rethinking Value in the Bio-economy

PubMed Central

2016-01-01

Current debates in science and technology studies emphasize that the bio-economy—or, the articulation of capitalism and biotechnology—is built on notions of commodity production, commodification, and materiality, emphasizing that it is possible to derive value from body parts, molecular and cellular tissues, biological processes, and so on. What is missing from these perspectives, however, is consideration of the political-economic actors, knowledges, and practices involved in the creation and management of value. As part of a rethinking of value in the bio-economy, this article analyzes three key political-economic processes: financialization, capitalization, and assetization. In doing so, it argues that value is managed as part of a series of valuation practices, it is not inherent in biological materialities. PMID:28458406

Current Concepts in Orthopedic Management of Multiple Trauma

PubMed Central

Kucukdurmaz, Fatih; Alijanipour, Pouya

2015-01-01

Multiple trauma patients frequently present challenging clinical scenarios with musculoskeletal injuries being the most common indications for surgical procedures in these patients. Despite our substantial knowledge, a universally approved objective definition for “multiple trauma” is yet to be delineated. Several controversial aspects of economics, pathophysiology, animal models, diagnosis, management and outcome of patients with multiple trauma have recently been explored and although some progress has been made, it seems that the available evidence is still inconclusive in some occasions. This manuscript revisits several current concepts of multiple trauma that have been the focus of recent investigation. We aim to provide the reader with an updated perspective based on the most recently published literature in the field of multiple trauma. PMID:26312111

National healthcare systems and the need for health information governance.

PubMed

Hovenga, Evelyn J S

2013-01-01

This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

A Mobile Internet Service for Self-Management of Physical Activity in People With Rheumatoid Arthritis: Challenges in Advancing the Co-Design Process During the Requirements Specification Phase

PubMed Central

Martin, Cathrin; H. Opava, Christina; Brusewitz, Maria; Keller, Christina; Åsenlöf, Pernilla

2015-01-01

Background User involvement in the development of health care services is important for the viability, usability, and effectiveness of services. This study reports on the second step of the co-design process. Objective The aim was to explore the significant challenges in advancing the co-design process during the requirements specification phase of a mobile Internet service for the self-management of physical activity (PA) in rheumatoid arthritis (RA). Methods A participatory action research design was used to involve lead users and stakeholders as co-designers. Lead users (n=5), a clinical physiotherapist (n=1), researchers (n=2) with knowledge in PA in RA and behavioral learning theories, an eHealth strategist (n=1), and an officer from the patient organization (n=1) collaborated in 4 workshops. Data-collection methods included video recordings and naturalistic observations. Results The inductive qualitative video-based analysis resulted in 1 overarching theme, merging perspectives, and 2 subthemes reflecting different aspects of merging: (1) finding a common starting point and (2) deciding on design solutions. Seven categories illustrated the specific challenges: reaching shared understanding of goals, clarifying and handling the complexity of participants’ roles, clarifying terminology related to system development, establishing the rationale for features, negotiating features, transforming ideas into concrete features, and participants’ alignment with the agreed goal and task. Conclusions Co-designing the system requirements of a mobile Internet service including multiple stakeholders was a complex and extensive collaborative decision-making process. Considering, valuing, counterbalancing, and integrating different perspectives into agreements and solutions (ie, the merging of participants’ perspectives) were crucial for moving the process forward and were considered the core challenges of co-design. Further research is needed to replicate the results and to increase knowledge on key factors for a successful co-design of health care services. PMID:26381221

Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi.

PubMed

Agyeman-Duah, Josephine Nana Afrakoma; Theurer, Antje; Munthali, Charles; Alide, Noor; Neuhann, Florian

2014-01-02

Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher's perspectives by means of document review and participatory observation. Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.

A Mobile Internet Service for Self-Management of Physical Activity in People With Rheumatoid Arthritis: Challenges in Advancing the Co-Design Process During the Requirements Specification Phase.

PubMed

Revenäs, Åsa; Martin, Cathrin; H Opava, Christina; Brusewitz, Maria; Keller, Christina; Åsenlöf, Pernilla

2015-09-17

User involvement in the development of health care services is important for the viability, usability, and effectiveness of services. This study reports on the second step of the co-design process. The aim was to explore the significant challenges in advancing the co-design process during the requirements specification phase of a mobile Internet service for the self-management of physical activity (PA) in rheumatoid arthritis (RA). A participatory action research design was used to involve lead users and stakeholders as co-designers. Lead users (n=5), a clinical physiotherapist (n=1), researchers (n=2) with knowledge in PA in RA and behavioral learning theories, an eHealth strategist (n=1), and an officer from the patient organization (n=1) collaborated in 4 workshops. Data-collection methods included video recordings and naturalistic observations. The inductive qualitative video-based analysis resulted in 1 overarching theme, merging perspectives, and 2 subthemes reflecting different aspects of merging: (1) finding a common starting point and (2) deciding on design solutions. Seven categories illustrated the specific challenges: reaching shared understanding of goals, clarifying and handling the complexity of participants' roles, clarifying terminology related to system development, establishing the rationale for features, negotiating features, transforming ideas into concrete features, and participants' alignment with the agreed goal and task. Co-designing the system requirements of a mobile Internet service including multiple stakeholders was a complex and extensive collaborative decision-making process. Considering, valuing, counterbalancing, and integrating different perspectives into agreements and solutions (ie, the merging of participants' perspectives) were crucial for moving the process forward and were considered the core challenges of co-design. Further research is needed to replicate the results and to increase knowledge on key factors for a successful co-design of health care services.

Evaluating Social and National Education Textbooks Based on the Criteria of Knowledge-Based Economy from the Perspectives of Elementary Teachers in Jordan

ERIC Educational Resources Information Center

Al-Edwan, Zaid Suleiman; Hamaidi, Diala Abdul Hadi

2011-01-01

Knowledge-based economy is a new implemented trend in the field of education in Jordan. The ministry of education in Jordan attempts to implement this trend's philosophy in its textbooks. This study examined the extent to which the (1st-3rd grade) social and national textbooks reflect knowledge-based economy criteria from the perspective of…

Demystifying knowledge translation: learning from the community.

PubMed

Bowen, Sarah; Martens, Patricia

2005-10-01

While there is increasing interest in research related to so-called Knowledge Translation, much of this research is undertaken from the perspective of researchers. The objective of this paper is to explore, through the participatory evaluation of Manitoba's The Need to Know Project, the characteristics of effective knowledge translation initiatives from the perspective of community partners. The multi-method evaluation adopted a utilization-focused approach, where stakeholders participated in identifying evaluation questions, and methods were made transparent to participants. Over 100 open-ended, semi-structured interviews were conducted with project stakeholders over the first three years of the project. These interviews explored the perspectives of participants on all aspects of project development. Formal feedback processes allowed further refinement of emerging theory. This research suggests that there has been insufficient emphasis on personal factors in knowledge translation. The themes of 'quality of relationships' and 'trust' connected many different components of knowledge translation, and were essential for collaborative research. Organizational barriers and lack of confidence in researchers present greater challenges to knowledge translation than individual interest or community capacity. The costs of participation in collaborative research for community partners and the benefits for researchers, also require greater attention. Participation of community partners in The Need to Know Project has provided unique perspectives on knowledge translation theory. It has identified limitations to the common interpretations of knowledge translation principles and highlighted the characteristics of collaborative research initiatives that are of greatest importance to community partners.

How do line managers experience and handle the return to work of employees on sick leave due to work-related stress? A one-year follow-up study.

PubMed

Ladegaard, Yun; Skakon, Janne; Elrond, Andreas Friis; Netterstrøm, Bo

2017-08-28

To examine how line managers experience and manage the return to work process of employees on sick leave due to work-related stress and to identify supportive and inhibiting factors. Semi-structured interviews with 15 line managers who have had employees on sick leave due to work-related stress. The grounded theory approach was employed. Even though managers may accept the overall concept of work-related stress, they focus on personality and individual circumstances when an employee is sick-listed due to work-related stress. The lack of a common understanding of stress creates room for this focus. Line managers experience cross-pressure, discrepancies between strategic and human-relationship perspectives and a lack of organizational support in the return to work process. Organizations should aim to provide support for line managers. Research-based knowledge and guidelines on work-related stress and return to work process are essential, as is the involvement of coworkers. A commonly accepted definition of stress and a systematic risk assessment is also important. Cross-pressure on line managers should be minimized and room for adequate preventive actions should be provided as such an approach could support both the return to work process and the implementation of important interventions in the work environment. Implication for rehabilitation Organizations should aim to provide support for line managers handling the return to work process. Cross-pressure on line managers should be minimized and adequate preventive actions should be provided in relation to the return to work process. Research-based knowledge and guidelines on work-related stress and return to work are essential. A common and formal definition of stress should be emphasized in the workplace.

Perspectives on knowledge in engineering design

NASA Technical Reports Server (NTRS)

Rasdorf, W. J.

1985-01-01

Various perspectives are given of the knowledge currently used in engineering design, specifically dealing with knowledge-based expert systems (KBES). Constructing an expert system often reveals inconsistencies in domain knowledge while formalizing it. The types of domain knowledge (facts, procedures, judgments, and control) differ from the classes of that knowledge (creative, innovative, and routine). The feasible tasks for expert systems can be determined based on these types and classes of knowledge. Interpretive tasks require reasoning about a task in light of the knowledge available, where generative tasks create potential solutions to be tested against constraints. Only after classifying the domain by type and level can the engineer select a knowledge-engineering tool for the domain being considered. The critical features to be weighed after classification are knowledge representation techniques, control strategies, interface requirements, compatibility with traditional systems, and economic considerations.

Generating Co-Management at Kasha Katuwe Tent Rocks National Monument, New Mexico

NASA Astrophysics Data System (ADS)

Pinel, Sandra Lee; Pecos, Jacob

2012-03-01

Collaborative planning theory and co-management paradigms promise conflict prevention and the incorporation of indigenous knowledge into plans. Critics argue that without devolved power to culturally legitimate institutions, indigenous perspectives are marginalized. Co-management practice in North America is largely limited to treaty-protected fish and wildlife because federal agencies cannot devolve land management authority. This paper explores why the Pueblo de Cochiti, a federally recognized American Indian Tribe, and the U.S. Bureau of Land Management sustained an rare joint management agreement for the Kasha-Katuwe Tent Rocks National Monument in New Mexico despite a history of conflict over federal control of customary tribal lands that discouraged the Pueblo from working with federal agencies. Based on the participant interviews and documents, the case suggests that clear agreements, management attitudes, and the direct representation of indigenous forms of government helped achieve presumed co-management benefits. However, parties enter these agreements strategically. We should study, not assume, participant goals in collaborative processes and co-management institutions and pay special attention to the opportunities and constraints of federal laws and institutional culture for collaborative resource management with tribal and local communities.

Managing workplace health promotion in municipal organizations: The perspective of senior managers.

PubMed

Larsson, Robert; Åkerlind, Ingemar; Sandmark, Hélène

2015-01-01

Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

Challenging Obesity: Patient, Provider, and Expert Perspectives on the Roles of Available and Emerging Nonsurgical Therapies

PubMed Central

Apovian, Caroline M.; Garvey, W. Timothy; Ryan, Donna H.

2015-01-01

Objective Adult obesity is recognized as a chronic disease. According to principles of chronic disease management, healthcare professionals should work collaboratively with patients to determine appropriate therapeutic strategies that address overweight and obesity, specifically considering a patient’s disease status in addition to their individual needs, preferences, and attitudes regarding treatment. A central role and responsibility of healthcare professionals in this process is to inform and educate patients about their treatment options. Although current recommendations for the management of adult obesity provide general guidance regarding safe and proper implementation of lifestyle, pharmacological, and surgical interventions, healthcare professionals need awareness of specific evidence-based information that supports individualized clinical application of these therapies. More specifically, healthcare professionals should be up-to-date on approaches that promote successful lifestyle management and be knowledgeable about newer weight loss pharmacotherapies, so they can offer patients with obesity a wide range of options to personalize their treatment. Accordingly, this educational activity has been developed to provide participants with the latest information on treatment recommendations and therapeutic advances in lifestyle intervention and pharmacotherapy for adult obesity management. Design and Methods This supplement is based on the content presented at a live CME symposium held in conjunction with ObesityWeek 2014. Results This supplement provides an expert summary of current treatment recommendations and recent advances in nonsurgical therapies for the management of adult obesity. Patient and provider perspectives on obesity management are highlighted in embedded video clips available via QR codes, and new evidence will be applied using clinically relevant case studies. Conclusions This supplement provides a topical update of obesity management, including clinical practice examples, for healthcare professionals who treat or provide care for adults with obesity. PMID:26154880

Teaching Practice: A Perspective on Inter-Text and Prior Knowledge

ERIC Educational Resources Information Center

Costley, Kevin C.; West, Howard G.

2012-01-01

The use of teaching practices that involve intertextual relationship discovery in today's elementary classrooms is increasingly essential to the success of young learners of reading. Teachers must constantly strive to expand their perspective of how to incorporate the dialogue included in prior knowledge assessment. Teachers must also consider how…

Value Relativism and Perspective Taking are Two Distinct Facets of Wisdom-Related Knowledge.

PubMed

Kunzmann, Ute; Nowak, Jana; Thomas, Stefanie; Nestler, Steffen

2017-12-18

There has been mixed evidence for age differences in wisdom-related knowledge across the adult life span. This study investigated two potential moderators of the link between age and wisdom-related knowledge: the wisdom criteria and the wisdom tasks. To test these moderators, 40 younger and 40 older participants completed four wisdom tasks differing in context-richness. Independent trained raters coded the resulting think-aloud protocols in terms of value relativism, as defined in the Berlin wisdom paradigm, and perspective taking, as defined by Grossmann. The type of task did not show any main or interaction effects on the present two wisdom criteria. However, age differences in the two wisdom criteria were multidirectional: whereas perspective taking did not differ by age group, value relativism was lower in older than younger adults. In addition, value relativism, but not perspective taking, was related to measures of fluid and crystallized intelligence, whereas perspective taking, but not value relativism, was related to a measure of life investment. This study provides evidence for the idea that value relativism and perspective taking are two distinct facets of wisdom-related knowledge. Implications for future age-comparative research interested in wisdom are discussed. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nursing home manager's knowledge, attitudes and beliefs about advance care planning for people with dementia in long-term care settings: a cross-sectional survey.

PubMed

Beck, Esther-Ruth; McIlfatrick, Sonja; Hasson, Felicity; Leavey, Gerry

2017-09-01

To examine nursing home managers' knowledge, attitudes, beliefs and current practice regarding advance care planning for people with dementia in long-term care settings informed by the theory of planned behaviour. Internationally, advance care planning is advocated for people with dementia. However, evidence suggests that discussions with people with dementia are rare, particularly in long-term care settings. Whilst nursing home managers can be considered central to implementation in this setting, there is a dearth of research that has examined their perspective. This study reports on their role with regard to advance care planning and the perceived factors which influence this. A cross-sectional postal survey was carried out as part of a larger scale sequential explanatory mixed-methods study between January-March 2015. Nursing home managers in a region in the UK (n = 178). A response rate of 66% (n = 116) was achieved. Nursing home managers demonstrated a lack of knowledge of advance care planning, with negative attitudes underpinned by concerns regarding the capacity and lack of perceived benefits to the person with dementia. Currently, they do not view advance care planning as part of their role, with lack of ownership impacting upon current practice behaviours. Whilst nursing home managers recognise the potential benefits of advance care planning, barriers and challenges create a reluctance to facilitate. Targeted training to address the knowledge deficit is required, with the wider components of advance care planning promoted. There is a need for greater role clarification to ensure nurses in long-term care settings identify with the process in the future. A gap between rhetoric and reality of implementation is evident; therefore, long-term care settings must critically examine system, organisational and individual factors for failure to implement advance care planning for people with dementia. Increased cognisance of the context in which advance care planning takes place is vital for improved implementation in this context. In addition strong nursing leadership is imperative to facilitate initiation, engagement and re-evaluation of the process of advance care planning. © 2016 John Wiley & Sons Ltd.

Knowledge deficit of patients with stage 1-4 CKD: a focus group study.

PubMed

Lopez-Vargas, Pamela A; Tong, Allison; Phoon, Richard K S; Chadban, Steven J; Shen, Yvonne; Craig, Jonathan C

2014-04-01

Patients with early-stage chronic kidney disease (CKD) must make lifestyle modifications and adhere to treatment regimens to prevent their progression to end-stage kidney disease. The aim of this study was to elicit the perspectives of patients with stage 1-4 CKD about their disease, with a specific focus on their information needs in managing and living with CKD and its sequelae. Patients with CKD stages 1-4 were purposively sampled from three major hospitals in Sydney, Australia to participate in focus groups. Transcripts were thematically analysed. From nine focus groups including 38 participants, six major themes were identified: medical attentiveness (shared decision-making, rapport, indifference and insensitivity); learning self-management (diet and nutrition, barriers to physical activity, medication safety); contextualizing comorbidities (prominence of CKD, contradictory treatment); prognostic uncertainty (hopelessness, fear of disease progression, disbelief regarding diagnosis); motivation and coping mechanisms (engage in research, pro-active management, optimism, feeling normal); and knowledge gaps (practical advice, access to information, comprehension of pathology results and CKD diagnosis, education for general practitioners). Patients capacity to slow the progression of CKD may be limited by their lack of knowledge about the disease, its comorbidities, psychosocial influences and their ability to interact and communicate effectively with their health-care provider. Support from a multidisciplinary care team, combined with provision of comprehensive, accessible and practical educational resources may enhance patients' ability and motivation to access and adhere to therapeutic and lifestyle interventions to retard progression of CKD. © 2014 Asian Pacific Society of Nephrology.

The formation, elements of success, and challenges in managing a critical care program: part II.

PubMed

St Andre, Arthur

2015-05-01

Leaders of critical care services require knowledge and skills not typically acquired during their medical education and training. Leaders possess personality characteristics and evolve and adopt behaviors and knowledge in addition to those useful in the care of patients and rounding with an ICU team. Successful leaders have impeccable integrity, possess a service mentality, are decisive, and speak the truth consistently and accurately. Effective leaders are thoughtful listeners, introspective, develop a range of relationships, and nurture others. They understand group psychology, observe, analyze assumptions, decide, and improve the system of care and the performance of their team members. A leader learns to facilely adapt to circumstance, generate new ideas, and be a catalyst of change. Those most successful further their education as a leader and learn when and where to seek mentorship. Leaders understand their organization and its operational complexities. Leaders learn to participate and knowledgeably contribute to the fiscal aspects of income, expense, budget, and contracts from an institutional and department perspective. Clinician compensation must be commensurate with expectations and be written to motivate and make clear duties that are clinical and nonclinical. A leader understands and plans to address the evolving challenges facing healthcare, especially resource constraints, the emotions and requirements of managing the end of life, the complexities of competing demands and motivations, the bureaucracy of healthcare practice, and reimbursement. Responsibilities to manage and evolve must be met with intelligence, sensitivity, and equanimity.

Clinical knowledge governance: the international perspective.

PubMed

Garde, Sebastian

2013-01-01

As a basis for semantic interoperability, ideally, a Clinical Knowledge Resource for a clinical concept should be defined formally and defined once in a way that all clinical professions and all countries can agree on. Clinical Knowledge Governance is required to create high-quality, reusable Clinical Knowledge Resources and achieve this aim. Traditionally, this is a time-consuming and cumbersome process, relying heavily on face-to-face meetings and being able to get sufficient input from clinicians. However, in a national or even international space, it is required to streamline the processes involved in creating Clinical Knowledge Resources. For this, a Web 2.0 tool that supports online collaboration of clinicians during their creation and publishing of Clinical Knowledge Resources has been developed. This tool is named the Clinical Knowledge Manager (CKM) and supports the development, review and publication of Clinical Knowledge Resources. Also, post-publication activities such as adding terminology bindings, translating the Clinical Knowledge Resource into another language and republishing it are supported. The acceptance of Clinical Knowledge Resources depends on their quality and being able to determine their quality, for example it is important to know that a broad umber of reviewers from various clinical disciplines have been involved in the development of the Clinical Knowledge Resource. We are still far from realizing the vision of a global repository of a great number of reusable, high-quality Clinical Knowledge Resources, which can provide the basis for broad semantic interoperability between systems. However progress towards this aim is being made around the world.

The subject of pedagogy from theory to practice--the view of newly registered nurses.

PubMed

Ivarsson, Bodil; Nilsson, Gunilla

2009-07-01

The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.

Development of perspective-based water management strategies for the Rhine and Meuse basins.

PubMed

van Deursen, W P A; Middelkoop, H

2005-01-01

Water management is surrounded by uncertainties. Water management thus has to answer the question: given the uncertainties, what is the best management strategy? This paper describes the application of the perspectives method on water management in the Rhine and Meuse basins. In the perspectives method, a structured framework to analyse water management strategies under uncertainty is provided. Various strategies are clustered in perspectives according to their underlying assumptions. This framework allows for an analysis of current water management strategies, but also allows for evaluation of the robustness of proposed future water strategies. It becomes clear that no water management strategy is superior to the others, but that inherent choices on risk acceptance and costs make a real political dilemma which will not be solved by further optimisation.

The laboratory workforce shortage: a managerial perspective.

PubMed

Cortelyou-Ward, Kendall; Ramirez, Bernardo; Rotarius, Timothy

2011-01-01

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the next decade. This article examines the current situation of the clinical laboratory workforce. It analyzes the different types of personnel; the managerial, supervision, and line positions that are key for different types of laboratories; the job outlook and recent projections for different types of staff; and the current issues, trends, and challenges of the laboratory workforce. Laboratory managers need to take action with strategies suggested for overcoming these challenges. Most importantly, they need to become transformational leaders by developing effective staffing models, fostering healthy and productive work environments, and creating value with a strategic management culture and implementation of knowledge management.

Management of Breast Milk Oversupply in Traditional Persian Medicine.

PubMed

Kabiri, Marya; Kamalinejad, Mohammad; Sohrabvand, Farnaz; Bioos, Soodabeh; Babaeian, Mohammad

2017-10-01

Comprehensive explanation about milk oversupply is not available in the current literature because few studies have been done on this topic. In traditional Persian medicine, milk oversupply and its management have been described. The aim of this study was to investigate milk oversupply from the perspective of medieval Persian practitioners. In this study, some main medical resources of traditional Persian medicine such as Al-Havi and the Canon of Medicine were studied to extract valuable information about milk oversupply. Etiology of milk overproduction according to traditional Persian medicine is based on humors theory and cannot be easily compared with current medical concepts. Diet modifications and natural remedies have been applied for managing this condition but the majority of traditional Persian medicine interventions for reducing milk oversupply have not been scientifically investigated in modern medicine. The knowledge of milk oversupply in traditional Persian medicine may be helpful to conduct further related studies.

Can MicroRNAs Improve the Management of Lung Cancer Patients? A Clinician's Perspective

PubMed Central

Tufman, Amanda; Tian, Fei; Huber, Rudolf Maria

2013-01-01

The treatment of patients with lung cancer is increasingly individualised. Rather than treating lung cancer as a single disease, clinicians are often called upon to consider the precise histology and molecular biology of each tumour in addition to the individual characteristics of each patient. Paralleling advances in lung cancer management, advances in the detection of lung cancer are changing practice. Lung cancer screening promises to find disease at a curable stage; however, the high false positive rate in screening trials has clinical and fiscal ramifications which demand attention. Biomarkers able to stratify for the risk of cancer, prognosticate the course of disease, or predict the response to treatment are in increasing demand. This paper summarizes some of the clinical problems faced by those treating lung cancer patients, and examines how knowledge about the role of microRNAs in lung cancer biology may change patient management. PMID:24396506

An Informatics Blueprint for Healthcare Quality Information Systems

PubMed Central

Niland, Joyce C.; Rouse, Layla; Stahl, Douglas C.

2006-01-01

There is a critical gap in our nation's ability to accurately measure and manage the quality of medical care. A robust healthcare quality information system (HQIS) has the potential to address this deficiency through the capture, codification, and analysis of information about patient treatments and related outcomes. Because non-technical issues often present the greatest challenges, this paper provides an overview of these socio-technical issues in building a successful HQIS, including the human, organizational, and knowledge management (KM) perspectives. Through an extensive literature review and direct experience in building a practical HQIS (the National Comprehensive Cancer Network Outcomes Research Database system), we have formulated an “informatics blueprint” to guide the development of such systems. While the blueprint was developed to facilitate healthcare quality information collection, management, analysis, and reporting, the concepts and advice provided may be extensible to the development of other types of clinical research information systems. PMID:16622161

Management of Breast Milk Oversupply in Traditional Persian Medicine

PubMed Central

Kabiri, Marya; Kamalinejad, Mohammad; Sohrabvand, Farnaz; Bioos, Soodabeh

2017-01-01

Comprehensive explanation about milk oversupply is not available in the current literature because few studies have been done on this topic. In traditional Persian medicine, milk oversupply and its management have been described. The aim of this study was to investigate milk oversupply from the perspective of medieval Persian practitioners. In this study, some main medical resources of traditional Persian medicine such as Al-Havi and the Canon of Medicine were studied to extract valuable information about milk oversupply. Etiology of milk overproduction according to traditional Persian medicine is based on humors theory and cannot be easily compared with current medical concepts. Diet modifications and natural remedies have been applied for managing this condition but the majority of traditional Persian medicine interventions for reducing milk oversupply have not been scientifically investigated in modern medicine. The knowledge of milk oversupply in traditional Persian medicine may be helpful to conduct further related studies. PMID:28817945

Cancer risk management decision making for BRCA+ women.

PubMed

Leonarczyk, Terri Jabaley; Mawn, Barbara E

2015-01-01

Women with pathogenic BRCA genetic mutations face high risks for cancer development. Estimates vary among mutation carriers, with lifetime risks ranging from 41% to 90% for breast cancer and 8% to 62% for ovarian cancer. Cancer risk management options for BRCA mutation positive (BRCA+) women have life-altering implications. This qualitative, phenomenological study explored the experience of cancer risk management decision making for women who are unaffected carriers of a BRCA mutation (previvors). Fifteen previvors recruited from Facing Our Risk of Cancer Empowered (FORCE), an online informational and support group, were interviewed. Findings consisted of four major themes: the early previvor experience, intense emotional upheaval; the decisional journey, navigating a personal plan for survival; lack of knowledge and experience among health care providers; and support is essential. Findings highlight the different decisional perspectives of previvors based on age and individual factors and the need for increased competence among health care providers. © The Author(s) 2014.

Managing physical and mental health conditions: Consumer perspectives on integrated care.

PubMed

Rollins, Angela L; Wright-Berryman, Jennifer; Henry, Nancy H; Quash, Alicia M; Benbow, Kyle; Bonfils, Kelsey A; Hedrick, Heidi; Miller, Alex P; Firmin, Ruthie; Salyers, Michelle P

2017-01-01

Despite the growing trend of integrating primary care and mental health services, little research has documented how consumers with severe mental illnesses manage comorbid conditions or view integrated services. We sought to better understand how consumers perceive and manage both mental and physical health conditions and their views of integrated services. We conducted semi-structured interviews with consumers receiving primary care services integrated in a community mental health setting. Consumers described a range of strategies to deal with physical health conditions and generally viewed mental and physical health conditions as impacting one another. Consumers viewed integration of primary care and mental health services favorably, specifically its convenience, friendliness and knowledge of providers, and collaboration between providers. Although integration was viewed positively, consumers with SMI may need a myriad of strategies and supports to both initiate and sustain lifestyle changes that address common physical health problems.

An Attainable Global Perspective.

ERIC Educational Resources Information Center

de Castaneda, Viann Pedersen

Concordia College (Minnesota) has established a global studies curriculum that encourages the development of a global perspective in future business leaders. Global perspective is seen as having five dimensions: (1) perspective consciousness; (2) "state of the planet" awareness; (3) cross-cultural awareness; (4) knowledge of global…

Perspectives on Promoting Hospital Primary Vaginal Birth: A Qualitative Study.

PubMed

Kennedy, Holly P; Doig, Eleanor; Tillman, Stephanie; Strauss, Amanda; Williams, Beth; Pettker, Christian; Illuzzi, Jessica

2016-12-01

One in three women will deliver by cesarean, a procedure that can be life saving, but which also carries short- and long-term risks. There is growing interest in preventing primary cesarean deliveries, while optimizing the health of the mother and infant. The primary aim of this study was to use participatory action strategies and ethnographic interview data collected from diverse stakeholders in birth (caregivers, women, policymakers) about facilitators and barriers to the achievement of primary vaginal birth in first-time mothers in hospital settings. The secondary aim was to use the findings to identify strategies to promote primary vaginal birth and future areas of research. Individual and small group interviews were conducted with caregivers and policymakers (N = 79) and first-time mothers (N = 24) at a northeastern hospital. All interviews were audio-recorded, transcribed, and analyzed using Atlas.ti. Four broad themes were identified: 1) preparation for childbirth, 2) early labor management, 3) caregiver knowledge and practice style, and 4) birth environment (physical, cultural/emotional). The first two were closely linked from caregivers' perspectives. If the woman was not prepared for childbirth, it was perceived she would be more likely to present to the hospital in early labor. Once there, it was hard to prevent admission and interventions. A woman's knowledge and confidence were perceived as powerful mediators for vaginal birth. Caregivers and first-time mothers identified early labor management and childbirth preparation as important factors to promote primary vaginal birth in hospital settings. Both deserve further inquiry as potential strategies to decrease rising cesarean delivery rates. © 2016 Wiley Periodicals, Inc.

Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare

PubMed Central

2010-01-01

Background This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Methods Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs) in Sweden were subjected to qualitative analysis. Results The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1) they have high status and expertise; 2) they lack knowledge of the system; 3) they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Conclusions Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others) in relation to the physician role. Further research is needed to elucidate how managers in healthcare organisations assume the manager role in relation to the medical profession. Studies indicate that lack of clarity concerning manager role authority and responsibility may have negative consequences not only for the working conditions of managers, physicians, and other healthcare professionals, but also for the quality of care. PMID:20849581

Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare.

PubMed

von Knorring, Mia; de Rijk, Angelique; Alexanderson, Kristina

2010-09-17

This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs) in Sweden were subjected to qualitative analysis. The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1) they have high status and expertise; 2) they lack knowledge of the system; 3) they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others) in relation to the physician role. Further research is needed to elucidate how managers in healthcare organisations assume the manager role in relation to the medical profession. Studies indicate that lack of clarity concerning manager role authority and responsibility may have negative consequences not only for the working conditions of managers, physicians, and other healthcare professionals, but also for the quality of care.

Practices of depression care in home health care: Home health clinician perspectives

PubMed Central

Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

2015-01-01

Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

Qualitative evaluation of a delirium prevention and management programme.

PubMed

Kang, Yun; Moyle, Wendy; Cooke, Marie; O'Dwyer, Siobhan

2017-12-01

To evaluate the effect of an educational programme on registered nurses' knowledge and attitude in delirium care for hospitalised older adults with and without dementia, and to examine the strengths and weaknesses of the programme from the participants' perspectives. Providing care for patients with delirium or delirium superimposed on dementia often poses particular challenges such as distinguishing between delirium and dementia for nurses. A descriptive qualitative study was used. A delirium educational programme based on adult learning principles was provided to the participants. A purposive sample of 12 registered nurses who participated in the educational programme undertook individual interviews. Content analysis was conducted to identify unique and common themes indicative of registered nurse perceptions. Registered nurses reported improved knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. Active learning in the programme facilitated the participants' learning processes. This active learning included deep learning, collaborative learning and application of new concepts to practice. Most participants felt that they had inadequate management support to apply their new knowledge in practice, and this included staff resource and policies and protocols. The qualitative findings indicated that the delirium education had benefited the participants by improving their knowledge and attitude towards the delirium care of hospitalised older adults with dementia and at risk of delirium. This study provided an understanding of the strengths and limitations of the educational programme delivered to registered nurses in South Korea. Registered nurses in South Korea should need not only appropriate education, but also adequate resources, policies and guidelines as well as support from managers and from all other healthcare professionals. © 2017 John Wiley & Sons Ltd.

The clinical implementation of primary HPV screening.

PubMed

Mariani, Luciano; Igidbashian, Sarah; Sandri, Maria Teresa; Vici, Patrizia; Landoni, Fabio

2017-03-01

To evaluate, from a gynecology perspective, the transition from cytology-based HPV screening to primary HPV screening. Studies examining switching from cytology-based screening to primary HPV-DNA testing with triaging of patients with positive test results were retrieved and reviewed, with a particular focus on screening in an Italian setting. The increased complexity of patient-management decisions when implementing HPV-based screening was a critical issue discussed in the literature. The change in strategy represents a paradigm shift in moving from a medical perspective of identifying the disease in individual patients, to a public-healthcare perspective of excluding HPV from the healthy population and identifying a small sub-group of individuals at increased risk of HPV. With knowledge about HPV screening evolving rapidly, new programs and related algorithms need to be sufficiently flexible to be adjusted according to ongoing research and the validation of new assays. The establishment of a national working group (including epidemiologists, gynecologists, pathologists, and healthcare providers) will be necessary to properly implement and govern this important technical and cultural transition. © 2016 International Federation of Gynecology and Obstetrics.

Development of a toolkit to enhance care processes for people with a long-term neurological condition: a qualitative descriptive study.

PubMed

Sezier, Ann; Mudge, Suzie; Kayes, Nicola; Kersten, Paula; Payne, Deborah; Harwood, Matire; Potter, Eden; Smith, Greta; McPherson, Kathryn M

2018-06-30

To (A) explore perspectives of people with a long-term neurological condition, and of their family, clinicians and other stakeholders on three key processes: two-way communication, self-management and coordination of long-term care; and (B) use these data to develop a 'Living Well Toolkit', a structural support aiming to enhance the quality of these care processes. This qualitative descriptive study drew on the principles of participatory research. Data from interviews and focus groups with participants (n=25) recruited from five hospital, rehabilitation and community settings in New Zealand were analysed using conventional content analysis. Consultation with a knowledge-user group (n=4) and an implementation champion group (n=4) provided additional operational knowledge important to toolkit development and its integration into clinical practice. Four main, and one overarching, themes were constructed: (1) tailoring care: referring to getting to know the person and their individual circumstances; (2) i nvolving others: representing the importance of negotiating the involvement of others in the person's long-term management process; (3) exchanging knowledge: referring to acknowledging patient expertise; and (4) enabling: highlighting the importance of empowering relationships and processes. The overarching theme was: a ssume nothing . These themes informed the development of a toolkit comprising of two parts: one to support the person with the long-term neurological condition, and one targeted at clinicians to guide interaction and support their engagement with patients. Perspectives of healthcare users, clinicians and other stakeholders were fundamental to the development of the Living Well Toolkit. The findings were used to frame toolkit specifications and highlighted potential operational issues that could prove key to its success. Further research to evaluate its use is now underway. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The usability axiom of medical information systems.

PubMed

Pantazi, Stefan V; Kushniruk, Andre; Moehr, Jochen R

2006-12-01

In this article we begin by connecting the concept of simplicity of user interfaces of information systems with that of usability, and the concept of complexity of the problem-solving in information systems with the concept of usefulness. We continue by stating "the usability axiom" of medical information technology: information systems must be, at the same time, usable and useful. We then try to show why, given existing technology, the axiom is a paradox and we continue with analysing and reformulating it several times, from more fundamental information processing perspectives. We underline the importance of the concept of representation and demonstrate the need for context-dependent representations. By means of thought experiments and examples, we advocate the need for context-dependent information processing and argue for the relevance of algorithmic information theory and case-based reasoning in this context. Further, we introduce the notion of concept spaces and offer a pragmatic perspective on context-dependent representations. We conclude that the efficient management of concept spaces may help with the solution to the medical information technology paradox. Finally, we propose a view of informatics centred on the concepts of context-dependent information processing and management of concept spaces that aligns well with existing knowledge centric definitions of informatics in general and medical informatics in particular. In effect, our view extends M. Musen's proposal and proposes a definition of Medical Informatics as context-dependent medical information processing. The axiom that medical information systems must be, at the same time, useful and usable, is a paradox and its investigation by means of examples and thought experiments leads to the recognition of the crucial importance of context-dependent information processing. On the premise that context-dependent information processing equates to knowledge processing, this view defines Medical Informatics as a context-dependent medical information processing which aligns well with existing knowledge centric definitions of our field.

Ecosystem services driven by the diversity of soil biota - understanding and management in agriculture - The Biodiversa SoilMan-Project

NASA Astrophysics Data System (ADS)

Potthoff, Martin; Pérès, Guénola; Taylor, Astrid; Schrader, Stefan; Landa, Blanca; Nicolai, Annegret; Sandor, Mignon; Öptik, Maarja; Gema, Guzmán; Bergmann, Holger; Cluzeau, Daniel; Banse, Martin; Bengtsson, Jan; Guernion, Muriel; Zaller, Johann; Roslin, Tomas; Scheu, Stefan; Gómez Calero, José Alfonso

2017-04-01

Soil biota diversity is ensuring primary production in terrestrial ecosystems and agricultural productivity. Water and nutrient cycling, soil formation and aggregation, decomposition and carbon sequestration as well as control of pest organisms are important functions in soil that are driven by biota and biota interactions. In agricultural systems these functions support and regulate ecosystem services directed to agricultural production and agricultural sustainability. A main goal of future cropping systems will be to maintain or raise agricultural productivity while keeping production sustainable in spite of increasing food demands and ongoing soil degradation caused by inappropriate soil management practices. Farm based tools that farmers use to engineer soils for plant production depend as soil management factors on decisions by farmers, which are triggered by regional traditions, knowledge and also by agriculture policies as a governance impact. However, biological impacts on soil fertility and soil health are often neglected or overseen when planning and shaping soil management in annual cropping systems or perennial systems like vineyards. In order to get progress in conservation farming and in agricultural sustainability not only knowledge creation is in need, but also a clash of perspectives has to be overcome within the societies (generals public, farmers associations, NGOs) The talk will present the conception of the recently startet SoilMan-project and summaries selected results from current and recent European research projects.

Stop the pain! A nation-wide quality improvement programme in paediatric oncology pain control.

PubMed

Zernikow, Boris; Hasan, Carola; Hechler, Tanja; Huebner, Bettina; Gordon, Deb; Michel, Erik

2008-10-01

Little is known about the impact of translation of pain management clinical practice guidelines on pain control in paediatrics. In an effort to overcome this, a longitudinal, nation-wide, multi-centre paediatric quality improvement (QI) study was initiated by the German Society of Pediatric Haematology and Oncology (GPOH) entitled Schmerz-Therapie in der Onkologischen Paediatrie (STOP). The project's primary major aims were to improve paediatric oncology pain control in Germany, and to evaluate the project's impact on the pain management quality. To achieve these aims, STOP encompassed six sequential phases to evaluate present practice, develop recommendations for practical pain control, actively engage participants in improvement strategies, and assess change. The purpose of this paper is to briefly describe STOP in its entirety, report on comparisons between active quality management (QM) departments that actively participated in the project and non-active QM departments regarding differences in pain control, patients' and parents' perspectives on pain control and health professionals' knowledge, and to discuss the impact of STOP as a whole. Four hypotheses were examined: (1) changes in health care professionals' knowledge on pain in paediatric oncology and pain management after a three-year period (2) impact of active participation in the STOP-project; (3) differences in patients' and parents' perspective in active QM versus non-active QM departments; (4) impact of the STOP-project on the health care professionals' knowledge in active QM versus non-active QM departments. Data included surveys, interviews, and standardised pre-/post-intervention documentation of pain control. All German paediatric oncology departments were invited to participate. The prime means of intervention was education (printed material, passive participation; additional lectures and feed-back, active participation). Quality indicators were defined and compared with regards to the four hypotheses. Sixty-eight departments participated passively. Eight departments participated actively, enrolling 224 patients (median age, 9 years) and documenting a total of 2265 treatment days. In the areas addressed, all health professionals demonstrated increases in knowledge on pain and pain control after a three-year period. STOP objectively improved pain control in the actively participating departments. Painful modes of drug administration were used less frequently; the usage of mixed opioid agonists-antagonists was reduced; the physicians' knowledge of the treatment of neuropathic pain increased; pain ratings significantly decreased, and less episodes of strong pain were observed. There was a significant increase in the proportion of health-care professionals who post-interventionally judged that pain therapy had been initiated earlier and at exactly the right time. Neither patients nor parents felt, however, that there was any quality improvement. According to participants' self-assessment, STOP improved practical pain management in actively participating departments, while in passively participating departments the change to the better was negligible. STOP predominantly aimed at and succeeded in the improvement of structure, process and outcome quality. With regard to patients' and parents' opinions, the interview tools might have been unsuited to measure the quality of pain control, or STOP was insufficient to improve pain control to a magnitude significant to the patient.

An Indigenous Knowledges Perspective on Valid Meaning Making: A Commentary on Research with the EDI and Aboriginal Communities

ERIC Educational Resources Information Center

Sam, Michele A.

2011-01-01

Offering an Indigenous perspective, this commentary discusses collaborative research, shared meaning making, and knowledge building specific to child development, and reflects on social, cultural, and historical aspects that influence these processes. Drawing upon experiences of developing a collaborative research approach with which to engage…

Thinking Socially: Teaching Social Knowledge to Foster Social Behavioral Change

ERIC Educational Resources Information Center

Crooke, Pamela J.; Winner, Michelle Garcia; Olswang, Lesley B.

2016-01-01

This article addresses the complexity of what it means to "be social" from the perspective of social thinking. This perspective recognizes social cognitive processing abilities as the foundation for social knowledge and, in turn, social behaviors. The article further describes variables that influence how one understands how to do what…

Rethinking Environmental Science Education from Indigenous Knowledge Perspectives: An Experience with a Dene First Nation Community

ERIC Educational Resources Information Center

Datta, Ranjan Kumar

2018-01-01

This auto-ethnographic article explores how land-based education might challenge Western environmental science education (ESE) in an Indigenous community. This learning experience was developed from two perspectives: first, land-based educational stories from Dene First Nation community Elders, knowledge holders, teachers, and students; and…

Exploring family communication about sickle cell disease in adolescence.

PubMed

Graff, J Carolyn; Hankins, Jane; Graves, Rebecca J; Robitaille, Kimberly Y; Roberts, Ruth; Cejda, Katherine; Hardy, Belinda T; Johnson, Margery; Porter, Jerlym S

2012-01-01

Sickle cell disease (SCD) is a lifelong disorder that involves progressive organ damage and requires ongoing medical attention to prevent and treat episodic acute complications. Children with SCD need ongoing monitoring and extra attention that may be stressful to family members. Communication within families can help resolve family stress and may be associated with medical follow-up and management of SCD. Focus groups were conducted with 12 African American families to explore the communication that occurred within and outside of the family from the perspectives of adolescents with SCD, siblings, and parents. Factors that influence family communication were explored. The extended family was an important social network and resource to adolescents, siblings, and parents. Family member knowledge of SCD was an important factor that influenced communication about SCD; adolescents and parents communicated more easily than siblings and also reported having more knowledge of SCD than siblings. Future research focusing on the knowledge of immediate and extended family members and their recognition of their contribution to the child with SCD is recommended.

Conceptual framework of knowledge management for ethical decision-making support in neonatal intensive care.

PubMed

Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M

2005-06-01

This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.

Challenges in managing patients in Australia with chronic hepatitis B: the General Practitioners' perspective.

PubMed

Wallace, Jack; Hajarizadeh, Behzad; Richmond, Jacqui; McNally, Stephen

2013-10-01

General Practitioners (GPs) are essential to reducing the impact of chronic hepatitis B (CHB) given their clinical management role where only 56% of people with the infection in Australia have been diagnosed. This qualitative study aimed to identify the challenges GPs face in effectively responding to CHB. Semi-structured interviews were conducted with 26 GPs self-identifying as having a 'high caseload' of patients and/or a particular interest in CHB. Participants were recruited from five jurisdictions and came from diverse ethnicities, clinical experience and practice profile. Interview data were analysed according to the principles of grounded theory. Patient and GP knowledge, a lack of community awareness, and language and cultural diversity impeded the GP response to CHB. Communication with specialists was reported as challenging with unclear referral pathways, limited feedback from specialists after referral, and poor liaison and support for managing people living with CHB. Regulations restricting GPs capacity to respond included the lack of prescribing opportunities, fear of Medicare auditing for screening the populations most at risk, and inadequate financial support given the complexity of CHB and the communities most affected by the infection. General Practitioners require additional skills and resources to support the effective management of people with CHB. These include improved awareness and knowledge about the infection, adequate financial resources to support patient management, and effective referral pathways and support. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Factors influencing oncology nurses' use of hazardous drug safe-handling precautions.

PubMed

Polovich, Martha; Clark, Patricia C

2012-05-01

To examine relationships among factors affecting nurses' use of hazardous drug (HD) safe-handling precautions, identify factors that promote or interfere with HD precaution use, and determine managers' perspectives on the use of HD safe-handling precautions. Cross-sectional, mixed methods; mailed survey to nurses who handle chemotherapy and telephone interviews with managers. Mailed invitation to oncology centers across the United States. 165 nurses who reported handling chemotherapy and 20 managers of nurses handling chemotherapy. Instruments measured the use of HD precautions and individual and organizational factors believed to influence precaution use. Data analysis included descriptive statistics and hierarchical regression. Manager interview data were analyzed using content analysis. Chemotherapy exposure knowledge, self-efficacy, perceived barriers, perceived risk, interpersonal influences, and workplace safety climate. Nurses were well educated, experienced, and certified in oncology nursing. The majority worked in outpatient settings and administered chemotherapy to an average of 6.8 patients per day. Exposure knowledge, self-efficacy for using personal protective equipment, and perceived risk of harm from HD exposure were high; total precaution use was low. Nurse characteristics did not predict HD precaution use. Fewer barriers, better workplace safety climate, and fewer patients per day were independent predictors of higher HD precaution use. HD handling policies were present, but many did not reflect current recommendations. Few managers formally monitored nurses' HD precaution use. Circumstances in the workplace interfere with nurses' use of HD precautions. Interventions should include fostering a positive workplace safety climate, reducing barriers, and providing appropriate nurse-patient ratios.

Facilitating smallholder tree farming in fragmented tropical landscapes: Challenges and potentials for sustainable land management.

PubMed

Rahman, Syed Ajijur; Sunderland, Terry; Roshetko, James M; Healey, John Robert

2017-08-01

Under changing land use in tropical Asia, there is evidence of forest product diversification through implementation of tree-based farming by smallholders. This paper assesses in two locations, West Java, Indonesia and eastern Bangladesh, current land use conditions from the perspective of smallholder farmers, the factors that facilitate their adoption of tree farming, and the potential of landscape-scale approaches to foster sustainable land management. Data were collected through rapid rural appraisals, focus group discussions, field observations, semi-structured interviews of farm households and key informant interviews of state agricultural officers. Land at both study sites is typically fragmented due to conversion of forest to agriculture and community settlement. Local land use challenges are associated with pressures of population increase, poverty, deforestation, shortage of forest products, lack of community-scale management, weak tenure, underdeveloped markets, government decision-making with insufficient involvement of local people, and poor extension services. Despite these challenges, smallholder tree farming is found to be successful from farmers' perspectives. However, constraints of local food crop cultivation traditions, insecure land tenure, lack of capital, lack of knowledge, lack of technical assistance, and perceived risk of investing in land due to local conflict (in Bangladesh) limit farmers' willingness to adopt this land use alternative. Overcoming these barriers to adoption will require management at a landscape scale, including elements of both segregation and integration of land uses, supported by competent government policies and local communities having sufficiently high social capital. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring the attributes of critical thinking: a conceptual basis.

PubMed

Forneris, Susan G

2004-01-01

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

The good doctor: the carer's perspective.

PubMed

Levine, Carol

2004-01-01

Carers are family members, friends, and neighbours who perform medical tasks and personal care, manage housekeeping and financial affairs, and provide emotional support to people who are ill, disabled, or elderly. From a carer's perspective, the primary requisite for a good doctor is competence. Assuming equal technical skills and knowledge, the difference between 'good' and 'bad' doctors comes down to attitudes and behaviour-communication. An important aspect of communication is what doctors say to carers, and how they interpret what carers say to them. Body language-stances, gestures and expression-communicates as well. Good doctors are surrounded by courteous, helpful and efficient assistants. Doctors can make two types of errors in dealing with carers. Type 1 errors occur when doctors exclude the carer from decision making and information. Type 2 errors occur when doctors speak only to the carer and ignore the patient. Good doctors, patients and carers confront the existential meaning of illness together.

Informed Consent and Genomic Incidental Findings: IRB Chair Perspectives

PubMed Central

Simon, Christian M.; Williams, Janet K.; Shinkunas, Laura; Brandt, Debra; Daack-Hirsch, Sandra; Driessnack, Martha

2013-01-01

It is unclear how genomic incidental finding (GIF) prospects should be addressed in informed consent processes. An exploratory study on this topic was conducted with 34 purposively sampled Chairs of institutional review boards (IRBs) at centers conducting genome-wide association studies. Most Chairs (96%) reported no knowledge of local IRB requirements regarding GIFs and informed consent. Chairs suggested consent processes should address the prospect of, and study disclosure policy on, GIFs; GIF management and follow-up; potential clinical significance of GIFs; potential risks of GIF disclosure; an opportunity for participants to opt out of GIF disclosure; and duration of the researcher's duty to disclose GIFs. Chairs were concerned about participant disclosure preferences changing over time; inherent limitations in determining the scope and accuracy of claims about GIFs; and making consent processes longer and more complex. IRB Chair and other stakeholder perspectives can help advance informed consent efforts to accommodate GIF prospects. PMID:22228060

Informed consent and genomic incidental findings: IRB chair perspectives.

PubMed

Simon, Christian M; Williams, Janet K; Shinkunas, Laura; Brandt, Debra; Daack-Hirsch, Sandra; Driessnack, Martha

2011-12-01

It is unclear how genomic incidental finding (GIF) prospects should be addressed in informed consent processes. An exploratory study on this topic was conducted with 34 purposively sampled Chairs of institutional review boards (IRBs) at centers conducting genome-wide association studies. Most Chairs (96%) reported no knowledge of local IRB requirements regarding GIFs and informed consent. Chairs suggested consent processes should address the prospect of, and study disclosure policy on, GIFs; GIF management and follow-up; potential clinical significance of GIFs; potential risks of GIF disclosure; an opportunity for participants to opt out of GIF disclosure; and duration of the researcher's duty to disclose GIFs. Chairs were concerned about participant disclosure preferences changing over time; inherent limitations in determining the scope and accuracy of claims about GIFs; and making consent processes longer and more complex. IRB Chair and other stakeholder perspectives can help advance informed consent efforts to accommodate GIF prospects.

Time perspective and social preference in older and younger adults: Effects of self-regulatory fatigue.

PubMed

Segerstrom, Suzanne C; Geiger, Paul J; Combs, Hannah L; Boggero, Ian A

2016-09-01

Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, 1 with younger adults (N = 101) and 1 with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Time Perspective and Social Preference in Older and Younger Adults: Effects of Self-Regulatory Fatigue

PubMed Central

Segerstrom, Suzanne C.; Geiger, Paul J.; Combs, Hannah L.; Boggero, Ian A.

2016-01-01

Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, one with younger adults (N = 101) and one with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. PMID:27243763

Comparing Pharmacy Benefit Managers: Moving Well Beyond the Simple Spreadsheet Analysis

PubMed Central

Calabrese, David

2008-01-01

Unabated increases in prescription drug demands, advancing technology, and rising drug inflation rates combined with a sagging economy, continue to intensify budget pressures for payors responsible for delivering pharmacy benefits to plan members. At the same time, high levels of complexity and resource requirements in drug benefit administration have led to a state in which plan sponsors remain heavily dependent on pharmacy benefit managers to assist in these efforts. With pharmacy representing such a critical component of healthcare delivery from clinical and economic perspectives, it is essential that sponsors exercise high levels of due diligence in pharmacy benefit manager review and appraisal to ensure proper balance of quality clinical care, sufficient access, and optimal cost-efficiency in the delivery of such benefits. This review is designed to provide a comprehensive understanding of current pharmacy benefit management business practices and help equip plan sponsors with the knowledge, strategies, and safeguards to drive a well-informed pharmacy benefit selection process and, inevitably, a better-aligned pharmacy benefit management–payor relationship. PMID:25126235

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program

PubMed Central

Kristensen, Erling; Enevoldsen, Carsten

2008-01-01

Background Research has been scarce when it comes to the motivational and behavioral sides of farmers' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers' goals among veterinarians. Methods The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians' competences as experienced by the farmers and time constraints in the farmers' everyday life. Results Farmers' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers' primary focus was on production and profit, however, farmers' valued teamwork and animal welfare more. Conclusion The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers' expectations. On the other hand veterinarians did not focus enough on the major products, which farmers really wanted to buy, i.e. teamwork and animal welfare. Consequently, disciplines like sociology, economics and marketing may offer new methodological approaches to veterinarians as these disciplines have understood that accounting for individual differences is central to motivate change, i.e. 'know thy customer'. PMID:19091134

A watershed-based adaptive knowledge system for developing ecosystem stakeholder partnerships

NASA Astrophysics Data System (ADS)

Lin, Hebin; Thornton, Jeffrey A.; Shadrin, Nickolai

2015-11-01

This study proposes a Watershed-based Adaptive Knowledge System (WAKES) to consistently coordinate multiple stakeholders in developing sustainable partnerships for ecosystem management. WAKES is extended from the institutional mechanism of Payments for Improving Ecosystem Services at the Watershed-scale (PIES-W). PIES-W is designed relating to the governance of ecosystem services fl ows focused on a lake as a resource stock connecting its infl owing and outfl owing rivers within its watershed. It explicitly realizes the values of conservation services provided by private land managers and incorporates their activities into the public organizing framework for ecosystem management. It implicitly extends the "upstream-to-downstream" organizing perspective to a broader vision of viewing the ecosystems as comprised of both "watershed landscapes" and "marine landscapes". Extended from PIES-W, WAKES specifies two corresponding feedback: Framework I and II. Framework I is a relationship matrix comprised of three input-output structures of primary governance factors intersecting three subsystems of a watershed with regard to ecosystem services and human stakeholders. Framework II is the Stakeholder-and-Information structure channeling five types of information among four stakeholder groups in order to enable the feedbacks mechanism of Framework I. WAKES identifies the rationales behind three fundamental information transformations, illustrated with the Transboundary Diagnostic Analysis and the Strategic Action Program of the Bermejo River Binational Basin. These include (1) translating scientific knowledge into public information within the Function-and-Service structure corresponding to the ecological subsystem, (2) incorporating public perceptions into political will within the Service- and- Value structure corresponding to the economic subsystem, and (3) integrating scientific knowledge, public perceptions and political will into management options within the Value-and-Stakeholder structure corresponding to the social subsystem. This study seeks to share a vision of social adaptation for a global sustainable future through developing a network to adopt contributions from and forming partnerships among all ecosystem stakeholders.

Hazard perception, risk perception, and the need for decontamination by residents exposed to soil pollution: the role of sustainability and the limits of expert knowledge.

PubMed

Vandermoere, Frédéric

2008-04-01

This case study examines the hazard and risk perception and the need for decontamination according to people exposed to soil pollution. Using an ecological-symbolic approach (ESA), a multidisciplinary model is developed that draws upon psychological and sociological perspectives on risk perception and includes ecological variables by using data from experts' risk assessments. The results show that hazard perception is best predicted by objective knowledge, subjective knowledge, estimated knowledge of experts, and the assessed risks. However, experts' risk assessments induce an increase in hazard perception only when residents know the urgency of decontamination. Risk perception is best predicted by trust in the risk management. Additionally, need for decontamination relates to hazard perception, risk perception, estimated knowledge of experts, and thoughts about sustainability. In contrast to the knowledge deficit model, objective and subjective knowledge did not significantly relate to risk perception and need for decontamination. The results suggest that residents can make a distinction between hazards in terms of the seriousness of contamination on the one hand, and human health risks on the other hand. Moreover, next to the importance of social determinants of environmental risk perception, this study shows that the output of experts' risk assessments-or the objective risks-can create a hazard awareness rather than an alarming risk consciousness, despite residents' distrust of scientific knowledge.

Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study.

PubMed

Dong, Skye T; Butow, Phyllis N; Agar, Meera; Lovell, Melanie R; Boyle, Frances; Stockler, Martin; Forster, Benjamin C; Tong, Allison

2016-04-01

Managing symptom clusters or multiple concurrent symptoms in patients with advanced cancer remains a clinical challenge. The optimal processes constituting effective management of symptom clusters remain uncertain. To describe the attitudes and strategies of clinicians in managing multiple co-occurring symptoms in patients with advanced cancer. Semistructured interviews were conducted with 48 clinicians (palliative care physicians [n = 10], oncologists [n = 6], general practitioners [n = 6], nurses [n = 12], and allied health providers [n = 14]), purposively recruited from two acute hospitals, two palliative care centers, and four community general practices in Sydney, Australia. Transcripts were analyzed using thematic analysis and adapted grounded theory. Six themes were identified: uncertainty in decision making (inadequacy of scientific evidence, relying on experiential knowledge, and pressure to optimize care); attunement to patient and family (sensitivity to multiple cues, prioritizing individual preferences, addressing psychosocial and physical interactions, and opening Pandora's box); deciphering cause to guide intervention (disaggregating symptoms and interactions, flexibility in assessment, and curtailing investigative intrusiveness); balancing complexities in medical management (trading off side effects, minimizing mismatched goals, and urgency in resolving severe symptoms); fostering hope and empowerment (allaying fear of the unknown, encouraging meaning making, championing patient empowerment, and truth telling); and depending on multidisciplinary expertise (maximizing knowledge exchange, sharing management responsibility, contending with hierarchical tensions, and isolation and discontinuity of care). Management of symptom clusters, as both an art and a science, is currently fraught with uncertainty in decision making. Strengthening multidisciplinary collaboration, continuity of care, more pragmatic planning of clinical trials to address more than one symptom, and training in symptom cluster management are required. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Walking the tightrope-perspectives on local politicians' role in implementing a national social care policy on evidence-based practice.

PubMed

Bäck, A; Ståhl, C; von Thiele Schwarz, U; Richter, A; Hasson, H

2016-01-01

Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers' perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

Knowledge Management: A Skeptic's Guide

NASA Technical Reports Server (NTRS)

Linde, Charlotte

2006-01-01

A viewgraph presentation discussing knowledge management is shown. The topics include: 1) What is Knowledge Management? 2) Why Manage Knowledge? The Presenting Problems; 3) What Gets Called Knowledge Management? 4) Attempts to Rethink Assumptions about Knowledgs; 5) What is Knowledge? 6) Knowledge Management and INstitutional Memory; 7) Knowledge Management and Culture; 8) To solve a social problem, it's easier to call for cultural rather than organizational change; 9) Will the Knowledge Management Effort Succeed? and 10) Backup: Metrics for Valuing Intellectural Capital i.e. Knowledge.

Enhancing introductory hydrology curriculum by integrating perspectives from multi-disciplinary graduate fields of study

NASA Astrophysics Data System (ADS)

Arnold, T. E.; Henson, W.; Reijo, C. J.; Laing, J.; Weinkam, G.

2015-12-01

A cross-disciplinary hydrology course was developed that combined field and classroom based techniques to educate undergraduate level students on issues related to water resources in Florida, USA. Six instructors from separate departments brought a different perspective, research experience, and view on water quality and quantity issues. The course progressed by examining hydrologic processes at different spatio-temporal scales beginning with the geologic scale (the formation of aquifers) and ending with present-day water management and policy concerns. We were challenged to introduce students from various academic backgrounds and levels to the core concepts of hydrology and water chemistry. Additionally, the instructors faced the task of making our research fit together seamlessly, such that one topic would naturally progress to the next topic. We ensured that students' knowledge progressed enough so they could address complex management issues through critical thinking and application of basic field techniques. It is our objective to share the experiences and challenges in developing an interdisciplinary course that: 1) introduced new research ideas and concepts from six separate fields, 2) enhanced lecture concepts by hands-on, field-based activities, and 3) would keep students from science and non-science backgrounds engaged and challenged but not overwhelmed.

The Use of Absorptive Capacity in Improving the New Product Development (NPD

NASA Astrophysics Data System (ADS)

Gunawan, W.; Gerardus, P.; Tji, B. J.; Richard, K.

2017-01-01

The term Absorptive Capacity (AC) refers to maximizing the external knowledge transfer into the organization in order to improve its performance. Since its introduction in year 1990, AC has been applied widely in many fields such as: economy, business, KM, HR, intellectual capital, IT, operation management, marketing, etc. Due to its wide application, nevertheless, The AC application in both Indonesian industry and higher education institutions (HEIs) are still rare to find. The Indonesian Directorate General of Higher Education (DGHE) has encouraged creating effective collaboration model that enables to link the HEIs with the industries in order to improve knowledge creation in improving product development that can be used by the firms. For this reason, the article examines the effective AC model that enables to assist in improving new product development (NPD) process in the polytechnic perspectives.

Integrating gender medicine into the workplace health and safety policy in the scientific research institutions: a mandatory task.

PubMed

Giammarioli, Anna Maria; Siracusano, Alessandra; Sorrentino, Eugenio; Bettoni, Monica; Malorni, Walter

2012-01-01

Gender medicine is a multi-faceted field of investigation integrating various aspects of psycho-social and biological sciences but it mainly deals with the impact of the gender on human physiology, pathophysiology, and clinical features of diseases. In Italy, the Decree Law 81/2008 recently introduced the gender issue in the risk assessment at the workplaces. This review briefly describes our current knowledge on gender medicine and on the Italian legislation in risk management. Public or private scientific institutions should be the first to pay attention to the safety of their workers, who are simultaneously subjected to biological, chemical and physical agents. Main tasks of risk management in scientific research institutions are here analyzed and discussed in a gender perspective.

Physician perspectives on the management of viral hepatitis and hepatocellular carcinoma in Myanmar

PubMed Central

Kim, Yoona A.; Trinh, Sam; Thura, Si; Kyi, Khin Pyone; Lee, Thomas; Sze, Stan; Richards, Adam; Aronsohn, Andrew; Wong, Grace L. H.; Tanaka, Yasuhito; Dusheiko, Geoffrey

2017-01-01

Background In Myanmar, over five million people are infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). Hepatitis has been a recent focus with the development of a National Strategic Plan on Hepatitis and plans to subsidize HCV treatment. Methods During a two-day national liver disease symposium covering HCV, HBV, hepatocellular (HCC), and end-stage liver disease (ESLD), physician surveys were administered using the automated response system (ARS) to assess physician knowledge, perceptions of barriers to screening and treatment, and proposed solutions. Multivariate logistic regression was used to estimate odds ratio (OR) relating demography and practice factors with higher provider knowledge and improvement. Results One hundred two physicians attending from various specialty areas (31.0% specializing in gastroenterology/hepatology and/or infectious disease) were of mixed gender (46.8% male), were younger than or equal to 40 years old (51.1% 20 to 40 years), had less experience (61.6% with ≤10 years of medical practice), were from the metropolitan area of Yangon (72.1%), and saw <10 liver disease patients per week (74.3%). The majority of physicians were not comfortable with treating or managing patients with liver disease. The post-test scores demonstrated an improvement in liver disease knowledge (9.0% ± 27.0) compared to the baseline pre-test scores; no variables were associated with significant improvement in hepatitis knowledge. Physicians identified the cost of diagnostic blood tests and treatment as the most significant barrier to treatment. Top solutions proposed were universal screening policies (46%), removal of financial barriers for treatment (29%), patient education (14%) and provider education (11%). Conclusions Physician knowledge improved after this symposium, and many other needs were revealed by the physician input on barriers to care and their solutions. These survey results are important in guiding the next steps to improve liver disease management and future medical education efforts in Myanmar. PMID:28797080

Physician perspectives on the management of viral hepatitis and hepatocellular carcinoma in Myanmar.

PubMed

Kim, Yoona A; Trinh, Sam; Thura, Si; Kyi, Khin Pyone; Lee, Thomas; Sze, Stan; Richards, Adam; Aronsohn, Andrew; Wong, Grace L H; Tanaka, Yasuhito; Dusheiko, Geoffrey; Nguyen, Mindie H

2017-01-01

In Myanmar, over five million people are infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). Hepatitis has been a recent focus with the development of a National Strategic Plan on Hepatitis and plans to subsidize HCV treatment. During a two-day national liver disease symposium covering HCV, HBV, hepatocellular (HCC), and end-stage liver disease (ESLD), physician surveys were administered using the automated response system (ARS) to assess physician knowledge, perceptions of barriers to screening and treatment, and proposed solutions. Multivariate logistic regression was used to estimate odds ratio (OR) relating demography and practice factors with higher provider knowledge and improvement. One hundred two physicians attending from various specialty areas (31.0% specializing in gastroenterology/hepatology and/or infectious disease) were of mixed gender (46.8% male), were younger than or equal to 40 years old (51.1% 20 to 40 years), had less experience (61.6% with ≤10 years of medical practice), were from the metropolitan area of Yangon (72.1%), and saw <10 liver disease patients per week (74.3%). The majority of physicians were not comfortable with treating or managing patients with liver disease. The post-test scores demonstrated an improvement in liver disease knowledge (9.0% ± 27.0) compared to the baseline pre-test scores; no variables were associated with significant improvement in hepatitis knowledge. Physicians identified the cost of diagnostic blood tests and treatment as the most significant barrier to treatment. Top solutions proposed were universal screening policies (46%), removal of financial barriers for treatment (29%), patient education (14%) and provider education (11%). Physician knowledge improved after this symposium, and many other needs were revealed by the physician input on barriers to care and their solutions. These survey results are important in guiding the next steps to improve liver disease management and future medical education efforts in Myanmar.

Knowledge about tuberculosis transmission and prevention and perceptions of health service utilization among index cases and contacts in Brazil: Understanding losses in the latent tuberculosis cascade of care.

PubMed

Salame, Flavia Matos; Ferreira, Márcia Danielle; Belo, Marcia Teresa; Teixeira, Eleny Guimarães; Cordeiro-Santos, Marcelo; Ximenes, Ricardo Arraes; de Albuquerque, Maria de Fátima Militão; Hill, Philip C; Menzies, Dick; Trajman, Anete

2017-01-01

Tuberculosis contacts are candidates for active and latent tuberculosis infection screening and eventual treatment. However, many losses occur in the different steps of the contacts' cascade of care. Reasons for this are poorly understood. To describe the different steps where losses in the contact cascade occur and to explore knowledge and attitudes regarding tuberculosis transmission/prevention and perceptions about tuberculosis services in order to understand the reasons for losses from the tuberculosis service users' perspective. We collected routine data from the index case and contact registry books and from patients' records to build the cascade of care of contacts in 12 health facilities in three Brazilian cities with high tuberculosis incidence rates. During a knowledge, attitudes and practices (KAP) survey, trained interviewers administered a semi-structured questionnaire to 138 index cases and 98 contacts. Most of the losses in the cascade occurred in the first two steps (contact identification, 43% and tuberculin skin testing placement, 91% of the identified contacts). Among KAP-interviewed contacts, 67% knew how tuberculosis is transmitted, 87% knew its key symptoms and 81% declared they would take preventive therapy if prescribed. Among KAP-interviewed index cases, 67% knew they could spread tuberculosis, 70% feared for the health of their families and 88% would like their family to be evaluated in the same services. Only a small proportion of contacts are evaluated for active and latent tuberculosis, despite their-and their index cases'-reasonable knowledge, positive attitudes towards prevention and satisfaction with tuberculosis services. In these services, education of service users would not be a sufficient solution. Healthcare workers' and managers' perspective, not explored in this study, may bring more light to this subject.

Supporting productive thinking: The semiotic context for Cognitive Systems Engineering (CSE).

PubMed

Flach, John

2017-03-01

The central thesis of this paper is that Rasmussen framed his approach to Cognitive Systems Engineering from the perspective of a Triadic Semiotic Model. This frame became the context for integrating multiple intellectual threads including Control Theory, Information Theory, Ecological Psychology, and Gestalt Psychology into a coherent theoretical framework. The case is made that the triadic semiotic framework is essential for a complete appreciation of the constructs that were central to Rasmussen's approach: Abstraction Hierarchy, Skill-Rules-Knowledge Model, Ecological Interface Design, and Proactive Risk Management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dealing with fear - from the perspective of adolescent girls with cancer.

PubMed

Anderzén-Carlsson, Agneta; Sörlie, Venke; Kihlgren, Annica

2012-07-01

Previously fears in adolescents with cancer has been identified in relation to medical procedures, death, altered appearance and as having an overall influence on life, but to our knowledge young people's perspectives on dealing with fear have not been previously investigated. To examine adolescents' perspectives on dealing with cancer related fear. Six girls participated in qualitative interviews focussing on their fear and and how they dealt with it. Data were analysed by means of qualitative content analysis. The results revealed two perspectives. First, the adolescents' own personal battle with fear. Second, they reported that they were not alone with their fear, as they shared it with significant others. An environment characterized by emotional presence helped them to deal with their fear, as well as prevented it from occurring. There is a need for staff and parents to be vigilant to the adolescents' need to feel cared for and allow them the opportunity to deal with their own fear, as at times they want to manage in their own way. Young patients have resources to cope with their fears and therefore should not be viewed as victims, but as young people with a great amount of competence, who benefit from a supportive environment. Copyright © 2011 Elsevier Ltd. All rights reserved.

A new approach in cross-domain collaborative research

NASA Astrophysics Data System (ADS)

Diviacco, Paolo; Fox, Peter; Busato, Alessandro

2016-04-01

Scientific research commonly faces the study of complex systems where multiple skills and competences are needed at the same time. Effective collaboration among researchers then becomes of paramount importance. Multidisciplinary studies imply the use of information and knowledge from domains that can be rather far from each other. Notwithstanding this, researchers, need to understand: what they handle, how to extract what they need and eventually produce something that can be used also by others. The management of information and knowledge in this perspective is not trivial. To develop methods and tools able to support such activities we need to analyze how collaborative research takes place. Besides the standard view that picture scientists committed to their endeavour to achieve solid and undebatable results, modern epistemology and sociology of science added a more fluid perspective where science can be considered mostly a social construct conditioned also by cognitive issues. These aspects cannot be obliterated; on the contrary they need to be carefully taken into consideration. Information is to be built from different perspectives and ways of thinking by actors with different point of views, approaches and aims, and in this, data should be understandable by all the designated community. In fact different communities develop their own ways of thinking, language and even myths, in other words they can be considered such as different cultures. To address these issues we invoke two strategies: (I) to formalize all the knowledge relevant for the study. This will means resolving all conflicting models among actors; something that is theoretically and has been demonstrated practically, very difficult to achieve. (II) Exploit the results of ethnographic studies conducted in the 1990's that explained how the introduction of representative artifacts allow different cultures to understand and use the same concepts in a different way. Both approaches have limitations and strengths, thus we propose to balance their simultaneous use: leveraging the formalization strength of web semantics while, at the same time, representing graphically snapshots of context dependent knowledge. A web based collaborative portal has been developed that integrates both approaches. First tests are taking place with encouraging results.

Generating Knowledge in a Learning Study--From the Perspective of a Teacher Researcher

ERIC Educational Resources Information Center

Thorsten, Anja

2017-01-01

The purpose of this article is to discuss and describe how a clinical research method can be used to generate knowledge about teaching and learning. This will be addressed from a teacher researcher's perspective, taking a conducted Learning Study as the departure. Learning Study is an interventionist, iterative and collaborative research approach,…

Contemporary Perspectives on Social Learning in Early Childhood Education. Contemporary Perspectives in Early Childhood Education

ERIC Educational Resources Information Center

Saracho, Olivia, Ed.; Spodek, Bernard, Ed.

2007-01-01

Social epistemology is a broad set of approaches to the study of knowledge and to gain information about the social dimensions. This intellectual movement of wide cross-disciplinary sources reconstructs the problems of epistemology when knowledge is considered to be intrinsically social. In the first chapter, "Social Epistemology and Social…

Belief, Knowledge and Understanding: How to Deal with the Relations between Different Cultural Perspectives in Classrooms

ERIC Educational Resources Information Center

Moreira-dos-Santos, Frederik; El-Hani, Charbel N.

2017-01-01

This article discusses how to deal with the relations between different cultural perspectives in classrooms, based on a proposal for considering understanding and knowledge as goals of science education, inspired by Dewey's naturalistic humanism. It thus combines educational and philosophical interests. In educational terms, our concerns relate to…

Bologna in Context: A Horizontal Perspective on the Dynamics of Governance Sites for a Europe of Knowledge

ERIC Educational Resources Information Center

Gornitzka, Ase

2010-01-01

This article presents a horizontal perspective on the dynamics of governance sites currently active for the European of Knowledge and places the Bologna process in this wider European level context. It introduces two dynamics of change in political organisation: (a) institutional differentiation and specialisation and (b) the interaction between…

Contemporary Perspectives on Early Childhood Curriculum. Contemporary Perspectives in Early Childhood Education.

ERIC Educational Resources Information Center

Saracho, Olivia N. Ed.; Spodek, Bernard, Ed.

Noting that the curriculum in early childhood education is dramatically different from that at other levels of education, this volume seeks to clarify some of the issues related to early childhood curriculum development and its bases in both personal knowledge and knowledge from the different disciplines to achieve a "balanced curriculum."…

Learning and Development: A Global Perspective. Symposium Series 15.

ERIC Educational Resources Information Center

Thomas, Alan, Ed.; Ploman, Edward W., Ed.

Fourteen papers presented at the Global Learning Symposium examine the learning perspective and its relationship to problems of world development. The learning perspective is compared and contrasted with the education perspective to reflect the degree to which the distinction reveals new knowledge on existing problems. Papers and presenters are:…

A Study of Personal Health Record User's Behavioral Model Based on the PMT and UTAUT Integrative Perspective.

PubMed

Hsieh, Hui-Lung; Kuo, Yu-Ming; Wang, Shiang-Ru; Chuang, Bi-Kun; Tsai, Chung-Hung

2016-12-23

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.

Australian engineering educators' attitudes towards Aboriginal cultures and perspectives

NASA Astrophysics Data System (ADS)

Goldfinch, Thomas; Prpic, Juliana Kaya; Jolly, Lesley; Leigh, Elyssebeth; Kennedy, Jade

2017-07-01

In Australia, representation of Aboriginal populations within the engineering profession is very low despite participation targets set by Government departments, professional bodies and Universities. Progressing the Aboriginal inclusion agenda within Australian Engineering Education requires a clearer understanding of engineering educators' preparedness for increased numbers of students from this non-traditional cohort. This research stems from a recently completed project that explored Aboriginal perspectives in engineering education and proposed a model for embedding perspectives in curricula. Nine engineering academics were interviewed to explore attitudes towards Aboriginal perspectives in engineering and the viability of the proposed model. Results of the interviews indicate efforts to embed Aboriginal perspectives are starting from a small base of knowledge and experience. Individuals' motivations and values indicate that there is significant support for improving this, but that efforts can be hampered by conceptions of Aboriginal perspectives that do not consider how Aboriginal knowledges may change engineering itself.

Evaluation of an educational program on deciphering heterogeneity for medical coverage decisions.

PubMed

Warholak, Terri L; Hilgaertner, Jianhua W; Dean, Joni L; Taylor, Ann M; Hines, Lisa E; Hurwitz, Jason; Brown, Mary; Malone, Daniel C

2014-06-01

It is increasingly important for decision makers, such as medical and pharmacy managers (or pharmacy therapeutics committee members and staff), to understand the variation and diversity in treatment response as decisions shift from an individual patient perspective to optimizing care for populations of patients. To assess the effectiveness of an instructional program on heterogeneity designed for medical and pharmacy managers. A live educational program was offered to members of the Academy of Managed Care Pharmacy at the fall 2012 educational meeting and also to medical directors and managers attending a national payer roundtable meeting in October 2012. Participants completed a retrospective pretest-posttest assessment of their knowledge, attitudes, and self-efficacy immediately following the program. Participants were offered the opportunity to participate in a follow-up assessment 6 months later. Willing participants for the follow-up assessment were contacted via e-mail and telephone. Rasch rating scale models were used to compare pre- and postscores measuring participants' knowledge about and attitude towards heterogeneity. A total of 49 individuals completed the retrospective pretest-posttest assessment and agreed to be a part of the program evaluation. Fifty percent (n = 25) of participants had heard of the phrase "heterogeneity of treatment effect," and 36 (72%) were familiar with the phrase "individualized treatment effect" prior to the live program. Participants reported a significant improvement in knowledge of heterogeneity (P  less than  0.01) and attitudes about heterogeneity (P  less than  0.01) immediately after attending the program. At the time of the educational program, participants had either never considered heterogeneity (26%) or reported not knowing (28%) whether their organizations considered it when determining basic coverage. Participants were more likely to report "sometimes" considering heterogeneity for determining necessity for individual appeals, prior authorization, tier placement for pharmaceutical therapies, and other types of medical management. At the 6-month follow-up, 21 of the 49 willing participants (43% response rate) completed the evaluation; participants continued to have a good understanding of heterogeneity, but there was no significant difference in attitudes towards heterogeneity between pre- and 6-month follow-up. A live educational program was effective in improving participants' immediate knowledge and attitudes regarding the topic of heterogeneity. Participating managed care pharmacists and medical managers indicated that heterogeneity of treatment effect was likely to be used in determining prior authorizations and determining necessity.

Shared mental models of integrated care: aligning multiple stakeholder perspectives.

PubMed

Evans, Jenna M; Baker, G Ross

2012-01-01

Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter-organizational and inter-professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration. The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief. The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory-based framework of psychological factors that may influence inter-organizational and inter-professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care. MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care. Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.

Managing respiratory care services.

PubMed

Thalman, Janice J

2004-06-01

Managing in a health care environment is not for the frail of heart or weak of spirit. Health care is a system in crisis that is exacerbated because it got there by doing what once made it successful. From 1900 to 2004, focus of health care has shifted from controlling infectious diseases to episodic care and to present-day chronic and perspective care. The system has moved from issues of mortality, to morbidity, to mobility, to quality of life, to feeling good and, finally, to looking good. Managing the delivery of health care, if you choose to accept it, is not an impossible mission, but it will be a challenging job. Obviously, the focus of managers is how the system can be designed to innovate and improve care. Organizations and professions must change not only structures and processes, but national priorities for improvement with better methods of disseminating and applying knowledge. Managers of respiratory care departments must foster the use of information technology in clinical care, must create payment policies that encourage innovation and tested performance, and must enhance education programs to strengthen and retain the health care work forces.

[HUMAN RESOURCES MANAGEMENT BASED ON COMPETENCIES].

PubMed

Larumbe Andueza, Ma Carmen; De Mendoza Cánton, Juana Hermoso

2016-05-01

We are living in a time with a lot of changes in which health organizations have more challenges to face. One of them is to recognize, strengthen, develop and retain the talent they have. Competency-based human resources management is emerging as a tool that contributes to achieve that aim. Competencies from the generic or characteristic perspective: personality traits, values and motivations, which are deeply rooted in the person. Through elaborating a competencies map for the organization, and identifying the job competencies profile, above all in key jobs, the employees know what it is going to expect from them. After, detect and cover the learning needs, it is possible to achieve better adjust between worker-job. The nursing unit manager is a key job because it is a link between management team and nursing team. The way that it is performed, it will have impact on the quality of care and its team motivation. So, the most adequate person who covers this job would have a part of knowledge, skills, attitudes and compatible interests with her job. Competency-based management helps identify both the potential and learning needs to performing this job.

Manager-physician relationships: an organizational theory perspective.

PubMed

Kaissi, Amer

2005-01-01

Manager-physician relationships are a critical determinant of the success of health care organizations. As the health care industry is moving toward a situation characterized by higher scarcity of resources, fiercer competition, more corporitization, and strict cost-containment approaches, managers and physicians should, more than ever, work together under conjoint or shared authority. Thus, their relationship can be described as one of high rewards, but also of high risk because of the wide range of differences that exist between them: different socializations and trainings resulting in different worldviews, value orientation and expectations and different cultures. In brief, managers and physicians represent different "tribes," each with its language, values, culture, thought patterns, and rules of the game. This article's main objective is to determine the underlying factors in the manager-physician relationship and to suggest ways that make this relationship more effective. Four different organizational perspectives will be used. The occupational perspective will give insights on the internal characteristics of the occupational communities of managers and physicians. The theory of deprofessionalization of physicians will also be discussed. The structuring perspective will look at the manager-physician relationship as a structure in the organization and will determine the effects of contextual factors (size, task uncertainty, strategy, and environment) on this relationship and the resulting effect on performance and effectiveness of the organization. The culture and control perspective will help detect the cultural differences between managers and physicians and how these interact to affect control over the decision-making areas in the hospital. The power, conflict, and dialectics perspective will shed the light on the conflicting interests of managers and physicians and how these shape the "power game" in the organization. Consequently, a theoretical model of manager-physician relationships that encompasses all these perspectives is developed.

Family management of a chronic health condition: perspectives of adolescents.

PubMed

Wollenhaupt, Josanne; Rodgers, Beth; Sawin, Kathleen J

2012-02-01

A growing number of adolescents and their families are dealing with a chronic health condition that impacts their daily life. Research using the Family Management Style Framework (FMSF) has added much to our understanding of how the family integrates chronic condition management into family life. Less clear, however, is the adolescent perspective of the FMSF components. The purpose of this secondary qualitative analysis was to explore 25 interviews of adolescents with spina bifida to uncover the adolescent's perspective of the three major FMSF components: Definition of the Situation, Management Behaviors, and Perceived Consequences. Adolescents were able to articulate their perspectives and their observations of their parents' behaviors that related to the three components and related dimensions of the framework. Data from this analysis led to proposed expansion of the FMSF definitions from an adolescent perspective. Implications for integrating the adolescent perspective into future research and clinical practice are discussed.

Challenges, developments and perspectives in intermittent ...

EPA Pesticide Factsheets

Although more than half the world's river networks comprise channels that periodically cease to flow and dry [intermittent rivers (IRs)], river ecology was largely developed from and for perennial systems. Ecological knowledge of IRs is rapidly increasing, so there is a need to synthesise this knowledge and deepen ecological understanding.In this Special Issue, we bring together 13 papers spanning observational case studies, field and laboratory experiments and reviews to guide research and management in this productive field of freshwater science. We summarise new developments in IR ecology, identify research gaps and needs, and address how the study of IRs as highly dynamic ecosystems informs ecological understanding more broadly.This series of articles reveals that contemporary IR ecology is a multifaceted and maturing field of research at the interface between aquatic and terrestrial ecology. This research contributes to fresh water and general ecology by testing concepts across a range of topics, including disturbance ecology, metacommunity ecology and coupled aquatic-terrestrial ecosystems.Drying affects flow continuity through time and flow connectivity across longitudinal, lateral and vertical dimensions of space, which aligns well with the recent emphasis of mainstream ecology on meta-system perspectives. Although most articles here focus on the wet phase, there is growing interest in dry phases, and in the terrestrial vegetation and invertebrate assemb

The Prescription Opioid Epidemic: Social Media Responses to the Residents' Perspective Article.

PubMed

Choo, Esther K; Mazer-Amirshahi, Maryann; Juurlink, David; Kobner, Scott; Scott, Kevin; Lin, Michelle

2016-01-01

In June 2014, Annals of Emergency Medicine collaborated with the Academic Life in Emergency Medicine (ALiEM) blog-based Web site to host an online discussion session featuring the Annals Residents' Perspective article "The Opioid Prescription Epidemic and the Role of Emergency Medicine" by Poon and Greenwood-Ericksen. This dialogue included a live videocast with the authors and other experts, a detailed discussion on the ALiEM Web site's comment section, and real-time conversations on Twitter. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,262 unique page views from 433 cities in 41 countries on the ALiEM Web site, 408,498 Twitter impressions, and 168 views of the video interview with the authors. Four major themes about prescription opioids identified included the following: physician knowledge, inconsistent medical education, balance between overprescribing and effective pain management, and approaches to solutions. Free social media technologies provide a unique opportunity to engage with a diverse community of emergency medicine and non-emergency medicine clinicians, nurses, learners, and even patients. Such technologies may allow more rapid hypothesis generation for future research and more accelerated knowledge translation. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Knowledge expectations of recently diagnosed patients with knee osteoarthritis.

PubMed

Pellinen, Tiina; Villberg, Jari; Raappana, Maarit; Leino-Kilpi, Helena; Kettunen, Tarja

2016-11-01

The aim of this study was to assess the socio-demographic and disease-related symptoms and emotions and knowledge expectations of patients recently diagnosed with knee osteoarthritis. A further aim was to determine associations between selected demographic variables and patients' expected knowledge. Patient counselling and information provision are recommended for all patients with knee osteoarthritis. In healthcare centres, there is a good possibility to establish the knowledge expectations of patients with knee osteoarthritis during counselling. Recent empirical evidence indicates a lack of research on knowledge expectations among recently diagnosed patients with knee osteoarthritis. A quantitative, descriptive inquiry design was adopted. The data were collected from 252 recently diagnosed patients with knee osteoarthritis by a postal survey in 2013, using the Hospital Patient's Knowledge Expectations Scale as well as additional questions and statements. The data were analysed using multivariate linear regression. Most of the respondents were female pensioners who also had other chronic diseases. Approximately half of the participants had had counselling on osteoarthritis. Knowledge expectations concerning pain management were emphasized. From the empowering knowledge perspective, the highest knowledge expectations concerned bio-physiological dimensions of knowledge, followed by ethical and financial dimensions. Age, employment status, pain and emotions of concern and hope among women and tiredness or fatigue and vocational/higher education among men were associated with knowledge expectations. Patients with knee osteoarthritis have high knowledge expectations and there is a need to improve the counselling and care of pain and tiredness or fatigue symptoms. The development of the counselling of recently diagnosed patients with knee osteoarthritis also needs further research. © 2016 John Wiley & Sons Ltd.

Patient-centered priorities for improving medication management and adherence.

PubMed

McMullen, Carmit K; Safford, Monika M; Bosworth, Hayden B; Phansalkar, Shobha; Leong, Amye; Fagan, Maureen B; Trontell, Anne; Rumptz, Maureen; Vandermeer, Meredith L; Brinkman, William B; Burkholder, Rebecca; Frank, Lori; Hommel, Kevin; Mathews, Robin; Hornbrook, Mark C; Seid, Michael; Fordis, Michael; Lambert, Bruce; McElwee, Newell; Singh, Jasvinder A

2015-01-01

The Centers for Education and Research on Therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient-centered perspective and to explore the potential of patient-centered medication management to improve chronic disease treatment. Patients, providers, researchers, and other stakeholders (N = 28) identified and prioritized ideas for future research and practice. We analyzed stakeholder voting on priorities and reviewed themes in workshop discussions. Ten priority areas emerged. Three areas were highly rated by all stakeholder groups: creating tools and systems to facilitate and evaluate patient-centered medication management plans; developing training on patient-centered prescribing for providers; and increasing patients' knowledge about medication management. However, priorities differed across stakeholder groups. Notably, patients prioritized using peer support to improve medication management while researchers did not. Engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research. Workshop participants recognized the potential benefits of patient-centered medication management but also identified many challenges to implementation that require additional research and innovation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A method to assess how interactive water simulation tools influence transdisciplinary decision-making processes in water management

NASA Astrophysics Data System (ADS)

Leskens, Johannes

2015-04-01

In modern water management, often transdisciplinary work sessions are organized in which various stakeholders participate to jointly define problems, choose measures and divide responsibilities to take actions. Involved stakeholders are for example policy analysts or decision-makers from municipalities, water boards or provinces, representatives of pressure groups and researchers from knowledge institutes. Parallel to this increasing attention for transdisciplinary work sessions, we see a growing availability of interactive IT-tools that can be applied during these sessions. For example, dynamic flood risk maps have become recently available that allow users during a work sessions to instantaneously assess the impact of storm surges or dam breaches, displayed on digital maps. Other examples are serious games, realistic visualizations and participatory simulations. However, the question is if and how these interactive IT-tools contribute to better decision-making. To assess this, we take the process of knowledge construction during a work session as a measure for the quality of decision-making. Knowledge construction can be defined as the process in which ideas, perspectives and opinions of different stakeholders, all having their own expertise and experience, are confronted with each other and new shared meanings towards water management issues are created. We present an assessment method to monitor the process of knowledge construction during work sessions in water management in which interactive IT tools are being used. The assessment method is based on a literature review, focusing on studies in which knowledge construction was monitored in other contexts that water management. To test the applicability of the assessment method, we applied it during a multi-stakeholder work session in Westland, located in the southwest of the Netherlands. The discussions during the work session were observed by camera. All statements, expressed by the various members of a stakeholder session, were classified according to our assessment method. We can draw the following preliminary conclusions. First, the case study showed that the method was useful to show the knowledge construction process over time, in terms of content and cognitive level of statements and interaction, attention and response between stakeholders. It was observed that the various aspects of knowledge construction all were influenced by the use of the 3Di model. The model focused discussions on technical issues of flood risk management, non-flood specialists were able to participate in discussions and in suggesting solutions and more topics could be evaluated in respect to non-interactive flood maps. Second, the method is considered useful as a benchmark for different interactive IT tools. The method is also considered useful to gain insight in how to optimally set-up multi-stakeholder meetings in which interactive IT-tools are being used. Further, the method can provide model developers insight in how to better meet the technical requirements of interactive IT tools to support the knowledge construction process during multi-stakeholder meeting

Incorporating Cultural Perspectives into Diabetes Self-Management Programs for East Asian Immigrants: A Mixed-Study Review.

PubMed

Park, Chorong; Nam, Soohyun; Whittemore, Robin

2016-04-01

It is important to understand East Asian immigrants (EAIs)' unique perspectives in managing diabetes in order to provide culturally-competent care. However, it is not known whether EAIs' perspectives are addressed in diabetes self-management interventions developed for EAIs. Therefore, a mixed-study review was conducted to identify EAIs' perspective from qualitative research (n = 9 studies) and to evaluate the components of EAI diabetes self-management interventions (n = 7). Themes from the qualitative synthesis demonstrated that EAIs have unique cultural values and traditional health beliefs while struggling with multi-contextual barriers due to immigration. The evaluation of EAI diabetes self-management interventions revealed that there was a lack of consensus on cultural strategies for EAIs' across the interventions. Addressing language barriers was the only factor consistently integrated in the cultural components of intervention by employing bilingual interventionists. EAIs' perspectives and experiences need to be incorporated in the future diabetes self-management interventions to better provide culturally-competent care.

Challenges and Opportunities for Integrating Social Science Perspectives into Climate and Global Change Assessments

NASA Astrophysics Data System (ADS)

Larson, E. K.; Li, J.; Zycherman, A.

2017-12-01

Integration of social science into climate and global change assessments is fundamental for improving understanding of the drivers, impacts and vulnerability of climate change, and the social, cultural and behavioral challenges related to climate change responses. This requires disciplinary and interdisciplinary knowledge as well as integrational and translational tools for linking this knowledge with the natural and physical sciences. The USGCRP's Social Science Coordinating Committee (SSCC) is tasked with this challenge and is working to integrate relevant social, economic and behavioral knowledge into processes like sustained assessments. This presentation will discuss outcomes from a recent SSCC workshop, "Social Science Perspectives on Climate Change" and their applications to sustained assessments. The workshop brought academic social scientists from four disciplines - anthropology, sociology, geography and archaeology - together with federal scientists and program managers to discuss three major research areas relevant to the USGCRP and climate assessments: (1) innovative tools, methods, and analyses to clarify the interactions of human and natural systems under climate change, (2) understanding of factors contributing to differences in social vulnerability between and within communities under climate change, and (3) social science perspectives on drivers of global climate change. These disciplines, collectively, emphasize the need to consider socio-cultural, political, economic, geographic, and historic factors, and their dynamic interactions, to understand climate change drivers, social vulnerability, and mitigation and adaptation responses. They also highlight the importance of mixed quantitative and qualitative methods to explain impacts, vulnerability, and responses at different time and spatial scales. This presentation will focus on major contributions of the social sciences to climate and global change research. We will discuss future directions for sustained assessments that integrate and reflect the social science understanding of the complex relationships between social and natural worlds in a changing climate, and factors that impact effective mitigation and adaptation strategies that address risks and vulnerabilities of climate change.

A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health.

PubMed

Johnston, Leah; Doyle, Joyce; Morgan, Bec; Atkinson-Briggs, Sharon; Firebrace, Bradley; Marika, Mayatili; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Rowley, Kevin

2013-08-09

Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller's Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge.

A Review of Programs That Targeted Environmental Determinants of Aboriginal and Torres Strait Islander Health

PubMed Central

Johnston, Leah; Doyle, Joyce; Morgan, Bec; Atkinson-Briggs, Sharon; Firebrace, Bradley; Marika, Mayatili; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Rowley, Kevin

2013-01-01

Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge. PMID:23939388

Determining specific competencies for General Internal Medicine residents (PGY 4 and PGY 5). What are they and are programs currently teaching them? A survey of practicing Canadian General Internists.

PubMed

Card, Sharon E; Pausjenssen, Anne M; Ottenbreit, Rachel C

2011-11-03

General Internal Medicine (GIM) has recently been approved as a subspecialty by the Royal College of Physicians and Surgeons of Canada. As such, there is a need to define areas of knowledge that a General Internist must learn in those two years of training. There is limited literature as to what competencies are needed in a GIM practice. Draft competencies for GIM (4th and 5th year residents in internal medicine) training were developed over eight years with input from many stakeholders. Practicing General Internists were surveyed and asked their perspective as to the level of importance of each of these competencies for GIM training. They were also asked if training gaps exist in current training programs. The survey was offered widely online in both English and French to gain perspectives from as many different contexts as possible. 157 General Internists, in practice on average for 15 years, responded from all of Canada's provinces and territories. Practice profiles were diverse (large urban centers to rural centers). The majority of the competencies surveyed were perceived as important to attain at least proficiency in. Perioperative care, risk reduction, and the management of common, emergent, and complex internal medicine problems were identified as key areas to focus training programs on, with respondents perceiving these should be mastered to an expert level. Training gaps were identified, most frequently in that of the manager role (example managing practice). This is the first study we are aware of to attempt to isolate the opinions of practicing Canadian General Internists as to the major competencies that should be mastered as a General Internist. We suggest that "generalism" in the context of GIM, does not mean a bit of knowledge about everything but that defined objectives for training in this 'newest' of Royal College subspecialties can be identified. This includes mastery of core areas such as perioperative care, risk reduction, and management of common, emergent and multiple internal medicine problems. The training gaps identified need to be addressed to ensure that General Internists continue to provide excellence in health care delivery.

Contrasting and not-so-contrasting perspectives between local stakeholders and scientists and across dryland sites in participatory assessment of land management

NASA Astrophysics Data System (ADS)

Bautista, Susana; Zucca, Claudio; Urghege, Anna M.; Ramón Vallejo, V.

2015-04-01

The participation of stakeholders and the integration of scientific and local knowledge in the assessment of environmental problems and potential solutions have been increasingly demanded by international institutions. Participatory assessment has the potential to engender social learning among all stakeholders, including scientists, which then has the potential to increase collaboration and the probability for adoption of good practices. Using PRACTICE participatory assessment tool, IAPro, a number of assessment criteria were identified, selected and weighted by local stakeholder platforms (SHPs) and scientists in 18 dryland sites distributed across 11 countries. These criteria were then applied to the assessment of a variety of local land management actions. In total, around 50 criteria were proposed by the SHPs, ranging from 6 to 14 per platform. The proposed criteria represented a wide variety of social, economic, cultural, and environmental aspects. Many of them were proposed by many of the SHPs, stressing their potential as universal assessment criteria across drylands. In most cases, these repeatedly proposed criteria were the same criteria proposed by the scientific panel. The relative importance given to the variety of criteria by each SHP was evenly distributed among the economic wealth criterion and each of the main categories of ecosystem services (provisioning, supporting & regulating, and cultural). In general, African and American sites where local people economies heavily rely on natural lands gave higher weights than European sites to "economic-wealth", "provision of goods", and "supporting and regulating services" criteria, and also to "socio-cultural services". All European SHPs selected and gave great importance to criteria that are related to security, such hydrogeological hazard, flood prevention, and fire risk. The participatory assessment process in IAPro facilitated social learning among the stakeholders, including scientists, and promoted knowledge exchange at multiple levels. The change between the initial and final perspectives on the assessment criteria and the quality of the management actions assessed was considered to be a metric of the learning gained through the IAPro process. A decrease in the variability of weights and rates given by the stakeholders to each criteria and management action reflects the consensus building process that takes place during the discussion sessions.

Intersectional perspective in elderly care.

PubMed

Cuesta, Marta; Rämgård, Margareta

2016-01-01

Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care) the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions) and interrelates them to processes of power (objective dimension). This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employees' well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over 6 months, the staff were engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.). The result of this study presents three themes that express the staff's experiences and connect these experiences to structural discrimination. 1) Intersectionality, knowledge, and experiences of professionalism; 2) Intersectionality, knowledge, and experiences of collaboration; and 3) Intersectionality, knowledge, and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness raising, strengthening the employee's self-confidence, in a positive way.

Intersectional perspective in elderly care

PubMed Central

Cuesta, Marta; Rämgård, Margareta

2016-01-01

Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care) the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions) and interrelates them to processes of power (objective dimension). This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employees’ well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over 6 months, the staff were engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.). The result of this study presents three themes that express the staff's experiences and connect these experiences to structural discrimination. 1) Intersectionality, knowledge, and experiences of professionalism; 2) Intersectionality, knowledge, and experiences of collaboration; and 3) Intersectionality, knowledge, and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness raising, strengthening the employee's self-confidence, in a positive way. PMID:27167554

The effect of coworker knowledge sharing on performance and its boundary conditions: an interactional perspective.

PubMed

Kim, Seckyoung Loretta; Yun, Seokhwa

2015-03-01

Considering the importance of coworkers and knowledge sharing in current business environment, this study intends to advance understanding by investigating the effect of coworker knowledge sharing on focal employees' task performance. Furthermore, by taking an interactional perspective, this study examines the boundary conditions of coworker knowledge sharing on task performance. Data from 149 samples indicate that there is a positive relationship between coworker knowledge sharing and task performance, and this relationship is strengthened when general self-efficacy or abusive supervision is low rather than high. Our findings suggest that the recipients' characteristics and leaders' behaviors could be important contingent factors that limit the effect of coworker knowledge sharing on task performance. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2015 APA, all rights reserved.

The Teacher's Roles in Light of Knowledge Economy from the Perspective of the Educational Supervisors' in Palestine

ERIC Educational Resources Information Center

Sabbah, Suhair Sulaiman Mohammed; Naser, Inas Aref Saleh; Awajneh, Ahlam Mustafa Hasan

2016-01-01

This study aims at identifying the teacher's roles in light of knowledge economy from the perspective of the educational supervisors in Palestine. To achieve the study's objective, a questionnaire consisted of 35 items was developed and applied on 50 male and female supervisors in the Directorate of Education in governorate of Ramallah, al-Bireh…

The Effects of University Mergers in China since 1990s: From the Perspective of Knowledge Production

ERIC Educational Resources Information Center

Mao, Ya-qing; Du, Yuan; Liu, Jing-juan

2009-01-01

Purpose: The purpose of this paper is to discover and better understand the efficiency of university mergers from the perspective of knowledge production, with the research capability as the point of contact. Design/methodology/approach: In total, 20 colleges and universities directly under the central ministries that merged in 2000 were taken as…

Potential Teachers' Appropriate and Inappropriate Application of Pedagogical Resources in a Model-Based Physics Course: A "Knowledge in Pieces" Perspective on Teacher Learning

ERIC Educational Resources Information Center

Harlow, Danielle B.; Bianchini, Julie A.; Swanson, Lauren H.; Dwyer, Hilary A.

2013-01-01

We used a "knowledge in pieces" perspective on teacher learning to document undergraduates' pedagogical resources in a model-based physics course for potential teachers. We defined pedagogical resources as small, discrete ideas about teaching science that are applied appropriately or inappropriately in specific contexts. Neither…

Explicit Knowledge and Processes from a Usage-Based Perspective: The Developmental Trajectory of an Instructed L2 Learner

ERIC Educational Resources Information Center

Roehr-Brackin, Karen

2014-01-01

This article considers explicit knowledge and processes in second language (L2) learning from a usage-based theoretical perspective. It reports on the long-term development of a single instructed adult learner's use of two L2 constructions, the German Perfekt of "gehen" ("go," "walk") and "fahren"…

Prioritizing the 21st Century Superintendent's Skill Set and Knowledge Base from the School Board Leadership Perspective

ERIC Educational Resources Information Center

Shaw, Teri L.

2014-01-01

The purpose of this study was to identify the extent that specific research based skill sets and areas of knowledge emerged as highly important, moderately important, and less important from the perspective of school board leadership as it pertains to 21st century superintendents. The study further disaggregated the data by specific school…

Using Voice, Meaning, Mutual Construction of Knowledge, and Transfer of Learning to Apply an Ecological Perspective to Group Work Training

ERIC Educational Resources Information Center

Orr, Jonathan J.; Hulse-Killacky, Diana

2006-01-01

Concepts of voice, meaning, mutual construction of knowledge, and transfer of learning are presented in this paper as critical ingredients that support the teaching of group work from an ecological perspective. Examples of these concepts are given to illustrate their application in group work classes. (Contains 1 table.)

Provision and Preservation of Knowledge: A Department of Educational and Psychological Research as Laboratory for Analyzing Scientific Discourse.

ERIC Educational Resources Information Center

Bierschenk, Bernhard

Two kinds of perspectives governing the provision and preservation of knowledge, a universal and an ecological perspective, are discussed in this paper. In the first case, scientific observations are represented through a semantic interpretation of facts. This is illustrated with a series of experiments on semantic feature perception in the recall…

Extending the psycho-historical framework to understand artistic production.

PubMed

Kozbelt, Aaron; Ostrofsky, Justin

2013-04-01

We discuss how the psycho-historical framework can be profitably applied to artistic production, facilitating a synthesis of perception-based and knowledge-based perspectives on realistic observational drawing. We note that artists' technical knowledge itself constitutes a major component of an artwork's historical context, and that links between artistic practice and psychological theory may yet yield conclusions in line with universalist perspectives.

Implications of R. S. Peters' Notion of "Cognitive Perspective" for Science Education

ERIC Educational Resources Information Center

Hadzigeorgiou, Yannis

2017-01-01

This paper discusses R.S. Peters' notion of "cognitive perspective," which, through careful reading, can be interpreted as a wider perspective resulting from an awareness of the relationships of one's knowledge and understanding to one's own life. This interpretation makes cognitive perspective a holistic notion akin to that of…

A Qualitative Study of Cognitive, Behavioral, and Psychosocial Challenges Associated With Pediatric Type 2 Diabetes in Ethnic Minority Parents and Adolescents.

PubMed

St George, Sara M; Pulgarón, Elizabeth R; Ferranti, Dina; Agosto, Yaray; Toro, Maria I; Ramseur, Kevin C; Delamater, Alan M

2017-04-01

Purpose The purpose of this descriptive qualitative study was to explore cognitive, behavioral, and psychosocial challenges associated with having and/or parenting an adolescent with pediatric type 2 diabetes (T2D) from the perspectives of ethnic minority parents and adolescents. Methods Ethnic minority (79.2% non-Hispanic black, 29.6% Hispanic) adolescents (n = 14, 78.6% female, 14.7 ± 1.9 years) and their parents (n = 13, 100% female) participated in either individual family interviews or multifamily focus group sessions. Sessions were audio recorded, transcribed, and coded by a team of 4 raters. QSR NVivo 10 was used to perform a content analysis and to extract coded adolescent and parent responses. Results Six themes corresponding to 3 broad categories (cognitive, behavioral, and psychosocial challenges) emerged. Regarding cognitive challenges, families described difficulties learning about a new disease and managing youth knowledge deficits and/or superficial knowledge. In terms of behavioral challenges, parents and adolescents discussed ongoing difficulties with making and maintaining positive youth health behavior changes as well as with ensuring regimen adherence. Finally, managing youth emotions related to diabetes and navigating social relationships with peers and other family members around the disclosure of T2D were the primary psychosocial challenges to emerge. Conclusions Directions for future research include developing and evaluating brief family interventions and adolescent psychosocial screening measures. Recommendations for clinical practice include increasing family knowledge of T2D, enhancing parenting skills for managing youth behavior change, and conducting routine psychosocial screening during follow-up clinic visits.

Evaluation of the district health management fellowship training programme: a case study in Iran

PubMed Central

Gholipour, Kamal; Tabrizi, Jafar Sadegh; Farahbakhsh, Mostafa; Iezadi, Shabnam; Ghiasi, Akbar; Jahanbin, Hasan

2018-01-01

Objective To evaluate the district health management fellowship training programme in the north-west of Iran. Data sources/study setting The programme was introduced to build the managerial capacity of district health managers in Iran. Eighty-nine heads of units in the province’s health centre, district health managers and the health deputies of the district health centres in the north-west provinces of Iran had registered for the district health management fellowship training programme in Tabriz in 2015–2016. Study design This was an educational evaluation study to evaluate training courses to measure participants' reactions and learning and, to a lesser extent, application of training to their job and the organisational impact. Data collection/extraction methods Valid and reliable questionnaires were used to assess learning techniques and views towards the fellowship, and self-assessment of health managers’ knowledge and skills. Also, pretest and post-test examinations were conducted in each course and a portfolio was provided to the trainees to be completed in their work settings. Principal findings About 63% of the participants were medical doctors and 42.3% of them had over 20 years of experience. Learning by practice (scored 18.37 out of 20) and access to publications (17.27) were the most useful methods of training in health planning and management from the participants’ perspective. Moreover, meeting peers from other districts and the academic credibility of teachers were the most important features of the current programme. Based on the managers’ self-assessment, they were most skilful in quality improvement, managing, planning and evaluation of the district. The results of the post-test analysis on data collected from district health managers showed the highest scores in managing the district (77 out of 100) and planning and evaluation (69) of the courses. Conclusion The results of this study indicated that training courses, methods and improvement in managers' knowledge about the health system and the skills necessary to manage their organisation were acceptable. PMID:29525773

Young Children's Knowledge About the Moon: A Complex Dynamic System

NASA Astrophysics Data System (ADS)

Venville, Grady J.; Louisell, Robert D.; Wilhelm, Jennifer A.

2012-08-01

The purpose of this research was to use a multidimensional theoretical framework to examine young children's knowledge about the Moon. The research was conducted in the interpretive paradigm and the design was a multiple case study of ten children between the ages of three and eight from the USA and Australia. A detailed, semi-structured interview was conducted with each child. In addition, each child's parents were interviewed to determine possible social and cultural influences on the child's knowledge. We sought evidence about how the social and cultural experiences of the children might have influenced the development of their ideas. From a cognitive perspective we were interested in whether the children's ideas were constructed in a theory like form or whether the knowledge was the result of gradual accumulation of fragments of isolated cultural information. Findings reflected the strong and complex relationship between individual children, their social and cultural milieu, and the way they construct ideas about the Moon and astronomy. Findings are presented around four themes including ontology, creatures and artefacts, animism, and permanence. The findings support a complex dynamic system view of students' knowledge that integrates the framework theory perspective and the knowledge in fragments perspective. An initial model of a complex dynamic system of young children's knowledge about the Moon is presented.

Water quality monitoring strategies - A review and future perspectives.

PubMed

Behmel, S; Damour, M; Ludwig, R; Rodriguez, M J

2016-11-15

The reliable assessment of water quality through water quality monitoring programs (WQMPs) is crucial in order for decision-makers to understand, interpret and use this information in support of their management activities aiming at protecting the resource. The challenge of water quality monitoring has been widely addressed in the literature since the 1940s. However, there is still no generally accepted, holistic and practical strategy to support all phases of WQMPs. The purpose of this paper is to report on the use cases a watershed manager has to address to plan or optimize a WQMP from the challenge of identifying monitoring objectives; selecting sampling sites and water quality parameters; identifying sampling frequencies; considering logistics and resources to the implementation of actions based on information acquired through the WQMP. An inventory and critique of the information, approaches and tools placed at the disposal of watershed managers was proposed to evaluate how the existing information could be integrated in a holistic, user-friendly and evolvable solution. Given the differences in regulatory requirements, water quality standards, geographical and geological differences, land-use variations, and other site specificities, a one-in-all solution is not possible. However, we advance that an intelligent decision support system (IDSS) based on expert knowledge that integrates existing approaches and past research can guide a watershed manager through the process according to his/her site-specific requirements. It is also necessary to tap into local knowledge and to identify the knowledge needs of all the stakeholders through participative approaches based on geographical information systems and adaptive survey-based questionnaires. We believe that future research should focus on developing such participative approaches and further investigate the benefits of IDSS's that can be updated quickly and make it possible for a watershed manager to obtain a timely, holistic view and support for every aspect of planning and optimizing a WQMP. Copyright © 2016 Elsevier B.V. All rights reserved.

A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation

PubMed Central

Boyden, Jackelyn Y.; Kalish, Virginia B.; Muir, J. Cameron; Richardson, Suzanne; Connor, Stephen R.

2016-01-01

Abstract Background: An estimated 6,000 to 18,000 additional hospice and palliative medicine (HPM) physicians are needed in the United States. A source could be the military graduate medical education system where 15% of U.S. medical residents are trained. A community-based hospice and palliative care organization created a one-week rotation for military residents including participation in interdisciplinary group visits at patients' homes, facilities, and an inpatient hospice unit. Objective: Our goal was to evaluate the effectiveness of a one-week community HPM rotation for military medical residents. Methods: A mixed-methods, multi-stakeholder perspective program evaluation model was used for program years 2011 to 2013. Data were managed and analyzed using Microsoft Excel and Atlas.ti. Participants in the rotation were residents training at two local military hospitals. Program evaluation data were collected from residents, military program liaisons, and hospice clinical preceptors. Quantitative data included pre- and post-tests based on Accreditation Council for Graduate Medical Education competencies completed by residents. Qualitative data included resident essays and semi-structured interviews with hospice preceptors and military program liaisons. Results: Quantitative and qualitative data suggested that the rotation increased military residents' knowledge, attitudes, and comfort level with HPM. Quantitative analysis of test scores indicated improvements from pre- to post-tests in each of five areas of learning. Qualitative data indicated the rotation created a greater appreciation for the overall importance of HPM and increased understanding of eligibility and methods for pain and symptom management. Conclusions: A one-week community hospice rotation for medical military residents impacts participant's knowledge of and attitudes toward HPM. PMID:27139524

Getting help quickly: older people and community worker perspectives of contingency planning for falls management.

PubMed

Charlton, Kimberly; Murray, Carolyn M; Kumar, Saravana

2018-01-01

Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67-89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn't fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups. Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling. Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.

A primer of drug safety surveillance: an industry perspective. Part II: Product labeling and product knowledge.

PubMed

Allan, M C

1992-01-01

To place the fundamentals of clinical drug safety surveillance in a conceptual framework that will facilitate understanding and application of adverse drug event data to protect the health of the public and support a market for pharmaceutical manufacturers' products. Part II of this series discusses specific issues regarding product labeling, such as developing the labeling, changing the labeling, and the legal as well as commercial ramifications of the contents of the labeling. An adverse event report scenario is further analyzed and suggestions are offered for maintaining the product labeling as an accurate reflection of the drug safety surveillance data. This article also emphasizes the necessity of product knowledge in adverse event database management. Both scientific and proprietary knowledge are required. Acquiring product knowledge is a part of the day-to-day activities of drug safety surveillance. A knowledge of the history of the product may forestall adverse publicity, as shown in the illustration. This review uses primary sources from the federal laws (regulations), commentaries, and summaries. Very complex topics are briefly summarized in the text. Secondary sources, ranging from newspaper articles to judicial summaries, illustrate the interpretation of adverse drug events and opportunities for drug safety surveillance intervention. The reference materials used were articles theoretically or practically applicable in the day-to-day practice of drug safety surveillance. The role of clinical drug safety surveillance in product monitoring and drug development is described. The process of drug safety surveillance is defined by the Food and Drug Administration regulations, product labeling, product knowledge, and database management. Database management is subdivided into the functions of receipt, retention, retrieval, and review of adverse event reports. Emphasis is placed on the dynamic interaction of the components of the process. Suggestions are offered to facilitate communication of a review of adverse event data for various audiences. Careful drug safety surveillance is beneficial to the health of the public and the commercial well-being of the manufacturer. Attention to the basic principles is essential and, as illustrated, may be sufficient to resolve some problems.

Multimedia Workstations: Electronic Assistants for Health-Care Professionals.

PubMed

Degoulet, P; Jean, F-C; Safran, C

1996-01-01

The increasing costs of health care and the economic reality has produced an interesting paradox for the health professional to perform more clinical work with fewer support personnel. Moreover, an explosion of the knowledge-base that underlies sound clinical care not only makes effective time management critical, but also knowledge management compelling. A multimedia workstation is an electronic assistant for the busy health professional that can help with administrative tasks and give access to clinical information and knowledge networks. The multimedia nature of processed information reflects an evolution of medical technologies that involve more and more complex objects such as video sequences or digitized signals. Analysis of the 445 Medline-indexed publications for the January 1991 to December 1994 period, that included the word "workstation" either in their title or in their abstract, helps in refining objectives and challenges both for health professionals and decision makers. From an engineering perspective, development of a workstation requires the integration into the same environments of tools to localize, access, manipulate and communicate the required information. The long-term goal is to establish an easy access in a collaborative working environment that gives the end-user the feeling of a single virtual health enterprise, driven by an integrated computer system when the information system relies on a set of heterogeneous and geographically distributed components. Consequences in terms of migration from traditional client/server architectures to more client/network architectures are considered.

What is conservation physiology? Perspectives on an increasingly integrated and essential science†

PubMed Central

Cooke, Steven J.; Sack, Lawren; Franklin, Craig E.; Farrell, Anthony P.; Beardall, John; Wikelski, Martin; Chown, Steven L.

2013-01-01

Globally, ecosystems and their constituent flora and fauna face the localized and broad-scale influence of human activities. Conservation practitioners and environmental managers struggle to identify and mitigate threats, reverse species declines, restore degraded ecosystems, and manage natural resources sustainably. Scientific research and evidence are increasingly regarded as the foundation for new regulations, conservation actions, and management interventions. Conservation biologists and managers have traditionally focused on the characteristics (e.g. abundance, structure, trends) of populations, species, communities, and ecosystems, and simple indicators of the responses to environmental perturbations and other human activities. However, an understanding of the specific mechanisms underlying conservation problems is becoming increasingly important for decision-making, in part because physiological tools and knowledge are especially useful for developing cause-and-effect relationships, and for identifying the optimal range of habitats and stressor thresholds for different organisms. When physiological knowledge is incorporated into ecological models, it can improve predictions of organism responses to environmental change and provide tools to support management decisions. Without such knowledge, we may be left with simple associations. ‘Conservation physiology’ has been defined previously with a focus on vertebrates, but here we redefine the concept universally, for application to the diversity of taxa from microbes to plants, to animals, and to natural resources. We also consider ‘physiology’ in the broadest possible terms; i.e. how an organism functions, and any associated mechanisms, from development to bioenergetics, to environmental interactions, through to fitness. Moreover, we consider conservation physiology to include a wide range of applications beyond assisting imperiled populations, and include, for example, the eradication of invasive species, refinement of resource management strategies to minimize impacts, and evaluation of restoration plans. This concept of conservation physiology emphasizes the basis, importance, and ecological relevance of physiological diversity at a variety of scales. Real advances in conservation and resource management require integration and inter-disciplinarity. Conservation physiology and its suite of tools and concepts is a key part of the evidence base needed to address pressing environmental challenges. PMID:27293585

Participatory methods of incorporating scientific with traditional knowledge for volcanic hazard management on Ambae Island, Vanuatu

NASA Astrophysics Data System (ADS)

Cronin, Shane J.; Gaylord, David R.; Charley, Douglas; Alloway, Brent V.; Wallez, Sandrine; Esau, Job W.

2004-10-01

Ambae Island is the largest of Vanuatu’s active volcanoes. It is also one of the nation’s potentially most dangerous, with 60 million m3 of lake-water perched at over 1340 m in the summit caldera and over the active vent. In 1995, small phreatic explosions, earthquake swarms and heightened gas release led to calls for evacuation preparation and community volcanic hazard awareness programs for the ~9500 inhabitants. Differences in perspective or world-view between the island dwellers adhering to traditional beliefs (Kastom) and external scientists and emergency managers led to a climate of distrust following this crisis. In an attempt to address these issues, rebuild dialogue and respect between communities, outside scientists and administrators, and move forward in volcanic hazard education and planning for Ambae, we adapted and applied Participatory Rural Appraisal (PRA) approaches. Initial gender-segregated PRA exercises from two representative communities provided a mechanism for cataloguing local traditional viewpoints and hazard perceptions. Ultimately, by combining elements of these viewpoints and perceptions with science-based management structures, we derived volcanic hazard management guidelines, supported by an alert system and map that were more readily accepted by the test communities than the earlier “top-down” plans imposed by outside governmental and scientific agencies. The strength of PRA approaches is that they permit scientists to understand important local perspective issues, including visualisations of volcanic hazards, weaknesses in internal and external communication systems, and gender and hierarchy conflicts, all of which can hinder community emergency management. The approach we describe has much to offer both developing and industrialised communities that wish to improve their awareness programs and mitigative planning. This approach should also enhance communication and understanding between volcanologists and the communities they serve.

Factors Influencing Knowledge Sharing among Undergraduate Students: A Malaysian Perspective

ERIC Educational Resources Information Center

Ong, Hway-Boon; Yeap, Peik-Foong; Tan, Siow-Hooi; Chong, Lee-Lee

2011-01-01

Knowledge sharing can enhance learning and help to build the knowledge workforce. This paper reports on a study of knowledge sharing behaviour among undergraduate students in Malaysia. Knowledge sharing was found to be influenced by the mechanisms used, various barriers to communication and the motivations behind knowledge sharing. The mechanisms…

More Stake, Less Gravy? Issues of Knowledge and Power in Higher Education.

ERIC Educational Resources Information Center

Bak, Nelleke; Paterson, Andrew

1997-01-01

Two perspectives on higher education's stakeholders and their involvement in the development of knowledge in universities are examined and contrasted: (1) that the "stakeholder" notion of knowledge doesn't allow for critical engagement with knowledge, and (2) that the "stakeholder" view of knowledge acknowledges clear links between knowledge and…

Knowledge Management in Libraries in the 21st Century.

ERIC Educational Resources Information Center

Shanhong, Tang

This paper begins with a section that describes characteristics of knowledge management in libraries, including: human resource management is the core of knowledge management in libraries; the objective of knowledge management in libraries is to promote knowledge innovation; and information technology is a tool for knowledge management in…

The challenge of bridging science and policy in the Baltic Sea eutrophication governance in Finland: the perspective of science.

PubMed

Pihlajamäki, Mia; Tynkkynen, Nina

2011-03-01

This article examines the views of scientists on intricacies of scientific knowledge that affect science-policy interface in the Baltic Sea eutrophication governance in Finland. The analysis demonstrates that these intricacies can be divided into five categories: (1) uncertainty of knowledge concerning ecological processes, (2) heterogeneity of knowledge, (3) societal and political call for (certain) knowledge, (4) contingency of the knowledge that ends up taken as a baseline for decision making and further research, and (5) linkages of knowledge production, processing, and communication to particular characteristics of individual researchers and research societies. By explicating these aspects, this article illustrates the ways in which scientific knowledge concerning eutrophication is human-bound and susceptible to interpretation, thus adding on to the uncertainty of the Baltic Sea environmental governance. The aim is, then, to open up perspectives on how ambiguities related to science-policy interface could be coped with.

Virtue training in medical schools: the perspective of behavioral science course directors.

PubMed

Olufowote, James Olumide

2015-01-01

Although the multidisciplinary research on physician socialization has focused on areas such as developments in learners' ideological commitments and ethics knowledge and skills, the literature on physician virtues has been anecdotal. To contribute empirical knowledge of virtue development during socialization, I performed constant comparisons on interviews with 20 directors of preclinical behavioral science courses. In discussing their courses, participants revealed foci on virtues involved in making intimate connections with patients (e.g., empathy) and "being professional" with colleagues (e.g., trustworthiness). To cultivate virtues for intimate connections, participants used the strategies of learner engagement with patients' narratives of illness, service in underserved communities, and shadowing and observing role models. To develop virtues for being professional, participants used the strategy of small learner groups, which consisted of discussions, project collaborations, and group evaluations. I conclude with implications for training students of various health sciences and managing health care teams.

Strategies for transdisciplinary research on peri-urban groundwater management in the Ganges delta

NASA Astrophysics Data System (ADS)

Hermans, Leon; Thissen, Wil; Gomes, Sharlene; Banerjee, Poulomi; Narain, Vishal; Salehin, Mashfiqus; Hasan, Rezaul; Barua, Anamika; Alam Khan, Shah; Bhattacharya, Samir; Kempers, Remi; Banerjee, Parthasarathi; Hossain, Zakir; Majumdar, Binoy; Hossain, Riad

2016-04-01

Transdisciplinary science transcends disciplinary boundaries. The reasons to engage in transdisciplinary science are many and include the desire to nurture a more direct relationship between science and society, as well as the desire to explain phenomena that cannot be explained by any of the existing disciplinary bodies of knowledge in isolation. Both reasons also reinforce each other, as reality often features a level of complexity that demands and inspires the combination of scientific knowledge from various disciplines. The challenge in transdisciplinary science, however, is not so much to cross disciplinary boundaries, but to ensure an effective connection between disciplines. This contribution reports on the strategy used in a transdisciplinary research project to address groundwater management in peri-urban areas in the Ganges delta. Groundwater management in peri-urban areas in rapidly urbanizing deltas is affected by diverse forces such as rapid population growth, increased economic activity and changing livelihood patterns, and other forces which result in a growing pressure on available groundwater resources. Understanding the intervention possibilities for a more sustainable groundwater management in these peri-urban areas requires an understanding of the dynamic interplay between various sub-systems, such as the physical groundwater system, the water using activities in households and livelihoods, and the institutional system of formal and informal rules that are used by various parties to access groundwater resources and to distribute the associated societal and economic costs and benefits. The ambition in the reported project is to contribute both new scientific knowledge, as well as build capacity with peri-urban stakeholders to improve the sustainability and equitability of local groundwater management. This is done by combining science and development activities, led by different organizations. The scientific component further consists of three sub-components. The connection between these scientific disciplines is made by using a multi-polar strategy. Each research works with a different framework rooted in its own scientific discipline, featuring its own concepts and theories: a hydrogeological framework, a sustainable livelihoods framework and an institutional development framework. Rather than forcing these frameworks into a new framework that is perhaps only fit for the purpose of this single research, the disciplinary frameworks are left in-tact, but are connected by a translation of key variables from one framework to the other. Often, what is an exogenous variable in one framework, is endogenous in another, and vice versa. Investigating the connections between these different poles would require an integrating perspective, for which again different scientific integration perspectives will be explored, rooted in different scientific traditions. The poster will present this framework and the initial findings and experiences with this transdisciplinary research strategy.

Strategies for living with the risk of anaphylaxis in adolescence: qualitative study of young people and their parents.

PubMed

Gallagher, Michael; Worth, Allison; Cunningham-Burley, Sarah; Sheikh, Aziz

2012-12-01

Adolescents with anaphylaxis are at increased risk of fatal outcomes. Gaps in their knowledge of day-to-day and emergency management have been identified. There are also gaps in services available to support adolescents at risk of anaphylaxis. To explore the experiences and healthcare needs of adolescents living with the risk of anaphylaxis; to understand the perspectives of their parents; and to look at how care might be improved. A qualitative study was undertaken using in-depth interviews with adolescents with a recent history of severe allergic reactions and with their parents. Twenty-six adolescents at risk of anaphylaxis living in Scotland and their parents (n=28) were recruited. Most anaphylactic reactions reported by participants appeared to result from accidents, misinformation, or inexperience. For many, management involved finding a balance between taking their allergies seriously whilst not allowing these concerns to dominate their lives. Risks were often difficult to judge, with reactions sometimes taking place even after careful checking of meal ingredients. Most admitted taking some risks with trace-labelled foods. Appropriate healthcare support for adolescents in learning to manage the risk of anaphylaxis independently and advice and support for their parents was inconsistently provided. Adolescents tend to see their risk management strategies as 'good enough', but these strategies were often inconsistent with clinical best practice and, in some cases, had not prevented reactions. Building on adolescents' existing skills and knowledge and the use of Internet and associated social media resources may help to support more effective self-management among adolescents.

Learner-Centered (LCI) vs. Teacher-Centered (TCI) Instruction: A Classroom Management Perspective

ERIC Educational Resources Information Center

Minter, Mary Kennedy

2011-01-01

Teacher education should incorporate management and leadership training with an emphasis on student audience analysis. Macro perspectives of teaching are needed for a workable approach to the management of education.

RhD isoimmunization and current management modalities.

PubMed

Neal, J L

2001-01-01

To review the literature on current perspectives and treatment of RhD isoimmunization. A search was conducted on MEDLINE and CINAHL, and supplemental articles/ bulletins were obtained from cited references and the Web site of the American College of Obstetricians and Gynecologists. Recent texts also were reviewed. Key search words: isoimmunization, Rho (d) immune globulin, fetal erythroblastosis, intrauterine blood transfusions, alloimmunization. Articles and comprehensive works from indexed journals in the English language relevant to key words and published after 1995 were evaluated. Historically relevant periodicals and texts were also reviewed and selected. Data were extracted and organized under the following headings: testing of the antepartum patient, antepartum treatment of isoimmunization, testing of the postpartum patient, anti-D immune globulin, antepartum anti-D immune globulin prophylaxis, other antepartum and obstetric indications for anti-D immune globulin administration, postpartum anti-D immune globulin prophylaxis, nursing implications, and future possibilities. RhD isoimmunized pregnancies continue to contribute to worldwide perinatal and neonatal morbidity and mortality. This review describes the basic knowledge necessary to care for these pregnancies and the current management modalities. The management options for RhD compromised gestations continue to evolve almost as quickly as technological advances are made. Multiple areas of research in this field have surfaced, and nurses can become valuable members of these research teams. The literature also indicates that with the available knowledge and resources, the current rate of RhD isoimmunization can be further decreased with closer adherence to proposed management guidelines by all health care professionals.

Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers

PubMed Central

Samuel, Susan M.; Flynn, Rachel; Zappitelli, Michael; Dart, Allison; Parekh, Rulan; Pinsk, Maury; Mammen, Cherry; Wade, Andrew; Scott, Shannon D.

2017-01-01

Background: Treatment protocols for childhood nephrotic syndrome are highly variable between providers and care centres. We conducted a qualitative study to understand the complex multilevel processes that lead to practice variation and influence provider management of nephrotic syndrome. Methods: Focus groups with multidisciplinary pediatric nephrology care providers (n = 67) from 10 Canadian pediatric nephrology centres that had more than 1 pediatric nephrologist were conducted between September 2013 and April 2015. Focus group discussions were guided by the Ottawa Model for Research Use. We used a semistructured interview guide to elicit participants' perspectives regarding 1) the work setting and context of the clinical environment, 2) reasons for variation at the provider level and 3) clinical practice guidelines for nephrotic syndrome. Focus group discussions were transcribed and analyzed concurrently with the use of qualitative content analysis. Results: Emerging themes were grouped into 2 categories: centre-level factors and provider-level factors. At the centre level, the type of care model used, clinic structures and resources, and lack of communication and collaboration within and between Canadian centres influenced care variation. At the provider level, use of experiential knowledge versus empirical knowledge and interpretation of patient characteristics influenced provider management of nephrotic syndrome. Interpretation: Centre- and provider-level factors play an important role in shaping practice differences in the management of childhood nephrotic syndrome. Further research is needed to determine whether variation in care is associated with disparities in outcomes. PMID:28592406

GP management of dementia--a consumer perspective.

PubMed

Millard, Fiona

2008-01-01

As the population ages, the general practitioner is likely to have an increasingly important role in diagnosing and managing dementia. Many people in the community dealing with dementia have little help until a diagnosis is made, and their experiences produce a profile of their met and unmet needs. A nondirected interview technique elicits a wide range of themes from individual life phenomena, with each person attributing their own meaning to events and experiences. Open ended discussion can produce unexpected information that is outside the experience of the researcher but relevant to the people being studied, reflecting the unique nature of each person's experience with dementia. Patients expect their GP to know about dementia and look to their GP for help with the disease, but these expectations may not always be matched by the doctor's knowledge about dementia or their perceived role in dementia care.

Craniocerebral aspergillosis in immunocompetent hosts: surgical perspective.

PubMed

Shamim, Muhammad Shahzad; Siddiqui, Arshad A; Enam, Syed Ather; Shah, Ahmed Ali; Jooma, Rashid; Anwar, Saleha

2007-01-01

Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. Aspergillosis of the central nervous system is difficult to diagnose and equally difficult to treat. Surgery remains the cornerstone of management followed by systemic antifungal medications. Results are better in immunocompetent patients as compared to those who are immunocompromised.

Atmospheric nitrogen compounds II: emissions, transport, transformation, deposition and assessment

NASA Astrophysics Data System (ADS)

Aneja, Viney P.; Roelle, Paul A.; Murray, George C.; Southerland, James; Erisman, Jan Willem; Fowler, David; Asman, Willem A. H.; Patni, Naveen

The Atmospheric Nitrogen Compounds II: Emissions, Transport, Transformation, Deposition and Assessment workshop was held in Chapel Hill, NC from 7 to 9 June 1999. This international conference, which served as a follow-up to the workshop held in March 1997, was sponsored by: North Carolina Department of Environment and Natural Resources; North Carolina Department of Health and Human Services, North Carolina Office of the State Health Director; Mid-Atlantic Regional Air Management Association; North Carolina Water Resources Research Institute; Air and Waste Management Association, RTP Chapter; the US Environmental Protection Agency and the North Carolina State University (College of Physical and Mathematical Sciences, and North Carolina Agricultural Research Service). The workshop was structured as an open forum at which scientists, policy makers, industry representatives and others could freely share current knowledge and ideas, and included international perspectives. The workshop commenced with international perspectives from the United States, Canada, United Kingdom, the Netherlands, and Denmark. This article summarizes the findings of the workshop and articulates future research needs and ways to address nitrogen/ammonia from intensively managed animal agriculture. The need for developing sustainable solutions for managing the animal waste problem is vital for shaping the future of North Carolina. As part of that process, all aspects of environmental issues (air, water, soil) must be addressed as part of a comprehensive and long-term strategy. There is an urgent need for North Carolina policy makers to create a new, independent organization that will build consensus and mobilize resources to find technologically and economically feasible solutions to this aspect of the animal waste problem.

Technical Skill, Industry Knowledge and Experience, and Interpersonal Skill Competencies for Fashion Design Careers: A Comparison of Perspectives between Fashion Industry Professionals and Fashion Educators

ERIC Educational Resources Information Center

Yang, Eunyoung

2010-01-01

In updating fashion and apparel related design programs, many educators are striving to address the perspective of the fashion industry to obtain the career-specific skill and knowledge requirements sought by employers when hiring college or university graduates. Identifying such competencies from the view of fashion industry professionals as well…

Semantically-enabled Knowledge Discovery in the Deep Carbon Observatory

NASA Astrophysics Data System (ADS)

Wang, H.; Chen, Y.; Ma, X.; Erickson, J. S.; West, P.; Fox, P. A.

2013-12-01

The Deep Carbon Observatory (DCO) is a decadal effort aimed at transforming scientific and public understanding of carbon in the complex deep earth system from the perspectives of Deep Energy, Deep Life, Extreme Physics and Chemistry, and Reservoirs and Fluxes. Over the course of the decade DCO scientific activities will generate a massive volume of data across a variety of disciplines, presenting significant challenges in terms of data integration, management, analysis and visualization, and ultimately limiting the ability of scientists across disciplines to make insights and unlock new knowledge. The DCO Data Science Team (DCO-DS) is applying Semantic Web methodologies to construct a knowledge representation focused on the DCO Earth science disciplines, and use it together with other technologies (e.g. natural language processing and data mining) to create a more expressive representation of the distributed corpus of DCO artifacts including datasets, metadata, instruments, sensors, platforms, deployments, researchers, organizations, funding agencies, grants and various awards. The embodiment of this knowledge representation is the DCO Data Science Infrastructure, in which unique entities within the DCO domain and the relations between them are recognized and explicitly identified. The DCO-DS Infrastructure will serve as a platform for more efficient and reliable searching, discovery, access, and publication of information and knowledge for the DCO scientific community and beyond.

Middle Range Theory: A Perspective on Development and Use.

PubMed

Liehr, Patricia; Smith, Mary Jane

This replication and critique addresses ongoing development and use of middle range theory since considering this body of nursing knowledge 18 years ago. Middle range theory is appreciated as essential to the structure of nursing knowledge. Nine middle range theories that demonstrate ongoing use by the theory authors are analyzed using the criteria of theory name, theory generation, disciplinary perspective, theory model, practice use and research use. Critique conclusions indicate the importance of staying with the theory over time, naming and development consistent with the disciplinary perspective, movement to an empirical level, and bringing middle range theory to the interdisciplinary table.

Understanding students' explanations of biological phenomena: Conceptual frameworks or p-prims?

NASA Astrophysics Data System (ADS)

Southerland, Sherry A.; Abrams, Eleanor; Cummins, Catherine L.; Anzelmo, Julie

2001-07-01

This study explores two differing perspectives of the nature of students' biological knowledge structures, conceptual frameworks, and p-prims. Students from four grade levels and from three regions of the United States were asked to explain a variety of biological phenomena. Students' responses to the interview probes were analyzed to describe 1) patterns in the nature of students' explanations across grade levels and interview probes, and 2) the consistency of students' explanations across individual interview probes and across the range of probes. The results were interpreted from both perspectives of knowledge structures. While definitive assertions supporting either perspective could not be made, each hypothesis was explored. Although the more prevalent description of student conceptions within a broader conceptual framework could not be discounted, the p-prim of need as a rationale for change was also found to offer a useful description of knowledge frameworks for this content area. The difficulties endemic to the use of biology for the study of basic knowledge structures are also discussed.

Survey of family physicians' perspectives on management of immigrant patients: attitudes, barriers, strategies, and training needs.

PubMed

Papic, Ognjen; Malak, Ziad; Rosenberg, Ellen

2012-02-01

Immigrants in Canada form a significant portion of the population and have unique and complex health needs. This study was undertaken to evaluate family physicians' perspectives on the care of this population. Questionnaires were distributed to family physicians in Montreal (n=598). The main outcomes of interest were attitudes of family physicians to care of immigrants including barriers perceived, resources and strategies used to accommodate immigrant patients, as well as physicians' training in immigrant care. Family physicians find communication difficulties to be the key barrier and would like to see the access to interpreters improved. Very few physicians make use of professional interpreters. Only a minority of physicians have received specific cross-cultural competence training but those who have seem to provide better quality of care. Knowledge of physician perspectives is an essential element on which to base interventions to improve the quality of care to this population. Physicians should be reminded of the importance of using professional interpretation services in multi-lingual encounters. Cross-cultural training should be further advanced in Canadian medical curricula. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The architect's perspective on the tour and map perspective.

PubMed

Papadopoulou, Athina

2015-09-01

Literature in linguistics suggests that when people are asked to provide an oral spatial description, they usually provide a body-centered narrative; they adopt a Tour Perspective, that is, an imaginary tour of the space rather than a Map Perspective, that is, a description focused on spatial relations as seen from above (Linde and Labov in Language 51(1):924-939, 1975; Howald in Discursive constraints on space in narrative: evidence from guilty plea discourse, eVox 3, 2009). I conducted a pilot experiment to address the following questions: Does the formal knowledge of architects--their familiarity with plan drawings and maps--override the tendency to adopt the tour perspective? Does the tour perspective depend on the actual experience of space? Twenty-two graduate students in architecture were asked to respond to the following questions: (1) "Can you describe the layout of your apartment?" (2) "Can you describe the layout of an ideal apartment?" In the responses to the first question most participants used the tour perspective. In the responses to the second question most participants used the map perspective. The results provide evidence that architects' formal knowledge does not override the preference of the tour perspective in descriptions of experienced space. Moreover, that the tour perspective is associated with the actual experience of space.

Indicators of distress in newly diagnosed breast cancer patients

PubMed Central

Lucidi, Fabio; Mallia, Luca; D’Aiuto, Massimiliano; Merluzzi, Thomas V.

2015-01-01

Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life. Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment. Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress. Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68). Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress. PMID:26244115

Management of eWork health issues: a new perspective on an old problem.

PubMed

Kirk, Elizabeth; Strong, Jenny

2010-01-01

Contact centres are vehicles for a rapidly growing group of knowledge workers, or eWorkers. Using computers and high-speed telecommunications connections as work tools, these employees spend long hours performing mentally demanding work while maintaining static, physically stressful, seated positions. The complex interplay between job demands, work environment, and individual differences combine to produce high levels of physical discomfort among eWorkers. This paper discusses a new view that has emerged, one that focuses on the management rather than the elimination of work related upper limb disorders (WRULD) and computer vision syndrome (CVS) issues that are prevalent among eWorkers. It also reviews a cultural shift among practitioners and business that moves towards a consultative process and the sharing of knowledge among all stakeholders. The controlled work conditions and large single location workforce found within contact centres provide the opportunity to understand the personal and industry cost of eWork injuries and the ability to develop and review new multifaceted interventions. Advances in training and workplace design aimed at decreasing discomfort and injury and reducing the associated economic burden may then be adapted for all eWorkforce groups.

Nursing students' experiences with refugees with mental health problems in Jordan: A qualitative content analysis.

PubMed

Dotevall, Camilla; Winberg, Elin; Rosengren, Kristina

2018-02-01

The aim of this study was to describe Jordanian nursing students' experience of caring for refugees with mental health problems. According to refugees' experiences of crisis, a well-educated staff is needed to provide high quality of care due to mental health problems. Therefore, health professionals play an important role in creating an environment that promotes human rights regardless of ethnic origin. The study comprised eight interviews and was analysed using content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nursing students' perspective and thoughts regarding caring for refugees with mental health problems. The results formed one category: to be challenged by refugees' mental health issues and three subcategories: managing refugees' mental health needs, affected by refugees' mental health, and improve mental healthcare for refugees. Language problems could be managed by using interpreters to decrease cultural clashes to facilitate equal healthcare. In addition, well-educated (theoretical knowledge) and trained (practical knowledge) nursing students have potential to fulfil refugees' care needs regardless of ethnicity or background by using nursing interventions built on communication skills and cultural competences (theory, practice) to facilitate high quality of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical Group Structural Integration May Not Ensure That Care Is Integrated, From The Patient's Perspective.

PubMed

Kerrissey, Michaela J; Clark, Jonathan R; Friedberg, Mark W; Jiang, Wei; Fryer, Ashley K; Frean, Molly; Shortell, Stephen M; Ramsay, Patricia P; Casalino, Lawrence P; Singer, Sara J

2017-05-01

Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient. Medical groups' structural characteristics were taken from the National Study of Physician Organizations and included practice size, specialty mix, technological capabilities, and care management processes. Patients' survey responses were most favorable for the domain of test result communication and least favorable for the domain of provider support for medication and home health management. Medical groups' characteristics were not consistently associated with patients' perceptions of integrated care. However, compared to patients of primary care groups, patients of multispecialty groups had strong favorable perceptions of medical group staff knowledge of patients' medical histories. Opportunities exist to improve patient care, but structural integration of medical groups might not be sufficient for delivering care that patients perceive as integrated. Project HOPE—The People-to-People Health Foundation, Inc.

"Hit the ground running": perspectives of new nurses and nurse managers on role transition and integration of new graduates.

PubMed

Chernomas, Wanda M; Care, W Dean; McKenzie, Jo-Ann Lapointe; Guse, Lorna; Currie, Jan

2010-01-01

The workplace for new graduates must be a constructive learning environment to facilitate their development. Nurse managers need new graduates who can "hit the ground running." Conflict between the needs of new nurses and the realities of the workplace often creates role confusion and tension in new graduates and threatens employers' ability to retain them. As part of a larger study that examined the effectiveness of a new strategy on new nurse retention and workplace integration, we conducted focus groups with new nurses and nurse managers. This paper discusses the perspectives of new nurses on their role transition from graduates to practising professionals and the perspectives of nurse managers on the workplace integration of new nurses. The thematic findings integrate new nurses' perspectives on their needs during role transition with the perspectives of nurse managers in meeting those needs. The discussion includes strategies to facilitate successful transition and integration of new nurses into the workplace within the context of recruitment and retention.

Generation of priority research questions to inform conservation policy and management at a national level.

PubMed

Rudd, Murray A; Beazley, Karen F; Cooke, Steven J; Fleishman, Erica; Lane, Daniel E; Mascia, Michael B; Roth, Robin; Tabor, Gary; Bakker, Jiselle A; Bellefontaine, Teresa; Berteaux, Dominique; Cantin, Bernard; Chaulk, Keith G; Cunningham, Kathryn; Dobell, Rod; Fast, Eleanor; Ferrara, Nadia; Findlay, C Scott; Hallstrom, Lars K; Hammond, Thomas; Hermanutz, Luise; Hutchings, Jeffrey A; Lindsay, Kathryn E; Marta, Tim J; Nguyen, Vivian M; Northey, Greg; Prior, Kent; Ramirez-Sanchez, Saudiel; Rice, Jake; Sleep, Darren J H; Szabo, Nora D; Trottier, Geneviève; Toussaint, Jean-Patrick; Veilleux, Jean-Philippe

2011-06-01

Integrating knowledge from across the natural and social sciences is necessary to effectively address societal tradeoffs between human use of biological diversity and its preservation. Collaborative processes can change the ways decision makers think about scientific evidence, enhance levels of mutual trust and credibility, and advance the conservation policy discourse. Canada has responsibility for a large fraction of some major ecosystems, such as boreal forests, Arctic tundra, wetlands, and temperate and Arctic oceans. Stressors to biological diversity within these ecosystems arise from activities of the country's resource-based economy, as well as external drivers of environmental change. Effective management is complicated by incongruence between ecological and political boundaries and conflicting perspectives on social and economic goals. Many knowledge gaps about stressors and their management might be reduced through targeted, timely research. We identify 40 questions that, if addressed or answered, would advance research that has a high probability of supporting development of effective policies and management strategies for species, ecosystems, and ecological processes in Canada. A total of 396 candidate questions drawn from natural and social science disciplines were contributed by individuals with diverse organizational affiliations. These were collaboratively winnowed to 40 by our team of collaborators. The questions emphasize understanding ecosystems, the effects and mitigation of climate change, coordinating governance and management efforts across multiple jurisdictions, and examining relations between conservation policy and the social and economic well-being of Aboriginal peoples. The questions we identified provide potential links between evidence from the conservation sciences and formulation of policies for conservation and resource management. Our collaborative process of communication and engagement between scientists and decision makers for generating and prioritizing research questions at a national level could be a model for similar efforts beyond Canada. ©2010 Society for Conservation Biology.

Healthcare professionals' response to cachexia in advanced cancer: a qualitative study.

PubMed

Millar, Claire; Reid, Joanne; Porter, Sam

2013-11-01

To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer. A qualitative approach based on symbolic interactionism. A regional cancer center in a large teaching hospital in the United Kingdom. 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer. Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection. Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer. Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals. This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care. Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their families.

General practitioners' knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia: A mixed-methods systematic review.

PubMed

Jennings, Aisling A; Foley, Tony; Walsh, Kieran A; Coffey, Alice; Browne, John P; Bradley, Colin P

2018-06-13

To synthesise the existing published literature on general practitioners (GP)'s knowledge, attitudes, and experiences of managing behavioural and psychological symptoms of dementia (BPSD) with a view to informing future interventions. We conducted a systematic review and synthesis of quantitative and qualitative studies that explored GPs' experiences of managing BPSD (PROSPERO protocol registration CRD42017054916). Seven electronic databases were searched from inception to October 2017. Each stage of the review process involved at least 2 authors working independently. The meta-ethnographic approach was used to synthesise the findings of the included studies while preserving the context of the primary data. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) was used to assess the confidence in our individual review findings. Of the 1638 articles identified, 76 full texts were reviewed and 11 were included. Three main concepts specific to GPs' experiences of managing BPSD emerged: unmet primary care resource needs, justification of antipsychotic prescribing, and the pivotal role of families. A "line of argument" was drawn, which described how in the context of resource limitations a therapeutic void was created. This resulted in GPs being over reliant on antipsychotics and family caregivers. These factors appeared to culminate in a reactive response to BPSD whereby behaviours and symptoms could escalate until a crisis point was reached. This systematic review offers new insights into GPs' perspectives on the management of BPSD and will help to inform the design and development of interventions to support GPs managing BPSD. © 2018 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

Management and leadership competence in hospitals: a systematic literature review.

PubMed

Pihlainen, Vuokko; Kivinen, Tuula; Lammintakanen, Johanna

2016-01-01

Purpose - The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks. Design/methodology/approach - A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis. Findings - The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general. Research limitations/implications - One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care. Originality/value - The authors' evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

Cross-boundary issues for national parks: What works ``on the ground''

NASA Astrophysics Data System (ADS)

Buechner, Marybeth; Schonewald-Cox, Christine; Sauvajot, Raymond; Wilcox, Bruce A.

1992-11-01

In recent years, cross-boundary management has become an essential part of park management. In this article we compare the perspectives of managers of several US national parks to the advice on this issue presented in the published literature. Data were obtained from interviews of the superintendents, assistant superintendents and resources managers of five major western national parks and from a survey of participants in a NPS workshop attended by park superintendents, scientists, and resource managers; law enforcement personnel; and interpreters. Three themes related to boundary management were consistently stressed by park managers: (10 a lack of sufficient funds and personnel within the parks; (2) the need for reliable information on both political and natural processes; and, (3) the importance of personal interactions between park staff and individuals from the surrounding area. Basic data collection, the documentation of trends, cooperative groups and personal contacts, educational programs, and land acquisition were the most useful strategies. A lack of funds and information, ineffective communication, enforcement problems, and a lack of motivation for parties to reach a negotiated agreement were the most serious obstacles. A wide range of valuable institutional knowledge concerning boundary management exists within the National Park Service; however, there appears to be a gap between published strategies and the approaches that work “on the ground”.

Introduction: Exotic Annual Bromus in the Western USA

USGS Publications Warehouse

Germino, Matthew; Chambers, Jeanne C.; Brown, Cynthia S.

2016-01-01

The spread and impacts of exotic species are unambiguous, global threats to many ecosystems. A prominent example is the suite of annual grasses in the Bromus genus (Bromus hereafter) that originate from Europe and Eurasia but have invaded or are invading large areas of the Western USA. This book brings a diverse, multidisciplinary group of authors together to synthesize current knowledge, research needs, and management implications for Bromus. Exotic plant invasions are multifaceted problems, and understanding and managing them requires the biological, ecological, sociological, and economic perspectives that are integrated in this book. Knowing how well information from one geographic or environmental setting can transfer to another is a key need for broadly distributed Bromus species especially given ongoing climate change. Thus, the chapters in the book compare and contrast invasibility of different ecoregions and invasiveness of different Bromus species. A universal theme is managing for ecosystems that are resilient to disturbance and resistant to invasion which will be essential for adaptation to the human-caused problem of Bromus in the Western USA.

[Sickness absence certification from the medical perspective].

PubMed

Echevarría-Zuno, Santiago; Mar-Obeso, Alvaro Julián; Borja-Aburto, Víctor Hugo; Méndez-Bueno, Francisco Javier; Aguilar-Sánchez, Leticia; Rascón-Pacheco, Ramón Alberto

2009-01-01

Sickness absence certification is a medical task with important clinical, social, occupational and ethical implications, in addition to economic consequences for the worker, the employers and social security institutions. In 2007, IMSS affiliated workers received certifications for 65,384,690 days of absence, with cash benefits for 8.1 billion pesos. The duration of return to work depends on the efficiency of health care team as well as factors associated to the worker and the occupational environment. The correct management of sickness absence certification requires adequate disease diagnosis, regulatory knowledge and adequate communication with the patient. The purpose of control and auditing is to make sure that the certification is adequate in the indication and the optimal length, in order to warrant a responsible and sustainable management of this resource of social protection. If expenditure reduction is not possible, the objective is to avoid inefficient or irrational management. Treating physicians, with proper information, can contribute to optimize the provision of this benefit to those who need it.

Older patients' experience of primary hypothyroidism: A qualitative study.

PubMed

Ingoe, Lorna E; Hickey, Janis; Pearce, Simon; Rapley, Tim; Razvi, Salman; Wilkes, Scott; Hrisos, Susan

2018-06-01

Primary hypothyroidism is a common endocrine disorder, more so in an increasing UK ageing population. There is no qualitative research examining the older patient perspective of symptoms, treatment and self-management of hypothyroidism. In this study we explored the experience of hypothyroidism in older people and examined how this may influence their understanding and acceptance of diagnosis, treatment with Levothyroxine and the monitoring process. We conducted semi-structured interviews with 18 participants aged between 80 and 93 years. Interview transcripts were analysed using a thematic approach. The themes involved older individuals' knowledge about symptoms, confidence in diagnosis and understanding of clinical management regimen to understand hypothyroidism. Interpretation of the themes was informed by the Health Belief Model. Our findings can help to inform the development of interventions by treating clinicians and support staff to engage older patients in the long-term management of this chronic condition. © 2018 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Emergency planning and management in health care: priority research topics.

PubMed

Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

2014-06-01

Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

Leadership is the key to chief medical officer success.

PubMed

Kirschman, D

1999-01-01

Senior physician executives were surveyed in 1998/99 to ascertain that they see as their greatest value to their organizations. They believe that their most significant contribution is their accumulated knowledge and experience--both in medicine and management. This medical management perspective is considered the key advantage of serving on the senior management team and helping to shape the organization's decisions and direction. Additionally, they rated their relationships with physicians as a critical aspect of their position. They were also asked what activities they most enjoyed. The number one response was working with the physicians on the medical staff and in the community. This includes the day-to-day involvement as a leader, as a mentor and educator, and overall as a liasion to the organization's practitioners. The activities that they found most rewarding were also those they perceived to be of greatest value. If these physicians are correct about what is valued in their organizations, they are the right people in the right jobs--and they enjoy what they do.

The cost-effectiveness of syndromic management in pharmacies in Lima, Peru.

PubMed

Adams, Elisabeth J; Garcia, Patricia J; Garnett, Geoffrey P; Edmunds, W John; Holmes, King K

2003-05-01

Many people with sexually transmitted diseases (STDs) in Lima, Peru, seek treatment in pharmacies. The goal was to assess the cost-effectiveness of training pharmacy workers in syndromic management of STDs. Cost-effectiveness from both the program and societal perspectives was determined on the basis of study costs, societal costs (cost of medicine), and the number of cases adequately managed. The latter was calculated from estimated incidence, proportion of symptomatic patients, proportion seeking treatment in pharmacies, and proportion of cases adequately managed in both comparison and intervention districts. Univariate and multivariate sensitivity analyses were performed. Under base-case assumptions, from the societal perspective the intervention saved an estimated US$1.51 per case adequately managed; from the program perspective, it cost an estimated US$3.67 per case adequately managed. In the sensitivity analyses, the proportion of females with vaginal discharge or pelvic inflammatory disease who seek treatment in pharmacies had the greatest impact on the estimated cost-effectiveness, along with the medication costs under the societal perspective. Training pharmacists in syndromic management of STDs appears to be cost-effective when only program costs are used and cost-saving from the societal perspective. Our methods provide a template for assessing the cost-effectiveness of managing STD syndromes, on the basis of indirect estimates of effectiveness.

Interpretive Management: What General Managers Can Learn from Design.

ERIC Educational Resources Information Center

Lester, Richard K.; Piore, Michael J.; Malek, Kamal M.

1998-01-01

An analytical management approach reflects a traditional perspective and an interpretive approach involves a perspective suited to rapidly changing, unpredictable markets. Both approaches are valid, but each serves different purposes and calls for different strategies and skills. (JOW)

Conclusions, synthesis, and future directions: understanding sources of population change

USGS Publications Warehouse

Esler, Daniel N.; Flint, Paul L.; Derksen, Dirk V.; Savard, Jean-Pierre L.; Eadie, John M.

2015-01-01

The material in this volume reflects the burgeoning interest in sea ducks, both as study species with compelling and unique ecological attributes and as taxa of conservation concern. In this review, we provide perspective on the current state of sea duck knowledge by highlighting key findings in the preceding chapters that are of particular value for understanding or influencing population change. We also introduce a conceptual model that characterizes links among topics covered by individual chapters and places them in the context of demographic responses. Finally, we offer recommendations for areas of future research that we suggest will have importance for understanding and managing sea duck population dynamics.

The apelinergic system as an alternative to catecholamines in low-output septic shock.

PubMed

Coquerel, David; Sainsily, Xavier; Dumont, Lauralyne; Sarret, Philippe; Marsault, Éric; Auger-Messier, Mannix; Lesur, Olivier

2018-01-19

Catecholamines, in concert with fluid resuscitation, have long been recommended in the management of septic shock. However, not all patients respond positively and controversy surrounding the efficacy-to-safety profile of catecholamines has emerged, trending toward decatecholaminization. Contextually, it is time to re-examine the "maintaining blood pressure" paradigm by identifying safer and life-saving alternatives. We put in perspective the emerging and growing knowledge on a promising alternative avenue: the apelinergic system. This target exhibits invaluable pleiotropic properties, including inodilator activity, cardio-renal protection, and control of fluid homeostasis. Taken together, its effects are expected to be greatly beneficial for patients in septic shock.

Communication challenges in system development: involvement of system developers in small-scale IT projects.

PubMed

Petersen, Lone Stub; Bjoernes, Charlotte D; Bertelsen, Pernille

2010-01-01

A well-known challenge in system development is the aspect of user participation. In this paper we shift perspective from how to involve users in system development to how project managers with a clinical background, but without technical system knowledge, can involve system developers in IT projects. Using data from the development of an online patient book (an ICT application for clinical practice), we analyze challenges using the concept of language-games. We conclude that further research and development of participatory and communicative methods to involve system developers in IT projects, based in a clinical context, is needed.

Commentary: Coming Full Circle--Psychoanalysis, Psychodynamics, and Forensic Psychiatry.

PubMed

Hegarty, Angela M

2015-12-01

Drs. Simopoulos and Cohen argue that knowledge of one's unconscious processes improves the forensic psychiatrist's capacity to manage complex forensic situations and to generate forensic formulations and opinions that are demonstrably more valid and reliable, much like competence in cultural assessment and formulation. In practice, the challenges posed by the application of these principles in forensic settings are far outweighed by the potential benefit. Forensic practice is informed by many specialties. Forensic psychiatrists do not have to complete full training in these disciplines to make use of the knowledge and perspectives they offer. The same may not be true of psychodynamic assessment and formulation. Although much can be learned from supervision, case seminars, conferences, and reading, such knowledge does little to foster awareness of one's unconscious processes that by definition operate outside awareness and thus contribute to the vitiating effect of bias. To date, the only method whereby psychiatrists can effectively come to appreciate their own unconscious processes in action is arguably through their own analysis conducted in the course of training in analysis or psychodynamic psychotherapy. © 2015 American Academy of Psychiatry and the Law.

Teaching with a Global Perspective

ERIC Educational Resources Information Center

Richardson, Percy

2012-01-01

The benefits of teaching from a global perspective far outweigh the disadvantages. Teaching from a global perspective provides the employer with global workers. Such teaching produces students who possess the knowledge of languages, culture, social systems, dress, religion, and cultural norms, as well as skills for employment in the global…

Perspectives on the Transition From Bacterial Phytopathogen Genomics Studies to Applications Enhancing Disease Management: From Promise to Practice.

PubMed

Sundin, George W; Wang, Nian; Charkowski, Amy O; Castiblanco, Luisa F; Jia, Hongge; Zhao, Youfu

2016-10-01

The advent of genomics has advanced science into a new era, providing a plethora of "toys" for researchers in many related and disparate fields. Genomics has also spawned many new fields, including proteomics and metabolomics, furthering our ability to gain a more comprehensive view of individual organisms and of interacting organisms. Genomic information of both bacterial pathogens and their hosts has provided the critical starting point in understanding the molecular bases of how pathogens disrupt host cells to cause disease. In addition, knowledge of the complete genome sequence of the pathogen provides a potentially broad slate of targets for the development of novel virulence inhibitors that are desperately needed for disease management. Regarding plant bacterial pathogens and disease management, the potential for utilizing genomics resources in the development of durable resistance is enhanced because of developing technologies that enable targeted modification of the host. Here, we summarize the role of genomics studies in furthering efforts to manage bacterial plant diseases and highlight novel genomics-enabled strategies heading down this path.

Intrinsic and extrinsic factors affecting patient engagement in diabetes self-management: perspectives of a certified diabetes educator.

PubMed

Rodriguez, Kellie M

2013-02-01

Patients with diabetes are responsible for the vast majority of management requirements of their condition. However, their ability and motivation to engage in required self-management behaviors may be mitigated by multiple intrinsic and extrinsic factors. Intrinsic barriers include attitudes and health beliefs, limited diabetes knowledge and technical skill, reduced functional health literacy, and inadequate self-efficacy to promote positive behavior change. Extrinsic barriers include financial considerations, inadequate family and community support systems, ineffective clinical relationships, and limited access to effective diabetes health care delivery. Diabetes providers have opportunities for enhancing patient engagement with clinical recommendations and diabetes self-management through effective communication, including efforts to contextually assess patients' perceptions of diabetes and how the condition fits within the context of their changing lives. This article provides a conceptual framework for establishing and building an effective clinical alliance with patients with the goal of empowering them to take more control of their diabetes and reduce their risks for poor diabetes outcomes. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Envisioning the future of wildlife in a changing climate: Collaborative learning for adaptation planning

USGS Publications Warehouse

LeDee, Olivia E.; Karasov, W.H.; Martin, Karl J.; Meyer, Michael W.; Ribic, Christine; Van Deelen, Timothy R.

2011-01-01

Natural resource managers are tasked with assessing the impacts of climate change on conservation targets and developing adaptation strategies to meet agency goals. The complex, transboundary nature of climate change demands the collaboration of scientists, managers, and stakeholders in this effort. To share, integrate, and apply knowledge from these diverse perspectives, we must engage in social learning. In 2009, we initiated a process to engage university researchers and agency scientists and managers in collaborative learning to assess the impacts of climate change on terrestrial fauna in the state of Wisconsin, USA. We constructed conceptual Bayesian networks to depict the influence of climate change, key biotic and abiotic factors, and existing stressors on the distribution and abundance of 3 species: greater prairie-chicken (Tympanuchus cupido), wood frog (Lithobates sylvaticus), and Karner blue butterfly (Plebejus melissa samuelis). For each species, we completed a 2-stage expert review that elicited dialogue on information gaps, management opportunities, and research priorities. From our experience, collaborative network modeling proved to be a powerful tool to develop a common vision of the potential impacts of climate change on conservation targets.

Knowledge management in Portuguese healthcare institutions.

PubMed

Cruz, Sofia Gaspar; Ferreira, Maria Manuela Frederico

2016-06-01

Knowledge management imposes itself as a pressing need for the organizations of several sectors of the economy, including healthcare. to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution's management model. a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature. the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model. management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.

Designing the RiverCare knowledge base and web-collaborative platform to exchange knowledge in river management

NASA Astrophysics Data System (ADS)

Cortes Arevalo, Juliette; den Haan, Robert-Jan; van der Voort, Mascha; Hulscher, Suzanne

2016-04-01

Effective communication strategies are necessary between different scientific disciplines, practitioners and non-experts for a shared understanding and better implementation of river management measures. In that context, the RiverCare program aims to get a better understanding of riverine measures that are being implemented towards self-sustaining multifunctional rivers in the Netherlands. During the RiverCare program, user committees are organized between the researchers and practitioners to discuss the aim and value of RiverCare outputs, related assumptions and uncertainties behind scientific results. Beyond the RiverCare program end, knowledge about river interventions, integrated effects, management and self-sustaining applications will be available to experts and non-experts by means of River Care communication tools: A web-collaborative platform and a serious gaming environment. As part of the communication project of RiverCare, we are designing the RiverCare web-collaborative platform and the knowledge-base behind that platform. We aim at promoting collaborative efforts and knowledge exchange in river management. However, knowledge exchange does not magically happen. Consultation and discussion of RiverCare outputs as well as elicitation of perspectives and preferences from different actors about the effects of riverine measures has to be facilitated. During the RiverCare research activities, the platform will support the user committees or collaborative sessions that are regularly held with the organizations directly benefiting from our research, at project level or in study areas. The design process of the collaborative platform follows an user centred approach to identify user requirements, co-create a conceptual design and iterative develop and evaluate prototypes of the platform. The envisioned web-collaborative platform opens with an explanation and visualisation of the RiverCare outputs that are available in the knowledge base. Collaborative sessions are initiated by one facilitator that invites other users to contribute by agreeing on an objective for the session and ways and period of collaboration. Upon login, users can join the different sessions that they are invited or will be willing to participate. Within these sessions, users collaboratively engage on the topic at hand, acquiring knowledge about the ongoing results of RiverCare, sharing knowledge between actors and co-constructing new knowledge in the process as input for RiverCare research activities. An overview of each session will be presented to registered and non-registered users to document collaboration efforts and promote interaction with actors outside RiverCare. At the user requirements analysis stage of the collaborative platform, a questionnaire and workshop session was launched to uncover the end user's preferences and expectations about the tool to be designed. Results comprised insights about design criteria of the collaborative platform. The user requirements will be followed by interview sessions with RiverCare researchers and user committee members to identify considerations for data management, objectives of collaboration, expected outputs and indicators to evaluate the collaborative platform. On one side, considerations of intended users are important for co-designing tools that effectively communicate and promote a shared understanding of scientific outputs. On the other one, active involvement of end-users is important for the establishment of measurable indicators to evaluate the tool and the collaborative process.