The ethics of social media in dental practice: challenges.

PubMed

Peltier, Bruce; Curley, Arthur

2013-07-01

This is the first of two essays written to consider several important trends in dental practice that result from innovations in digital and social media. This essay reviews ethical and legal implications of the use of websites, Facebook, review sites, email and other digital innovations in dental practice. The second essay provides ethical tools for analysis, illuminates areas of ethical concern in today's practice environment and offers recommendations for future practice.

Circulation Policies in Academic Medical Libraries: A Comparative Study of Allocation Strategies, Demographic Analysis, Service Offerings, and Implications for Practice

ERIC Educational Resources Information Center

Whitehead, Michele L.; Gutierrez, Laura; Miller, Melody

2014-01-01

The purpose of this study is to gain an understanding of current academic medical library circulation polices and examine methods libraries utilize to meet patron needs. Key informants were selected from five states. Statistics regarding financial practices, users, services, space access, and circulation practices were collected via survey…

Medical humanities and their discontents: definitions, critiques, and implications.

PubMed

Shapiro, Johanna; Coulehan, Jack; Wear, Delese; Montello, Martha

2009-02-01

The humanities offer great potential for enhancing professional and humanistic development in medical education. Yet, although many students report benefit from exposure to the humanities in their medical education, they also offer consistent complaints and skepticism. The authors offer a pedagogical definition of the medical humanities, linking it to medicine as a practice profession. They then explore three student critiques of medical humanities curricula: (1) the content critique, examining issues of perceived relevance and intellectual bait-and-switch, (2) the teaching critique, which examines instructor trustworthiness and perceived personal intrusiveness, and (3) the structural/placement critique, or how and when medical humanities appear in the curriculum. Next, ways are suggested to tailor medical humanities to better acknowledge and reframe the needs of medical students. These include ongoing cross-disciplinary reflective practices in which intellectual tools of the humanities are incorporated into educational activities to help students examine and, at times, contest the process, values, and goals of medical practice. This systematic, pervasive reflection will organically lead to meaningful contributions from the medical humanities in three specific areas of great interest to medical educators: professionalism, "narrativity," and educational competencies. Regarding pedagogy, the implications of this approach are an integrated required curriculum and innovative concepts such as "applied humanities scholars." In turn, systematic integration of humanities perspectives and ways of thinking into clinical training will usefully expand the range of metaphors and narratives available to reflect on medical practice and offer possibilities for deepening and strengthening professional education.

The role and management implications of modeling owl populations and the habitats they occupy

Treesearch

Amy E. Kearns

1997-01-01

Modeling ecosystems is an evolving science that is both practical and theoretical. The integration of modeling, landscape ecology, management, and rapidly changing technology offers an array of possible solutions to modern environmental quandaries. In order to address these concerns, a workshop was developed to discuss the role and management implications of modeling...

Implications of Electronic Newspapers for Public Relations Teaching, Practice, and Research.

ERIC Educational Resources Information Center

Curtin, Patricia A.; Cameron, Glen T.

Electronic newspapers offer a new media channel for public relations materials, but a study of their proposed use and implications for the profession does not fit well into already established research areas. This paper reviews the development and features of electronic newspapers and suggests new avenues of research and uses pertinent to the…

Reflective practice and its implications for pharmacy education.

PubMed

Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-02-12

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.

Reflective Practice and Its Implications for Pharmacy Education

PubMed Central

Bosnic-Anticevich, Sinthia; Smith, Lorraine

2014-01-01

Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286

Rejecting the Null: Research and Social Justice Means Asking Different Questions

ERIC Educational Resources Information Center

Chapman, Stephanie; Schwartz, Jonathan P.

2012-01-01

The focus of this article is on the specific ethical issues related to social justice research and the practical implications of engaging in social justice research, including the potential impact of research results on practice, policy, and advocacy at the local and national level. Specific recommendations are offered, including identifying…

The Social Psychology of Black-White Interracial Interactions: Implications for Culturally Competent Clinical Practice

ERIC Educational Resources Information Center

Jordan, Alexander H.; Lovett, Benjamin J.; Sweeton, Jennifer L.

2012-01-01

Social psychological research suggests that because of concerns about being perceived in stereotypical ways, people may experience negative affect and diminished attention and cognitive capacity during interracial interactions. The authors discuss this research in relation to therapy and assessment and also offer practical suggestions for ensuring…

Bella's Beetle: Approaching Bioscience Practice from Its Silent Kinaesthetic and Affective Side

ERIC Educational Resources Information Center

Hay, David

2017-01-01

This article critically explores the epistemic "practices" of bioscience, using creative writing and analyses of science studies to implicate the non-linguistic side of science where a "feeling for the organism" matters more, perhaps, than theoretical precision. It offers new critique of curricula in science which are so…

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

ERIC Educational Resources Information Center

Serrano Velarde, Kathia

2018-01-01

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

How Do Staff Perceive Schoolwide Positive Behavior Supports? Implications for Teams in Planning and Implementing Schools

ERIC Educational Resources Information Center

Feuerborn, Laura L.; Tyre, Ashli D.

2016-01-01

Schoolwide Positive Behavior Support (SWPBS) offers an alternative to reactive and exclusionary school discipline practices. However, the shift to SWPBS requires substantial change in the practices of staff, and many leadership teams struggle to rally staff support for implementation. With a more thorough understanding of staff perceptions, level…

Terror management theory applied clinically: implications for existential-integrative psychotherapy.

PubMed

Lewis, Adam M

2014-01-01

Existential psychotherapy and Terror Management Theory (TMT) offer explanations for the potential psychological effects of death awareness, although their respective literatures bases differ in clarity, research, and implications for treating psychopathology. Existential therapy is often opaque to many therapists, in part due to the lack of consensus on what constitutes its practice, limited published practical examples, and few empirical studies examining its efficacy. By contrast, TMT has an extensive empirical literature base, both within social psychology and spanning multiple disciplines, although previously unexplored within clinical and counseling psychology. This article explores the implications of a proposed TMT integrated existential therapy (TIE), bridging the gap between disciplines in order to meet the needs of the aging population and current challenges facing existential therapists.

Pargament's Theory of Religious Coping: Implications for Spiritually Sensitive Social Work Practice

PubMed Central

Xu, Jianbin

2016-01-01

This article proposes that Pargament's theory of religious coping can be a theoretical beacon to spiritually sensitive social work practice. It begins with a discussion of the raison d'être of spiritually sensitive social work, which is examined as being able to cast a holistic and positive glow on social work. Then it provides an overview and a critique of Pargament's theory, emphasising that the theory offers a fuller and more impartial picture of religious coping. In addition, it explores the implications of Pargament's theory for spiritually sensitive social work practice with religious clients in terms of engagement, assessment and intervention. This article concludes by discussing how social work practitioners can avoid the pitfalls and limitations of Pargament's theory. PMID:27559234

Yes We Can! Improving Urban Schools through Innovative Educational Reform. Contemporary Perspectives on Access, Equity, and Achievement

ERIC Educational Resources Information Center

Howell, Leanne L., Ed.; Lewis, Chance W., Ed.; Carter, Norvella, Ed.

2011-01-01

Yes We Can: Improving Urban Schools through Innovative Educational Reform is a empirically-based book on urban education reform to not only proclaim that hope is alive for urban schools, but to also produce a body of literature that examines current practices and then offer practical implications for all involved in this arduous task. This book is…

Attachment Theory: Implications for School Psychology

ERIC Educational Resources Information Center

Kennedy, Janice H.; Kennedy, Charles E.

2004-01-01

The effective practice of school psychology requires a strong research and theoretical base, a framework that encompasses developmental processes and outcomes, both adaptive and maladaptive, which facilitates assessment and intervention and offers insight into classroom and family dynamics. Attachment theory provides the school psychologist with…

Personalizing knowledge delivery services: a conceptual framework

NASA Technical Reports Server (NTRS)

Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

2003-01-01

Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program

PubMed Central

Meagher, Karen M.

2016-01-01

Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation—deliberative public bioethics—into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice. PMID:26843669

Changing the Publication Culture From "Nice to Do" to "Need to Do": Implications for Nurse Leaders in Acute Care Settings.

PubMed

Tyndall, Deborah E; Caswell, Nicole I

2017-01-01

Nurses in clinical settings often generate innovative practice ideas to inform their practice and improve patient outcomes. Yet, few publish and share these innovations with a wider audience. Barriers impeding clinical nurses from writing for publication include discomfort with writing, lack of time, and scarce resources. A qualitative study was designed to determine obstacles and facilitators to writing for publication. Interviews were conducted with five clinical nurses who had recently published in peer-reviewed journals. Three themes emerged from the data: culture of "nice to do," personal motivation, and writing experiences. Findings from the study offer implications for nurse leaders to help increase publication efforts by clinical nurses in acute care settings. Nurse leaders can promote publication by clinical nurses through three main strategies: create a culture that supports publication, offer incentives to motivate nurses to publish and reward those who do publish, and provide writing experiences that facilitate writing for publication. © 2016 Wiley Periodicals, Inc.

Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

PubMed

Meagher, Karen M; Lee, Lisa M

2016-01-01

Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

The Theory and Practice of Genre Criticism: Genre Criticism: The Analysis of Form, Part I; Genre Criticism: Judgment Argument and Evidence, Part II; [and] Genre Criticism: A Topical Bibliography, Part III.

ERIC Educational Resources Information Center

Creps, Earl

A three-part study of the forms of rhetorical criticism is offered. Part one reviews the nature of genre criticism, enumerates several concepts of form and the types of genre criticism they produce, and discusses the implications of this relationship between form and genre. Part two is an essay on the methodological implications of form-grounded…

Closing the Reference Interview: Implications for Policy and Practice.

ERIC Educational Resources Information Center

Nolan, Christopher W.

1992-01-01

Discusses reasons why patrons or librarians terminate the reference interview, including the content of the interview, interpersonal dynamics, and institutional or policy factors. Goals and objectives of the person terminating the interview are considered, and guidelines for policy development and performance improvement are offered. (30…

The Role of the School Psychologist in the Examination of Complex Language Disorders.

ERIC Educational Resources Information Center

Werder, Hans

1988-01-01

School psychologists must utilize an interdisciplinary approach to understand and analyze language disturbances, by examining the student's motor coordination, sensorium, perception, cognition, emotionality, and sociability. Implications for the practice of school psychology are offered in the areas of dyslalia, dysgrammatia, retardation of…

An Essential Interrelationship: Healthy Self-Esteem and Productive Creativity.

ERIC Educational Resources Information Center

Yau, Cecilia

1991-01-01

This paper defines the term "self-image" or "self-esteem" and defines the term "creativity" from psychoanalytic and humanist interpretations. It then proposes the theory that a positive self-image enhances the possibilities for creative productivity or lifestyle. Practical implications for child rearing are offered. (JDD)

Water and Plant Cells: Notes on a Teaching Scheme for O-Level.

ERIC Educational Resources Information Center

Grenville, H. W.

1983-01-01

Offers suggestions for teaching some aspects of water economy in plants. These include diffusion/osmosis, water transport, the part played by turgor in structural support, and its implications for plant organs or whole plants. Several practical demonstrations/experiments are also described. (JN)

The forensic evaluation and report: an agenda for research.

PubMed

Buchanan, Alec; Norko, Michael

2013-01-01

The written report is a central component of forensic psychiatric practice. In the report, an evaluator assembles and organizes data, interprets results of an evaluation, and offers an opinion in response to legal questions. The past 30 years have seen substantial development in principles and practice of forensic report writing. Drawing on recent advances in the psychiatric report, the authors explore topics including narrative, forensic ethics, coercion within the justice system, and implications of limitations on data in forming forensic opinions. They offer an analysis of unanswered questions in these areas, suggesting opportunities for further empirical study and theoretical development. This proposed agenda is important in training, in the development of policy, and in establishing professional guidelines.

Reconsidering Behaviorist Composition Pedagogies: Positivism, Empiricism, and the Paradox of Postmodernism.

ERIC Educational Resources Information Center

Wallace, David

1996-01-01

Explores how positivism and empiricism may be distinguished in practice by examining four proposals for writing pedagogy based on behaviorist learning theory. Argues that empiricism offers a viable means of addressing what Douglas Hess has dubbed "the splendid paradox of postmodernism." Suggests several implications for empiricism in…

Creating Safe Spaces for Music Learning

ERIC Educational Resources Information Center

Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

2014-01-01

This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

Strategic Renewal and Development Implications of Organisational Effectiveness Research in Higher Education in Australia.

ERIC Educational Resources Information Center

Lysons, Art

1999-01-01

Suggests that organizational effectiveness research has made considerable progress in empirically deriving a systematic framework of theoretical and practical utility in Australian higher education. Offers a taxonomy based on the competing values framework and discusses use of inter-organizational comparisons and profiles for diagnosis in…

Hacking Say and Reviving ELIZA: Lessons from Virtual Environments

ERIC Educational Resources Information Center

Mazar, Rochelle; Nolan, Jason

2009-01-01

As text-based predecessors to Second Life, MOOs can offer educators important insights on managing virtual communities to create rich, meaningful learning experiences. Rochelle Mazar and Jason Nolan outline two instructional experiments in MOOs that have implications for current educational practice in Second Life. One involves modifying and…

Open Hands, Open Hearts: Working with Native Youth in the Schools.

ERIC Educational Resources Information Center

Garrett, Michael Tlanusta; Bellon-Harn, Monica L.; Torres-Rivera, Edil; Garrett, J. T.; Roberts, Lisen C.

2003-01-01

A comprehensive discussion of the potential for cultural discontinuity experienced by native youth in the schools is offered with implications for culturally responsive service delivery. Practical recommendations are provided for special educators and related service professionals working with native youth to improve knowledge, awareness, and…

Ecosystemic Complexity Theory of Conflict: Understanding the Fog of Conflict

ERIC Educational Resources Information Center

Brack, Greg; Lassiter, Pamela S.; Hill, Michele B.; Moore, Sarah A.

2011-01-01

Counselors often engage in conflict mediation in professional practice. A model for understanding the complex and subtle nature of conflict resolution is presented. The ecosystemic complexity theory of conflict is offered to assist practitioners in navigating the fog of conflict. Theoretical assumptions are discussed with implications for clinical…

The "Good Enough" Parent: Implications for Child Protection

ERIC Educational Resources Information Center

Choate, Peter W.; Engstrom, Sandra

2014-01-01

Child protection workers must determine under what conditions a child should be sustained within the family system. A standard that is often referred to is "good enough" parenting or minimal parenting competence. Research and clinical literature fails to offer workers guidance on the practical application of this terminology. Such…

Living Mathematx: Towards a Vision for the Future

ERIC Educational Resources Information Center

Gutiérrez, Rochelle

2017-01-01

This paper offers specific implications for teaching and learning and brings into conversation ideas from ethnomathematics (including Western mathematics), postcolonial theory, aesthetics, biology, and Indigenous knowledge in order to propose a new vision for practicing mathematics, what I call mathematx. I build upon the work of sustainability in…

Examining the front lines of local environmental public health practice: a Maryland case study.

PubMed

Resnick, Beth; Zablotsky, Joanna; Nachman, Keeve; Burke, Thomas

2008-01-01

Local environmental public health (EPH) is the foundation of a nation's environmental protection infrastructure. With increasing pressure to demonstrate the ability of EPH activities to effectively protect health, the Johns Hopkins Center for Excellence in EPH Practice, as part of the Centers for Disease Control and Prevention's (CDC's) EPH capacity-building effort, developed the Profile of Maryland Environmental Public Health Practice. This profile offers an examination of front-line local EPH strengths, needs, challenges, and provides recommendations to strengthen the EPH infrastructure. A multistep process was conducted, including site visits to all of Maryland's 24 local EPH agencies and a questionnaire addressing administrative structure, communication, funding, workforce, crisis management, technology, and legal authority, completed by local EPH directors. The Maryland Profile revealed a dedicated and responsive workforce limited by a neglected, fragmented, and underfunded EPH infrastructure. Recommendations regarding leadership, workforce, training, technology, communication, and legal authority are offered. This research has implications for the national EPH infrastructure. Recommendations offered are consistent with the CDC's findings in A National Strategy to Revitalize Environmental Public Health Services. These findings and recommendations offer opportunities to facilitate the advancement of an EPH system to better protect the nation's health.

Future trends in health and health care: implications for social work practice in an aging society.

PubMed

Spitzer, William J; Davidson, Kay W

2013-01-01

Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.

Exploring team working and shared leadership in multi-disciplinary cancer care.

PubMed

Willcocks, Stephen George

2018-02-05

Purpose The purpose of this paper is to explore the relevance of shared leadership to multi-disciplinary cancer care. It examines the policy background and applies concepts from shared leadership to this context. It includes discussion of the implications and recommendations. Design/methodology/approach This is a conceptual paper examining policy documents and secondary literature on the topic. While it focuses on the UK National Health Services, it is also relevant to other countries given they follow a broadly similar path with regard to multi-disciplinary working. Findings The paper suggests that shared leadership is a possible way forward for multi-disciplinary cancer care, particularly as policy developments are supportive of this. It shows that a shared perspective is likely to be beneficial to the further development of multi-disciplinary working. Research limitations/implications Adopting shared leadership needs to be explored further using appropriate empirical research. Practical implications The paper offers comments on the implications of introducing shared leadership and makes recommendations including being aware of the barriers to its implementation. Originality/value The paper offers an alternative view on leadership in the health-care context.

Being Subject-Centred: A Philosophy of Teaching and Implications for Higher Education

ERIC Educational Resources Information Center

Morrison-Saunders, Angus; Hobson, Julia

2013-01-01

Being subject-centred as a higher education teacher offers a rich and illuminating philosophical and practical understanding of learning. Building upon previous research on subject-centred learning, we draw on reflection, literature review and a phenomenological approach to show how our ways of being infuse the teaching and learning environment.…

Reflections of an Emerging Male-to-Female Transgendered Consciousness.

ERIC Educational Resources Information Center

Glenn, Wendell D.

1999-01-01

Provides a first-person account of one individual's experience as a plainclothes, African American, male-to-female transgendered person, describing his life growing up and how he balanced internal and external factors and offering implications for social work practice with both plainclothes and fixed/prepared male-to-female transgendered youth.…

University of Toronto Instructors' Experiences with Developing MOOCs

ERIC Educational Resources Information Center

Najafi, Hedieh; Rolheiser, Carol; Harrison, Laurie; Håklev, Stian

2015-01-01

We interviewed eight University of Toronto (U of T) instructors who have offered MOOCs on Coursera or EdX between 2012 and 2014 to understand their motivation for MOOC instruction, their experience developing and teaching MOOCs, and their perceptions of the implications of MOOC instruction on their teaching and research practices. Through…

Making Sense of Cluster Analysis: Revelations from Pakistani Science Classes

ERIC Educational Resources Information Center

Pell, Tony; Hargreaves, Linda

2011-01-01

Cluster analysis has been applied to quantitative data in educational research over several decades and has been a feature of the Maurice Galton's research in primary and secondary classrooms. It has offered potentially useful insights for teaching yet its implications for practice are rarely implemented. It has been subject also to negative…

McLuhan's Challenge to Critical Media Literacy: "The City as Classroom" Textbook

ERIC Educational Resources Information Center

Mason, Lance

2016-01-01

This paper examines the high school media education textbook that Marshall McLuhan and coauthors published in 1977. "The City as Classroom" textbook provides an articulation of the practical implications of McLuhan's media theories. I offer an explication of this approach and its significance for contemporary media education, while…

Opening the Eyes of Counselors to the Emotional Abuse of Men: An Overlooked Dynamic in Dysfunctional Families

ERIC Educational Resources Information Center

Gold, Joshua M.; Pitariu, Gabriela V.

2004-01-01

The authors suggest that counselors should expand their awareness of emotional abuse within heterosexual relationships, offering definitions of emotional abuse and statistics that confirm the victimization of men. The implications of this knowledge for counselors" personal growth and therapeutic practice are discussed. The statistics on the…

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Responsible leader behavior in health sectors.

PubMed

Longest, Beaufort

2017-02-06

Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

Empowerment through agency-promoting dialogue: an explicit application of harm reduction theory to reframe HIV test counseling.

PubMed

Mattson, M

2000-01-01

The counseling that accompanies HIV testing can be an important prevention tool for encouraging people to practice safer sex to avoid AIDS, but there is scant research about how HIV test counseling operates in practice. This article critiques the current Centers for Disease Control and Prevention (CDC) protocol for HIV test counseling for not being genuinely client centered and ignoring the unique needs of clients and offers an alternative approach that adapts and explicitly applies the tenets of harm reduction theory (HRT). Excerpts from actual HIV test counseling sessions illustrate both the weaknesses in the current approach to HIV test counseling and project how the alternative theoretical perspective offered could provide counseling that encourages agency-promoting and empowering dialogue. The implications for the development of HRT as a health communication heuristic and a practical training and evaluation strategy are discussed along with limitations and future research directions.

Applied Ethics and eHealth: Principles, Identity, and RFID

NASA Astrophysics Data System (ADS)

Whitehouse, Diane; Duquenoy, Penny

The social and ethical implications of contemporary technologies are becoming an issue of steadily growing importance. This paper offers an overview in terms of identity and the field of ethics, and explores how these apply to eHealth in both theory and practice. The paper selects a specific circumstance in which these ethical issues can be explored. It focuses particularly on radio-frequency identifiers (RFID). It ends by discussing ethical issues more generally, and the practice of ethical consideration.

Lo que los educadores necesitan saber sobre...El agrupamiento por habilidad [y] La compactacion del curriculum [y] Los alumnos dotados y el aprendizaje cooperativo [y] La actividad tutoral. Guias practica (What Educators Need To Know about...Ability Grouping [and] Curriculum Compacting [and] Gifted Students and Cooperative Learning [and] Mentoring. Practitioners' Guides).

ERIC Educational Resources Information Center

Siegle, Del, Ed.

These four pamphlets in Spanish offer guidelines supported by theory-driven quality research that is problem-based, practice-relevant, and consumer-oriented. Each pamphlet has a section summarizing research from the literature or topic notes as well as implications for the classroom. The first guide offers principles for teachers concerning the…

The ethics of waiting and anticipating life beyond.

PubMed

Milton, Constance L

2014-01-01

Waiting is a common everyday experience. It is particularly important to person(s) and families living with changing complex health patterns and may be especially vital to those who are anticipating the end-of-life and beyond. The author in this column offers a discussion of potential definitions, meanings, and straight thinking responsibilities for healthcare professionals, as they provide professional services with persons and families who may be arduously experiencing the phenomenon of waiting with ever-changing health situations. Implications for professional nurse practice are offered from a humanbecoming perspective.

www.mydrugdealer.com: Ethics and legal implications of Internet-based access to substances of abuse.

PubMed

Klein, Carolina A; Kandel, Surendra

2011-01-01

The Internet has increasingly become an intrinsic part of everyday life, offering countless possibilities for education, services, recreation, and more. In fact, an entire virtual life within the digitalized World Wide Web is possible and common among many Internet users. Today's psychiatrists must therefore incorporate this dimension of human life into clinical practice, to achieve an adequate assessment of the tools and risks available to the patient. We focus on the Internet as a portal for the trade of and access to substances of abuse. We review the legal regulations that may inform care and standards of practice and analyze the difficulties that arise in assessment and monitoring of the current situation. We consider the potential impact of Internet-based narcotics trade on addiction morbidities and the practice of clinical psychiatry, as well as on the potential legal implications that the forensic expert may face.

Making history critical.

PubMed

Learmonth, Mark

2017-08-21

Purpose The purpose of this paper is to explore a possible discursive history of National Health Service (NHS) "management" (with management, for reasons that will become evident, very much in scare quotes). Such a history is offered as a complement, as well as a counterpoint, to the more traditional approaches that have already been taken to the history of the issue. Design/methodology/approach Document analysis and interviews with UK NHS trust chief executives. Findings After explicating the assumptions of the method it suggests, through a range of empirical sources that the NHS has undergone an era of administration, an era of management and an era of leadership. Research limitations/implications The paper enables a recasting of the history of the NHS; in particular, the potential for such a discursive history to highlight the interests supported and denied by different representational practices. Practical implications Today's so-called leaders are leaders because of conventional representational practices - not because of some essence about what they really are. Social implications New ideas about the nature of management. Originality/value The value of thinking in terms of what language does - rather than what it might represent.

Utility of the Electrocardiogram in Drug Overdose and Poisoning: Theoretical Considerations and Clinical Implications

PubMed Central

Yates, Christopher; Manini, Alex F

2012-01-01

The ECG is a rapidly available clinical tool that can help clinicians manage poisoned patients. Specific myocardial effects of cardiotoxic drugs have well-described electrocardiographic manifestations. In the practice of clinical toxicology, classic ECG changes may hint at blockade of ion channels, alterations of adrenergic tone, or dysfunctional metabolic activity of the myocardium. This review will offer a structured approach to ECG interpretation in poisoned patients with a focus on clinical implications and ECG-based management recommendations in the initial evaluation of patients with acute cardiotoxicity. PMID:22708912

A History of Ideas in Science Education: Implications for Practice.

ERIC Educational Resources Information Center

DeBoer, George E.

This book offers a perspective on the science education enterprise that individuals can use as they attempt to understand what happens in science classrooms and what should happen. This book is a historical account of ideas in science education that covers the time period from approximately the middle of the nineteenth century to 1991. How science…

An Operational Definition of Twice-Exceptional Learners: Implications and Applications

ERIC Educational Resources Information Center

Reis, Sally M.; Baum, Susan M.; Burke, Edith

2014-01-01

In this article, a new definition of twice-exceptional children is proposed. In addition to introducing this new definition, the authors provide a research-based rationale for the definition, offer a clear profile of twice-exceptional youth, and summarize the development of new programs and practices to enable these students to develop their gifts…

Assessment and Case Law: Implications for the Grading Practices of Music Educators

ERIC Educational Resources Information Center

Russell, Joshua A.

2011-01-01

Assessment continues to be a topic of discussion and concern for many music educators and music teacher educators. The discussion of assessment in music education can spark lively and passionate debate among music educators, music teacher educators, students, policy makers, and parents alike. This article offers a discussion of some of the…

Cancer Awareness and Secondary Prevention Practices in Black Americans: Implications for Intervention.

ERIC Educational Resources Information Center

Bloom, Joan R.; And Others

The morbidity and mortality rates for cancer are higher for blacks than for whites. The following three contending theories offer possible explanations for these rates: (1) the histology types among cancers of the same site are distributed differently for blacks and whites; (2) there is increased susceptibility in lower social classes, of which…

Roles, Duties and Challenges of Special/Support Teachers at Secondary Education: Implications for Promoting Inclusive Practices

ERIC Educational Resources Information Center

Vlachou, Anastasia; Didaskalou, Eleni; Kontofryou, Maria

2015-01-01

Recent inclusive policy directives and advice offered to schools strongly recommend special/support teachers to expand their role and extend their duties. In light of this, we investigated how Greek secondary special/support teachers perceive and experience their role, work profile and the challenges they encounter. Qualitative analysis revealed…

Possibilities and Implications of Using a Motion-Tracking System in Physical Education

ERIC Educational Resources Information Center

Chow, Jia Yi; Tan, Clara Wee Keat; Lee, Miriam Chang Yi; Button, Chris

2014-01-01

Advances in technology have created new opportunities for enhanced delivery of teaching to improve the acquisition of game skills in physical education (PE). The availability of a motion-tracking system (i.e. the A-Eye), which determines positional information of students in a practice context, might offer a suitable technology to support…

Rethinking Lifelong Learning through Online Distance Learning in Chinese Educational Policies, Practices and Research

ERIC Educational Resources Information Center

Yang, Min

2008-01-01

This paper offers a critique of the Chinese philosophy of online distance learning as a means of building a lifelong learning society. Literature about lifelong learning and its implications for online distance learning is reviewed. Documents, reports and research papers are examined to explore the characteristics of the Chinese philosophy of…

Transplant tourism: a modern iteration of an ancient problem.

PubMed

Khamash, Hasan A; Gaston, Robert S

2008-08-01

To explore the scope and implications of emerging global problem of transplant tourism, a practice in which patients seek transplant services (most commonly kidney allografts) in countries other than their permanent residence. Potential remedies that must be implemented if abuses are to be curbed are also offered. Although traveling abroad for medical services may not be problematic from a number of perspectives, what makes transplant tourism so troubling is its link with organ trafficking and transplant commercialism. Unlike many illegal markets, however, this one is driven by the need of patients with irreversible kidney failure, who, along with kidney vendors, are the most vulnerable participants in the process in terms of medical and financial outcomes. This review explores the scope and implications of transplant tourism, and offers potential remedies that must be implemented if abuses are to be curbed.

Old age, vulnerability and sexual violence: implications for knowledge and practice.

PubMed

Jones, H; Powell, J L

2006-09-01

This paper seeks to offer further analysis on the relationship between abuse of power, elder abuse and sexual violence. Importantly, current definitions are examined and the existing literature is reviewed to establish what the current level of debate is on sexual violence in its relationship to elderly women. Through the analysis of available literature it is possible to observe which and how older people have been marginalized both in particular disciplines of study and policy spaces. We conclude that marginalization results in inadequate redress to issues of violence and power that may manifest against the older person, and which leads to feelings of vulnerability. There are important implications for helping health professionals, especially nurses, for understanding the policy, theory and practice. The need for empirical research in this difficult area is paramount.

Crowdfunding: an innovative way to fund your project.

PubMed

Walker, Dawn-Marie

2017-06-22

Background Getting research funded is extremely difficult, with research councils rejecting more than 70% of grant applications ( Else 2014 ). It is even more difficult if you are a junior researcher who doesn't have a track record of being awarded grant money or leading a research project. Crowdfunding may offer a solution. It is a method of raising funds from members of the public online and can offer an alternative to the more formal methods of research funding. Aim To outline how this model works and provide tips on designing a campaign. Discussion The authors provide an overview of the literature regarding this model, as well as a set of resources for future reference when designing a campaign. Conclusion Crowdfunding can provide small amounts of money for your first project. Implications for practice It is expected that clinicians practice evidence based medicine, and research in health environments is commonplace. Crowdfunding can offer you support in becoming more engaged in research.

Overcoming barriers in care for the dying: Theoretical analysis of an innovative program model.

PubMed

Wallace, Cara L

2016-08-01

This article explores barriers to end-of-life (EOL) care (including development of a death denying culture, ongoing perceptions about EOL care, poor communication, delayed access, and benefit restrictions) through the theoretical lens of symbolic interactionism (SI), and applies general systems theory (GST) to a promising practice model appropriate for addressing these barriers. The Compassionate Care program is a practice model designed to bridge gaps in care for the dying and is one example of a program offering concurrent care, a recent focus of evaluation though the Affordable Care Act. Concurrent care involves offering curative care alongside palliative or hospice care. Additionally, the program offers comprehensive case management and online resources to enrollees in a national health plan (Spettell et al., 2009).SI and GST are compatible and interrelated theories that provide a relevant picture of barriers to end-of-life care and a practice model that might evoke change among multiple levels of systems. These theories promote insight into current challenges in EOL care, as well as point to areas of needed research and interventions to address them. The article concludes with implications for policy and practice, and discusses the important role of social work in impacting change within EOL care.

One dozen considerations when working with women in substance abuse groups.

PubMed

Bright, Charlotte Lyn; Osborne, Victoria A; Greif, Geoffrey L

2011-01-01

Women and men have different histories, presentations, and behaviors in substance abuse groups. Twelve considerations are offered for the beginning group leader when encountering women with substance abuse issues. These include understanding sexism, what brings women to treatment, and how women behave in group treatment. Implications for clinical practice with women in single-gender and mixed-gender groups are included.

Neuroscience Meets Music Education: Exploring the Implications of Neural Processing Models on Music Education Practice

ERIC Educational Resources Information Center

Collins, Anita

2013-01-01

Over the past two decades, neuroscientists have been fascinated by the way the brain processes music. Using new technologies, neuroscientists offer us a better understanding of the human brain's structures and functions. They have further proposed explanatory models for how the brain processes music. While these models shed light on how the…

An Overview of the Use of Mechanical Turk in Behavioral Sciences: Implications for Social Work

ERIC Educational Resources Information Center

Chan, Chitat; Holosko, Michael J.

2016-01-01

Crowdsourcing is a process in which a firm parcels out work to a "crowd" and offers payment for anyone within the crowd who completes the task determined by that firm. A growing number of behavioral scientists have begun using the Mechanical Turk (MTurk) to facilitate their research and practice, but there is apparently not one academic…

Testing Hypothesized Differences between Adult Children of Alcoholics (ACOAs) and Non-ACOAs in a College Student Sample

ERIC Educational Resources Information Center

Jones, Amy L.; Perera-Diltz, Dilani M.; Salyers, Kathleen M.; Laux, John M.; Cochrane, Wendy S.

2007-01-01

The authors compared college adult children of alcoholics (ACOAs) and non-ACOAs using the Substance Abuse Subtle Screening Inventory-3 (F.G. Miller, 1999).The results failed to support the hypothesis that ACOAs have higher rates of substance dependence, defensiveness, and codependency than do non-ACOAs. Practical implications are offered for…

Stem Cell Research and Clinical Translation: A Roadmap about Good Clinical Practice and Patient Care

PubMed Central

Scopetti, Matteo; Gatto, Vittorio

2017-01-01

The latest research achievements in the field of stem cells led in 2016 to the publication of “Guidelines for Stem Cell Research and Clinical Translation” by the International Society for Stem Cell Research (ISSCR). Updating the topics covered in previous publications, the new recommendations offer interesting ethical and scientific insights. Under the common principles of research integrity, protection of patient's welfare, respect for the research subjects, transparency and social justice, the centrality of good clinical practice, and informed consent in research and translational medicine is supported. The guidelines implement the abovementioned publications, requiring rigor in all areas of research, promoting the validity of the scientific activity results and emphasizing the need for an accurate and efficient public communication. This paper aims to analyze the aforementioned guidelines in order to provide a valid interpretive tool for experts. In particular, a research activity focused on the bioethical, scientific, and social implications of the new recommendations is carried out in order to provide food for thought. Finally, as an emerging issue of potential impact of current guidelines, an overview on implications of compensation for egg donation is offered. PMID:29090010

Stem Cell Research and Clinical Translation: A Roadmap about Good Clinical Practice and Patient Care.

PubMed

Frati, Paola; Scopetti, Matteo; Santurro, Alessandro; Gatto, Vittorio; Fineschi, Vittorio

2017-01-01

The latest research achievements in the field of stem cells led in 2016 to the publication of "Guidelines for Stem Cell Research and Clinical Translation" by the International Society for Stem Cell Research (ISSCR). Updating the topics covered in previous publications, the new recommendations offer interesting ethical and scientific insights. Under the common principles of research integrity, protection of patient's welfare, respect for the research subjects, transparency and social justice, the centrality of good clinical practice, and informed consent in research and translational medicine is supported. The guidelines implement the abovementioned publications, requiring rigor in all areas of research, promoting the validity of the scientific activity results and emphasizing the need for an accurate and efficient public communication. This paper aims to analyze the aforementioned guidelines in order to provide a valid interpretive tool for experts. In particular, a research activity focused on the bioethical, scientific, and social implications of the new recommendations is carried out in order to provide food for thought. Finally, as an emerging issue of potential impact of current guidelines, an overview on implications of compensation for egg donation is offered.

Substance abuse treatment and services by criminal justice and other funding sources.

PubMed

Arfken, Cynthia L; Kubiak, Sheryl Pimlott

2009-01-01

Studies have found funding source, whether public or private, is associated with treatment and services offered in community-based agencies. However, the association of criminal justice funding with community-based treatment and services is unknown. Using a mixed method case study approach with 34 agencies within one state we assessed administrators' perspectives of the most important funding source, treatment and services offered. We found that agencies rely on multiple funding sources and the source rated most important was associated with treatment and services offered in the agency. Those agencies citing a criminal justice entity as the most important funder were more likely to offer specific ancillary services and adopt motivational interviewing than those citing private funds. Although client characteristics or training opportunities may determine these services and practices, the agency's most important funding source may have implications for services offered.

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

PubMed

Nestor, M S

2000-09-01

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

An exploratory study on the user experience of foot reflexology therapy using reflexology artifacts

NASA Astrophysics Data System (ADS)

Okere, Hector Chimeremeze; Sulaiman, Suziah; Rambli, Dayang Rohaya Awang; Foong, Oi-Mean

2015-07-01

The reputation and significance of foot reflexology therapy has continuously been on the rise. It is currently widely used as a complementary therapy, for stress relief and a potential diagnostic tool. In the society nowadays, there exist a lot of reflexology artifacts that claim to be an alternative substitutes to the traditional foot reflexology practice since the practices promote relaxation and stress relief. However, there has been very little or no attention given towards the verification of such anecdote and the identification of the similarities, differences and opportunities these reflexology artifacts offer. This paper hence aims to address this issue through the exploration of the practices. The study examined the interactive nature of four different sets of common reflexology artifacts from both the patients' and the experts' perspective. Data were collected through audio recorded semi-structured interview. The study findings revealed answers to those anecdotes, highlighting the similarities, difference and opportunities these reflexology artifacts offer. Implications for future research were also discussed.

Historical thinking in clinical medicine: lessons from R.G. Collingwood's philosophy of history.

PubMed

Chin-Yee, Benjamin H; Upshur, Ross E G

2015-06-01

The aim of this article is to create a space for historical thinking in medical practice. To this end, we draw on the ideas of R.G. Collingwood (1889-1943), the renowned British philosopher of history, and explore the implications of his philosophy for clinical medicine. We show how Collingwood's philosophy provides a compelling argument for the re-centring of medical practice around the patient history as a means of restoring to the clinical encounter the human meaning that is too often lost in modern medicine. Furthermore, we examine how Collingwood's historical thinking offers a patient-centred epistemology and a more pluralistic concept of evidence that includes the qualitative, narrative evidence necessary for human understanding. We suggest that clinical medicine can benefit from Collingwood's historical thinking, and, more generally, illustrates how a philosophy of medicine that draws on diverse sources from the humanities offers a richer, more empathetic clinical practice. © 2015 John Wiley & Sons, Ltd.

Behavioral Health Integration into Primary Care: a Microsimulation of Financial Implications for Practices.

PubMed

Basu, Sanjay; Landon, Bruce E; Williams, John W; Bitton, Asaf; Song, Zirui; Phillips, Russell S

2017-12-01

New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. To evaluate the financial impact for primary care practices of integrating behavioral health services. Microsimulation model. We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey. A collaborative care model (CoCM), involving telephone-based follow-up from a behaviorist care manager, or a primary care behaviorist model (PCBM), involving an in-clinic behaviorist. Net revenue change per full-time physician. When behavioral health integration services were offered only to Medicare patients, net revenue was higher under CoCM (averaging $25,026 per MD in year 1 and $28,548/year in subsequent years) than PCBM (-$7052 in year 1 and -$3706/year in subsequent years). When behavioral health integration services were offered to all patients and were reimbursed by Medicare and private payers, only practices adopting the CoCM approach consistently gained net revenues. The outcomes of the model were sensitive to rates of patient referral acceptance, presentation, and therapy completion, but the CoCM approach remained consistently financially viable whereas PCBM would not be in the long-run across practice types. New Medicare payments may offer financial viability for primary care practices to integrate behavioral health services, but this viability depends on the approach toward care integration.

Nursing Practice With Incarcerated Women: A Focused Comparative Review of the Nursing and Feminist Literature.

PubMed

Hardill, Kathy

2015-01-01

Nurses who practice with criminalized women will recognize this group as profoundly marginalized through multiple, intersecting mechanisms. The number of women imprisoned in North America, Latin America, Australia, and Western Europe continues to rise as it has for the past 20 years or more. As a nurse who has practiced almost exclusively with marginalized people, I have met and cared for many women whose health is made vulnerable by race, poverty, homelessness, mental health issues, and other factors. Many of them have been repeatedly incarcerated, experiencing chronically destabilizing cycles of getting arrested, going to jail, getting out, being homeless, getting arrested again, and repeating the cycle. To better understand the implications for nursing with respect to criminalized women, a focused review of the nursing and feminist scholarly literature on incarcerated women was conducted. The predominant themes and trends from both bodies of literature are presented and cross-compared. An analysis of what each body of scholarly work can offer to the other, including implications for nursing practice, concludes the literature review.

Virtual patients: practical advice for clinical authors using Labyrinth.

PubMed

Begg, Michael

2010-09-01

Labyrinth is a tool originally developed in the University of Edinburgh's Learning Technology Section for authoring and delivering branching case scenarios. The scenarios can incorporate game-informed elements such as scoring, randomising, avatars and counters. Labyrinth has grown more popular internationally since a version of the build was made available on the open source network Source Forge. This paper offers help and advice for clinical educators interested in creating cases. Labyrinth is increasingly recognised as a tool offering great potential for delivering cases that promote rich, situated learning opportunities for learners. There are, however, significant challenges to generating such cases, not least of which is the challenge for potential authors in approaching the process of constructing narrative-rich, context-sensitive cases in an unfamiliar authoring environment. This paper offers a brief overview of the principles informing Labyrinth cases (game-informed learning), and offers some practical advice to better prepare educators with little or no prior experience. Labyrinth has continued to grow and develop, from its roots as a research and development environment to one that is optimised for use by non-technical clinical educators. The process becomes increasingly iterative and better informed as the teaching community push the software further. The positive implications of providing practical advice and concept insight to new case authors is that it ideally leads to a broader base of users who will inform future iterations of the software. © Blackwell Publishing Ltd 2010.

The Catholic child, adolescent, and family.

PubMed

Murrell, Kevin

2004-01-01

This article identifies core features of Catholic spiritual and religious tradition and worldview. It reviews clinical implications of this worldview in working with the psychiatric problems of Catholic children and adolescents. Core Catholic beliefs and practices are discussed, with case examples illustrating principles of assessment and treatment. Collaboration between child and adolescent psychiatrists and Catholic clergy and counselors is encouraged, and recommendations for successful collaborative efforts are offered.

A note on nonlinearity bias and dichotomous choice CVM: implications for aggregate benefits estimation

Treesearch

R.A. Souter; J. Michael Bowker

1996-01-01

It is a generally known statistical fact that the mean of a nonlinear function of a set of random variables is not equivalent to the function evaluated at the means of the variables. However, in dichotomous choice contingent valuation studies, a common practice is to calculate an overall mean (or median) by integrating over offer space (numerically or analytically) an...

Responsive Persistence Part II. Practices of Postmodern Therapists.

PubMed

Sutherland, Olga; Dienhart, Anna; Turner, Jean

2013-10-01

This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video-recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution-oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed. © 2013 American Association for Marriage and Family Therapy.

Constructing public and political discourse on alcohol issues: towards a framework for analysis.

PubMed

Hansen, Anders; Gunter, Barrie

2007-01-01

To examine the possibilities for research into news reporting and its role in reflecting and informing public and political beliefs and action in relation to alcohol and drinking practices. Studies on media and alcohol, focusing on the role of media in relation to alcohol consumption and drinking-related practices, policies and beliefs. Most research on alcohol and media has focused on either advertising or entertainment media content, rather than on news reporting and its wider social implications. The role of news reporting could usefully be widened. We offer a framework for analysing the role of news media in relation to public debate and practice with regard to alcohol and drinking.

The changing health care delivery structure: opportunities for nursing practice and administration.

PubMed

Barter, M; Graves, J; Phoon, J; Corder, K

1995-01-01

The increase in national health care expenditures has placed great stress on the economy and has contributed to a widespread consensus that reform of the health care delivery system is necessary. Three interrelated strategies are frequently used to cope with the turbulent environment in the health care industry today: managed care, hospital merger and acquisition to form integrated health care delivery systems, and redefined roles for nurses and other health care workers. These strategies have profound implications and will offer great opportunities for nursing administrators to foster nursing practice in new and improved systems of care delivery.

Practical Discourse Revisited: Hermeneutics at the Intersection of Philosophy and Nursing.

PubMed

Padgett, Stephen M

Three early papers by Janice Thompson-Practical Discourse, Critical Scholarship, and Hermeneutic Inquiry-are examined in reference to the historical context of the time (1985-1990), and implications for current scholarship. Hermeneutic philosophy has been neglected in recent years, overshadowed by its weaker cousin phenomenology. I argue that renewed attention to hermeneutics would help us focus on the "situatedness" of nursing scholars, the class politics of academia, and a better balance in interpretative work between faith and suspicion. Critical hermeneutics also offers a more robust understanding of praxis and phronesis, and links to pragmatism and social studies of science.

Queering high school biology textbooks

NASA Astrophysics Data System (ADS)

Snyder, Vicky L.; Broadway, Francis S.

2004-08-01

As teachers committed to educating all students, we need to learn more about how instructional materials shape representations of sexuality and gender. Through its insistent deconstruction of the norms that structure practice and belief, queer theory offers perspectives from which science educators can question assumptions embedded in textbooks. This article applies queer theory to analyze eight biology textbooks used in the United States. Specifically, we ask how biology textbooks address sexuality outside the heterosexual norm and if they propagate heteronormative attitudes. The textbooks examined offer deafening silences, antiseptic factoids, socially sanitized concepts, and politically correct binary-gendered illustrations. In these textbooks, the term homosexuality was used only in the context of AIDS where, along with iv drug users, they were identified as an affected group. The pervasive acceptance of heteronormative behavior privileges students that fit the heterosexual norm, and oppresses through omission and silence those who do not. We offer implications for practice to help science educators broaden their perspectives on the constructs of sexuality and gender to construct new ways of knowing and understanding differences in science classrooms and the natural world.

The Bribery Act 2010: an overview for district nurses.

PubMed

Griffith, Richard; Tengnah, Cassam

2012-10-01

The Bribery Act 2010 has been in force for a little over a year and has already served to reinforce the need for NHS organisations to adopt a proactive approach to preventing any suggestion that their staff are accepting inducements, in the form of gifts or hospitality, that could influence their performance. The robust policies on the acceptance of gifts and hospitality demanded by the 2010 Act require district nurses to be very cautious when offered a gift by a patient or commercial organisation. This article considers the implications of the Bribery Act 2010 on district nurse practice and the implications of failing to meet its provisions.

"Maybe She Was Provoked": Exploring Gender Stereotypes About Male and Female Perpetrators of Intimate Partner Violence.

PubMed

Scarduzio, Jennifer A; Carlyle, Kellie E; Harris, Kate Lockwood; Savage, Matthew W

2017-01-01

The current study is concerned with the different types of gender stereotypes that participants may draw upon when exposed to news stories about intimate partner violence (IPV). We qualitatively analyzed open-ended responses examining four types of gender stereotypes-aggression, emotional, power and control, and acceptability of violence. We offer theoretical implications that extend past research on intimate terrorism and situational couple violence, the gender symmetry debate, and how stereotypes are formed. We also discuss practical implications for journalists who write stories about IPV and individuals who provide services to victims and perpetrators. © The Author(s) 2016.

Universal prescriptivism: traditional moral decision-making theory revisited.

PubMed

Crigger, N J

1994-09-01

Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed.

Exploring the Implications of Citizenship-as-Equality in Critical Citizenship Education. A Response to "The Practice of Equality: A Critical Understanding of Democratic Citizenship Education"

ERIC Educational Resources Information Center

Zembylas, Michalinos

2015-01-01

This is a response to Ruitenberg's (2015) argument that citizenship-as-equality should be the focus of citizenship education. My aim in the response is to offer clarifying comments and questions and suggest further ideas for expanding her analysis, highlighting in particular two perspectives that deserve more attention: first, the role of emotions…

Goethe's Conception of "Experiment as Mediator" and Implications for Practical Work in School Science

NASA Astrophysics Data System (ADS)

Park, Wonyong; Song, Jinwoong

2018-03-01

There has been growing criticism over the aims, methods, and contents of practical work in school science, particularly concerning their tendency to oversimplify the scientific practice with focus on the hypothesis-testing function of experiments. In this article, we offer a reading of Johann Wolfgang von Goethe's scientific writings—particularly his works on color as an exquisite articulation of his ideas about experimentation—through the lens of practical school science. While avoiding the hasty conclusions made from isolated experiments and observations, Goethe sought in his experiments the interconnection among diverse natural phenomena and rejected the dualistic epistemology about the relation of humans and nature. Based on a close examination of his color theory and its underlying epistemology, we suggest three potential contributions that Goethe's conception of scientific experimentation can make to practical work in school science.

Understanding variations in secondary findings reporting practices across U.S. genome sequencing laboratories.

PubMed

Ackerman, Sara L; Koenig, Barbara A

2018-01-01

Increasingly used for clinical purposes, genome and exome sequencing can generate clinically relevant information that is not directly related to the reason for testing (incidental or secondary findings). Debates about the ethical implications of secondary findings were sparked by the American College of Medical Genetics (ACMG) 2013 policy statement, which recommended that laboratories report pathogenic alterations in 56 genes. Although wide variation in laboratories' secondary findings policies has been reported, little is known about its causes. We interviewed 18 laboratory directors and genetic counselors at 10 U.S. laboratories to investigate the motivations and interests shaping secondary findings reporting policies for clinical exome sequencing. Analysis of interview transcripts and laboratory documents was informed by sociological theories of standardization. Laboratories varied widely in terms of the types of secondary findings reported, consent-form language, and choices offered to patients. In explaining their adaptation of the ACMG report, our participants weighed genetic information's clinical, moral, professional, and commercial value in an attempt to maximize benefits for patients and families, minimize the costs of sequencing and analysis, adhere to professional norms, attract customers, and contend with the uncertain clinical implications of much of the genetic information generated. Nearly all laboratories in our study voluntarily adopted ACMG's recommendations, but their actual practices varied considerably and were informed by laboratory-specific judgments about clinical utility and patient benefit. Our findings offer a compelling example of standardization as a complex process that rarely leads simply to uniformity of practice. As laboratories take on a more prominent role in decisions about the return of genetic information, strategies are needed to inform patients, families, and clinicians about the differences between laboratories' practices and ensure that the consent process prompts a discussion of the value of additional genetic information for patients and their families.

Understanding and Managing Zoonotic Risk in the New Livestock Industries

PubMed Central

Waage, Jeff; Barnett, Tony; Pfeiffer, Dirk U.; Rushton, Jonathan; Rudge, James W.; Loevinsohn, Michael E.; Scoones, Ian; Smith, Richard D.; Cooper, Ben S.; White, Lisa J.; Goh, Shan; Horby, Peter; Wren, Brendan; Gundogdu, Ozan; Woods, Abigail; Coker, Richard J.

2013-01-01

Background: In many parts of the world, livestock production is undergoing a process of rapid intensification. The health implications of this development are uncertain. Intensification creates cheaper products, allowing more people to access animal-based foods. However, some practices associated with intensification may contribute to zoonotic disease emergence and spread: for example, the sustained use of antibiotics, concentration of animals in confined units, and long distances and frequent movement of livestock. Objectives: Here we present the diverse range of ecological, biological, and socioeconomic factors likely to enhance or reduce zoonotic risk, and identify ways in which a comprehensive risk analysis may be conducted by using an interdisciplinary approach. We also offer a conceptual framework to guide systematic research on this problem. Discussion: We recommend that interdisciplinary work on zoonotic risk should take into account the complexity of risk environments, rather than limiting studies to simple linear causal relations between risk drivers and disease emergence and/or spread. In addition, interdisciplinary integration is needed at different levels of analysis, from the study of risk environments to the identification of policy options for risk management. Conclusion: Given rapid changes in livestock production systems and their potential health implications at the local and global level, the problem we analyze here is of great importance for environmental health and development. Although we offer a systematic interdisciplinary approach to understand and address these implications, we recognize that further research is needed to clarify methodological and practical questions arising from the integration of the natural and social sciences. PMID:23665854

Understanding critical care nurses' autonomy in Jordan.

PubMed

Maharmeh, Mahmoud

2017-10-02

Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Defining Neuromarketing: Practices and Professional Challenges

PubMed Central

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

2011-01-01

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

Defining neuromarketing: practices and professional challenges.

PubMed

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

2010-01-01

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

On Retirement of Physicians

PubMed Central

Levy, Roy

1986-01-01

This article takes a look at retirement in general, and the implications for physicians in particular. The recent application of the principles in the Canadian Charter of Rights has raised some unresolved issues for those doctors with contractual employment. They may no longer have mandatory retirement at age 65. Problems can and do arise when self-employed physicians defer retirement from active practice indefinitely. The evaluation of older physicians' competence is explored, and some suggestions offered. PMID:21267269

Intervening as a passenger in drinking/driving situations.

PubMed

Smith, Mary Jane; Kennison, Monica; Gamble, Susan; Loudin, Barbara

2004-08-01

This study sought to query adolescents about drinking/driving situations and interventions used in these circumstances. A human science qualitative method was used to analyze descriptions of situations and interventions to gain the perspective of the life world of the young person. Findings include the drinking/driving situations of entangled, endangered, and stranded. Passenger interventions included persuading, interfering, planning ahead, and threatening. Practice, education, and research implications for those who work with adolescents are offered.

Moving research tools into practice: the successes and challenges in promoting uptake of classification tools.

PubMed

Cunningham, Barbara Jane; Hidecker, Mary Jo Cooley; Thomas-Stonell, Nancy; Rosenbaum, Peter

2018-05-01

In this paper, we present our experiences - both successes and challenges - in implementing evidence-based classification tools into clinical practice. We also make recommendations for others wanting to promote the uptake and application of new research-based assessment tools. We first describe classification systems and the benefits of using them in both research and practice. We then present a theoretical framework from Implementation Science to report strategies we have used to implement two research-based classification tools into practice. We also illustrate some of the challenges we have encountered by reporting results from an online survey investigating 58 Speech-language Pathologists' knowledge and use of the Communication Function Classification System (CFCS), a new tool to classify children's functional communication skills. We offer recommendations for researchers wanting to promote the uptake of new tools in clinical practice. Specifically, we identify structural, organizational, innovation, practitioner, and patient-related factors that we recommend researchers address in the design of implementation interventions. Roles and responsibilities of both researchers and clinicians in making implementations science a success are presented. Implications for rehabilitation Promoting uptake of new and evidence-based tools into clinical practice is challenging. Implementation science can help researchers to close the knowledge-to-practice gap. Using concrete examples, we discuss our experiences in implementing evidence-based classification tools into practice within a theoretical framework. Recommendations are provided for researchers wanting to implement new tools in clinical practice. Implications for researchers and clinicians are presented.

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

PubMed

Glen, S

2004-12-01

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

The alliance in reflective supervision: a commentary on Tomlin, Weatherston, and Pavkov's critical components of reflective supervision.

PubMed

Watkins, C Edward

2015-01-01

What are the critical components of reflective supervision? In this commentary, I offer a complementary perspective on A.M. Tomlin, D.J. Weatherston, and T. Pavkov's (2014) seminal study about that very question. I consider their findings within the context of what we now know about the supervisory alliance-a highly robust, heuristic, and eminently practical construct that appears to capture the spirit of reflection, collaboration, and regularity at its best. Matters of alliance theory, practice, and research are briefly addressed, and effort is made to consider the implications of the supervisory alliance as fundamental, foundational, and quintessentially organizational for reflective supervision practice. © 2015 Michigan Association for Infant Mental Health.

Drug Offers as a Context for Violence Perpetration and Victimization

PubMed Central

Helm, Susana; Okamoto, Scott; Kaliades, Alexis; Giroux, Danielle

2014-01-01

Objective Drug use has been linked empirically with aggression and violence among youth in national and State of Hawai`i samples. However, the nature of this link and its implications for prevention are unclear. Therefore, this paper explores the intersection of drugs with aggression and violence by using the drug offer context as the unit of analysis. Method Native Hawaiian youth are sampled because substance use rates tend to be higher and onset tends to be earlier than their non-Hawaiian peers. Fourteen sex-specific focus group discussions were held with rural Native Hawaiian middle school students (N=64). Students discussed what they thought they would do in terms of drug refusal strategies in a variety of drug offer contexts. Results While aggression and violence were perceived to be socially inappropriate, students nonetheless felt drug use would be less socially competent. Narrative analyses indicated aggression and violence were perceived to function as potential drug refusal strategies. As proximal drug resistance, aggression and violence perpetration served as an immediate deterrent to the drug offerer, and thus drug use. As distal drug resistance, victimization served as a rationale for avoiding drug using contexts. Conclusions Implications are discussed in terms of prevention policy and practice, specifically in terms of a school-based prevention curriculum. Future research in Hawaiian epistemology and gendered approaches are warranted. PMID:24564559

The primacy of basics in advanced life support.

PubMed

Chamberlain, Douglas; Frenneaux, Michael; Fletcher, David

2009-06-01

The standards required for optimal effect of chest compressions and the degree to which most practice falls short of ideal have not been widely appreciated. This review highlights some of the important data now available and offers a haemodynamic explanation that broadens current concepts. New techniques have permitted a detailed examination of how compressions are performed in practice. The implications of recent experimental work adds a new imperative to the need for improvement. In addition to highlighting the need for improved training and audit, the greater understanding of mechanisms in resuscitation suggest that guidelines for management of adult cardiac arrest of presumed cardiac origin need further revision and simplification.

Local randomness: Examples and application

NASA Astrophysics Data System (ADS)

Fu, Honghao; Miller, Carl A.

2018-03-01

When two players achieve a superclassical score at a nonlocal game, their outputs must contain intrinsic randomness. This fact has many useful implications for quantum cryptography. Recently it has been observed [C. Miller and Y. Shi, Quantum Inf. Computat. 17, 0595 (2017)] that such scores also imply the existence of local randomness—that is, randomness known to one player but not to the other. This has potential implications for cryptographic tasks between two cooperating but mistrustful players. In the current paper we bring this notion toward practical realization, by offering near-optimal bounds on local randomness for the CHSH game, and also proving the security of a cryptographic application of local randomness (single-bit certified deletion).

Integration of professional judgement and decision-making in high-level adventure sports coaching practice.

PubMed

Collins, Loel; Collins, Dave

2015-01-01

This study examined the integration of professional judgement and decision-making processes in adventure sports coaching. The study utilised a thematic analysis approach to investigate the decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. Results revealed that, in order to make judgements and decisions in practice, expert coaches employ a range of practical and pedagogic management strategies to create and opportunistically use time for decision-making. These approaches include span of control and time management strategies to facilitate the decision-making process regarding risk management, venue selection, aims, objectives, session content, and differentiation of the coaching process. The implication for coaches, coach education, and accreditation is the recognition and training of the approaches that "create time" for the judgements in practice, namely "creating space to think". The paper concludes by offering a template for a more expertise-focused progression in adventure sports coaching.

Translational research: a concept analysis.

PubMed

Wendler, M Cecilia; Kirkbride, Geri; Wade, Kristen; Ferrell, Lynne

2013-01-01

BACKGROUND/CONCEPTUAL FRAMEWORK: Little is known about which approaches facilitate adoption and sustainment of evidence-based practice change in the highly complex care environments that constitute clinical practice today. The purpose of this article was to complete a concept analysis of translational research using a modified Walker and Avant approach. DESIGN/DATA COLLECTION: Using a rigorous and thorough review of the recent health care literature generated by a deep electronic search from 2004-2011, 85 appropriate documents were retrieved. Close reading of the articles by three coresearchers yielded an analysis of the emerging concept of translational research. Using the iterative process described by Walker and Avant, a tentative definition of the concept of translational research, along with antecedents and consequences were identified. Implications for health care professionals in education, practice, and research are offered. Further research is needed to determine the adequacy of the definition, to identify empirical referents, and to guide theory development. The study resulted in a theoretical definition of the concept of translational research, along with identification of antecedents and consequences and a description of an ideal or model case to illustrate the definition. Implications for practice and education include the importance of focusing on translational research approaches that may reduce the research-practice gap in health care, thereby improving patient care delivery. Research is needed to determine the usefulness of the definition in health care clinical practice.

A systematic review of collaboration and network research in the public affairs literature: implications for public health practice and research.

PubMed

Varda, Danielle; Shoup, Jo Ann; Miller, Sara

2012-03-01

We explored and analyzed how findings from public affairs research can inform public health research and practice, specifically in the area of interorganizational collaboration, one of the most promising practice-based approaches in the public health field. We conducted a systematic review of the public affairs literature by following a grounded theory approach. We coded 151 articles for demographics and empirical findings (n = 258). Three primary findings stand out in the public affairs literature: network structure affects governance, management strategies exist for administrators, and collaboration can be linked to outcomes. These findings are linked to priorities in public health practice. Overall, we found that public affairs has a long and rich history of research in collaborations that offers unique organizational theory and management tools to public health practitioners.

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

PubMed

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

2018-03-08

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

“The Birthing From Within Holistic Sphere”: A Conceptual Model for Childbirth Education

PubMed Central

England, Pam; Horowitz, Rob

2000-01-01

An expanded conceptual model of childbirth education is offered, proposing the benefits of balancing informative teaching processes with creative, experiential, introspective learning processes for parents. The application of these two teaching dimensions to exploring four different perspectives of birth (the mother's, the father's, the baby's, and the culture's) is discussed, along with examples from “Birthing From Within” classes. Implications for current practice and the evolving role of childbirth educator are noted. PMID:17273200

Student outcomes of distance learning in nursing education: an integrative review.

PubMed

Patterson, Barbara J; Krouse, Anne M; Roy, Linda

2012-09-01

Distance learning offers a distinctive environment to educate nursing students. While there is a significant body of evidence in the literature related to course, program, and faculty outcomes of distance education, little attention has been given by researchers to evaluate student outcomes, with the exception of student satisfaction. There is a need to evaluate and translate findings related to student outcomes in distance learning into educational practice. Integrative reviews offer one strategy to contribute to evidence-based teaching practice initiatives. A search of available published qualitative and quantitative research on student outcomes of distance learning from 1999 to 2009 was conducted using a number of databases. Astin's Input-Environment-Output conceptual model provided a framework for this review. Thirty-three studies met the inclusion criteria. Bothcognitive and affective student outcomes emerged. The cognitive outcomes were student learning, learning process, and technology proficiency. Affective outcomes included personal and professional growth, satisfaction, and connectedness. Implications, recommendations, and future research are discussed.

Opportunities and challenges for public libraries to enhance community resilience.

PubMed

Veil, Shari R; Bishop, Bradley Wade

2014-04-01

This study bridges a gap between public library and emergency management policy versus practice by examining the role of public libraries in the community resource network for disaster recovery. Specifically, this study identifies the opportunities and challenges for public libraries to fulfill their role as a FEMA-designated essential community organization and enhance community resilience. The results indicate there are several opportunities for libraries to enhance community resilience by offering technology resources and assistance; providing office, meeting, and community living room space; serving as the last redundant communication channel and a repository for community information and disaster narratives; and adapting or expanding services already offered to meet the changing needs of the community. However, libraries also face challenges in enhancing community resilience, including the temptation to overcommit library capacity and staff capability beyond the library mission and a lack of long-term disaster plans and collaboration with emergency managers and government officials. Implications for library and emergency management practice and crisis research are discussed. © 2013 Society for Risk Analysis.

Experiencing stigma as a nurse with mental illness.

PubMed

Peterson, A L

2017-06-01

WHAT IS KNOWN ON THE SUBJECT?: Stigma involves connecting individuals with a particular label to negative characteristics; this is based not on the stigmatized condition itself, but cultural reactions to it. Stigma exists towards nurses with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a first-person account of experiencing stigma as a nurse with a mental illness. This paper incorporates the existing literature to offer a broader cultural perspective on the experiences of a nurse with a mental illness. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses are likely to encounter a nurse with a mental illness at some point in their practice. Nurses' reactions towards colleagues with mental illness can have significant implications for those colleague(s)' wellbeing. Nurses with mental illness will have to navigate their person and professional journey while giving consideration to the attitudes of their nursing peers and leaders. Limited research has been done on the stigma faced by nurses with mental illness from their nursing peers. Mental illness is not generally considered acceptable within the context of nursing culture, so when nurses do experience mental illness, their experiences in a professional context may be influenced by stereotypes, particularly those relating to dangerousness. Using autoethnography as a research method, the author examines her own subjective experiences of stigma as a nurse with a mental illness, and draws upon existing literature on stigma, deviance and the phenomenon of mental illness in nurses to analyse broader cultural implications for nursing. Assessment of suitability to return to work arises throughout the narratives, and consideration is given to the way that risk assessment by nursing leaders is impacted by negative stereotypes that surround mental illness. © 2017 John Wiley & Sons Ltd.

Understanding customer reactions to brokered ultimatums: applying negotiation and justice theory.

PubMed

Humphrey, Stephen E; Ellis, Aleksander P J; Conlon, Donald E; Tinsley, Catherine H

2004-06-01

There has been little research examining customer reactions to brokered ultimatum game (BUG) contexts (i.e. exchanges in which 1 party offers an ultimatum price for a resource through an intermediary, and the ultimatum offer is accepted or rejected by the other party). In this study, the authors incorporated rational decision-making theory and justice theory to examine how customers' bids, recommendations, and repatronage behavior are affected by characteristics of BUG contexts (changing from an ultimatum to negotiation transaction, response timeliness, and offer acceptance or rejection). Results indicated that customers attempt to be economically efficient with their bidding behavior. However, negotiation structures, long waits for a response, and rejected bids create injustice perceptions (particularly informational and distributive injustice), negatively influencing customers' recommendations to others and their repatronage. The authors then discuss the practical and theoretical implications of their results. (c) 2004 APA

Enhancing Sense of Coherence and Mindfulness in an Ecclesiastical, Intercultural Group Training Context.

PubMed

Mayer, Claude-Hélène; Viviers, Rian; Flotman, Aden-Paul; Schneider-Stengel, Detlef

2016-12-01

Sense of coherence (SOC) and mindfulness (MI) are believed to promote the health and well-being of individuals and organisations. The aim of this longitudinal study was to contribute to the literature on the development of SOC through training and interventions and thereby explore the development of these constructs in a group of senior professionals in the German Catholic Church. A sample of eight participants voluntarily enrolled for a 12-day training programme spread over a period of nine months to develop intercultural and inter-religious competencies, SOC and MI. Quantitative scores of the pre- and post-test SOC and MI questionnaires were qualitatively analysed. Results indicate that the majority of participants scored lower in the post-test on SOC and slightly higher in MI. The discussion explores the pitfalls in the development of these constructs in the study's participants and highlights the implications for theory and practice. Practical training implications for developing SOC and MI are offered.

Inequities in genetic testing for hereditary breast cancer: implications for public health practice.

PubMed

Sayani, Ambreen

2018-05-20

The Ontario Breast Screening Program for women with a genetic predisposition to breast cancer is one of the first international models of a government-funded public health service that offers systematic genetic screening to women at a high risk of breast cancer. However, since the implementation of the program in 2011, enrolment rates have been lower than anticipated. Whilst there may be several reasons for this to happen, it does call into consideration the 'inverse equity law', whereby the more advantaged in society are the first to participate and benefit from universal health services. An outcome of this phenomenon is an increase in the health divide between those that are at a social advantage versus those that are not. Using an intersectionality lens, this paper explores the role of the social determinants of health and social identity in creating possible barriers in the access to genetic screening for hereditary breast cancer, and the implications for public health practice in recognising and ameliorating these differences.

Raising African American boys: an exploration of gender and racial socialization practices.

PubMed

Howard, Lionel C; Rose, Jason C; Barbarin, Oscar A

2013-01-01

Although parental socialization practices are critical to a child's social development, little is known of the details of how parental practices function to meet the specific challenges of supporting young boys' development as African American and men. Accordingly, this article offers a window onto how 15 parents of African American boys (ages 3-8) conceive and implement strategies for their sons' social and emotional development. Using ethnographic observations and structured interview data, this article explores the ways they promote emerging racial and gender identities and socioemotional well-being. Findings reveal that highly incongruous messages and expectations are communicated to young boys about race and gender. The study's findings have implications for young African American boys' emerging racial and gender identities. © 2013 American Orthopsychiatric Association.

Globalisation, economics and professionalism.

PubMed

Tan, Chay-Hoon; Macneill, Paul

2015-01-01

This paper presents an analysis of the effect of globalisation and attendant economic factors on the global practice of medicine, medical education, medical ethics and medical professionalism. The authors discuss the implications of these trends, citing case scenarios in the healthcare insurance, medical tourism, pharmaceutical industries, and the educational systems as well as in clinical practice, to illustrate the impact of globalisation and economics on professionalism. Globalisation, on the one hand, offers benefits for the global practice of medicine and for medical education. On the other, globalisation can have negative effects, particularly when the main driver is to maximise profitability across national boundaries rather than concern for human well-being. Appraising the effect of globalisation on professionalism involves assessing its effects at the intrapersonal, interpersonal, and institutional levels, and its effect on society at large.

Should physicians' dual practice be limited? An incentive approach.

PubMed

González, Paula

2004-06-01

We develop a principal-agent model to analyze how the behavior of a physician in the public sector is affected by his activities in the private sector. We show that the physician will have incentives to over-provide medical services when he uses his public activity as a way of increasing his prestige as a private doctor. The health authority only benefits from the physician's dual practice when it is interested in ensuring a very accurate treatment for the patient. Our analysis provides a theoretical framework in which some actual policies implemented to regulate physicians' dual practice can be addressed. In particular, we focus on the possibility that the health authority offers exclusive contracts to physicians and on the implications of limiting physicians' private earnings. Copyright 2004 John Wiley & Sons, Ltd.

Research governance: implications for health library and information professionals.

PubMed

Sen, Barbara A

2003-03-01

The Research Governance Framework for Health and Social Care published by the Department of Health in 2001 provides a model of best practice and a framework for research in the health and social care sector. This article reviews the Department of Health Research Governance Framework, discusses the implications of research governance for library and information professionals undertaking research in the health- and social-care sector and recommends strategies for best practice within the information profession relating to research governance. The scope of the Framework document that covers both clinical and non-clinical research is outlined. Any research involving, amongst other issues, patients, NHS staff and use or access to NHS premises may require ethics committee approval. Particular reference is made to the roles, responsibilities and professional conduct and the systems needed to support effective research practice. Issues such as these combine to encourage the development of a quality research culture which supports best practice. Questions arise regarding the training and experience of researchers, and access to the necessary information and support. The use of the Framework to guide research practice complements the quality issues within the evidence-based practice movement and supports the ongoing development of a quality research culture. Recommendations are given in relation to the document's five domains of ethics, science, information, health and safety and finance and intellectual property. Practical recommendations are offered for incorporating research governance into research practice in ways which conform to the Framework's standards and which are particularly relevant for research practitioners in information science. Concluding comments support the use of the Research Governance Framework as a model for best practice.

Towards a Phenomenology of Technologically Mediated Moral Change: Or, What Could Mark Zuckerberg Learn from Caregivers in the Southern Netherlands?

PubMed

Sharon, Tamar

2017-01-01

Kamphof offers an illuminating depiction of the technological mediation of morality. Her case serves as the basis for a plea for modesty up and against the somewhat heroic conceptualizations of techno-moral change to date-less logos, less autos, more practice, more relationality. Rather than a displacement of these conceptualizations, I question whether Kamphof's art of living offers only a different perspective: in scale (as a micro-event of techno-moral change), and in unit of analysis (as an art of living oriented to relations with others rather than the relation to the self). As a supplement and not an alternative, this modest art has nonetheless audacious implications for the ethics of surveillance.

On teaching computer ethics within a computer science department.

PubMed

Quinn, Michael J

2006-04-01

The author has surveyed a quarter of the accredited undergraduate computer science programs in the United States. More than half of these programs offer a 'social and ethical implications of computing' course taught by a computer science faculty member, and there appears to be a trend toward teaching ethics classes within computer science departments. Although the decision to create an 'in house' computer ethics course may sometimes be a pragmatic response to pressure from the accreditation agency, this paper argues that teaching ethics within a computer science department can provide students and faculty members with numerous benefits. The paper lists topics that can be covered in a computer ethics course and offers some practical suggestions for making the course successful.

Privacy Practices of Health Social Networking Sites: Implications for Privacy and Data Security in Online Cancer Communities.

PubMed

Charbonneau, Deborah H

2016-08-01

While online communities for social support continue to grow, little is known about the state of privacy practices of health social networking sites. This article reports on a structured content analysis of privacy policies and disclosure practices for 25 online ovarian cancer communities. All of the health social networking sites in the study sample provided privacy statements to users, yet privacy practices varied considerably across the sites. The majority of sites informed users that personal information was collected about participants and shared with third parties (96%, n = 24). Furthermore, more than half of the sites (56%, n = 14) stated that cookies technology was used to track user behaviors. Despite these disclosures, only 36% (n = 9) offered opt-out choices for sharing data with third parties. In addition, very few of the sites (28%, n = 7) allowed individuals to delete their personal information. Discussions about specific security measures used to protect personal information were largely missing. Implications for privacy, confidentiality, consumer choice, and data safety in online environments are discussed. Overall, nurses and other health professionals can utilize these findings to encourage individuals seeking online support and participating in social networking sites to build awareness of privacy risks to better protect their personal health information in the digital age.

Interprofessional collaborative practice incorporating training for alcohol and drug use screening for healthcare providers in rural areas.

PubMed

Puskar, Kathy; Mitchell, Ann M; Albrecht, Susan A; Frank, Linda R; Kane, Irene; Hagle, Holly; Lindsay, Dawn; Lee, Heeyoung; Fioravanti, Marie; Talcott, Kimberly S

2016-07-01

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment-SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.

Non-invasive prenatal testing for single gene disorders: exploring the ethics.

PubMed

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

2013-07-01

Non-invasive prenatal testing for single gene disorders is now clearly on the horizon. This new technology offers obvious clinical benefits such as safe testing early in pregnancy. Before widespread implementation, it is important to consider the possible ethical implications. Four hypothetical scenarios are presented that highlight how ethical ideals of respect for autonomy, privacy and fairness may come into play when offering non-invasive prenatal testing for single gene disorders. The first scenario illustrates the moral case for using these tests for 'information only', identifying a potential conflict between larger numbers of women seeking the benefits of the test and the wider social impact of funding tests that do not offer immediate clinical benefit. The second scenario shows how the simplicity and safety of non-invasive prenatal testing could lead to more autonomous decision-making and, conversely, how this could also lead to increased pressure on women to take up testing. In the third scenario we show how, unless strong safeguards are put in place, offering non-invasive prenatal testing could be subject to routinisation with informed consent undermined and that woman who are newly diagnosed as carriers may be particularly vulnerable. The final scenario introduces the possibility of a conflict of the moral rights of a woman and her partner through testing for single gene disorders. This analysis informs our understanding of the potential impacts of non-invasive prenatal testing for single gene disorders on clinical practice and has implications for future policy and guidelines for prenatal care.

Addressing the Philosophical Confusion Regarding Constructivism in Chemical Education

NASA Astrophysics Data System (ADS)

Bernal, Pedro J.

2006-02-01

In the Chemical Education Today section of the May 2003 issue of this Journal , Eric Scerri wrote about the consequences of what he regards as a philosophical confusion in the work of constructivist chemical education researchers. This issue has important implications for both the teaching and practice of science. I offer a view of the confusion that places the emphasis on the careless use of philosophical terms that Scerri noted and on the tendency of psychological constructivists to go from psychological premises to unwarranted epistemological conclusions.

Faculty and Technology: Implications for Faculty Training and Technology Leadership

NASA Astrophysics Data System (ADS)

Keengwe, Jared; Kidd, Terry; Kyei-Blankson, Lydia

2009-02-01

The purpose of this study was to explore the factors affecting ICT adoption process and the implications for faculty training and technology leadership. Respondents represented a wide range of academic and professional positions. They identified themselves as Assistant, Associate, and Professor as well as Instructional Designer, Director of Technology, Information Manager, eLearning Manager, Assistant Department Chair, Associate Vice President of Academic Affairs and Consultant. The respondents identified Organizational Support, Leadership, Training and Development, and Resources as the predominate themes affecting Information and Communication Technology (ICT) adoption process in higher education. Evidence from this study offers insights on how higher education administrators and technology leaders could help their faculty and staff to implement appropriate ICT tools and practices to improve student learning.

Testing two global models to prevent violence against women and children: methods and baseline data analysis of a seven-year prospective study.

PubMed

McFarlane, Judith; Nava, Angeles; Gilroy, Heidi; Paulson, Rene; Maddoux, John

2012-12-01

Worldwide, two models of care are offered most often to abused women-safe shelter and justice services. No evidence exists on the differential effectiveness of the models. To provide evidence for best practice and policy, 300 abused women, 150 first-time users of a shelter and 150 first time-applicants for a protection order, participated in a seven-year study. Safety, abuse, and the emotional and physical functioning of the women and their children were measured. The procedural logistics, sampling process, metrics, and baseline descriptors for these 300 women and 300 children is presented along with implications for practice and policy.

Learning and change in a community mental health setting.

PubMed

Mancini, Michael A; Miner, Craig S

2013-10-01

This article offers methodological reflections and lessons learned from a three-year university-community partnership that used participatory action research methods to develop and evaluate a model for learning and change. Communities of practice were used to facilitate the translation of recovery-oriented and evidence-based programs into everyday practice at a community mental health agency. Four lessons were drawn from this project. First, the processes of learning and organizational change are complex, slow, and multifaceted. Second, development of leaders and champions is vital to sustained implementation in an era of restricted resources. Third, it is important to have the agency's values, mission, policies, and procedures align with the principles and practices of recovery and integrated treatment. And fourth, effective learning of evidence-based practices is influenced by organizational culture and climate. These four lessons are expanded upon and situated within the broader literature and implications for future research are discussed.

A Systematic Review of Collaboration and Network Research in the Public Affairs Literature: Implications for Public Health Practice and Research

PubMed Central

Shoup, Jo Ann; Miller, Sara

2012-01-01

Objectives. We explored and analyzed how findings from public affairs research can inform public health research and practice, specifically in the area of interorganizational collaboration, one of the most promising practice-based approaches in the public health field. Methods. We conducted a systematic review of the public affairs literature by following a grounded theory approach. We coded 151 articles for demographics and empirical findings (n = 258). Results. Three primary findings stand out in the public affairs literature: network structure affects governance, management strategies exist for administrators, and collaboration can be linked to outcomes. These findings are linked to priorities in public health practice. Conclusions. Overall, we found that public affairs has a long and rich history of research in collaborations that offers unique organizational theory and management tools to public health practitioners. PMID:22021311

Best clinical trials reported in 2010.

PubMed

Garner, John B; Grayburn, Paul A; Yancy, Clyde W

2011-07-01

Each year, a number of clinical trials emerge with data sufficient to change clinical practice. Determining which findings will result in practice change and which will provide only incremental benefit can be a dilemma for clinicians. The authors review selected clinical trials reported in 2010 in journals, at society meetings, and at conferences, focusing on those studies that have the potential to change clinical practice. This review offers 3 separate means of analysis: an abbreviated text summary, organized by subject area; a comprehensive table of relevant clinical trials that provides a schematic review of the hypotheses, interventions, methods, primary end points, results, and implications; and a complete bibliography for further reading as warranted. It is hoped that this compilation of relevant clinical trials and their important findings released in 2010 will be of benefit in the everyday practice of cardiovascular medicine. Copyright © 2011 Elsevier Inc. All rights reserved.

Does integrating research into the prosthetics and orthotics undergraduate curriculum enhance students' clinical practice? An interview study on students' perception.

PubMed

Al Qaroot, Bashar S; Sobuh, Mohammad

2016-06-01

Problem-based learning (where rather than feeding students the knowledge, they look for it themselves) has long been thought of as an ideal approach in teaching because it would encourage students to acquire knowledge from an undetermined medium of wrong and right answers. However, the effect of such approach in the learning experience of prosthetics and orthotics students has never been investigated. This study explores the implications of integrating problem-based learning into teaching on the students' learning experience via implementing a research-informed clinical practice module into the curriculum of last year prosthetics and orthotics undergraduate students at the University of Jordan (Amman, Jordan). Qualitative research pilot study. Grounded theory approach was used based on the data collected from interviewing a focus group of four students. Students have identified a number of arguments from their experience in the research-informed clinical practice where, generally speaking, students described research-informed clinical practice as a very good method of education. Integrating problem-based learning into teaching has many positive implications. In particular, students pointed out that their learning experience and clinical practice have much improved after the research-informed clinical practice. Findings from this investigation demonstrate that embedding problem-based learning into prosthetics and orthotics students' curriculum has the potential to enhance students' learning experience, particularly students' evidence-based practice. This may lead to graduates who are more knowledgeable and thus who can offer the optimal patient care (i.e. clinical practice). © The International Society for Prosthetics and Orthotics 2014.

Genealogy as a critical toolbox: deconstructing the professional identity of nurses.

PubMed

Miró-Bonet, Margalida; Bover-Bover, Andreu; Moreno-Mulet, Cristina; Miró-Bonet, Rosa; Zaforteza-Lallemand, Concha

2014-04-01

To discuss the Foucauldian concept of genealogy as a framework for understanding and transforming nurses' professional identity. The professional identity of nurses has primarily been defined by personal and interpersonal attributes and by the intradisciplinary dimensions of nursing, leading to its conceptualization as a universal, monolithic phenomenon. The Foucauldian genealogical perspective offers a critical lens to examine what constitutes this professional identity; Spanish nursing offers a historical case study of an active effort to impose an identity that fits the monolithic ideal. Five of the 33 professional conduct manuals for nurses' training published from 1956-1976 during the Franco dictatorship in Spain and six interviews with nursing instructors or students at the time were analysed using a theoretical framework drawn from Foucault's writing. Foucault's genealogical framework considers practices of normalization and resistance as a means of understanding knowledge continuities and discontinuities, clarifying practices that constitute nurses' professional identity in a particular way in specific contexts and analysing the implications of this theoretical frame. The genealogy concept offers valuable tools to determine how professional identities are constituted, questions assumptions about the profession and its professionals and envisions alternative approaches. This theoretical approach helps both scholars and practitioners understand, question and transform their practices as needed. The genealogical approach prioritizes analysis of the phenomenon over its description and challenges many unknown, forgotten, excluded and/or unquestioned aspects of identity from a position of diversity and complexity. © 2013 John Wiley & Sons Ltd.

Potential facilitators and barriers to adopting standard treatment guidelines in clinical practice.

PubMed

Sharma, Sangeeta; Pandit, Ajay; Tabassum, Fauzia

2017-04-18

Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice. The top three factors influencing clinical practice guideline adoption were innovation characteristics, environmental context and individual characteristics. The respondents differed in the following areas: concerns about flexibility offered by the guideline; denying patients' individuality; professional autonomy; insights into gaps in current practice and evidence-based practice; changing practices with little or no benefit. Barriers included negative staff attitudes/beliefs, guideline integration into organizational structures/processes, time/resource constraints. Fearing third parties (government and insurance companies) restricting medicines reimbursement and poor liability protection offered by the guidelines emerged as the barriers. Facilitators include aligning organizational structures/processes with the innovation; providing leadership support to guide diffusion; increasing awareness and enabling early innovation during pre/in-service training, with regular feedback on outcomes and use. Practical implications Guideline adoption in clinical practice is partly within doctors' control. There are other key prevailing factors in the local context such as environmental, social context, professional and organizational culture affecting its adoption. Organizational policy and accreditation standards necessitating adherence can serve as a driver. Originality/value This survey among clinicians, despite limitations, gives helpful insights. While favourable attitudes may be helpful, clinical adoption could be improved more effectively by targeting barriers.

The symbolic constitution of addiction: language, alienation, ambivalence.

PubMed

Kemp, Ryan

2012-07-01

The author offers an articulation of addiction, via existential-phenomenology and Lacanian psychoanalysis, where it is argued that the addicted subject is constituted via a symbolic structuring evolving from societal practices, laws and the effects of language. Language carries a heritage, which bears on the knowledge and practices of designated subjects and practitioners of that discourse. Addiction, as one particular form of embodied existence and knowledgeable practice, finds expression through the speech and habits of the addict. Addiction, it is argued, is symbolically saturated with ambivalence and alienation. Also the addict is described as the complete modern technocratic subject, consumed by the ideology of consumption. The clinical implications are briefly explored where it is noted that two major approaches to addiction, namely 12-step fellowships and motivational interviewing, both attend to language as a critical component of their treatment approach.

Dare we speak of ethics? Attending to the unsayable amongst nurse leaders.

PubMed

Schick Makaroff, Kara; Storch, Janet; Newton, Lorelei; Fulton, Tom; Stevenson, Lynne

2010-09-01

There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research.

Service Providers’ Experiences and Perspectives on Recovery-Oriented Mental Health System Reform

PubMed Central

Piat, Myra; Lal, Shalini

2016-01-01

Objective With the use of a qualitative approach, this study focuses on service providers’ experiences and perspectives on recovery-oriented reform. Methods Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. PMID:22491368

Toward the adoption of complexity science in health care: implications for risk-taking and decision-making activities.

PubMed

Perez, Bianca; Liberman, Aaron

2011-01-01

This article explores the issues of risk taking and decision making in health care. An analysis of various sociocultural and psychological influences is provided for understanding of the dominant mind set in this industry. In tandem with this analysis, the evolution of system theories is described so as to promote understanding of the relative merits of the mechanistic and complexity philosophies. These philosophies are at odds with each other, conceptually and practically speaking; however, it seems that the complexity approach offers more promising strategies for the growth and development of health care. Recommendations for improving employee competencies and the organizational structure and culture in health care are offered in light of this analysis. These recommendations are relevant to activities that are clinical and administrative in nature.

Trust in leadership: meta-analytic findings and implications for research and practice.

PubMed

Dirks, Kurt T; Ferrin, Donald L

2002-08-01

In this study, the authors examined the findings and implications of the research on trust in leadership that has been conducted during the past 4 decades. First, the study provides estimates of the primary relationships between trust in leadership and key outcomes, antecedents, and correlates (k = 106). Second, the study explores how specifying the construct with alternative leadership referents (direct leaders vs. organizational leadership) and definitions (types of trust) results in systematically different relationships between trust in leadership and outcomes and antecedents. Direct leaders (e.g., supervisors) appear to be a particularly important referent of trust. Last, a theoretical framework is offered to provide parsimony to the expansive literature and to clarify the different perspectives on the construct of trust in leadership and its operation.

Legal implications of premenstrual syndrome: a Canadian perspective.

PubMed Central

Meehan, E; MacRae, K

1986-01-01

A summary of the symptoms, prevalence and history of premenstrual syndrome (PMS) is presented. The legal implications of PMS, particularly its use as a defence in criminal prosecutions and as an implicit factor in specific offences, are discussed by means of an analysis of Canadian legal cases, with reference to those in England and the United States. The authors offer suggestions on how physicians can make use of PMS in a courtroom more reliable. They conclude that PMS is unlikely to become a substantive criminal defence until the medical community more fully recognizes its significance. Although the role of PMS as a mitigating factor in sentencing may be illogical, the courts now recognize the syndrome in a legally and practically important manner. Images p602-a PMID:3756691

Twenty-first century science as a relational process: from eureka! to team science and a place for community psychology.

PubMed

Tebes, Jacob Kraemer; Thai, Nghi D; Matlin, Samantha L

2014-06-01

In this paper we maintain that twenty-first century science is, fundamentally, a relational process in which knowledge is produced (or co-produced) through transactions among researchers or among researchers and public stakeholders. We offer an expanded perspective on the practice of twenty-first century science, the production of scientific knowledge, and what community psychology can contribute to these developments. We argue that: (1) trends in science show that research is increasingly being conducted in teams; (2) scientific teams, such as transdisciplinary teams of researchers or of researchers collaborating with various public stakeholders, are better able to address complex challenges; (3) transdisciplinary scientific teams are part of the larger, twenty-first century transformation in science; (4) the concept of heterarchy is a heuristic for team science aligned with this transformation; (5) a contemporary philosophy of science known as perspectivism provides an essential foundation to advance twenty-first century science; and (6) community psychology, through its core principles and practice competencies, offers theoretical and practical expertise for advancing team science and the transformation in science currently underway. We discuss the implications of these points and illustrate them briefly with two examples of transdisciplinary team science from our own work. We conclude that a new narrative is emerging for science in the twenty-first century that draws on interpersonal transactions in teams, and active engagement by researchers with the public to address critical accountabilities. Because of its core organizing principles and unique blend of expertise on the intersection of research and practice, community psychologists are well-prepared to help advance these developments, and thus have much to offer twenty-first century science.

21st Century Science as a Relational Process: From Eureka! to Team Science and a Place for Community Psychology

PubMed Central

Tebes, Jacob Kraemer; Thai, Nghi D.; Matlin, Samantha L.

2014-01-01

In this paper we maintain that 21st century science is, fundamentally, a relational process in which knowledge is produced (or co-produced) through transactions among researchers or among researchers and public stakeholders. We offer an expanded perspective on the practice of 21st century science, the production of scientific knowledge, and what community psychology can contribute to these developments. We argue that: 1) trends in science show that research is increasingly being conducted in teams; 2) scientific teams, such as transdisciplinary teams of researchers or of researchers collaborating with various public stakeholders, are better able to address complex challenges; 3) transdisciplinary scientific teams are part of the larger, 21st century transformation in science; 4) the concept of heterarchy is a heuristic for team science aligned with this transformation; 5) a contemporary philosophy of science known as perspectivism provides an essential foundation to advance 21st century science; and 6) community psychology, through its core principles and practice competencies, offers theoretical and practical expertise for advancing team science and the transformation in science currently underway. We discuss the implications of these points and illustrate them briefly with two examples of transdisciplinary team science from our own work. We conclude that a new narrative is emerging for science in the 21st century that draws on interpersonal transactions in teams, and active engagement by researchers with the public to address critical accountabilities. Because of its core organizing principles and unique blend of expertise on the intersection of research and practice, community psychologists are extraordinarily well-prepared to help advance these developments, and thus have much to offer 21st century science. PMID:24496718

Effectiveness of Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Function of People With Traumatic Brain Injury: A Systematic Review.

PubMed

Chang, Pei-Fen J; Baxter, Mary Frances; Rissky, Jenna

2016-01-01

After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients' motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Latin American Social Medicine and Global Social Medicine

PubMed Central

Yamada, Seiji

2003-01-01

A fundamental change in the theory underlying public health and medicine is needed. Latin American social medicine (LASM), originating in a region of the world that has been subjected to colonial and postcolonial influence, will be part of this change. To the extent that the social production of disease among people in other regions is a consequence of various large-scale forms of domination, LASM offers a relevant analysis, models of resistance, and exemplars of social medicine in practice. I draw upon LASM to examine the social production of disease in the Marshall Islands and Iraq. I suggest a basis for a global social medicine in the shared experience of suffering and describe implications for public health theory and practice. PMID:14652319

Dissipative Prototyping Methods: A Manifesto

NASA Astrophysics Data System (ADS)

Beesley, P.

Taking a designer's unique perspective using examples of practice in experimental installation and digital protoyping, this manifesto acts as provocation for change and unlocking new potential by encouraging changes of perspective about the material realm. Diffusive form-language is proposed as a paradigm for architectural design. This method of design is applied through 3D printing and related digital fabrication methods, offering new qualities that can be implemented in design of realms including present earth and future interplanetary environments. A paradigm shift is encouraged by questioning conventional notions of geometry that minimize interfaces and by proposing the alternatives of maximized interfaces formed by effusive kinds of formal composition. A series of projects from the Canadian research studio of the Hylozoic Architecture group are described, providing examples of component design methods employing diffusive forms within combinations of tension-integrity structural systems integrated with hybrid metabolisms employing synthetic biology. Cultural implications are also discussed, drawing from architectural theory and natural philosophy. The conclusion of this paper suggests that the practice of diffusive prototyping can offer formative strategies contributing to design of future living systems.

What results when firms implement practices: the differential relationship between specific practices, firm financial performance, customer service, and quality.

PubMed

Gibson, Cristina B; Porath, Christine L; Benson, George S; Lawler, Edward E

2007-11-01

Previous research on organizational practices is replete with contradictory evidence regarding their effects. Here, the authors argue that these contradictory findings may have occurred because researchers have often examined complex practice combinations and have failed to investigate a broad variety of firm-level outcomes. Thus, past research may obscure important differential effects of specific practices on specific firm-level outcomes. Extending this research, the authors develop hypotheses about the effects of practices that (a) enable information sharing, (b) set boundaries, and (c) enable teams on 3 different firm-level outcomes: financial performance, customer service, and quality. Relationships are tested in a sample of observations from over 200 Fortune 1000 firms. Results indicate that information-sharing practices were positively related to financial performance 1 year following implementation of the practices, boundary-setting practices were positively related to firm-level customer service, and team-enabling practices were related to firm-level quality. No single set of practices predicted all 3 firm-level outcomes, indicating practice-specific effects. These findings help resolve the theoretical tension in the literature regarding the effects of organizational practices and offer guidance as to how to best target practices to increase specific work-related outcomes. Implications for theory, research, and practice are discussed. (c) 2007 APA

Initiating decision-making in neurology consultations: 'recommending' versus 'option-listing' and the implications for medical authority.

PubMed

Toerien, Merran; Shaw, Rebecca; Reuber, Markus

2013-07-01

This article compares two practices for initiating treatment decision-making, evident in audio-recorded consultations between a neurologist and 13 patients in two hospital clinics in the UK. We call these 'recommending' and 'option-listing'. The former entails making a proposal to do something; the latter entails the construction of a list of options. Using conversation analysis (CA), we illustrate each, showing that the distinction between these two practices matters to participants. Our analysis centres on two distinctions between the practices: epistemic differences and differences in the slots each creates for the patient's response. Considering the implications of our findings for understanding medical authority, we argue that option-listing - relative to recommending - is a practice whereby clinicians work to relinquish a little of their authority. This article contributes, then, to a growing body of CA work that offers a more nuanced, tempered account of medical authority than is typically portrayed in the sociological literature. We argue that future CA studies should map out the range of ways - in addition to recommending - in which treatment decision-making is initiated by clinicians. This will allow for further evidence-based contributions to debates on the related concepts of patient participation, choice, shared decision-making and medical authority. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action

NASA Astrophysics Data System (ADS)

Downs, R. R.; Lenhardt, W. C.; Robinson, E.

2014-12-01

Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

Registered nurse and midwife experiences of using videoconferencing in practice: A systematic review of qualitative studies.

PubMed

Penny, Robyn A; Bradford, Natalie K; Langbecker, Danette

2018-03-01

To synthesise evidence of registered nurses' and midwives' experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice. Videoconferencing is a form of telehealth that can facilitate access to high-quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review. Yet use of videoconferencing has not translated smoothly into routine practice. Understanding the experiences of registered nurses and midwives may provide practitioners, service managers and policymakers with vital information to facilitate use of the technology. A qualitative meta-synthesis of primary qualitative studies undertaken according to Joanna Briggs Institute methodology. A systematic search of 19 databases was used to identify qualitative studies that reported on registered nurses' or midwives' experiences with videoconferencing in clinical or professional practice. Two reviewers independently appraised studies, extracted data and synthesised findings to construct core concepts. Nine studies met the criteria for inclusion. Five key synthesised findings were identified: useful on a continuum; broader range of information; implications for professional practice; barriers to videoconferencing; and technical support, training and encouragement. While videoconferencing offers benefits, it comes with personal, organisational and professional consequences for nurses and midwives. Understanding potential benefits and limitations, training and support required and addressing potential professional implications all influence adoption and ongoing use of videoconferencing. Registered nurses and midwives are well placed to drive innovations and efficiencies in practice such as videoconferencing. Nursing and midwifery practice must be reframed to adapt to the virtual environment while retaining valued aspects of professional practice. This includes ensuring professional standards keep pace with the development of knowledge in this area and addressing the findings highlighted in this meta-synthesis. © 2017 John Wiley & Sons Ltd.

The future of community pharmacy practice in South Africa in the light of the proposed new qualification for pharmacists: implications and challenges.

PubMed

Malangu, Ntambwe

2014-08-15

Community or retail pharmacies are regarded as one of the most common sources of health services throughout the world. In South Africa, community pharmacies have been providing some primary health care services to clients who could afford to pay. These services included screening, family planning, and emergency care for minor ailments. With the introduction of the new qualification, community pharmacies are poised to become providers of expanded services.  This paper describes the contents, the implications and challenges of the new qualification in light with future directions for community pharmacy practice in South Africa. Its purpose is to inform relevant stakeholders in South Africa and those outside South Africa that may pursue similar offerings. Published papers were identified through searches in MEDLINE and Google Scholar using a combination of search terms, namely: 'community, retail pharmacy, pharmacist/non-medical prescribing, South Africa'. Only articles published in English were considered. In addition, documents from the Ministry of Health of South Africa, the South African Pharmacy Council and curricula materials from schools of pharmacy were also reviewed. Laureates of the new qualification will essentially have the right to examine, diagnose, prescribe and monitor the treatment of their clients or patients. In doing so, this expanded function of prescribing for primary healthcare will imply several practice and infrastructural adjustments; and with many challenges laying ahead in need to be addressed. In conclusion, the authorized pharmacist prescriber qualification augurs a new era for community pharmacy practice in South Africa. This has many implications and some challenges that need to be managed. The pharmacy profession, academia, legislators and political decision-makers need to work together to resolve outstanding issues in a constructive manner.

Frames of Reference: A Metaphor for Analyzing and Interpreting Attitudes of Environmental Policy Makers and Policy Influencers

PubMed

Swaffield

1998-07-01

/ The concept of frame of reference offers a potentially useful analytical metaphor in environmental management. This is illustrated by a case study in which attitudes of individuals involved in the management of trees in the New Zealand high country are classified into seven distinctive frames of reference. Some practical and theoretical implications of the use of the frame metaphor are explored, including its potential contribution to the emerg- ing field of communicative planning. KEY WORDS: Frames of reference; Environmental policy analysis; Metaphor; New Zealand high country

Predicting Cost/Reliability/Maintainability of Advanced General Aviation Avionics Equipment

NASA Technical Reports Server (NTRS)

Davis, M. R.; Kamins, M.; Mooz, W. E.

1978-01-01

A methodology is provided for assisting NASA in estimating the cost, reliability, and maintenance (CRM) requirements for general avionics equipment operating in the 1980's. Practical problems of predicting these factors are examined. The usefulness and short comings of different approaches for modeling coast and reliability estimates are discussed together with special problems caused by the lack of historical data on the cost of maintaining general aviation avionics. Suggestions are offered on how NASA might proceed in assessing cost reliability CRM implications in the absence of reliable generalized predictive models.

Origin of probabilities and their application to the multiverse

NASA Astrophysics Data System (ADS)

Albrecht, Andreas; Phillips, Daniel

2014-12-01

We argue using simple models that all successful practical uses of probabilities originate in quantum fluctuations in the microscopic physical world around us, often propagated to macroscopic scales. Thus we claim there is no physically verified fully classical theory of probability. We comment on the general implications of this view, and specifically question the application of purely classical probabilities to cosmology in cases where key questions are known to have no quantum answer. We argue that the ideas developed here may offer a way out of the notorious measure problems of eternal inflation.

Acculturation: state of the science in nursing.

PubMed

Buscemi, Charles P

2011-01-01

With the onset of global migration, nurses are faced with dealing with cultures from around the world. Having an understanding of transcultural nursing concepts and translating them to practice will be key to nurses meeting the needs of an ever changing patient population. Acculturation is one example of how transcultural nursing concepts need to be better understood. The purpose of this paper is to describe the state of the science of acculturation in terms of the nursing discipline. It offers a historical review and evolution of acculturation, uses in nursing theory, and clinical implications.

What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis.

PubMed

Dadich, Ann; Doloswala, Navin

2018-05-10

Despite the relative abundance of frameworks and models to guide implementation science, the explicit use of theory is limited. Bringing together two seemingly disparate fields of research, this article asks, what can organisational theory offer implementation science? This is examined by applying a theoretical lens that incorporates agency, institutional, and situated change theories to understand the implementation of healthcare knowledge into practice. Interviews were conducted with 20 general practitioners (GPs) before and after using a resource to facilitate evidence-based sexual healthcare. Research material was analysed using two approaches - researcher-driven thematic coding and lexical analysis, which was relatively less researcher-driven. The theoretical lens elucidated the complex pathways of knowledge translation. More specifically, agency theory revealed tensions between the GP as agent and their organisations and patients as principals. Institutional theory highlighted the importance of GP-embeddedness within their chosen specialty of general practice; their medical profession; and the practice in which they worked. Situated change theory exposed the role of localised adaptations over time - a metamorphosis. This study has theoretical, methodological, and practical implications. Theoretically, it is the first to examine knowledge translation using a lens premised on agency, institutional, and situated change theories. Methodologically, the study highlights the complementary value of researcher-driven and researcher-guided analysis of qualitative research material. Practically, this study signposts opportunities to facilitate knowledge translation - more specifically, it suggests that efforts to shape clinician practices should accommodate the interrelated influence of the agent and the institution, and recognise that change can be ever so subtle.

Scaffolding student learning in clinical practice.

PubMed

Spouse, J

1998-05-01

For many years the profession has acknowledged a schism between theories taught in the classroom and the practice of clinicians. This tends to arise from beliefs that knowledge which has been generalized (formalized) can be readily transferred to informal settings (practice). Whilst apprehension of formalized knowledge is crucial to professional development, a mediator is necessary to demonstrate its relevance to practice. A variety of solutions have been offered which all have value but without effective social support fail to resolve the problem. Findings from a longitudinal study investigating the professional development of pre-registration nursing students indicate the importance of sponsorship by a member of clinical staff and participation in legitimate peripheral activities. In the absence of effective sponsorship, students found it difficult to participate in clinical activities or to learn. As a result, their professional development during placements became stunted with subsequent implications for their professional future. Questions concerned with this phenomena were explored using documentary evidence supplied by research participants, observations of their practice and focused interviews throughout their programme. Sociocultural or activity theories of human learning offer some attractive explanations. One strategy is scaffolding which takes place within sponsored nursing activities and builds on the important concept of the Zone of Proximal Development (ZPD), where speech becomes a tool to mediate learning and development. As a diagnostic tool, scaffolding enables both supervisor and learner to recognize knowledge-in-waiting and knowledge-in-use and hence learning need, thus stimulating opportunities for further learning and professional development beneficial to both learner and supervisor. It provides a means for theory and practice to become integrated.

Behavioral Economics: A New Lens for Understanding Genomic Decision Making.

PubMed

Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H

2018-05-01

This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.

An integrative discourse perspective on positive leadership in public health care.

PubMed

Pietiläinen, Ville; Salmi, Ilkka

2017-02-06

Purpose This study aims to take a discursive view on positive leadership (PL). A positive approach has gained momentum in recent years as appropriate leadership practices are implemented in organizations. Despite the turn toward discursive approaches in organization studies, there is insufficient evidence supporting PL as a socially constructed experience. Design/methodology/approach The present study addresses an integrative discourse perspective for capturing the PL concept as a social process within the public health-care context. Findings Four meanings of PL are highlighted: role-taking, servicing, balancing and deciphering. Research limitations/implications The meanings shift the emphasis of certain PL definitions to a contextual interpretation. For scholars, the perspective demonstrates a multidimensional process approach in the desired organizational context as a counterbalance to one unanimously agreed-upon PL definition. Practical implications For leaders, an integrative discourse perspective offers tools for comprehending PL as a process: how to identify, negotiate and reconcile various PL meanings. Originality/value An integrative discourse perspective provides a novel perspective capturing the PL concept within the public health-care field.

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

PubMed

Hopwood, Nick

2015-01-01

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

'Outside the Original Remit': Co-production in UK mental health research, lessons from the field.

PubMed

Lambert, Nicky; Carr, Sarah

2018-06-19

The aim of this discursive paper was to explore the development of co-production and service user involvement in UK university-based mental health research and to offer practical recommendations for practitioners co-producing research with service users and survivors, informed by an overview of the key literature on co-production in mental health and from a critical reflection on applied research through the medium of a case study. The paper is co-written by a mental health nurse academic and a service user/survivor researcher academic. The authors argue that the implications of co-production for mental health research remain underexplored, but that both the practitioner and service user/survivor researcher experience and perspective of co-production in research can provide practical reflections to inform developing research practice. The theories and values of emancipatory research can provide a framework from which both practitioners and service users can work together on a research project, in a way that requires reflection on process and power dynamics. The authors conclude that whilst co-produced investigations can offer unique opportunities for advancing emancipatory and applied research in mental health, practitioner researchers need to be more radical in their consideration of power in the research process. © 2018 Australian College of Mental Health Nurses Inc.

Improving nutritional care: innovation and good practice.

PubMed

Chapman, Carol; Barker, Mary; Lawrence, Wendy

2015-04-01

This paper presents examples of good practice in nutritional screening and care and identifies methods used to overcome contextual constraints and discusses the implications for nursing practice in hospitals. Nutritional screening is an important step in identifying those at risk of malnutrition, but does not produce improved nutritional care unless it results in a care plan that is acted on. The importance of nutrition and implications for clinical care make it imperative to improve practice. Qualitative investigation. Between January 2011-February 2012, focus groups were held using a semi-structured discussion guide with nine groups of health professionals (n = 80) from one hospital: four with nurses, three with doctors and two with dietitians. Discussions were audio-recorded, transcribed and coded into themes and sub-themes, which were then depicted in a thematic map and illustrated with verbatim quotes. Three strategies for sustaining effective nutritional practice emerged: establishing routines to ensure screening was undertaken; re-organizing aspects of care to promote good practice; developing innovative approaches. Issues to be addressed were the perceived disconnection between mandatory screening and the delivery of effective care, a requirement for nutrition education, organizational constraints of a large university hospital and the complexities of multidisciplinary working. Professionals seeking to improve nutritional care in hospitals need to understand the interaction of system and person to facilitate change. Nursing staff need to be able to exercise autonomy and the hospital system must offer enough flexibility to allow wards to organize nutritional screening and care in a way that meets the needs of individual patients. © 2014 John Wiley & Sons Ltd.

Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice Environment

PubMed

Dyess, Susan M; Sherman, Rose O; Pratt, Beth A; Chiang-Hanisko, Lenny

2016-01-14

With the growing complexity of healthcare practice environments and pending nurse leader retirements, the development of future nurse leaders is increasingly important. This article reports on focus group research conducted with Generation Y nurses prior to their initiating coursework in a Master’s Degree program designed to support development of future nurse leaders. Forty-four emerging nurse leaders across three program cohorts participated in this qualitative study conducted to capture perspectives about nursing leaders and leadership. Conventional content analysis was used to analyze and code the data into categories. We discuss the three major categories identified, including: idealistic expectations of leaders, leading in a challenging practice environment, and cautious but optimistic outlook about their own leadership and future, and study limitations. The conclusion offers implications for future nurse leader development. The findings provide important insight into the viewpoints of nurses today about leaders and leadership.

Important interactional strategies for everyday public health nursing practice.

PubMed

Porr, Caroline J

2015-01-01

This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice. © 2013 Wiley Periodicals, Inc.

The role of locally-designed organizational artifacts in supporting nurses’ work: an ethnographic study on the wards

PubMed

Talamo, Alessandra; Mellini, Barbara; Barbieri, Barbara

2017-01-01

This paper aims to describe how nurses' planning and coordination work is performed through the use of locally designed tools (i.e., diaries, planners, reminders, and organizers). These tools are investigated as the materialization of organizational work, thus offering a complementary perspective on nursing practice to that proposed by the professional mandate and supported by official artifacts in use. Ethnographic study. By analyzing locally designed artifacts, the rationale that enables nurses to make the flow of activities work is highlighted and explained. Evidence is provided by a description of how nurses' tacit knowledge is reified and embedded into objects produced by the nurses themselves. Implications for the design of digital systems supporting nursing practice are discussed. The analysis of these artifacts has allowed an understanding of practices used by the nurses to manage the workflow in the wards.

Novel low-risk commercial sex practices in the parks of Vietnam.

PubMed

Walters, I

2003-06-01

This is a paper about a novel form of commercial sex practice recorded in Vietnam, and its implications for HIV/AIDS prevention strategies. Female commercial sex workers occupy urban parks in the evenings, offering on-site masturbation services to clients at cheap prices even by local standards. All sex acts are performed in public by workers who sit on benches, path edges or stools,often behind bicycles or open umbrellas in the quest for some semblance of privacy. Clients are local men, with only an occasional foreigner involved Many sex workers were involved, some having 15 to 20 or more clients a night. Sex workers and clients in Vietnam, a s elsewhere, operate at high risk of HIV/AIDS infection. As a service which minimizes risks, this form of commercial sex practice should perhaps be given serious consideration by policy makers and authorities for formal deployment in the fight against AIDS.

Words and works in the history of alchemy.

PubMed

Nummedal, Tara E

2011-06-01

This essay considers the implications of a shift in focus from ideas to practices in the history of alchemy. On the one hand, it is argued, this new attention to practice highlights the diversity of ways that early modern Europeans engaged alchemy, ranging from the literary to the entrepreneurial and artisanal, as well as the broad range of social and cultural spaces that alchemists inhabited. At the same time, however, recent work has demonstrated what most alchemists shared-namely, a penchant for reading, writing, making, and doing, all at the same time. Any history of early modern alchemy, therefore, must attend to all of these practices, as well as the interplay among them. In this sense, alchemy offers a model for thinking and writing about early modern science more generally, particularly in light of recent work that has explored the intersection of scholarly, artisanal, and entrepreneurial forms of knowledge in the early modem period.

Using Bourdieu’s Theoretical Framework to Examine How the Pharmacy Educator Views Pharmacy Knowledge

PubMed Central

2015-01-01

Objective. To explore how different pharmacy educators view pharmacy knowledge within the United Kingdom MPharm program and to relate these findings to Pierre Bourdieu’s theoretical framework. Methods. Twelve qualitative interviews were conducted with 4 faculty members from 3 different types of schools of pharmacy in the United Kingdom: a newer school, an established teaching-based school, and an established research-intensive school. Selection was based on a representation of both science-based and practice-based disciplines, gender balance, and teaching experience. Results. The interview transcripts indicated how these members of the academic community describe knowledge. There was a polarization between science-based and practice-based educators in terms of Bourdieu’s description of field, species of capital, and habitus. Conclusion. A Bourdieusian perspective on the differences among faculty member responses supports our understanding of curriculum integration and offers some practical implications for the future development of pharmacy programs. PMID:26889065

Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives.

PubMed

Wilson, Anne; Whitaker, Nancy; Whitford, Deirdre

2012-05-31

Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice.

Using Bourdieu's Theoretical Framework to Examine How the Pharmacy Educator Views Pharmacy Knowledge.

PubMed

Waterfield, Jon

2015-12-25

To explore how different pharmacy educators view pharmacy knowledge within the United Kingdom MPharm program and to relate these findings to Pierre Bourdieu's theoretical framework. Twelve qualitative interviews were conducted with 4 faculty members from 3 different types of schools of pharmacy in the United Kingdom: a newer school, an established teaching-based school, and an established research-intensive school. Selection was based on a representation of both science-based and practice-based disciplines, gender balance, and teaching experience. The interview transcripts indicated how these members of the academic community describe knowledge. There was a polarization between science-based and practice-based educators in terms of Bourdieu's description of field, species of capital, and habitus. A Bourdieusian perspective on the differences among faculty member responses supports our understanding of curriculum integration and offers some practical implications for the future development of pharmacy programs.

A strategy for selecting sexual partners believed to pose little/no risks for HIV: serosorting and its implications for HIV transmission.

PubMed

Eaton, Lisa A; Kalichman, Seth C; O'Connell, Daniel A; Karchner, William D

2009-10-01

A common HIV/AIDS risk reduction strategy among men who have sex with men (MSM) is to limit their unprotected sex partners to those who are of the same HIV status, a practice referred to as serosorting. Decisions to serosort for HIV risk reduction are based on personal impressions and beliefs, and there is limited guidance offered on this community derived strategy from public health services. This paper reviews research on serosorting for HIV risk reduction and offers an evidence-based approach to serosorting guidance. Following a comprehensive electronic and manual literature search, we reviewed 51 studies relating to the implications of serosorting. Studies showed that HIV negative MSM who select partners based on HIV status are inadvertently placing themselves at risk for HIV. Infrequent HIV testing, lack of HIV status disclosure, co-occurring sexually transmitted infections, and acute HIV infection impede the potential protective benefits of serosorting. Public health messages should continue to encourage reductions in numbers of sexual partners and increases in condom use. Risk reduction messages should also highlight the limitations of relying on one's own and partner's HIV status in making sexual risk decisions.

Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

PubMed

Clark, Phillip G

2014-01-01

Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

Are individuals with higher psychopathic traits better learners at lying? Behavioural and neural evidence.

PubMed

Shao, R; Lee, T M C

2017-07-25

High psychopathy is characterized by untruthfulness and manipulativeness. However, existing evidence on higher propensity or capacity to lie among non-incarcerated high-psychopathic individuals is equivocal. Of particular importance, no research has investigated whether greater psychopathic tendency is associated with better 'trainability' of lying. An understanding of whether the neurobehavioral processes of lying are modifiable through practice offers significant theoretical and practical implications. By employing a longitudinal design involving university students with varying degrees of psychopathic traits, we successfully demonstrate that the performance speed of lying about face familiarity significantly improved following two sessions of practice, which occurred only among those with higher, but not lower, levels of psychopathic traits. Furthermore, this behavioural improvement associated with higher psychopathic tendency was predicted by a reduction in lying-related neural signals and by functional connectivity changes in the frontoparietal and cerebellum networks. Our findings provide novel and pivotal evidence suggesting that psychopathic traits are the key modulating factors of the plasticity of both behavioural and neural processes underpinning lying. These findings broadly support conceptualization of high-functioning individuals with higher psychopathic traits as having preserved, or arguably superior, functioning in neural networks implicated in cognitive executive processing, but deficiencies in affective neural processes, from a neuroplasticity perspective.

The Impact of Nonphysician Providers on Diagnostic and Interventional Radiology Practices: Operational and Educational Implications.

PubMed

Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard

2015-09-01

The numbers of nurse practitioners (NPs) and physician assistants (PAs) are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. The use of radiologist assistants is growing in some radiology practices as well. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside radiology departments warrants closer review, particularly with regard to their potential influence on radiology education and medical imaging resource utilization. In this article (the second in a two-part series), the authors review recent literature and offer recommendations for radiology practices regarding the impact NPs, PAs, and radiologist assistants may have on interventional and diagnostic radiology practices. Their potential impact on medical education is also discussed. Finally, staffing for radiology departments, as a result of an enlarging nonradiology NP and PA workforce ordering diagnostic imaging, is considered. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

PubMed

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home

PubMed Central

Flieger, Signe Peterson

2017-01-01

Background This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. Purpose The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Methodology/Approach Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Findings Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. Practice Implications (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and will ultimately help foster a relationship-centered PCMH. PMID:26939031

Adaptive role switching promotes fairness in networked ultimatum game.

PubMed

Wu, Te; Fu, Feng; Zhang, Yanling; Wang, Long

2013-01-01

In recent years, mechanisms favoring fair split in the ultimatum game have attracted growing interests because of its practical implications for international bargains. In this game, two players are randomly assigned two different roles respectively to split an offer: the proposer suggests how to split and the responder decides whether or not to accept it. Only when both agree is the offer successfully split; otherwise both get nothing. It is of importance and interest to break the symmetry in role assignment especially when the game is repeatedly played in a heterogeneous population. Here we consider an adaptive role assignment: whenever the split fails, the two players switch their roles probabilistically. The results show that this simple feedback mechanism proves much more effective at promoting fairness than other alternatives (where, for example, the role assignment is based on the number of neighbors).

Healthcare leadership's diversity paradox.

PubMed

Silver, Reginald

2017-02-06

Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of color in leadership roles that guide healthcare policy and access. This study connects contemporary literature to perspectives of executives in the field and offers practical solutions to improving the representation of people of color in executive healthcare leadership roles. Social implications The recommendations offered as a result of this research effort serve to create awareness of the challenges that people of color face in career attainment. Although the process of increasing the representation of people of color in executive healthcare leadership will be a complex task that will involve a number of players over the course of several years, this study serves to provide a practical roadmap with actionable tactics that can be deployed. Originality/value This paper is an extension of the work that was done by the author during the course of completing the program requirements for the author's doctoral program. The findings were previously discussed in the author's dissertation. The value of these findings is significant because they validate some of the topics in contemporary literature with the perspectives of practicing healthcare executives. This study is also unique from other studies in that it offers a long-term plan to increase the representation of people of color in executive roles by creating an early disposition toward executive level roles and identifies a number of practical steps toward that end.

Measuring homework compliance in cognitive-behavioral therapy for adolescent depression: review, preliminary findings, and implications for theory and practice.

PubMed

Gaynor, Scott T; Lawrence, P Scott; Nelson-Gray, Rosemery O

2006-09-01

Despite the importance placed on completion of extra-session homework in cognitive-behavioral therapy (CBT), a review of the available literature suggests there is much about the nature of homework compliance that remains to be empirically evaluated. This is especially true among youth receiving CBT. The present study begins to address how best to measure homework compliance and offers a fine-grained, single-case analysis of homework compliance during acute treatment with depressed adolescents. The results demonstrate that 56% of homework assignments were completed. Also observed was substantial within-subject temporal variability in homework compliance and a tendency for compliance to decrease during the course of treatment. These data call into question the adequacy of any static aggregate measure of homework compliance and have implications for both researchers and clinicians.

Postmodern feminist perspectives and nursing research: a passionately interested form of inquiry.

PubMed

Aranda, Kay

2006-06-01

The challenges posed by postmodern and poststructural theories profoundly disrupt the certainties of feminist and nursing research, yet at the same time offer possibilities for developing new epistemologies. While there are an increasing number of accounts discussing the theoretical implications of these ideas for nursing research, I wish to discuss the practical and the methodological implications of using postmodern feminist theories within empirical research. In particular, I identify the challenges I encountered through an examination of specific aspects of the research process and through examples drawn from empirical research. I conclude that using postmodern feminist theories requires a continuous engagement with, and interrogation of, the modern epistemological and ontological assumptions of qualitative, feminist nursing research and, in so doing, presents the possibility for nurse scholars to begin to develop a 'passionately interested' methodological approach to nursing inquiry.

Current status of information literacy instruction practices in medical libraries of Pakistan

PubMed Central

Ullah, Midrar; Ameen, Kanwal

2014-01-01

Objectives: The research explored the current practices of information literacy (IL) instruction in medical libraries of Pakistan. Methods: A semi-structured questionnaire was mailed to the head librarians of all 114 academic medical libraries in Pakistan. It investigated the types of IL instruction provided, topics covered, methods of delivery and assessment, level of integration in the curriculum, and level of collaboration with teaching staff. Results: The study revealed that 74% of the respondents had offered some types of IL instruction in their institutions during the previous year, ranging from library orientation to research-level skills. IL instruction is typically only offered to new students or first-time library users or on demand. A majority of the respondents developed IL instruction programs without faculty involvement. Librarians were primarily responsible for offering IL instruction in medical institutions. Face-to-face instruction in computer labs or lecture halls and individual instruction at reference desks were identified as the most common IL instruction delivery methods. The data indicated that oral feedback, written feedback, and searching in a computer lab were the most popular assessment methods that medical librarians used. Conclusion: IL instruction activities in medical libraries of Pakistan are in their infancy. Medical librarians also lack systematic approaches to IL instruction. Implications: Medical librarians need to develop educational partnerships with faculty for integrating IL instruction into the mainstream curriculum. PMID:25349546

A Clinical Translation of the Article Titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder".

PubMed

Shannon, Robin Adair

2015-01-01

The purpose of this article is to offer a clinical translation of a literature review titled "Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder" by Ryberg (2015). The literature review was conducted to determine the strength of the research evidence regarding the effectiveness of the Early Start Denver Model in improving cognitive, language, and behavioral functioning of children with autism spectrum disorder. In an effort to narrow the gap between evidence and practice, this clinical translation will discuss the components of the literature review in terms of its rationale for and objectives, methods, results, and implications for evidence-based nursing practice. © The Author(s) 2015.

Clinical peripherality: development of a peripherality index for rural health services.

PubMed

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-25

The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities.

Clinical peripherality: development of a peripherality index for rural health services

PubMed Central

Swan, Gillian M; Selvaraj, Sivasubramaniam; Godden, David J

2008-01-01

Background The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a "clinical peripherality" indicator that has potential application to remote and rural general practice communities for planning and research purposes. Methods Profiles of general practice communities in Scotland were created from a variety of public data sources. Four candidate variables were chosen that described demographic and geographic characteristics of each practice: population density, number of patients on the practice list, travel time to nearest specialist led hospital and travel time to Health Board administrative headquarters. A clinical peripherality index, based on these variables, was derived using factor analysis. Relationships between the clinical peripherality index and services offered by the practices and the staff profile of the practices were explored in a series of univariate analyses. Results Factor analysis on the four candidate variables yielded a robust one-factor solution explaining 75% variance with factor loadings ranging from 0.83 to 0.89. Rural and remote areas had higher median values and a greater scatter of clinical peripherality indices among their practices than an urban comparison area. The range of services offered and the profile of staffing of practices was associated with the peripherality index. Conclusion Clinical peripherality is determined by the nature of the practice and its location relative to secondary care and administrative and educational facilities. It has features of both gravity model-based and travel time/accessibility indicators and has the potential to be applied to training of staff for rural and remote locations and to other aspects of health policy and planning. It may assist planners in conceptualising the effects on general practices of centralising specialist clinical services or administrative and educational facilities. PMID:18221533

Revisiting Communicative Competence in Augmentative and Alternative Communication.

PubMed

Tsai, Meng-Ju

2016-01-01

This tutorial paper is to explore the novel nature of communicative competence in augmentative and alternative communication (AAC) practice by comparing it to communicative competence in naturally verbal dyadic communication. This paper first reviews the four domains of communicative competence in AAC practice. Second, it examines competence in dyadic communications between naturally verbal people without disabilities, deriving new insights and using these to analyze the evolution of communicative competence in AAC practice. Communicative competence in AAC practice should be reconceptualized from a new perspective as dyadic, learned, co-constructed, and of relative value, ascertained through performance. In the past decades, the study of communicative competence in AAC practice has primarily focused on individual persons who use AAC. However, the conceptualization of communicative competence should shift away from an individualized construct toward a dyadic construct. This leads to a discussion of potential implications and future research directions. This paper might offer AAC researchers and practitioners an opportunity to deepen their understanding of communicative competence and promote more positive outcomes for people who use AAC. © 2017 S. Karger AG, Basel.

Factors affecting social workers' inclusion of animals in practice.

PubMed

Risley-Curtiss, Christina; Rogge, Mary E; Kawam, Elisa

2013-04-01

Experts suggest that social work practitioners can improve their client service with a more thorough understanding of the impact of other animals on individuals and families. Studies indicate that some social work practitioners are including animals in their practices through assessment and interventions. Little is known about what factors contribute to this inclusion, especially because there is a lack of attention in social work education and research to animal-human relationships. This study used logistical regression to examine the impact of certain demographic, knowledge, and practice variables on the inclusion of animals in social work practice. Findings include that knowing other social workers who include animals in practice and primary client population served were significant for inclusion of animals in assessment, animal-assisted intervention, and treating clients for animal abuse or loss of an animal. Although practitioners' having a companion animal was positively related to including animals in interventions and treating clients for loss of an animal, contributing to animal welfare through volunteering at shelters or financially contributing to animal groups did not have an effect on inclusion of animals in practice. Implications for these and other findings are discussed, and recommendations for social work research, education, and practice are offered.

Waiting to see the doctor. The impact of organizational structure on medical practice.

PubMed

Wolinsky, F D; Marder, W D

1983-05-01

In this article it is assessed whether or not the scheduling and office visit queues a patient faces depend upon the organizational structure of the physician's practice (i.e., does the physician practice in the fee-for-service system or in a health maintenance organization [HMO], and if in an HMO, in what type of an HMO). Data pooled from two national studies (N = 2448) reveal two major findings. First, although scheduling queues may be predicted from the organizational structure of physicians' practices and other factors, office queues appear to be more of a random phenomenon. Second, a distinct pattern emerges among the effects of the organizational structure of physicians' practices on patient queues, including 1) physicians in solo practice offer their patients the shortest queues, 2) physicians in group model HMOs maximize scheduling queues but minimize waiting room queues, 3) patient queues for physicians practicing in IPAs are no different from those of their counterparts in group-practice fee-for-service settings, and 4) patient queues for salaried physicians practicing in a predominantly salaried environment are among the longest. The implications of these findings are discussed with special reference to extent and future studies of the effects of organizational structure on medical practice.

When holistic care is not holistic enough: The role of sexual health in mental health settings.

PubMed

Hendry, Avril; Snowden, Austyn; Brown, Michael

2018-03-01

To explore the preparation that mental health nurses receive to address sexual health in practice. People who use the mental health services often have complex sexual health needs. Mental health nurses are well placed to offer support. However, this rarely happens in practice, and therefore, people's sexual health needs are not being routinely addressed. It is not known why this is the case. Systematic review and meta-ethnography. EBSCO, PsycINFO, MEDLINE and ASSIA databases were searched using Booleans with Mesh and key terms including "mental health nurse" and "sexual health". Date range was June 2006 to June 2016. Discursive papers were excluded. Included papers (n = 7) were synthesised using a meta-ethnographic approach. The search yielded seven studies. Five key themes were identified: the (not so) therapeutic relationship; personal values dictating professional ones; institutionalised fear; being human; and education: the answer but where is it? The findings illustrate the complexity of supporting people with mental health and sexual health needs. They show the discomfort many nurses have about broaching sexual health. Arguably more than with most issues, personal values impacted strongly on professional practice. Understanding the depth and multifaceted nature of these themes is important, because strategies can then be developed to mitigate the barriers to best practice. For example, the findings presented here offer a framework from which structured education and support can be built. There is a need for Mental health nurses to be more responsive to concerns around sexual health and it should be routinely included in their practice. This study illuminates why this is not currently the case. By understanding this, remedial action can be taken by nurse educators. Implications are also discussed in relation to policy, research and practice. © 2017 John Wiley & Sons Ltd.

Understanding barriers to preventive health actions for occupational noise-induced hearing loss.

PubMed

Patel, D S; Witte, K; Zuckerman, C; Murray-Johnson, L; Orrego, V; Maxfield, A M; Meadows-Hogan, S; Tisdale, J; Thimons, E D

2001-01-01

A theoretically based formative evaluation was conducted with coal miners in the Appalachian Mountains who were at high risk for noise-induced hearing loss (NIHL). The results of four focus groups indicate that despite high levels of knowledge, strong perceived severity of negative consequences, and strong perceived susceptibility to hearing loss, two main categories of barriers (environmental and individual) keep coal miners from using their hearing protection devices (HPD). Further analysis suggests that the environmental factors, rather than individual variables, more strongly influence decisions against protective actions. Recommendations and practical implications are offered.

How mothers talk about placement of their child with autism outside the home.

PubMed

Corman, Michael K

2013-10-01

In this article I use insights offered by the poststructural shift and linguistic turn in social scientific inquiry, specifically discourse analysis, to explore mothers' talk about the placement of their child with autism outside of the home. By viewing mothers' talk as data, I bring to light the discourses and interpretive practices that mothers drew on to organize their talk of placement. In doing so, I provide insights into how mothers gave meaning to processes of placement while also expanding on commonsensical discursive notions of "good" mothering, caregiving, and family. Implications of the findings are discussed.

Leadership in Nursing Homes: Directors of Nursing Aligning Practice With Regulations.

PubMed

Siegel, Elena O; Bettega, Kristen; Bakerjian, Debra; Sikma, Suzanne

2018-06-01

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.]. Copyright 2018, SLACK Incorporated.

Baccalaureate Degrees at Ontario Colleges: Issues and Implications

ERIC Educational Resources Information Center

Panacci, Adam G.

2014-01-01

This paper identifies and examines major issues and implications of the proposal to substantially increase the number of applied baccalaureate degrees offered by Ontario's Colleges of Applied Arts and Technology, including increasing four-year applied degree offerings and introducing three-year applied degrees. Currently, provincial legislation…

Rural domestic waste management in Zhejiang Province, China: Characteristics, current practices, and an improved strategy.

PubMed

Guan, Yidong; Zhang, Yuan; Zhao, Dongye; Huang, Xiaofeng; Li, Haini

2015-06-01

Lack of access to adequate sanitation facilities has serious health implications for rural dwellers and can degrade the ecosystems. This study offers a systemantic and quantitative overview of historical data on rural domestic waste (RDW) production and past and current management practices in a prototype region in China, where rural areas are undergoing rapid urbanization and are confronted with great environmental challenges associated with poor RDW management practices. The results indicate that RDW is characterized with a large fraction of kitchen waste (42.9%) and high water content (53.4%). The RDW generation (RDWG) per capita between 2012 and 2020 is estimated to increase from 0.68 to 1.01 kg/d-cap. The Hill 1 model is able to adequately simulate/project the population growth in a rural area from 1993 to 2020. The annual RDWG in the region is estimated to double from 6,033,000 tons/year in 2008 to 12,030,000 tons/year by 2020. By comparing three RDW management scenarios based on the life-cycle inventory approach and cost-benefit analysis, it is strongly recommended that the present Scenario 2 (sanitary landfill treatment) be upgraded to Scenario 3 (source separation followed by composting and landfill of RDW) to significantly reduce the ecological footprint and to improve the cost-effectiveness and long-term sustainability. Rural domestic waste (RDW) is affecting 720 million people in China and more than 3221 million people worldwide. Consequently, handling and disposal of RDW have serious health implications to rural dwellers and the ecosystems. This study offers a systemantic and quantitative overview and analysis of historical data on RDW production and management practices in a prototype region in China, which is confronted with great environmental challenges associated with RDW. Then we predict future production of RDW and propose a sustainable RDW management strategy, which holds the promise of greatly mitigating the mounting environmental pressure associated with RDW and provides science-based guidance for decision makers and practitioners for assuring rapid yet "green" economic development.

Realizing good care within a context of cross-cultural diversity: an ethical guideline for healthcare organizations in Flanders, Belgium.

PubMed

Denier, Yvonne; Gastmans, Chris

2013-09-01

In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.

The Psychology of Working Theory.

PubMed

Duffy, Ryan D; Blustein, David L; Diemer, Matthew A; Autin, Kelsey L

2016-03-01

In the current article, we build on research from vocational psychology, multicultural psychology, intersectionality, and the sociology of work to construct an empirically testable Psychology of Working Theory (PWT). Our central aim is to explain the work experiences of all individuals, but particularly people near or in poverty, people who face discrimination and marginalization in their lives, and people facing challenging work-based transitions for which contextual factors are often the primary drivers of the ability to secure decent work. The concept of decent work is defined and positioned as the central variable within the theory. A series of propositions is offered concerning (a) contextual predictors of securing decent work, (b) psychological and economic mediators and moderators of these relations, and (c) outcomes of securing decent work. Recommendations are suggested for researchers seeking to use the theory and practical implications are offered concerning counseling, advocacy, and public policy. (c) 2016 APA, all rights reserved).

Medical Rejuvenation in Georgia in the past: the Sukhumi Station.

PubMed

Musajo-Somma, Laura; Musajo-Somma, Alfredo

2016-12-01

If youth and body appearance enhancement is as old as Homo Sapiens, reliable medical technology for such activities is only about 100 years old. At the dawn of the 20th century, surgical operations performed under the Voronoff's treatment plan (monkey gonads' tissue grafting into humans) or the Steinach's technique (vasoligation) offered a promise of longevity, beauty and therefore youth restoration. The many links with a newly recognized discipline, endocrinology, offer a critical insight on the strong interactions between medicine and surgery in the promise of successful antiaging. On the front-line of scientific research, the Institute of Experimental Endocrinology's primate station in Sukhumi (West Georgia, now Abkhazia, on the Black Sea coast) developed a leadership role in the medical research, including rejuvenation with testis' tissues. Authors focus their attention to the everlasting commitment to experimental and clinical research as developed by Sukhumi scholars and the related moral, practical and ideological implications.

Genome typing of nonhuman primate models: implications for biomedical research.

PubMed

Haus, Tanja; Ferguson, Betsy; Rogers, Jeffrey; Doxiadis, Gaby; Certa, Ulrich; Rose, Nicola J; Teepe, Robert; Weinbauer, Gerhard F; Roos, Christian

2014-11-01

The success of personalized medicine rests on understanding the genetic variation between individuals. Thus, as medical practice evolves and variation among individuals becomes a fundamental aspect of clinical medicine, a thorough consideration of the genetic and genomic information concerning the animals used as models in biomedical research also becomes critical. In particular, nonhuman primates (NHPs) offer great promise as models for many aspects of human health and disease. These are outbred species exhibiting substantial levels of genetic variation; however, understanding of the contribution of this variation to phenotypes is lagging behind in NHP species. Thus, there is a pivotal need to address this gap and define strategies for characterizing both genomic content and variability within primate models of human disease. Here, we discuss the current state of genomics of NHP models and offer guidelines for future work to ensure continued improvement and utility of this line of biomedical research. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cognitive Behavioural Suicide Prevention for Male Prisoners: Case examples

PubMed Central

Pratt, Daniel; Gooding, Patricia; Awenat, Yvonne; Eccles, Steve; Tarrier, Nicholas

2015-01-01

Suicide is a serious public health problem but a problem that is preventable. This complex and challenging problem is particularly prevalent amongst prisoners; associated with a five-fold increase in risk compared to the general community. Being in prison can lead people to experience fear, distrust, lack of control, isolation, and shame, which is often experienced as overwhelming and intolerable with some choosing suicide as a way to escape. Few effective psychological interventions exist to prevent suicide although cognitive behaviour therapies appear to offer some promise. Offering cognitive behaviour suicide prevention (CBSP) therapy to high risk prisoners may help to reduce the likelihood of preventable self-inflicted deaths. In this paper we present three cases drawn from a randomised controlled trial designed to investigate the feasibility of CBSP for male prisoners. Implications of the current findings for future research and clinical practice are considered. PMID:27713616

Analysing reduced tillage practices within a bio-economic modelling framework.

PubMed

Townsend, Toby J; Ramsden, Stephen J; Wilson, Paul

2016-07-01

Sustainable intensification of agricultural production systems will require changes in farm practice. Within arable cropping systems, reducing the intensity of tillage practices (e.g. reduced tillage) potentially offers one such sustainable intensification approach. Previous researchers have tended to examine the impact of reduced tillage on specific factors such as yield or weed burden, whilst, by definition, sustainable intensification necessitates a system-based analysis approach. Drawing upon a bio-economic optimisation model, 'MEETA', we quantify trade-off implications between potential yield reductions, reduced cultivation costs and increased crop protection costs. We extend the MEETA model to quantify farm-level net margin, in addition to quantifying farm-level gross margin, net energy, and greenhouse gas emissions. For the lowest intensity tillage system, zero tillage, results demonstrate financial benefits over a conventional tillage system even when the zero tillage system includes yield penalties of 0-14.2% (across all crops). Average yield reductions from zero tillage literature range from 0 to 8.5%, demonstrating that reduced tillage offers a realistic and attainable sustainable intensification intervention, given the financial and environmental benefits, albeit that yield reductions will require more land to compensate for loss of calories produced, negating environmental benefits observed at farm-level. However, increasing uptake of reduced tillage from current levels will probably require policy intervention; an extension of the recent changes to the CAP ('Greening') provides an opportunity to do this.

Policy and regulatory responses to dual practice in the health sector.

PubMed

García-Prado, Ariadna; González, Paula

2007-12-01

Physician dual practice is a widespread phenomenon which has implications for the equity, efficiency and quality of health care provision. Central to the analysis of physician dual practice is the trade-off between its benefits and costs, as well as the convenience of regulating it to undermine its adverse consequences. In this paper, we study and analyze different governmental responses to this activity. We find that internationally, there are wide variations in how governments tackle this issue. While some governments fully prohibit this practice, others regulate or restrict dual job holding with different intensities and regulatory instruments. The measures implemented include limiting the income physicians can earn through dual job holding, offering work benefits to physicians in exchange for their working exclusively in the public sector, raising public salaries, and allowing physicians to perform private practice at public facilities. We present the pros and cons of each of these alternatives and show how the health care market and institutional arrangements are crucial for the design and implementation of each of these strategies. The paper also identifies the need for empirical evidence on the effect of different government strategies on dual practice.

The Stopit! programme to reduce bullying and undermining behaviour in hospitals.

PubMed

Benmore, Graham; Henderson, Steven; Mountfield, Joanna; Wink, Brian

2018-05-21

Purpose The impact of bullying and undermining behaviours on the National Health Service on costs, patient safety and retention of staff was well understood even before the Illing report, published in 2013, that reviewed the efficacy of training interventions designed to reduce bullying and harassment in the outputs. The purpose of this paper is to provide an example of a good programme well evaluated. Design/methodology/approach The methodology follows a broad realist approach, by specifying the underlying programme assumptions and intention of the designers. Three months after the event, Q-sort methodology was employed to group participants into one of three contexts - mechanism - output groups. Interviews were then undertaken with members of two of these groups, to evaluate how the programme had influenced each. Findings Q-sort identified a typology of three beneficiaries from the Stopit! workshops, characterised as professionals, colleagues and victims. Each group had acted upon different parts of the programme, depending chiefly upon their current and past experiences of bullying in hospitals. Research limitations/implications The paper demonstrates the effectiveness of using Q-sort method to identify relevant CMOs in a realist evaluation framework. Practical implications The paper considers the effectiveness of the programme to reduce bullying, rather than teach victims to cope, and how it may be strengthened based upon the research findings and Illing recommendations. Social implications Workplace bullying is invariably implicated in scandals concerning poor hospital practice, poor patient outcomes and staff illness. All too frequently, the sector responds by offering training in resilience, which though helpful, places the onus on the victim to cope rather than the employer to reduce or eliminate the practice. This paper documents and evaluates an attempt to change workplace practices to directly address bullying and undermining. Originality/value The paper describes a new programme broadly consistent with Illing report endorsements. Second, it illustrates a novel evaluation method that highlights rigorously the contexts, mechanisms and outcomes at the pilot stage of an intervention identifies contexts and mechanisms via factor analysis using Q-sort methodology.

Anthropology, organ transplantation and the immune system: resituating commodity and gift exchange.

PubMed

Kierans, Ciara

2011-11-01

This article reflects on contributions from medical anthropology to our understanding of the bio-social and bio-political implications of renal transplantation. Taking up the idea of transplantation as a 'complex', a vast assemblage of people, places, practices and procedures which intersect medical, social and cultural domains, I point to a reliance in the anthropological literature on overly pre-determined conceptual frameworks, organised around a distinct polarisation between organ giving and receiving, where one side (supply) takes analytical, and indeed moral, precedence over the other (receipt). These frameworks tend to fail us when it comes to thinking about the wider social, cultural and political implications of transplant technologies. In an attempt to offer a less polarised view, I draw attention to the material and symbolic role of the immune system in transplantation and the ways in which it simultaneously shapes opportunities for procurement and the lived realities of recipiency. This helps us see the many complex ways in which suffering and inequality are constituted all along the variegated chains of supply and demand that are internal to, and made possible by, transplantation practices themselves. Copyright © 2011 Elsevier Ltd. All rights reserved.

Repetitive flood victims and acceptance of FEMA mitigation offers: an analysis with community-system policy implications.

PubMed

Kick, Edward L; Fraser, James C; Fulkerson, Gregory M; McKinney, Laura A; De Vries, Daniel H

2011-07-01

Of all natural disasters, flooding causes the greatest amount of economic and social damage. The United States' Federal Emergency Management Agency (FEMA) uses a number of hazard mitigation grant programmes for flood victims, including mitigation offers to relocate permanently repetitive flood loss victims. This study examines factors that help to explain the degree of difficulty repetitive flood loss victims experience when they make decisions about relocating permanently after multiple flood losses. Data are drawn from interviews with FEMA officials and a survey of flood victims from eight repetitive flooding sites. The qualitative and quantitative results show the importance of rational choices by flood victims in their mitigation decisions, as they relate to financial variables, perceptions of future risk, attachments to home and community, and the relationships between repetitive flood loss victims and the local flood management officials who help them. The results offer evidence to suggest the value of a more community-system approach to FEMA relocation practices. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Establishing the boundaries and building bridges: a literature review on ecological theory: implications for research into the refugee parenting experience.

PubMed

Williams, Nombasa

2010-03-01

Currently an ecological model for conceptualizing and capturing the refugee parenting experience is lacking. After an extensive review of the literature related to the usages of Bronfenbrenner's ecological model of child development, a gap was found in knowledge and research centred on describing the environment of pre-resettlement (i.e. pre-flight, flight, migration, camp) contexts and their impact on refugee parents and carer experiences. The culture of the refugee parenting experience may be characterized by disruptions in and alterations to family structure and organization; values and norms; and gender roles. This paper begins by examining the definition and usages of existing ecological frameworks in the 20th and 21st century. Particular attention is drawn to the gaps in the existing literature and an ecological model is offered. The paper concludes with a discussion of the implications for practice. The outcomes of this paper suggest the need for practitioners, policymakers and researchers to engage and develop culturally competent, relevant and appropriate interventions (i.e. reconciling differing beliefs and behaviours concerning child-rearing practices; affirming positive parenting practices of these families during engagement protocols and processes; adopting a strengths-based orientation) in the area of child protection whilst at the same time safeguarding and promoting the welfare of children within pre- and post-resettlement contexts.

Communicating microarray results of uncertain clinical significance in consultation summary letters and implications for practice.

PubMed

Paul, Jean Lillian; Pope-Couston, Rachel; Wake, Samantha; Burgess, Trent; Tan, Tiong Yang

2016-01-01

Letter-writing is an integral practice for genetic health professionals. In Victoria, Australia, patients with a chromosomal variant of uncertain clinical significance (VUS) referred to a clinical geneticist (CG) for evaluation receive consultation summary letters. While communication of uncertainty has been explored in research to some extent, little has focused on how uncertainty is communicated within consultation letters. We aimed to develop a multi-layered understanding of the ways in which CGs communicate diagnostic uncertainty in consultation summary letters. We used theme-oriented discourse analysis of 49 consultation summary letters and thematic analysis of a focus group involving eight CGs. Results showed that CGs have become more confident in their description of VUS as 'contributing factors' to patients' clinical features, but remain hesitant to assign definitive causality. CGs displayed strong epistemic stance when discussing future technological improvements to provide hope and minimise potentially disappointing outcomes for patients and families. CGs reported feeling overwhelmed by their workload associated with increasing numbers of patients with VUS, and this has led to a reduction in the number of review appointments offered over time. This study provides a rich description of the content and process of summary letters discussing VUS. Our findings have implications for letter-writing and workforce management. Furthermore, these findings may be of relevance to VUS identified by genomic sequencing in clinical practice.

Introduction to Special Series: The Great Debate—Evaluating the Health Implications of Positive Psychology

PubMed Central

Miller, Suzanne M.; Christensen, Alan J.

2010-01-01

Background In recent years, investigators have focused increased attention on positive psychology constructs and their associations with health outcomes, such as morbidity, mortality, and adaptation to illness. The database regarding some of these concepts and models has grown appreciably, but work in this area has been subject to controversy. Purpose This special series of papers offers contrasting perspectives regarding research on positive psychology and health. Both proponents and critics were invited to review recent developments concerning a number of positive constructs that have been evaluated in the oncology literature and in health research, more generally. Methods Papers are presented in the format of a debate. Significant advances are reviewed by one set of investigators, Drs, Lisa G. Aspinwall and Richard G. Tedeschi, while shortcomings and concerns are highlighted by another set of investigators, Drs. James C. Coyne and Howard Tennen. Each of these review papers is followed by a rebuttal by the opposing side. A commentary on the exchange is provided by Dr. Sherri Sheinfeld Gorin. Results These papers address a range of important considerations regarding conceptualization of constructs, methodological rigor, dissemination of findings, and implications for practice. Conclusion The critiques and recommendations offered in these papers may help inform future efforts in this area, as the field continues to evolve. PMID:20306165

The institution of the institutional practice of psychology: health care reform and psychology's future workforce.

PubMed

Rozensky, Ronald H

2011-11-01

Implications for the future of professional psychology are discussed and related to the Patient Protection and Affordable Care Act, patient-centered health care homes and accountable care organizations, and the growing importance of interprofessional competencies in health care. The need for increased information about the psychology workforce is related to the history of the institutional practice of psychology and how that data must be used to plan for the supply of psychologists required to meet the service demands of the changing health care system. Several challenges to the field of psychology are offered, along with steps that must be taken by the profession to prepare for increased institutionally based health care services in the future. (PsycINFO Database Record (c) 2011 APA, all rights reserved). 2011 APA, all rights reserved

Menopause, the metabolic syndrome, and mind-body therapies

PubMed Central

Innes, Kim E.; Selfe, Terry Kit; Taylor, Ann Gill

2009-01-01

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

"This is a question we have to ask everyone": asking young people about self-harm and suicide.

PubMed

O'Reilly, M; Kiyimba, N; Karim, K

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: An essential part of the mental health assessment is to evaluate the risk of harm to self. Fundamentally this involves asking directly about self-harming behaviour and suicidal thoughts or urges, but practitioners often find it difficult to open up these conversations. This evaluation of risk is particularly important as self-harm and suicidal thoughts are frequently found in young people who attend mental health services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Young people are not always routinely asked directly about self-harm or suicidal thoughts when they are assessed. There are two ways that mental health practitioners introduce this topic: first, by building up to it by initially asking about general feelings, and second by stating that it is a requirement to ask everyone. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These questions should not be avoided by mental health practitioners just because they are difficult. We offer suggestions as to how to ask questions about self-harm and suicide based on real-world practice. Introduction Questions about self-harm and suicide are essential in risk assessments with children and young people, yet little is known about how mental health practitioners do this. Aim The core aim was to examine how questions about self-harm and suicidal ideation are asked in real-world practice. Method A qualitative design was employed to analyse 28 video-recorded naturally occurring mental health assessments in a child and adolescent mental health service. Data were analysed using conversation analysis (CA). Results In 13 cases young people were asked about self-harm and suicide, but 15 were not. Analysis revealed how practitioners asked these questions. Two main styles were revealed. First was an incremental approach, beginning with inquiries about emotions and behaviours, building to asking about self-harm and suicidal intent. Second was to externalize the question as being required by outside agencies. Discussion The study concluded that the design of risk questions to young people had implications for how open they were to engaging with the practitioner. Implications for practice The study has implications for training and practice for psychiatric nurses and other mental health practitioners in feeling more confident in communicating with young people about self-harm and suicidal ideation. © 2016 John Wiley & Sons Ltd.

Collaborative explanation, explanatory roles, and scientific explaining in practice.

PubMed

Love, Alan C

2015-08-01

Scientific explanation is a perennial topic in philosophy of science, but the literature has fragmented into specialized discussions in different scientific disciplines. An increasing attention to scientific practice by philosophers is (in part) responsible for this fragmentation and has put pressure on criteria of adequacy for philosophical accounts of explanation, usually demanding some form of pluralism. This commentary examines the arguments offered by Fagan and Woody with respect to explanation and understanding in scientific practice. I begin by scrutinizing Fagan's concept of collaborative explanation, highlighting its distinctive advantages and expressing concern about several of its assumptions. Then I analyze Woody's attempt to reorient discussions of scientific explanation around functional considerations, elaborating on the wider implications of this methodological recommendation. I conclude with reflections on synergies and tensions that emerge when the two papers are juxtaposed and how these draw attention to critical issues that confront ongoing philosophical analyses of scientific explanation. Copyright © 2015 Elsevier Ltd. All rights reserved.

"If It Feels Right, Do It": Intuitive Decision Making in a Sample of High-Level Sport Coaches.

PubMed

Collins, Dave; Collins, Loel; Carson, Howie J

2016-01-01

Comprehensive understanding and application of decision making is important for the professional practice and status of sports coaches. Accordingly, building on a strong work base exploring the use of professional judgment and decision making (PJDM) in sport, we report a preliminary investigation into uses of intuition by high-level coaches. Two contrasting groups of high-level coaches from adventure sports (n = 10) and rugby union (n = 8), were interviewed on their experiences of using intuitive and deliberative decision making styles, the source of these skills, and the interaction between the two. Participants reported similarly high levels of usage to other professions. Interaction between the two styles was apparent to varying degrees, while the role of experience was seen as an important precursor to greater intuitive practice and employment. Initially intuitive then deliberate decision making was a particular feature, offering participants an immediate check on the accuracy and validity of the decision. Integration of these data with the extant literature and implications for practice are discussed.

Reproducible research: a minority opinion

NASA Astrophysics Data System (ADS)

Drummond, Chris

2018-01-01

Reproducible research, a growing movement within many scientific fields, including machine learning, would require the code, used to generate the experimental results, be published along with any paper. Probably the most compelling argument for this is that it is simply following good scientific practice, established over the years by the greats of science. The implication is that failure to follow such a practice is unscientific, not a label any machine learning researchers would like to carry. It is further claimed that misconduct is causing a growing crisis of confidence in science. That, without this practice being enforced, science would inevitably fall into disrepute. This viewpoint is becoming ubiquitous but here I offer a differing opinion. I argue that far from being central to science, what is being promulgated is a narrow interpretation of how science works. I contend that the consequences are somewhat overstated. I would also contend that the effort necessary to meet the movement's aims, and the general attitude it engenders would not serve well any of the research disciplines, including our own.

[New business model for medical specialists].

PubMed

Houwen, L G H J Louis

2013-01-01

The reforms in the field of medical specialist care have important implications for the professional practice of medical specialists and their working relationship with the hospital. This leads to a considerable amount of pressure placed upon the way physicians have traditionally practiced their liberal professions, which is by forming partnerships and practicing from within the hospitals based on an admission agreement. As of 2015, the tax benefits for entrepreneurs will be abolished and the formation of regional partnerships will be discouraged. These developments not only pose threats but also offer opportunities for both the entrepreneurial medical specialist and the innovative hospital. In this article, the prospect of a future business model for specialist medical care will be outlined and explored by proposing three new organizational forms. The central vision of this model is that physicians who wish to retain their status of liberal professional practitioners in the twenty-first century should be more involved in the ownership structure of hospitals. The social importance of responsible patient care remains paramount.

Genomics England's implementation of its public engagement strategy: Blurred boundaries between engagement for the United Kingdom's 100,000 Genomes project and the need for public support.

PubMed

Samuel, Gabrielle Natalie; Farsides, Bobbie

2018-04-01

The United Kingdom's 100,000 Genomes Project has the aim of sequencing 100,000 genomes from National Health Service patients such that whole genome sequencing becomes routine clinical practice. It also has a research-focused goal to provide data for scientific discovery. Genomics England is the limited company established by the Department of Health to deliver the project. As an innovative scientific/clinical venture, it is interesting to consider how Genomics England positions itself in relation to public engagement activities. We set out to explore how individuals working at, or associated with, Genomics England enacted public engagement in practice. Our findings show that individuals offered a narrative in which public engagement performed more than one function. On one side, public engagement was seen as 'good practice'. On the other, public engagement was presented as core to the project's success - needed to encourage involvement and ultimately recruitment. We discuss the implications of this in this article.

Health Promotion Practice and Interprofessional Education in Aging: Senior Wellness Fairs.

PubMed

Diwan, Sadhna; Perdue, Megan; Lee, Sang E; Grossman, Brian R

2016-01-01

Senior wellness fairs (SWFs) offer a unique opportunity for community health promotion and interprofessional education (IPE). The authors describe and evaluate the impact of a 3-year, university-community SWF collaboration on interprofessional competencies among students across multiple professional programs. Participation in the SWF enhanced student knowledge and skills in providing health promotion information to older adults in an interprofessional, collaborative setting as indicated by mean scores on the Perceived Learning Outcomes Survey, an instrument developed for this project. Open-ended data highlighted aspects of the SWF that students found most useful (interaction with seniors, community resources, interprofessional learning, and self-awareness) and most challenging (communication barriers, limited opportunity for interaction, and physical environment). Pre- and posttest scores on the Multidisciplinary SWF Practice Learning Quiz, another instrument developed for this project, illustrated improvement in student understanding of other professions and the importance of interprofessional cooperation to promote and maintain healthy aging. Implications and suggestions for structuring learning opportunities that combine community health promotion practice and interprofessional learning are discussed.

Developing a policy for paediatric biobanks: principles for good practice

PubMed Central

Hens, Kristien; Van El, Carla E; Borry, Pascal; Cambon-Thomsen, Anne; Cornel, Martina C; Forzano, Francesca; Lucassen, Anneke; Patch, Christine; Tranebjaerg, Lisbeth; Vermeulen, Eric; Salvaterra, Elena; Tibben, Aad; Dierickx, Kris

2013-01-01

The participation of minors in biobank research can offer great benefits for science and health care. However, as minors are a vulnerable population they are also in need of adequate protective measures when they are enrolled in research. Research using biobanked biological samples from children poses additional ethical issues to those raised by research using adult biobanks. For example, small children have only limited capacity, if any, to understand the meaning and implications of the research and to give a documented agreement to it. Older minors are gradually acquiring this capacity. We describe principles for good practice related to the inclusion of minors in biobank research, focusing on issues related to benefits and subsidiarity, consent, proportionality and return of results. Some of these issues are currently heavily debated, and we conclude by providing principles for good practice for policy makers of biobanks, researchers and anyone involved in dealing with stored tissue samples from children. Actual implementation of the principles will vary according to different jurisdictions. PMID:22713814

Financial remuneration for clinical and behavioral research participation: ethical and practical considerations.

PubMed

Permuth-Wey, Jennifer; Borenstein, Amy R

2009-04-01

Although the practice of providing payment to clinical research participants has been ongoing for more than a century, it remains an ethically controversial topic among members of the research community. The aims of this commentary are to summarize ethical and practical considerations regarding financial remuneration of research participants and to make recommendations for researchers contemplating this practice. A PubMed search was conducted to explore the ethical implications surrounding financial remuneration and review the body of empiric data on this topic. Financial remuneration is perceived to be ethically acceptable by many researchers and research participants and can be helpful in the recruitment process. It is recommended that when investigators are contemplating whether to offer payment to research participants, they should consider the nature of the study and the potential benefits and risks to the participants, institutional or organizational guidelines, and cultural and societal norms specific to the population being studied. Financial remuneration has the ability to serve as a sign of appreciation for the contributions of research participants and a way to facilitate clinical and behavioral research.

Eliminating "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) terminology in clinical breast practice: The cognitive psychology point of view.

PubMed

Pravettoni, Gabriella; Yoder, Whitney R; Riva, Silvia; Mazzocco, Ketti; Arnaboldi, Paola; Galimberti, Viviana

2016-02-01

There is evidence from the literature that the terms "ductal carcinoma in situ" and "lobular carcinoma in situ" (DCIS and LCIS) should be eliminated in clinical breast cancer practice and replaced with the new "ductal intraepithelial neoplasia" (DIN) and "lobular intraepithelial neoplasia" (LIN) terminology. The main purpose of the present article is to expand on this argument from a cognitive psychology perspective and offer suggestions for further research, emphasizing how the elimination of the term "carcinoma" in "in situ" breast cancer diagnoses has the potential to reduce both patient and health care professional confusion and misperceptions that are often associated with the DCIS and LCIS diagnoses, as well as limit the adverse psychological effects of women receiving a DCIS or LCIS diagnosis. We comment on the recent peer-reviewed literature on the clinical implications and psychological consequences for breast cancer patients receiving a DCIS or LCIS diagnosis and we use a cognitive perspective to offer new insight into the benefits of embracing the new DIN and LIN terminology. Using cognitive psychology and cognitive science in general, as a foundation, further research is advocated in order to yield data in support of changing the terminology and therefore, offer a chance to significantly improve the lives and psychological sequelae of women facing such a diagnosis. Typology: Controversies/Short Commentary. Copyright © 2015 Elsevier Ltd. All rights reserved.

The sales and marketing practices of English-language internet alcohol vendors.

PubMed

Williams, Rebecca S; Schmidt, Allison

2014-03-01

This study aimed to fill information gaps about the sales and marketing practices of internet alcohol vendors and their implications for addressing youth access and other legal violations. Further, it aimed to expand the limited scientific literature on internet alcohol sales using systematic survey methods to inform future efforts to regulate this industry and prevent sales to minors. The design was a cross-sectional website content analysis survey. [Not applicable]. A total of 105 internet alcohol vendor websites. Six key content analysis topics were explored: products offered, average prices and proportions of vendors using different promotions, policy statements and methods for age verification, payment and delivery. Websites sell and promote a variety of alcohol products, offered as cheaply as $1.93 for a 750-ml bottle. Vendors rely heavily upon age verification methods that are unlikely to prevent sales to minors. Many vendors advertise shipping of products via methods through which it is illegal or against delivery company policies to transport alcohol, and 99% of vendors accept credit cards. Limiting and enforcing delivery and payment options are types of policy interventions that have been used successfully with internet cigarette vendors that may be applicable to internet alcohol vendors as well. Internet alcohol vendor practices are insufficient to prevent sales to minors, and need further regulation and enforcement of existing policies. Their sales practices are similar to those of internet cigarette vendors prior to regulation, and similar regulatory approaches may be effective in reducing internet alcohol sales to minors. © 2013 Society for the Study of Addiction.

Examining Quality Management Audits in Nuclear Medicine Practice as a lifelong learning process: opportunities and challenges to the nuclear medicine professional and beyond.

PubMed

Pascual, Thomas N B

2016-08-01

This essay will explore the critical issues and challenges surrounding lifelong learning for professionals, initially exploring within the profession and organizational context of nuclear medicine practice. It will critically examine how the peer-review process called Quality Management Audits in Nuclear Medicine Practice (QUANUM) of the International Atomic Energy Agency (IAEA) can be considered a lifelong learning opportunity to instill a culture of quality to improve patient care and elevate the status of the nuclear medicine profession and practice within the demands of social changes, policy, and globalization. This will be explored initially by providing contextual background to the identity of the IAEA as an organization responsible for nuclear medicine professionals, followed by the benefits that QUANUM can offer. Further key debates surrounding lifelong learning, such as compulsification of lifelong learning and impact on professional change, will then be weaved through the discussion using theoretical grounding through a qualitative review of the literature. Keeping in mind that there is very limited literature focusing on the implications of QUANUM as a lifelong learning process for nuclear medicine professionals, this essay uses select narratives and observations of QUANUM as a lifelong learning process from an auditor's perspective and will further provide a comparative perspective of QUANUM on the basis of other lifelong learning opportunities such as continuing professional development activities and observe parallelisms on its benefits and challenges that it will offer to other professionals in other medical speciality fields and in the teaching profession.

Use of Bloodborne Pathogens Exposure Control Plans in Private Dental Practices: Results and Clinical Implications of a National Survey

PubMed Central

Laramie, Angela K.; Bednarsh, Helene; Isman, Beverly; Boiano, James M.; McCrone, Susan H.

2018-01-01

Dental healthcare workers (DHWs) are at risk for occupational exposure to bloodborne pathogens (BBPs). The Occupational Safety and Health Administration Bloodborne Pathogens Standard requires employers to have a written exposure control plan (ECP) detailing methods and means to reduce and manage occupational BBP exposures. Because little information is available on whether ECPs are created and used, the National Institute for Occupational Safety and Health and the Organization for Safety, Asepsis and Prevention conducted an online survey to determine if dental practices had an ECP, whether present ECPs had the necessary components, and if impediments existed to prevent having an ECP in place. Respondents were primarily from nonfranchised practices (69%) and dentists who owned the practice (63%). Seventy-two percent of survey participants had an ECP and 20% were unaware of any federal requirements for an ECP prior to the survey. Engineering controls were used by many practices, although the type varied. Fifteen percent of practices did not offer the hepatitis B vaccine for employees. The survey revealed many dental practices were unaware of or were lacking required elements of the ECP Findings from this survey indicate DHWs would benefit from increased education regarding methods to prevent occupational exposures to BBPs. PMID:28570085

What Is the Optimal Target Convective Volume in On-Line Hemodiafiltration Therapy?

PubMed

Canaud, Bernard; Koehler, Katrin; Bowry, Sudhir; Stuard, Stefano

2017-01-01

Conventional diffusion-based dialysis modalities including high-flux hemodialysis are limited in their capacity to effectively remove large uremic toxins and to improve outcomes for end-stage chronic kidney disease (ESKD) patients. By increasing convective solute transport, hemodiafiltration (HDF) enhances solute removal capacity over a broad range of middle- and large-size uremic toxins implicated in the pathophysiology of chronic kidney disease. Furthermore, by offering flexible convection volume, on-line HDF permits customizing the treatment dose to the patient's needs. In addition, convective-based modalities have been shown to improve hemodynamic stability and to reduce patients' inflammation profile - both of which are implicated in CKD morbidity and mortality. Growing clinical evidence indicates that HDF-based modalities provide ESKD patients with a number of clinical and biological benefits, including improved outcomes. Interestingly, it has recently emerged that the clinical benefits associated with HDF are positively associated with the total ultrafiltered volume per session (and per week), namely convective dose. In this chapter, we revisit the concept of convective dose and discuss the threshold value above which an improvement in ESKD patient outcome can be expected. This particular point will be addressed by stratifying the level of efficacy of convective volumes, schematically defined as minimal, optimal, personalized, and maximal. In addition, factors and best clinical practices implicated in the achievement of an optimal convective dose are reviewed. To conclude, we show how HDF differs from standard hemodialysis and why HDF offers a paradigm shift in renal replacement therapy. © 2017 S. Karger AG, Basel.

Objective Comparison of Commercially Available Breast Implant Devices.

PubMed

Henderson, Peter W; Nash, David; Laskowski, Marta; Grant, Robert T

2015-10-01

Breast implants are frequently used for both cosmetic breast augmentation and breast reconstruction after mastectomy. Three companies currently offer FDA-approved breast implants (Allergan, Mentor, and Sientra), but their product offerings-including permanent breast implants, breast tissue expanders, sizers, and post-operative warranty-can be difficult to compare because of brand names and company-specific jargon. The ability to have a brand-agnostic understanding of all available options is important for both the surgical trainee as well as the surgeon in clinical practice. After a brief review of the history of breast implant devices, this review utilizes a unique conceptual framework based on variables such as fill material, shape, relative dimensions, and surface coating to facilitate a better understanding of the similarities and differences between the different company's offerings. Specifically, we identify which types of devices are offered by all three companies, those that are offered by only one company, those that have very limited product offerings, and those combinations that are not available at all. Finally, clinical implications are drawn from this framework that can be used by both cosmetic and reconstructive surgeons to counsel patients about all available options. Importantly, this project is entirely independent of any company's funding, support, or input. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Community pharmacist-delivered Medicare Annual Wellness Visits within a family medicine practice.

PubMed

Evans, Taylor A; Fabel, Patricia H; Ziegler, Bryan

To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, SC, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice. The pharmacy team contacted each office and obtained information about the physician practices and their willingness to participate in the program. Two financial models were created and evaluated to determine budget implications. Many patients were seen at the physician offices; they were eligible for AWV, but had not received them. Meetings were scheduled with 3 of the 6 offices; however, none of the offices moved forward with the proposed program. Integrating a pharmacist into the AWV role may be profitable to both the pharmacy and the medical office with persistence and time to have a successful collaboration. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Understanding literacy as our WORLD inheritance: Re-visioning literacy discourse and its implications for teaching practice

NASA Astrophysics Data System (ADS)

Parr, Michelann; Campbell, Terry A.

2012-08-01

While universal literacy is one of the most pervasive targets of today's educational systems, it is at the same time perhaps the narrowest of all goals. Standardised testing reduces language and literacy to tasks associated with reading and writing. As learning communities become increasingly diverse, teachers, administrators and policy makers are finding themselves in a position where in order to maximise student development they need to broaden their conceptualisations of literacy, merge curricular areas and implement inclusive practices. Addressing literacy instructors and policy makers in particular, the authors of this article present a WORLD view of literacy (Word, Orality, Re-vision, Literacies, Discourses) towards making sense of contemporary literacy research. The purpose of this paper is multi-layered in terms of theory and practice. On the philosophical and theoretical level, it is intended to extend our understanding of literacy in view of both historical conceptualisations and contemporary views of literacy. On the reflective and practical level, it offers a unique way to assess our literacy practice and re-vision what we do. Demonstrating the universality of this approach, this is illustrated by a few ideas from a poem, a children's book, a dystopian novel for teenagers and a film.

Epistemic agency in an environmental sciences watershed investigation fostered by digital photography

NASA Astrophysics Data System (ADS)

Zimmerman, Heather Toomey; Weible, Jennifer L.

2018-05-01

This collective case study investigates the role of digital photography to support high school students' engagement in science inquiry practices during a three-week environmental sciences unit. The study's theoretical framework brings together research from digital photography, participation in environmental science practices, and epistemic agency. Data analysed include field notes and video transcripts from two groups of learners (n = 19) that focus on how high school students used digital photography during their participation in two distinct environmental monitoring practices: stream mapping and macroinvertebrate identification. Our study resulted in two findings related to the role of digital photography where students developed knowledge as they engaged in environmental monitoring inquiry practices. First, we found that digital photography was integral to the youths' epistemic agency (defined as their confidence that they could build knowledge related to science in their community) as they engaged in data collection, documenting environmental monitoring procedures, and sharing data in the classroom. Based this finding, an implication of our work is a refined view of the role of digital photography in environmental sciences education where the use of photography enhances epistemic agency in inquiry-based activities. Second, we found that the youths innovated a use of digital photography to foster a recognition that they were capable and competent in scientific procedures during a streamside study. Based on this finding, we offer a theoretical implication that expands the construct of epistemic agency; we posit that epistemic agency includes a subcomponent where the students purposefully formulate an external recognition as producers of scientific knowledge.

The equivalence of computerized and paper-and-pencil psychological instruments: implications for measures of negative affect.

PubMed

Schulenberg, S E; Yutrzenka, B A

1999-05-01

The use of computerized psychological assessment is a growing practice among contemporary mental health professionals. Many popular and frequently used paper-and-pencil instruments have been adapted into computerized versions. Although equivalence for many instruments has been evaluated and supported, this issue is far from resolved. This literature review deals with recent research findings that suggest that computer aversion negatively impacts computerized assessment, particularly as it relates to measures of negative affect. There is a dearth of equivalence studies that take into account computer aversion's potential impact on the measurement of negative affect. Recommendations are offered for future research in this area.

The Patient Protection and Affordable Care Act: implications for pediatric pharmacy practice.

PubMed

Vallejos, Ximena; Benavides, Sandra

2013-01-01

The impact of the Patient Protection and Affordable Care Act on the pediatric health care landscape includes expanded health insurance coverage and health care delivery improvements by increasing implementation of patient-centered medical homes and accountable care organizations. These offer opportunities for pharmacists to assume responsibility for the medication-related needs of pediatric patients through pharmacotherapy selection, medication therapy management performance, and medication reconciliation at each transition of care. Medically complex children with at least 2 chronic disease states may be the target population. Studies demonstrating the positive outcomes and cost-effectiveness of pharmacists in pediatric ambulatory care settings are needed.

Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

PubMed

Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

2017-09-01

This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

PubMed

Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

2017-03-01

Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

Computational perspectives in the history of science: to the memory of Peter Damerow.

PubMed

Laubichler, Manfred D; Maienschein, Jane; Renn, Jürgen

2013-03-01

Computational methods and perspectives can transform the history of science by enabling the pursuit of novel types of questions, dramatically expanding the scale of analysis (geographically and temporally), and offering novel forms of publication that greatly enhance access and transparency. This essay presents a brief summary of a computational research system for the history of science, discussing its implications for research, education, and publication practices and its connections to the open-access movement and similar transformations in the natural and social sciences that emphasize big data. It also argues that computational approaches help to reconnect the history of science to individual scientific disciplines.

The Role of Bacteria, Probiotics and Diet in Irritable Bowel Syndrome

PubMed Central

Harper, Ashton; Naghibi, Malwina M.; Garcha, Davinder

2018-01-01

Irritable bowel syndrome is a highly prevalent gastrointestinal disorder that threatens the quality of life of millions and poses a substantial financial burden on healthcare systems around the world. Intense research into the human microbiome has led to fascinating discoveries which directly and indirectly implicate the diversity and function of this occult organ in irritable bowel syndrome (IBS) pathophysiology. The benefit of manipulating the gastrointestinal microbiota with diet and probiotics to improve symptoms has been demonstrated in a wealth of both animal and human studies. The positive and negative mechanistic roles bacteria play in IBS will be explored and practical probiotic and dietary choices offered. PMID:29373532

The effect of a contingent monetary reward on probation referrals to a drug abuse program.

PubMed

Hunsaker, A C

1985-01-01

Faced with reductions in public funds and calls for greater accountability, substance abuse programs can possibly increase revenues through patient fees by increasing referrals from the criminal justice system. Accountability can be improved through the use of organizational behavior management techniques. This study demonstrates the utility of behavioral techniques to increase referrals and revenue in an outpatient drug abuse program. The rate of criminal justice referrals increased substantially when counselors were offered "commissions" based on patient fees. These results are discussed with respect to the practicality of behavioral techniques in the management of drug abuse programs and with regard to policy implications.

Waiting time as a competitive device: an example from general medical practice.

PubMed

Iversen, Tor; Lurås, Hilde

2002-09-01

From a theoretical model we predict that only physicians with quality characteristics perceived as inferior by patients are willing to embark on waiting time reductions. Because of variation in these quality characteristics among physicians, market equilibrium is likely to show a range of waiting times for physician services. This hypothesis is supported by results from a study of Norwegian general practitioners. Since the waiting time offered by a physician influences the number of patient-initiated consultations, a policy implication of our study is that the distinction between patient-initiated and physician-initiated consultations may be less clear-cut than often assumed in the literature.

Illustrating an integrated typology of meaning reconstruction in discourse: grief-related disclosures.

PubMed

Kunkel, Adrianne; Dennis, Michael Robert; Garner, Benjamin

2014-01-01

A typology of meaning reconstruction in grief-related discourse is offered as an extension to extant approaches to meaning making as a factor in relieving distress. Sensemaking, acceptance or resignation without understanding, realization of benefits via positive reappraisal, and realignment of roles and relationships are advanced as the 4 types of meaning reconstruction that are formed by the 4 intersections of Park's ( 2010 ) categorical distinctions in meaning making (i.e., searching for comprehensibility/searching for significance and assimilation/accommodation). Interpretive analysis of grief-related texts from an emotional disclosure study reveals 25 themes across the 4 types. Related theoretical insights and practical implications are discussed.

Medical marijuana in pediatric oncology: A review of the evidence and implications for practice.

PubMed

Ananth, Prasanna; Reed-Weston, Anne; Wolfe, Joanne

2018-02-01

Medical marijuana (MM) has become increasingly legal at the state level and accessible to children with serious illness. Pediatric patients with cancer may be particularly receptive to MM, given purported benefits in managing cancer-related symptoms. In this review, we examine the evidence for MM as a supportive care agent in pediatric oncology. We describe the current legal status of MM, mechanism of action, common formulations, and potential benefits versus risks for pediatric oncology patients. We offer suggestions for how providers might approach MM requests. Throughout, we comment on avenues for future investigation on this growing trend in supportive care. © 2017 Wiley Periodicals, Inc.

Practices of excellent companies in the drug industry.

PubMed

Pringle, F; Kleiner, B H

1997-01-01

Examines excellence in three major pharmaceutical companies: Merck, Lilly, and Glaxo. Provides an overview of recent trends in the health care industry. Shows that although all three companies are facing tough competition and strict cost-containment pressures, they continue to develop innovative strategies for increasing the quality of their product offering. Analyses Merck's recent acquisition of Medco and its implications; also highlights Merck's "Vital Interests" programme. Discusses Lilly's recent purchase of PCS from McKesson Drug and Lilly's recent efforts to concentrate on its core business. Introduces Helix, Glaxo's new computer network for pharmacists and explains the benefits of this unique service, both to its users and the sponsor.

Recruitment ad analysis offers new opportunities to attract GPs to short-staffed practices.

PubMed

Hemphill, Elizabeth; Kulik, Carol T

2013-01-01

As baby-boomer practitioners exit the workforce, physician shortages present new recruitment challenges for practices seeking GPs. This article reports findings from two studies examining GP recruitment practice. GP recruitment ad content analysis (Study 1) demonstrated that both Internet and print ads emphasize job attributes but rarely present family or practice attributes. Contacts at these medical practices reported that their practices offer distinctive family and practice attributes that could be exploited in recruitment advertising (Study 2). Understaffed medical practices seeking to attract GPs may differentiate their job offerings in a crowded market by incorporating family and/or practice attributes into their ads.

16 CFR 453.3 - Misrepresentations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Misrepresentations. (a) Embalming provisions—(1) Deceptive acts or practices. In selling or offering to sell funeral... practices. In selling or offering to sell funeral goods or funeral services to the public, it is a deceptive... practices. In selling or offering to sell funeral goods and funeral services to the public, it is a...

Physician-assisted suicide and/or euthanasia: Pragmatic implications for palliative care [corrected].

PubMed

Hudson, Peter; Hudson, Rosalie; Philip, Jennifer; Boughey, Mark; Kelly, Brian; Hertogh, Cees

2015-10-01

Despite the availability of palliative care in many countries, legalization of euthanasia and physician-assisted suicide (EAS) continues to be debated-particularly around ethical and legal issues--and the surrounding controversy shows no signs of abating. Responding to EAS requests is considered one of the most difficult healthcare responsibilities. In the present paper, we highlight some of the less frequently discussed practical implications for palliative care provision if EAS were to be legalized. Our aim was not to take an explicit anti-EAS stance or expand on findings from systematic reviews or philosophical and ethico-legal treatises, but rather to offer clinical perspectives and the potential pragmatic implications of legalized EAS for palliative care provision, patients and families, healthcare professionals, and the broader community. We provide insights from our multidisciplinary clinical experience, coupled with those from various jurisdictions where EAS is, or has been, legalized. We believe that these issues, many of which are encountered at the bedside, must be considered in detail so that the pragmatic implications of EAS can be comprehensively considered. Increased resources and effort must be directed toward training, research, community engagement, and ensuring adequate resourcing for palliative care before further consideration is given to allocating resources for legalizing euthanasia and physician-assisted suicide.

Theory-led confirmation bias and experimental persona

NASA Astrophysics Data System (ADS)

Allen, Michael

2011-04-01

Questionnaire and interview findings from a survey of three Year 8 (ages 12-13 years) science practical lessons (n = 52) demonstrate how pupils' data collection and inference making were sometimes biased by desires to confirm a personal theory. A variety of behaviours are described where learners knowingly rejected anomalies, manipulated apparatus, invented results or carried out other improper operations to either collect data which they believed were scientifically correct, or achieve social conformity. It is proposed that confirmation bias was a consequence of the degree to which individuals were laden by theory, and driven by this, experimenters assumed one of three different personas: becoming right answer confirmers; good scientists; or indifferent spectators. These personas have parallels with historical instances of scientific behaviour. Implications of a continued teacher-tolerance of pupil confirmation bias include the promotion of unscientific experimenting, and the persistence of unchallenged science misconceptions. Solutions are offered in the way of practical strategies that might reduce experimenters' theory-ladeness.

Low-frequency 1/f noise in graphene devices

NASA Astrophysics Data System (ADS)

Balandin, Alexander A.

2013-08-01

Low-frequency noise with a spectral density that depends inversely on frequency has been observed in a wide variety of systems including current fluctuations in resistors, intensity fluctuations in music and signals in human cognition. In electronics, the phenomenon, which is known as 1/f noise, flicker noise or excess noise, hampers the operation of numerous devices and circuits, and can be a significant impediment to the development of practical applications from new materials. Graphene offers unique opportunities for studying 1/f noise because of its two-dimensional structure and widely tunable two-dimensional carrier concentration. The creation of practical graphene-based devices will also depend on our ability to understand and control the low-frequency noise in this material system. Here, the characteristic features of 1/f noise in graphene and few-layer graphene are reviewed, and the implications of such noise for the development of graphene-based electronics including high-frequency devices and sensors are examined.

Blood Tests for People with Severe Learning Disabilities Receiving Dental Treatment under General Anaesthesia.

PubMed

Clough, Stacey; Shehabi, Zahra; Morgan, Claire; Sheppey, Claire

2016-11-01

People with learning disabilities (LDs) have poorer health than their non-disabled peers due to failures in reasonable adjustments. One hundred patients with severe LD and challenging behaviour attended for dental treatment under GA, during which routine blood testing was provided. Communication with general medical practitioners (GMPs) and blood test results were evaluated, showing poor communication with GMPs and significant undiagnosed disease among this group. Blood tests generate similar costs in primary and secondary care but a holistic approach to care under GA reduces expenses brought by lost clinical time and resources due to complex behaviours in an out-patient setting. Clinical relevance: This article discusses a holistic approach to healthcare for people with severe LD, including patient outcomes, financial and resource implications, and offers practical guidance on venepuncture technique, which is relevant to many aspects of both community and hospital dental practice.

Low-frequency 1/f noise in graphene devices.

PubMed

Balandin, Alexander A

2013-08-01

Low-frequency noise with a spectral density that depends inversely on frequency has been observed in a wide variety of systems including current fluctuations in resistors, intensity fluctuations in music and signals in human cognition. In electronics, the phenomenon, which is known as 1/f noise, flicker noise or excess noise, hampers the operation of numerous devices and circuits, and can be a significant impediment to the development of practical applications from new materials. Graphene offers unique opportunities for studying 1/f noise because of its two-dimensional structure and widely tunable two-dimensional carrier concentration. The creation of practical graphene-based devices will also depend on our ability to understand and control the low-frequency noise in this material system. Here, the characteristic features of 1/f noise in graphene and few-layer graphene are reviewed, and the implications of such noise for the development of graphene-based electronics including high-frequency devices and sensors are examined.

Brief report: reporting practices of methodological information in four journals of pediatric and child psychology.

PubMed

Raad, Jennifer M; Bellinger, Skylar; McCormick, Erica; Roberts, Michael C; Steele, Ric G

2008-08-01

To replicate Sifers, Puddy, Warren, and Roberts (2002) examining reporting rates of demographic, methodological, and ethical information in articles published during 1997, and to compare these rates to those found in articles published during 2005, in order to determine whether and how reporting practices of these variables have changed over time. We examined reporting demographic, methodological, and ethical information in articles in four journals: Journal of Pediatric Psychology, Journal of Clinical Child and Adolescent Psychology, Journal of Abnormal Child Psychology, and Child Development. Reporting rates during 2005 were compared to articles published during 1997. These four journals improved on many of the 23 variables compared to Sifers et al. including increases in the reporting of ethnicity, attrition, child assent procedures, socioeconomic status, reliability, and reward/incentive offered to participants. Improvements in descriptive information have implications for interpretation, replication, and generalizability of research findings.

Challenges for Managed Care from 340B Contract Pharmacies.

PubMed

Fein, Adam J

2016-03-01

The federal 340B Drug Pricing Program has expanded rapidly, with important yet still unmeasured impact on both managed care practice and policies. Notably, providers increasingly rely on external, contract pharmacies to extend 340B pricing to a broad set of patients. In 2014, 1 in 4 U.S. retail, mail, and specialty pharmacy locations acted as contract pharmacies for 340B-covered entities. This commentary discusses crucial ways in which 340B growth is affecting managed care pharmacy through formulary rebates, profits from managed care paid prescriptions, disruption of retail pharmacy networks, and reduced generic dispensing rates. Managed care should become more engaged in the discussion on how the 340B program should evolve and offer policy proposals to mitigate the challenges being encountered. There is also an urgent need for objective, transparent research on the 340B program's costs, benefits, and implications for managed care pharmacy and practice.

The dark side of transparency: How and when pay administration practices affect employee helping.

PubMed

Bamberger, Peter; Belogolovsky, Elena

2017-04-01

This study examines a long-standing contention of practitioners and scholars alike, namely that pay transparency may adversely affect employees' tendency to offer assistance to coworkers. Drawing from research on social comparison, information vividness, and envy, we develop and test a moderated-mediation model positing that transparency adversely affects the amount of help individuals afford to peers who, based on pay for performance, are paid more than them. Testing our hypotheses in the context of a multiround simulation-based laboratory experiment, we find that this adverse effect of pay transparency on helping is largely explained by transparency's positive association with episodic envy, but only when individual differences grounded in differential social value orientations, specifically those regarding individualism beliefs and prosocial motivation, are taken into consideration. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Adopting public health approaches to communication disability: challenges for the education of speech-language pathologists.

PubMed

Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Law, James

2014-01-01

Public health approaches to communication disability challenge the profession of speech-language pathology (SLP) to reconsider both frames of reference for practice and models of education. This paper reviews the impetus for public health approaches to communication disability and considers how public health is, and could be, incorporated into SLP education, both now and in the future. The paper describes tensions between clinical services, which have become increasingly specialized, and public health approaches that offer a broader view of communication disability and communication disability prevention. It presents a discussion of these tensions and asserts that public health approaches to communication are themselves a specialist field, requiring specific knowledge and skills. The authors suggest the use of the term 'communication disability public health' to refer to this type of work and offer a preliminary definition in order to advance discussion. Examples from three countries are provided of how some SLP degree programmes are integrating public health into the SLP curriculum. Alternative models of training for communication disability public health that may be relevant in the future in different contexts and countries are presented, prompting the SLP profession to consider whether communication disability public health is a field of practice for speech-language pathologists or whether it has broader workforce implications. The paper concludes with some suggestions for the future which may advance thinking, research and practice in communication disability public health. © 2015 S. Karger AG, Basel.

The moderating effects of parenting styles on African-American and Caucasian children's suicidal behaviors.

PubMed

Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron

2010-04-01

Given that parenting practices have been linked to suicidal behavior in adolescence, examining the moderating effect of parenting styles on suicidal behavior early in development could offer potential insight into possible buffers as well as directions for suicide prevention and intervention later in adolescence. Hence, the moderating effects of parenting styles, including authoritarian, permissive, and features of authoritative parenting, on depressed and aggressive children's suicidal behavior, including ideation and attempts, were evaluated with young children (N = 172; 72% male, 28% female) ranging from 6 to 12 years of age. African American (69%) and Caucasian (31%) children admitted for acute psychiatric inpatient care completed standardized measures of suicidal behavior, depressive symptoms, and proactive and reaction aggression. Their parents also completed standardized measures of parental distress and parenting style. Hierarchical regression analyses revealed that, while statistically controlling for age and gender, children who endorsed more depressive symptoms or reactive aggression reported more current and past suicidal behavior than children who endorsed fewer depressive or aggressive symptoms. The significant positive relationship observed between depressive symptoms and childhood suicidal behavior, however, was attenuated by parental use of authoritarian parenting practices for African-American and older children but not for younger and Caucasian children. The ethnic/racial difference observed for the buffering effect of authoritarian parenting practices offers potential theoretical and clinical implications for conceptualizing the moderating effects of parenting styles on African-American and Caucasian children's suicidal behavior.

Perinatal Practices & Traditions Among Asian Indian Women.

PubMed

Goyal, Deepika

2016-01-01

As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.

Health Decision Making: Lynchpin of Evidence-Based Practice

PubMed Central

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. Implications for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers’ intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed. PMID:19015288

Unique Contributors to the Curriculum: From Research to Practice for Speech-Language Pathologists in Schools.

PubMed

Powell, Rachel K

2018-04-05

This lead article of the Clinical Forum focuses on the research that supports why speech-language pathologists (SLPs) are an integral part of the overarching curriculum for all students in schools. Focus on education has shifted to student performance in our global world, specifically in college and career readiness standards. This article reviews recommendations on best practice from the American Speech-Language-Hearing Association on SLPs' roles in schools, as well as data on school-based services. Implementation of these practices as it is applicable to school initiatives will be explored. Methods of interventions available in schools, from general education to special education, will be discussed based on national guidelines for a Response to Intervention and Multi-Tiered System of Support. Research regarding teacher knowledge of the linguistic principles of reading instruction will be explored, as well as correlation between teacher knowledge and student performance. The implications for how SLPs as the linguistic experts offer unique roles in curriculum and the evidence available to support this role will be explored. Implications for future research needs will be discussed. The demands of a highly rigorous curriculum allow SLPs a unique opportunity to apply their knowledge in linguistic principles to increase student performance and achievement. With the increased focus on student achievement, growth outcome measures, and value-added incentives, it is critical that SLPs become contributors to the curriculum for all students and that data to support this role are gathered through focused research initiatives.

Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

PubMed

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2009-03-01

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

Technology, design and dementia: an exploratory survey of developers.

PubMed

Jiancaro, Tizneem; Jaglal, Susan B; Mihailidis, Alex

2017-08-01

Despite worldwide surges in dementia, we still know relatively little about the design of home technologies that support this population. The purpose of this study was to investigate design considerations from the perspective of developers. Participants, including technical and clinical specialists, were recruited internationally and answered web-based survey questions comprising Likert-type responses with text entry options. Developers were queried on 23 technology acceptance characteristics and 24 design practices. In all, forty developers completed the survey. Concerning "technology acceptance", cost, learnability, self-confidence (during use) and usability were deemed very important. Concerning "design practice", developers overwhelmingly valued user-centred design (UCD). In terms of general assistive technology (AT) models, these were largely unknown by technical specialists compared to clinical specialists. Recommendations based on this study include incorporating "self-confidence" into design protocols; examining the implications of "usability" and UCD in this context; and considering empathy-based design approaches to suit a diverse user population. Moreover, clinical specialists have much to offer development teams, particularly concerning the use of conceptual AT models. Implications of rehabilitation Stipulate precise usability criteria. Consider "learnability" and "self-confidence" as technology adoption criteria. Recognize the important theoretical role that clinical specialists can fulfil concerning the use of design schemas. Acknowledge the diversity amongst users with dementia, potentially adopting techniques, such as designing for "extraordinary users".

A survey of UK fertility clinics' approach to surrogacy arrangements.

PubMed

Norton, Wendy; Crawshaw, Marilyn; Hudson, Nicky; Culley, Lorraine; Law, Caroline

2015-09-01

This paper draws on the findings of the first survey of surrogacy arrangements in Human Fertilisation and Embryology Authority (HFEA) licensed fertility clinics since 1998. Given the complex social, ethical and legal issues involved, surrogacy continues to raise debate worldwide and fuel calls for increased domestic provision in developed countries. However, little is known about how recent changes have affected HFEA licensed clinics. A 24-item online survey was undertaken between August and October 2013, designed to improve understanding of recent trends and current practices associated with UK-based surrogacy, and consider the implications for future policy and practice in UK and cross-border surrogacy arrangements. The response rate was 51.4%, comprising 54 clinics. Quantitative data were analysed using descriptive statistics, and open-ended qualitative responses analysed for extending understanding. Of the participating clinics, 42.6% offered surrogacy (mostly gestational surrogacy). Heterosexual couples using gestational surrogacy were the largest group currently using services followed by male same-sex couples. Most clinics reported having encountered problems with surrogacy treatments, suggesting barriers still exist to expanding the UK provision of surrogacy arrangements. It is important that professionals are well informed about the legal implications of surrogacy and that clinics have consistent and appropriate operational protocols for surrogacy arrangements. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Coping and Sexual Harassment: How Victims Cope across Multiple Settings.

PubMed

Scarduzio, Jennifer A; Sheff, Sarah E; Smith, Mathew

2018-02-01

The ways sexual harassment occurs both online and in face-to-face settings has become more complicated. Sexual harassment that occurs in cyberspace or online sexual harassment adds complexity to the experiences of victims, current research understandings, and the legal dimensions of this phenomenon. Social networking sites (SNS) are a type of social media that offer unique opportunities to users and sometimes the communication that occurs on SNS can cross the line from flirtation into online sexual harassment. Victims of sexual harassment employ communicative strategies such as coping to make sense of their experiences of sexual harassment. The current study qualitatively examined problem-focused, active emotion-focused, and passive emotion-focused coping strategies employed by sexual harassment victims across multiple settings. We conducted 26 in-depth interviews with victims that had experienced sexual harassment across multiple settings (e.g., face-to-face and SNS). The findings present 16 types of coping strategies-five problem-focused, five active emotion-focused, and six passive emotion-focused. The victims used an average of three types of coping strategies during their experiences. Theoretical implications extend research on passive emotion-focused coping strategies by discussing powerlessness and how victims blame other victims. Furthermore, theoretically the findings reveal that coping is a complex, cyclical process and that victims shift among types of coping strategies over the course of their experience. Practical implications are offered for victims and for SNS sites.

Preparing practicing dentists to engage in practice-based research

PubMed Central

DeRouen, Timothy A.; Hujoel, Philippe; Leroux, Brian; Mancl, Lloyd; Sherman, Jeffrey; Hilton, Thomas; Berg, Joel; Ferracane, Jack

2013-01-01

Background The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices—a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR). Methods The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: “What is the question?”; “What are the options?”; “How do you evaluate the evidence?”; and “How do you conduct a study?” Results The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received. Despite their admission that the research methodology by itself was not of great interest, the dentists recognized the importance of the background material in equipping them to conduct quality studies in their practices. Conclusions Dentists interested in participating in practice-based research view training in research methodology as helpful to becoming better practitioner-investigators. The PRECEDENT training program seemed to reinforce their interest. Practice Implications As dentistry evolves to become more evidence-based, more and more of the evidence will come from practice-based research. This training program prepares practicing dentists to become engaged in this trend. PMID:18310739

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

PubMed

Wilson, Anthea

2015-01-01

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

Observation Care: Ethical and Legal Considerations for the Emergency Physician.

PubMed

Ali, Nissa J; Jesus, John; Smulowitz, Peter B

2016-03-01

The Medicare observation rules remain controversial despite Centers for Medicare and Medicaid Services revisions and the new 2-midnight rule. The increased financial risks for patients and heightened awareness of the rule have placed emergency physicians (EPs) at the center of the controversy. This article reviews the primary ethical and legal (particularly with respect to the Emergency Medical Treatment and Active Labor Act) implications of the existing observation rule for EPs and offers practical solutions for EPs faced with counseling patients on the meaning and ramifications of the observation rule. We conclude that while we believe it does not violate the intent of the Emergency Medical Treatment and Active Labor Act to respond to patient questions about their admission status, the observation rules challenge the ethical principles of transparency related to the physician-patient relationship and justice as fairness. Guidance for physicians is offered to improve transparency and patient fairness. Copyright © 2016 Elsevier Inc. All rights reserved.

Transcultural nursing. A source guide.

PubMed

Mahon, P Y

1997-01-01

The concept of transcultural nursing is relatively new to the nursing literature. It had been less than 30 years since Madeleine Leininger first began to develop a theory of transcultural nursing as part of a doctoral study in anthropology. Much has changed in that time, and nursing staff development and inservice educators need to provide educational offerings within a multicultural context in a timely manner. Cultural diversity is the standard in the mid-1990s, and those nursing staff development programs that are sensitive to this fact produce employees with advantages over those from settings that do not prepare staff for practice in a constantly changing world. This annotated bibliography about transcultural nursing details key references for staff development and inservice programs. It is not intended as an exhaustive review but rather focuses on the most relevant, timely, and useful of the ever increasing number of publications concerning this important subject. Six major books and four of the most pertinent recent journal articles are included. Conclusions and implications for nursing staff educators are offered.

Defining the paramedic process.

PubMed

Carter, Holly; Thompson, James

2015-01-01

The use of a 'process of care' is well established in several health professions, most evidently within the field of nursing. Now ingrained within methods of care delivery, it offers a logical approach to problem solving and ensures an appropriate delivery of interventions that are specifically suited to the individual patient. Paramedicine is a rapidly advancing profession despite a wide acknowledgement of limited research provisions. This frequently results in the borrowing of evidence from other disciplines. While this has often been useful, there are many concerns relating to the acceptable limit of evidence transcription between professions. To date, there is no formally recognised 'process of care'-defining activity within the pre-hospital arena. With much current focus on the professional classification of paramedic work, it is considered timely to formally define a formula that underpins other professional roles such as nursing. It is hypothesised that defined processes of care, particularly the nursing process, may have features that would readily translate to pre-hospital practice. The literature analysed was obtained through systematic searches of a range of databases, including Ovid MEDLINE, Cumulative Index to Nursing and Allied Health. The results demonstrated that the defined process of care provides nursing with more than just a structure for practice, but also has implications for education, clinical governance and professional standing. The current nursing process does not directly articulate to the complex and often unstructured role of the paramedic; however, it has many principles that offer value to the paramedic in their practice. Expanding the nursing process model to include the stages of Dispatch Considerations, Scene Assessment, First Impressions, Patient History, Physical Examination, Clinical Decision-Making, Interventions, Re-evaluation, Transport Decisions, Handover and Reflection would provide an appropriate model for pre-hospital practices.

Global implications of China's healthcare reform.

PubMed

Yan, Fei; Tang, Shenglan; Zhang, Jian

2016-01-01

The ongoing healthcare reform in China has a powerful spillover effect beyond the health sector and the borders of China. A successful completion of the Chinese reform will offer a new model for social justice development, shift the global economy toward sustainability and create a new hub for science and technology in medical and health science. However, reforming the healthcare system in the most populated country is a daunting task. China will not live up to its promise, and all the potentials may end with hype not hope if coherent national strategies are not constructed and state-of-the-art navigation is not achieved with staggering domestic and global challenges. The cost of failure will be immensely high, socioeconomic costs for Chinese and an opportunity cost for the world as a whole. A full appreciation of the global implications of China's healthcare reform is crucial in keeping China receptive toward good practices evidence-approved elsewhere and open minded to fulfill its international obligations. More critically, the appreciation yields constructive engagements from global community toward a joint development and global prosperity. The current report provides a multiple disciplinary assessment on the global implications of the healthcare reform in China. Copyright © 2014 John Wiley & Sons, Ltd.

Implications for social policy of variability in racial groups.

PubMed

Helms, Janet E

2008-11-01

Social policy and federal and state legislation require the use of single cut scores when tests of cognitive ability, knowledge, or skills (CAKS) are used to make high-stakes assessment decisions, such as whether students or employees may be promoted. Rationales offered for the requirement are that cut scores provide objective standards and are fairer than using subjective criteria, such as racial group membership. It is argued that failure to consider threats to statistical conclusion validity, such as differences in variability between groups, obscures the differential impact of using a common cut score as the basis for highstakes decisions. Analyses of 40 Black and White samples revealed that (a) Whites might be considerably advantaged and Blacks might be considerably disadvantaged by the same cut score and (b) depending on where the cut score is set, decisions based on ratios of numbers of Whites numbers of Blacks might be fairer than use of CAKS test cut scores. Implications for assessment practice and social policy are discussed.

Psychosocial and environmental factors in the prognosis of individuals with chronic pain and comorbid mental health.

PubMed

Hruschak, Valerie; Cochran, Gerald

2017-08-01

Chronic pain has considerable medical, social, and economic implications as its high prevalence rate and negative societal burden provides justification that it is a major health issue. The value of understanding psychological, social, and environmental factors in chronic pain has become widely recognized and accepted as a biopsychosocial phenomenon in which the social work perspective offers a valuable lens. Through the critical application of systems theory and ecological perspective, accompanied with the diathesis stress model, this article examines psychosocial and environmental influences as being contributory factors in the prognosis of individuals with chronic pain and comorbid mental health disorders. The social work profession will also be explored as playing a definite role in addressing elements pertaining to pain management depicted from these theories. Lastly, implications for research, policy, and practice will be reviewed to better understand the association between psychosocial and environmental influences of individuals with chronic pain and comorbid mental health issues.

The Potential Value of the U.N. Convention on the Rights of the Child in Pediatric Bioethics Settings.

PubMed

Silva, Michael Da; Lew, Cheryl D; Lundy, Laura; Lang, Kellie R; Melamed, Irene; Shaul, Randi Zlotnik

2016-01-01

This article provides support for the use of a particular international human rights law document, the U.N. Convention on the Rights of the Child (CRC), in contemporary pediatric bioethics practice without relying on the legally binding force of the document. It first demonstrates that the CRC's core commitments and values substantially overlap with the core commitments and values of mainstream bioethics and with the laws of many domestic jurisdictions where mainstream bioethics are currently practiced. It then explores some implications of this overlap. For instance, the substantial international human rights law scholarship on how to understand these commitments and values can be helpful in suggesting ways to operationalize them in domestic bioethics practice and can offer insightful, internationally generated ethical perspectives that may not have been considered. The article also argues that the CRC can help health-care organizations develop policies consistent with the best interests of children and that the CRC can serve as a common language of values for transnational health-care collaborations. However, as a final case discussion demonstrates, whatever the merits of the CRC, one may face practical difficulties in trying to use it.

Scientific biography, cognitive deficits, and laboratory practice. James McKeen Cattell and early American experimental psychology, 1880-1904.

PubMed

Sokal, Michael M

2010-09-01

Despite widespread interest in individual life histories, few biographies of scientists make use of insights derived from psychology, another discipline that studies people, their thoughts, and their actions. This essay argues that recent theoretical work in psychology and tools developed for clinical psychological practice can help biographical historians of science create and present fuller portraits of their subjects' characters and temperaments and more nuanced analyses of how these traits helped shape their subjects' scientific work. To illustrate this thesis, the essay examines the early career of James McKeen Cattell--an influential late nineteenth- and early twentieth-century experimental psychologist--through a lens offered by psychology and argues that Cattell's actual laboratory practices derived from an "accommodation" to a long-standing "cognitive deficit." These practices in turn enabled Cattell to achieve more precise experimental results than could any of his contemporaries; and their students readily adopted them, along with their behavioral implications. The essay concludes that, in some ways, American psychology's early twentieth-century move toward a behavioral understanding of psychological phenomena can be traced to Cattell's personal cognitive deficit. It closes by reviewing several "remaining general questions" that this thesis suggests.

Risk assessment in mental health care: values and costs.

PubMed

Szmukler, George; Rose, Nikolas

2013-01-01

Risk assessment has assumed increasing salience in mental health care in a number of countries. The frequency of serious violent incidents perpetrated by people with a mental illness is an insufficient explanation. Understandings of mental illness and of the role of those charged with their care (or control) play a key role. "Moral outrage", associated with an implied culpability when certain types of tragedy occur, is very significant. This leads to tensions concerning the role of post-incident inquiries, and contributes to a flawed conception of what such inquiries can offer. At the same time, understanding of probability and prediction is generally very poor, among both professionals and the public. Unrealistic expectations for risk assessment and management in general psychiatric practice carry a variety of significant costs, taking a number forms, to those with a mental illness, to mental health professionals and to services. Especially important are changes in professional practice and accountabilities that are significantly divorced from traditional practice, implications for trust in patient-clinician relationships and the organisations in which mental health professionals work, and practices that often breach the ethical principle of justice (or fairness) and heighten discrimination against people with mental illness. Copyright © 2013 John Wiley & Sons, Ltd.

Emergency management leadership in 2030: Shaping the next generation meta-leader.

PubMed

Cwiak, Carol L; Campbell, Ronald; Cassavechia, Matthew G; Haynes, Chuck; Lloyd, Lanita A; Brockway, Neil; Navarini, George O; Piatt, Byron E; Senger, Mary

The complexities, interdependencies, and ambiguity that face next generation emergency management meta-leaders in an ever-evolving global community heighten the expectation and need for competencies that far exceed those common in practice today and necessitate the ability to move seamlessly through the dimensions of meta-leadership (ie, the person, the situation, and connectivity) while utilizing scientific-based evidence, information, resources, processes, and tools. The objective of this effort was to examine the recently developed next generation emergency management competencies through a meta-leadership lens by juxtaposing the competencies and the meta-leadership model. This resulted in a new framing of the skills and attributes within the meta-leadership model as they are relevant to each competency. Selected trends, drivers, and challenges were used to provide examples within each competency area of the utility of meta-leadership to next generation emergency management practice. This effort also offers training and education implications for next generation emergency management meta-leaders. The examination of the new framing created in this effort is intended to prompt dialog and research within the emergency management practice and academic communities that furthers the practice and study of emergency management.

The effects of a two-step transfer on a visuomotor adaptation task.

PubMed

Aiken, Christopher A; Pan, Zhujun; Van Gemmert, Arend W A

2017-11-01

The literature has shown robust effects of transfer-of-learning to the contralateral side and more recently transfer-of-learning effects to a new effector type on the ipsilateral side. Few studies have investigated the effects of transfer-of-learning when skills transfer to both a new effector type and the contralateral side (two-step transfer). The purpose of the current study was to investigate the effects of two-step transfer and to examine which aspects of the movement transfer and which aspects do not. Individuals practiced a 30° visual rotation task with either the dominant or non-dominant limb and with either the use of the fingers and wrist or elbow and shoulder. Following practice, participants performed the task with the untrained effector type on the contralateral side. Results showed that initial direction error and trajectory length transferred from the dominant to the non-dominant side and movement time transferred from the elbow and shoulder condition to the wrist and finger conditions irrespective of which limb was used during practice. The results offer a unique perspective on the current theoretical and practical implications for transfer-of-learning and are further discussed in this paper.

A qualitative study of discourses on heterosexual anal sexual practice among key, and general populations in Tanzania: implications for HIV prevention.

PubMed

Wamoyi, Joyce; Mongi, Aika; Sally, Mtenga; Kakoko, Deodatus; Shamba, Donat; Geubbels, Eveline; Kapiga, Saidi

2015-04-24

The risk of contracting HIV through heterosexual anal sex (HAS) is significantly higher than from vaginal intercourse. Little has been done to understand the discourses around HAS and terms people use to describe the practice in Tanzania. A better understanding of discourses on HAS would offer useful insights for measurement of the practice as well as designing appropriate interventions to minimise the risks inherent in the practice. This study employed qualitative approaches involving 24 focus group discussions and 81 in-depth interviews. The study was conducted in 4 regions of Tanzania, and included samples from the general population and among key population groups (fishermen, truck drivers, sex workers, food and recreational facilities workers). Discourse analysis was conducted with the aid of NVIVO versions 8 and 10 software. Six discourses were delineated in relation to how people talked about HAS. Secrecy versus openness discourse describes the terms used when talking about HAS. "Other" discourse involved participants' perception of HAS as something practiced by others unrelated to them and outside their communities. Acceptability/trendiness discourse: young women described HAS as something trendy and increasingly gaining acceptability in their communities. Materiality discourse: describes HAS as a practice that was more profitable than vaginal sex. Masculinity discourse involved discussions on men proving their manhood by engaging in HAS especially when women initiated the practice. Masculine attitudes were also reflected in how men described the practice using a language that would be considered crude. Public health discourse: describes HAS as riskier for HIV infection than vaginal sex. The reported use of condoms was low due to the perceptions that condoms were unsuitable for anal sex, but also perceptions among some participants that anal sex was safer than vaginal sex. Discourses among young women and adult men across the study populations were supportive of HAS. These findings provide useful insights in understanding how different population groups talked about HAS and offer a range of terms that interventions and further research on magnitude of HAS could draw on when addressing health risks of HAS among different study populations.

Chlamydia and HIV testing, contraception advice, and free condoms offered in general practice: a qualitative interview study of young adults' perceptions of this initiative.

PubMed

Jones, Leah Ffion; Ricketts, Ellie; Town, Katy; Rugman, Claire; Lecky, Donna; Folkard, Kate; Nardone, Anthony; Hartney, Thomas Nathan; McNulty, Cliodna

2017-07-01

Opportunistic chlamydia screening is actively encouraged in English general practices. Based on recent policy changes, Public Health England piloted 3Cs and HIV in 2013-2014, integrating the offer of chlamydia testing with providing condoms, contraceptive information, and HIV testing (referred to as 3Cs and HIV) according to national guidelines. To determine young adults' opinions of receiving a broader sexual health offer of 3Cs and HIV at their GP practice. Qualitative interviews were conducted in a general practice setting in England between March and June 2013. Thirty interviews were conducted with nine male and 21 female patients aged 16-24 years, immediately before or after a routine practice attendance. Data were transcribed verbatim and analysed using a thematic framework. Participants indicated that the method of testing, timing, and the way the staff member approached the topic were important aspects to patients being offered 3Cs and HIV. Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers. Participants highlighted convenience of the practice, assurance of confidentiality, and that the sexual health discussion was appropriate and routine. Barriers identified for patients were embarrassment, unease, lack of time, religion, and patients believing that certain patients could take offence. Suggested facilitators include raising awareness, reassuring confidentiality, and ensuring the offer is made in a professional and non-judgemental way at the end of the consultation. General practice staff should facilitate patients' preferences by ensuring that 3Cs and HIV testing services are made available at their surgery and offered to appropriate patients in a non-judgemental way. © British Journal of General Practice 2017.

Generation Y and Blood Donation: The Impact of Altruistic Help in a Darwiportunistic Scenario

PubMed Central

Scholz, Christian

2010-01-01

Summary This article focuses on the members of Generation Y and their willingness to offer voluntary (unpaid) blood donations. Using statistics from various sources, a three-stage model is developed to explain blood donation behaviour especially of this generation. It consists of i) developing altruism, ii) raising the willingness to donate blood, and iii) activating actual blood donation behaviour. Members of Generation Y live in a Darwinistic society. They also to some degree act opportunistically, but not in contradiction to altruism. For that reason, the article positions itself in the theoretical framework of Darwi-portunism and derives practical suggestions as well as implications for research. PMID:21048826

"You Must Know Where You Come From": South African Youths' Perceptions of Religion in Time of Social Change.

PubMed

Brittian, Aerika S; Lewin, Nina; Norris, Shane A

2013-11-01

This study examined South African youths' perceptions of religion during a period of social and economic transition. In-depth interviews were conducted with 55 Black South African youth (age 18) living in the Johannesburg-Soweto metropolitan area. Data were analyzed in a manner consistent with grounded theory methodology and structural coding. Beliefs about the function of religion were captured by the following themes: provides support, connection to the past, moral compass, promotes healthy development, and intersections between African traditional practices and Christian beliefs. Themes are discussed and directions for future research are presented. In addition, applications of the current research and implications for promoting youths' resilience are offered.

Suicide by people in a community justice pathway: population-based nested case–control study

PubMed Central

King, Carlene; Senior, Jane; Webb, Roger T.; Millar, Tim; Piper, Mary; Pearsall, Alison; Humber, Naomi; Appleby, Louis; Shaw, Jenny

2015-01-01

The elevated risk of suicide in prison and after release is a well-recognised and serious problem. Despite this, evidence concerning community-based offenders' suicide risk is sparse. We conducted a population-based nested case–control study of all people in a community justice pathway in England and Wales. Our data show 13% of general population suicides were in community justice pathways before death. Suicide risks were highest among individuals receiving police cautions, and those having recent, or impending prosecution for sexual offences. Findings have implications for the training and practice of clinicians identifying and assessing suicidality, and offering support to those at elevated risk. PMID:26159602

The Mediating Role of Perceived Descriptive and Injunctive Norms in the Effects of Media Messages on Youth Smoking.

PubMed

Nan, Xiaoli; Zhao, Xiaoquan

2016-01-01

This research advances and tests a normative mediation model of media effects on youth smoking. The model predicts that exposure to various types of smoking-related media messages, including anti-smoking ads, cigarette ads, and smoking scenes in movies and television shows, exerts indirect effects on youth smoking intentions through the mediation of perceived descriptive and injunctive norms. Analysis of the data from the 3rd Legacy Media Tracking Survey offers general support for the proposed model with some unexpected findings, revealing a complex picture of media influence on youth smoking via normative and non-normative mechanisms. Theoretical and practical implications of the findings are discussed.

Evaluating the effects of a peer-support model: reducing negative body esteem and disordered eating attitudes and behaviours in grade eight girls.

PubMed

Thompson, Carmen; Russell-Mayhew, Shelly; Saraceni, Reana

2012-01-01

During adolescence girls become increasingly preoccupied with unrealistic ideals about body weight, often leading to dieting and unhealthy compensatory behaviours. These practices have been linked to adverse psychological, social, and health consequences. Peer-support groups offer promise in addressing risk factors for disordered eating. This study explored the effects of peer-support on measures of body satisfaction, weight loss/weight gain behaviour, internalization of media ideals, weight based teasing, and communication, for a cohort of grade 8 girls. High-risk participants demonstrated trends toward decreased internalization of media ideals and increased body satisfaction at post-test. Implications and future research direction are discussed.

Relationship quality and relationship context as antecedents of person- and task-focused interpersonal citizenship behavior.

PubMed

Settoon, Randall P; Mossholder, Kevin W

2002-04-01

A model hypothesizing relationship quality and relationship context as antecedents of two complementary forms of interpersonal citizenship behavior (ICB) was tested. Measures with coworkers as the frame of reference were used to collect data from 273 individuals working in 2 service-oriented organizations. As hypothesized, variables reflecting relationship quality were associated with person-focused ICB, as mediated by empathic concern. Also as hypothesized, a relationship context variable, network centrality, exhibited a direct relationship with task-focused ICB. Unexpectedly, network centrality was directly associated with person-focused ICB. and empathic concern was associated with task-focused ICB. The results are discussed, and implications for research and practice are offered.

Conference scene: Latin American Pharmacogenomics and Personalized Medicine Conference.

PubMed

Suarez-Kurtz, Guilherme

2012-10-01

There are nearly 600 million people living in 24 Latin American countries, speaking two major languages (Portuguese and Spanish) and sharing ancestral roots in America, Europe and Africa. Ethnic and cultural diversity, socioeconomical, scientific and technological disparities across Latin America must be taken into account in the design, interpretation and implications of pharmacogenomic studies in this region. The conference covered some of these aspects, but also took on a more global approach on the growing contribution of genomic information and biotechnological tools to the way medicines are developed, regulated and prescribed to patients. Translation of pharmacogenomics into clinical practice was the topic of a keynote lecture and two debate sessions. A preconference Introductory Course of Pharmacogenomics was offered.

Marshalling Social Support: A “Care-Getting” Model for Persons Living with Cancer

PubMed Central

Kahana, Eva; Kahana, Boaz; Wykle, May; Kulle, Diana

2009-01-01

This paper offers a stress theory based conceptual framework for understanding proactive options for care-getting for patients living with cancer that is also relevant to patients living with other chronic or life threatening illnesses. Barriers and facilitators to active efforts for obtaining responsive care from both informal and formal sources are discussed. This “Care-Getting” model explores benefits of proactive care-getting for diminishing physical discomfort/suffering, burden of illness and disability, and psychological distress. We highlight unique issues in care-getting that patients face at different stages of the life course. Implications of prior research related to the model for practice and intervention are discussed. PMID:20107524

The Role of Relational Harmony in the Use of Drug-Refusal Strategies of Rural Native Hawaiian Youths

PubMed Central

Bills, Kaycee; Okamoto, Scott K.; Helm, Susana

2016-01-01

This study examined the role of maintaining relational harmony among family members in the use of drug refusal strategies for rural Hawaiian youth. Youth focus groups were conducted to validate refusal strategies used in realistic, hypothetical drug-related problem situations. The findings suggested gender-specific motivations for maintaining relational harmony among family members when faced with drug offers from them. Specifically, boys described instrumental concerns when using refusal strategies (i.e., not wanting to get into trouble), while girls described holistic relational concerns (i.e., not wanting family members to be upset with each other). Implications for prevention and social work practice are discussed. PMID:28133439

Black Male Mental Health and the Black Church: Advancing a Collaborative Partnership and Research Agenda.

PubMed

Robinson, Michael A; Jones-Eversley, Sharon; Moore, Sharon E; Ravenell, Joseph; Adedoyin, A Christson

2018-06-01

This article explores the role the Black Church could play in facilitating spiritually sensitive, culturally relevant and gender-specific services to address the mental health and well-being of Black males. The help-seeking behaviors of Black men are examined as the authors offer two theories: the body, mind, spirit, environment, social, transcendent, and health, illness, men, and masculinities that may assist the Black Church in functioning as an effective support networks for healthy Black male mental health. Next, the authors discuss implications for practice, research, and education, and lastly, eight recommendations for Black Church leadership, social workers, and mental health professionals are also discussed.

Ways of dealing with science learning: a study based on Swedish early childhood education practice

NASA Astrophysics Data System (ADS)

Gustavsson, Laila; Jonsson, Agneta; Ljung-Djärf, Agneta; Thulin, Susanne

2016-07-01

The Swedish school system offers curriculum-based early childhood education (ECE) organised as preschool (for 0-5-year-olds) and preschool class (for 6-year-olds). The intention to create a playful and educational environment based on children's perspectives, interests, and questions is strongly based on historical and cultural traditions. This article develops knowledge of ECE teachers' approaches to science-learning situations. The study applies a phenomenographic approach. The analysis is based on approximately 9.5 hours of video documentation of teacher-led and child-initiated Swedish ECE science activities. We identified two descriptive categories and four subcategories dealing with science-learning situations: (A) making anything visible, containing the three subcategories (Aa) addressing everyone, (Ab) addressing everything, and (Ac) addressing play and fantasy; and (B) creating a shared space for learning (Ba) addressing common content. These categories are related to how efforts to take advantage of children's perspectives are interpreted and addressed in educational practice. The article discusses and exemplifies the use of various categories and their potential implications for ECE learning practice.

Technology and Quality of Life Outcomes

PubMed Central

Hacker, Eileen Danaher

2010-01-01

Objectives To discuss recent technological advances in quality of life data collection and guidance for use in research and clinical practice. The use of telephone-, computer-, and web/Internet based technologies to collect quality of life data, reliability and validity issues, and cost will be discussed along with the potential pitfalls associated with these technologies. Data Sources Health care literature and web resources. Conclusion Technology has provided researchers and clinicians with an opportunity to collect QOL data from patients that were previously not accessible. Most technologies offer a variety of options, such as language choice, formatting options for the delivery of questions, and data management services. Choosing the appropriate technology for use in research and/or clinical practice primarily depends on the purpose for QOL data collection. Implications for Nursing Practice Technology is changing the way nurses assess quality of life in patients with cancer and provide care. As stakeholders in the health care delivery system and patient advocates, nurses must be intimately involved in the evaluation and use of new technologies that impact quality of life and/or the delivery of care. PMID:20152578

"A touch of physiotherapy" - the significance and meaning of touch in the practice of physiotherapy.

PubMed

Bjorbækmo, Wenche Schrøder; Mengshoel, Anne Marit

2016-01-01

Touch, while ubiquitous and ever present in the practice of physiotherapy, is conspicuously absent from physiotherapy-related research. Based on a theoretical perspective inspired by phenomenology, this article explores and elaborates on the meaning and significance of touch in the practice of physiotherapy. The research data were generated through 16 close observations conducted in primary care clinics, and through interviews with 9 physiotherapists and with 9 patients suffering from chronic neck problems. The findings revealed how the use of touch in the practice of physiotherapy brings people into proximity in ways more complex than simple skin-to-skin contact. Through nontouch, touch, and movements, physiotherapists invite their patients to participate in the process of creating and performing therapy; dialogue through touch and movement is vital. Touch in physiotherapy depends on the physiotherapist's embodied skills; those they cultivate in order to respectfully listen to their patients and guide them to explore their own bodily capacity, limits and possibilities. The findings also suggest that observing therapy from outside and from participating in it offer significant different experiences, information, understanding, and meanings. The differences between physiotherapy as observed expression and as lived experience would seem to have important implications for understanding the practice of physiotherapy.

Education System Reform in China after 1978: Some Practical Implications

ERIC Educational Resources Information Center

Sun, Miantao

2010-01-01

Purpose: This paper aims to provide an overview of education system reform in China since 1978, and its practical implications. Design/methodology/approach: Data were collected from literature review and interview. An overview of education system reform and its practical implications was found through data analysis. Findings: There has been two…

16 CFR 233.4 - Bargain offers based upon the purchase of other merchandise.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bargain offers based upon the purchase of... PRACTICE RULES GUIDES AGAINST DECEPTIVE PRICING § 233.4 Bargain offers based upon the purchase of other... given a customer on the condition that he purchase a particular article at the price usually offered by...

You and your manager: reducing workplace stress by creating and maintaining a good relationship.

PubMed

Hills, Laura Sachs

2007-01-01

The relationship a medical practice employee has with his or her practice manager is probably the most important relationship the employee will have at work. No matter what position an employee has in the medical practice, it's to his or her advantage to get along well with the practice manager. This article offers concrete suggestions to medical practice employees to help them establish and cultivate a positive working relationship with their practice managers. It examines different working styles of practice managers and suggests strategies for medical practice employees who want or need different amounts and styles of supervision. It describes five personal characteristics a practice manager expects in employees and two basic rules of thumb for using the practice manager's time efficiently. This article also emphasizes the importance of good communication with the practice manager and offers 12 practical and specific tips for building the employee-practice manager relationship. Finally, this article offers advice to medical practice employees about what to do when they disagree with their practice managers.

Reproductive implications of psychological distress for couples undergoing IVF.

PubMed

Quant, Hayley S; Zapantis, Athena; Nihsen, Michael; Bevilacqua, Kris; Jindal, Sangita; Pal, Lubna

2013-11-01

To study implications of psychological distress on in vitro fertilization (IVF) outcome of an infertile couple. Prospective study in an academic infertility practice setting. Couples undergoing embryo transfer (ET) following IVF were offered participation. Female patient (n = 89) and partner (n = 77) completed questionnaires reflecting dysphoria (POMS) and pessimism (LOT) after undergoing ET. Relationship between dysphoria and pessimism and implications of individual and couple's psychological distress on IVF cycle parameters and outcomes were assessed using multivariable analyses. Statistically significant correlations between dysphoria and pessimism were observed within the individual and between partners, (p < 0.01). Higher couple pessimism correlated with longer duration of controlled ovarian hyperstimulation (COH, p = 0.02); higher partner psychological distress related to lower fertilization rate (FR, p = 0.03). On adjusted analyses, partner's depression score was an independent predictor of reduced likelihood of clinical pregnancy (p = 0.03). Our data validate the concept of a "stressed couple". Adverse implications of a couple's psychological distress for gamete biology (longer duration of COH and lower FR with increasing distress) are suggested. Partner's depressive scores negatively correlated with IVF success. These findings suggest the importance of including partner's evaluation in studies that focus on effects of psychological stress on IVF outcome; future studies should examine whether interventions aimed at reducing psychological stress for the infertile couple may improve IVF cycle success.

Associations among school characteristics and foodservice practices in a nationally representative sample of United States schools.

PubMed

Thomson, Jessica L; Tussing-Humphreys, Lisa M; Martin, Corby K; LeBlanc, Monique M; Onufrak, Stephen J

2012-01-01

Determine school characteristics associated with healthy/unhealthy food service offerings or healthy food preparation practices. Secondary analysis of cross-sectional data. Nationally representative sample of public and private elementary, middle, and high schools. Data from the 2006 School Health Policies and Practices Study Food Service School Questionnaire, n = 526 for Healthy and Unhealthy Offerings analysis; n = 520 for Healthy Preparation analysis. Scores for healthy/unhealthy foodservice offerings and healthy food preparation practices. Multivariable regression to determine significant associations among school characteristics and offerings/preparation practices. Public schools and schools participating in the United States Department of Agriculture (USDA) Team Nutrition reported more healthy offerings and preparation than private or nonparticipating schools, respectively. Elementary schools reported fewer unhealthy offerings than middle or high schools; middle schools reported fewer unhealthy offerings than high schools. Schools requiring foodservice managers to have a college education reported more healthy preparation, whereas those requiring completion of a foodservice training program reported fewer unhealthy offerings and more healthy preparation than schools without these requirements. Results suggest the school nutrition environment may be improved by requiring foodservice managers to hold a nutrition-related college degree and/or successfully pass a foodservice training program, and by participating in a school-based nutrition program, such as USDA Team Nutrition. Copyright © 2012 Society for Nutrition Education and Behavior. All rights reserved.

The contribution of nurses' perceptions and actions in defining scope and stabilising professional boundaries of nursing practice.

PubMed

Lillibridge, J; Axford, R; Rowley, G

2000-10-01

This paper reports on the findings of a naturalistic inquiry study that explored the scope and boundaries of nursing practice. Findings from interview and observation data suggest that nurses negotiate and adjust professional boundaries on an individual, case-by-case basis, thereby managing the scope of their practice as they see it in that circumstance. The strategies they used are presented in four major categories: 1) maintaining a comfort zone, 2) expanding into safe territory, 3) moving into the grey zone and 4) stepping over the line. Findings show that nurses' efforts to maintain the comfort zone serve to perpetuate the status quo and may threaten holistic care. Expanding nursing actions to include functional roles such as coordinating care, sharing information, advocating (for patients), collaborating and innovating offers the profession critical building blocks for defining the scope of nursing practice. Clarifying the grey zone (or overlapping territory) is an essential task for the profession in determining the boundaries of nursing practice. The data revealed that, partly due to the ambiguity of the grey zone, nurses may step over the line into medical decision-making and outside the legal sanctions for the professional nursing role. The implications of this study highlight the need for nursing to define its scope of practice and in so doing stabilise professional boundaries.

SUBSTANCE USE SCREENING AND INTERVENTIONS IN DENTAL CLINICS: SURVEY OF PRACTICE-BASED RESEARCH NETWORK DENTISTS ON CURRENT PRACTICES, POLICIES, AND BARRIERS

PubMed Central

Wright, Shana; Matthews, Abigail G.; Rotrosen, John; Shelley, Donna; Buchholz, Matthew P.; Curro, Frederick A.

2013-01-01

Background Dental visits represent an opportunity to identify and assist patients with substance use, but little is known about how dentists are addressing tobacco, alcohol and illicit drugs. We surveyed dentists to learn about the role their practices might play in providing substance use screening and interventions. Methods A 41-item, web-based survey was distributed to all 210 dentists active in the PEARL dental practice-based research network. The questionnaire assessed clinic policies and current practices, attitudes, and perceived barriers to providing services for tobacco, alcohol, and illicit drug use. Results 143 dentists completed the survey (68% response rate). While screening was common, fewer were providing follow-up counseling or referrals for substance use. Insufficient knowledge/training was the most frequently cited barrier to intervention. Many dentists said they would offer assistance for tobacco (67%) or alcohol or illicit drugs (52%) if reimbursed; an affirmative response was more likely among those who saw publicly insured patients. Conclusions Dentists recognize the importance of screening for substance use, but lack clinical training and systems that could facilitate intervention. Practice Implications If barriers were reduced through changes in reimbursement, education, and systems-level support, our findings indicate that dentists may be willing to address substance use, including use of alcohol and illicit drugs as well as tobacco. PMID:23729460

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed Central

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-01

Objective The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Design Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Setting Compensable injury management in general practice in Melbourne, Australia. Participants 25 GPs who were treating, or had treated a patient with compensable injury. Results The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. Conclusions In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. PMID:26792215

A perspective on medical school admission research and practice over the last 25 years.

PubMed

Kreiter, Clarence D; Axelson, Rick D

2013-01-01

Over the last 25 years a large body of research has investigated how best to select applicants to study medicine. Although these studies have inspired little actual change in admission practice, the implications of this research are substantial. Five areas of inquiry are discussed: (1) the interview and related techniques, (2) admission tests, (3) other measures of personal competencies, (4) the decision process, and (5) defining and measuring the criterion. In each of these areas we summarize consequential developments and discuss their implication for improving practice. (1) The traditional interview has been shown to lack both reliability and validity. Alternatives have been developed that display promising measurement characteristics. (2) Admission test scores have been shown to predict academic and clinical performance and are generally the most useful measures obtained about an applicant. (3) Due to the high-stakes nature of the admission decision, it is difficult to support a logical validity argument for the use of personality tests. Although standardized letters of recommendation appear to offer some promise, more research is needed. (4) The methods used to make the selection decision should be responsive to validity research on how best to utilize applicant information. (5) Few resources have been invested in obtaining valid criterion measures. Future research might profitably focus on composite score as a method for generating a measure of a physician's career success. There are a number of social and organization factors that resist evidence-based change. However, research over the last 25 years does present important findings that could be used to improve the admission process.

Representations of disability and normality in rehabilitation technology promotional materials.

PubMed

Phelan, Shanon K; Wright, Virginia; Gibson, Barbara E

2014-01-01

To explore the ways in which promotional materials for two rehabilitation technologies reproduce commonly held perspectives about disability and rehabilitation. Our analysis was informed by critical disability studies using techniques from discourse analysis to examine texts (words and images) and their relation to social practices and power. Using this approach, promotional materials for (a) hearing aid and (b) robotic gait training technologies were interrogated using three central questions: (1) Who are represented? (2) What is promised? and (3) Who has authority? Messages of normalization pervaded representations of disabled children and their families, and the promises offered by the technologies. The latter included efficiency and effectiveness, progress and improvement, success and inclusion, and opportunities for a normal life. Normalization discourses construct childhood disability through texts and images. These discourses reinforce pervasive negative messages about disability that are taken up by children and families and have ethical implications for clinical practice. Rehabilitation has largely focused on "fixing" the individual, whereas broadening the clinical gaze to the social dimensions of disablement may lead to a more sensitive and informed approach within family-clinician discussions surrounding these advanced technologies and the use they make of promotional materials. Implications for Rehabilitation Awareness of the potential effects of implicit and explicit messages about disability in promotional materials may lead to a more sensitive and informed approach within family-clinician discussions surrounding rehabilitation technologies. In practice, it is important for rehabilitation professionals to remember that parents' and children's values and beliefs are shaped over time, and parents' and professionals' perspectives on disability strongly influence how disabled children internalize what disability means to them.

The cardio-respiratory effects of intra-abdominal hypertension: Considerations for critical care nursing practice.

PubMed

Christensen, Martin; Craft, Judy

2018-02-01

Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondary intra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation. Recent work suggests that intensive care unit nurses are often unaware of the secondary effects of intra-abdominal pressure and therefore this is not monitored effectively. Therefore being aware of the cardio-respiratory effects may alert theintensive care nurse nurse to the development of intra-abdominal hypertension. The aim of this paper is to discuss the pathophysiology associated with the cardio-respiratory effects seen with intra-abdominal hypertension in the critically ill. In particular it will discuss how intra-abdominal hypertension can inadvertently be overlooked because of the low flow states that it produces which could be misconstrued as something else. It will also discuss how intra-abdominal hypertension impedes ventilation and respiratory mechanics which can often result in a non-cardiogenic pulmonary oedema. To close, the paper will offer some implications for critical care nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Beyond a politics of recrimination: Scandal, ethics and the rehabilitation of violence

PubMed Central

Johnson, Jamie M.

2016-01-01

The practice of contemporary warfare seems to be plagued by scandal. It is often assumed that the act of bearing witness to these moments of ethical failure, in which the relationship between the martial and the ethical breaks down, plays an important role in holding powerful actors to account for their conduct. Considerable faith has been placed in the role of transparency and truth-telling as foundations for normative engagements with war. This article argues that we must be cautious about this investment. Drawing on the work of Jean Baudrillard, this article offers a method for critically reading scandals as a series of line-drawing manoeuvres. Taken together, these manoeuvres demonstrate how scandals function to enable, excuse and obscure the complex landscapes of violence that define the spectacular and mundane sites of contemporary war. Reducing critical engagements with violent practices to a logic of recrimination, scandals often function to revitalise the very principles they appear to contest. Focusing upon the socio-political implications of wartime scandals, this article demonstrates that the performative force of scandals is therefore the reproduction of a violent status quo rather than opening up new spaces for imagining less violent futures. Offering a critical reading of controversies relating to the provision of humanitarian assistance and education in Afghanistan, this article reflects on the ambiguities and anxieties of critiquing violence. PMID:29278252

Trading secrets: Jews and the early modern quest for clandestine knowledge.

PubMed

Jütte, Daniel

2012-12-01

This essay explores the significance and function of secrecy and secret sciences in Jewish-Christian relations and in Jewish culture in the early modern period. It shows how the trade in clandestine knowledge and the practice of secret sciences became a complex, sometimes hazardous space for contact between Jews and Christians. By examining this trade, the essay clarifies the role of secrecy in the early modern marketplace of knowledge. The attribution of secretiveness to Jews was a widespread topos in early modern European thought. However, relatively little is known about the implications of such beliefs in science or in daily life. The essay pays special attention to the fact that trade in secret knowledge frequently offered Jews a path to the center of power, especially at court. Furthermore, it becomes clear that the practice of secret sciences, the trade in clandestine knowledge, and a mercantile agenda were often inextricably interwoven. Special attention is paid to the Italian-Jewish alchemist, engineer, and entrepreneur Abramo Colorni (ca. 1544-1599), whose career illustrates the opportunities provided by the marketplace of secrets at that time. Much scholarly (and less scholarly) attention has been devoted to whether and what Jews "contributed" to what is commonly called the "Scientific Revolution." This essay argues that the question is misdirected and that, instead, we should pay more attention to the distinctive opportunities offered by the early modern economy of secrecy.

Transference, counter-transference and repetition: some implications for nursing practice.

PubMed

Jones, Alun C

2005-11-01

This discussion paper offers an introductory text for nurses and explores the psychoanalytic ideas of transference, counter-transference and repetition compulsion. Disguised case vignettes provide illustrations of the ideas as they might apply to nursing, including professional practice and occupational choice. The literature suggests that transference can be a source of creativity as well as destructiveness and influence important communications with oneself and others including the choice of nursing and other health professions as an occupation. Recognizing possibilities of transference, counter-transference along with repetitive patterns of behaviours, can help nurses of all specialities to address situations constructively by responding thoughtfully and appropriately. This discussion concludes with the suggestions that we know little about the motivational factors underlying nursing as an occupational preference; moreover, nursing does not have a culture of personal therapy. As such nurses are denied opportunities to understand the possible reasons underlying their occupational choice or gain experiential knowledge of interpersonal dynamics occurring between patients and colleagues. Transference and counter-transference are thought to have some bearing on all relationships. Forming a natural part of the way human beings relate to each other, transference and counter-transference can bring about sincere human interest, caring and concern. However, there is also potential for disagreements. Recognizing the possible origins of relational difficulties can offer opportunities for professional development to nurses along with the benefits for health service users.

48 CFR 13.104 - Promoting competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... cost of the purchase. (a) The contracting officer must not— (1) Solicit quotations based on personal... practicable competition ordinarily can be obtained by soliciting quotations or offers from sources within the... the maximum extent practicable. Whenever practicable, request quotations or offers from two sources...

Women at Midlife: Implications for Theories of Women's Adult Development.

ERIC Educational Resources Information Center

Lippert, Laurel

1997-01-01

Discusses research on midlife transitions in women and its implications for theories of women's adult development. Presents findings on menopause, the postparental period, and the roles of women at midlife. Offers several theoretical approaches in light of research findings and makes recommendations for future research. Suggests implications for…

Bridge to the future: nontraditional clinical settings, concepts and issues.

PubMed

Faller, H S; Dowell, M A; Jackson, M A

1995-11-01

Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.

The social implications of using drones for biodiversity conservation.

PubMed

Sandbrook, Chris

2015-11-01

Unmanned aerial vehicles, or 'drones', appear to offer a flexible, accurate and affordable solution to some of the technical challenges of nature conservation monitoring and law enforcement. However, little attention has been given to their possible social impacts. In this paper, I review the possible social impacts of using drones for conservation, including on safety, privacy, psychological wellbeing, data security and the wider understanding of conservation problems. I argue that negative social impacts are probable under some circumstances and should be of concern for conservation for two reasons: (1) because conservation should follow good ethical practice; and (2) because negative social impacts could undermine conservation effectiveness in the long term. The paper concludes with a call for empirical research to establish whether the identified social risks of drones occur in reality and how they could be mitigated, and for self-regulation of drone use by the conservation sector to ensure good ethical practice and minimise the risk of unintended consequences.

Primary School Teachers’ Assessment Profiles in Mathematics Education

PubMed Central

Veldhuis, Michiel; van den Heuvel-Panhuizen, Marja

2014-01-01

The aim of this study was to contribute to knowledge about classroom assessment by identifying profiles of teachers’ assessment of their students’ understanding of mathematics. For carrying out this study we used data of a nationwide teacher survey (N = 960) in the Netherlands. The data were collected by an online questionnaire. Through exploratory factor analyses the underlying structure of what is measured by this questionnaire was uncovered as consisting of five factors: Goal centeredness of assessment, Authentic nature of assessment, Perceived usefulness of assessment, Diversity of assessment problem format, and Allocated importance of assessing skills and knowledge. By using a latent class analysis four different assessment profiles of teachers were identified: Enthusiastic assessors, Mainstream assessors, Non-enthusiastic assessors, and Alternative assessors. The findings suggest that teachers with particular assessment profiles have qualitatively different assessment practices. The paper concludes with discussing theoretical implications of these assessment profiles and indications these profiles can offer both for designing material for professional development in classroom assessment and for evaluating changes in teachers’ classroom assessment practice. PMID:24466255

Inter-personal violence and abuse in adolescent intimate relationships: mental health impact and implications for practice.

PubMed

Barter, Christine; Stanley, Nicky

2016-10-01

This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.

Maximizing competence through professional development: increasing disability knowledge among One-Stop Career Center staff.

PubMed

Hall, Allison Cohen; Timmons, Jaimie Ciulla; Boeltzig, Heike; Hamner, Doris; Fesko, Sheila

2006-01-01

The Workforce Investment Act of 1998 (USA) mandates that partners in the One-Stop Career Center system be prepared to serve a diverse customer base. Effective service delivery depends in part on a focus on human resources and professional development. This article presents innovative strategies for One-Stop Career Center staff training related to serving customers with disabilities. Findings from case study research conducted in several One-Stops across the country revealed that staff struggled with both knowledge and attitudes around disability issues. To address these concerns, local leaders developed practices that provided opportunities to gain practical skills and put acquired knowledge to use. These included a formalized curriculum focused on disability issues; informal support and consultation from a disability specialist; and exposure and learning through internships for students with disabilities. Implications are offered to stimulate thinking and creativity in local One-Stops regarding the most effective ways to facilitate staff learning and, in turn, improve services for customers with disabilities.

Predicting Child Physical Activity and Screen Time: Parental Support for Physical Activity and General Parenting Styles

PubMed Central

Crain, A. Lauren; Senso, Meghan M.; Levy, Rona L.; Sherwood, Nancy E.

2014-01-01

Objective: To examine relationships between parenting styles and practices and child moderate-to-vigorous physical activity (MVPA) and screen time. Methods: Participants were children (6.9 ± 1.8 years) with a body mass index in the 70–95th percentile and their parents (421 dyads). Parent-completed questionnaires assessed parental support for child physical activity (PA), parenting styles and child screen time. Children wore accelerometers to assess MVPA. Results: Parenting style did not predict MVPA, but support for PA did (positive association). The association between support and MVPA, moreover, varied as a function of permissive parenting. For parents high in permissiveness, the association was positive (greater support was related to greater MVPA and therefore protective). For parents low in permissiveness, the association was neutral; support did not matter. Authoritarian and permissive parenting styles were both associated with greater screen time. Conclusions: Parenting practices and styles should be considered jointly, offering implications for tailored interventions. PMID:24812256

The Effect of Social and Classroom Ecological Factors on Promoting Self-Determination in Elementary School

PubMed Central

Cho, Hyunjeong; Wehmeyer, Michael; Kingston, Neil

2014-01-01

Promoting the self-determination of students with disabilities as a means to access the general curriculum has been the subject of research in recent years, as has the importance of efforts to promote self-determination during elementary years. To examine the status of such efforts in the field, 203 elementary special educators were surveyed in 23 states to determine how (a) classroom instructional practices or strategies, (b) classroom ecological or setting variables, and (c) self-reported barriers to promoting self-determination affected their perceptions of the importance of teaching self-determination and the frequency with which they did so. Results indicated that special educators’ perceived importance of teaching self-determination was not impacted by classroom instructional factors, but was affected by classroom ecological factors. Classroom ecological factors were not, however, significant in the frequency with which teachers provided instruction on self-determination, but classroom instructional practices were. Limitations and implications are discussed, and suggestions for future research are offered. PMID:25067895

[Latest international guidelines for screening, prevention and treatment of familial breast cancer - implications for the relevant practice in Hungary].

PubMed

Romics, László; Kocsis, Judit; Ormándi, Katalin; Molnár, Béla Ákos

2016-07-01

Screening, prevention and treatment of familial breast cancer require a multidisciplinary approach. New guidelines were published in the United Kingdom for the management of familial breast cancer. The authors summarise these new guidelines and analyse the relevant practice in Hungary. Relevant guidelines of the National Institute for Health and Care Excellence and Familial Breast Cancer Report (NHS Scotland) are described. New guidelines will increase the number of genetic tests as well as genetic counselling. An increase in the number of breast magnetic resonance imaging is expected, too. Chemoprevention can be offered for individuals with medium risk and above. Promising trials are underway with platinum based chemotherapy and polyADP-ribose polimerase inhibitors for the systemic treatment of familial breast cancer. The increase in the number of genetic tests, counselling, and breast magnetic resonance imaging may have a significant impact on health care budget. These guidelines will change some aspects of the current management of familial breast cancer. Orv. Hetil., 2016, 157(28), 1117-1125.

Can a workbook work? Examining whether a practitioner evaluation toolkit can promote instrumental use.

PubMed

Campbell, Rebecca; Townsend, Stephanie M; Shaw, Jessica; Karim, Nidal; Markowitz, Jenifer

2015-10-01

In large-scale, multi-site contexts, developing and disseminating practitioner-oriented evaluation toolkits are an increasingly common strategy for building evaluation capacity. Toolkits explain the evaluation process, present evaluation design choices, and offer step-by-step guidance to practitioners. To date, there has been limited research on whether such resources truly foster the successful design, implementation, and use of evaluation findings. In this paper, we describe a multi-site project in which we developed a practitioner evaluation toolkit and then studied the extent to which the toolkit and accompanying technical assistance was effective in promoting successful completion of local-level evaluations and fostering instrumental use of the findings (i.e., whether programs directly used their findings to improve practice, see Patton, 2008). Forensic nurse practitioners from six geographically dispersed service programs completed methodologically rigorous evaluations; furthermore, all six programs used the findings to create programmatic and community-level changes to improve local practice. Implications for evaluation capacity building are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Primary school teachers' assessment profiles in mathematics education.

PubMed

Veldhuis, Michiel; van den Heuvel-Panhuizen, Marja

2014-01-01

The aim of this study was to contribute to knowledge about classroom assessment by identifying profiles of teachers' assessment of their students' understanding of mathematics. For carrying out this study we used data of a nationwide teacher survey (N = 960) in the Netherlands. The data were collected by an online questionnaire. Through exploratory factor analyses the underlying structure of what is measured by this questionnaire was uncovered as consisting of five factors: Goal centeredness of assessment, Authentic nature of assessment, Perceived usefulness of assessment, Diversity of assessment problem format, and Allocated importance of assessing skills and knowledge. By using a latent class analysis four different assessment profiles of teachers were identified: Enthusiastic assessors, Mainstream assessors, Non-enthusiastic assessors, and Alternative assessors. The findings suggest that teachers with particular assessment profiles have qualitatively different assessment practices. The paper concludes with discussing theoretical implications of these assessment profiles and indications these profiles can offer both for designing material for professional development in classroom assessment and for evaluating changes in teachers' classroom assessment practice.

[Friend or Foe in the Pocket? - The Role of the Individual, Peergroup and Parents for (dys)functional Mobile Phone Use].

PubMed

Knop, Karin; Hefner, Dorothée

2018-02-01

Friend or Foe in the Pocket? - The Role of the Individual, Peergroup and Parents for (dys)functional Mobile Phone Use In order to provide consultative support to parents as well as to children and young people, background knowledge regarding the motives of mobile phone use, functions of usage, comprehension of the attraction of this all-round medium also as knowledge about potential hazards are essential. This study offers empirical results about potentials and risks. The peergroup plays an important role for riskful and problematic mobile phone involvement. Parents function as a role model and the explicit parental mediation practices and their impact on the child are in focus. Data was acquired from a quota-sample survey with 500 children between the age of 8 and 14 years and one of their parents, qualitative interviews (20 children and their parents) and eight peergroup-discussions (52 participants). The present paper illuminates the above mentioned aspects and derives implications for guidance practice.

A note on digital dental radiography in forensic odontology.

PubMed

Chiam, Sher-Lin

2014-09-01

Digital dental radiography, intraoral and extraoral, is becoming more popular in dental practice. It offers convenience, such as lower exposure to radiation, ease of storing of images, and elimination of chemical processing. However, it also has disadvantages and drawbacks. One of these is the potential for confusion of the orientation of the image. This paper outlines one example of this, namely, the lateral inversion of the image. This source of confusion is partly inherent in the older model of phosphor storage plates (PSPs), as they allow both sides to be exposed without clue to the fact that the image is acquired on the wrong side. The native software allows digital manipulation of the X-ray image, permitting both rotation and inversion. Attempts to orientate the X-ray according to the indicator incorporated on the plate can then sometimes lead to inadvertent lateral inversion of the image. This article discusses the implications of such mistakes in dental digital radiography to forensic odontology and general dental practice.

Current issues of personnel and laboratory practices in genetic testing

PubMed Central

Mark, Hon Fong Louie; Kelly, Thaddeus; Watson, Michael S; Hoeltge, Gerald; Miller, Wayne A; Beauregard, Laurent

1995-01-01

As genetic testing is an area with implications extending far beyond that of the primary patient, it is appropriately an area that is under increased scrutiny. To ensure that high quality is maintained in the delivery of genetic services, several agencies have developed standards and guidelines. The present article summarises important recommendations made by the American College of Medical Genetics (ACMG), the College of American Pathologists (CAP), the US Health Care Financing Administration (HCFA), and the US Food and Drug Administration (FDA) as they relate to genetic testing. Some of the standards are based on voluntary compliance, whereas others have the force of regulation. They all address issues of personnel credentials, laboratory operations, and the most critical quality assurance and control measures for diagnostic laboratories from the perspective of various agencies. In most instances, the standards promulgated by these agencies are offered as minimum criteria. The exact impact of these regulations on the practice of medical genetics has yet to be established. Images PMID:8558555

Gendered Perceptions of Drugs, Aggression, and Violence

PubMed Central

Helm, Susana; Okamoto, Scott K.

2016-01-01

Objective Drug use has been linked empirically with aggression and violence among youth in national and State of Hawai‘i samples. In addition, aggression and violence appear to be gendered experiences perceived differently by girls and boys. This paper explores the intersection of drug offers/drug refusals with aggression and violence with specific attention paid to gendered perceptions of drug use situations as a context for aggression and violence. Methods A qualitative study, in which fourteen sex-specific focus group discussions were held, focused on rural Native Hawaiian middle school students (N=64). Students were asked to discuss drug refusal strategies in a variety of drug offer contexts. Feminist theories and approaches were used to examine the role of aggression and violence in drug refusal as perceived by Native Hawaiian girls as compared to boys. Results Girls and boys differed in their perceptions of aggression and violence in drug offer situations, initially as evidenced by the extent to which the girls groups focused on the intersection of drugs and violence. Further, qualitative analyses reflected gender norms and stereotypes about aggression and violence perpetration, and girls' apparently unique concerns about sexual violence victimization. Conclusions Implications are discussed in terms of prevention research and practice, specifically in terms of school-based prevention curricula. PMID:27456534

How participation in surgical mortality audit impacts surgical practice.

PubMed

Lui, Chi-Wai; Boyle, Frances M; Wysocki, Arkadiusz Peter; Baker, Peter; D'Souza, Alisha; Faint, Sonya; Rey-Conde, Therese; North, John B

2017-04-19

Surgical mortality audit is an important tool for quality assurance and professional development but little is known about the impact of such activity on professional practice at the individual surgeon level. This paper reports the findings of a survey conducted with a self-selected cohort of surgeons in Queensland, Australia, on their experience of participating in the audit and its impact on their professional practice, as well as implications for hospital systems. The study used a descriptive cross-sectional survey design. All surgeons registered in Queensland in 2015 (n = 919) were invited to complete an anonymous online questionnaire between September and October 2015. 184 surgeons completed and returned the questionnaire at a response rate of 20%. Thirty-nine percent of the participants reported that involvement in the audit process affected their clinical practice. This was particularly the case for surgeons whose participation included being an assessor. Thirteen percent of the participants had perceived improvement to hospital practices or advancement in patient care and safety as a result of audit recommendations. Analysis of the open-ended responses suggested the audit experience had led surgeons to become more cautious, reflective in action and with increased confidence in best practice, and recognise the importance of effective communication and clear documentation. This is the first study to examine the impact of participation in a mortality audit process on the professional practice of surgeons. The findings offer evidence for surgical mortality audit as an effective strategy for continuous professional development and for improving patient safety initiatives.

Practice guidelines for program evaluation in community-based rehabilitation.

PubMed

Grandisson, Marie; Hébert, Michèle; Thibeault, Rachel

2017-06-01

This paper proposes practice guidelines to evaluate community-based rehabilitation (CBR) programs. These were developed through a rigorous three-phase research process including a literature review on good practices in CBR program evaluation, a field study during which a South Africa CBR program was evaluated, and a Delphi study to generate consensus among a highly credible panel of CBR experts from a wide range of backgrounds and geographical areas. The 10 guidelines developed are summarized into a practice model highlighting key features of sound CBR program evaluation. They strongly indicate that sound CBR evaluations are those that give a voice and as much control as possible to the most affected groups, embrace the challenge of diversity, and foster use of evaluation processes and findings through a rigorous, collaborative and empowering approach. The practice guidelines should facilitate CBR evaluation decisions in respect to facilitating an evaluation process, using frameworks and designing methods. Implications for rehabilitation Ten practice guidelines provide guidance to facilitate sound community-based rehabilitation (CBR) program evaluation decisions. Key indications of good practice include: • being as participatory and empowering as possible; • ensuring that all, including the most affected, have a real opportunity to share their thoughts; • highly considering mixed methods and participatory tools; • adapting to fit evaluation context, local culture and language(s); • defining evaluation questions and reporting findings using shared CBR language when possible, which the framework offered may facilitate.

Exercise thallium-201 perfusion scintigraphy in the assessment of coronary artery disease

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

Mahmarian, J.J.; Verani, M.S.

1991-05-21

Exercise thallium-201 perfusion scintigraphy has been used extensively over the last decade for the detection and localization of coronary artery disease. Single-photon emission computed tomography (SPECT) is a refinement of presently available techniques, offering improved identification over planar imaging of individual vessel stenosis and quantification of the extent of abnormally perfused myocardium. In this review, the planar and SPECT techniques are discussed in light of the most recently published large patient series, and with regard to the many factors that affect the sensitivity and specificity of perfusion imaging in identifying coronary artery disease. The clinical implications of exercise perfusion scintigraphymore » and its future applications in cardiology practice are discussed.67 references.« less

Commentary: ambiguity and uncertainty: neglected elements of medical education curricula?

PubMed

Luther, Vera P; Crandall, Sonia J

2011-07-01

Despite significant advances in scientific knowledge and technology, ambiguity and uncertainty are still intrinsic aspects of contemporary medicine. To practice confidently and competently, a physician must learn rational approaches to complex and ambiguous clinical scenarios and must possess a certain degree of tolerance of ambiguity. In this commentary, the authors discuss the role that ambiguity and uncertainty play in medicine and emphasize why openly addressing these topics in the formal medical education curriculum is critical. They discuss key points from original research by Wayne and colleagues and their implications for medical education. Finally, the authors offer recommendations for increasing medical student tolerance of ambiguity and uncertainty, including dedicating time to attend candidly to ambiguity and uncertainty as a formal part of every medical school curriculum.

Human trafficking law and social structures.

PubMed

Wooditch, Alese

2012-08-01

Human trafficking has only recently emerged at the forefront of policy reform, even in developed nations. Yet, heightened awareness of the issue has not translated into effective policy as the majority of nations have ineffective antitrafficking practices; many countries have failed to criminalize human trafficking, whereas others do not actively enforce statutes in place. By applying Black's theory of law, this study offers a preliminary understanding into the variation of global prosecutorial efforts in human trafficking and adequacy of antitrafficking law. To isolate this relationship, the effects of trafficking markets are controlled. As with prior research, the study finds limited support for the theory. The article concludes with a discussion on the implications of the quantity of antitrafficking law and morphology association for policy development.

Perceived message sensation value and psychological reactance: a test of the dominant thought disruption hypothesis.

PubMed

Quick, Brian L

2013-01-01

The present study tests to see whether perceived message sensation value reduces psychological reactance within the context of anti-marijuana ads for television. After controlling for sensation seeking, biological sex, and marijuana use, the results indicate that message novelty is negatively associated with a freedom threat, whereas dramatic impact and emotional arousal were not associated with the antecedent to reactance. Results support the use of novel messages in future ads while at the same time offer an explanation to the challenges involved in creating effective anti-marijuana ads. Overall, the results provide partial support for the dominant thought disruption hypothesis and are discussed with an emphasis on the theoretical and practical implications for health communication researchers and practitioners.

Social effects of an anthropomorphic help agent: humans versus computers.

PubMed

David, Prabu; Lu, Tingting; Kline, Susan; Cai, Li

2007-06-01

The purpose of this study was to examine perceptions of fairness of a computer-administered quiz as a function of the anthropomorphic features of the help agent offered within the quiz environment. The addition of simple anthropomorphic cues to a computer help agent reduced the perceived friendliness of the agent, perceived intelligence of the agent, and the perceived fairness of the quiz. These differences were observed only for male anthropomorphic cues, but not for female anthropomorphic cues. The results were not explained by the social attraction of the anthropomorphic agents used in the quiz or by gender identification with the agents. Priming of visual cues provides the best account of the data. Practical implications of the study are discussed.

Interaction of core self-evaluations and perceived organizational support on work-to-family enrichment.

PubMed

McNall, Laurel A; Masuda, Aline D; Shanock, Linda Rhoades; Nicklin, Jessica M

2011-01-01

The purpose of this article was to offer an empirical test of J. H. Greenhaus and G. N. Powell's (2006) model of work-family enrichment by examining dispositional (i.e., core self-evaluations; CSEs) and situational (i.e., perceived organizational support; POS) factors associated with work-to-family enrichment (WFE) and whether these variables interact in predicting WFE. In a survey of 220 employed adults, our hierarchical regression analysis revealed that in highly supportive work environments, individuals reported high WFE regardless of CSE. However, when POS was low, individuals high in CSEs reported higher WFE than those low in CSEs, in support of conservation of resources theory (S. E. Hobfoll, 2002). Implications for research and practice are discussed.

The use of electronic games in therapy: a review with clinical implications.

PubMed

Horne-Moyer, H Lynn; Moyer, Brian H; Messer, Drew C; Messer, Elizabeth S

2014-12-01

Therapists and patients enjoy and benefit from interventions that use electronic games (EG) in health care and mental health settings, with a variety of diagnoses and therapeutic goals. We reviewed the use of electronic games designed specifically for a therapeutic purpose, electronic games for psychotherapy (EGP), also called serious games, and commercially produced games used as an adjunct to psychotherapy, electronic games for entertainment (EGE). Recent research on the benefits of EG in rehabilitation settings, EGP, and EGE indicates that electronic methods are often equivalent to more traditional treatments and may be more enjoyable or acceptable, at least to some consumers. Methodological concerns include the lack of randomized controlled trials (RCT) for many applications. Suggestions are offered for using EG in therapeutic practice.

Guidelines on product liability for the hospital blood bank. The British Committee for Standards in Haematology.

PubMed

1990-01-01

This report aims to clarify the position of the hospital blood bank in the light of product liability legislation contained in the Consumer Protection Act of 1987. Blood has been defined a 'product' under this Act. The potential for the blood bank to be seen in the role of 'supplier', 'keeper' or even 'producer' in the chain of product supply to the patient is explained and advice given on the resulting implications for blood bank practice. It will be necessary to define, adopt and implement standard operating procedures (SOP) for all blood bank activities. Guidance is given on the format, preparation and content of SOPs and specimen examples offered. The fundamental importance of quality assurance is emphasized.

“You Must Know Where You Come From”: South African Youths' Perceptions of Religion in Time of Social Change

PubMed Central

Brittian, Aerika S.; Lewin, Nina; Norris, Shane A.

2014-01-01

This study examined South African youths' perceptions of religion during a period of social and economic transition. In-depth interviews were conducted with 55 Black South African youth (age 18) living in the Johannesburg-Soweto metropolitan area. Data were analyzed in a manner consistent with grounded theory methodology and structural coding. Beliefs about the function of religion were captured by the following themes: provides support, connection to the past, moral compass, promotes healthy development, and intersections between African traditional practices and Christian beliefs. Themes are discussed and directions for future research are presented. In addition, applications of the current research and implications for promoting youths' resilience are offered. PMID:24932064

Moral awareness and ethical predispositions: investigating the role of individual differences in the recognition of moral issues.

PubMed

Reynolds, Scott J

2006-01-01

The impact of the role of individual ethical predispositions, preferences for utilitarian and formalistic ideals, on managerial moral awareness was examined in 2 studies. Results suggested that a manager's ethical predispositions influence his or her responses to the characteristics of the moral issue. Both utilitarianism and formalism shaped moral awareness, but formalism demonstrated a greater capacity to do so in that formalists recognized both harm and the violation of a behavioral norm as indicators of the moral issue, whereas utilitarians responded only to harm. These findings provide support for the basic arguments underlying theories of moral development and offer several implications for the study and practice of moral awareness in organizations. (c) 2006 APA, all rights reserved.

Arguing to learn in science: the role of collaborative, critical discourse.

PubMed

Osborne, Jonathan

2010-04-23

Argument and debate are common in science, yet they are virtually absent from science education. Recent research shows, however, that opportunities for students to engage in collaborative discourse and argumentation offer a means of enhancing student conceptual understanding and students' skills and capabilities with scientific reasoning. As one of the hallmarks of the scientist is critical, rational skepticism, the lack of opportunities to develop the ability to reason and argue scientifically would appear to be a significant weakness in contemporary educational practice. In short, knowing what is wrong matters as much as knowing what is right. This paper presents a summary of the main features of this body of research and discusses its implications for the teaching and learning of science.

Care delivery for Filipino Americans using the Neuman systems model.

PubMed

Angosta, Alona D; Ceria-Ulep, Clementina D; Tse, Alice M

2014-04-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States.

Was Mackenbach right? Towards a practical political science of redistribution and health inequalities.

PubMed

Schrecker, Ted

2017-07-01

In 2010, Mackenbach reflected on England's lack of success in reducing health inequalities between 1997 and 2010, asserting that "it is difficult to imagine a longer window of opportunity for tackling health inequalities"; asking "[i]f this did not work, what will?"; and concluding that reducing health inequalities was not politically feasible at least in that jurisdiction. Exploring the empirics of that observation offers a window into the politics of reducing health inequalities. For purposes of future comparative research, I outline three (not mutually exclusive) perspectives on political feasibility, identify their implications for a political science of health inequalities, and explore what they mean for advocacy in support of reducing those inequalities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Determining the status of non-transferred embryos in Ireland: a conspectus of case law and implications for clinical IVF practice

PubMed Central

Sills, Eric Scott; Murphy, Sarah Ellen

2009-01-01

The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-transferred) embryos derived from IVF brings challenges both for clinical practice and public health policy because there is no judicial or legislative framework in place to address the medical, scientific, or ethical uncertainties. Complex legal issues exist regarding informed consent and ownership of embryos, particularly the use of non-transferred embryos if a couple separates or divorces. But since case law is only beginning to emerge from outside Ireland and because legislation on IVF and human embryo status is entirely absent here, this matter is poised to raise contractual, constitutional and property law issues at the highest level. Our analysis examines this medico-legal challenge in an Irish context, and summarises key decisions on this issue rendered from other jurisdictions. The contractual issues raised by the Roche case regarding informed consent and the implications the initial judgment may have for future disputes over embryos are also discussed. Our research also considers a putative Constitutional 'right to procreate' and the implications EU law may have for an Irish case concerning the fate of frozen embryos. Since current Medical Council guidelines are insufficient to ensure appropriate regulation of the advanced reproductive technologies in Ireland, the report of the Commission on Assisted Human Reproduction is most likely to influence embryo custody disputes. Public policy requires the establishment and implementation of a more comprehensive legislative framework within which assisted reproductive medical services are offered. PMID:19589140

Workforce Diversity: Implications for Business Educators.

ERIC Educational Resources Information Center

Ball, Stacy L.

1997-01-01

Responses from 112 human resource managers in Chicago indicated that 42% offer diversity programs because it is an ethical approach to management; they offer only a few of the programs available and identified in the literature. Organizations whose major purpose is recruiting and developing a diverse work force offered more programs and a wider…

The significance of sensory appeal for reduced meat consumption.

PubMed

Tucker, Corrina A

2014-10-01

Reducing meat (over-)consumption as a way to help address environmental deterioration will require a range of strategies, and any such strategies will benefit from understanding how individuals might respond to various meat consumption practices. To investigate how New Zealanders perceive such a range of practices, in this instance in vitro meat, eating nose-to-tail, entomophagy and reducing meat consumption, focus groups involving a total of 69 participants were held around the country. While it is the damaging environmental implications of intensive farming practices and the projected continuation of increasing global consumer demand for meat products that has propelled this research, when asked to consider variations on the conventional meat-centric diet common to many New Zealanders, it was the sensory appeal of the areas considered that was deemed most problematic. While an ecological rationale for considering these 'meat' alternatives was recognised and considered important by most, transforming this value into action looks far less promising given the recurrent sensory objections to consuming different protein-based foods or of reducing meat consumption. This article considers the responses of focus group participants in relation to each of the dietary practices outlined, and offers suggestions on ways to encourage a more environmentally viable diet. Copyright © 2014 Elsevier Ltd. All rights reserved.

Breast-feeding policies and routines among Arizona hospitals and nursery staff: results and implications of a descriptive study.

PubMed

Strembel, S; Sass, S; Cole, G; Hartner, J; Fischer, C

1991-08-01

In 1988, Arizona's 61 hospitals providing obstetrical services were canvased with regard to hospital routines that favor either breast-feeding or bottle-feeding. Forty-five hospitals provided responses that were used in the survey. Practices favoring breast-feeding, which were reported by a majority of the hospitals (more than 50%), were demand feeding, staff assessment for "latch-on" (the action of nipple presentation and sucking initiation) and positioning, "rooming-in" (the practice of minimal mother-infant separation), and information about follow-up support services. Hospital practices suggested to promote bottle-feeding were the provision of pacifiers and supplemental water or glucose, issuance of formula packs at discharge, and a first feed of sterile water. A positive significant relationship was identified for policies advocating breast-feeding and the prevalence of breast-feeding encouragement from professional staff. Of 44 respondents, 41 indicated that their hospital's policies endorse breast-feeding as the ideal method of feeding healthy newborns. Hospital staff perceived that they encourage mothers to breast-feed and offer support to those who initiate breast-feeding. On the basis of this information, we conclude that dietetics practitioners should evaluate current breast-feeding practices and integrate policies supportive of breast-feeding into the health care system.

Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices.

PubMed

Lyons, Anthony; Heywood, Wendy; Fileborn, Bianca; Minichiello, Victor; Barrett, Catherine; Brown, Graham; Hinchliff, Sharron; Malta, Sue; Crameri, Pauline

2017-06-01

Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older people's knowledge of STIs and safer sexual practices. A total of 2,137 Australians aged 60 years and older completed the survey, which included 15 questions assessing knowledge of STIs and safer sexual practices. We examined both levels of knowledge and factors associated with an overall knowledge score. In total, 1,652 respondents reported having sex in the past five years and answered all knowledge questions. This group had good general knowledge but poorer knowledge in areas such as the protection offered by condoms and potential transmission modes for specific STIs. Women had better knowledge than men. Men in their 60s, men with higher education levels, and men who thought they were at risk of STIs reported better knowledge than other men. Knowledge was also better among men and women who had been tested for STIs or reported 'other' sources of knowledge on STIs. Many older Australians lack knowledge of STIs and safer sexual practices. Implications for public health: To reverse current trends toward increasing STI diagnoses in this population, policies and education campaigns aimed at improving knowledge levels may need to be considered. © 2017 The Authors.

A transposon and transposase system for human application.

PubMed

Hackett, Perry B; Largaespada, David A; Cooper, Laurence J N

2010-04-01

The stable introduction of therapeutic transgenes into human cells can be accomplished using viral and nonviral approaches. Transduction with clinical-grade recombinant viruses offers the potential of efficient gene transfer into primary cells and has a record of therapeutic successes. However, widespread application for gene therapy using viruses can be limited by their initially high cost of manufacture at a limited number of production facilities as well as a propensity for nonrandom patterns of integration. The ex vivo application of transposon-mediated gene transfer now offers an alternative to the use of viral vectors. Clinical-grade DNA plasmids can be prepared at much reduced cost and with lower immunogenicity, and the integration efficiency can be improved by the transient coexpression of a hyperactive transposase. This has facilitated the design of human trials using the Sleeping Beauty (SB) transposon system to introduce a chimeric antigen receptor (CAR) to redirect the specificity of human T cells. This review examines the rationale and safety implications of application of the SB system to genetically modify T cells to be manufactured in compliance with current good manufacturing practice (cGMP) for phase I/II trials.

Rents From the Essential Health Benefits Mandate of Health Insurance Reform.

PubMed

Mendoza, Roger Lee

2015-01-01

The essential health benefits mandate constitutes one of the most controversial health care reforms introduced under the U.S. Affordable Care Act of 2010. It bears important theoretical and practical implications for health care risk and insurance management. These essential health benefits are examined in this study from a rent-seeking perspective, particularly in terms of three interrelated questions: Is there an economic rationale for standardized, minimum health care coverage? How is the scope of essential health services and treatments determined? What are the attendant and incidental costs and benefits of such determination/s? Rents offer ample incentives to business interests to expend considerable resources for health care marketing, particularly when policy processes are open to contestation. Welfare losses inevitably arise from these incentives. We rely on five case studies to illustrate why and how rents are created, assigned, extracted, and dissipated in equilibrium. We also demonstrate why rents depend on persuasive marketing and the bargained decisions of regulators and rentiers, as conditioned by the Tullock paradox. Insights on the intertwining issues of consumer choice, health care marketing, and insurance reform are offered by way of conclusion.

Conducting research in clinical psychology practice: Barriers, facilitators, and recommendations.

PubMed

Smith, Kirsten V; Thew, Graham R

2017-09-01

The combination of clinical psychologists' therapeutic expertise and research training means that they are in an ideal position to be conducting high-quality research projects. However, despite these skills and the documented benefits of research to services and service users, research activity in practice remains low. This article aims to give an overview of the advantages of, and difficulties in conducting research in clinical practice. We reviewed the relevant literature on barriers to research and reflected on our clinical and research experiences in a range of contexts to offer practical recommendations. We considered factors involved in the planning, sourcing support, implementation, and dissemination phases of research, and outline suggestions to improve the feasibility of research projects in post-qualification roles. We suggest that research leadership is particularly important within clinical psychology to ensure the profession's continued visibility and influence within health settings. Clinical implications Emerging evidence suggests that clinical settings that foster research are associated with better patient outcomes. Suggestions to increase the feasibility of research projects in clinical settings are detailed. Limitations The present recommendations are drawn from the authors' practical experience and may need adaptation to individual practitioners' settings. This study does not attempt to assess the efficacy of the strategies suggested. © 2017 The Authors. British Journal of Clinical Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Challenges in the development and reimbursement of personalized medicine-payer and manufacturer perspectives and implications for health economics and outcomes research: a report of the ISPOR personalized medicine special interest group.

PubMed

Faulkner, Eric; Annemans, Lieven; Garrison, Lou; Helfand, Mark; Holtorf, Anke-Peggy; Hornberger, John; Hughes, Dyfrig; Li, Tracy; Malone, Daniel; Payne, Katherine; Siebert, Uwe; Towse, Adrian; Veenstra, David; Watkins, John

2012-12-01

Personalized medicine technologies can improve individual health by delivering the right dose of the right drug to the right patient at the right time but create challenges in deciding which technologies offer sufficient value to justify widespread diffusion. Personalized medicine technologies, however, do not neatly fit into existing health technology assessment and reimbursement processes. In this article, the Personalized Medicine Special Interest Group of the International Society for Pharmacoeconomics and Outcomes Research evaluated key development and reimbursement considerations from the payer and manufacturer perspectives. Five key areas in which health economics and outcomes research best practices could be developed to improve value assessment, reimbursement, and patient access decisions for personalized medicine have been identified. These areas are as follows: 1 research prioritization and early value assessment, 2 best practices for clinical evidence development, 3 best practices for health economic assessment, 4 addressing health technology assessment challenges, and 5 new incentive and reimbursement approaches for personalized medicine. Key gaps in health economics and outcomes research best practices, decision standards, and value assessment processes are also discussed, along with next steps for evolving health economics and outcomes research practices in personalized medicine. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Occupational health and safety management practices and musculoskeletal disorders in aged care.

PubMed

Oakman, Jodi; Bartram, Timothy

2017-05-15

Purpose The purpose of this paper is to examine whether occupational health and safety (OHS) management used to manage musculoskeletal disorders (MSDs) in the aged care sector reflects contemporary research evidence of best practice to reduce the incidence of these disorders. Design/methodology/approach In total, 58 interviews were conducted with managers and supervisors in the aged care sector across four organisations in Australia. Policies and procedures relating to MSDs were reviewed for each organisation. Findings Policies and procedures for managing MSDs do not reflect contemporary evidence, which supports a complex aetiology, related to a range of physical and psychosocial workplace factors. Despite strong evidence that psychosocial factors contribute to MSD development, these were not included in the policies and procedures reviewed. Findings from the interviews management practices including leadership and various components of HRM were functioning well but fragmentation was evident due to the challenging nature of the aged care sector. Practical implications To address the significant burden of MSDs in the aged care sector, policies and procedures need to include coverage of psychosocial and physical workplace factors. The development of systematic and integrated OHS management at the workplace level may play an important role in the effective management of MSDs. Originality/value This study offers insights into the previously unexplored area of MSD risk management and the role of management practices such as HRM in the aged care sector.

Integrative intervention: a new perspective and brief review in aphasia.

PubMed

Marshall, Rebecca Shisler; Mohapatra, Bijoyaa

2017-09-01

While integrative treatment practices have become a popular treatment in different areas of study, its use in the field of aphasiology is still limited. The following paper is an attempt to address the different alternative practices that could potentially be used to remediate aphasia. A narrative review was completed regarding integrative intervention that could potentially apply to aphasia population. Through this article we have explored various treatment options for integrative health care in aphasiology. Integrative treatments including brain specific antioxidants, progesterone and estradiol therapy, nutrition, synbiotic treatment, exercise, yoga, meditation and positive mood states have demonstrated positive changes in health and behavior in healthy aging or disorders such as stroke and aphasia. Offering integrative treatment for people with aphasia allows potential for high impact gains when combined with current speech language therapeutic practices. This paper highlights the rehabilitation possibilities for aphasia therapy. Combining complementary and traditional treatment approaches could be viewed as one of the contemporary approaches to clinical practice and research for practitioners and health care systems. Implications for Rehabilitation There has been very little research that explores the potential of various types of integrative treatment for individuals with aphasia. An integrative approach to the treatment of aphasia has potential for future clinical application. Combining treatment approaches could be viewed as a viable approach to clinical practice and in the health care system.

Exploring leadership in the context of dentistry in the UK.

PubMed

Willcocks, Stephen George

2016-05-03

Purpose The purpose of this paper is to explore selective leadership approaches in the context of dentistry in the UK. Design/methodology/approach This is a conceptual paper utilising published sources from relevant literature about leadership theory and practice and the policy background to dentistry in the UK. Findings This paper suggests that there is merit in identifying and applying an eclectic mix of leadership theory to the case of dentistry. It offers insight into individual aspects of the leadership role for dentists and applies this to the dental context. It also contrasts these individual approaches with shared leadership and suggests this may also be relevant to dentistry. It highlights the fact that leadership will be of growing concern for dentistry in the light of recent policy changes. Research limitations/implications This paper points out that there are developmental implications depending on the particular approach taken. It argues that leadership development will become increasingly important in dentistry in the UK. Originality/value This paper addresses a topic that has so far received limited attention in the literature.

The Hydrologic Implications Of Unique Urban Soil Horizon Sequencing On The Functions Of Passive Green Infrastructure

NASA Astrophysics Data System (ADS)

Shuster, W.; Schifman, L. A.; Herrmann, D.

2017-12-01

Green infrastructure represents a broad set of site- to landscape-scale practices that can be flexibly implemented to increase sewershed retention capacity, and can thereby improve on the management of water quantity and quality. Although much green infrastructure presents as formal engineered designs, urbanized landscapes with highly-interspersed pervious surfaces (e.g., right-of-way, parks, lawns, vacant land) may offer ecosystem services as passive, infiltrative green infrastructure. Yet, infiltration and drainage processes are regulated by soil surface conditions, and then the layering of subsoil horizons, respectively. Drawing on a unique urban soil taxonomic and hydrologic dataset collected in 12 cities (each city representing a major soil order), we determined how urbanization processes altered the sequence of soil horizons (compared to pre-urbanized reference soil pedons) and modeled the hydrologic implications of these shifts in layering with an unsaturated zone code (HYDRUS2D). We found that the different layering sequences in urbanized soils render different types and extents of supporting (plant-available soil water), provisioning (productive vegetation), and regulating (runoff mitigation) ecosystem services.

Beyond the individual victim: multilevel consequences of abusive supervision in teams.

PubMed

Farh, Crystal I C; Chen, Zhijun

2014-11-01

We conceptualize a multilevel framework that examines the manifestation of abusive supervision in team settings and its implications for the team and individual members. Drawing on Hackman's (1992) typology of ambient and discretionary team stimuli, our model features team-level abusive supervision (the average level of abuse reported by team members) and individual-level abusive supervision as simultaneous and interacting forces. We further draw on team-relevant theories of social influence to delineate two proximal outcomes of abuse-members' organization-based self-esteem (OBSE) at the individual level and relationship conflict at the team level-that channel the independent and interactive effects of individual- and team-level abuse onto team members' voice, team-role performance, and turnover intentions. Results from a field study and a scenario study provided support for these multilevel pathways. We conclude that abusive supervision in team settings holds toxic consequences for the team and individual, and offer practical implications as well as suggestions for future research on abusive supervision as a multilevel phenomenon. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Interpersonal relatedness and self-definition in normal and disrupted personality development: retrospect and prospect.

PubMed

Luyten, Patrick; Blatt, Sidney J

2013-04-01

Two-polarities models of personality propose that personality development evolves through a dialectic synergistic interaction between two fundamental developmental psychological processes across the life span-the development of interpersonal relatedness on the one hand and of self-definition on the other. This article offers a broad review of extant research concerning these models, discusses their implications for psychology and psychiatry, and addresses future research perspectives deriving from these models. We first consider the implications of findings in this area for clinical research and practice. This is followed by a discussion of emerging research findings concerning the role of developmental, cross-cultural, evolutionary, and neurobiological factors influencing the development of these two fundamental personality dimensions. Taken together, this body of research suggests that theoretical formulations that focus on interpersonal relatedness and self-definition as central coordinates in personality development and psychopathology provide a comprehensive conceptual paradigm for future research in psychology and psychiatry exploring the interactions among neurobiological, psychological, and sociocultural factors in adaptive and disrupted personality development across the life span.

Micro-pigmentation: implications for patients and professionals.

PubMed

Collingridge, Kim; Calcluth, Julie

In the UK, reconstructive breast surgery is routinely offered to patients undergoing surgery for breast cancer. The results can be excellent, but without a nipple-areola complex the patient can feel incomplete. In response to patient need, an innovative nurse-led micro-pigmentation service has been developed in the authors' NHS trust, which provides women (and men) an opportunity to complete their reconstruction process. With the use of coloured pigments, micro-pigmentation creates a permanent image of a nipple-areola complex, which improves the aesthetic appearance of the surgically-created breast. As with the development of any new nurse-led innovation, the micro-pigmentation service has professional and client implications. Breast cancer can be devastating and may induce many psychological concerns, not least about body image and sexuality. This article addresses these issues, along with professional matters, such as autonomous practice, role expansion and the blurring of clinical boundaries. These factors are considered in relation to the nursing management of the micro-pigmentation service, where patient autonomy is encouraged to promote acceptance of self-image and closure on the breast cancer experience.

Confronting Therapeutic Failure: A Conversation Guide

PubMed Central

2015-01-01

We reflect on the impact of bad news on both clinician and patient in the setting of cancer treatment failure. We review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. The goal of such a conversation guide is to describe both the process and the tasks that constitute vital steps for clinicians and to comment on the emotional impact of the conversation on the clinician. Confronting therapeutic failure is the hardest task for oncologists. We offer practical tips derived from a thorough review of the evidence and our clinical experience. Implications for Practice: Discussing the failure of anticancer therapy remains a very difficult conversation for oncologists and their patients. In this article, the process of confronting this failure is broken down into various components, and practical tips are provided for clinicians following a classic protocol for breaking bad news. Also addressed are the emotions of the oncologist and the reasons why these conversations are typically so hard. These insights are based on solid research intended to deepen the therapeutic connection between physician and patient. PMID:26099747

Connecting the Space between Design and Research: Explorations in Participatory Research Supervision

ERIC Educational Resources Information Center

Caldwell, Glenda Amayo; Osborne, Lindy; Mewburn, Inger; Nottingham, Anitra

2016-01-01

In this article we offer a single case study using an action research method for gathering and analysing data offering insights valuable to both design and research supervision practice. We do not attempt to generalise from this single case, but offer it as an instance that can improve our understanding of research supervision practice. We…

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.

PubMed

Basu, Sanjay; Phillips, Russell S; Song, Zirui; Landon, Bruce E; Bitton, Asaf

2016-09-01

We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. We estimated practices' changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (-$53,500, 95% CI, -$69,700 to -$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. © 2016 Annals of Family Medicine, Inc.

Challenges of being a scholarly clinician as perceived by stroke rehabilitation professionals.

PubMed

Fillion, Barbara; Rochette, Annie; Girard, Anik

2014-01-01

Stroke rehabilitation clinicians are responsible for offering quality services through evidence-based practices. How is this role fulfilled on a daily basis? (1) To explore the perceptions, experiences, and attitudes of rehabilitation professionals regarding their scholar role; (2) To identify factors that facilitate or hinder this role in their practices. Qualitative design of a phenomenological orientation. Face-to-face interviews conducted with professionals with at least 1 year experience in stroke rehabilitation using a pre-tested interview guide. Transcripts were coded using QDA-Miner software. Mean age of the participants was 40.7 years ± 11.2. Participants were mostly women (n = 9/11). The role of scholar emerged as not having great value. Main themes (5) emerging from the analysis are emphasis on tacit knowledge; experience and clinical intuition leading to self-confidence and comfort in clinical practice; dissatisfaction with the lack of knowledge sharing among clinicians; importance of diversifying clinical tasks; and the underdevelopment of reflective practice. Four factors identified as influencing the role of scholar: motivation, critical incident as a main trigger of reflective practice, interns facilitating reflective practice, and lack of time. From these results emerged questions about measures to encourage the scholar role and facilitate reflective practice in stroke rehabilitation. Implications for Rehabilitation Reflective practice has to be encouraged in professional rehabilitation of stroke. Managers' involvement is crucial to promote and support the role of scholar among professionals in stroke rehabilitation. The updated knowledge and networking from reading scientific paper, participation in trainings and conferences should be systematically disseminated.

The decision to adopt evidence-based and other innovative mental health practices: risky business?

PubMed

Panzano, Phyllis C; Roth, Dee

2006-08-01

A risk-based decision-making framework was used to examine the decision to adopt innovative mental health practices, including both evidence-based and other research-guided practices. Seventy-eight projects involving decisions to adopt one of four innovative mental health practices were the focus of this study. Key informants with direct knowledge about the adoption decision provided data for hypothesis testing. As predicted, the propensity to adopt an innovative practice-as measured by decision stage-was negatively related to the perceived risk of adopting the practice, positively related to expected capacity to manage risk, and positively related to an organization's past propensity to take risks. Further, perceived risk, anticipated resource availability, and exposure to field-based evidence explained a substantial part of what differentiated adopters from nonadopters. Finally, several features of innovations known to influence innovation adoption decisions were found to be related in expected ways to perceived risk, capacity to manage risk, and risk propensity. This research supports the view that the decision to adopt an innovative mental health practice is a decision made in consideration of risk. Contrary to popular views that early adopters of innovations are willing to take enormous risks, these data offer the novel idea that early adopters act because they see the risks associated with adopting as lower than their nonadopter counterparts, partly because the risks are seen as more manageable. Implications of results are discussed for organizations considering adoption of innovative health care practices and for state or local mental health authorities hoping for a higher level of adoption in their areas.

Workplace Democracy: A Review of Literature and Implications for Human Resource Development

ERIC Educational Resources Information Center

Hatcher, Tim

2007-01-01

A review of workplace democracy revealed that both practice and research need updating. The results are discussed in terms of history, theory, research and practice. Implications for human resource development research and practice are also included. (Contains 2 tables.)

Introversion and medical student education: challenges for both students and educators.

PubMed

Davidson, Bernard; Gillies, Ralph A; Pelletier, Allen L

2015-01-01

Introversion is one of the personality factors that has been shown to be associated with performance in medical school. Prior cross-sectional studies highlight performance evaluation differences between introverted and extraverted medical students, though the mechanisms and implications of these differences remain relatively unexplained and understudied. This gap in the literature has become more salient as medical schools are employing more interactive learning strategies into their curricula which may disproportionately challenge introverted learners. In this article, we provide an overview and working definition of introversion as a valid construct occurring on a continuum. We apply a goodness of fit model to explore how various medical training contexts may be more or less challenging for introverted students and the potential consequences of a poor fit. As preliminary support for these hypothesized challenges, we share observations from students self-identified as introverts. Examples include introverted students feeling at times like misfits, questioning a need to change their identity to succeed in medical school, and being judged as underperformers. We offer pragmatic suggestions for improving the fit between introverted students and their training contexts, such as teachers and students pausing between a question being asked and the initial response being offered and teachers differentiating between anxious and introverted behaviors. We conclude with suggested areas for future qualitative and quantitative research to examine how medical school curricula and the teaching environment may be differentially impacting the learning and health of introverted and extraverted students. Extraverted behaviors will continue to be an important part of medical training and practice, but the merits of introverted behaviors warrant further consideration as both medical training and practice evolve. Educators who make manageable adjustments to current teaching practices can improve the learning for both introverted and extraverted styles of academic engagement.

Mental Health Mobile Apps: From Infusion to Diffusion in the Mental Health Social System.

PubMed

East, Marlene Lynette; Havard, Byron C

2015-01-01

The roles of mental health educators and professionals in the diffusion of mental health mobile apps are addressed in this viewpoint article. Mental health mobile apps are emerging technologies that fit under the broad heading of mobile health (mHealth). mHealth, encompassed within electronic health (eHealth), reflects the use of mobile devices for the practice of public health. Well-designed mental health mobile apps that present content in interactive, engaging, and stimulating ways can promote cognitive learning, personal growth, and mental health enhancement. As key influencers in the mental health social system, counselor educators and professional associations may either help or hinder diffusion of beneficial mHealth technologies. As mental health mobile apps move towards ubiquity, research will continue to be conducted. The studies published thus far, combined with the potential of mental health mobile apps for learning and personal growth, offer enough evidence to compel mental health professionals to infuse these technologies into education and practice. Counselor educators and professional associations must use their influential leadership roles to train students and practitioners in how to research, evaluate, and integrate mental health mobile apps into practice. The objectives of this article are to (1) increase awareness of mHealth and mental health mobile apps, (2) demonstrate the potential for continued growth in mental health mobile apps based on technology use and acceptance theory, mHealth organizational initiatives, and evidence about how humans learn, (3) discuss evidence-based benefits of mental health mobile apps, (4) examine the current state of mHealth diffusion in the mental health profession, and (5) offer solutions for impelling innovation diffusion by infusing mental health mobile apps into education, training, and clinical settings. This discussion has implications for counselor educators, mental health practitioners, associations, continuing education providers, and app developers.

Lessons learned from the Apple stores.

PubMed

Pinkney, Henry; Baum, Neil

2012-01-01

Medical practices have an opportunity to improve the services that they offer their patients. Practices can look at other businesses and industries for examples of outstanding customer service. This article will discuss the services provided by Apple, Inc., and how medical practices can learn from this industry giant and improve the services that they offer patients.

Factors influencing how senior nurses and midwives acquire and integrate coaching skills into routine practice: a grounded theory study.

PubMed

Rafferty, Rae; Fairbrother, Greg

2015-06-01

To introduce a theory which describes the process of and explicates the factors moderating, the acquisition and integration of leadership coaching skills into the routine practice of senior nurses and midwives. Organizations invest significant resources in leadership coaching programs to ensure that coaching is embedded as a core function of the manager's role. However, even after training, many managers remain unable to undertake this role successfully. The process by which health professionals translate 'manager as coach' training into successful practice outcomes, has remained largely unexplored. A grounded theory study design. Data, collected between February 2012-May 2013, included in-depth interviews with 20 senior nurses and midwives who had attended a leadership coaching program and analysis of nine reflective practice journals. Multiple researchers coded and analysed the data using constant comparative techniques. The outcomes of coaching training ranged from inappropriate use of the coaching skills through to transformed managerial practice. These outcomes were influenced by the dynamic interaction of three central domains of the emergent theoretical model: pre-existing individual perceptions, program elements and contemporaneous experiences. Interactions occurred within the domains and between them, impacting on activators such as courage, motivation, commitment and confidence. The study offers new insights into how senior nurses and midwives acquire and integrate coaching skills into their routine practice. The process is described as multifactorial and dynamic and has implications for the training design, delivery and organizational support of future leadership coaching programs. © 2015 John Wiley & Sons Ltd.

The intraprofessional and interprofessional relations of neurorehabilitation nurses: a negotiated order perspective.

PubMed

Miller, Karen-Lee; Kontos, Pia C

2013-08-01

To report a study of the negotiation practices of neurorehabilitation nurses with one another and with allied health professionals to understand nursing relations. Negotiated order theory offers a promising theoretical lens with which to explore negotiation between nurses and other professionals. This study is the first to apply the perspective to nurse-nurse and nurse-allied health professional relations. The study is a secondary analysis of findings from a multi-site arts-based intervention to improve patient-centred neurorehabilitation practice. Interviews and ethnographic observations were conducted (2008-2011) in two neurorehabilitation units in Ontario, Canada. Participants (n = 31) included registered and practical nurses, nurse leaders, and allied health professionals from physical, occupational, and recreational therapy, speech language pathology, and social work. Neurorehabilitation nursing is characterized by heavy workload, high patient acuity, and poor interprofessional collaboration. This practice context was negotiated by nurses through two strategies: (1) intraprofessional collegialism, accomplished through tactics including task and knowledge sharing, emotional support, coercive threats, and suppression of dissension; and (2) vying for an autonomous essential nursing role in interprofessional practice, accomplished by claiming unique nursing knowledge based on 24/7 nursing proximity, the expansion of the division of professional labour with allied health professionals and modifying physical therapy care plans. The intraprofessional context and negotiations therein were linked in significant ways to interprofessional negotiations. Understanding this complexity has important implications for improving patient safety and interprofessional practice interventions. © 2012 Blackwell Publishing Ltd.

Customer Service: Implications for Reference Practice.

ERIC Educational Resources Information Center

Whitlatch, Jo Bell

1995-01-01

The past decade has seen an increasing emphasis on customer service in business research and management. Two concepts in understanding business customer service practices are discussed: the service encounter and total quality management. Highlights include customer service research and practices in business; implications for library reference…

Effective ingredients of verbal de-escalation: validating an English modified version of the 'De-Escalating Aggressive Behaviour Scale'.

PubMed

Mavandadi, V; Bieling, P J; Madsen, V

2016-08-01

WHAT IS KNOWN ON THE SUBJECT?: Verbal de-escalation is an intervention aimed at calmly managing an agitated client to prevent violence. Effective de-escalation can help reduce the use of seclusion and restraint in psychiatric settings. Despite its importance in practice, there is little agreement on the necessary techniques of de-escalation and most of the research on the topic is based on expert opinion. To our knowledge, only one attempt at quantifying de-escalation skill has been pursued through the German-language De-Escalating Aggressive Behaviour Scale (DABS). While the DABS identified seven qualities necessary for de-escalation, it has not been validated in English and may lack important descriptors. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The present study enhanced the original DABS with best, acceptable and least desirable staff de-escalation practice descriptions for each of the seven items. This enhancement of the DABS lead to the creation of the English modified DABS (EMDABS). The EMDABS was psychometrically validated for use in research and practice: raters could use the EMDABS with a high level of agreement and consistency. Also, the scale appeared to measure a single cohesive construct - de-escalation. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With further validation, the EMDABS has potential to be the first English quantitative measure of de-escalation. The EMDABS offers seven items, with associated best practice descriptions, that may be used to inform de-escalation practice. The EMDABS can be used to evaluate training and education programmes and inform how these programmes and independent de-escalation practice may be improved. Introduction Verbal de-escalation is crucial to a non-coercive psychiatric environment. Despite its importance, the literature on de-escalation is sparse and mostly qualitative. To address this, Nau et al. (2009) quantified de-escalation by creating the German-language De-Escalating Aggressive Behaviour Scale (DABS). The DABS provides seven skills necessary for de-escalation, however it has not been validated in English and lacks the necessary anchor descriptions to make it useful. Aim To modify the DABS to include descriptions of best, acceptable and least desirable staff practice and to validate the English modified DABS (EMDABS). Method To develop item descriptions for the EMDABS, 50 conflictual staff-patient interactions were reviewed, summarized and cross-referenced with the literature (n = 19). Three raters then used the EMDABS to evaluate 272 simulations depicting these interactions. Results The EMDABS demonstrated very good inter-rater reliability [ICC (3, 1) = 0.752] and strong internal consistency (α = 0.901). A factor analysis revealed that the seven items were best represented by a single factor. Discussion The EMDABS was validated for future use in research and practice. Additional validation and future research directions are discussed. Implications for practice The EMDABS holds promise as a quantitative measure of de-escalation. Its seven items and best practice guidelines have clinical implications for improving practice and training. © 2016 John Wiley & Sons Ltd.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-20

The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Compensable injury management in general practice in Melbourne, Australia. 25 GPs who were treating, or had treated a patient with compensable injury. The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Voice recognition software for clinical use.

PubMed

Korn, K

1998-11-01

The current generation voice recognition products truly offer the promise of voice recognition systems, that are financially and operationally acceptable for use in a health care facility. Although the initial capital outlay for the purchase of such equipment may be substantial, the long-term benefit is felt to outweigh the expense. The ability to utilize computer equipment for educational purposes and information management alone helps to rationalize the cost. In addition, it is important to remember that the Internet has become a substantial source of information which provides another functional use for this equipment. Although one can readily see the implication for such a program in clinical practice, other uses for the program should not be overlooked. Uses far beyond the writing of clinic notes and correspondence can be easily envisioned. Utilization of voice recognition software offers clinical practices the ability to produce quality printed records in a timely and cost-effective manner. After learning procedures for the selected product and appropriately formatting word processing software and printers, printed progress notes should be able to be produced in less time than traditional dictation and transcription methods. Although certain procedures and practices may need to be altered, or may preclude optimal utilization of this type of system, many advantages are apparent. It is recommended that facilities consider utilization of Voice Recognition products such as Dragon Systems Naturally Speaking Software, or at least consider a trial of this method with one of the limited-feature products, if current dictation practices are unsatisfactory or excessively costly. Free downloadable trial software or single user software can provide a reduced-cost method for trial evaluation of such products if a major commitment is not felt to be desired. A list of voice recognition software manufacturer web sites may be accessed through the following: http://www.dragonsys.com/ http://www.software.ibm/com/is/voicetype/ http://www.lhs.com/

Learning to teach science for social justice in urban schools

NASA Astrophysics Data System (ADS)

Vora, Purvi

This study looks at how beginner teachers learn to teach science for social justice in urban schools. The research questions are: (1) what views do beginner teachers hold about teaching science for social justice in urban schools? (2) How do beginner teachers' views about teaching science for social justice develop as part of their learning? In looking at teacher learning, I take a situative perspective that defines learning as increased participation in a community of practice. I use the case study methodology with five teacher participants as the individual units of analysis. In measuring participation, I draw from mathematics education literature that offers three domains of professional practice: Content, pedagogy and professional identity. In addition, I focus on agency as an important component of increased participation from a social justice perspective. My findings reveal two main tensions that arose as teachers considered what it meant to teach science from a social justice perspective: (1) Culturally responsive teaching vs. "real" science and (2) Teaching science as a political act. In negotiating these tensions, teachers drew on a variety of pedagogical and conceptual tools offered in USE that focused on issues of equity, access, place-based pedagogy, student agency, ownership and culture as a toolkit. Further, in looking at how the five participants negotiated these tensions in practice, I describe four variables that either afforded or constrained teacher agency and consequently the development of their own identity and role as socially just educators. These four variables are: (1) Accessing and activating social, human and cultural capital, (2) reconceptualizing culturally responsive pedagogical tools, (3) views of urban youth and (4) context of participation. This study has implications for understanding the dialectical relationship between agency and social justice identity for beginner teachers who are learning how to teach for social justice. Also, it suggests teacher agency as an important domain of professional practice when measuring teacher learning from a situative perspective.

Centering Pregnancy: practical tips for your practice.

PubMed

DeCesare, Julie Z; Jackson, Jessica R

2015-03-01

With increased access to care, current health delivery systems will need expansion to meet higher demands and needs. To define Centering Pregnancy and practical tips for implementation into both private and academic practices. Evidence was gathered through literature reviews. It was found that Centering Pregnancy offers a patient-centered, evidence-based approach to helping with access issues, as well as improving outcomes. This article describes the benefits of Centering Pregnancy to the practice, the provider, and the patient. Practical implementation tips will be offered, with suggestions for negating common implementation barriers.

Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: Implications for Policy and Practice

ERIC Educational Resources Information Center

Cooper, Paul

2011-01-01

In this paper some key practice and policy implications emerging from a review of literature on effective teacher strategies for social, emotional and behavioural difficulties are set out. Particular attention is given to implications in relation to the development of teachers' skills.

Climate Change, Climate Justice, and Environmental Health: Implications for the Nursing Profession.

PubMed

Nicholas, Patrice K; Breakey, Suellen

2017-11-01

Climate change is an emerging challenge linked to negative outcomes for the environment and human health. Since the 1960s, there has been a growing recognition of the need to address climate change and the impact of greenhouse gas emissions implicated in the warming of our planet. There are also deleterious health outcomes linked to complex climate changes that are emerging in the 21st century. This article addresses the social justice issues associated with climate change and human health and discussion of climate justice. Discussion paper. A literature search of electronic databases was conducted for articles, texts, and documents related to climate change, climate justice, and human health. The literature suggests that those who contribute least to global warming are those who will disproportionately be affected by the negative health outcomes of climate change. The concept of climate justice and the role of the Mary Robinson Foundation-Climate Justice are discussed within a framework of nursing's professional responsibility and the importance of social justice for the world's people. The nursing profession must take a leadership role in engaging in policy and advocacy discussions in addressing the looming problems associated with climate change. Nursing organizations have adopted resolutions and engaged in leadership roles to address climate change at the local, regional, national, and global level. It is essential that nurses embrace concepts related to social justice and engage in the policy debate regarding the deleterious effects on human health related to global warming and climate change. Nursing's commitment to social justice offers an opportunity to offer significant global leadership in addressing the health implications related to climate change. Recognizing the negative impacts of climate change on well-being and the underlying socioeconomic reasons for their disproportionate and inequitable distribution can expand and optimize the profession's role in education, practice, research, and policy-making efforts to address climate change. © 2017 Sigma Theta Tau International.

Genome Diversity and Evolution in the Budding Yeasts (Saccharomycotina)

PubMed Central

Dujon, Bernard A.; Louis, Edward J.

2017-01-01

Considerable progress in our understanding of yeast genomes and their evolution has been made over the last decade with the sequencing, analysis, and comparisons of numerous species, strains, or isolates of diverse origins. The role played by yeasts in natural environments as well as in artificial manufactures, combined with the importance of some species as model experimental systems sustained this effort. At the same time, their enormous evolutionary diversity (there are yeast species in every subphylum of Dikarya) sparked curiosity but necessitated further efforts to obtain appropriate reference genomes. Today, yeast genomes have been very informative about basic mechanisms of evolution, speciation, hybridization, domestication, as well as about the molecular machineries underlying them. They are also irreplaceable to investigate in detail the complex relationship between genotypes and phenotypes with both theoretical and practical implications. This review examines these questions at two distinct levels offered by the broad evolutionary range of yeasts: inside the best-studied Saccharomyces species complex, and across the entire and diversified subphylum of Saccharomycotina. While obviously revealing evolutionary histories at different scales, data converge to a remarkably coherent picture in which one can estimate the relative importance of intrinsic genome dynamics, including gene birth and loss, vs. horizontal genetic accidents in the making of populations. The facility with which novel yeast genomes can now be studied, combined with the already numerous available reference genomes, offer privileged perspectives to further examine these fundamental biological questions using yeasts both as eukaryotic models and as fungi of practical importance. PMID:28592505

Shared Decision-Making for Nursing Practice: An Integrative Review.

PubMed

Truglio-Londrigan, Marie; Slyer, Jason T

2018-01-01

Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.

Benefits and Limitations of Real Options Analysis for the Practice of River Flood Risk Management

NASA Astrophysics Data System (ADS)

Kind, Jarl M.; Baayen, Jorn H.; Botzen, W. J. Wouter

2018-04-01

Decisions on long-lived flood risk management (FRM) investments are complex because the future is uncertain. Flexibility and robustness can be used to deal with future uncertainty. Real options analysis (ROA) provides a welfare-economics framework to design and evaluate robust and flexible FRM strategies under risk or uncertainty. Although its potential benefits are large, ROA is hardly used in todays' FRM practice. In this paper, we investigate benefits and limitations of a ROA, by applying it to a realistic FRM case study for an entire river branch. We illustrate how ROA identifies optimal short-term investments and values future options. We develop robust dike investment strategies and value the flexibility offered by additional room for the river measures. We benchmark the results of ROA against those of a standard cost-benefit analysis and show ROA's potential policy implications. The ROA for a realistic case requires a high level of geographical detail, a large ensemble of scenarios, and the inclusion of stakeholders' preferences. We found several limitations of applying the ROA. It is complex. In particular, relevant sources of uncertainty need to be recognized, quantified, integrated, and discretized in scenarios, requiring subjective choices and expert judgment. Decision trees have to be generated and stakeholders' preferences have to be translated into decision rules. On basis of this study, we give general recommendations to use high discharge scenarios for the design of measures with high fixed costs and few alternatives. Lower scenarios may be used when alternatives offer future flexibility.

16 CFR 238.1 - Bait advertisement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bait advertisement. 238.1 Section 238.1 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES AGAINST BAIT ADVERTISING § 238.1 Bait advertisement. No advertisement containing an offer to sell a product should be published when the offer is not a bona fide effort...

12 CFR 563b.340 - What sales practices are prohibited?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What sales practices are prohibited? 563b.340... FROM MUTUAL TO STOCK FORM Standard Conversions Offers and Sales of Stock § 563b.340 What sales practices are prohibited? (a) In connection with offers, sales, or purchases of conversion shares under this...

Analytical Implications of Using Practice Theory in Workplace Information Literacy Research

ERIC Educational Resources Information Center

Moring, Camilla; Lloyd, Annemaree

2013-01-01

Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical focus and interest when researching workplace…

Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model

PubMed Central

Basu, Sanjay; Phillips, Russell S.; Song, Zirui; Landon, Bruce E.; Bitton, Asaf

2016-01-01

PURPOSE We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODS We estimated practices’ changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. RESULTS Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (−$53,500, 95% CI, −$69,700 to −$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. CONCLUSIONS PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding. PMID:27621156

Getting with the times: a narrative review of the literature on group decision making in virtual environments and implications for promotions committees.

PubMed

Acai, Anita; Sonnadara, Ranil R; O'Neill, Thomas A

2018-06-01

Concerns around the time and administrative burden of trainee promotion processes have been reported, making virtual meetings an attractive option for promotions committees in undergraduate and postgraduate medicine. However, whether such meetings can uphold the integrity of decision-making processes has yet to be explored. This narrative review aimed to summarize the literature on decision making in virtual teams, discuss ways to improve the effectiveness of virtual teams, and explore their implications for practice. In August 2017, the Web of Science platform was searched with the terms 'decision making' AND 'virtual teams' for articles published within the last 20 years. The search yielded 336 articles, which was narrowed down to a final set of 188 articles. A subset of these, subjectively deemed to be of high-quality and relevant to the work of promotions committees, was included in this review. Virtual team functioning was explored with respect to team composition and development, idea generation and selection, group memory, and communication. While virtual teams were found to potentially offer a number of key benefits over face-to-face meetings including convenience and scheduling flexibility, inclusion of members at remote sites, and enhanced idea generation and external storage, these benefits must be carefully weighed against potential challenges involving planning and coordination, integration of perspectives, and relational conflict among members, all of which can potentially reduce decision-making quality. Avenues to address these issues and maximize the outcomes of virtual promotions meetings are offered in light of the evidence.

Impact of signals and experience on trust and trusting behavior.

PubMed

Chen, Ying-Hueih; Chien, Shu-Hua; Wu, Jyh-Jeng; Tsai, Pei-Yin

2010-10-01

Trust is an essential factor that drives virtual interaction and transactions on the Internet. Researchers have investigated the trust development process, and identified several important factors that form the basis for trust. This research combines the signal perspective and trust theory to examine the impact of market signals and past experience on trust formation and trusting behavior. Three market signals, including brand image, Web-site investment, and privacy policies, are identified and empirically tested to determine their impact on consumer trust. Based on 322 active Web users, the quantitative results suggest that brand image, Web-site investment, privacy policies, and past experience all positively impact trust formation. Furthermore, trust shows a positive effect on Web-site stickiness. Both theoretical and practical implications of the results are also offered.

Bioregulatory systems medicine: an innovative approach to integrating the science of molecular networks, inflammation, and systems biology with the patient's autoregulatory capacity?

PubMed Central

Goldman, Alyssa W.; Burmeister, Yvonne; Cesnulevicius, Konstantin; Herbert, Martha; Kane, Mary; Lescheid, David; McCaffrey, Timothy; Schultz, Myron; Seilheimer, Bernd; Smit, Alta; St. Laurent, Georges; Berman, Brian

2015-01-01

Bioregulatory systems medicine (BrSM) is a paradigm that aims to advance current medical practices. The basic scientific and clinical tenets of this approach embrace an interconnected picture of human health, supported largely by recent advances in systems biology and genomics, and focus on the implications of multi-scale interconnectivity for improving therapeutic approaches to disease. This article introduces the formal incorporation of these scientific and clinical elements into a cohesive theoretical model of the BrSM approach. The authors review this integrated body of knowledge and discuss how the emergent conceptual model offers the medical field a new avenue for extending the armamentarium of current treatment and healthcare, with the ultimate goal of improving population health. PMID:26347656

Plasmonic engineering of spontaneous emission from silicon nanocrystals.

PubMed

Goffard, Julie; Gérard, Davy; Miska, Patrice; Baudrion, Anne-Laure; Deturche, Régis; Plain, Jérôme

2013-01-01

Silicon nanocrystals offer huge advantages compared to other semi-conductor quantum dots as they are made from an abundant, non-toxic material and are compatible with silicon devices. Besides, among a wealth of extraordinary properties ranging from catalysis to nanomedicine, metal nanoparticles are known to increase the radiative emission rate of semiconductor quantum dots. Here, we use gold nanoparticles to accelerate the emission of silicon nanocrystals. The resulting integrated hybrid emitter is 5-fold brighter than bare silicon nanocrystals. We also propose an in-depth analysis highlighting the role of the different physical parameters in the photoluminescence enhancement phenomenon. This result has important implications for the practical use of silicon nanocrystals in optoelectronic devices, for instance for the design of efficient down-shifting devices that could be integrated within future silicon solar cells.

Becoming Inclusive: A Code of Conduct for Inclusion and Diversity.

PubMed

Schmidt, Bonnie J; MacWilliams, Brent R; Neal-Boylan, Leslie

There are increasing concerns about exclusionary behaviors and lack of diversity in the nursing profession. Exclusionary behaviors, which may include incivility, bullying, and workplace violence, discriminate and isolate individuals and groups who are different, whereas inclusive behaviors encourage diversity. To address inclusion and diversity in nursing, this article offers a code of conduct. This code of conduct builds on existing nursing codes of ethics and applies to nursing students and nurses in both educational and practice settings. Inclusive behaviors that are demonstrated in nurses' relationships with patients, colleagues, the profession, and society are described. This code of conduct provides a basis for measureable change, empowerment, and unification of the profession. Recommendations, implications, and a pledge to action are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Mergers and acquisitions: some implications of cultural change.

PubMed

Cavanaugh, S J

1996-01-01

A result of recent National Health Service reforms is the need to investigate, and possibly change, the culture of the professional working relationship between members of staff and their employer. This is particularly the case in situations of mergers and acquisitions where staff working from different cultural environments must work together. Mergers are becoming a feature of health service provision, perhaps this becomes most obvious with the recent moves by colleges of nursing and midwifery into the higher education sector and amalgamations of some purchasing authorities. Mergers highlight the practical issues of bringing together different organizational and work cultures to deliver a high quality service. This article discusses some aspects of the nature of organizational culture, the human impact of mergers and acquisitions and offers strategies for managing these events.

Contempt and defensiveness in couple relationships related to childhood sexual abuse histories for self and partner.

PubMed

Walker, Eric C; Sheffield, Rachel; Larson, Jeffry H; Holman, Thomas B

2011-01-01

This study examined the relationship between a history of childhood sexual abuse (CSA) for one or both members of a romantic couple and perceptions of contempt and defensiveness for self and partner. Data from the Relationship Evaluation (RELATE) were analyzed for 10,061 couples. The findings suggest that when either or both partner(s) has a history of CSA, contempt and defensiveness in the couple relationship are greater than when neither reports a history of CSA. Furthermore, the males' experience of CSA had a greater impact on their perceptions of self and partner's contempt and defensiveness than females' experience of CSA. Explanations of gender differences are offered and implications for future research and practice are suggested. © 2011 American Association for Marriage and Family Therapy.

Instructional Storytelling: Application of the Clinical Judgment Model in Nursing.

PubMed

Timbrell, Jessica

2017-05-01

Little is known about the teaching and learning implications of instructional storytelling (IST) in nursing education or its potential connection to nursing theory. The literature establishes storytelling as a powerful teaching-learning method in the educational, business, humanities, and health sectors, but little exploration exists that is specific to nursing. An example of a story demonstrating application of the domains of Tanner's clinical judgment model links storytelling with learning outcomes appropriate for the novice nursing student. Application of Tanner's clinical judgment model offers consistency of learning experience while preserving the creativity inherent in IST. Further research into student learning outcomes achievement using IST is warranted as a step toward establishing best practices with IST in nursing education. [J Nurs Educ. 2017;56(5):305-308.]. Copyright 2017, SLACK Incorporated.

Why do employees worry about their jobs? A meta-analytic review of predictors of job insecurity.

PubMed

Keim, Alaina C; Landis, Ronald S; Pierce, Charles A; Earnest, David R

2014-07-01

We used psychological contract theory as a framework to meta-analytically review subjective and objective predictors of employees' perceived job insecurity. Seventy-six samples from 68 studies were included in our review. Results revealed that lower levels of job insecurity are associated with having an internal locus of control, lower amounts of role ambiguity and role conflict, greater amounts of organizational communication, less organizational change, younger employees, and white-collar and permanent work. Moderator analyses further revealed that relations between job insecurity and age, gender, education, and formal contracts are moderated by unemployment rates, countries of origin, and type of job insecurity measure. We discuss theoretical and practical implications for psychological contract theory and occupational health, and offer directions for future research.

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

PubMed

Tam, Kim-Pong

2015-03-01

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

Strengths, altered investment, risk management, and other elaborations on the behavioural constellation of deprivation.

PubMed

Pepper, Gillian V; Nettle, Daniel

2017-01-01

We are grateful to have received so many insightful commentaries from interested colleagues regarding our proposed behavioural constellation of deprivation (BCD) and our thoughts on its causes and consequences. In this response article, we offer some clarifications regarding our perspective and tackle some common misperceptions, including, for example, assumptions that the BCD is adaptive and that it should include all behaviours that vary with socioeconomic status. We then welcome some excellent proposals for extensions and modifications of our ideas, such as the conceptualisation of the BCD as a risk-management strategy and the calls for a greater focus on strengths and differential investment rather than deficits and disinvestment. Finally, we highlight some insightful explorations of the implications of our ideas for ethics, policy, and practice.

An Older Transgender Woman's Quest for Identity.

PubMed

Walker, Charles A; Cohen, Harriet; Jenkins, David

2016-02-01

Despite sensationalized media attention, transgender individuals are the most marginalized and misunderstood group in the lesbian, gay, bisexual, and transgender (LGBT) community. The current article presents a case study of one woman's quest for identity. Narrative inquiry was used to analyze data from interview transcripts and four themes emerged during analysis: (a) naming the ambiguity, (b) revealing-concealing the authentic self, (c) discovering the transgender community, and (d) embracing the "T" identity. Lifespan and empowerment theories were used to harvest meanings from these themes. Implications for nursing practice and research were examined based on study findings. Participatory action research offers an approach for future studies in which researchers advocate for transgender individuals and remove obstacles to their health care access. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 31-38.]. Copyright 2016, SLACK Incorporated.

Care Delivery for Filipino Americans Using the Neuman Systems Model

PubMed Central

Angosta, Alona D.; Ceria-Ulep, Clementina D.; Tse, Alice M.

2016-01-01

Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States. PMID:24740949

Ethical issues in nanomedicine: Tempest in a teapot?

PubMed

Allon, Irit; Ben-Yehudah, Ahmi; Dekel, Raz; Solbakk, Jan-Helge; Weltring, Klaus-Michael; Siegal, Gil

2017-03-01

Nanomedicine offers remarkable options for new therapeutic avenues. As methods in nanomedicine advance, ethical questions conjunctly arise. Nanomedicine is an exceptional niche in several aspects as it reflects risks and uncertainties not encountered in other areas of medical research or practice. Nanomedicine partially overlaps, partially interlocks and partially exceeds other medical disciplines. Some interpreters agree that advances in nanotechnology may pose varied ethical challenges, whilst others argue that these challenges are not new and that nanotechnology basically echoes recurrent bioethical dilemmas. The purpose of this article is to discuss some of the ethical issues related to nanomedicine and to reflect on the question whether nanomedicine generates ethical challenges of new and unique nature. Such a determination should have implications on regulatory processes and professional conducts and protocols in the future.

"In the city, everybody only cares for himself": social relations and illness in Abidjan, Co˘te d'Ivoire.

PubMed

Bossart, Rita

2003-12-01

Various studies on African solidarity, survival strategies and the 'therapy man agement group' [J. M. Janzen (1978) The Quest for Therapy in Lower Zaire, Berkeley, Los Angeles & London: University of California Press] have suggested that institutionalized relationships in the form of networks or groups afford an individual access to resources, also in case of illness. My study reconsiders these arguments in ethnographic research about everyday illness management. It focuses on a heterogeneous urban neighbourhood in Abidjan and analyses who offers help to whom, and what kind of help people offer to one another. The findings show that social networks play an important but at the same time restricted role in illness management. The main source of assistance in response to affliction is household members. Apart from emotional and moral support, relatives living outside the household and non-kin play only a minor role. The social network offers help only sporadically, and very often the sick person has to ask friends and family several times before she or he receives financial or practical support. The emphasis given to social networks in the existing literature is often overestimated, at least in the case of illness. These findings implicate the importance of strengthening informal and formal security systems, especially in an urban context of economic hardship and political insecurity.

Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London.

PubMed

Kohut, Kelly; D'Mello, Lucia; Bancroft, Elizabeth K; Thomas, Sarah; Young, Mary-Anne; Myhill, Kathryn; Shanley, Susan; Briggs, Brian H J; Newman, Michelle; Saraf, Ifthikhar M; Cox, Penny; Scambler, Sarah; Wagman, Lyndon; Wyndham, Michael T; Eeles, Rosalind A; Ferris, Michelle

2012-03-01

At present cancer genetics referrals are reactive to individuals asking for a referral and providing a family history thereafter. A previous pilot study in a single General Practice (GP) catchment area in North London showed a 1.5-fold increase in breast cancer risk in the Ashkenazi Jewish population compared with the non-Ashkenazi mixed population. The breast cancer incidence was equal in the Ashkenazim in both pre- and postmenopausal groups. We wanted to investigate the effect of proactively seeking family history data from the entire female population of the practice to determine the effect on cancer genetics referral. Objectives To determine the need for cancer genetics intervention for women in a single GP catchment area. (1) to determine the incidence and strength of family history of cancer in women aged over 18 in the practice, (2) to offer cancer genetics advice and determine the uptake of counselling in those with a positive family history, (3) to identify potential BRCA1/BRCA2 gene mutation carriers who can be offered clinical follow up with appropriate translational research studies. Design Population-based cohort study of one General Practice female population. Participants Three hundred and eighty-three women over the age of 18 from one General Practice who responded to a questionnaire about family history of cancer. The whole female adult GP population was the target and the total number sampled was 3,820. Results 10% of patients completed the questionnaire (n = 383). A family history of cancer was present in 338 cases, 95 went on to have genetic counselling or had previously had counselling and 47 were genetically tested. We identified three carriers of an Ashkenazi Jewish founder mutation in BRCA1. Conclusions Response rate to a family history questionnaire such as that used in genetics centres was low (10%) and other approaches will be needed to proactively assess family history. Although the Ashkenazim are present in 39% of the GP catchment area, 62% of those who returned a family history questionnaire were from this ethnic group and of those returned, 44% warranted referral to a cancer genetics unit. In the non Ashkenazim, the questionnaire return rate was 38% and 18% of those warranted referral to cancer genetics.

Social Justice Advocacy in Rural Communities: Practical Issues and Implications

ERIC Educational Resources Information Center

Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.

2012-01-01

The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…

Democratic Schooling in Norway: Implications for Leadership in Practice

ERIC Educational Resources Information Center

Moller, Jorunn

2006-01-01

This article explores the meaning of an education based on democratic values and the implications for school leadership in practice. Based on findings from a case study in a Norwegian upper secondary school, the study describes democratic school leadership in practice, with particular attention to the distribution of power and leadership in the…

The Impact of a Staff Development Offering on Nursing Practice.

ERIC Educational Resources Information Center

Foglesong, Dianne H.

1983-01-01

Describes a problem-focused audit used to measure the impact of a staff development offering on pain relief. Concludes that the audit provided concrete evidence that the class on pain did influence nursing practice and affected patients directly. (NRJ)

Managing your practice's first impression: the process of front-desk reengineering.

PubMed

Walsh, Alison L

2004-01-01

Patients must be regarded as consumers. As such, they are increasingly informed, questioning, cost-conscious, technologically savvy, and demanding. Just as health plans have developed defined contribution products that offer consumers more control over how and where their health-care dollars are spent, practice success is linked to reengineering office operations to offer consumers and patients greater choice, control, autonomy, and service. Patients and consumers want practices that deliver clinical and business services that meet the criteria of reliability, effciency, service offerings, patient focus, enthusiasm, customization, and trust. Physician practices must also take care to avoid destructive and disruptive behaviors and conditions such as noise, interference, excessive repetition, long waits, appointment delays, and staff rudeness. A successful patient-focused practice emerges when physicians and office staff begin to look at the clinical and service experience through the patient's eyes.

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision.

PubMed

Biggs, M Antonia; Harper, Cynthia C; Brindis, Claire D

2015-08-01

To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required. In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants. Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols. Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision. III.

Is Western Australia's rural surgical workforce going to sustain the future? A quantitative and qualitative analysis.

PubMed

Shanmugakumar, Sharanyaa; Playford, Denese; Burkitt, Tessa; Tennant, Marc; Bowles, Tom

2017-03-01

Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia's rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the training of general surgeons. What is known about the topic? A paper published in 1998 suggested that Australia's rural surgeons were soon to reach retirement age. However, there have been no published peer-reviewed papers on Australia's surgical workforce since then. More recent workforce statistics released from the RACS suggest that the rural workforce is in crisis. What does this paper add? This paper provides up-to-date whole-of-state information for WA, showing where surgical services are being provided and by whom, giving a precise geographical spread of the workforce. It shows the skill set and on-call rosters of these practitioners. What are the implications for practitioners? The present study provides geographical workforce data, which is important to health planners, the general public and surgeons considering where to practice. In particular, these data are relevant to trainees considering their rural training options.

Child incarceration and long-term adult health outcomes: a longitudinal study.

PubMed

Barnert, Elizabeth S; Abrams, Laura S; Tesema, Lello; Dudovitz, Rebecca; Nelson, Bergen B; Coker, Tumaini; Bath, Eraka; Biely, Christopher; Li, Ning; Chung, Paul J

2018-03-12

Purpose Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper aims to discuss this issue. Design/methodology/approach The authors analyzed data from 14,689 adult participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to compare adult health outcomes among those first incarcerated between 7 and 13 years of age (child incarceration); first incarcerated at>or=14 years of age; and never incarcerated. Findings Compared to the other two groups, those with a history of child incarceration were disproportionately black or Hispanic, male, and from lower socio-economic strata. Additionally, individuals incarcerated as children had worse adult health outcomes, including general health, functional limitations (climbing stairs), depressive symptoms, and suicidality, than those first incarcerated at older ages or never incarcerated. Research limitations/implications Despite the limitations of the secondary database analysis, these findings suggest that incarcerated children are an especially medically vulnerable population. Practical implications Programs and policies that address these medically vulnerable children's health needs through comprehensive health and social services in place of, during, and/or after incarceration are needed. Social implications Meeting these unmet health and social service needs offers an important opportunity to achieve necessary health care and justice reform for children. Originality/value No prior studies have examined the longitudinal relationship between child incarceration and adult health outcomes.

The Promise of Tailoring Incentives for Healthy Behaviors

PubMed Central

Kullgren, Jeffrey T.; Williams, Geoffrey C.; Resnicow, Kenneth; An, Lawrence C.; Rothberg, Amy; Volpp, Kevin G.; Heisler, Michele

2017-01-01

Purpose To describe how tailoring financial incentives for healthy behaviors to employees’ goals, values, and aspirations might improve the efficacy of incentives. Design/methodology/approach We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee’s life goals, values, or aspirations. Findings Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Research implications Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Practical implications Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees’ autonomous motivation for sustained health improvements. Social implications Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Originality/value Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors. PMID:29242715

Recommendations for Culturally Sensitive Research Methods

ERIC Educational Resources Information Center

Awad, Germine H.; Patall, Erika A.; Rackley, Kadie R.; Reilly, Erin D.

2016-01-01

As the US continues to diversify, methods for accurately assessing human behavior must evolve. This paper offers multicultural research considerations at several stages of the research process for psychological research and consultation. Implications regarding the comparative research framework are discussed and suggestions are offered on how to…

Generalist solutions to complex problems: generating practice-based evidence - the example of managing multi-morbidity

PubMed Central

2013-01-01

Background A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Discussion Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a ‘complex intervention’ (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Summary Answers to the complex problem of multi-morbidity won’t come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity. PMID:23919296

Generalist solutions to complex problems: generating practice-based evidence--the example of managing multi-morbidity.

PubMed

Reeve, Joanne; Blakeman, Tom; Freeman, George K; Green, Larry A; James, Paul A; Lucassen, Peter; Martin, Carmel M; Sturmberg, Joachim P; van Weel, Chris

2013-08-07

A growing proportion of people are living with long term conditions. The majority have more than one. Dealing with multi-morbidity is a complex problem for health systems: for those designing and implementing healthcare as well as for those providing the evidence informing practice. Yet the concept of multi-morbidity (the presence of >2 diseases) is a product of the design of health care systems which define health care need on the basis of disease status. So does the solution lie in an alternative model of healthcare? Strengthening generalist practice has been proposed as part of the solution to tackling multi-morbidity. Generalism is a professional philosophy of practice, deeply known to many practitioners, and described as expertise in whole person medicine. But generalism lacks the evidence base needed by policy makers and planners to support service redesign. The challenge is to fill this practice-research gap in order to critically explore if and when generalist care offers a robust alternative to management of this complex problem. We need practice-based evidence to fill this gap. By recognising generalist practice as a 'complex intervention' (intervening in a complex system), we outline an approach to evaluate impact using action-research principles. We highlight the implications for those who both commission and undertake research in order to tackle this problem. Answers to the complex problem of multi-morbidity won't come from doing more of the same. We need to change systems of care, and so the systems for generating evidence to support that care. This paper contributes to that work through outlining a process for generating practice-based evidence of generalist solutions to the complex problem of person-centred care for people with multi-morbidity.

Teaching clinical reasoning to medical students.

PubMed

Gay, Simon; Bartlett, Maggie; McKinley, Robert

2013-10-01

Keele Medical School's new curriculum includes a 5-week course to extend medical students' consultation skills beyond those historically required for competent inductive diagnosis. Clinical reasoning is a core skill for the practice of medicine, and is known to have implications for patient safety, yet historically it has not been explicitly taught. Rather, it has been assumed that these skills will be learned by accumulating a body of knowledge and by observing expert clinicians. This course aims to assist students to develop their own clinical reasoning skills and promote their greater understanding of, and potential to benefit from, the clinical reasoning skills of others. The course takes place in the fourth or penultimate year, and is integrated with students' clinical placements, giving them opportunities to practise and quickly embed their learning. This course emphasises that clinical reasoning extends beyond initial diagnosis into all other aspects of clinical practice, particularly clinical management. It offers students a variety of challenging and interesting opportunities to engage with clinical reasoning across a wide range of clinical practice. It addresses bias through metacognition and increased self-awareness, considers some of the complexities of prescribing and non-pharmacological interventions, and promotes pragmatic evidence-based practice, information management within the consultation and the maximising of patient adherence. This article describes clinical reasoning-based classroom and community teaching. Early evaluation suggests that students value the course and benefit from it. © 2013 John Wiley & Sons Ltd.

Sleep health education in pediatric community settings: rationale and practical suggestions for incorporating healthy sleep education into pediatric practice.

PubMed

Gruber, Reut; Cassoff, Jamie; Knäuper, Bärbel

2011-06-01

This article offers practical ways to incorporate healthy sleep education into pediatric practice and discusses key questions, barriers, and strategies associated with such efforts. The rationale for incorporating healthy sleep education in pediatric practice settings is presented, and desirable features of sleep education programs that may be implemented in pediatric practice are identified. Potential barriers are reviewed and strategies offered to overcome these barriers, such as developing resources applicable to healthy sleep education and practical information for pediatricians. Key factors regarding effectiveness of such interventional programs and key points relevant to successful healthy sleep education in pediatric practice are highlighted. Copyright © 2011. Published by Elsevier Inc.

Beyond regulatory compression: confronting the liminal spaces of health research regulation

PubMed Central

Taylor-Alexander, Samuel; Dove, Edward S.; Fletcher, Isabel; Ganguli Mitra, Agomoni; McMillan, Catriona; Laurie, Graeme

2016-01-01

ABSTRACT Biomedicine and the life sciences continuously rearrange the relationship between culture and biology. In consequence, we increasingly look for a suitable regulatory response to reduce perceived uncertainty and instability. This article examines the full implications of this ‘regulatory turn’ by drawing on the anthropological concept of liminality. We offer the term ‘regulatory compression’ to characterise the effects of extant regulatory approaches on health research practices. With its focus on transformation and the ‘in-between’, liminality allows us to see how regulatory frameworks rely on a silo-based approach to classifying and regulating research objects such that they: (1) limit the flexibility necessary in clinical and laboratory research; (2) result in the emergence of unregulated spaces that lie between the bounded regulatory spheres; and (3) curtail modes of public participation in the health research enterprise. We suggest there is a need to develop the notion of ‘processual regulation’, a novel framework that requires a temporal-spatial examination of regulatory spaces and practices as these are experienced by all actors, including the relationship of actors with the objects of regulation. PMID:28058061

EHR Learning - It's about Nursing, Leadership and Long-Term Commitments.

PubMed

Furlong, Karen E

2016-01-01

Despite a global commitment to the adoption of technologies, such as electronic health records (EHRs), to support the delivery of health services, there is little empirical guidance to support effective planning for the integration of these tools into practice settings (Suter et al. 2009). In particular, although EHR learning is known to positively influence integration (Byrne 2012), individual perspectives are often overlooked because of investigative designs that devalue such viewpoints by exploring the utility of technologies rather than the lived experiences of individual users of the technology. Therefore, this qualitative study offered nurse participants opportunities to make sense of EHR learning through talking about their experiences. This narrative inquiry was a collaborative interpretive method of discovery: stories and thematic analysis were the two separate yet complementary frames used to support data analysis. Finally, several practice implications and recommendations about EHR learning are presented with an emphasis placed upon patient safety as a way to impart accountability on behalf of learners, educators and those charged with governing responsibilities during times of EHR integration. Copyright © 2016 Longwoods Publishing.

Impact of spirometry feedback and brief motivational counseling on long term smoking outcomes: A comparison of smokers with and without lung impairment

PubMed Central

McClure, Jennifer B.; Ludman, Evette J.; Grothaus, Lou; Pabiniak, Chester; Richards, Julie

2009-01-01

Objective We compared long-term outcomes among smokers with and without impaired lung functioning who received brief counseling highlighting their spirometric test results. Methods Participants in this analysis all received a brief motivational intervention for smoking cessation including spirometric testing and feedback (~20 minutes), were advised to quit smoking, offered free access to a phone-based smoking cessation program, and followed for one year. Outcomes were analyzed for smokers with (n = 99) and without (n = 168) impaired lung function. Results Participants with lung impairment reported greater use of self-help cessation materials at 6 months, greater use of non-study-provided counseling services at 6 and 12 months, higher 7-day PPA rates at 6 months, and were more likely to talk with their doctor about their spirometry results. Conclusion Further research is warranted to determine if spirometry feedback has a differential treatment effect among smokers with and without lung impairment. Practice Implications It is premature to make practice recommendations based on these data. PMID:20434863

Demands for religious care in the Taiwanese health system.

PubMed

Tzeng, Huey-Ming; Yin, Chang-Yi

2006-03-01

In order to care ethically nurses need to care holistically; holistic care includes religious/spiritual care. This research attempted to answer the question: Do nurses have the resources to offer religious care? This article discusses only one aspect--the provision of religious care within the Taiwanese health care system. It is assumed that, if hospitals do not provide enough religious services, nurses working in these hospitals cannot be fully ethical beings or cannot respect patients' religious needs. The relevant literature was reviewed, followed by a survey study on the provision of religious facilities and services. Aspects considered are: the religions influences in and on Taiwanese society; the religious needs of patients and their families; strategies that patients use to enable them to cope with their health care problems; professional motives for attuning to patients' religious needs; and hospital provision for meeting the religious and spiritual needs of patients. A survey of nursing executives showed differences between religious service provision in hospitals with and without a hospice ward. The practical implications for hospital management and nursing practice are discussed.

Reducing cognitive skill decay and diagnostic error: theory-based practices for continuing education in health care.

PubMed

Weaver, Sallie J; Newman-Toker, David E; Rosen, Michael A

2012-01-01

Missed, delayed, or wrong diagnoses can have a severe impact on patients, providers, and the entire health care system. One mechanism implicated in such diagnostic errors is the deterioration of cognitive diagnostic skills that are used rarely or not at all over a prolonged period of time. Existing evidence regarding maintenance of effective cognitive reasoning skills in the clinical education, organizational training, and human factors literatures suggest that continuing education plays a critical role in mitigating and managing diagnostic skill decay. Recent models also underscore the role of system level factors (eg, cognitive decision support tools, just-in-time training opportunities) in supporting clinical reasoning process. The purpose of this manuscript is to offer a multidisciplinary review of cognitive models of clinical decision making skills in order to provide a list of best practices for supporting continuous improvement and maintenance of cognitive diagnostic processes through continuing education. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Growth of Chlamydomonas reinhardtii in acetate-free medium when co-cultured with alginate-encapsulated, acetate-producing strains of Synechococcus sp. PCC 7002.

PubMed

Therien, Jesse B; Zadvornyy, Oleg A; Posewitz, Matthew C; Bryant, Donald A; Peters, John W

2014-01-01

The model alga Chlamydomonas reinhardtii requires acetate as a co-substrate for optimal production of lipids, and the addition of acetate to culture media has practical and economic implications for algal biofuel production. Here we demonstrate the growth of C. reinhardtii on acetate provided by mutant strains of the cyanobacterium Synechococcus sp. PCC 7002. Optimal growth conditions for co-cultivation of C. reinhardtii with wild-type and mutant strains of Synechococcus sp. 7002 were established. In co-culture, acetate produced by a glycogen synthase knockout mutant of Synechococcus sp. PCC 7002 was able to support the growth of a lipid-accumulating mutant strain of C. reinhardtii defective in starch production. Encapsulation of Synechococcus sp. PCC 7002 using an alginate matrix was successfully employed in co-cultures to limit growth and maintain the stability. The ability of immobilized strains of the cyanobacterium Synechococcus sp. PCC 7002 to produce acetate at a level adequate to support the growth of lipid-accumulating strains of C. reinhartdii offers a potentially practical, photosynthetic alternative to providing exogenous acetate into growth media.

Genomics England’s implementation of its public engagement strategy: Blurred boundaries between engagement for the United Kingdom’s 100,000 Genomes project and the need for public support

PubMed Central

Samuel, Gabrielle Natalie; Farsides, Bobbie

2017-01-01

The United Kingdom’s 100,000 Genomes Project has the aim of sequencing 100,000 genomes from National Health Service patients such that whole genome sequencing becomes routine clinical practice. It also has a research-focused goal to provide data for scientific discovery. Genomics England is the limited company established by the Department of Health to deliver the project. As an innovative scientific/clinical venture, it is interesting to consider how Genomics England positions itself in relation to public engagement activities. We set out to explore how individuals working at, or associated with, Genomics England enacted public engagement in practice. Our findings show that individuals offered a narrative in which public engagement performed more than one function. On one side, public engagement was seen as ‘good practice’. On the other, public engagement was presented as core to the project’s success – needed to encourage involvement and ultimately recruitment. We discuss the implications of this in this article. PMID:29241419

Automotive technicians' training as a community-of-practice: implications for the design of an augmented reality teaching aid.

PubMed

Anastassova, Margarita; Burkhardt, Jean-Marie

2009-07-01

The paper presents an ergonomic analysis carried out in the early phases of an R&D project. The purpose was to investigate the functioning of today's Automotive Service Technicians (ASTs) training in order to inform the design of an Augmented Reality (AR) teaching aid. The first part of the paper presents a literature review of some major problems encountered by ASTs today. The benefits of AR as technological aid are also introduced. Then, the methodology and the results of two case studies are presented. The first study is based on interviews with trainers and trainees; the second one on observations in real training settings. The results support the assumption that today's ASTs' training could be regarded as a community-of-practice (CoP). Therefore, AR could be useful as a collaboration tool, offering a shared virtual representation of real vehicle's parts, which are normally invisible unless dismantled (e.g. the parts of a hydraulic automatic transmission). We conclude on the methods and the technologies to support the automotive CoP.

Exploring a shared leadership perspective for NHS doctors.

PubMed

Willcocks, Stephen George; Wibberley, Gemma

2015-01-01

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

Predicting child physical activity and screen time: parental support for physical activity and general parenting styles.

PubMed

Langer, Shelby L; Crain, A Lauren; Senso, Meghan M; Levy, Rona L; Sherwood, Nancy E

2014-07-01

To examine relationships between parenting styles and practices and child moderate-to-vigorous physical activity (MVPA) and screen time. Participants were children (6.9 ± 1.8 years) with a body mass index in the 70-95th percentile and their parents (421 dyads). Parent-completed questionnaires assessed parental support for child physical activity (PA), parenting styles and child screen time. Children wore accelerometers to assess MVPA. Parenting style did not predict MVPA, but support for PA did (positive association). The association between support and MVPA, moreover, varied as a function of permissive parenting. For parents high in permissiveness, the association was positive (greater support was related to greater MVPA and therefore protective). For parents low in permissiveness, the association was neutral; support did not matter. Authoritarian and permissive parenting styles were both associated with greater screen time. Parenting practices and styles should be considered jointly, offering implications for tailored interventions. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade.

PubMed

Pbert, Lori; Farber, Harold; Horn, Kimberly; Lando, Harry A; Muramoto, Myra; O'Loughlin, Jennifer; Tanski, Susanne; Wellman, Robert J; Winickoff, Jonathan P; Klein, Jonathan D

2015-04-01

Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a "state-of-the-art" article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco. Copyright © 2015 by the American Academy of Pediatrics.

Eight worst advertising mistakes.

PubMed

Maley, Catherine

2010-11-01

This article presents strategies for advertising the medical practice. The emphasis is on breaking out of the old rules of how one should advertise and delves into asking questions that lead to a true strategy unique to one's medical practice and offerings. The article discusses the myriad ways to think about and create a patient-centered approach, turning from "here is what we offer" to instead "what you want we offer." Copyright © 2010 Elsevier Inc. All rights reserved.

Managing in the interprofessional environment: a theory of action perspective.

PubMed

Rogers, Tim

2004-08-01

Managers of multidisciplinary teams face difficult dilemmas in managing competing interests, diverse perspectives and interpersonal conflicts. This paper illustrates the potential of the theory of action methodology of Argyris and Schön (1974, 1996) to illuminate these problems and contribute to their resolution. An empirical example of a depth-investigation with one multidisciplinary community health care team leader in Australia demonstrates that the theory of action offers a more accurate account of the causal dimensions of her dilemmas and provides more scope for effective intervention than her lay explanation will allow. It also provides a more satisfactory analysis of her difficulties with two common problems identified in the literature: defining the appropriate level of autonomy for team members and developing constructive dialogue across perceived discipline-based differences of opinion. Consequently the theory of action appears to offer enormous promise to managers of multidisciplinary teams wanting to understand and resolve their problems and develop a rigorous reflective practice. Further research on the viability of the theory to facilitate a self-correcting system that can promote learning even under conditions of stress and conflict is suggested and implications for learning and teaching for the multidisciplinary environment are briefly discussed.

Professional knowledge and the epistemology of reflective practice.

PubMed

Kinsella, Elizabeth Anne

2010-01-01

Reflective practice is one of the most popular theories of professional knowledge in the last 20 years and has been widely adopted by nursing, health, and social care professions. The term was coined by Donald Schön in his influential books The Reflective Practitioner, and Educating the Reflective Practitioner, and has garnered the unprecedented attention of theorists and practitioners of professional education and practice. Reflective practice has been integrated into professional preparatory programmes, continuing education programmes, and by the regulatory bodies of a wide range of health and social care professions. Yet, despite its popularity and widespread adoption, a problem frequently raised in the literature concerns the lack of conceptual clarity surrounding the term reflective practice. This paper seeks to respond to this problem by offering an analysis of the epistemology of reflective practice as revealed through a critical examination of philosophical influences within the theory. The aim is to discern philosophical underpinnings of reflective practice in order to advance increasingly coherent interpretations, and to consider the implications for conceptions of professional knowledge in professional life. The paper briefly examines major philosophical underpinnings in reflective practice to explicate central themes that inform the epistemological assumptions of the theory. The study draws on the work of Donald Schön, and on texts from four philosophers: John Dewey, Nelson Goodman, Michael Polanyi, and Gilbert Ryle. Five central epistemological themes in reflective practice are illuminated: (1) a broad critique of technical rationality; (2) professional practice knowledge as artistry; (3) constructivist assumptions in the theory; (4) the significance of tacit knowledge for professional practice knowledge; and (5) overcoming mind body dualism to recognize the knowledge revealed in intelligent action. The paper reveals that the theory of reflective practice is concerned with deep epistemological questions of significance to conceptions of knowledge in health and social care professions.

Preventing employee theft: 15 techniques for preventing bookkeeping embezzlement.

PubMed

Hills, Laura Sachs

2004-01-01

Medical practices are unfortunately the target of embezzlement more often than you might think. This article offers practical suggestions for keeping your employees honest and thwarting a would-be embezzler. It describes the common symptoms of an embezzler at work and offers 15 practical techniques for preventing bookkeeping embezzlement. This article also suggests a simple method for conducting mini-audits from time to time and precautions to take to ensure the reliability of computer passwords. The article advocates keeping tighter control of office supplies and a method for spotting telephone abuse. Finally, it offers suggestions for dealing with employees who steal time on the job.

Changing Set: Teaching Family Therapy from a Feminist Perspective.

ERIC Educational Resources Information Center

Leslie, Leigh A.; Clossick, Michelle L.

1992-01-01

Notes that feminist writings in family therapy have critiqued models and offered alternative methods for family interventions. Attempts to expand current application of feminist perspective to family therapy by examining implications for training. Three areas are considered: implications of a feminist perspective for training, strategies for…

Field Birding and Digital Objects: Immaterial Technologies and Their Implications for One Practice of Coming to Know the More-than-Human

ERIC Educational Resources Information Center

Watson, Gavan Peter Longley

2011-01-01

This paper focuses on the implications of two emerging digital technologies on the act of field birding, and the implications of these objects for thinking about wild birds. While the adoption of new immaterial technologies promises to improve the ease with which birding is practiced, their use leads to new ethical considerations. Using the…

Stem cell terminology: practical, theological and ethical implications.

PubMed

Shanner, Laura

2002-01-01

Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.

What to do when trust has been breached in your practice.

PubMed

Hills, Laura

2013-01-01

We've all experienced gossiping, missed deadlines, someone taking credit for another's work, and little white lies. These and other breaches of trust are commonplace. However, they do more damage in the medical practice than many practice managers realize. This article argues that medical practice employees need to trust their managers, patients, doctors, one another, and even the security of their jobs so they are able to focus on their daily tasks and perform well. It defines trust as both a logical and emotional act and describes common breaches of workplace trust. It defines three characteristics of high-trust organizations and illustrates through examples how practice managers can demonstrate their trustworthiness through their actions, not only through their words. This article also offers seven steps for rebuilding trust that has been breached. It offers readers two instruments: a survey tool practice managers can use to assess the trust in their practices and a self-quiz practice managers can take to assess their own trustworthiness. Finally, this article offers research about the impact of trust on the bottom line and 10 truths about trust that medical practice managers can share with their employees.

Simulation-based otolaryngology - head and neck surgery boot camp: 'how I do it'.

PubMed

Chin, C J; Chin, C A; Roth, K; Rotenberg, B W; Fung, K

2016-03-01

In otolaryngology, surgical emergencies can occur at any time. An annual surgical training camp (or 'boot camp') offers junior residents from across North America the opportunity to learn and practice these skills in a safe environment. The goals of this study were to describe the set-up and execution of a simulation-based otolaryngology boot camp and to determine participants' confidence in performing routine and emergency on-call procedures in stressful situations before and after the boot camp. There were three main components of the boot camp: task trainers, simulations and an interactive panel discussion. Surveys were given to participants before and after the boot camp, and their confidence in performing the different tasks was assessed via multiple t-tests. Participants comprised 22 residents from 12 different universities; 10 of these completed both boot camp surveys. Of the nine tasks, the residents reported a significant improvement in confidence levels for six, including surgical airway and orbital haematoma management. An otolaryngology boot camp gives residents the chance to learn and practice emergency skills before encountering the emergencies in everyday practice. Their confidence in multiple skillsets was significantly improved after the boot camp. Given the shift towards competency-based learning in medical training, this study has implications for all surgical and procedural specialties.

EMQN/CMGS best practice guidelines for the molecular genetic testing of Huntington disease.

PubMed

Losekoot, Monique; van Belzen, Martine J; Seneca, Sara; Bauer, Peter; Stenhouse, Susan A R; Barton, David E

2013-05-01

Huntington disease (HD) is caused by the expansion of an unstable polymorphic trinucleotide (CAG)n repeat in exon 1 of the HTT gene, which translates into an extended polyglutamine tract in the protein. Laboratory diagnosis of HD involves estimation of the number of CAG repeats. Molecular genetic testing for HD is offered in a wide range of laboratories both within and outside the European community. In order to measure the quality and raise the standard of molecular genetic testing in these laboratories, the European Molecular Genetics Quality Network has organized a yearly external quality assessment (EQA) scheme for molecular genetic testing of HD for over 10 years. EQA compares a laboratory's output with a fixed standard both for genotyping and reporting of the results to the referring physicians. In general, the standard of genotyping is very high but the clarity of interpretation and reporting of the test result varies more widely. This emphasizes the need for best practice guidelines for this disorder. We have therefore developed these best practice guidelines for genetic testing for HD to assist in testing and reporting of results. The analytical methods and the potential pitfalls of molecular genetic testing are highlighted and the implications of the different test outcomes for the consultand and his or her family members are discussed.

Teaching virtue: pedagogical implications of moral psychology.

PubMed

Frey, William J

2010-09-01

Moral exemplar studies of computer and engineering professionals have led ethics teachers to expand their pedagogical aims beyond moral reasoning to include the skills of moral expertise. This paper frames this expanded moral curriculum in a psychologically informed virtue ethics. Moral psychology provides a description of character distributed across personality traits, integration of moral value into the self system, and moral skill sets. All of these elements play out on the stage of a social surround called a moral ecology. Expanding the practical and professional curriculum to cover the skills and competencies of moral expertise converts the classroom into a laboratory where students practice moral expertise under the guidance of their teachers. The good news is that this expanded pedagogical approach can be realized without revolutionizing existing methods of teaching ethics. What is required, instead, is a redeployment of existing pedagogical tools such as cases, professional codes, decision-making frameworks, and ethics tests. This essay begins with a summary of virtue ethics and informs this with recent research in moral psychology. After identifying pedagogical means for teaching ethics, it shows how these can be redeployed to meet a broader, skills based agenda. Finally, short module profiles offer concrete examples of the shape this redeployed pedagogical agenda would take in the practical and professional ethics classroom.

Motor learning from virtual reality to natural environments in individuals with Duchenne muscular dystrophy.

PubMed

Quadrado, Virgínia Helena; Silva, Talita Dias da; Favero, Francis Meire; Tonks, James; Massetti, Thais; Monteiro, Carlos Bandeira de Mello

2017-11-10

To examine whether performance improvements in the virtual environment generalize to the natural environment. we had 64 individuals, 32 of which were individuals with DMD and 32 were typically developing individuals. The groups practiced two coincidence timing tasks. In the more tangible button-press task, the individuals were required to 'intercept' a falling virtual object at the moment it reached the interception point by pressing a key on the computer. In the more abstract task, they were instructed to 'intercept' the virtual object by making a hand movement in a virtual environment using a webcam. For individuals with DMD, conducting a coincidence timing task in a virtual environment facilitated transfer to the real environment. However, we emphasize that a task practiced in a virtual environment should have higher rates of difficulties than a task practiced in a real environment. IMPLICATIONS FOR REHABILITATION Virtual environments can be used to promote improved performance in ?real-world? environments. Virtual environments offer the opportunity to create paradigms similar ?real-life? tasks, however task complexity and difficulty levels can be manipulated, graded and enhanced to increase likelihood of success in transfer of learning and performance. Individuals with DMD, in particular, showed immediate performance benefits after using virtual reality.

An Overview of Interrater Agreement on Likert Scales for Researchers and Practitioners

PubMed Central

O'Neill, Thomas A.

2017-01-01

Applications of interrater agreement (IRA) statistics for Likert scales are plentiful in research and practice. IRA may be implicated in job analysis, performance appraisal, panel interviews, and any other approach to gathering systematic observations. Any rating system involving subject-matter experts can also benefit from IRA as a measure of consensus. Further, IRA is fundamental to aggregation in multilevel research, which is becoming increasingly common in order to address nesting. Although, several technical descriptions of a few specific IRA statistics exist, this paper aims to provide a tractable orientation to common IRA indices to support application. The introductory overview is written with the intent of facilitating contrasts among IRA statistics by critically reviewing equations, interpretations, strengths, and weaknesses. Statistics considered include rwg, rwg*, r′wg, rwg(p), average deviation (AD), awg, standard deviation (Swg), and the coefficient of variation (CVwg). Equations support quick calculation and contrasting of different agreement indices. The article also includes a “quick reference” table and three figures in order to help readers identify how IRA statistics differ and how interpretations of IRA will depend strongly on the statistic employed. A brief consideration of recommended practices involving statistical and practical cutoff standards is presented, and conclusions are offered in light of the current literature. PMID:28553257

IMPLEMENTATION AND SUSTAINABILITY OF CHILD-PARENT PSYCHOTHERAPY: THE ROLE OF REFLECTIVE CONSULTATION IN THE LEARNING COLLABORATIVE MODEL.

PubMed

Noroña, Carmen Rosa; Acker, Michelle L

2016-11-01

Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned. © 2016 Michigan Association for Infant Mental Health.

Legal and ethical issues in robotic surgery.

PubMed

Mavroforou, A; Michalodimitrakis, E; Hatzitheo-Filou, C; Giannoukas, A

2010-02-01

With the rapid introduction of revolutionary technologies in surgical practice, such as computer-enhanced robotic surgery, the complexity in various aspects, including medical, legal and ethical, will increase exponentially. Our aim was to highlight important legal and ethical implications emerged from the application of robotic surgery. Search of the pertinent medical and legal literature. Robotic surgery may open new avenues in the near future in surgical practice. However, in robotic surgery, special training and experience along with high quality assessment are required in order to provide normal conscientious care and state-of-the-art treatment. While the legal basis for professional liability remains exactly the same, litigation with the use of robotic surgery may be complex. In case of an undesirable outcome, in addition to physician and hospital, the manufacturer of the robotic system may be sued. In respect to ethical issues in robotic surgery, equipment safety and reliability, provision of adequate information, and maintenance of confidentiality are all of paramount importance. Also, the cost of robotic surgery and the lack of such systems in most of the public hospitals may restrict the majority from the benefits offered by the new technology. While surgical robotics will have a significant impact on surgical practice, it presents challenges so much in the realm of law and ethics as of medicine and health care.

Assessing advantages and barriers to telemedicine adoption in the practice setting: A MyCareTeam(TM) exemplar.

PubMed

L'Esperance, Shaun T; Perry, Donna J

2016-06-01

Telemedicine is an evolving field that holds great potential to improve patient outcomes. The National Organization of Nurse Practitioner Faculties core competencies now require all nurse practitioners (NPs) to be competent utilizing telemedicine to address various patient and healthcare system needs. While telemedicine offers advantages to patient care, adoption of new technologies can be challenging. An assessment of perceived advantages and barriers to MyCareTeam, an online diabetes management system, was conducted at an adult diabetes clinic. Two survey questionnaires were developed based on the Diffusion of Innovations (DOI) theory. The surveys were administered to patients in the clinic waiting room and sent to all clinical staff via an e-mail link. The findings of this project suggested a novel way to classify patients with regard to their use of the technology with implications for practice. Recommendations include outreach to enhance knowledge and awareness of MyCareTeam, reinforcing the full scope of the system, and improved technical support. DOI theory is a framework that may be utilized by NPs as a tool for assessing advantages and barriers to telemedicine applications in the practice setting in order to identify strategies to promote adoption and use. ©2015 American Association of Nurse Practitioners.

Biomedical practices from a patient perspective. Experiences of Polish female migrants in Barcelona, Berlin and London.

PubMed

Main, Izabella

2016-08-01

This paper focuses on the diversity in patients' experience of bio-medicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations.

Principal-agent relationships in general practice: the first wave of English Personal Medical Services pilot contracts.

PubMed

Sheaff, R; Lloyd-Kendall, A

2000-07-01

To investigate how far English National Health Service (NHS) Personal Medical Services (PMS) contracts embody a principal-agent relationship between health authorities (HAs) and primary health care providers, especially, but not exclusively, general practices involved in the first wave (1998) of PMS pilot projects; and to consider the implications for relational and classical theories of contract. Content analysis of 71 first-wave PMS contracts. Most PMS contracts reflect current English NHS policy priorities, but few institute mechanisms to ensure that providers realise these objectives. Although PMS contracts have some classical characteristics, relational characteristics are more evident. Some characteristics match neither the classical nor the relational model. First-wave PMS contracts do not appear to embody a strong principal-agent relationship between HAs and primary health care providers. This finding offers little support for the relevance of classical theories of contract, but also implies that relational theories of contract need to be revised for quasi-market settings. Future PMS contracts will need to focus more on evidence-based processes of primary care, health outputs and patient satisfaction and less upon service inputs. PMS contracts will also need to be longer-term contracts in order to promote the 'institutional embedding' of independent general practice in the wider management systems of the NHS.

Critique of a practice-based pilot study in chiropractic practices in Western Australia.

PubMed

Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F; Nedkoff, Lee; Fisher, Colleen

2016-01-01

Practice-based data collection can offer insight into the nature of chiropractic practice and contribute to resolving the conundrum of the chiropractic profession's role in contemporary healthcare, subsequently informing care service policy. However, there is little formal data available about chiropractic practice to inform decision-makers about the nature and role of chiropractic within the context of a modern multidisciplinary healthcare context in Australia, particularly at a local and regional level. This was a mixed-methods data transformation model (qualitative to quantitative) pilot study the purpose of which was to provide a critique of the research design and collect data from a selected sample of chiropractic practices in Western Australia, with a view to offer recommendations related to the design, feasibility and implementation of a future confirmatory study. A narrative critique of the research methods of this pilot study is offered in this paper covering: (a) practice and patient recruitment, (b) enrollment of patients, (c) data collection methods, (d) acceptability of the study methods, (e) sample size calculations, and (f) design critique. The result of this critique provides a sensible sample size estimate and recommendations as to the design and implementation of a future confirmatory study. Furthermore, we believe that a confirmatory study is not only feasible, but indeed necessary, with a view to offer meaningful insight into chiropractic practice in Western Australia. ACTRN12616000434493 Australian New Zealand Clinical Trials Registry (ANZCTR). Registered 5 April 2016. First participant enrolled 01 July 2014, retrospectively registered.

Alternative Educational Futures for a Knowledge Society

ERIC Educational Resources Information Center

Young, Michael

2010-01-01

This article offers a critical analysis of recent trends in educational policy with particular reference to their assumptions about the knowledge society. It examines the implications of the analysis for the issue of elitism and the promotion of greater educational equality. The article concludes by offering an alternative approach to educational…

Global megatrends and their implications for environmental assessment practice

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

Retief, Francois, E-mail: francois.retief@nwu.ac.za; Bond, Alan; Research Unit for Environmental Sciences and Management, North-West University

This paper addresses the future of environmental assessment (EA) practice in light of a rapidly changing world. We apply a literature review-based methodology to firstly identify key global megatrends and then reflect upon the implications for EA practice based on some known challenges. The key megatrends identified are synthesised into six categories: i) demographics, ii) urbanization, iii) technological innovation, iv) power shifts, v) resource scarcity and vi) climate change. We then discuss the implications of these megatrends for EA practice against four known EA challenges namely: dealing with i) complexity and uncertainty, ii) efficiency, iii) significance and iv) communication andmore » participation. Our analysis suggests important implications for EA practice such as: increased difficulties with accuracy of prediction; the need for facilitative adaptation; an increase in the occurrence of unexpected events; higher expectations for procedural efficiency; challenges with information and communication management; dealing with significance judgements; and mitigation amidst resource scarcity and increasing pressures on earth systems. The megatrends underscore the need for continued evolution of EA thinking and practice, especially moving away from seeking a predictable single future or outcome towards the possibility of multiple scenarios with associated adaptability and enhanced system resilience capable of responding to rapid change.« less

Psychology and the Notion of the Spirit: Implications of Max Scheler's Anthropological Philosophy in Theory of Psychology.

PubMed

Lehmann, Olga V; Klempe, Sven Hroar

2015-09-01

After many decades with neglect Max Scheler and his anthropological contributions to the understanding of human existence, have gotten  more attention in psychology and other humanities. One factor is the actuality of his main project of revaluating the roles of values in philosophy and science. Yet another is the way individual scholars have applied Scheler's philosophy and terms on different fields and arenas. Viktor Frankl was one of these, and he brought Scheler's philosophical anthropology into psychotherapeutic practice, offering theoretical and empirical arguments for considering the notion of the spirit as an interdependent -yet separate- entity in regards to the psyche and the soma. During this commentary on Allyushin (Integrative Psychology Behaviour, 48, 503-523, 2014), we will discuss some general aspects of Scheler's contribution to phenomenology, but focus specifically on the implication of his notion of the spirit for psychological theory, acknowledging the work that has been done in the field for at least 60 years in logotherapy and existential analysis. With this purpose, we will highlight four other notions interrelated with the motivational quality of the notion of the spirit: resentment, axiology of values; self-detachment and self-transcendence.

Nonlinear effects of team tenure on team psychological safety climate and climate strength: Implications for average team member performance.

PubMed

Koopmann, Jaclyn; Lanaj, Klodiana; Wang, Mo; Zhou, Le; Shi, Junqi

2016-07-01

The teams literature suggests that team tenure improves team psychological safety climate and climate strength in a linear fashion, but the empirical findings to date have been mixed. Alternatively, theories of group formation suggest that new and longer tenured teams experience greater team psychological safety climate than moderately tenured teams. Adopting this second perspective, we used a sample of 115 research and development teams and found that team tenure had a curvilinear relationship with team psychological safety climate and climate strength. Supporting group formation theories, team psychological safety climate and climate strength were higher in new and longer tenured teams compared with moderately tenured teams. Moreover, we found a curvilinear relationship between team tenure and average team member creative performance as partially mediated by team psychological safety climate. Team psychological safety climate improved average team member task performance only when team psychological safety climate was strong. Likewise, team tenure influenced average team member task performance in a curvilinear manner via team psychological safety climate only when team psychological safety climate was strong. We discuss theoretical and practical implications and offer several directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Peace, development, disarmament and human rights education: The dilemma between the status quo and curriculum overload

NASA Astrophysics Data System (ADS)

Marks, Stephen

1983-09-01

With the purpose of facilitating the promotion of peace, development, disarmament and human rights education in the context of intense competition for curriculum time, including from other new `educations', some tentative definitions are offered. Clarification of the basic concepts and their implications leads to a discussion of the inter-relationships amongst them. Hence, a conceptual approach is suggested which is based on the Peace — Human Rights — Development dialectic, defended as crucial with regards to education which must go beyond the transmission of knowledge to the involvement of the participants in their own social reality so that they become subjects rather than objects of their own history. Models are developed to illustrate the pedagogical implications of the dialectical relations among the concepts, aimed at (1) enabling coverage of the topics and their inter-relationships in traditional courses, and (2) suggesting themes for specialized courses which would allow more in-depth analysis. Finally, practical issues with examples for secondary-and tertiary-level teaching are discussed. Rather than giving in to some utopian ideal, educators should realistically draw on the ideas currently being worked out in peace, development, disarmament and human rights education.

Implications for Minority Groups of the Movement Toward Minimum-Competency Testing. A Symposium presented at the 1979 Annual Meeting of the National Council on Measurement in Education.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Tests, Measurement, and Evaluation, Princeton, NJ.

Proceedings of the symposium on Implications for Minority Groups of the Movement Toward Minimum-Competency Testing (MCT) include the following papers: (1) "Implications of Minimum-Competency Testing for Minority Students" by A. Graham Down, who asserts that MCT offers more hope than any development in public school policy since 1954 for realizing…

Deterring Violent Extremism in America by Utilizing Good Counter-Radicalization Practices from Abroad: A Policy Perspective

DTIC Science & Technology

2017-03-01

offering rehabilitation programs to former extremists. This thesis provides a way ahead for American policy makers by sharing good practices in each of...and offering training to prevent terrorism from when individuals are young. Understanding that humans are fallible, American policy makers and...in the United Kingdom that provided trained Islamic scholars to offer advice about the true teaching of Islam.102 The hotline “El-Hatef el- Islami’s

The applicability of terrestrial visitor impact management strategies to the protection of coral reefs

USGS Publications Warehouse

Marion, J.L.; Rogers, C.S.

1994-01-01

A dramatic expansion in nature-based tourism to tropical coastal destinations has occurred in the past 20 years. Tourism development, combined with intense recreational pressures, has irreversibly transformed and degraded many popular scenic natural environments. This paper examines the management of recreational impacts to coral reefs using Virgin Islands National Park as a case study. A review of terrestrial recreational ecology research explores the implications and potential applicability of some principal findings to the protection of coral reefs. Visitor impact management recommendations for the protection of coral reefs are offered. Managers can minimize coral reef recreational impacts by (1) restricting high-impact uses, (2) containing rather than dispersing recreational use, (3) encouraging the use of resistant environments, (4) teaching low-impact recreational practices, and (5) enforcing park rules and regulations.

Scientists@Home: What Drives the Quantity and Quality of Online Citizen Science Participation?

PubMed Central

Nov, Oded; Arazy, Ofer; Anderson, David

2014-01-01

Online citizen science offers a low-cost way to strengthen the infrastructure for scientific research and engage members of the public in science. As the sustainability of online citizen science projects depends on volunteers who contribute their skills, time, and energy, the objective of this study is to investigate effects of motivational factors on the quantity and quality of citizen scientists' contribution. Building on the social movement participation model, findings from a longitudinal empirical study in three different citizen science projects reveal that quantity of contribution is determined by collective motives, norm-oriented motives, reputation, and intrinsic motives. Contribution quality, on the other hand, is positively affected only by collective motives and reputation. We discuss implications for research on the motivation for participation in technology-mediated social participation and for the practice of citizen science. PMID:24690612

The Health Policy Process in Vietnam: Going Beyond Kingdon’s Multiple Streams Theory

PubMed Central

Kane, Sumit

2016-01-01

This commentary reflects upon the article along three broad lines. It reflects on the theoretical choices and omissions, particularly highlighting why it is important to adapt the multiple streams framework (MSF) when applying it in a socio-political context like Vietnam’s. The commentary also reflects upon the analytical threads tackled by Ha et al; for instance, it highlights the opportunities offered by, and raises questions about the centrality of the Policy Entrepreneur in getting the policy onto the political agenda and in pushing it through. The commentary also dwells on the implications of the article for development aid policies and practices. Throughout, the commentary signposts possible themes for Ha et al to consider for further analysis, and more generally, for future research using Kingdon’s multiple streams theory. PMID:27694671

Use of technology for note taking and therapeutic alliance.

PubMed

Wiarda, Nicholas R; McMinn, Mark R; Peterson, Mary A; Gregor, Joel A

2014-09-01

Is psychotherapeutic alliance helped or harmed by using an iPad or computer during an intake session? Two studies are reported where psychotherapists use one of three different technologies in semistructured initial interviews: paper and pen, iPad, or a computer. The studies were conducted at a Primary Care Clinic and a Community Mental Health Clinic to provide a broader context to account for recent behavioral health integration into medical settings in addition to a traditional psychotherapy setting. The Primary Care Study consisted of 60 participants from a behavioral health service at a primary care clinic. The Community Mental Health Study involved 55 participants from a community mental health clinic in semirural Oregon. No differences were found for the three technologies in either study. Practice and training implications are offered. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Gradient Calculation Methods on Arbitrary Polyhedral Unstructured Meshes for Cell-Centered CFD Solvers

NASA Technical Reports Server (NTRS)

Sozer, Emre; Brehm, Christoph; Kiris, Cetin C.

2014-01-01

A survey of gradient reconstruction methods for cell-centered data on unstructured meshes is conducted within the scope of accuracy assessment. Formal order of accuracy, as well as error magnitudes for each of the studied methods, are evaluated on a complex mesh of various cell types through consecutive local scaling of an analytical test function. The tests highlighted several gradient operator choices that can consistently achieve 1st order accuracy regardless of cell type and shape. The tests further offered error comparisons for given cell types, leading to the observation that the "ideal" gradient operator choice is not universal. Practical implications of the results are explored via CFD solutions of a 2D inviscid standing vortex, portraying the discretization error properties. A relatively naive, yet largely unexplored, approach of local curvilinear stencil transformation exhibited surprisingly favorable properties

An actor-focused model of justice rule adherence and violation: the role of managerial motives and discretion.

PubMed

Scott, Brent A; Colquitt, Jason A; Paddock, E Layne

2009-05-01

Research on organizational justice has focused primarily on the receivers of just and unjust treatment. Little is known about why managers adhere to or violate rules of justice in the first place. The authors introduce a model for understanding justice rule adherence and violation. They identify both cognitive motives and affective motives that explain why managers adhere to and violate justice rules. They also draw distinctions among the justice rules by specifying which rules offer managers more or less discretion in their execution. They then describe how motives and discretion interact to influence justice-relevant actions. Finally, the authors incorporate managers' emotional reactions to consider how their actions may change over time. Implications of the model for theory, research, and practice are discussed. (c) 2009 APA, all rights reserved.

Dialogic reverberations: police, domestic abuse, and the discontinuance of cases.

PubMed

Lea, Susan J; Lynn, Nick

2012-10-01

This study investigated the social construction of domestic abuse by police officers, specifically in the context of arguments presented to the prosecutor for a decision on whether to proceed with or discontinue the case. Nineteen police files were examined with a particular focus on the MG3, the "Report to Crown Prosecutors for Charging Decision." Access to such sensitive material is usually denied to researchers; therefore, this study offers unusual insights into the treatment of victims and perpetrators of interpersonal violence by the police. Discourse analysis revealed three dominant speech genres: impartiality, credibility, and the "real" victim. These genres separately and in interaction served to construct domestic abuse cases in ways that did not support the victim's account. The "dialogic reverberations" of these findings are discussed and the implications of the work for research and practice are considered.

Healthy aging persons and their brains: promoting resilience through creative engagement.

PubMed

McFadden, Susan H; Basting, Anne D

2010-02-01

Creative engagement, as an expression of and a support for resilience, may have a neuroprotective effect among older adults, contributing to retention of cognitive capacity. Recent research on creative activities shows that they strengthen social networks and give persons a sense of control; both outcomes have been associated with brain health. The authors cite evidence suggesting that positive social interactions can nurture resilience and creative engagement among older persons, including those living with dementia. The motivational, attentional, affective, and social components of creative activities combine to offer older persons meaningful opportunities to express and strengthen their resilience, regardless of their cognitive status, despite the biopsychosocial challenges of aging. The article addresses implications for future research, clinical practice, and public policy, and suggests how gaps in current research on resilience and creativity might be addressed.

Geriatric education across 94 million acres: adapting conference programming in a rural state.

PubMed

Murphy-Southwick, Colleen; McBride, Melen

2006-01-01

Montana, a predominantly rural state, with a unique blend of geography and history, low population density, and cultural diversity represents the challenges for program development and implementation across remote areas. The paper discusses two statewide multidisciplinary geriatric education programs for health professionals offered by the recently established Montana Geriatric Education Center (MTGEC); use of telecommunications technology; collaborations with Geriatric Education Centers (GECs) and the Montana Healthcare Telemedicine Alliance (MHTA); and training outcomes, insights, and implications for continuing education of health professionals who practice in hard-to-reach regions. In addition, data from a statewide needs assessment are presented specific to preferred format. The MTGEC training model that combined traditional classroom and videoconference increased attendance by twofold and may be adapted in other regions to train providers in remote areas of the U.S.

Scientists@Home: what drives the quantity and quality of online citizen science participation?

PubMed

Nov, Oded; Arazy, Ofer; Anderson, David

2014-01-01

Online citizen science offers a low-cost way to strengthen the infrastructure for scientific research and engage members of the public in science. As the sustainability of online citizen science projects depends on volunteers who contribute their skills, time, and energy, the objective of this study is to investigate effects of motivational factors on the quantity and quality of citizen scientists' contribution. Building on the social movement participation model, findings from a longitudinal empirical study in three different citizen science projects reveal that quantity of contribution is determined by collective motives, norm-oriented motives, reputation, and intrinsic motives. Contribution quality, on the other hand, is positively affected only by collective motives and reputation. We discuss implications for research on the motivation for participation in technology-mediated social participation and for the practice of citizen science.

The big five personality traits and individual job performance growth trajectories in maintenance and transitional job stages.

PubMed

Thoresen, Carl J; Bradley, Jill C; Bliese, Paul D; Thoresen, Joseph D

2004-10-01

This study extends the literature on personality and job performance through the use of random coefficient modeling to test the validity of the Big Five personality traits in predicting overall sales performance and sales performance trajectories--or systematic patterns of performance growth--in 2 samples of pharmaceutical sales representatives at maintenance and transitional job stages (K. R. Murphy, 1989). In the maintenance sample, conscientiousness and extraversion were positively associated with between-person differences in total sales, whereas only conscientiousness predicted performance growth. In the transitional sample, agreeableness and openness to experience predicted overall performance differences and performance trends. All effects remained significant with job tenure statistically controlled. Possible explanations for these findings are offered, and theoretical and practical implications of findings are discussed. (c) 2004 APA, all rights reserved

Deciding about patients' requests for extraction: ethical and legal guidelines.

PubMed

Broers, Dyonne L M; Brands, Wolter G; Welie, Jos V M; de Jongh, Ad

2010-02-01

and Overview. Dentists frequently are faced with patients' requests for an extraction, sometimes of the entire dentition. In this article, the authors offer guidelines to help dentists and oral surgeons make decisions regarding such requests for extraction. In most cases of patients' requesting extractions, the ethical principle of nonmaleficence will play a decisive role in the dentist's decision making. In cases in which the request appears influenced by a specific mental condition such as a phobia of dental treatment, extraction rarely is justifiable. Practice Implications. Dental professionals should keep in mind that they cannot be forced to carry out treatment that is at odds with the ethical principle of nonmaleficence or that is outside of the bounds of accepted treatment. To aid dentists in making treatment decisions in such cases, the authors present a flowchart that integrates possible considerations.

Effectiveness of a School-based Academic Asthma Health Education and Counseling Program on Fostering Acceptance of Asthma in Older School-age Students with Asthma

PubMed Central

Kintner, Eileen K.; Cook, Gwendolyn; Marti, C. Nathan; Gomes, Melissa; Meeder, Linda; Van Egeren, Laurie A.

2014-01-01

Purpose The purpose was to evaluate the effectiveness of the academic asthma education and counseling SHARP program on fostering psychosocial acceptance of asthma. Design and Methods This was a phase III, two-group, cluster randomized, single-blinded, longitudinal study. Students from grades 4 and 5 (N = 205) with asthma and their caregivers completed surveys at pre-intervention and at 1, 12, and 24 months post-intervention. Analysis involved multilevel modeling. Results All students demonstrated significant improvement in aspects of acceptance; students in SHARP demonstrated significant improvement in openness to sharing and connectedness with teachers over students in the control condition. Practice Implications The SHARP program offers a well-tested, effective program for psychosocial acceptance of asthma, which is welcomed by schools. PMID:25443593

Learning Styles in Engineering Education: The Quest to Improve Didactic Practices

ERIC Educational Resources Information Center

Holvikivi, Jaana

2007-01-01

This article discusses a dilemma that engineering educators encounter when attempting to develop pedagogical methods: that of finding efficient and scientifically valid didactic practices. The multitude of methods offered by educational consultants is perplexing. Moreover, the popularity of commercially offered solutions such as learning styles…

Student Empowerment: Definition, Implications, and Strategies for Implementation.

ERIC Educational Resources Information Center

Duhon-Haynes, Gwendolyn M.

This review of the literature defines the concept of student empowerment, discusses the implications of student empowerment in educational settings, and outlines strategies for facilitating increased empowerment. A definition of "empowerment" as "bringing into a state of belief one's ability to act effectively," is offered and the critical…

Research Overview: Implications for Staff Development. Higher Education in TAFE. Monograph Series 01/2009

ERIC Educational Resources Information Center

Moodie, Gavin; Wheelahan, Leesa; Billett, Stephen; Kelly, Ann

2009-01-01

A project funded through the National Vocational Education and Training Research and Evaluation program investigated higher education programs--mostly bachelor's and associate degrees--offered by technical and further education (TAFE) institutes. This overview highlights some of the implications for staff development identified through this…

Research Overview: Implications for TAFE Managers. Higher education in TAFE. Monograph Series 01/2009

ERIC Educational Resources Information Center

Moodie, Gavin; Wheelahan, Leesa; Billett, Stephen; Kelly, Ann

2009-01-01

A project funded through the National Vocational Education and Training Research and Evaluation program investigated higher education programs--mostly bachelor's and associate degrees--offered by technical and further education (TAFE) institutes. This overview highlights the implications for TAFE management identified through this project. [This…

Research Overview: Implications for Teachers. Higher Education in TAFE. Monograph Series 01/2009

ERIC Educational Resources Information Center

Moodie, Gavin; Wheelahan, Leesa; Billett, Stephen; Kelly, Ann

2009-01-01

A project funded through the National Vocational Education and Training Research and Evaluation program investigated higher education programs--mostly bachelor's and associate degrees--offered by technical and further education (TAFE) institutes. This overview highlights some of the implications for teachers identified by this project. [This…

Learning Styles of African American Children: Instructional Implications

ERIC Educational Resources Information Center

Hale, Janice Ellen

2016-01-01

This article offers examples of valiant efforts to develop meaningful instructional implications from learning styles scholarship. Additionally, an example is given of an advance in the public policy arena that merges the efforts of psychological scholars with that of lawmakers to apply their research to effect change for children. The…

Sociomateriality in medical practice and learning: attuning to what matters.

PubMed

Fenwick, Tara

2014-01-01

In current debates about professional practice and education, increasing emphasis is placed on understanding learning as a process of ongoing participation rather than one of acquiring knowledge and skills. However, although this socio-cultural view is important and useful, issues have emerged in studies of practice-based learning that point to certain oversights. Three issues are described here: (i) the limited attention paid to the importance of materiality - objects, technologies, nature, etc.-- in questions of learning; (ii) the human-centric view of practice that fails to note the relations among social and material forces, and (iii) the conflicts between ideals of evidence-based standardised models and the sociomaterial contingencies of clinical practice. It is argued here that a socio-material approach to practice and learning offers important insights for medical education. This view is in line with a growing field of research in the materiality of everyday life, which embraces wide-ranging families of theory that can be only briefly mentioned in this short paper. The main premise they share is that social and material forces, culture, nature and technology, are enmeshed in everyday practice. Objects and humans act upon one another in ways that mutually transform their characteristics and activity. Examples from research in medical practice show how materials actively influence clinical practice, how learning itself is a material matter, how protocols are in fact temporary sociomaterial achievements, and how practices form unique and sometimes conflicting sociomaterial worlds, with diverse diagnostic and treatment approaches for the same thing. This discussion concludes with implications for learning in practice. What is required is a shift from an emphasis on acquiring knowledge to participating more wisely in particular situations. This focus is on learning how to attune to minor material fluctuations and surprises, how to track one's own and others' effects on 'intra-actions' and emerging effects, and how to improvise solutions. © 2013 John Wiley & Sons Ltd.

Shared Decision-Making for Nursing Practice: An Integrative Review

PubMed Central

Truglio-Londrigan, Marie; Slyer, Jason T.

2018-01-01

Background: Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. Objective: To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. Methods: An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Results: Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. Conclusion: A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions. PMID:29456779

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

PubMed

Connelly, Lynne M; Peltzer, Jill N

2016-01-01

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

Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

PubMed

Mesman, Roos; Faber, Marjan J; Westert, Gert P; Berden, Bart

2018-01-01

Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality. The interviews were recorded, transcribed verbatim and underwent inductive content analysis. Results Two overarching themes were inductively derived from the data: (1) minimum volume standards and (2) implications of volume-based policies. Although surgeons acknowledged the premise 'more is better', they were critical about the validity and underlying evidence for minimum volume standards. Patients often inquire about caseload, which is met with both understanding and discomfort. Surgeons offered many examples of controversies surrounding the process of determining thresholds as well as the ways in which health insurers use volume as a purchasing criterion. Furthermore, being held accountable for caseload may trigger undesired strategic behaviour, such as unwarranted operations. Volume-based policies also have implications for the survival of low-volume providers and affect patient travel times, although the latter is not necessarily problematic in the Dutch context. Conclusions Surgeons in this study acknowledged that more volume leads to better quality. However, validity issues, undesired strategic behaviour and the ways in which minimum volume standards are established and applied have made surgeons critical of current policy practice. These findings suggest that volume remains a controversial quality measure and causes polarization that is not conducive to a collective effort for quality improvement. We recommend enforcing thresholds that are based on the best achievable level of consensus and assessing additional criteria when passing judgement on quality of care.

Downsides of an overly context-sensitive self: implications from the culture and subjective well-being research.

PubMed

Suh, Eunkook M

2007-12-01

The self becomes context sensitive in service of the need to belong. When it comes to achieving personal happiness, an identity system that derives its worth and meaning excessively from its social context puts itself in a significantly disadvantageous position. This article integrates empirical findings and ideas from the self, subjective well-being, and cross-cultural literature and tries to offer insights to why East Asian cultural members report surprisingly low levels of happiness. The various cognitive, motivational, behavioral, and affective characteristics of the overly relation-oriented self are discussed as potential explanations. Implications for the study of self and culture are offered.

Unconventional eating practices and their health implications.

PubMed

Hanning, R M; Zlotkin, S H

1985-04-01

The authors discuss a number of unconventional or faddist foods and eating practices and their health implications. Among the topics included are vegetarianism, Zen macrobiotic diets, fast foods, junk foods, megavitamins and their toxicity, health foods, fad diets in infancy, and elimination diets.

A Synthesis of Relevant Literature on the Development of Emotional Competence: Implications for Design of Augmentative and Alternative Communication Systems.

PubMed

Na, Ji Young; Wilkinson, Krista; Karny, Meredith; Blackstone, Sarah; Stifter, Cynthia

2016-08-01

Emotional competence refers to the ability to identify, respond to, and manage one's own and others' emotions. Emotional competence is critical to many functional outcomes, including making and maintaining friends, academic success, and community integration. There appears to be a link between the development of language and the development of emotional competence in children who use speech. Little information is available about these issues in children who rely on augmentative and alternative communication (AAC). In this article, we consider how AAC systems can be designed to support communication about emotions and the development of emotional competence. Because limited research exists on communication about emotions in a context of aided AAC, theory and research from other fields (e.g., psychology, linguistics, child development) is reviewed to identify key features of emotional competence and their possible implications for AAC design and intervention. The reviewed literature indicated that the research and clinical attention to emotional competence in children with disabilities is encouraging. However, the ideas have not been considered specifically in the context of aided AAC. On the basis of the reviewed literature, we offer practical suggestions for system design and AAC use for communication about emotions with children who have significant disabilities. Three key elements of discussing emotions (i.e., emotion name, reason, and solution) are suggested for inclusion in order to provide these children with opportunities for a full range of discussion about emotions. We argue that supporting communication about emotions is as important for children who use AAC as it is for children who are learning speech. This article offers a means to integrate information from other fields for the purpose of enriching AAC supports.

Interpersonal complaints regarding cancer care through a gender lens.

PubMed

Olsson, Erik Masao

2016-07-11

Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients' and relatives' complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.

The mutuality metaphor: understanding healthcare provision in NHS Scotland.

PubMed

Howieson, Brian

2016-06-20

Purpose - Better Health, Better Care Action Plan (Scottish Government, 2007) sets out how the Scottish Government intends to strengthen public ownership of the National Health Service in Scotland. The purpose of this paper is to advance extant knowledge by understanding how a state-led mutual health policy may be interpreted, and importantly, communicated. Design/methodology/approach - The definitional problem of mutuality will be discussed and analysed in terms of how it is (or perhaps should be) communicated? will be offered. Findings - It actually may be more instructive to think of, and communicate, mutuality as a metaphor to aid understanding of the openness and fluidity found in NHS Scotland. Research limitations/implications - The existence of paradox and ambiguity does not, however, negate the usefulness of the term "mutuality". Quite the opposite in fact: it is precisely by examining healthcare and its delivery through the lens of mutuality (rather than rejecting its complexity as a failure) that this amorphousness can be better appreciated. Practical implications - There is a need for more public, professional, and academic debate to explore and clarify its implementation, and how it is to be led. This must be provided whilst recognising the daily imperatives that NHS leaders must face. This would suggest, therefore, that a dual development path may help. Originality/value - Although Better Health, Better Care Action Plan was published in 2007, some eight years on there is still confusion and misunderstanding as to what mutuality in healthcare is, not only in policy and theory, but also in practice. It is hoped that this analysis will help address, in part, some of this confusion and misunderstanding.

Exploring policy makers' perspectives on a clinical controversy: airway surgery for adult obstructive sleep apnoea.

PubMed

Elshaug, A G; Hiller, J E; Moss, J R

2009-10-01

Worldwide, there is increasing focus on measures to reduce ineffective healthcare practices. Upper airway surgeries for the treatment of adult obstructive sleep apnoea (OSA) represent a case-study in this area, given recent publications that draw into question their efficacy. Policy stakeholders were canvassed to assess their perspectives on this. Senior health policy stakeholders from Australia were criterion and snowball sampled (to identify opinion leaders). Participants were presented with preparatory material and took part in individual semistructured interviews. These focused on eliciting responses to recently published evidence and a relevant Cochrane review. Questions were posed relating to clinical effectiveness and associated policy implications. Interviews were taped and transcribed for thematic analysis. Participant comments were de-identified. Ten stakeholders were interviewed before saturation was reached. Thematic analysis highlighted participant concern with the diversity of procedures on offer, coupled with limited effectiveness (suggesting potential clinical uncertainty) and considerations therefore of resource allocation (potential opportunity cost). Stakeholders seem aware of the methodological complexities, the ethical issues raised and the role of patients in considerations regarding appropriateness. Finally, policy stakeholders acknowledge that these procedures appear appropriate only for a minority, with consensus that policy level restrictions to government funding for these procedures may be warranted. This report highlights that this clinical controversy is of interest and relevance from a policy perspective with lessons and potential implications for clinical practice. It further highlights the need for clinical consensus on definitions of surgical "success" in treating this condition, as this forms an important pretext to policy considerations.

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

PubMed

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

2015-10-01

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

Prescriptive Statements and Educational Practice: What Can Structural Equation Modeling (SEM) Offer?

ERIC Educational Resources Information Center

Martin, Andrew J.

2011-01-01

Longitudinal structural equation modeling (SEM) can be a basis for making prescriptive statements on educational practice and offers yields over "traditional" statistical techniques under the general linear model. The extent to which prescriptive statements can be made will rely on the appropriate accommodation of key elements of research design,…

Narrative Inquiry: Theory and Practice

ERIC Educational Resources Information Center

Savin-Baden, Maggi; Van Niekerk, Lana

2007-01-01

This article offers an overview of the method of narrative inquiry and explores competing trends in the use of the approach. It not only examines the theories relating to the method but also offers practical guidance on using narrative inquiry, including an exploration of what might count as a narrative and ways of analysing narrative data. The…

Principles and Practices of the Circle of Trust[R] Approach

ERIC Educational Resources Information Center

Chadsey, Terry; Jackson, Marcy

2012-01-01

Through the Center for Courage & Renewal, the authors offer personal and professional retreats and programs designed to explore vocational and life questions, offer renewal and encouragement, and deepen engagement in professional practice. Using what they call the Circle of Trust[R] approach, they invite groups into a communal process based upon a…

Use of Selected Dental School Courses for Continuing Education.

ERIC Educational Resources Information Center

Sanger, Roger G.

1981-01-01

In an effort to market current predoctoral dental courses offered at the University of Colorado Health Sciences Center School of Dentistry to the practicing dentist, a 10-hour forensic odontology course was offered to both predoctoral dental students and practicing dentists and their staffs. Positive reactions and cost effectiveness of this pilot…

Observations

ERIC Educational Resources Information Center

Joosten, Albert Max

2016-01-01

Joosten begins his article by telling us that love and knowledge together are the foundation for our work with children. This combination is at the heart of our observation. With this as the foundation, he goes on to offer practical advice to aid our practice of observation. He offers a "List of Objects of Observation" to help guide our…

Professional Development in Teaching and Learning for Early Career Academic Geographers: Contexts, Practices and Tensions

ERIC Educational Resources Information Center

Vajoczki, Susan; Biegas, Tamara C.; Crenshaw, Melody; Healey, Ruth L.; Osayomi, Tolulope; Bradford, Michael; Monk, Janice

2011-01-01

This paper provides a review of the practices and tensions informing approaches to professional development for early career academic geographers who are teaching in higher education. We offer examples from Britain, Canada, Nigeria and the USA. The tensions include: institutional and departmental cultures; models that offer generic and…

Learning through Artful Knowing

ERIC Educational Resources Information Center

van Meer, Pleuntje

2016-01-01

In this paper, van Meer offers an exploration in the context of action learning doctoral research in which she explores leadership consultancy practice. The purpose is to grow insight on learning as a lived experience. Artful knowing offers a way to learn about life and practice, through a deeply personal, reflective and sense-making process. The…

Communication and Exchange of Specialized Health-Related Support Among People With Experiential Similarity on Facebook.

PubMed

Gage-Bouchard, Elizabeth A; LaValley, Susan; Mollica, Michelle; Beaupin, Lynda Kwon

2017-10-01

Social support is an important factor that shapes how people cope with illness, and health-related communication among peers managing the same illness (network ties with experiential similarity) offers specialized information, resources, and emotional support. Facebook has become a ubiquitous part of many Americans' lives, and may offer a way for patients and caregivers experiencing a similar illness to exchange specialized health-related support. However, little is known about the content of communication among people who have coped with the same illness on personal Facebook pages. We conducted a content analysis of 12 months of data from 18 publicly available Facebook pages hosted by parents of children with acute lymphoblastic leukemia, focusing on communication between users who self-identified as parents of pediatric cancer patients. Support exchanges between users with experiential similarity contained highly specialized health-related information, including information about health services use, symptom recognition, compliance, medication use, treatment protocols, and medical procedures. Parents also exchanged tailored emotional support through comparison, empathy, encouragement, and hope. Building upon previous research documenting that social media use can widen and diversify support networks, our findings show that cancer caregivers access specialized health-related informational and emotional support through communication with others who have experienced the same illness on personal Facebook pages. These findings have implications for health communication practice and offer evidence to tailor M-Health interventions that leverage existing social media platforms to enhance peer support for patients and caregivers.

The role of self-interest in elite bargaining.

PubMed

LeVeck, Brad L; Hughes, D Alex; Fowler, James H; Hafner-Burton, Emilie; Victor, David G

2014-12-30

One of the best-known and most replicated laboratory results in behavioral economics is that bargainers frequently reject low offers, even when it harms their material self-interest. This finding could have important implications for international negotiations on many problems facing humanity today, because models of international bargaining assume exactly the opposite: that policy makers are rational and self-interested. However, it is unknown whether elites who engage in diplomatic bargaining will similarly reject low offers because past research has been based almost exclusively on convenience samples of undergraduates, members of the general public, or small-scale societies rather than highly experienced elites who design and bargain over policy. Using a unique sample of 102 policy and business elites who have an average of 21 y of practical experience conducting international diplomacy or policy strategy, we show that, compared with undergraduates and the general public, elites are actually more likely to reject low offers when playing a standard "ultimatum game" that assesses how players bargain over a fixed resource. Elites with more experience tend to make even higher demands, suggesting that this tendency only increases as policy makers advance to leadership positions. This result contradicts assumptions of rational self-interested behavior that are standard in models of international bargaining, and it suggests that the adoption of global agreements on international trade, climate change, and other important problems will not depend solely on the interests of individual countries, but also on whether these accords are seen as equitable to all member states.

The role of self-interest in elite bargaining

PubMed Central

LeVeck, Brad L.; Hughes, D. Alex; Fowler, James H.; Hafner-Burton, Emilie; Victor, David G.

2014-01-01

One of the best-known and most replicated laboratory results in behavioral economics is that bargainers frequently reject low offers, even when it harms their material self-interest. This finding could have important implications for international negotiations on many problems facing humanity today, because models of international bargaining assume exactly the opposite: that policy makers are rational and self-interested. However, it is unknown whether elites who engage in diplomatic bargaining will similarly reject low offers because past research has been based almost exclusively on convenience samples of undergraduates, members of the general public, or small-scale societies rather than highly experienced elites who design and bargain over policy. Using a unique sample of 102 policy and business elites who have an average of 21 y of practical experience conducting international diplomacy or policy strategy, we show that, compared with undergraduates and the general public, elites are actually more likely to reject low offers when playing a standard “ultimatum game” that assesses how players bargain over a fixed resource. Elites with more experience tend to make even higher demands, suggesting that this tendency only increases as policy makers advance to leadership positions. This result contradicts assumptions of rational self-interested behavior that are standard in models of international bargaining, and it suggests that the adoption of global agreements on international trade, climate change, and other important problems will not depend solely on the interests of individual countries, but also on whether these accords are seen as equitable to all member states. PMID:25512497

Empathy in general practice-the gap between wishes and reality: comparing the views of patients and physicians.

PubMed

Derksen, F A W M; Olde Hartman, Tim; Bensing, Jozien; Lagro-Janssen, Antoine

2018-03-27

Empathy is regarded by patients and general practitioners (GPs) as fundamental in patient-GP communication. Patients do not always experience empathy and GPs encounter circumstances which hamper applying it. To explore why receiving and offering empathy during the encounter in general practice does not always meet the wishes of both patients and GPs. A qualitative research method, based on focus group interviews with patients and in-depth interviews with GPs, was carried out. Within the research process, iterative data collection and analysis were applied. Both patients and GPs perceive a gap between what they wish for with regard to empathy, and what they actually encounter in general practice. Patients report on circumstances which hamper receiving empathy and GPs on circumstances offering it. Various obstacles were mentioned: (i) circumstances related to practice organization, (ii) circumstances related to patient-GP communication or connectedness, (iii) differences between the patient's and the GP's expectations, (iv) time pressure and its causes and (v) the GP's individual capability to offer empathy. When patients do not receive empathy from their GP or practice staff, they feel frustrated. This causes a gap between their expectations on the one hand and their actual experiences on the other. GPs generally want to incorporate empathy; the GP's private, professional and psychological well-being appears to be an important contributing factor in practicing empathy in daily practice. But they encounter various obstacles to offer this. It is up to GPs to take responsibility for showing practice members the importance of an appropriate empathical behaviour towards patients.

Implications of dual practice for universal health coverage.

PubMed

McPake, Barbara; Russo, Giuliano; Hipgrave, David; Hort, Krishna; Campbell, James

2016-02-01

Making progress towards universal health coverage (UHC) requires that health workers are adequate in numbers, prepared for their jobs and motivated to perform. In establishing the best ways to develop the health workforce, relatively little attention has been paid to the trends and implications of dual practice - concurrent employment in public and private sectors. We review recent research on dual practice for its potential to guide staffing policies in relation to UHC. Many studies describe the characteristics and correlates of dual practice and speculate about impacts, but there is very little evidence that is directly relevant to policy-makers. No studies have evaluated the impact of policies on the characteristics of dual practice or implications for UHC. We address this lack and call for case studies of policy interventions on dual practice in different contexts. Such research requires investment in better data collection and greater determination on the part of researchers, research funding bodies and national research councils to overcome the difficulties of researching sensitive topics of health systems functions.

Research Overview: Implications for Public Policy. Higher Education in TAFE. Monograph Series 01/2009

ERIC Educational Resources Information Center

Moodie, Gavin; Wheelahan, Leesa; Billett, Stephen; Kelly, Ann

2009-01-01

A project funded through the National Vocational Education and Training Research and Evaluation program investigated higher education programs--mostly bachelor's and associate degrees--offered by technical and further education (TAFE) institutes. This overview highlights some of the implications for public policy identified through this project.…

Adult Children of Divorce and Relationship Education: Implications for Counselors and Counselor Educators

ERIC Educational Resources Information Center

Johnson, Veronica I.

2011-01-01

This article explores the impact of relationship education on young adults' optimism about relationships and attitudes toward marriage whose parents were divorced and offers implications and suggestions for counselors and counselor educators. Previous research in the area of intimate and family relationships has demonstrated that adults who have…

Working with the Young Child: Clinical Implications of Contemporary Developmental Science

ERIC Educational Resources Information Center

Gold, Claudia M.

2017-01-01

The recognition that adverse childhood experiences have long-term negative effects parallels the explosion of evidence demonstrating how early experience gets into the body and brain. This knowledge, in turn, has significant implications for treatment of emotional and behavioral problems in early childhood. In this article, I offer a guide to…

Implications for Child Bilingual Acquisition, Optionality and Transfer

ERIC Educational Resources Information Center

Serratrice, Ludovica

2014-01-01

Amaral & Roeper's Multiple Grammars (MG) proposal offers an appealingly simple way of thinking about the linguistic representations of bilingual speakers. This article presents a commentary on the MG language acquisition theory proposed by Luiz Amaral and Tom Roeper in this issue, focusing on the theory's implications for child…

Curricluar Implications of Automated Data Processing for Educational Institutions. Final Report.

ERIC Educational Resources Information Center

Bangs, F. Kendrick; And Others

Integrated data processing in offices was studied to determine implications for the development of office occupations curriculums in public secondary schools and post-high school institutions offering less than baccalaureate degrees. Interviews were held with representatives of 285 businesses, teachers in 176 public high and post-high schools in…

Informal Learning in Professional and Personal Life: Implications for Instructional Design and Performance Improvement

ERIC Educational Resources Information Center

Klein, James D.; Moore, Alison L.

2016-01-01

This article focuses on informal learning and its implications for instructional design and performance improvement. The authors begin by sharing a story of how a novice instructional designer employs informal learning strategies in her professional and personal life. Next, they offer a definition of informal learning that encompasses both…