Enhancing predictive accuracy and reproducibility in clinical evaluation research: Commentary on the special section of the Journal of Evaluation in Clinical Practice.

PubMed

Bryant, Fred B

2016-12-01

This paper introduces a special section of the current issue of the Journal of Evaluation in Clinical Practice that includes a set of 6 empirical articles showcasing a versatile, new machine-learning statistical method, known as optimal data (or discriminant) analysis (ODA), specifically designed to produce statistical models that maximize predictive accuracy. As this set of papers clearly illustrates, ODA offers numerous important advantages over traditional statistical methods-advantages that enhance the validity and reproducibility of statistical conclusions in empirical research. This issue of the journal also includes a review of a recently published book that provides a comprehensive introduction to the logic, theory, and application of ODA in empirical research. It is argued that researchers have much to gain by using ODA to analyze their data. © 2016 John Wiley & Sons, Ltd.

Advantages and disadvantages of interdisciplinary consultation in the prescription of assistive technologies for mobility limitations.

PubMed

de Laat, Fred A; van Heerebeek, Bart; van Netten, Jaap J

2018-03-28

To explore the advantages and disadvantages experienced by professionals in interdisciplinary consultation involving the user, prescriber and technician in the prescription of assistive technologies for mobility limitations. Cross-sectional study. Prescribers (N = 39) and orthopaedic technicians (N = 50), who were regularly involved in an interdisciplinary consultation completed a questionnaire about advantages and disadvantages of the interdisciplinary consultation. Advantages of the interdisciplinary consultation were mentioned within all CanMEDS areas of medical practice, including better and quicker prescription of the assistive technology, shared knowledge of medical diagnosis and device possibilities, shared decision making of the device prescription and clear communication rules. Disadvantages were mentioned in the CanMEDS areas management and collaboration, including planning problems (financial) reimbursement of this type of consultation, and time efficiency. On a 10-point scale, mean (standard deviation) rates of interdisciplinary consultations were 7.9 (0.6) according to prescribers, and 7.8 (0.9) by technicians. All participants wanted to continue the interdisciplinary consultation. Prescribers and technicians in the field of assistive technologies for walking mobility limitations appreciate an interdisciplinary consultation. Advantages are found in all CanMEDS areas, whereas disadvantages only concern coordination. It should be encouraged to realize this kind of consultation in all situations where such technologies are prescribed. Implications for rehabilitation Interdisciplinary consultation involving the user, prescriber and technician to prescribe assistive technologies for mobility limitations has many advantages in all CanMEDS areas of medical practice, and few disadvantages, related to management and collaboration only. The disadvantages of interdisciplinary consultation, such as (financial) reimbursement by health insurance companies, have to be taken into account. Professionals in the field of ankle-foot-orthoses and orthopaedic shoes (medical specialist as prescriber and orthopaedic technician) who are involved in interdisciplinary consultation appreciate it and want to continue.

Logos: the emblem in the marketing wars.

PubMed

Chan, S D

1994-07-01

The logo is a powerful marketing tool. It is a condensed form of communication for a selected niche in a mass audience. Effective logo design principles include considerations of art design, visual perception, memory retention, and succinct nonverbal communication. Design principles for logos for dental practices are presented. Dental practices may realize significant advantages if logos are properly conceived and executed and are creatively implemented.

Patients' experiences of continuity in the care of type 2 diabetes: a focus group study in primary care

PubMed Central

Alazri, Mohammed H; Neal, Richard D; Heywood, Phil; Leese, Brenda

2006-01-01

Background Continuity of care is fundamental to general practice and type 2 diabetes is a common chronic disease with major health and social impacts. Nevertheless continuity, as experienced by patients with type 2 diabetes, remains a neglected area. Aim To explore perceptions and experiences of continuity of care in general practice from the perspectives of patients with type 2 diabetes, focusing on the advantages and disadvantages of different types of continuity. Design of study Focus groups with patients. Setting Seven practices with different organisational structures in Leeds, UK. Method Seventy-nine patients with type 2 diabetes were recruited. Focus group interviews were conducted with 79 patients with type 2 diabetes from seven practices in Leeds, UK. Results Patients experienced three different types of continuity: relational (or longitudinal) continuity, cross-boundary (or team) continuity, and continuity of information. Patients' perceptions of continuity were influenced by several factors including a personal relationship between themselves and their healthcare professional, their own beliefs and behaviours, presence of diabetes, and the systems and structures of general practices. Patients identified the advantages and disadvantages of two types of continuity. Relational or longitudinal continuity was important in providing psychosocial care, but with a risk of misdiagnosis. The advantages of cross-boundary or team continuity were to provide physical care, whereas the main disadvantages were the absence of personal care and patient confusion. Conclusion Perceptions of continuity by patients with type 2 diabetes were influenced by several factors; they perceived several advantages and disadvantages associated with different types of continuity. Patients might expect certain healthcare benefits by following certain types of continuity. PMID:16834874

Two-Photon Excitation Microscopy for the Study of Living Cells and Tissues

PubMed Central

Benninger, Richard K.P.; Piston, David W.

2013-01-01

Two-photon excitation microscopy is an alternative to confocal microscopy that provides advantages for three-dimensional and deep tissue imaging. This unit will describe the basic physical principles behind two-photon excitation and discuss the advantages and limitations of its use in laser-scanning microscopy. The principal advantages of two-photon microscopy are reduced phototoxicity, increased imaging depth, and the ability to initiate highly localized photochemistry in thick samples. Practical considerations for the application of two-photon microscopy will then be discussed, including recent technological advances. This unit will conclude with some recent applications of two-photon microscopy that highlight the key advantages over confocal microscopy and the types of experiments which would benefit most from its application. PMID:23728746

Culturally Competent MMPI Assessment of Hispanic Populations.

ERIC Educational Resources Information Center

Dana, Richard H.

1995-01-01

Describes culturally competent assessment practice as a context for discussing advantages and disadvantages of various "corrections" currently available for the Minnesota Multiphasic Personality Inventory with Hispanic populations. Corrections include moderator variables, special scales, special norms, translations, and aids to…

Sell your practice to grow and compete--the synergism of vertical integration.

PubMed

Robison, D L

1988-01-01

There are many advantages for selling a group practice to achieve vertical integration with a larger entity, including shared medical and management services, and greater efficiency, which results in greater profits. Health care in the 1990s will have a more formalized, structured system, greatly reducing freedoms enjoyed by both physicians and patients. An attractive option for smaller groups or solo practitioners is vertical integration.

State-of-the-evidence reviews: advantages and challenges of including grey literature.

PubMed

Benzies, Karen M; Premji, Shahirose; Hayden, K Alix; Serrett, Karen

2006-01-01

Increasingly, health policy decision-makers and professionals are turning to research-based evidence to support decisions about policy and practice. Systematic reviews are useful for gathering, summarizing, and synthesizing published and unpublished research about clearly defined interventions. State-of-the-evidence reviews are broader than traditional systematic reviews and may include not only published and unpublished research, but also published and unpublished non-research literature. Decisions about whether to include this "grey literature" in a review are challenging and lead to many questions about whether the advantages outweigh the challenges. The primary purpose of this article is to describe what constitutes grey literature, and methods to locate it and assess its quality. The secondary purpose is to discuss the core issues to consider when making decisions to include grey literature in a state-of-the-evidence review. A recent state-of-the-evidence review is used as an exemplar to present advantages and challenges related to including grey literature in a review. Despite the challenges, in the exemplar, inclusion of grey literature was useful to validate the results of a research-based literature search. Decisions about whether to include grey literature in a state-of-the-evidence review are complex. A checklist to assist in decision-making was created as a tool to assist the researcher in determining whether it is advantageous to include grey literature in a review.

The stakeholder preference for best management practices in the Three Gorges Reservoir Region.

PubMed

Qiu, Jiali; Shen, Zhenyao; Chen, Lei; Xie, Hui; Sun, Chengchun; Huang, Qin

2014-11-01

A qualitative analysis of in-depth interviews with 92 farmers and 42 policy managers in Wuxi County, the Three Gorges Reservoir Region, was conducted to identify stakeholder preferences for alternative best management practices (BMPs) and to determine the factors that affect their acceptance. Policy manager support for most of the practices was relatively stronger than support by farmers, except for the grade stabilization structure (GSS), hillside ditch (HD) and constructed wetland alternative, owing to their perceptions of soil benefits, economic advantages and environmental advantages. Farmers opposed those practices that occupied cultivated lands or changed the conventional planting methods, such as field border, conservation tillage (CT) and contour buffer strips. They tended to accept the BMPs with off-farm pollution reduction, such as GSS, riparian forest buffer and HD, and the BMPs associated with soil benefits, such as nutrient management and Terrace. The result that almost all respondents did not accept CT differed from reports in the existing literature. There is a significant correlation between the acceptance of some BMPs and the townships where the farmers lived (P ≤ 0.05). The environmental conditions and social factors would affect farmer support for BMPs, including local soil conditions, farming methods, economic income, education level and age. The economic advantages of the BMPs were the main motivation for farmers to accept the practices. Furthermore, intensive education efforts, financial incentives or economic subsidies may promote the adoption of the BMPs in our study area.

The Stakeholder Preference for Best Management Practices in the Three Gorges Reservoir Region

NASA Astrophysics Data System (ADS)

Qiu, Jiali; Shen, Zhenyao; Chen, Lei; Xie, Hui; Sun, Chengchun; Huang, Qin

2014-11-01

A qualitative analysis of in-depth interviews with 92 farmers and 42 policy managers in Wuxi County, the Three Gorges Reservoir Region, was conducted to identify stakeholder preferences for alternative best management practices (BMPs) and to determine the factors that affect their acceptance. Policy manager support for most of the practices was relatively stronger than support by farmers, except for the grade stabilization structure (GSS), hillside ditch (HD) and constructed wetland alternative, owing to their perceptions of soil benefits, economic advantages and environmental advantages. Farmers opposed those practices that occupied cultivated lands or changed the conventional planting methods, such as field border, conservation tillage (CT) and contour buffer strips. They tended to accept the BMPs with off-farm pollution reduction, such as GSS, riparian forest buffer and HD, and the BMPs associated with soil benefits, such as nutrient management and Terrace. The result that almost all respondents did not accept CT differed from reports in the existing literature. There is a significant correlation between the acceptance of some BMPs and the townships where the farmers lived ( P ≤ 0.05). The environmental conditions and social factors would affect farmer support for BMPs, including local soil conditions, farming methods, economic income, education level and age. The economic advantages of the BMPs were the main motivation for farmers to accept the practices. Furthermore, intensive education efforts, financial incentives or economic subsidies may promote the adoption of the BMPs in our study area.

Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.

PubMed

2016-11-15

This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.

Information technology, the internet, and the future of neurology.

PubMed

Maulden, Sarah A

2003-05-01

This review addresses the impact of information technology and the Internet on the current and future practice of neurology. Information technology is influencing medical practice in ways that could be both beneficial and harmful. Scenarios are presented to depict some of the ways in which the practice of neurology is being influenced by the growth of technology. First, the advantages and disadvantages of e-mail as a means of doctor-patient communication are presented. Some of the ethical and legal issues arising in this context are discussed.Second, the Internet is changing neurologists' relationships to other professionals in the health care industry. Geographical isolation is less problematic than in the past. Telemedicine, including remote consulting via the Web, has special implications for neurologists in several areas, including stroke management, movement disorders, and epilepsy.Third, the growing availability of large databases, powerful search engines, and online full-text journals is discussed. Skill in navigating and managing these resources will become increasingly important. New computer-assisted decision support systems will continue to be implemented. Applications exist or are being developed for use by clinicians for many specific neurologic disorders.Finally, some of the problematic issues concerning medical use of the Internet are discussed, including availability, portability, security, quality, and outcomes. Medical information systems, with their attendant advantages and limitations, will become increasingly significant in the practice of neurology. Despite overall improvement in access to information, major barriers still exist to the proper implementation and utilization of truly integrated information systems.

In Their Own Words: Interviews with Musicians Reveal the Advantages and Disadvantages of Wearing Earplugs.

PubMed

Beach, Elizabeth F; O'Brien, Ian

2017-06-01

Musicians are at risk of hearing loss from sound exposure, and earplugs form part of many musicians' hearing conservation practices. Although musicians typically report a range of difficulties when wearing earplugs, there are many who have managed to successfully incorporate earplugs into their practice of music. The study aim was to provide a detailed account of earplug usage from the perspective of the musician, including motivating factors, practical strategies, and attitudes. In-depth interviews with 23 musicians were transcribed and content analysis was performed. Responses were coded and classified into three main themes: advantages, disadvantages, and usage patterns and strategies, together with an overlapping fourth theme, youth perspectives. Several positive aspects of wearing earplugs were identified, including long-term hearing protection and reduced levels of fatigue and pain. Musicians reported that earplugs present few problems for communication, improve sound clarity in ensembles, are discreet, and are easy to handle. However, earplugs also present challenges, including an overall dullness of sound, reduced immediacy, and an impaired ability to judge balance and intonation due to the occlusion effect, all of which influence usage habits and patterns. The experiences of the younger musicians and long-term users of earplugs indicate that practice, persistence, and a flexible approach are required for successful earplug usage. In time, there may be greater acceptance of earplugs, particularly amongst a new generation of musicians, some of whom regard the earplugs as a performance enhancement tool as well as a protective device.

Practical Applications of Data Processing to School Purchasing.

ERIC Educational Resources Information Center

California Association of School Business Officials, San Diego. Imperial Section.

Electronic data processing provides a fast and accurate system for handling large volumes of routine data. If properly employed, computers can perform myriad functions for purchasing operations, including purchase order writing; equipment inventory control; vendor inventory; and equipment acquisition, transfer, and retirement. The advantages of…

Twilight of the electric dinosaurs

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

Green, L. Jr.

1990-11-22

This article examines the future practicality of large electric generating plants and various technologies for transmitting energy other than electricity. The author describes advantages, cost and methods of chemical energy transmission in the form of methanol. Uses, production (including environmental impacts) and supply of methanol are also discussed.

The swing of it: Hammock camping

USGS Publications Warehouse

Marion, Jeff

2016-01-01

Hammock camping is dramatically expanding along the Appalachian Trail and raising both questions and concerns among Trail land managers, club members, and backpackers. This article examines some of the advantages and disadvantages of hammock camping, including resource and social impacts. Some Leave No Trace hammock camping practices are included for those using hammocks at well-established campsites and when "pristine-site" camping.

Evidence-based medicine: augmentation mammaplasty.

PubMed

Lista, Frank; Ahmad, Jamil

2013-12-01

After studying this article, the participant should be able to: 1. Recognize the role of biofilm in breast implant surgery and possible ways to reduce the incidence of capsular contracture. 2. Describe the advantages and disadvantages of various surgical approaches including the incision placement and implant location. 3. List the advantages and disadvantages of implant characteristics including implant fill, shell surface characteristics, and implant shape. 4. Take steps to avoid the phenomena of double capsule and late seroma. This article was prepared to accompany practice-based assessment with ongoing surgical education for the Maintenance of Certification for the American Board of Plastic Surgery. It is structured to outline the care of the patient presenting for cosmetic breast augmentation.

When to Use What Research Design

ERIC Educational Resources Information Center

Vogt, W. Paul; Gardner, Dianne C.; Haeffele, Lynne M.

2012-01-01

Systematic, practical, and accessible, this is the first book to focus on finding the most defensible design for a particular research question. Thoughtful guidelines are provided for weighing the advantages and disadvantages of various methods, including qualitative, quantitative, and mixed methods designs. The book can be read sequentially or…

Changing the Frame: Queering Access to Higher Education for Trans* Students

ERIC Educational Resources Information Center

Marine, Susan B.

2017-01-01

College access and graduation results in significant life advantages, including higher lifetime incomes, better physical and mental health outcomes, and greater rates of civic engagement. Unfortunately, trans* youth have been systematically prevented from full participation in post-secondary education due to genderist practices and policies.…

Direct seeding of fine hardwood tree species

Treesearch

Lenny D. Farlee

2013-01-01

Direct seeding of fine hardwood trees has been practiced in the Central Hardwoods Region for decades, but results have been inconsistent. Direct seeding has been used for reforestation and afforestation based on perceived advantages over seedling planting, including cost and operational efficiencies, opportunities for rapid seedling establishment and early domination...

Increasing the Success of Online Students

ERIC Educational Resources Information Center

Harrell, Ivan L., II

2008-01-01

The introduction of the Internet has dramatically changed the process of information transmission as well as practically every other aspect of American society, including the higher education system. Many colleges and universities have taken advantage of the utility of the Internet and instituted online courses and online degree and certificate…

Uav Photogrammetry: a Practical Solution for Challenging Mapping Projects

NASA Astrophysics Data System (ADS)

Saadatseresht, M.; Hashempour, A. H.; Hasanlou, M.

2015-12-01

We have observed huge attentions to application of unmanned aerial vehicle (UAV) in aerial mapping since a decade ago. Though, it has several advantages for handling time/cost/quality issues, there are a dozen of challenges in working with UAVs. In this paper, we; as the Robotic Photogrammetry Research Group (RPRG), will firstly review these challenges then show its advantages in three special practical projects. For each project, we will share our experiences through description of the UAV specifications, flight settings and processing steps. At the end, we will illustrate final result of each project and show how this technology could make unbelievable benefits to clients including 3D city realistic model in decimetre level, ultra high quality map production in several centimetre level, and accessing to a high risk and rough relief area for mapping aims.

Bayesian inference for psychology. Part II: Example applications with JASP.

PubMed

Wagenmakers, Eric-Jan; Love, Jonathon; Marsman, Maarten; Jamil, Tahira; Ly, Alexander; Verhagen, Josine; Selker, Ravi; Gronau, Quentin F; Dropmann, Damian; Boutin, Bruno; Meerhoff, Frans; Knight, Patrick; Raj, Akash; van Kesteren, Erik-Jan; van Doorn, Johnny; Šmíra, Martin; Epskamp, Sacha; Etz, Alexander; Matzke, Dora; de Jong, Tim; van den Bergh, Don; Sarafoglou, Alexandra; Steingroever, Helen; Derks, Koen; Rouder, Jeffrey N; Morey, Richard D

2018-02-01

Bayesian hypothesis testing presents an attractive alternative to p value hypothesis testing. Part I of this series outlined several advantages of Bayesian hypothesis testing, including the ability to quantify evidence and the ability to monitor and update this evidence as data come in, without the need to know the intention with which the data were collected. Despite these and other practical advantages, Bayesian hypothesis tests are still reported relatively rarely. An important impediment to the widespread adoption of Bayesian tests is arguably the lack of user-friendly software for the run-of-the-mill statistical problems that confront psychologists for the analysis of almost every experiment: the t-test, ANOVA, correlation, regression, and contingency tables. In Part II of this series we introduce JASP ( http://www.jasp-stats.org ), an open-source, cross-platform, user-friendly graphical software package that allows users to carry out Bayesian hypothesis tests for standard statistical problems. JASP is based in part on the Bayesian analyses implemented in Morey and Rouder's BayesFactor package for R. Armed with JASP, the practical advantages of Bayesian hypothesis testing are only a mouse click away.

Social work practice in the digital age: therapeutic e-mail as a direct practice methodology.

PubMed

Mattison, Marian

2012-07-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include the potential to reach clients in geographically remote and underserved communities, enhancing and extending the therapeutic relationship and improving treatment outcomes. Risks include threats to client confidentiality and privacy, liability coverage for practitioners, licensing jurisdiction, and the lack of competency standards for delivering e-mail interventions. Currently, the social work profession does not have adequate instructive guidelines and best-practice standards for using e-mail as a direct practice methodology. Practitioners need (formal) academic training in the techniques connected to e-mail exchanges with clients. The author describes the ethical and legal risks for practitioners using therapeutic e-mail with clients and identifies recommendations for establishing best-practice standards.

Divesting strategies for medical practices.

PubMed

Sullivan, John D

2006-01-01

The decision to sell a medical practice is never easy. There is often a personal attachment to a medical practice started from scratch that has grown into a full-fledged operation. Selling has advantages as well as drawbacks. Much like selling a home, most of the price can be reflected in the preparation and market research. This article will examine the advantages, disadvantages, and strategies associated with the process of selling a medical practice.

3 CFR 8524 - Proclamation 8524 of May 20, 2010. National Safe Boating Week, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

..., let us recommit during National Safe Boating Week to practicing safe techniques so boaters of all ages... awareness and teach safe boating practices. Boaters can take advantage of these opportunities to learn, make... activities to observe this occasion by learning more about safe boating practices and to take advantage of...

Grain size of recall practice for lengthy text material: fragile and mysterious effects on memory.

PubMed

Wissman, Kathryn T; Rawson, Katherine A

2015-03-01

The current research evaluated the extent to which the grain size of recall practice for lengthy text material affects recall during practice and subsequent memory. The grain size hypothesis states that a smaller vs. larger grain size will increase retrieval success during practice that in turn will enhance subsequent memory for lengthy text material. Participants were prompted to recall directly after studying each section (section recall) or after all sections had been studied (whole-text recall) during practice, and then all participants completed a final test after a delay. Results across 7 experiments (including 587 participants and 1,394 recall protocols) partially disconfirmed the predictions of the grain size hypothesis: Although the smaller grain size produced sizable recall advantages during practice as expected (ds from 1.02 to 1.87 across experiments), the advantage was substantially or completely attenuated across a delay. Experiments 2-7 falsified several plausible methodological and theoretical explanations for the fragility of the effect, indicating that it was not due to particular text materials, retrieval from working memory during practice, the length of the retention interval, the spacing between study and practice recall, a disproportionate increase in recall of unimportant details, or a deficit in integration of ideas across text sections. In sum, results conclusively establish an initially sizable but mysteriously fragile effect of grain size, for which an explanation remains elusive. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Economic feasibility of including game habitats in timber management systems

Treesearch

Lowell K. Halls

1975-01-01

Profits largely determine management decisions on commercial forest lands. Past decisions have therefore favored timber production over wildlife, and practices advantageous to wildlife were usually incidental. This paper explains how effective timber management on public and private lands can be coordinated with wildlife needs to obtain revenues from hunting as well...

Uniform data system standardizes technical computations and the purchasing of commercially important gases

NASA Technical Reports Server (NTRS)

Johnson, V. J.; Mc Carty, R. D.; Roder, H. M.

1970-01-01

Integrated tables of pressure, volume, and temperature for the saturated liquid, from the triple point to the critical point of the gases, have been developed. Tables include definition of saturated liquid curve. Values are presented in metric and practical units. Advantages of the new tables are discussed.

Studying the Emergence of Autism Spectrum Disorders in High-Risk Infants: Methodological and Practical Issues

ERIC Educational Resources Information Center

Zwaigenbaum, Lonnie; Thurm, Audrey; Stone, Wendy; Baranek, Grace; Bryson, Susan; Iverson, Jana; Kau, Alice; Klin, Ami; Lord, Cathy; Landa, Rebecca; Rogers, Sally; Sigman, Marian

2007-01-01

Detecting early signs of autism is essential for timely diagnosis and initiation of effective interventions. Several research groups have initiated prospective studies of high-risk populations including infant siblings, to systematically collect data on early signs within a longitudinal design. Despite the potential advantages of prospective…

Small-Sided Games: Developmentally Appropriate Applications in Traditional Activities.

ERIC Educational Resources Information Center

Petersen, Susan; Cruz, Luz

This paper presents a systematic progression of small-sided games within two traditional sports units (soccer and volleyball). Developmentally appropriate guidelines encourage teachers at all levels to incorporate small-sided games (2v2, 3v3, and 4v4). Advantages of small-sided games include: allowing students numerous practice opportunities;…

Creating a Research Agenda in Career Counselling: The Place of Action Theory

ERIC Educational Resources Information Center

Young, Richard A.; Domene, Jose F.

2012-01-01

After identifying historical and current problems in career counselling research, we propose a research agenda based on contextual action theory. This theory has been used as a framework for research in the career field and for general counselling practice. It is advantageous for several reasons including its conceptual basis, its detailed…

Analyzing Differentiation in the Classroom: Using the COS-R

ERIC Educational Resources Information Center

VanTassel-Baska, Joyce

2012-01-01

The use of a classroom observation tool to monitor differentiation strategies is described, and relevant research findings using the form are reported. The advantages for using this approach to document differentiation are discussed as are the reasons teachers may question its intent. Applications for practice include its use as a self-assessment…

Integrating molecular and morphological approaches for characterizing parasite cryptic species: implications for parasitology.

PubMed

Nadler, Steven A; DE León, Gerardo Pérez-Ponce

2011-11-01

Herein we review theoretical and methodological considerations important for finding and delimiting cryptic species of parasites (species that are difficult to recognize using traditional systematic methods). Applications of molecular data in empirical investigations of cryptic species are discussed from an historical perspective, and we evaluate advantages and disadvantages of approaches that have been used to date. Developments concerning the theory and practice of species delimitation are emphasized because theory is critical to interpretation of data. The advantages and disadvantages of different molecular methodologies, including the number and kind of loci, are discussed relative to tree-based approaches for detecting and delimiting cryptic species. We conclude by discussing some implications that cryptic species have for research programmes in parasitology, emphasizing that careful attention to the theory and operational practices involved in finding, delimiting, and describing new species (including cryptic species) is essential, not only for fully characterizing parasite biodiversity and broader aspects of comparative biology such as systematics, evolution, ecology and biogeography, but to applied research efforts that strive to improve development and understanding of epidemiology, diagnostics, control and potential eradication of parasitic diseases.

Unconventional techniques of fundus imaging: A review

PubMed Central

Shanmugam, Mahesh P; Mishra, Divyansh Kailash Chandra; Rajesh, R; Madhukumar, R

2015-01-01

The methods of fundus examination include direct and indirect ophthalmoscopy and imaging with a fundus camera are an essential part of ophthalmic practice. The usage of unconventional equipment such as a hand-held video camera, smartphone, and a nasal endoscope allows one to image the fundus with advantages and some disadvantages. The advantages of these instruments are the cost-effectiveness, ultra portability and ability to obtain images in a remote setting and share the same electronically. These instruments, however, are unlikely to replace the fundus camera but then would always be an additional arsenal in an ophthalmologist's armamentarium. PMID:26458475

Problem-Based Learning in Biomechanics: Advantages, Challenges, and Implementation Strategies.

PubMed

Clyne, Alisa Morss; Billiar, Kristen L

2016-07-01

Problem-based learning (PBL) has been shown to be effective in biomedical engineering education, particularly in motivating student learning, increasing knowledge retention, and developing problem solving, communication, and teamwork skills. However, PBL adoption remains limited by real challenges in effective implementation. In this paper, we review the literature on advantages and challenges of PBL and present our own experiences. We also provide practical guidelines for implementing PBL, including two examples of PBL modules from biomechanics courses at two different institutions. Overall, we conclude that the benefits for both professors and students support the use of PBL in biomedical engineering education.

The use of online methodologies in studying paraphilias - A review.

PubMed

Griffiths, Mark D

2012-12-01

Aims The paper outlines the advantages, disadvantages, and other implications of using the Internet to collect data from those people displaying sexually paraphilic behavior. Method Using empirical and clinical studies published in the paraphilia literature, the main issues concerning online paraphilic data collection are reviewed and discussed. Results The specific online data collection methods examined included the collection of paraphilic data via (i) online questionnaires, (ii) online forums, (iii) online interviews, and (iv) online participant observation. Conclusions It is concluded that there are many useful and practical advantages of using online research methodologies to examine sexually paraphilic behavior.

The Advantages and Challenges of Unannounced Standardized Patients Methodology to Assess Healthcare Communication

PubMed Central

Siminoff, Laura A.; Rogers, Heather L.; Waller, Allison C.; Harris-Haywood, Sonja; Esptein, Ronald M.; Borrell Carrio, Francesc; Gliva-McConvey, Gayle; Longo, Daniel R.

2011-01-01

Objective This paper provides an overview of the implementation of using Unannounced Standardized Patients (USPs) to conduct health communication research in clinical settings. Methods Certain types of health communication situations are difficult to capture because of their rarity or unpredictable nature. In primary care the real reasons for a visit are frequently unknown until the consultation is well under way. Therefore, it is logistically difficult for communication studies to capture many real-time communications between patients and their physicians. Although the USP methodology is ideal for capturing these communication behaviors, challenges to using this method include developing collaborative relationships with clinical practices, logistical issues such as safeguarding the identity of the USP, training USPs and creating their identities, maintaining fidelity to the role, and analyzing the resultant data. Results This paper discusses the challenges and solutions to USP implementation. We provide an example of how to implement a USP study using an on-going study being conducted in primary care practices. Conclusion This paper explores the advantages and challenges as well as strategies to overcome obstacles to implementing a USP study. Practice Implications Despite the challenges, USP methodology can contribute much to our understanding of health communication and practice. PMID:21316182

Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System

PubMed Central

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills. Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment. Success factors include continued support and investment from both organizations’ leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers. PMID:24867551

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

PubMed

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

[Internet research methods: advantages and challenges].

PubMed

Liu, Yi; Tien, Yueh-Hsuan

2009-12-01

Compared to traditional research methods, using the Internet to conduct research offers a number of advantages to the researcher, which include increased access to sensitive issues and vulnerable / hidden populations; decreased data entry time requirements; and enhanced data accuracy. However, Internet research also presents certain challenges to the researcher. In this article, the advantages and challenges of Internet research methods are discussed in four principle issue areas: (a) recruitment, (b) data quality, (c) practicality, and (d) ethics. Nursing researchers can overcome problems related to sampling bias and data truthfulness using creative methods; resolve technical problems through collaboration with other disciplines; and protect participant's privacy, confidentiality and data security by maintaining a high level of vigilance. Once such issues have been satisfactorily addressed, the Internet should open a new window for Taiwan nursing research.

Randomized controlled trials in evidence-based mental health care: getting the right answer to the right question.

PubMed

Essock, Susan M; Drake, Robert E; Frank, Richard G; McGuire, Thomas G

2003-01-01

The purpose of clinical research is to answer this question: Would a new treatment, when added to the existing range of treatment options available in practice, help patients? Randomized controlled trials (RCTs)--in particular, double-blind RCTs--have important methodological advantages over observational studies for addressing this question. These advantages, however, come at a price. RCTs compare treatments using a particular allocation rule for assigning patients to treatments (random assignment) that does not mimic real-world practice. "Favorable" results from an RCT indicating that a new treatment is superior to existing treatments are neither necessary nor sufficient for establishing a "yes" answer to the question posed above. Modeled on an experimental design, RCTs are expensive in time and money and must compare simple differences in treatments. Findings have a high internal validity but may not address the needs of the field, particularly where treatment is complex and rapidly evolving. Design of clinical research needs to take account of the way treatments are allocated in actual practice and include flexible designs to answer important questions most effectively.

Advantages and limitations of teleneurology.

PubMed

Wechsler, Lawrence R

2015-03-01

The growing disparity between the demand for neurological services and the need for neurologists requires new and innovative strategies for delivering care. Teleneurology allows neurological expertise to be delivered to remote locations to supplement or replace in-person neurological care. To summarize the current status of teleneurology. Applications of teleneurology include acute care, outpatient teleneurology, and teleconsultations. Existing barriers to further expansion of teleneurology are also discussed. Published studies pertaining to teleneurology were reviewed. Practical experience with telemedicine in neurological practice contributed to the conclusions. Outcomes after intravenous tissue plasminogen activator treatment via telemedicine (telestroke) are similar to those achieved with in-person evaluations. Other aspects of teleneurology are less established but have demonstrated feasibility, high patient satisfaction, and, in some cases, cost savings. Teleneurology provides neurological expertise to rural areas with limited availability of neurologists and improves care for patients with difficulty traveling owing to neurological disease. It is likely that use of teleneurology will continue to grow and become incorporated into many aspects of neurological practice. Understanding the advantages and limitations of teleneurology is vital to delivering optimal clinical care for patients with neurological disease regardless of the setting.

Social media and nutrition education: the food hero experience.

PubMed

Tobey, Lauren N; Manore, Melinda M

2014-01-01

Social media can be a quick, low-cost, direct way for nutrition educators to broaden the scope of their targeted programs. The authors' viewpoint is that for social media to be effective, strategies for its use should follow "best practices" guidelines. This viewpoint suggests social media best practices based on experience gained from the Food Hero social marketing campaign. Understanding of how nutrition educators can take advantage of social media as a new mechanism for reaching their target audience is needed, including best practices for implementation, management, and evaluation. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Technical and Practical Issues in the Structure and Clinical Invariance of the Wechsler Scales: A Rejoinder to Commentaries

ERIC Educational Resources Information Center

Weiss, Lawrence G.; Keith, Timothy Z.; Zhu, Jianjun; Chen, Hsinyi

2013-01-01

This discussion article addresses issues related to expansion of the Wechsler model from four to five factors; multiple broad CHC abilities measured by the Arithmetic subtest; advantages and disadvantages of including complex tasks requiring integration of multiple broad abilities when measuring intelligence; limitations of factor analysis, which…

Parenting Styles and Practices of Latino Parents and Latino Fifth Graders' Academic, Cognitive, Social, and Behavioral Outcomes

ERIC Educational Resources Information Center

Jabagchourian, John J.; Sorkhabi, Nadia; Quach, Wendy; Strage, Amy

2014-01-01

A vast literature documents a host of advantages conferred upon middle class European American children whose parents employ an authoritative style of parenting, including enhanced academic achievement and positive behavioral outcomes. The literature is much less clear about the relationship between parental authority style and child outcomes in…

Miniature personal UV solar dosimeter

NASA Technical Reports Server (NTRS)

Adams, R. R.; Macconochie, I. O.; Poole, B. D., Jr.

1981-01-01

Small light-powered meter measures accumulated radiation in ultraviolet or other selected regions. Practical advantages are device's low cost, small size, accuracy, and adaptability to specific wave-band measurements. Medical applications include detection of skin cancer, vitamin D production, and jaundice. Dosimeter also measures sunlight for solar energy designs, agriculture and meteorology, and monitors stability of materials and environmental and occupational lighting.

Automated Chromium Plating Line for Gun Barrels

DTIC Science & Technology

1979-09-01

consistent pretreatments and bath dwell times. Some of the advantages of automated processing include increased productivity (average of 20^) due to...when automated processing procedures’ are used. The current method of applying chromium electrodeposits to gun tubes is a manual, batch operation...currently practiced with rotary swaged gun tubes would substantially reduce the difficulties in automated processing . RECOMMENDATIONS

E-Learning for SMEs: Competition and Dimensions of Perceived Value

ERIC Educational Resources Information Center

Roffe, Ian

2004-01-01

E-learning is such an attractive opportunity for training providers to reconfigure delivery and support that it presents compelling reasons to engage with the practice. A broad range of provision is therefore available for every type of market segment, including small firms. Sustaining a competitive advantage from a host of offers is a practical…

Determination of antennae patterns and radar reflection characteristics of aircraft

NASA Astrophysics Data System (ADS)

Bothe, H.; MacDonald, D.; Pool, A.

1986-05-01

The different types of aircraft antennas, their radiation characteristics and their preferred siting on the airframe are described. Emphasis is placed on the various methods for determining aircraft antenna radiation patterns (ARP) and advantages, disadvantages and limitations of each method are indicated. Mathematical modelling, model measurements and in-flight measurements in conjunction with the applied flight test techniques are included. Examples of practical results are given. Methods of determining aircraft radar characteristics are also described, indicating advantages, disadvantages and limitations of each method. Relevant fundamentals of radar theory are included only as necessary to appreciation of the real meaning of radar cross section (RCS) and angular glint. The measuring methods included are dynamic full-scale, static full-scale, sub-scale optical, ultrasonic and radio modelling. References are made to RCS measuring facilities in the USA and Europe and the UK Radio Modelling Facility is used extensively to exemplify the sub scale technique.

Practices of weight regulation among elite athletes in combat sports: a matter of mental advantage?

PubMed

Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M

2013-01-01

The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Qualitative study. With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being "a real athlete." Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Weight regulation has mentally important functions extending beyond the common notion that combat-sport athletes reduce their weight merely to gain a physical edge over their opponents.

Bilinguals’ Working Memory (WM) Advantage and Their Dual Language Practices

PubMed Central

Yang, Eunju

2017-01-01

The present study investigates a possible working memory (WM) difference between monolingual and bilingual groups and explores the relationship between their WM advantage and language practices. A mixed methods design was employed for the study. To measure participants’ WM, auditory and visual digit span tasks were conducted on the different language groups: 20 Korean near-monolinguals, and 40 Korean–English bilinguals with two different levels of second language (L2) proficiency. Bilinguals’ daily language practices were explored through semi-structured interviews with eight bilinguals. The convergence of the findings from both tests and interview data suggests that knowing two languages does not guarantee bilingual WM advantages over monolinguals, but the advantage might be linked to bilinguals’ unique L2 use environment where they need to hold incoming L2 information while decoding it. PMID:28718840

Expediting the transfer of evidence into practice: building clinical partnerships*

PubMed Central

Rader, Tamara; Gagnon, Anita J.

2000-01-01

A librarian/clinician partnership was fostered in one hospital through the formation of the Evidence-based Practice Committee, with an ulterior goal of facilitating the transfer of evidence into practice. The paper will describe barriers to evidence-based practice and outline the committee's strategies for overcoming these barriers, including the development and promotion of a Web-based guide to evidence-based practice specifically designed for clinicians (health professionals). Educational strategies for use of the Web-based guide will also be addressed. Advantages of this partnership are that the skills of librarians in meeting the needs of clinicians are maximized. The evidence-based practice skills of clinicians are honed and librarians make a valuable contribution to the knowledgebase of the clinical staff. The knowledge acquired through the partnership by both clinicians and librarians will increase the sophistication of the dialogue between the two groups and in turn will expedite the transfer of evidence into practice. PMID:10928710

The Necessity of Functional Analysis for Space Exploration Programs

NASA Technical Reports Server (NTRS)

Morris, A. Terry; Breidenthal, Julian C.

2011-01-01

As NASA moves toward expanded commercial spaceflight within its human exploration capability, there is increased emphasis on how to allocate responsibilities between government and commercial organizations to achieve coordinated program objectives. The practice of program-level functional analysis offers an opportunity for improved understanding of collaborative functions among heterogeneous partners. Functional analysis is contrasted with the physical analysis more commonly done at the program level, and is shown to provide theoretical performance, risk, and safety advantages beneficial to a government-commercial partnership. Performance advantages include faster convergence to acceptable system solutions; discovery of superior solutions with higher commonality, greater simplicity and greater parallelism by substituting functional for physical redundancy to achieve robustness and safety goals; and greater organizational cohesion around program objectives. Risk advantages include avoidance of rework by revelation of some kinds of architectural and contractual mismatches before systems are specified, designed, constructed, or integrated; avoidance of cost and schedule growth by more complete and precise specifications of cost and schedule estimates; and higher likelihood of successful integration on the first try. Safety advantages include effective delineation of must-work and must-not-work functions for integrated hazard analysis, the ability to formally demonstrate completeness of safety analyses, and provably correct logic for certification of flight readiness. The key mechanism for realizing these benefits is the development of an inter-functional architecture at the program level, which reveals relationships between top-level system requirements that would otherwise be invisible using only a physical architecture. This paper describes the advantages and pitfalls of functional analysis as a means of coordinating the actions of large heterogeneous organizations for space exploration programs.

The relationship among the resiliency practices in supply chain, financial performance, and competitive advantage in manufacturing firms in Indonesia and Sierra Leone

NASA Astrophysics Data System (ADS)

Musa, I.; Nyoman Pujawan, I.

2018-04-01

Current supply chain management (SCM) has become a potentially treasured way of safeguarding competitive advantage and improving organizational performance since competition is no longer between organizations, but among supply chains. This research conceptualizes and develops four resiliency practices (Flexibility, Redundancy, Collaboration and Agility) and tests the relationships between organizations’ financial performance and competitive advantage in manufacturing firms. The study involves manufacturing firms in Indonesia and Sierra Leone. The study used stratified random sampling to pick a sample size of 95 manufacturing firms, which represented different industrial sectors. The respondents were mainly managers of different manufacturing companies. The relationships proposed in the conceptual framework were tested using correlation analysis. The results indicate that higher levels of resilience practices in manufacturing firms can lead to enhanced competitive advantage and improved financial performance.

Influences on physicians' adoption of electronic detailing (e-detailing).

PubMed

Alkhateeb, Fadi M; Doucette, William R

2009-01-01

E-detailing means using digital technology: internet, video conferencing and interactive voice response. There are two types of e-detailing: interactive (virtual) and video. Currently, little is known about what factors influence physicians' adoption of e-detailing. The objectives of this study were to test a model of physicians' adoption of e-detailing and to describe physicians using e-detailing. A mail survey was sent to a random sample of 2000 physicians practicing in Iowa. Binomial logistic regression was used to test the model of influences on physician adoption of e-detailing. On the basis of Rogers' model of adoption, the independent variables included relative advantage, compatibility, complexity, peer influence, attitudes, years in practice, presence of restrictive access to traditional detailing, type of specialty, academic affiliation, type of practice setting and control variables. A total of 671 responses were received giving a response rate of 34.7%. A total of 141 physicians (21.0%) reported using of e-detailing. The overall adoption model for using either type of e-detailing was found to be significant. Relative advantage, peer influence, attitudes, type of specialty, presence of restrictive access and years of practice had significant influences on physician adoption of e-detailing. The model of adoption of innovation is useful to explain physicians' adoption of e-detailing.

Using an ePortfolio System as an Electronic Laboratory Notebook in Undergraduate Biochemistry and Molecular Biology Practical Classes

ERIC Educational Resources Information Center

Johnston, Jill; Kant, Sashi; Gysbers, Vanessa; Hancock, Dale; Denyer, Gareth

2014-01-01

Despite many apparent advantages, including security, back-up, remote access, workflow, and data management, the use of electronic laboratory notebooks (ELNs) in the modern research laboratory is still developing. This presents a challenge to instructors who want to give undergraduate students an introduction to the kinds of data curation and…

Information Technology Adoption for Service Innovation Practices and Competitive Advantage: The Case of Financial Firms

ERIC Educational Resources Information Center

Chen, J. S.; Tsou, H. T.

2007-01-01

Background: The importance of information technology to current business practices has long drawn the attention of practitioners and academicians. Aim: This paper aims to broaden understanding about service innovation as a critical organizational capability through which information technology adoption influences the competitive advantage of a…

The control of sequential aiming movements: the influence of practice and manual asymmetries on the one-target advantage.

PubMed

Lavrysen, Ann; Helsen, Werner F; Tremblay, Luc; Elliott, Digby; Adam, Jos J; Feys, Peter; Buekers, Martinus J

2003-04-01

The present experiment was conducted to explore the effect of practice on the one-target advantage in manual aiming, as well as asymmetries in intermanual transfer of training. Reaction and movement times for the first movement were longer in the 2-target than in the 1-target task, regardless of the amount of practice, hand preference and practice hand. When two movements were required, peak velocity was lower and, proportionally, more time was spent after peak velocity. Our kinematic results suggest that the one-target advantage is related to both predefined strategies as well as movement implementation processes during execution. Therefore, an integration of advance planning and on-line explanations for the one-target advantage is suggested. Regarding manual asymmetries, right-handers showed more transfer of training from the left to the right hand than vice versa. Left-handers exhibited a reversed pattern of asymmetric transfer of training to right-handers, but they were more disadvantaged using their non-dominant hand. These latter two findings have implications for models of manual asymmetry and upper limb control.

Talking about a Christine Borland sculpture: effective empathy in contemporary anatomy art (and an emerging counterpart in medical training?)

PubMed Central

Richardson, Craig; Borland, Christine

2015-01-01

This Introduction and interview discusses the poetical and empathic insights that are a key to the effectiveness of contemporary artist Christine Borland's practice and its relevance to the medical humanities, visual art research and medical students’ training. It takes place in a context of intensive interest in reciprocity and conversation as well as expert exchange between the fields of Medicine and Contemporary Arts. The interview develops an understanding of medical research and the application of its historical resources and contemporary practice-based research in contemporary art gallery exhibitions. Artists tend not to follow prescriptive programmes towards new historical knowledge, however, a desire to form productive relationships between history and contemporary art practice does reveal practical advantages. Borland's research also includes investigations in anatomy, medical practices and conservation. PMID:27630533

A critical review of current nursing faculty practice.

PubMed

Sawyer, M J; Alexander, I M; Gordon, L; Juszczak, L J; Gilliss, C

2000-12-01

To critically examine the current literature on nursing faculty practice, using the National Organization of Nurse Practitioner Faculties (NONPF) Guidelines for Evaluation of Faculty Practice, and to examine faculty practice models' strengths, weaknesses, and barriers. Thirty-five articles describing models of faculty practice were identified through an exhaustive search on CINAHL and Medline. Two NONPF monographs on nursing faculty practice were used as guidelines for the critical review. Faculty practice has become an integral component of faculty-role expectations at many schools of nursing. Workload, especially without adequate compensation, remains a hindrance to practice. The value of faculty practice time and expertise has not been sufficiently demonstrated. Integration of practitioner, educator and researcher roles remains extremely difficult and sometimes elusive. Faculty practice offers many advantages to schools of nursing, including educational and research opportunities for faculty and students, as well as practice sites and affordable community healthcare. Providing health care in the community presents an opportunity for independent and collaborative practice. To fully utilize the great research opportunities provided by faculty practice, more emphasis must be placed on gathering and analyzing descriptive data.

Tacit Knowledge Flows and Institutional Theory: Accelerating Acculturation

DTIC Science & Technology

2010-01-01

sustainable competitive advantage , but different kinds of knowledge affect competitive advantage differently. This applies especially to the...such qualitative fieldwork and informs theory and practice alike. 1. Introduction Knowledge is key to sustainable competitive advantage ...4,8,19]. Knowledge enables effective action; effective action drives superior performance; and superior performance supports competitive advantage

Breastfeeding in Samoa: A Study to Explore Women's Knowledge and the Factors which Influence Infant Feeding Practices.

PubMed

Archer, Lucy E; Dunne, Thomas F; Lock, Lauren J; Price, Lucy A; Ahmed, Zubair

2017-01-01

A decline in breastfeeding rates in Samoa has been reported over the last century. To assess the length of time women breastfeed, their knowledge of both the advantages of and recommendations for breastfeeding, and the factors that influence their decisions to continue or discontinue breastfeeding, a questionnaire was distributed at Tupua Tamasese Meaole Hospital. One hundred and twenty-one eligible participants were included aged 18-50 years (mean age 28.2). Ninety percent of participants initiated breastfeeding, and the majority (78%) of babies were exclusively breastfed for at least the recommended 6 months. Many mothers introduced complementary (solid) foods later than World Health Organization (WHO) and United Nation's International Children's Fund (UNICEF) recommendations of 6 months. Awareness of the advantages of breastfeeding was mixed. The most widely known advantage was "the development of an emotional bond between mother and baby" (67%). Other advantages were less widely known. Only a small minority were aware that breastfeeding reduces risk of maternal diabetes and aids weight loss post partum. Doctors and healthcare workers were listed as the top factors encouraging breastfeeding. Participants' comments revealed a generally positive attitude towards breastfeeding, a very encouraging finding. Participants identified that the number of breastfeeding breaks available at work and the length of their maternity leave were factors discouraging breastfeeding. Future studies are necessary to determine if problems identified in this study are applicable on a national level. These could be important to determine measures to improve breastfeeding practices in Samoa.

The Role of the Autism Diagnostic Observation Schedule in the Assessment of Autism Spectrum Disorders in School and Community Settings.

PubMed

Akshoomoff, Natacha; Corsello, Christina; Schmidt, Heather

2006-01-01

Autism diagnostic practices among school and clinical psychologists, particularly those using the Autism Diagnostic Observation Schedule (ADOS), were examined using national survey results (N = 132). School and clinical psychologists were similar in following the Best Practice Guidelines for screening, diagnosis and assessment, School psychologists were more likely to include a school or home observation and teacher report than clinical psychologists but evaluated significantly fewer children with autism spectrum disorders per year compared to clinical psychologists. School psychologists who were ADOS users were more likely to consider themselves autism experts and include a review of records than ADOS non-users. Perceived advantages of the ADOS included its strength in capturing ASD-specific behaviors and the standardized structure provided for observation, while diagnostic discrimination and required resources were the most commonly identified disadvantages.

Watchful Waiting for Cases of Pediatric Otitis Media: Modeling Parental Response to Physician Advice.

PubMed

MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M

2016-08-01

Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice.

Codigestion of solid wastes: a review of its uses and perspectives including modeling.

PubMed

Mata-Alvarez, Joan; Dosta, Joan; Macé, Sandra; Astals, Sergi

2011-06-01

The last two years have witnessed a dramatic increase in the number of papers published on the subject of codigestion, highlighting the relevance of this topic within anaerobic digestion research. Consequently, it seems appropriate to undertake a review of codigestion practices starting from the late 1970s, when the first papers related to this concept were published, and continuing to the present day, demonstrating the exponential growth in the interest shown in this approach in recent years. Following a general analysis of the situation, state-of-the-art codigestion is described, focusing on the two most important areas as regards publication: codigestion involving sewage sludge and the organic fraction of municipal solid waste (including a review of the secondary advantages for wastewater treatment plant related to biological nutrient removal), and codigestion in the agricultural sector, that is, including agricultural - farm wastes, and energy crops. Within these areas, a large number of oversized digesters appear which can be used to codigest other substrates, resulting in economic and environmental advantages. Although the situation may be changing, there is still a need for good examples on an industrial scale, particularly with regard to wastewater treatment plants, in order to extend this beneficial practice. In the last section, a detailed analysis of papers addressing the important aspect of modelisation is included. This analysis includes the first codigestion models to be developed as well as recent applications of the standardised anaerobic digestion model ADM1 to codigestion. (This review includes studies ranging from laboratory to industrial scale.).

Leveraging business intelligence to make better decisions: Part I.

PubMed

Reimers, Mona

2014-01-01

Data is the new currency. Business intelligence tools will provide better performing practices with a competitive intelligence advantage that will separate the high performers from the rest of the pack. Given the investments of time and money into our data systems, practice leaders must work to take every advantage and look at the datasets as a potential goldmine of business intelligence decision tools. A fresh look at decision tools created from practice data will create efficiencies and improve effectiveness for end-users and managers.

Accurate monitoring leads to effective control and greater learning of patient education materials.

PubMed

Rawson, Katherine A; O'Neil, Rochelle; Dunlosky, John

2011-09-01

Effective management of chronic diseases (e.g., diabetes) can depend on the extent to which patients can learn and remember disease-relevant information. In two experiments, we explored a technique motivated by theories of self-regulated learning for improving people's learning of information relevant to managing a chronic disease. Materials were passages from patient education booklets on diabetes from NIDDK. Session 1 included an initial study trial, Session 2 included self-regulated restudy, and Session 3 included a final memory test. The key manipulation concerned the kind of support provided for self-regulated learning during Session 2. In Experiment 1, participants either were prompted to self-test and then evaluate their learning before selecting passages to restudy, were shown the prompt questions but did not overtly self-test or evaluate learning prior to selecting passages, or were not shown any prompts and were simply given the menu for selecting passages to restudy. Participants who self-tested and evaluated learning during Session 2 had a small but significant advantage over the other groups on the final test. Secondary analyses provided evidence that the performance advantage may have been modest because of inaccurate monitoring. Experiment 2 included a group who also self-tested but who evaluated their learning using idea-unit judgments (i.e., by checking their responses against a list of key ideas from the correct response). Participants who self-tested and made idea-unit judgments exhibited a sizable advantage on final test performance. Secondary analyses indicated that the performance advantage was attributable in part to more accurate monitoring and more effective self-regulated learning. An important practical implication is that learning of patient education materials can be enhanced by including appropriate support for learners' self-regulatory processes. (c) 2011 APA, all rights reserved.

Potential of personal health record portals in the care of individuals with spinal cord injuries and disorders: Provider perspectives.

PubMed

Hill, Jennifer N; Smith, Bridget M; Weaver, Frances M; Nazi, Kim M; Thomas, Florian P; Goldstein, Barry; Hogan, Timothy P

2018-05-01

Although personal health record (PHR) portals are designed for patients, healthcare providers are a key influence in how patients use their features and realize benefits from them. A few studies have examined provider attitudes toward PHR portals, but none have focused on those who care for individuals with spinal cord injuries and disorders (SCI/D). We characterize SCI/D provider perspectives of PHR portals, including perceived advantages and disadvantages of PHR portal use in SCI/D care. Cross-sectional; semi-structured interviews. Spinal Cord Injury (SCI) Centers in the Veterans Health Administration. Twenty-six SCI/D healthcare providers. None. Perceived advantages and disadvantages of PHR portals. The complex situations of individuals with SCI/D shaped provider perspectives of PHR portals and their potential role in practice. Perceived advantages of PHR portal use in SCI/D care included the ability to coordinate information and care, monitor and respond to outpatient requests, support patient self-management activities, and provide reliable health information to patients. Perceived disadvantages of PHR portal use in SCI/D care included concerns about the quality of patient-generated health data, other potential liabilities for providers and workload burden, and the ability of individuals with SCI/D to understand clinical information accessed through a portal. Our study highlights advantages and disadvantages that should be considered when promoting engagement of SCI/D healthcare providers in use of PHR portals, and portal features that may have the most utility in SCI/D care.

Special considerations for hiring an office manager.

PubMed

Sachs Hills, Laura

2004-01-01

Medical practice office managers come in many varieties. They can be hired from the outside or promoted from within. They can have a great deal of experience working in medical practices or practically none. Which type of office manager is the best choice for your practice? This article will help you decide. It describes three types of office managers and considers the pros and cons of each. It explores the characteristics, advantages, and disadvantages of lay administrators hired from the outside, office managers promoted from the ranks, and "super-aides" who are asked to manage while doing their old jobs. This article also offers a list of 10 characteristics to look for in office manager candidates, as well as six areas of overall responsibility for your office manager. Finally, it includes a quick checklist of 20 required duties of typical medical practice office managers that can help you shape your office manager's job description.

End-to-end imaging information rate advantages of various alternative communication systems

NASA Technical Reports Server (NTRS)

Rice, R. F.

1982-01-01

The efficiency of various deep space communication systems which are required to transmit both imaging and a typically error sensitive class of data called general science and engineering (gse) are compared. The approach jointly treats the imaging and gse transmission problems, allowing comparisons of systems which include various channel coding and data compression alternatives. Actual system comparisons include an advanced imaging communication system (AICS) which exhibits the rather significant advantages of sophisticated data compression coupled with powerful yet practical channel coding. For example, under certain conditions the improved AICS efficiency could provide as much as two orders of magnitude increase in imaging information rate compared to a single channel uncoded, uncompressed system while maintaining the same gse data rate in both systems. Additional details describing AICS compression and coding concepts as well as efforts to apply them are provided in support of the system analysis.

[Manual therapy in general practice].

PubMed

Березуцкий, Владимир И

2016-01-01

The article is devoted to manual therapy practice for diagnostics and treatment of vertebrogenic pain syndrome in general practice. Analytical roundup of sources proves medical advantage of implementation of manual therapy basic methods by general practice specialists.

Flexible but boring: medical students' perceptions of a career in general practice.

PubMed

Koehler, Nicole; McMenamin, Christine

2016-07-01

Australia will continue to face a general practitioner (GP) shortage unless a significant number of medical students make general practice their chosen career. Perceptions regarding general practice may influence career choices. Thus this study investigated what Australian medical students perceived to be the advantages and disadvantages of pursuing a career in general practice via an anonymous online survey. Fifty-one students indicated general practice to be their first ranked career preference, 200 indicated a career other than general practice, and 106 were undecided. Two-hundred and two students reported having been on a GP placement, whereas 88 students had not. Flexibility, continuity of patient care and work-life balance were the three most common stated advantages to pursuing a career in general practice whereas general practice being boring, poorly paid, and of low prestige were the three most common disadvantages stated. Some disadvantages stated by those with a non-GP preference were not stated by those with a GP preference (e.g. lack of procedural skills, lack of career advancement opportunities). Students with more than 80 h of GP placement experience were more likely to list the advantages of work-life balance and a diversity of problems/illnesses/patients than those with no placement experience but were also more likely to list the disadvantage of low prestige. Negative stereotypes regarding general practice continue to exist which may influence students' career choices.

12 CFR 563.201 - Corporate opportunity.

Code of Federal Regulations, 2010 CFR

2010-01-01

... duty to a savings association, you must not take advantage of corporate opportunities belonging to the...; and (2) The opportunity is of present or potential practical advantage to the savings association, either directly or through its subsidiary. (c) OTS will not deem you to have taken advantage of a...

Practices of Weight Regulation Among Elite Athletes in Combat Sports: A Matter of Mental Advantage?

PubMed Central

Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M

2013-01-01

Context The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. Objective To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Design Qualitative study. Setting With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Patients or Other Participants Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Data Collection and Analysis Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Results Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being “a real athlete.” Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Conclusions Weight regulation has mentally important functions extending beyond the common notion that combat-sport athletes reduce their weight merely to gain a physical edge over their opponents. PMID:23672331

The Impacts of Workplace Advantage, Learning Intentions, and Technology Skills on the Use of Information Technology-Assisted Instruction by Early Childhood Pre-Service Teachers

ERIC Educational Resources Information Center

Chen, Ru-Si

2015-01-01

The practical value and usefulness of IT-assisted instruction for Taiwanese preschool children are popular topics in academic and practical settings. The purpose of this study was to survey early childhood pre-service teachers' attitudes regarding the workplace advantage of IT-related pedagogy and their learning intentions regarding IT-based…

Culture, cultural factors and psychiatric diagnosis: review and projections.

PubMed

Alarcón, Renato D

2009-10-01

This paper aims to provide conceptual justifications for the inclusion of culture and cultural factors in psychiatric diagnosis, and logistic suggestions as to the content and use of this approach. A discussion of the scope and limitations of current diagnostic practice, criticisms from different quarters, and the role and relevance of culture in the diagnostic encounter, precede the examination of advantages and disadvantages of the approach. The cultural content of psychiatric diagnosis should include the main, well-recognized cultural variables, adequate family data, explanatory models, and strengths and weaknesses of every individual patient. The practical aspects include the acceptance of "cultural discordances" as a component of an updated definition of mental disorder, and the use of a refurbished cultural formulation. Clinical "telescoping" strategies to obtain relevant cultural data during the diagnostic interview, and areas of future research (including field trials on the cultural formulation and on "culture bound syndromes"), are outlined.

Evaluation of experimental design and computational parameter choices affecting analyses of ChIP-seq and RNA-seq data in undomesticated poplar trees.

Treesearch

Lijun Liu; V. Missirian; Matthew S. Zinkgraf; Andrew Groover; V. Filkov

2014-01-01

Background: One of the great advantages of next generation sequencing is the ability to generate large genomic datasets for virtually all species, including non-model organisms. It should be possible, in turn, to apply advanced computational approaches to these datasets to develop models of biological processes. In a practical sense, working with non-model organisms...

Liquid fuel cells.

PubMed

Soloveichik, Grigorii L

2014-01-01

The advantages of liquid fuel cells (LFCs) over conventional hydrogen-oxygen fuel cells include a higher theoretical energy density and efficiency, a more convenient handling of the streams, and enhanced safety. This review focuses on the use of different types of organic fuels as an anode material for LFCs. An overview of the current state of the art and recent trends in the development of LFC and the challenges of their practical implementation are presented.

Humanising midwifery care.

PubMed

Way, Susan; Scammell, Janet

2016-03-01

Since the publication of the Francis Report (2013), providing care that is kind and compassionate is high on the agenda of all NHS services, including maternity. This article introduces the humanising values framework that explores aspects of what it is to be human and offers practical examples of how it can be incorporated into midwifery care. Susan Way and Janet Scammell consider the advantages of woman-centred care, highlighting the benefits of humanising care.

Fiches Pratiques: Mots...a croiser; Profitons du cinema; Le discours rapporte; Cent ans (Practical Ideas: Words...to Cross; Let's Take Advantage of the Movies; Relating Others' Discourse; One Hundred Years).

ERIC Educational Resources Information Center

Vever, Daniel; And Others

1991-01-01

Four class activities for French language instruction are described, including a crossword puzzle exercise emphasizing French culture, use of films for developing a variety of language skills, techniques for helping students discuss others' ideas, and an exercise promoting discussion through photographs of older adults engaged in various…

[The application of radiological image in forensic medicine].

PubMed

Zhang, Ji-Zong; Che, Hong-Min; Xu, Li-Xiang

2006-04-01

Personal identification is an important work in forensic investigation included sex discrimination, age and stature estimation. Human identification depended on radiological image technique analysis is a practice and proper method in forensic science field. This paper intended to understand the advantage and defect by reviewed the employing of forensic radiology in forensic science field broadly and provide a reference to perfect the application of forensic radiology in forensic science field.

Characterizing nanoscale scanning probes using electron microscopy: A novel fixture and a practical guide

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

Jacobs, Tevis D. B., E-mail: tjacobs@pitt.edu; Wabiszewski, Graham E.; Goodman, Alexander J.

2016-01-15

The nanoscale geometry of probe tips used for atomic force microscopy (AFM) measurements determines the lateral resolution, contributes to the strength of the tip-surface interaction, and can be a significant source of uncertainty in the quantitative analysis of results. While inverse imaging of the probe tip has been used successfully to determine probe tip geometry, direct observation of the tip profile using electron microscopy (EM) confers several advantages: it provides direct (rather than indirect) imaging, requires fewer algorithmic parameters, and does not require bringing the tip into contact with a sample. In the past, EM-based observation of the probe tipmore » has been achieved using ad hoc mounting methods that are constrained by low throughput, the risk of contamination, and repeatability issues. We report on a probe fixture designed for use in a commercial transmission electron microscope that enables repeatable mounting of multiple AFM probes as well as a reference grid for beam alignment. This communication describes the design, fabrication, and advantages of this probe fixture, including full technical drawings for machining. Further, best practices are discussed for repeatable, non-destructive probe imaging. Finally, examples of the fixture’s use are described, including characterization of common commercial AFM probes in their out-of-the-box condition.« less

Characterizing nanoscale scanning probes using electron microscopy: A novel fixture and a practical guide

NASA Astrophysics Data System (ADS)

Jacobs, Tevis D. B.; Wabiszewski, Graham E.; Goodman, Alexander J.; Carpick, Robert W.

2016-01-01

The nanoscale geometry of probe tips used for atomic force microscopy (AFM) measurements determines the lateral resolution, contributes to the strength of the tip-surface interaction, and can be a significant source of uncertainty in the quantitative analysis of results. While inverse imaging of the probe tip has been used successfully to determine probe tip geometry, direct observation of the tip profile using electron microscopy (EM) confers several advantages: it provides direct (rather than indirect) imaging, requires fewer algorithmic parameters, and does not require bringing the tip into contact with a sample. In the past, EM-based observation of the probe tip has been achieved using ad hoc mounting methods that are constrained by low throughput, the risk of contamination, and repeatability issues. We report on a probe fixture designed for use in a commercial transmission electron microscope that enables repeatable mounting of multiple AFM probes as well as a reference grid for beam alignment. This communication describes the design, fabrication, and advantages of this probe fixture, including full technical drawings for machining. Further, best practices are discussed for repeatable, non-destructive probe imaging. Finally, examples of the fixture's use are described, including characterization of common commercial AFM probes in their out-of-the-box condition.

Regulation of occupational health and safety in the semiconductor industry: enforcement problems and solutions.

PubMed

Watterson, Andrew

2006-01-01

Reports of high incidences of occupational illnesses in the semiconductor industry should have triggered global investigations and rigorous inspection of the industry. Yet semiconductor plants remain essentially unregulated. Health and safety standards are inadequate and enforcement is lax. Roles for stakeholders in laying down good practice, monitoring, and regulating are proposed, and obstacles are described. Effective regulation has advantages for the industry as well as workers. Conditions for best practice include education at all levels, protection and support for labor inspectors, government commitment to enforcing laws, recognition of the right of workers to organize, and recognition of their rights.

Sequential Quantum Secret Sharing Using a Single Qudit

NASA Astrophysics Data System (ADS)

Bai, Chen-Ming; Li, Zhi-Hui; Li, Yong-Ming

2018-05-01

In this paper we propose a novel and efficient quantum secret sharing protocol using d-level single particle, which it can realize a general access structure via the thought of concatenation. In addition, Our scheme includes all advantages of Tavakoli’s scheme [Phys. Rev. A 92 (2015) 030302(R)]. In contrast to Tavakoli’s scheme, the efficiency of our scheme is 1 for the same situation, and the access structure is more general and has advantages in practical significance. Furthermore, we also analyze the security of our scheme in the primary quantum attacks. Sponsored by the National Natural Science Foundation of China under Grant Nos. 61373150 and 61602291, and Industrial Research and Development Project of Science and Technology of Shaanxi Province under Grant No. 2013k0611

Pulse Detonation Rocket Engine Research at NASA Marshall

NASA Technical Reports Server (NTRS)

Morris, Christopher I.

2003-01-01

This viewgraph representation provides an overview of research being conducted on Pulse Detonation Rocket Engines (PDRE) by the Propulsion Research Center (PRC) at the Marshall Space Flight Center. PDREs have a theoretical thermodynamic advantage over Steady-State Rocket Engines (SSREs) although unsteady blowdown processes complicate effective use of this advantage in practice; PRE is engaged in a fundamental study of PDRE gas dynamics to improve understanding of performance issues. Topics covered include: simplified PDRE cycle, comparison of PDRE and SSRE performance, numerical modeling of quasi 1-D rocket flows, time-accurate thrust calculations, finite-rate chemistry effects in nozzles, effect of F-R chemistry on specific impulse, effect of F-R chemistry on exit species mole fractions and PDRE performance optimization studies.

Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.

PubMed

Eckermann, Simon; Coelli, Tim

2013-01-01

Evidence based medicine supports net benefit maximising therapies and strategies in processes of health technology assessment (HTA) for reimbursement and subsidy decisions internationally. However, translation of evidence based medicine to practice is impeded by efficiency measures such as cost per case-mix adjusted separation in hospitals, which ignore health effects of care. In this paper we identify a correspondence method that allows quality variables under control of providers to be incorporated in efficiency measures consistent with maximising net benefit. Including effects framed from a disutility bearing (utility reducing) perspective (e.g. mortality, morbidity or reduction in life years) as inputs and minimising quality inclusive costs on the cost-disutility plane is shown to enable efficiency measures consistent with maximising net benefit under a one to one correspondence. The method combines advantages of radial properties with an appropriate objective of maximising net benefit to overcome problems of inappropriate objectives implicit with alternative methods, whether specifying quality variables with utility bearing output (e.g. survival, reduction in morbidity or life years), hyperbolic or exogenous variables. This correspondence approach is illustrated in undertaking efficiency comparison at a clinical activity level for 45 Australian hospitals allowing for their costs and mortality rates per admission. Explicit coverage and comparability conditions of the underlying correspondence method are also shown to provide a robust framework for preventing cost-shifting and cream-skimming incentives, with appropriate qualification of analysis and support for data linkage and risk adjustment where these conditions are not satisfied. Comparison on the cost-disutility plane has previously been shown to have distinct advantages in comparing multiple strategies in HTA, which this paper naturally extends to a robust method and framework for comparing efficiency of health care providers in practice. Consequently, the proposed approach provides a missing link between HTA and practice, to allow active incentives for evidence based net benefit maximisation in practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Specificity vs. Generalizability: Emergence of Especial Skills in Classical Archery

PubMed Central

Czyż, Stanisław H.; Moss, Sarah J.

2016-01-01

There is evidence that the recall schema becomes more refined after constant practice. It is also believed that massive amounts of constant practice eventually leads to the emergence of especial skills, i.e., skills that have an advantage in performance over other actions from within the same class of actions. This advantage in performance was noticed when one-criterion practice, e.g., basketball free throws, was compared to non-practiced variations of the skill. However, there is no evidence whether multi-criterion massive amounts of practice would give an advantage to the trained variations of the skill over non-trained, i.e., whether such practice would eventually lead to the development of (multi)-especial skills. The purpose of this study was to determine whether massive amount of practice involving four criterion variations of the skill will give an advantage in performance to the criterions over the class of actions. In two experiments, we analyzed data from female (n = 8) and male classical archers (n = 10), who were required to shoot 30 shots from four accustomed distances, i.e., males at 30, 50, 70, and 90 m and females at 30, 50, 60, and 70 m. The shooting accuracy for the untrained distances (16 distances in men and 14 in women) was used to compile a regression line for distance over shooting accuracy. Regression determined (expected) values were then compared to the shooting accuracy of the trained distances. Data revealed no significant differences between real and expected results at trained distances, except for the 70 m shooting distance in men. The F-test for lack of fit showed that the regression computed for trained and non-trained shooting distances was linear. It can be concluded that especial skills emerge only after very specific practice, i.e., constant practice limited to only one variation of the skill. PMID:27547196

Specificity vs. Generalizability: Emergence of Especial Skills in Classical Archery.

PubMed

Czyż, Stanisław H; Moss, Sarah J

2016-01-01

There is evidence that the recall schema becomes more refined after constant practice. It is also believed that massive amounts of constant practice eventually leads to the emergence of especial skills, i.e., skills that have an advantage in performance over other actions from within the same class of actions. This advantage in performance was noticed when one-criterion practice, e.g., basketball free throws, was compared to non-practiced variations of the skill. However, there is no evidence whether multi-criterion massive amounts of practice would give an advantage to the trained variations of the skill over non-trained, i.e., whether such practice would eventually lead to the development of (multi)-especial skills. The purpose of this study was to determine whether massive amount of practice involving four criterion variations of the skill will give an advantage in performance to the criterions over the class of actions. In two experiments, we analyzed data from female (n = 8) and male classical archers (n = 10), who were required to shoot 30 shots from four accustomed distances, i.e., males at 30, 50, 70, and 90 m and females at 30, 50, 60, and 70 m. The shooting accuracy for the untrained distances (16 distances in men and 14 in women) was used to compile a regression line for distance over shooting accuracy. Regression determined (expected) values were then compared to the shooting accuracy of the trained distances. Data revealed no significant differences between real and expected results at trained distances, except for the 70 m shooting distance in men. The F-test for lack of fit showed that the regression computed for trained and non-trained shooting distances was linear. It can be concluded that especial skills emerge only after very specific practice, i.e., constant practice limited to only one variation of the skill.

Socioeconomic issues of United States military neurosurgery.

PubMed

Moquin, Ross R; Ecklund, James M

2002-04-15

Although the practice of neurosurgery in the United States (US) Armed Forces is in many ways similar to the civilian practice of neurosurgery, there are many differences as well. The unique challenges, duties, and opportunities US military neurosurgeons are given, both in peacetime and in times of conflict, are discussed, as are pathways for entering into service. The advantages of military service for neurosurgeons include sponsored training, decreased direct exposure to tort actions, little involvement with third-party payers, significant opportunities for travel, and military specific experiences. The most appealing aspect of military practice is serving fellow members of the US Armed Forces. Disadvantages include the extreme gap between the military and civilian pay scales, lack of support personnel, and in some areas low surgery-related case volume. The greatest concern faced by the military neurosurgical community is the failure to retain experienced neurosurgeons after their obligated service time has been completed, for which several possible solutions are described. It is hoped that future changes will make the practice of military neurosurgery attractive enough so that it will be seen as a career in itself and not an obligation to endure before starting practice in the "real world."

How Does Iranian's Legal System Protect Human Vulnerability and Personal Integrity in Medical Research?

PubMed Central

Karoubi, Mohammad Taghi; Akhondi, Mohammad Mehdi

2011-01-01

The astonishing advance of medical science in recent decades has had endless advantages for humans, including improved level of health, prevention of disease and advances in treatment. These advances depend to a great extent on conducting continuous research. However, besides its enormous advantages, the sole interest of medical science undermines the principles of respect for human vulnerability and personal integrity, in both positive and negative approaches. The positive approach refers to the people who participate in research and practice, while the negative approach refers to people who are deprived of research and practice. The authors of this work, based on legal or moral grounds try to analyse the tension between the principle of respect for human vulnerability and personal integrity and the interest of medical science. Undoubtedly, in applying scientific knowledge and medical practice human vulnerability should be taken into account. In this regard, especially vulnerable individuals and groups should be protected and the personal integrity of such individuals respected. In the light of the merits of Islamic law, this paper is designed to examine the significance of the principles of human vulnerability and personal integrity in medical research by studying the international documents as formalised by UNESCO in order to explore the place of these principles in the Iranian legal system. PMID:23408269

Recent developments in microbial fuel cell technologies for sustainable bioenergy.

PubMed

Watanabe, Kazuya

2008-12-01

Microbial fuel cells (MFCs) are devices that exploit microbial catabolic activities to generate electricity from a variety of materials, including complex organic waste and renewable biomass. These sources provide MFCs with a great advantage over chemical fuel cells that can utilize only purified reactive fuels (e.g., hydrogen). A developing primary application of MFCs is its use in the production of sustainable bioenergy, e.g., organic waste treatment coupled with electricity generation, although further technical developments are necessary for its practical use. In this article, recent advances in MFC technologies that can become fundamentals for future practical MFC developments are summarized. Results of recent studies suggest that MFCs will be of practical use in the near future and will become a preferred option among sustainable bioenergy processes.

Sexual function and practice in elderly men of lower socioeconomic status.

PubMed

Cogen, R; Steinman, W

1990-08-01

Normal aging plus certain prevalent diseases are believed to render many elderly men impotent. Recent studies have suggested that educated middle-class and upper-class elderly men continue sexual activity, despite erectile dysfunction, by employing alternative practices such as mutual masturbation and oral sex. Few elderly men of lower socioeconomic background have been included in these studies, however. Using physician-administered interviews, 87 men attending an urban Veterans Administration geriatric clinic were studied to determine (1) the prevalence of erectile dysfunction, and (2) the sexual practices and attitudes of this group. Of the 87 men, 28% reported complete loss of erectile function, while 31% had frequent difficulties achieving vaginal intromission. Unlike economically advantaged groups, only 29% used mutual masturbation and 16% used oral sex. Attitudes toward these practices were negative. With one exception, men unable to perform coitus ceased all heterosexual activities.

Innovations at Miami practice show promise for treating high-risk Medicare patients.

PubMed

Tanio, Craig; Chen, Christopher

2013-06-01

Patients with five or more chronic conditions drive most Medicare costs. Our organization, ChenMed, developed a scalable primary care-led delivery model that focuses on this population while getting reimbursed through full-risk capitation by Medicare Advantage plans. ChenMed is a primary care-led group practice based in Florida that serves low-to-moderate-income elderly patients, largely through the Medicare Advantage program. Our model includes a number of innovations: a one-stop-shop approach for delivering multispecialty services in the community, smaller physician panel sizes of 350-450 patients that allow for intensive health coaching and preventive care, on-site physician pharmacy dispensing, a collaborative physician culture with peer review, and customized information technology. These innovations have improved patient medication adherence, increased the time doctors and patients spend together, and led to high rates of patient satisfaction. Additionally, our Medicare patients have substantially lower rates of hospital use than their peers in the Miami Medicare market. Creating chronic disease centers focused on seniors with multiple chronic conditions is a promising delivery system innovation with major potential to improve the cost and quality of care.

Work-based learning in health and social care.

PubMed

Phillips, Sue

This article examines some of the issues encountered in helping to develop and facilitate work-based learning (WBL) in clinical areas from the author's perspective of APEL/WBL co-ordinator. The advantages of work-based learning to both organisations and practitioners are discussed, together with possible drawbacks. The article concludes by identifying the positive aspects, including that of practice development, but suggests caution in attempting to use work-based learning in all circumstances.

Liquid fuel cells

PubMed Central

2014-01-01

Summary The advantages of liquid fuel cells (LFCs) over conventional hydrogen–oxygen fuel cells include a higher theoretical energy density and efficiency, a more convenient handling of the streams, and enhanced safety. This review focuses on the use of different types of organic fuels as an anode material for LFCs. An overview of the current state of the art and recent trends in the development of LFC and the challenges of their practical implementation are presented. PMID:25247123

Humidification of inspired gases during mechanical ventilation.

PubMed

Gross, J L; Park, G R

2012-04-01

Humidification of inspired gas is mandatory for all mechanically ventilated patients to prevent secretion retention, tracheal tube blockage and adverse changes occurring to the respiratory tract epithelium. However, the debate over "ideal" humidification continues. Several devices are available that include active and passive heat and moisture exchangers and hot water humidifiers Each have their advantages and disadvantages in mechanically ventilated patients. This review explores each device in turn and defines their role in clinical practice.

Privilege and status in an unequal society: shifting the focus of health promotion research to include the maintenance of advantage.

PubMed

Stephens, Christine

2010-10-01

There has been a great deal of social policy and health promotion practice directed toward the inclusion of underprivileged groups with the aim of improving their health. This focus on disadvantaged people and poor communities, to help them empower themselves and improve their lot, often fails because it ignores the role of the broader society. We neglect to note the crucial part that the advantaged play in perpetuating inequalities. Theory and empirical work from sociology and anthropology points to the everyday ways in which privileged people are able to maintain their advantage and even hi-jack the benefits of public health programmes designed to improve the health of the poor. Some examples from these other disciplines suggest ways in which a social psychological perspective can contribute to an understanding of how inequalities and poverty are perpetuated in everyday life. These understandings will inform the effectiveness of social programmes to reduce inequalities.

Advantages and pitfalls in the application of mixed-model association methods.

PubMed

Yang, Jian; Zaitlen, Noah A; Goddard, Michael E; Visscher, Peter M; Price, Alkes L

2014-02-01

Mixed linear models are emerging as a method of choice for conducting genetic association studies in humans and other organisms. The advantages of the mixed-linear-model association (MLMA) method include the prevention of false positive associations due to population or relatedness structure and an increase in power obtained through the application of a correction that is specific to this structure. An underappreciated point is that MLMA can also increase power in studies without sample structure by implicitly conditioning on associated loci other than the candidate locus. Numerous variations on the standard MLMA approach have recently been published, with a focus on reducing computational cost. These advances provide researchers applying MLMA methods with many options to choose from, but we caution that MLMA methods are still subject to potential pitfalls. Here we describe and quantify the advantages and pitfalls of MLMA methods as a function of study design and provide recommendations for the application of these methods in practical settings.

Environmental management and firm performance: a case study.

PubMed

Claver, Enrique; López, María D; Molina, José F; Tarí, Juan J

2007-09-01

This study has as its aim to help to clarify the relationship between environmental management and economic performance by integrating it into a wider framework that includes the relationship between environmental strategy and firm performance, the latter being understood as the combination of environmental performance, competitive advantage and economic performance. A case study of the COATO farming cooperative showed us that its environmental management, focused on prevention logic, has had a positive net effect on its environmental performance. Besides, the order in which these practices were adopted favoured the development of new organisational capabilities that have contributed to the appearance of advantages derived from the greater accumulated experience of employees in creating new projects that are designed to reduce residues and pollution. COATO has also obtained a competitive advantage in differentiation thanks to an improved brand image and to its increased credibility in business relationships. Finally, a positive correlation exists between the pioneering proactive strategy adopted by this cooperative and the improvement of its firm performance with respect to the other firms in its sector.

Simple solution to the medical instrumentation software problem

NASA Astrophysics Data System (ADS)

Leif, Robert C.; Leif, Suzanne B.; Leif, Stephanie H.; Bingue, E.

1995-04-01

Medical devices now include a substantial software component, which is both difficult and expensive to produce and maintain. Medical software must be developed according to `Good Manufacturing Practices', GMP. Good Manufacturing Practices as specified by the FDA and ISO requires the definition and compliance to a software processes which ensures quality products by specifying a detailed method of software construction. The software process should be based on accepted standards. US Department of Defense software standards and technology can both facilitate the development and improve the quality of medical systems. We describe the advantages of employing Mil-Std-498, Software Development and Documentation, and the Ada programming language. Ada provides the very broad range of functionalities, from embedded real-time to management information systems required by many medical devices. It also includes advanced facilities for object oriented programming and software engineering.

24 CFR 1710.4 - Exemptions-general.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., practice, or course of business which operates or would operate as a fraud or deceit upon a purchaser. (c... Secretary in order to take advantage of an exemption. If a developer elects to take advantage of an...

The use of infrared ear thermometers in pediatric and family practice offices.

PubMed

Silverman, B G; Daley, W R; Rubin, J D

1998-01-01

To describe the use of infrared (IR) ear thermometers in pediatric and family practice offices. The authors mailed a questionnaire to 350 randomly selected members of the American Academy of Pediatrics and to 355 randomly selected members of the American Academy of Family Physicians. Of respondents in clinical practice, 78% had used IR ear thermometers at least once in the past; 65% of pediatricians and 64% of family practice physicians were current users. Seventeen percent of pediatric offices and 18% of family practice offices that had used IR ear thermometers had discontinued use, most citing inaccuracy or lack of staff trust in the device. Pediatric offices were less likely than family practice offices to use the device in well neonates and sick neonates and more likely to use it in sick children. Advantages cited included rapid readings, ease of use, and accuracy. Seventy-five percent of current users reported at least one problem, including low readings and lack of staff trust. IR ear thermometers are widely used in pediatric and family practice offices. Some offices limit use of these devices to older children and adults, and most of the offices surveyed report using other devices as a check on the accuracy of IR thermometers. Statements by professional organizations that provide user guidelines and establish appropriate age cut-offs would be helpful.

The ADVANTAGE seeding trial: a review of internal documents.

PubMed

Hill, Kevin P; Ross, Joseph S; Egilman, David S; Krumholz, Harlan M

2008-08-19

Seeding trials, clinical studies conducted by pharmaceutical companies that are designed to seem as if they answer a scientific question but primarily fulfill marketing objectives, have not been described in detail. To describe a known seeding trial, ADVANTAGE (Assessment of Differences between Vioxx and Naproxen To Ascertain Gastrointestinal Tolerability and Effectiveness), through documents of the trial sponsor, Merck & Co. (Whitehouse Station, New Jersey). Merck internal and external correspondence, reports, and presentations elicited to inform legal proceedings of Cona v Merck and Co., Inc., and McDarby v Merck and Co., Inc. The documents were created between 1998 and 2006. An iterative case-study process of review, discussion, and re-review of documents to identify themes relevant to the design and conduct of ADVANTAGE. To supplement the case-study review, the authors did a systematic review of the literature to identify published manuscripts focused on seeding trials and their conduct. Review of the documents revealed 3 key themes: The trial was designed by Merck's marketing division to fulfill a marketing objective; Merck's marketing division handled both the scientific and the marketing data, including collection, analysis, and dissemination; and Merck hid the marketing nature of the trial from participants, physician investigators, and institutional review board members. Although the systematic review of the literature identified 6 articles that focused on the practice of seeding trials, none provided documentary evidence of their existence or conduct. The legal documents in these cases provide useful, but limited, information about the practices of the pharmaceutical industry. This description of 1 company's actions is incomplete and may have limited generalizability. Documentary evidence shows that ADVANTAGE is an example of marketing framed as science. The documents indicate that ADVANTAGE was a seeding trial developed by Merck's marketing division to promote prescription of Vioxx (rofecoxib) when it became available on the market in 1999.

Practical Work Activities as a Method of Assessing Learning in Chemistry Teaching

ERIC Educational Resources Information Center

Sedumedi, Thomas D. T.

2017-01-01

Practical work activities have been used for many purposes in science teaching. However, its use for assessment purposes has been limited. This study highlights the role of practical work activities in assessment. Practical work activities present various advantages as an assessment tool. Practical work activities allow the assessor access to a…

Practical application of power conditioning to electric propulsion for passenger vehicles

NASA Technical Reports Server (NTRS)

Demerdash, N. A.; Lee, F. C.; Nehl, T. W.; Overton, B. P.

1980-01-01

A functional model 15 HP, 120 volt, 4-pole, 7600 r.p.m. samarium-cobalt permanent magnet type brushless dc motor-transistorized power conditioner unit was designed, fabricated and tested for specific use in propulsion of electric passenger vehicles. This new brushless motor system, including its power conditioner package, has a number of important advantages over existing systems such as reduced weight and volume, higher reliability, and potential for improvements in efficiencies. These advantages are discussed in this paper in light of the substantial test data collected during experimentation with the newly developed conditioner motor propulsion system. Details of the power conditioner design philosophy and particulars are given in the paper. Also, described here are the low level electronic design and operation in relation to the remainder of the system.

Micellar liquid chromatography

NASA Astrophysics Data System (ADS)

Basova, Elena M.; Ivanov, Vadim M.; Shpigun, Oleg A.

1999-12-01

Background and possibilities of practical applications of micellar liquid chromatography (MLC) are considered. Various retention models in MLC, the effects of the nature and concentration of surfactants and organic modifiers, pH, temperature and ionic strength on the MLC efficiency and selectivity are discussed. The advantages and limitations of MLC are demonstrated. The performance of MLC is critically evaluated in relationship to the reversed-phase HPLC and ion-pair chromatography. The potential of application of MLC for the analysis of pharmaceuticals including that in biological fluids and separation of inorganic anions, transition metal cations, metal chelates and heteropoly compounds is described. The bibliography includes 146 references.

Development and Implementation of Sepsis Alert Systems.

PubMed

Harrison, Andrew M; Gajic, Ognjen; Pickering, Brian W; Herasevich, Vitaly

2016-06-01

Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload, and alert fatigue, due to suboptimal alert performance. Outside the ICU, barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Current evidence does not support routine use of sepsis alert systems in clinical practice. Continuous improvement in the afferent and efferent aspects will help translate theoretic advantages into measurable patient benefit. Copyright © 2016 Elsevier Inc. All rights reserved.

Silver biocide's real-world success.

PubMed

Pearson, Susan

2015-03-01

Although temperature control has been the UK's longest-serving means of controlling the growth and proliferation of Legionella in hot and cold water systems, there are other factors, including major rises in energy costs, that warrant the use of biocides--including in the healthcare sector. In 2000, the HSE's new 'L8' guidelines took this into account, giving equal weight to both temperature reg~mes and biocides, such as chlorine dioxide, as control methods. Susan Pearson BSc reports on one potentially effective biocide- silver hydrogen peroxide, explains how it 'works' in practice, and highlights the recent 'real-world' evidence of its effectiveness and advantages.

Guidelines to group practice. Fédération Dentaire Internationale. Technical Report No. 22.

PubMed

1985-09-01

This report reviews the types of group practice, the essential financial arrangements and the management procedures involved. The advantages and disadvantages of group practice to the dentist and the patient are reviewed.

Regional Climate Enterprises in the South Central U.S.: Crossover Relationships to Maximize User Engagement Effectiveness

NASA Astrophysics Data System (ADS)

Langston, M. A.; Shafer, M.; Bartush, B.; Brown, D. P.

2016-12-01

Several Federal agencies have recently established regional enterprises that provide climate science and services. These include DOI's Climate Science Centers (CSCs), USDA's Regional Climate Hubs (Hubs), DOI's Landscape Conservation Cooperatives (LCCs), and NOAA's Regional Integrated Sciences and Assessments Programs (RISAs), all of which have missions that include translating climate information for various constituencies and user groups. Each of these organizations makes a unique contribution to the regional climate services landscape; however, the potential for duplication of effort is also present. To ensure that appropriate levels of programmatic coordination are taking place, these entities have developed roles and relationships that crossover between organizations. These efforts have typically not been formally codified or prescribed; rather, they have developed organically and effectively in a fashion appropriate for the regional context. In this presentation, both advantages and disadvantages of this approach are addressed via examples from the South Central U.S. Advantages include flexibility and the development of extensive, multi-disciplinary networks; disadvantages include the lack of a holistic approach to oversight and planning. Best practices and opportunities to continue strengthening cross-organizational regional efficiencies are also highlighted.

Resident partnerships: an effective strategy for training in primary care.

PubMed

Adam, P; Williamson, H A; Zweig, S C; Delzell, J E

1997-06-01

To facilitate resident training in the ambulatory setting, a few family practice residency programs use a partnership system to train residents. Partnerships are pairs of residents from the same year that rotate together on inpatient services. We identified and characterized the advantages and disadvantages of partnership programs in family practice residencies. We conducted a national survey of family practice residencies, followed by phone interviews with residency directors of programs with partnerships. A total of 305 of 407 (75%) residencies responded; 10 programs fit our definition of partnership. Program directors were positive about resident partnerships. Benefits included improved outpatient continuity, enhanced medical communication skills, and emotional and intellectual support. Disadvantages were decreased inpatient exposure and difficulty coordinating residents' schedules. Directors were favorable about partnerships, which seem to be an underutilized technique to improve residency training.

Marketing occupational health care.

PubMed

Norris, M J; Harris, J C

1981-01-01

A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.

Anodal transcranial direct current stimulation over the primary motor cortex does not enhance the learning benefits of self-controlled feedback schedules.

PubMed

Carter, Michael J; Smith, Victoria; Carlsen, Anthony N; Ste-Marie, Diane M

2018-05-01

A distinct learning advantage has been shown when participants control their knowledge of results (KR) scheduling during practice compared to when the same KR schedule is imposed on the learner without choice (i.e., yoked schedules). Although the learning advantages of self-controlled KR schedules are well-documented, the brain regions contributing to these advantages remain unknown. Identifying key brain regions would not only advance our theoretical understanding of the mechanisms underlying self-controlled learning advantages, but would also highlight regions that could be targeted in more applied settings to boost the already beneficial effects of self-controlled KR schedules. Here, we investigated whether applying anodal transcranial direct current stimulation (tDCS) to the primary motor cortex (M1) would enhance the typically found benefits of learning a novel motor skill with a self-controlled KR schedule. Participants practiced a spatiotemporal task in one of four groups using a factorial combination of KR schedule (self-controlled vs. yoked) and tDCS (anodal vs. sham). Testing occurred on two consecutive days with spatial and temporal accuracy measured on both days and learning was assessed using 24-h retention and transfer tests without KR. All groups improved their performance in practice and a significant effect for practicing with a self-controlled KR schedule compared to a yoked schedule was found for temporal accuracy in transfer, but a similar advantage was not evident in retention. There were no significant differences as a function of KR schedule or tDCS for spatial accuracy in retention or transfer. The lack of a significant tDCS effect suggests that M1 may not strongly contribute to self-controlled KR learning advantages; however, caution is advised with this interpretation as typical self-controlled learning benefits were not strongly replicated in the present experiment.

Innovative Model of Practice-Oriented Training of Employees of the Town-Forming Enterprise in the Mining Region (by the Example of JSC "SUEK-Kuzbass")

NASA Astrophysics Data System (ADS)

Kulay, Svetlana; Kayachev, Gennady

2017-11-01

The article proposes to improve the system of training of employees of joint-stock company SUEK-Kuzbass in the educational institutions of the Kemerovo region according to the requirements of the company using practice-oriented training technology. The aim of the work is to substantiate the effectiveness of implementing practice-oriented training, identify priority directions and ways of its development. The main objectives of the study are: to identify the main advantages for the company and students; determine the criteria for the success and practical value of applying practice-oriented training for the company; conduct a comparative analysis of the target and practice-oriented model of training for the company. The real needs of the employer through the dual form of training were taking into account. The expansion of positive experience in training engineering personnel in higher education in technology-based training with the involvement of specialists from other regions of the company and expanding training in mining was also included.

DEVELOPING AND INSTRUCTING PRE-PERFORMANCE ROUTINES FOR TENPIN BOWLING COMPETITIONS (1).

PubMed

Lee, Seungmin; Lee, Keunchul; Kwon, Sungho

2015-06-01

This preliminary study developed pre-performance routines for tenpin bowlers and instructed them. To develop the routine, the situations before throwing the ball were divided into four phases; participants were examined through interviews and observations. This study used an A-B design; the A stage included the development of the routines for 3 wk., while the B stage included the instruction and two evaluations of the routine consistency. Practice was implemented for 4 hr. per day for 9 wk. The participants noted they understood the developed routine easily and experienced an atmosphere similar to that of a competition during training through the routines. They found it difficult to practice the relaxation phase, but emphasized that the relaxation phase was helpful. Consistent routines were associated with an improved mental state and performance in a competition. This study suggests that pre-performance routines stabilize the mental state of the athletes, apparently giving them a competitive advantage.

Embracing "Soft Skill" Diversity in the Workplace (Invited)

NASA Astrophysics Data System (ADS)

Thomas, T.

2010-12-01

Embracing "Soft Skill" Diversity in the Workplace Terri Thomas, Sr. Director Global Customer Support ShoreTel INRODUCTION Truly successful diversity programs go beyond gender, age, ethnicity, race, sexual orientation and spiritual practice. They include diversity of thought, style, leadership and communication styles, the so called “soft skills”. The increasing need for global workforces is stronger than ever and high performance teams have fully embraced, successfully harnessed and put into practice robust diversity programs than include a “soft skill” focus. Managing diversity presents significant organizational challenges, and is not an easy task, particularly in organizations that are heavily weighted with highly technical professionals such as engineers, accountants etc.. The focus of this presentation is on leveraging the “Soft Skills” diversity in technical work environments to create high performance and highly productive teams. WHY DIVERSITY and WHY NOW? Due to increasing changes in the U.S. population, in order to stay competitive, companies need to focus on diversity and look for ways to become inclusive organizations because diversity has the potential of yielding greater productivity and competitive advantages . Managing and valuing diversity is a key component of effective people management, which can improve workplace productivity (Black Enterprise, 2001). Changing demographics, from organizational restructuring, women in the workplace, equal opportunity legislation and other legal issues, are forcing organizations to become more aggressive in implementing robust diversity practices. However, YOU do not need to wait for your organization to introduce a formal “Diversity” program. There are steps you can take to introduce diversity into your own workgroups. There is no “one single answer” to solve this issue, however this discussion will provide thought provoking ideas, examples of success and failure and a starting point for you to implement “soft skill” diversity practices in your work environment. Most workplaces are made up of many aspects of diversity already so why not embrace it and use it to your competitive advantage.

Smart dental practice: capitalising on smart mobile technology.

PubMed

Plangger, K; Bredican, J; Mills, A J; Armstrong, J

2015-08-14

To keep pace with consumer adoption of smart mobile devices, such as smartphones and tablets, and the applications ('apps') developed for these devices, dental professionals should consider how this technology could be used to simultaneously improve both patient service experiences and dental practice management. Using U-Commerce as a theoretical lens, this article discusses the potential value of smart mobile technology to the dental practice context, with a particular focus on the unique and customisable capabilities of apps. To take full advantage of this technology, a process is outlined for identifying and designing bespoke dental apps that takes into account the unique advantages of these devices. Dental practices, with increasing financial and competitive pressures, may improve the efficiency and profitability of operations and better manage patients, employees and stakeholders by integrating smart mobile technology.

Optical monitoring of Disinfection By-product Precursors with Fluorescence Excitation-Emission Mapping (F-EEM): Practical Application Issues for Drinking, Waste and Reuse Water Industry

NASA Astrophysics Data System (ADS)

Gilmore, A. M.

2012-12-01

Drinking water, wastewater and reuse plants must deal with regulations associated with bacterial contamination and halogen disinfection procedures that can generate harmful disinfection by-products (DBPs) including trihalomethanes (THMs), haloacetic acids (HOAAs) and other compounds. The natural fluorescent chromophoric dissolved organic matter (CDOM) is regulated as the major DBP precursor. This study outlines the advantages and current limitations associated with optical monitoring of water treatment processes using tcontemporary Fluorescence Excitation-Emission Mapping (F-EEM). The F-EEM method coupled with practical peak indexing and multi-variate analyses is potentially superior in terms of cost, speed and sensitivity over conventional total organic carbon (TOC) meters and specific UV-absorbance (SUVA) measurements. Hence there is strong interest in developing revised environmental regulations around the F-EEM technique instruments which can incidentally simultaneously measure the SUVA and DOC parameters. Importantly, the F-EEM technique, compared to the single-point TOC and SUVA signals can resolve CDOM classes distinguishing those that strongly cause DBPs. The F-EEM DBP prediction method can be applied to surface water sources to evaluate DBP potential as a function of the point sources and reservoir depth profiles. It can also be applied in-line to rapidly adjust DOC removal processes including sedimentation-flocculation, microfiltration, reverse-osmosis, and ozonation. Limitations and interferences for F-EEMs are discussed including those common to SUVA and TOC in contrast to the advantages including that F-EEMs are less prone to interferences from inorganic carbon and metal contaminations and require little if any chemical preparation. In conclusion, the F-EEM method is discussed in terms of not only the DBP problem but also as a means of predicting (concurrent to DBP monitoring) organic membrane fouling in water-reuse and desalination plants.

Alignment: Discrepancies of Practice and Vision in U.S. Army Staffing

DTIC Science & Technology

2004-05-26

mitigating our own vulnerabilities through technological and informational advantage while maintaining superiority of lethal and non-lethal effects across...disadvantaged are burdened with the task of defending the prerogatives and alternatives of the most advantaged . To rectify the contemporary...Defense cannot afford to continue to measure recruits by Cold War standards but must take advantage of available technology and research to refine the

New therapeutic options for respiratory tract infections.

PubMed

Bassetti, Matteo; Righi, Elda; Carnelutti, Alessia

2016-04-01

The progressive increase of respiratory tract infections caused by multidrug-resistant organisms (MDROs) has been associated with delays in the prescription of an adequate antibiotic treatment and increased mortality, representing a major concern in both community and hospital settings. When infections because of methicillin-resistant Staphylococcus aureus (MRSA) are suspected, vancomycin still represents the first choice, although its efficacy has been recently questioned in favor of new drugs, reported to provide better clinical outcomes. Moreover, few therapeutic options are currently available for the treatment of severe infections caused by Multidrug-resistant (MDR) Gram-negative pathogens, which are frequently resistant to all the available β-lactams, including carbapenems. We have reviewed the therapeutic options for the treatment of respiratory tract infections that have recently become available with promising implications for clinical practice, including ceftaroline, ceftrobiprole, tedizolid, telavancin, delafloxacin, eravacycline, and new β-lactams/β-lactamase inhibitors. A number of new antimicrobials with activity against MDROs have been recently approved for the treatment of respiratory tract infections, and other agents are under investigation. Recent developments, with a specific focus on the possible advantages of new drugs for the management of respiratory tract infections caused by MDROs in everyday clinical practice are discussed. Newly approved and investigational drugs for the treatment of respiratory tract infections are expected to offer many advantages for the management of patients with suspected or confirmed infections caused by MDROs. Most promising features among new compounds include the broad spectrum of activity against both MRSA and MDR Gram-negative bacteria, a limited risk of antimicrobial resistance, the availability of oral formulations, and a promising safety profile.

Catalyst-Free Difunctionalization of Activated Alkenes in Water: Efficient Synthesis of β-Keto Sulfides and Sulfones.

PubMed

Wang, Huamin; Wang, Guangyu; Lu, Qingquan; Chiang, Chien-Wei; Peng, Pan; Zhou, Jiufu; Lei, Aiwen

2016-10-04

Difunctionalization of activated alkenes, a powerful strategy in chemical synthesis, has been accomplished for direct synthesis of a series of β-keto sulfides and β-keto sulfones. The transformation, mediated by O2 , proceeds smoothly in water and without any catalyst. Prominent advantages of this method include mild reaction conditions, purification simplicity, and gram-scale synthesis, underlining the practical utility of this methodology. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Metals as Biomaterials

NASA Astrophysics Data System (ADS)

Helsen, Jef A.; Jürgen Breme, H.

1998-10-01

Biomaterials is a field that continues to attract a significant amount of attention from researchers, industry, educationalists and regulators. This book is the first to provide readers with an understanding of fundamental theory relating to the use of metals in biomedical applications in addition to comprehensively covering applied aspects encompassing practical and technical advantages and disadvantages. Topics highlighted in the book include guidelines for selecting materials; shape memory alloys; degradation and surface modification; adhesion to ceramics and polymers; biocompartibility and tissue-implant interactions; and European and North American regulatory issues.

California's digital divide: clinical information systems for the haves and have-nots.

PubMed

Miller, Robert H; D'Amato, Katherine; Oliva, Nancy; West, Christopher E; Adelson, Joel W

2009-01-01

Strong barriers prevent the financing of clinical information systems (CIS) in health care delivery system organizations in market segments serving disadvantaged patients. These segments include community health centers, public hospitals, unaffiliated rural hospitals, and some Medicaid-oriented solo and small-group medical practices. Policy interventions such as loans, grants, pay-for-performance and other reimbursement changes, and support services assistance will help lower these barriers. Without intervention, progress will be slow and worsen health care disparities between the advantaged and disadvantaged populations.

Mergers and acquisitions involving equine veterinary practices.

PubMed

Jackman, Brad R; McCafferty, Owen E

2009-12-01

This article discusses mergers and acquisitions involving equine veterinary practices. Combining practices can be professionally and economically advantageous but requires a great deal of thought, planning, and implementation. If due diligence is performed and true business teamwork is undertaken, the benefits can be enormous and rewarding.

Simultaneous PET-MRI in Oncology: A Solution Looking for a Problem?

PubMed Central

Yankeelov, Thomas E.; Peterson, Todd E.; Abramson, Richard G.; Garcia-Izquierdo, David; Arlinghaus, Lori R.; Li, Xia; Atuegwu, Nkiruka C.; Catana, Ciprian; Manning, H. Charles; Fayad, Zahi A.; Gore, John C.

2012-01-01

With the recent development of integrated positron emission tomography-magnetic resonance imaging (PET-MRI) scanners, new possibilities for quantitative molecular imaging of cancer are realized. However, the practical advantages and potential clinical benefits of the ability to record PET and MRI data simultaneously must be balanced against the substantial costs and other requirements of such devices. In this review we highlight several of the key areas where integrated PET-MRI measurements, obtained simultaneously, are anticipated to have a significant impact on clinical and/or research studies. These areas include the use of MR-based motion corrections and/or a priori anatomical information for improved reconstruction of PET data; improved arterial input function characterization for PET kinetic modeling; the use of dual-modality contrast agents; and patient comfort and practical convenience. For widespread acceptance, a compelling case could be made if the combination of quantitative MRI and specific PET biomarkers significantly improves our ability to assess tumor status and response to therapy, and some likely candidates are now emerging. We consider the relative advantages and disadvantages afforded by PET-MRI and summarize current opinions and evidence as to the likely value of PET-MRI in the management of cancer. PMID:22795930

The challenges of editorship: a reflection on editing the Jung-Neumann correspondence.

PubMed

Liebscher, Martin

2016-04-01

The complete correspondence between C.G. Jung and Erich Neumann was published in 2015. This article attempts to provide insight into the practical task, as well as the theoretical background, of the editing process. The advantages and possibilities of an unabridged edition with an extensive historical contextualization are demonstrated, and compared to the approach of the editors of the Jung Letters and their selection therein of Jung's letters to Neumann. The practical points under consideration include the establishment of the letter corpus, the ascertainment of dates and the chronological arrangement of the letter exchange, as well as the deciphering of handwritten letters. Theoretical aspects under discussion involve the question of the merits of a critical contextualisation and the position of the editor vis-à-vis the research object. The example of the selecting and editing of Jung's letters to Neumann by Aniela Jaffé and Gerhard Adler reveals how drastically the close ties of those editors with Jung, Neumann, and members of the Zurich analytical circles compromised their editorial work at times. The advantage for an editor being able to work from an historical distance is appreciated. © 2016, The Society of Analytical Psychology.

Allografts for Ligament Reconstruction: Where Are We Now?

PubMed

Wydra, Frank B; York, Philip J; Johnson, Christopher R; Silvestri, Lorenzo

The use of musculoskeletal allografts by orthopedic surgeons continues to rise. The process of procuring and sterilizing allografts is evolving with much consideration to limiting the spread of infectious diseases and preserving tissue integrity. Research involving the application of allografts, particularly for ligament repair, is quite active, necessitating an update for the practicing orthopedist. Avoiding donor site morbidities is one of the most commonly cited advantages of allografts over autografts. There is controversy amongst studies for allografts in terms of their biological incorporation and clinical outcomes compared to autografts. This article focuses on reviewing the most current literature and usage of allograft tissue for ligamentous reconstruction amongst orthopedic surgeons today. It includes an in-depth analysis of the current processing, handling, and safety standards employed today, in addition to the advantages and disadvantages of allograft use.

Versatile logic devices based on programmable DNA-regulated silver-nanocluster signal transducers.

PubMed

Huang, Zhenzhen; Tao, Yu; Pu, Fang; Ren, Jinsong; Qu, Xiaogang

2012-05-21

A DNA-encoding strategy is reported for the programmable regulation of the fluorescence properties of silver nanoclusters (AgNCs). By taking advantage of the DNA-encoding strategy, aqueous AgNCs were used as signal transducers to convert DNA inputs into fluorescence outputs for the construction of various DNA-based logic gates (AND, OR, INHIBIT, XOR, NOR, XNOR, NAND, and a sequential logic gate). Moreover, a biomolecular keypad that was capable of constructing crossword puzzles was also fabricated. These AgNC-based logic systems showed several advantages, including a simple transducer-introduction strategy, universal design, and biocompatible operation. In addition, this proof of concept opens the door to a new generation of signal transducer materials and provides a general route to versatile biomolecular logic devices for practical applications. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Clinical studies in restorative dentistry: New directions and new demands.

PubMed

Opdam, N J M; Collares, K; Hickel, R; Bayne, S C; Loomans, B A; Cenci, M S; Lynch, C D; Correa, M B; Demarco, F; Schwendicke, F; Wilson, N H F

2018-01-01

Clinical research of restorative materials is confounded by problems of study designs, length of trials, type of information collected, and costs for trials, despite increasing numbers and considerable development of trials during the past 50 years. This opinion paper aims to discuss advantages and disadvantages of different study designs and outcomes for evaluating survival of dental restorations and to make recommendations for future study designs. Advantages and disadvantages of randomized trials, prospective and retrospective longitudinal studies, practice-based, pragmatic and cohort studies are addressed and discussed. The recommendations of the paper are that clinical trials should have rational control groups, include confounders such as patient risk factors in the data and analysis and should use outcome parameters relevant for profession and patients. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices

PubMed Central

Sinsky, Christine A.; Willard-Grace, Rachel; Schutzbank, Andrew M.; Sinsky, Thomas A.; Margolius, David; Bodenheimer, Thomas

2013-01-01

We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice. PMID:23690328

Biology teachers' dissection practices and the influences that lead to their adoption: An exploratory research

NASA Astrophysics Data System (ADS)

Milano, Regina Nicole

The lack of resolution in the on-going animal dissection debate inspired this mixed methods study to identify Connecticut secondary biology teachers' dissection practices and the influences that lead to their adoption. Qualitative findings indicate past experiences, managing objections to dissection, school culture, goals of biology teaching and ethics as major influences on dissection practices with 58.4% (n=7) of the sample dissecting and 41.6% not dissecting (n=5). Quantitative findings reveal gender, standards and curriculum, advantages of dissection and experiences as a student as major influences on dissection practices with 71.9% (n=92) of the sample dissecting and 28.1% (n=36) not dissecting. The study concludes that dissection policies are necessary and imminent in Connecticut school districts. Furthermore, it advises teacher-initiated, qualitative and quantitative assessments to expose disparities between student dissection perspectives and their own, prior to conducting dissection. Finally, it provides suggestions for addressing potential differences including administrative involvement.

Designing SoTL Studies--Part II: Practicality

ERIC Educational Resources Information Center

Bartsch, Robert A.

2013-01-01

This chapter suggests solutions to common practical problems in designing SoTL studies. In addition, the advantages and disadvantages of different types of designs are discussed. [Part I available at EJ1029363.

Advanced rechargeable sodium batteries with novel cathodes

NASA Technical Reports Server (NTRS)

Distefano, S.; Ratnakumar, B. V.; Bankston, C. P.

1989-01-01

Various high energy density rechargeable batteries are being considered for future space applications. Of these, the sodium-sulfur battery is one of the leading candidates. The primary advantage is the high energy density (760 Wh/kg theoretical). Energy densities in excess of 180 Wh/kg were realized in practical batteries. Other technological advantages include its chemical simplicity, absence of self-discharge, and long cycle life possibility. More recently, other high temperature sodium batteries have come into the spotlight. These systems can be described as follow: Na/Beta Double Prime-Al2O3/NaAlCl4/Metal Dichloride Sodium/metal dichloride systems are colloquially known as the zebra system and are currently being developed for traction and load leveling applications. The sodium-metal dichloride systems appear to offer many of the same advantages of the Na/S system, especially in terms of energy density and chemical simplicity. The metal dichloride systems offer increased safety and good resistance to overcharge and operate over a wide range of temperatures from 150 to 400 C with less corrosion problems.

Flexible phosphor sensors: a digital supplement or option to rigid sensors.

PubMed

Glazer, Howard S

2014-01-01

An increasing number of dental practices are upgrading from film radiography to digital radiography, for reasons that include faster image processing, easier image access, better patient education, enhanced data storage, and improved office productivity. Most practices that have converted to digital technology use rigid, or direct, sensors. Another digital option is flexible phosphor sensors, also called indirect sensors or phosphor storage plates (PSPs). Flexible phosphor sensors can be advantageous for use with certain patients who may be averse to direct sensors, and they can deliver a larger image area. Additionally, sensor cost for replacement PSPs is considerably lower than for hard sensors. As such, flexible phosphor sensors appear to be a viable supplement or option to direct sensors.

A double-edged sword: lactation consultants' perceptions of the impact of breast pumps on the practice of breastfeeding.

PubMed

Buckley, Kathleen M

2009-01-01

This qualitative descriptive study examined the beliefs and experiences of 12 lactation consultants regarding the impact of breast pumps on breastfeeding practices. Interview topics on breast pumps included types and patterns of use, mothers' experiences, and advantages and risks. The lactation consultants reported an increase in the use of breast pumps due to improved marketing, a change in society's view of pumps as a necessity rather than a luxury, and the impact of birthing technology. Reasons given for this increased use were mothers' need to have greater control over the breastfeeding process and to quantify the amount of breastmilk. Concerns were expressed regarding an overdependency on breastfeeding technology by some lactation consultants and mothers.

A Double-Edged Sword: Lactation Consultants' Perceptions of the Impact of Breast Pumps on the Practice of Breastfeeding

PubMed Central

Buckley, Kathleen M

2009-01-01

This qualitative descriptive study examined the beliefs and experiences of 12 lactation consultants regarding the impact of breast pumps on breastfeeding practices. Interview topics on breast pumps included types and patterns of use, mothers' experiences, and advantages and risks. The lactation consultants reported an increase in the use of breast pumps due to improved marketing, a change in society's view of pumps as a necessity rather than a luxury, and the impact of birthing technology. Reasons given for this increased use were mothers' need to have greater control over the breastfeeding process and to quantify the amount of breastmilk. Concerns were expressed regarding an overdependency on breastfeeding technology by some lactation consultants and mothers. PMID:20190850

The Psychiatrist as Leader-Teacher: Promoting Learning Beyond Residency.

PubMed

Waits, Wendi; Brent, Elizabeth

2015-08-01

In today's fast-paced, data-saturated, zero-tolerance practice environment, psychiatrists and other health care providers are expected to maintain clinical, fiscal, and administrative competence. The authors present a unique type of psychiatric leader—the leader-teacher—who incorporates teaching of these elements into day-to-day practice, enhancing lifelong learning for credentialed staff and increasing their confidence in managing complex clinical and administrative issues. Particular emphasis is placed on leader-teachers working in military environments. The article discusses the primary characteristics of this type of leader, including their tendency to (1) seek clarification, (2) distill information, (3) communicate guidance, and (4) catalogue products. The authors also address the advantages and disadvantages of being a leader-teacher and present several illustrative cases.

Better informed in clinical practice - a brief overview of dental informatics.

PubMed

Reynolds, P A; Harper, J; Dunne, S

2008-03-22

Uptake of dental informatics has been hampered by technical and user issues. Innovative systems have been developed, but usability issues have affected many. Advances in technology and artificial intelligence are now producing clinically useful systems, although issues still remain with adapting computer interfaces to the dental practice working environment. A dental electronic health record has become a priority in many countries, including the UK. However, experience shows that any dental electronic health record (EHR) system cannot be subordinate to, or a subset of, a medical record. Such a future dental EHR is likely to incorporate integrated care pathways. Future best dental practice will increasingly depend on computer-based support tools, although disagreement remains about the effectiveness of current support tools. Over the longer term, future dental informatics tools will incorporate dynamic, online evidence-based medicine (EBM) tools, and promise more adaptive, patient-focused and efficient dental care with educational advantages in training.

Impact of social media for the hematologist/oncologist.

PubMed

Abuhadra, Nour; Majhail, Navneet S; Nazha, Aziz

2017-10-01

In the era of modern communication, the physician and patient relationship has evolved to include an entirely new dimension-social media. This new dimension offers several opportunities for patient education, research and its dissemination, and professional development for health care providers; it can also serve as a platform for addressing important public health issues. However, these advantages come with challenges such as threats to patient and professional privacy. In this article, we dissect the benefits and drawbacks of this social evolution on the practicing hematologist-oncologist. We also perform a review of the current literature on the integration of social media in the practice of hematology/oncology; examine available guidelines for information exchange between health care professionals, industry, pharmaceutical companies, advocacy groups, and patients; and offer ways to create its seamless integration into clinical hematology-oncology practice. Copyright © 2017 Elsevier Inc. All rights reserved.

The Genesis of Cyberscience and its Mathematical Models (CYBERSCIENCE)

DTIC Science & Technology

2005-02-01

Of course, the idea of maintaining a complete development record has other advantages , and has frequently been proposed in the past as a solution to...system development. There is no question that this offers certain advantages . For exam- ple, if systems that satisfy a standard frequently prove...some substantial practical advantages . First, providing wildly 2Unfortunately, this terminology has not been standardized. For example, in the Safety

A Kantian argument against comparatively advantageous genetic modification.

PubMed

Jensen, David

2011-08-01

The genetic modification of children is becoming a more likely possibility given our rapid progress in medical technologies. I argue, from a broadly Kantian point of view, that at least one kind of such modification-modification by a parent for the sake of a child's comparative advantage-is not rationally justified. To argue this, I first characterize a necessary condition on reasons and rational justification: what is a reason for an agent to do an action in one set of circumstances must be a reason for any in those circumstances to do the action. I then show that comparatively advantageous genetic modification violates this principle since a child's "getting ahead" through genetic modification cannot be rationally justified unless other children also could receive the modification, thus rendering the advantage useless. Finally, I consider the major objection to this it seems to disallow all cases of a parent's helping a child get ahead, something that parents normally engage in with their children. I argue that typical practices of developing a comparative advantage in a child, as well as practices of societal competition in general, do not conflict because they involve circumstances that mitigate the universal character of reasons. Many ordinary cases of competitive advantage that we think of as unjust, in fact, can be explained by my argument.

House Calls in Private Practice.

ERIC Educational Resources Information Center

Whittington, Ronaele

1985-01-01

Relates the experiences of a social worker in private practice who offered house calls as an ongoing setting for counseling and psychotherapy to individuals and families. Describes advantages and disadvantages, liability, and target populations. (JAC)

Linking Competence Change and Organization Performance

ERIC Educational Resources Information Center

Boulay, David

2007-01-01

The notion of long term sustainable competitive advantage assumes that environment changes are engrained into organizations. Yet, the principles of continuous improvement suggest a shorter and shorter lifecycle of skills and knowledge that provides the sustainable advantage. Continuous change resulting from new ideas, practices, and technologies…

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users' perspective.

PubMed

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

2012-11-01

Prenatal fetal sex determination is clinically indicated for women who are at risk of having a child with a serious genetic disorder affecting a particular sex. Ultrasound has been the traditional method used, but early fetal sex determination using non-invasive prenatal diagnosis (NIPD) can now be performed using cell-free fetal DNA in maternal plasma. The study aim was to assess the views and experiences of service users who had used NIPD for fetal sex determination. In this paper, we report on the perceived benefits and disadvantages. A qualitative approach using semi-structured interviews was used. A total of 44 participants (38 women and 6 partners of participating women) were recruited. Participants' views and experiences of NIPD were overwhelmingly positive. Concerning benefits over traditional methods, three themes emerged: (1) technical aspects of technology; (2) timing; and (3) enhanced decision-making. Practical advantages of NIPD included avoiding miscarriage, and there were a number of psychological advantages associated with timing such as perceived control, early re-engagement, normalization of pregnancy and peace of mind. Participants also valued NIPD as it enabled a stepwise approach to decision-making. A number of disadvantages were discussed including concerns about social sexing and increased bonding at a time in pregnancy when miscarriage risk is high. However, participants felt these were fairly minor in comparison with the advantages of NIPD. Until definitive genetic diagnosis using NIPD is available, NIPD for fetal sex determination is perceived as a good interim measure with a number of notable advantages over traditional methods.

Non-invasive prenatal diagnosis for fetal sex determination: benefits and disadvantages from the service users' perspective

PubMed Central

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

2012-01-01

Prenatal fetal sex determination is clinically indicated for women who are at risk of having a child with a serious genetic disorder affecting a particular sex. Ultrasound has been the traditional method used, but early fetal sex determination using non-invasive prenatal diagnosis (NIPD) can now be performed using cell-free fetal DNA in maternal plasma. The study aim was to assess the views and experiences of service users who had used NIPD for fetal sex determination. In this paper, we report on the perceived benefits and disadvantages. A qualitative approach using semi-structured interviews was used. A total of 44 participants (38 women and 6 partners of participating women) were recruited. Participants' views and experiences of NIPD were overwhelmingly positive. Concerning benefits over traditional methods, three themes emerged: (1) technical aspects of technology; (2) timing; and (3) enhanced decision-making. Practical advantages of NIPD included avoiding miscarriage, and there were a number of psychological advantages associated with timing such as perceived control, early re-engagement, normalization of pregnancy and peace of mind. Participants also valued NIPD as it enabled a stepwise approach to decision-making. A number of disadvantages were discussed including concerns about social sexing and increased bonding at a time in pregnancy when miscarriage risk is high. However, participants felt these were fairly minor in comparison with the advantages of NIPD. Until definitive genetic diagnosis using NIPD is available, NIPD for fetal sex determination is perceived as a good interim measure with a number of notable advantages over traditional methods. PMID:22453293

Practice-based evidence study design for comparative effectiveness research.

PubMed

Horn, Susan D; Gassaway, Julie

2007-10-01

To describe a new, rigorous, comprehensive practice-based evidence for clinical practice improvement (PBE-CPI) study methodology, and compare its features, advantages, and disadvantages to those of randomized controlled trials and sophisticated statistical methods for comparative effectiveness research. PBE-CPI incorporates natural variation within data from routine clinical practice to determine what works, for whom, when, and at what cost. It uses the knowledge of front-line caregivers, who develop study questions and define variables as part of a transdisciplinary team. Its comprehensive measurement framework provides a basis for analyses of significant bivariate and multivariate associations between treatments and outcomes, controlling for patient differences, such as severity of illness. PBE-CPI studies can uncover better practices more quickly than randomized controlled trials or sophisticated statistical methods, while achieving many of the same advantages. We present examples of actionable findings from PBE-CPI studies in postacute care settings related to comparative effectiveness of medications, nutritional support approaches, incontinence products, physical therapy activities, and other services. Outcomes improved when practices associated with better outcomes in PBE-CPI analyses were adopted in practice.

Changes Are Needed to the Army Contract with Sikorsky to Use Existing DoD Inventory and Control Costs at the Corpus Christi Army Depot

DTIC Science & Technology

2011-11-03

contingency stock for requirements outside the CCAD/Sikorsky contract. 6 The DoD EMALL is a full-service eCommerce site, which strives to be the single...such quantity as (A) will result in the total cost and unit cost most advantageous to the United States where practicable.” Having more than one...practice and frequently does not allow DoD to take advantage of economic order quantities. Table 15 shows examples where higher quantities procured

Service providers' experiences of using a telehealth network 12 months after digitisation of a large Australian rural mental health service.

PubMed

Newman, Lareen; Bidargaddi, Niranjan; Schrader, Geoffrey

2016-10-01

Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support; (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care; (3) "Technical Complexity"; (4) "Technical Compatibility" with two sub-themes: technical-clinical and technical-administrative; and (5) "Broader Organisational Culture", with two sub-themes: organizational policy support and 'digital telehealth' culture. The digitised telehealth network was generally well received by providers and adopted into clinical practice. Compared with the previous analog system, staff found advantages in better visual and audio quality, more technical stability with less "drop-out", less time delay to conversations and less confusion for clients. Despite these advantages, providers identified a range of challenges to starting or continuing use and they recommended improvements to increase uptake among mental health service providers and other providers (including GPs), and to clinical uses other than mental health. To further increase uptake and impact of telehealth-mediated mental health care in rural and remote areas, even with a high quality digital system, future research must design innovative care models, consider time and cost incentives for providers to use telehealth, and must focus not only on technical training but also how to best integrate technology with clinical practice and must develop an organization-wide digital telehealth culture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stepping on Obstacles with a Sensory Substitution Device on the Lower Leg: Practice without Vision Is More Beneficial than Practice with Vision

PubMed Central

Lobo, Lorena; Travieso, David; Barrientos, Antonio; Jacobs, David M.

2014-01-01

Practice is essential for an adapted use of sensory substitution devices. Understanding the learning process is therefore a fundamental issue in this field of research. This study presents a novel sensory substitution device worn on the lower leg and uses the device to study learning. The device includes 32 vibrotactile actuators that each vibrate as a function of the distance to the nearest surface in a particular direction. Participants wearing the device were asked to approach an object and to step on the object. Two 144-trial practice conditions were compared in a pretest-practice-posttest design. Participants in the first condition practiced with vibrotactile stimulation while blindfolded. Participants in the second condition practiced with vibrotactile stimulation along with normal vision. Performance was relatively successful, both types of practice led to improvements in performance, and practice without vision led to a larger reduction in the number of errors than practice with vision. These results indicate that distance-based sensory substitution is promising in addition to the more traditional light-intensity-based sensory substitution and that providing appropriate sensorimotor couplings is more important than applying the stimulation to highly sensitive body parts. The observed advantage of practice without vision over practice with vision is interpreted in terms of the guidance hypothesis of feedback and learning. PMID:24901843

Enhanced technologies for unattended ground sensor systems

NASA Astrophysics Data System (ADS)

Hartup, David C.

2010-04-01

Progress in several technical areas is being leveraged to advantage in Unattended Ground Sensor (UGS) systems. This paper discusses advanced technologies that are appropriate for use in UGS systems. While some technologies provide evolutionary improvements, other technologies result in revolutionary performance advancements for UGS systems. Some specific technologies discussed include wireless cameras and viewers, commercial PDA-based system programmers and monitors, new materials and techniques for packaging improvements, low power cueing sensor radios, advanced long-haul terrestrial and SATCOM radios, and networked communications. Other technologies covered include advanced target detection algorithms, high pixel count cameras for license plate and facial recognition, small cameras that provide large stand-off distances, video transmissions of target activity instead of still images, sensor fusion algorithms, and control center hardware. The impact of each technology on the overall UGS system architecture is discussed, along with the advantages provided to UGS system users. Areas of analysis include required camera parameters as a function of stand-off distance for license plate and facial recognition applications, power consumption for wireless cameras and viewers, sensor fusion communication requirements, and requirements to practically implement video transmission through UGS systems. Examples of devices that have already been fielded using technology from several of these areas are given.

Software for Better Documentation of Other Software

NASA Technical Reports Server (NTRS)

Pinedo, John

2003-01-01

The Literate Programming Extraction Engine is a Practical Extraction and Reporting Language- (PERL-)based computer program that facilitates and simplifies the implementation of a concept of self-documented literate programming in a fashion tailored to the typical needs of scientists. The advantage for the programmer is that documentation and source code are written side-by-side in the same file, reducing the likelihood that the documentation will be inconsistent with the code and improving the verification that the code performs its intended functions. The advantage for the user is the knowledge that the documentation matches the software because they come from the same file. This program unifies the documentation process for a variety of programming languages, including C, C++, and several versions of FORTRAN. This program can process the documentation in any markup language, and incorporates the LaTeX typesetting software. The program includes sample Makefile scripts for automating both the code-compilation (when appropriate) and documentation-generation processes into a single command-line statement. Also included are macro instructions for the Emacs display-editor software, making it easy for a programmer to toggle between editing in a code or a documentation mode.

Tail docking in horses: a review of the issues.

PubMed

Lefebvre, D; Lips, D; Odberg, F O; Giffroy, J M

2007-09-01

Routinely performed painful procedures are of increasing interest and, in 2001 (Royal Order, May 17), Belgium prohibited docking in several vertebrates including horses. In 2004, opponents to this decision submitted a Bill (Doc51 0969/001) to Parliament, intending to obtain derogation for Belgian draught horses, which were traditionally docked. The Animal Welfare Council of Belgium, an official body advising the Minister of Public Health, was asked to evaluate this complex question, including biological, ethical and socio-economic aspects, on the basis of the available peer-reviewed studies. In this context, this study reviews legal aspects (overview of the European legislation), zootechnic aspects (uses of the Belgian draught horse) and biological aspects (pain potentially related to docking; horses' welfare linked to insect harassment and hygiene, communication and reproduction) of tail docking in draught horses. We conclude that (1) there is no benefit for horses in tail docking, including Belgian draught horses, (2) potential advantages of docking are essentially in favour of humans and these advantages could be scrupulously re-evaluated, taking into account practices of other countries. Therefore, there is no need to dock any horse other than for veterinary reasons.

Marketing the academic medical center group practice.

PubMed

Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

Should dentistry be part of the National Health Information Infrastructure?

PubMed

Schleyer, Titus K L

2004-12-01

The National Health Information Infrastructure, or NHII, proposes to improve the effectiveness, efficiency and overall quality of health in the United States by establishing a national, electronic information network for health care. To date, dentistry's integration into this network has not been discussed widely. The author reviews the NHII and its goals and structure through published reports and background literature. The author evaluates the advantages and disadvantages of the NHII regarding their implications for the dental care system. The NHII proposes to implement computer-based patient records, or CPRs, for most Americans by 2014, connect personal health information with other clinical and public health information, and enable different types of care providers to access CPRs. Advantages of the NHII include transparency of health information across health care providers, potentially increased involvement of patients in their care, better clinical decision making through connecting patient-specific information with the best clinical evidence, increased efficiency, enhanced bioterrorism defense and potential cost savings. Challenges in the implementation of the NHII in dentistry include limited use of CPRs, required investments in information technology, limited availability and adoption of standards, and perceived threats to privacy and confidentiality. The implementation of the NHII is making rapid strides. Dentistry should become an active participant in the NHII and work to ensure that the needs of dental patients and the profession are met. Practice Implications. The NHII has far-reaching implications on dental practice by making it easier to access relevant patient information and by helping to improve clinical decision making.

Simple Practical Investigations Using Invertase.

ERIC Educational Resources Information Center

Asare-Brown, Emma; Bullock, Clive

1988-01-01

Describes three activities, substrate inhibition, product inhibition by fructose and glucose, and gel immobilization of invertase for use with undergraduate biochemistry classes. Discusses materials, methods, and results. Stresses the advantages of practical exercises in undergraduate classes. (CW)

PubMed Central

Baum, S.; Sillem, M.; Ney, J. T.; Baum, A.; Friedrich, M.; Radosa, J.; Kramer, K. M.; Gronwald, B.; Gottschling, S.; Solomayer, E. F.; Rody, A.; Joukhadar, R.

2017-01-01

Introduction Minimally invasive operative techniques are being used increasingly in gynaecological surgery. The expansion of the laparoscopic operation spectrum is in part the result of improved imaging. This study investigates the practical advantages of using 3D cameras in routine surgical practice. Materials and Methods Two different 3-dimensional camera systems were compared with a 2-dimensional HD system; the operating surgeonʼs experiences were documented immediately postoperatively using a questionnaire. Results Significant advantages were reported for suturing and cutting of anatomical structures when using the 3D compared to 2D camera systems. There was only a slight advantage for coagulating. The use of 3D cameras significantly improved the general operative visibility and in particular the representation of spacial depth compared to 2-dimensional images. There was not a significant advantage for image width. Depiction of adhesions and retroperitoneal neural structures was significantly improved by the stereoscopic cameras, though this did not apply to blood vessels, ureter, uterus or ovaries. Conclusion 3-dimensional cameras were particularly advantageous for the depiction of fine anatomical structures due to improved spacial depth representation compared to 2D systems. 3D cameras provide the operating surgeon with a monitor image that more closely resembles actual anatomy, thus simplifying laparoscopic procedures. PMID:28190888

Scheduling observational and physical practice: influence on the coding of simple motor sequences.

PubMed

Ellenbuerger, Thomas; Boutin, Arnaud; Blandin, Yannick; Shea, Charles H; Panzer, Stefan

2012-01-01

The main purpose of the present experiment was to determine the coordinate system used in the development of movement codes when observational and physical practice are scheduled across practice sessions. The task was to reproduce a 1,300-ms spatial-temporal pattern of elbow flexions and extensions. An intermanual transfer paradigm with a retention test and two effector (contralateral limb) transfer tests was used. The mirror effector transfer test required the same pattern of homologous muscle activation and sequence of limb joint angles as that performed or observed during practice, and the non-mirror effector transfer test required the same spatial pattern movements as that performed or observed. The test results following the first acquisition session replicated the findings of Gruetzmacher, Panzer, Blandin, and Shea (2011) . The results following the second acquisition session indicated a strong advantage for participants who received physical practice in both practice sessions or received observational practice followed by physical practice. This advantage was found on both the retention and the mirror transfer tests compared to the non-mirror transfer test. These results demonstrate that codes based in motor coordinates can be developed relatively quickly and effectively for a simple spatial-temporal movement sequence when participants are provided with physical practice or observation followed by physical practice, but physical practice followed by observational practice or observational practice alone limits the development of codes based in motor coordinates.

Non-invasive neuroimaging using near-infrared light

NASA Technical Reports Server (NTRS)

Strangman, Gary; Boas, David A.; Sutton, Jeffrey P.

2002-01-01

This article reviews diffuse optical brain imaging, a technique that employs near-infrared light to non-invasively probe the brain for changes in parameters relating to brain function. We describe the general methodology, including types of measurements and instrumentation (including the tradeoffs inherent in the various instrument components), and the basic theory required to interpret the recorded data. A brief review of diffuse optical applications is included, with an emphasis on research that has been done with psychiatric populations. Finally, we discuss some practical issues and limitations that are relevant when conducting diffuse optical experiments. We find that, while diffuse optics can provide substantial advantages to the psychiatric researcher relative to the alternative brain imaging methods, the method remains substantially underutilized in this field.

Novel strategies for sedentary behavior research.

PubMed

Rosenberg, Dori E; Lee, I-Min; Young, Deborah Rohm; Prohaska, Thomas R; Owen, Neville; Buchner, David M

2015-06-01

This article reports on the "Novel Strategies for Sedentary Behavior Research" session of the Sedentary Behavior: Identifying Research Priorities workshop. The purpose of this session of the workshop were to propose strategies for accomplishing a research agenda in dealing with sedentary behavior and to consider research priorities for people at high risk for excess sedentary behavior. The four major recommendations from this workshop were as follows: 1) To add repeated objective measures of physical activity and sedentary behavior to existing cohort studies and standardize approaches to measurement and analysis. Epidemiologic studies will be the most efficient design for addressing some research questions. 2) To increase research efficiency, consider the advantages of a network of connected research studies and health systems. Advantages include access to existing data in electronic health records. 3) To carefully select a variety of high-risk study populations and preplan collaboration among studies in intervention research. This strategy can efficiently address the breadth of issues in sedentary behavior research. 4) To include comparative effectiveness designs and pure environmental interventions in intervention research. This strategy facilitates and enhances translation of interventions into practice.

Point-of-care ultrasound education: the increasing role of simulation and multimedia resources.

PubMed

Lewiss, Resa E; Hoffmann, Beatrice; Beaulieu, Yanick; Phelan, Mary Beth

2014-01-01

This article reviews the current technology, literature, teaching models, and methods associated with simulation-based point-of-care ultrasound training. Patient simulation appears particularly well suited for learning point-of-care ultrasound, which is a required core competency for emergency medicine and other specialties. Work hour limitations have reduced the opportunities for clinical practice, and simulation enables practicing a skill multiple times before it may be used on patients. Ultrasound simulators can be categorized into 2 groups: low and high fidelity. Low-fidelity simulators are usually static simulators, meaning that they have nonchanging anatomic examples for sonographic practice. Advantages are that the model may be reused over time, and some simulators can be homemade. High-fidelity simulators are usually high-tech and frequently consist of many computer-generated cases of virtual sonographic anatomy that can be scanned with a mock probe. This type of equipment is produced commercially and is more expensive. High-fidelity simulators provide students with an active and safe learning environment and make a reproducible standardized assessment of many different ultrasound cases possible. The advantages and disadvantages of using low- versus high-fidelity simulators are reviewed. An additional concept used in simulation-based ultrasound training is blended learning. Blended learning may include face-to-face or online learning often in combination with a learning management system. Increasingly, with simulation and Web-based learning technologies, tools are now available to medical educators for the standardization of both ultrasound skills training and competency assessment.

A DNA Tracer System for Hydrological Environment Investigations.

PubMed

Liao, Renkuan; Yang, Peiling; Wu, Wenyong; Luo, Dan; Yang, Dayong

2018-02-20

To monitor and manage hydrological pollution effectively, tracing sources of pollutants is of great importance and also is in urgent need. A variety of tracers have been developed such as isotopes, silica, bromide, and dyes; however, practical limitations of these traditional tracers still exist such as lack of multiplexed, multipoint tracing and interference of background noise. To overcome these limitations, a new tracing system based on DNA nanomaterials, namely DNA tracer, has already been developed. DNA tracers possess remarkable advantages including sufficient species, specificity, environmental friendly, stable migration, and high sensitivity as well as allowing for multipoints tracing. In this review article, we introduce the molecular design, synthesis, protection and signal readout strategies of DNA tracers, compare the advantages and disadvantages of DNA tracer with traditional tracers, and summarize the-state-of-art applications in hydrological environment investigations. In the end, we provide our perspective on the future development of DNA tracers.

Possible applications for municipal solid waste fly ash.

PubMed

Ferreira, C; Ribeiro, A; Ottosen, L

2003-01-31

The present study focuses on existing practices related to the reuse of Municipal Solid Waste (MSW) fly ash and identifies new potential uses. Nine possible applications were identified and grouped into four main categories: construction materials (cement, concrete, ceramics, glass and glass-ceramics); geotechnical applications (road pavement, embankments); "agriculture" (soil amendment); and, miscellaneous (sorbent, sludge conditioning). Each application is analysed in detail, including final-product technical characteristics, with a special emphasis on environmental impacts. A comparative analysis of the different options is performed, stressing the advantages but also the weaknesses of each option. This information is systemized in order to provide a framework for the selection of best technology and final products. The results presented here show new possibilities for this waste reuse in a short-term, in a wide range of fields, resulting in great advantages in waste minimization as well as resources conservation.

Efficiency of coherent-state quantum cryptography in the presence of loss: Influence of realistic error correction

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

Heid, Matthias; Luetkenhaus, Norbert

2006-05-15

We investigate the performance of a continuous-variable quantum key distribution scheme in a practical setting. More specifically, we take a nonideal error reconciliation procedure into account. The quantum channel connecting the two honest parties is assumed to be lossy but noiseless. Secret key rates are given for the case that the measurement outcomes are postselected or a reverse reconciliation scheme is applied. The reverse reconciliation scheme loses its initial advantage in the practical setting. If one combines postselection with reverse reconciliation, however, much of this advantage can be recovered.

Alternative divertor target concepts for next step fusion devices

NASA Astrophysics Data System (ADS)

Mazul, I. V.

2016-12-01

The operational conditions of a divertor target in the next steps of fusion devices are more severe in comparison with ITER. The current divertor designs and technologies have a limited application concerning these conditions, and so new design concepts/technologies are required. The main reasons which practically prevent the use of the traditional motionless solid divertor target are analyzed. We describe several alternative divertor target concepts in this paper. The comparative analysis of these concepts (including the advantages and the drawbacks) is made and the prospects for their practical implementation are prioritized. The concept of the swept divertor target with a liquid metal interlayer between the moving armour and motionless heat-sink is presented in more detail. The critical issues of this design are listed and outlined, and the possible experiments are presented.

Rockets: Physical science teacher's guide with activities

NASA Astrophysics Data System (ADS)

Vogt, Gregory L.; Rosenberg, Carla R.

1993-07-01

This guide begins with background information sections on the history of rocketry, scientific principles, and practical rocketry. The sections on scientific principles and practical rocketry are based on Isaac Newton's three laws of motion. These laws explain why rockets work and how to make them more efficient. The background sections are followed with a series of physical science activities that demonstrate the basic science of rocketry. Each activity is designed to be simple and take advantage of inexpensive materials. Construction diagrams, materials and tools lists, and instructions are included. A brief discussion elaborates on the concepts covered in the activities and is followed with teaching notes and discussion questions. The guide concludes with a glossary of terms, suggested reading list, NASA educational resources, and an evaluation questionnaire with a mailer.

A liberal arts education as preparation for medical school: how is it valued? How do graduates perform?

PubMed

Stratton, Terry D; Elam, Carol L; McGrath, Michael G

2003-10-01

This study examines the utility of a liberal arts education on medical students' preparation and performance. Data included a survey of admission committee members, a preadmission survey of two cohorts of students, and academic performance and extracurricular involvement during medical school. Some admission committee members perceived applicants with liberal arts backgrounds to have certain advantages. These students preferred "discussing issues," and showed an initial preference for the practice of psychiatry. Despite entering with lower total grade-point average and being less involved in extracurricular activities, they were more likely to receive formal commendation and be elected to Alpha Omega Alpha. Although similarities outweigh differences, students with liberal arts backgrounds may benefit from an educational breadth well-suited for practicing the "art of medicine."

Rockets: Physical science teacher's guide with activities

NASA Technical Reports Server (NTRS)

Vogt, Gregory L.; Rosenberg, Carla R. (Editor)

1993-01-01

This guide begins with background information sections on the history of rocketry, scientific principles, and practical rocketry. The sections on scientific principles and practical rocketry are based on Isaac Newton's three laws of motion. These laws explain why rockets work and how to make them more efficient. The background sections are followed with a series of physical science activities that demonstrate the basic science of rocketry. Each activity is designed to be simple and take advantage of inexpensive materials. Construction diagrams, materials and tools lists, and instructions are included. A brief discussion elaborates on the concepts covered in the activities and is followed with teaching notes and discussion questions. The guide concludes with a glossary of terms, suggested reading list, NASA educational resources, and an evaluation questionnaire with a mailer.

Fire Suppression and Response

NASA Technical Reports Server (NTRS)

Ruff, Gary A.

2004-01-01

This report is concerned with the following topics regarding fire suppression:What is the relative effectiveness of candidate suppressants to extinguish a representative fire in reduced gravity, including high-O2 mole fraction, low -pressure environments? What are the relative advantages and disadvantages of physically acting and chemically-acting agents in spacecraft fire suppression? What are the O2 mole fraction and absolute pressure below which a fire cannot exist? What effect does gas-phase radiation play in the overall fire and post-fire environments? Are the candidate suppressants effective to extinguish fires on practical solid fuels? What is required to suppress non-flaming fires (smoldering and deep seated fires) in reduced gravity? How can idealized space experiment results be applied to a practical fire scenario? What is the optimal agent deployment strategy for space fire suppression?

Implementation of real-time ultrasound in a thoracic surgery practice.

PubMed

Coonar, Aman S; Hughes, Jacqueline A; Walker, Susan; dePerrot, Marc; Waddell, Thomas K; Pierre, Andrew F; Darling, Gail E; Johnston, Michael R; Keshavjee, Shaf

2009-05-01

The purpose of this study was to implement real-time transthoracic ultrasound in a thoracic surgery and lung transplant practice. Ultrasound units that are light, small, robust, and portable are now available. Obstacles to use include demarcation issues between specialties, training, and a perception that basic ultrasound may be difficult to use. The experience of implementing this is described. After a training period, 62 studies were performed in 4 months. Patients and clinicians gave positive feedback. The learning time was short, and with ultrasonic guidance, all interventional procedures were successful at the first attempt, without any complications. Basic transthoracic ultrasound was found to be easy to learn and use by thoracic surgeons, fellows, and specialist nurses. Patients were appreciative. Real-time use may have genuine advantages to patient care.

Coronial law and practice: a human rights perspective.

PubMed

Freckelton, Ian; McGregor, Simon

2014-03-01

Coronial law and practice inevitably impact upon the human rights of those affected by deaths. It is important that such rights be incorporated in how death investigations, up to and including coronial inquests, take place. This article explores the significant impact of the jurisprudence emanating from the European Court of Human Rights, as well as the application of such law by the courts of the United Kingdom and potentially in other countries. It argues that viewing the work of coroners through the lens of human rights is a constructive approach and that, although in the coronial legislation of Australia and New Zealand, many human rights, especially those of family members, and civil liberties are explicitly protected, there remain real advantages in reflecting upon compliance with human rights by death investigation procedures and decision-making.

A lack of standardization: the basis for the ethical issues surrounding quality and performance reports.

PubMed

Suchy, Kirsten

2010-01-01

Consumers in the United States are taking advantage of the proliferation of publicly available, internet-based performance reports and quality appraisals of health plans, healthcare organizations, hospitals, and physicians to aid in their healthcare decision making. However, these appraisal practices have given rise to controversy and debate over certain distinctive ethical issues. This article advocates a standardized ethical framework to guide current and future development and implementation of performance reports. This framework, which would resolve a number of the major issues, includes the following ethical principles to guide the practice of public reporting on the Internet and facilitate enhanced quality improvement in the healthcare industry: legitimacy, data integrity and quality, transparency, informed understanding, equity, privacy and confidentiality, collaboration, accountability, and evaluation and continuous improvement.

Part-time and Job-Share Careers Among Pharmacy Practice Faculty Members

PubMed Central

Vest, Kathleen; Pohl, Shaunte; Mazan, Jennifer; Winkler, Susan

2014-01-01

Part-time and job-share policies may allow pharmacy practice faculty members to achieve work/life balance while pursuing their professional goals. Precedent for alternative work schedules within the health professions community can be found throughout the literature; however, little is known about part-time roles in academic pharmacy. The design and implementation of 3 different alternative faculty appointments are described and department chair and faculty perspectives are shared. Teaching, service, and scholarship responsibilities, as well as outcomes before and after changes in appointment, are described. Advantages and disadvantages, including advice for other colleges of pharmacy, are presented. Alternate appointments may be a key factor in retaining highly qualified faculty members who continue to bring their expertise to teaching, precepting, and scholarship within a college or school of pharmacy. PMID:24761010

Part-time and job-share careers among pharmacy practice faculty members.

PubMed

Griffin, Brooke; Vest, Kathleen; Pohl, Shaunte; Mazan, Jennifer; Winkler, Susan

2014-04-17

Part-time and job-share policies may allow pharmacy practice faculty members to achieve work/life balance while pursuing their professional goals. Precedent for alternative work schedules within the health professions community can be found throughout the literature; however, little is known about part-time roles in academic pharmacy. The design and implementation of 3 different alternative faculty appointments are described and department chair and faculty perspectives are shared. Teaching, service, and scholarship responsibilities, as well as outcomes before and after changes in appointment, are described. Advantages and disadvantages, including advice for other colleges of pharmacy, are presented. Alternate appointments may be a key factor in retaining highly qualified faculty members who continue to bring their expertise to teaching, precepting, and scholarship within a college or school of pharmacy.

Guidelines on nuclear medicine imaging in neuroblastoma.

PubMed

Bar-Sever, Zvi; Biassoni, Lorenzo; Shulkin, Barry; Kong, Grace; Hofman, Michael S; Lopci, Egesta; Manea, Irina; Koziorowski, Jacek; Castellani, Rita; Boubaker, Ariane; Lambert, Bieke; Pfluger, Thomas; Nadel, Helen; Sharp, Susan; Giammarile, Francesco

2018-06-25

Nuclear medicine has a central role in the diagnosis, staging, response assessment and long-term follow-up of neuroblastoma, the most common solid extracranial tumour in children. These EANM guidelines include updated information on 123 I-mIBG, the most common study in nuclear medicine for the evaluation of neuroblastoma, and on PET/CT imaging with 18 F-FDG, 18 F-DOPA and 68 Ga-DOTA peptides. These PET/CT studies are increasingly employed in clinical practice. Indications, advantages and limitations are presented along with recommendations on study protocols, interpretation of findings and reporting results.

Photo-thermal quartz tuning fork excitation for dynamic mode atomic force microscope

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

Bontempi, Alexia; Teyssieux, Damien; Thiery, Laurent

2014-10-13

A photo-thermal excitation of a Quartz Tuning Fork (QTF) for topographic studies is introduced. The non-invasive photo-thermal excitation presents practical advantages compared to QTF mechanical and electrical excitations, including the absence of the anti-resonance and its associated phase rotation. Comparison between our theoretical model and experiments validate that the optical transduction mechanism is a photo-thermal rather than photo-thermoacoustic phenomenon. Topographic maps in the context of near-field microscopy distance control have been achieved to demonstrate the performance of the system.

Fuzzy Finite-Time Command Filtered Control of Nonlinear Systems With Input Saturation.

PubMed

Yu, Jinpeng; Zhao, Lin; Yu, Haisheng; Lin, Chong; Dong, Wenjie

2017-08-22

This paper considers the fuzzy finite-time tracking control problem for a class of nonlinear systems with input saturation. A novel fuzzy finite-time command filtered backstepping approach is proposed by introducing the fuzzy finite-time command filter, designing the new virtual control signals and the modified error compensation signals. The proposed approach not only holds the advantages of the conventional command-filtered backstepping control, but also guarantees the finite-time convergence. A practical example is included to show the effectiveness of the proposed method.

Designs that make a difference: the Cardiac Universal Bed model.

PubMed

Johnson, Jackie; Brown, Katherine Kay; Neal, Kelly

2003-01-01

Information contained in this article includes some of the findings from a joint research project conducted by Corazon Consulting and Ohio State University Medical Center on national trends in Cardiac Universal Bed (CUB) utilization. This article outlines current findings and "best practice" standards related to the benefits of developing care delivery models to differentiate an organization with a competitive advantage in the highly dynamic marketplace of cardiovascular care. (OSUMC, a Corazon client, is incorporating the CUB into their Ross Heart Hospital slated to open this spring.)

Revolutionizing Child Welfare with Outcomes Management

PubMed Central

Toche-Manley, Linda L.; Dietzen, Laura; Nankin, Jesse; Beigel, Astrid

2013-01-01

Outcomes management technology holds great promise for improving the quality of services provided to youth in the child welfare system. Advantages include better detection of behavioral health and trauma-related issues, early indicators of case progress or risk of failure and program- and system-level learning. Yet organizational barriers to implementation persist. Attention is spent in this paper on addressing these barriers so the use of outcomes management technology becomes a common practice. A model for predicting resiliency is presented, along with case examples demonstrating its potential use for treatment planning and monitoring progress. PMID:23460130

Enzyme-potentiated desensitization in otolaryngic allergy.

PubMed

Pulec, Jack L

2002-03-01

This is a preliminary report of a new method of treating otolaryngic allergy with enzyme-potentiated desensitization (EPD). The nature of EPD and its use in otolaryngology are described. Thirty-six patients have been treated and followed in a private medical practice since February 1997. This article reviews the clinical features of EPD and provides six cases as examples; the clinical features described include allergic rhinitis, serous otitis media, asthma, dermatitis, fixed food allergy, and Ménière's disease. EPD is an effective technique for the treatment of otolaryngic allergy and offers advantages over conventional techniques.

Pre-registration house officer rotations incorporating general practice: does the order of rotation matter?

PubMed

Williams, C; Cantillon, P; Cochrane, M

2001-06-01

In relation to pre-registration house officer (PRHO) rotations incorporating general practice, previous research has recommended that where possible, no PRHO should undertake general practice as the first placement, because of the difficulties encountered. It was recognized that logistically, this could make such schemes almost unworkable. Within the context of a larger qualitative evaluation comparing how 24 PRHOs learned in hospital and general practice settings, the issue of rotation order was explored. In-depth semistructured interviews were conducted with the 12 PRHOs who were involved in general practice rotations. They were interviewed at the beginning and end of the PRHO year, and following their return to hospital work after the general practice placement. Each rotation order had both advantages and disadvantages, with no particular rotation order being obviously better or worse for the PRHOs involved. This small qualitative evaluation has highlighted a number of advantages and disadvantages specific to each rotation order, and makes some practical recommendations to help alleviate the problems encountered. It is important that future evaluations of similar schemes consider this issue, as there are conflicting reports about the significance of the rotation order.

Doctor-patient communication in radiology: a great opportunity for future radiology.

PubMed

Bazzocchi, M

2012-04-01

This text discusses several aspects of doctor-patient communication in radiology, including the origins, advantages, and ethical and legal aspects. Over the last 10 years, radiologists have assumed increasing responsibilities towards patients and society. Patients, who are becoming better informed and more aware about medical issues, have a right to be given a timely diagnosis and want to receive as much information as possible from the radiologist. This has implications for several levels of everyday radiological practice, including the organisation of work, legal and ethical aspects and radiologist training. Better interaction with the patient helps to build a closer, more trusting, relationship with the result that the radiologist will be more motivated in his or her work. Until now, radiologists were not adequately trained to communicate the diagnosis directly and verbally to patients, especially when the diagnosis was unfavourable. It is important to emphasise the need for more specific and practical training in this respect, which is indispensable for future developments of the discipline.

Active vibration absorber for CSI evolutionary model: Design and experimental results

NASA Technical Reports Server (NTRS)

Bruner, Anne M.; Belvin, W. Keith; Horta, Lucas G.; Juang, Jer-Nan

1991-01-01

The development of control of large flexible structures technology must include practical demonstration to aid in the understanding and characterization of controlled structures in space. To support this effort, a testbed facility was developed to study practical implementation of new control technologies under realistic conditions. The design is discussed of a second order, acceleration feedback controller which acts as an active vibration absorber. This controller provides guaranteed stability margins for collocated sensor/actuator pairs in the absence of sensor/actuator dynamics and computational time delay. The primary performance objective considered is damping augmentation of the first nine structural modes. Comparison of experimental and predicted closed loop damping is presented, including test and simulation time histories for open and closed loop cases. Although the simulation and test results are not in full agreement, robustness of this design under model uncertainty is demonstrated. The basic advantage of this second order controller design is that the stability of the controller is model independent.

Prohibiting physicians' dual practice in Iran: Policy options for implementation.

PubMed

Bazyar, Mohammad; Rashidian, Arash; Jahanmehr, Nader; Behzadi, Faranak; Moghri, Javad; Doshmangir, Leila

2018-04-23

In Iran, based on the recent national policy documents, physician dual practice (PDP) has been prohibited. This study aimed to develop policy options (POs) to implement physicians' dual practice prohibition law in Iran. International evidence published in English and local documents published in Persian about PDP analyzed and results (advantages, disadvantages, challenges and requirements to ban PDP, and applied policies to limit the dual practice) were extracted. Results discussed among the research team in 5 rounds of meetings. In each meeting, any possible PO to limit PDP in Iran was proposed based on brainstorming technique and 12 POs were developed. These 12 POs and their advantages and disadvantages were discussed in a focus group discussion attended by 14 informed policy makers, and 3 additional POs were added. Fifteen POs were developed. Each PO has its own advantages and disadvantages. It is worth to highlight that not only are the proposed POs not mutually exclusive but they are also mutually reinforcing; that is, each of these POs can be applied alone or they can be implemented alongside each other simultaneously. No single optimal PO exists for dealing with the dual practice in Iranian health system. Implementing a mix of POs could reduce possible complications of each PO and increase the chance of successful implementation of the law. It is advisable to follow a conservative and incremental approach and start with POs that will cause less resistance and political challenges. Copyright © 2018 John Wiley & Sons, Ltd.

Advantages of Aging.

ERIC Educational Resources Information Center

Palmore, Erdman

1979-01-01

There are at least 14 advantages of aging. Advantages to society of older persons include their lower criminal activity; greater political participation; increasing voluntary organization participation; work abilities; and visual perception abilities. Advantages for the individual include less criminal victimization; fewer accidents; social…

Discontinuity stresses in metallic pressure vessels

NASA Technical Reports Server (NTRS)

1971-01-01

The state of the art, criteria, and recommended practices for the theoretical and experimental analyses of discontinuity stresses and their distribution in metallic pressure vessels for space vehicles are outlined. The applicable types of pressure vessels include propellant tanks ranging from main load-carrying integral tank structure to small auxiliary tanks, storage tanks, solid propellant motor cases, high pressure gas bottles, and pressurized cabins. The major sources of discontinuity stresses are discussed, including deviations in geometry, material properties, loads, and temperature. The advantages, limitations, and disadvantages of various theoretical and experimental discontinuity analysis methods are summarized. Guides are presented for evaluating discontinuity stresses so that pressure vessel performance will not fall below acceptable levels.

Development and implementation of sepsis alert systems

PubMed Central

Harrison, Andrew M.; Gajic, Ognjen; Pickering, Brian W.; Herasevich, Vitaly

2016-01-01

Synopsis/Summary Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Important barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload & alert fatigue, due to suboptimal alert performance. Outside the ICU, additional barriers include differences in health care delivery models, charting behaviors, and availability of electronic data. Currently available evidence does not support routine use of sepsis alert systems in clinical practice. However, continuous improvement in both the afferent (data availability and accuracy of detection algorithms) and efferent (evidence-based decision support and smoother integration into clinical workflow) limbs of sepsis alert systems will help translate theoretical advantages into measurable patient benefit. PMID:27229639

Detecting of foreign object debris on airfield pavement using convolution neural network

NASA Astrophysics Data System (ADS)

Cao, Xiaoguang; Gu, Yufeng; Bai, Xiangzhi

2017-11-01

It is of great practical significance to detect foreign object debris (FOD) timely and accurately on the airfield pavement, because the FOD is a fatal threaten for runway safety in airport. In this paper, a new FOD detection framework based on Single Shot MultiBox Detector (SSD) is proposed. Two strategies include making the detection network lighter and using dilated convolution, which are proposed to better solve the FOD detection problem. The advantages mainly include: (i) the network structure becomes lighter to speed up detection task and enhance detection accuracy; (ii) dilated convolution is applied in network structure to handle smaller FOD. Thus, we get a faster and more accurate detection system.

An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications.

PubMed

Dweik, Raed A; Boggs, Peter B; Erzurum, Serpil C; Irvin, Charles G; Leigh, Margaret W; Lundberg, Jon O; Olin, Anna-Carin; Plummer, Alan L; Taylor, D Robin

2011-09-01

Measurement of fractional nitric oxide (NO) concentration in exhaled breath (Fe(NO)) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While Fe(NO) measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of Fe(NO) in clinical practice. To develop evidence-based guidelines for the interpretation of Fe(NO) measurements that incorporate evidence that has accumulated over the past decade. We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. The evidence related to the use of Fe(NO) measurements is reviewed and clinical practice recommendations are provided. In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV(1) reversibility or provocation tests are only indirectly associated with airway inflammation. Fe(NO) offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy.

An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FeNO) for Clinical Applications

PubMed Central

Dweik, Raed A.; Boggs, Peter B.; Erzurum, Serpil C.; Irvin, Charles G.; Leigh, Margaret W.; Lundberg, Jon O.; Olin, Anna-Carin; Plummer, Alan L.; Taylor, D. Robin

2011-01-01

Background: Measurement of fractional nitric oxide (NO) concentration in exhaled breath (FeNO) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While FeNO measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of FeNO in clinical practice. Purpose: To develop evidence-based guidelines for the interpretation of FeNO measurements that incorporate evidence that has accumulated over the past decade. Methods: We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. Results: The evidence related to the use of FeNO measurements is reviewed and clinical practice recommendations are provided. Conclusions: In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV1 reversibility or provocation tests are only indirectly associated with airway inflammation. FeNO offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy. PMID:21885636

The diffusion of evidence-based decision making among local health department practitioners in the United States.

PubMed

Harris, Jenine K; Erwin, Paul C; Smith, Carson; Brownson, Ross C

2015-01-01

Evidence-based decision making (EBDM) is the process, in local health departments (LHDs) and other settings, of translating the best available scientific evidence into practice. Local health departments are more likely to be successful if they use evidence-based strategies. However, EBDM and use of evidence-based strategies by LHDs are not widespread. Drawing on diffusion of innovations theory, we sought to understand how LHD directors and program managers perceive the relative advantage, compatibility, simplicity, and testability of EBDM. Directors and managers of programs in chronic disease, environmental health, and infectious disease from LHDs nationwide completed a survey including demographic information and questions about diffusion attributes (advantage, compatibility, simplicity, and testability) related to EBDM. Bivariate inferential tests were used to compare responses between directors and managers and to examine associations between participant characteristics and diffusion attributes. Relative advantage and compatibility scores were high for directors and managers, whereas simplicity and testability scores were lower. Although health department directors and managers of programs in chronic disease generally had higher scores than other groups, there were few significant or large differences between directors and managers across the diffusion attributes. Larger jurisdiction population size was associated with higher relative advantage and compatibility scores for both directors and managers. Overall, directors and managers were in strong agreement on the relative advantage of an LHD using EBDM, with directors in stronger agreement than managers. Perceived relative advantage has been demonstrated to be the most important factor in the rate of innovation adoption, suggesting an opportunity for directors to speed EBDM adoption. However, lower average scores across all groups for simplicity and testability may be hindering EBDM adoption. Recommended strategies for increasing perceived EBDM simplicity and testability are provided.

Dyslexia Linked to Visual Strengths Useful in Astronomy

NASA Astrophysics Data System (ADS)

Schneps, Matthew H.; Brockmole, J. R.; Rose, L. T.; Pomplun, M.; Sonnert, G.; Greenhill, L. J.

2011-05-01

Dyslexia is a hereditary neurological condition characterized by difficulties in reading, writing, and spelling. The fact that those with dyslexia include many accomplished scientists, including some recognized with a Nobel Prize, has prompted researchers to suggest that the neurology of dyslexia may predispose these individuals to advantages in visually-intensive domains such as science. Here, we report evidence of a link between dyslexia and abilities for visual processing useful in astronomy. First, we show that when images of natural scenes are Gaussian-blurred, so as to remove high-frequency detail (and resemble many astronomical images), college students with dyslexia significantly outperform those who are typical readers in learning the spatial contexts presented. Second, we show that when the threshold ability to detect radio signatures characteristic of black holes is measured in a laboratory simulation, astrophysicists with dyslexia significantly outperform those who are typical readers in this task when the visual periphery is important. In a third experiment, using eye-tracking technologies, we demonstrate that visual strategies significantly correlate with success in the black hole task, but that college students with dyslexia tend not to employ the strategies most likely to lead to success. Collectively, these studies suggest that dyslexia is linked to neurological advantages useful in astronomical careers, but that left to their own devices students with dyslexia may not benefit from these advantages without practice or training. These studies imply that many students who are struggling to read may find successful careers in astronomy or other fields that build on visual advantages linked to their reading disability, but that education and training may be vital in helping these students realize their strengths. This material is based upon work supported by the George E. Burch Fellowship (Smithsonian Institution) and the National Science Foundation under Grants HRD-0726032 and HRD-0930962.

Competency-based education and training in internal medicine.

PubMed

Weinberger, Steven E; Pereira, Anne G; Iobst, William F; Mechaber, Alex J; Bronze, Michael S

2010-12-07

Recent efforts to improve medical education include adopting a new framework based on 6 broad competencies defined by the Accreditation Council for Graduate Medical Education. In this article, the Alliance for Academic Internal Medicine Education Redesign Task Force II examines the advantages and challenges of a competency-based educational framework for medical residents. Efforts to refine specific competencies by developing detailed milestones are described, and examples of training program initiatives using a competency-based approach are presented. Meeting the challenges of a competency-based framework and supporting these educational innovations require a robust faculty development program. Challenges to competency-based education include teaching and evaluating the competencies related to practice-based learning and improvement and systems-based practice, as well as implementing a flexible time frame to achieve competencies. However, the Alliance for Academic Internal Medicine Education Redesign Task Force II does not favor reducing internal medicine training to less than 36 months as part of competency-based education. Rather, the 36-month time frame should allow for remediation to address deficiencies in achieving competencies and for diverse enrichment experiences in such areas as quality of care and practice improvement for residents who have demonstrated skills in all required competencies.

Dual education and industrial cooperation in electrical engineering

NASA Astrophysics Data System (ADS)

Váradiné Szarka, A.

2016-11-01

Dual education in higher education is a new system in Hungary introduced by Mercedes Benz with cooperation of Kecskemet College. In the new system companies support certain number of students and provide them strong practical education in their field. Students applying successfully for dual education study together with non-dual students at the university, so they go through the same university courses as their non-dual colleagues, but while non-dual students’ academic year includes 2×14 weeks active semester and 2×6 weeks exam session, all over 40 weeks, dual students have 48 working weeks including study at the university and practicing at the company. The main question of the success which one is the most effective model to be applied. This paper summarises 2 models of dual education with their advantages and disadvantages and also it presents practical realization at the University of Debrecen with special attention to measurement and instrumentation. Dual education in BSc level electrical engineering course cooperates with 6 multinational companies of the region in four specialization. Dual education also has great impact to the modernisation of engineering education. Detailed study of dual education in field of instrumentation and measurement is provided in the paper.

Administration, Best Practices, and Evaluation of the National Weather Center REU Program

NASA Astrophysics Data System (ADS)

Zaras, D. S.; Gonzalez-Espada, W.

2005-12-01

The National Weather Center Research Experiences for Undergraduates program in Norman, Oklahoma, is a unique undergraduate career exploration experience, drawing upon the resources available in the National Weather Center's (NWC) state, federal, and university groups. This program takes full advantage of our location by including a wide variety of professionals from throughout the NWC community as mentors and contributors of lectures, workshops, tours, field trips, and job shadow experiences to expose the students to a broad spectrum of research topics and careers in meteorology. Students actively practice good research methodology by being paired with mentors who are productive researchers. The program aims to provide a strong and transformative educational experience that models the life of a scientist. This presentation will include a brief overview of program administration, analysis of applicant characteristics, "best practices" learned since 2001, and new additions to the NWC program funded through a 2-Year Extension for Special Creativity. The presentation will conclude with a brief evaluation of how well the program meets its goals of helping students clarify graduate school and career plans, and build self-efficacy regarding their potential for a career in scientific research.

Barriers to Implementation of Optimal Laboratory Biosafety Practices in Pakistan

PubMed Central

Shafaq, Humaira; Hasan, Rumina; Qureshi, Shahida M.; Dojki, Maqboola; Hughes, Molly A.; Zaidi, Anita K. M.; Khan, Erum

2016-01-01

The primary goal of biosafety education is to ensure safe practices among workers in biomedical laboratories. Despite several educational workshops by the Pakistan Biological Safety Association (PBSA), compliance with safe practices among laboratory workers remains low. To determine barriers to implementation of recommended biosafety practices among biomedical laboratory workers in Pakistan, we conducted a questionnaire-based survey of participants attending 2 workshops focusing on biosafety practices in Karachi and Lahore in February 2015. Questionnaires were developed by modifying the BARRIERS scale in which respondents are required to rate barriers on a 1-4 scale. Nineteen of the original 29 barriers were included and subcategorized into 4 groups: awareness, material quality, presentation, and workplace barriers. Workshops were attended by 64 participants. Among barriers that were rated as moderate to great barriers by at least 50% of respondents were: lack of time to read biosafety guidelines (workplace subscale), lack of staff authorization to change/improve practice (workplace subscale), no career or self-improvement advantages to the staff for implementing optimal practices (workplace subscale), and unclear practice implications (presentation subscale). A lack of recognition for employees' rights and benefits in the workplace was found to be a predominant reason for a lack of compliance. Based on perceived barriers, substantial improvement in work environment, worker facilitation, and enabling are needed for achieving improved or optimal biosafety practices in Pakistan. PMID:27400192

A new strategy for complete identification of sea buckthorn cultivars by using random amplified polymorphic DNA markers.

PubMed

Yang, G; Ding, J; Wu, L R; Duan, Y D; Li, A Y; Shan, J Y; Wu, Y X

2015-03-13

DNA fingerprinting is both a popular and important technique with several advantages in plant cultivar identification. However, this technique has not been used widely and efficiently in practical plant identification because the analysis and recording of data generated from fingerprinting and genotyping are tedious and difficult. We developed a novel approach known as a cultivar identification diagram (CID) strategy that uses DNA markers to separate plant individuals in a more efficient, practical, and referable manner. A CID was manually constructed and a polymorphic marker was generated from each polymerase chain reaction for sample separation. In this study, 67 important sea buckthorn cultivars cultivated in China were successfully separated with random amplified polymorphic DNA markers using the CID analysis strategy, with only seven 11-nucleotide primers employed. The utilization of the CID of these 67 sea buckthorn cultivars was verified by identifying 2 randomly chosen groups of cultivars among the 67 cultivars. The main advantages of this identification strategy include fewer primers used and separation of all cultivars using the corresponding primers. This sea buckthorn CID was able to separate any sea buckthorn cultivars among the 67 studied, which is useful for sea buckthorn cultivar identification, cultivar-right-protection, and for the sea buckthorn nursery industry in China.

Introducing loupes to clinical practice: dental hygienists experiences and opinions.

PubMed

Hayes, M J; Taylor, J A; Smith, D R

2016-08-01

Recent literature has identified a number of potential advantages in wearing loupes for dental hygienists, including improved quality of care and ergonomics. The aim of the study was to determine dental hygienists' opinions about wearing loupes. A short online survey was distributed to all dental hygienists who had recently participated in a study investigating the efficacy of loupes on musculoskeletal disorders; all had only worn loupes for a 6-month period, and prior to the study had not worn loupes. All of those invited completed the survey (n = 12), achieving a 100% response rate. The majority of respondents noted that the loupes were adaptable to wear; however, only one-quarter of hygienists surveyed were wearing them often following the study. Respondents identified that the biggest advantage to loupes was calculus removal (91.7%), and most indicated that they felt the quality of their work increased when wearing loupes (75%). The biggest disadvantage to wearing loupes was the adjustment period (50%), with limited depth of vision, headache, vertigo and infection control noted by at least one-third of respondents. This study revealed that hygienists identify both benefits and limitations to wearing loupes, and therefore, ongoing support may be required for hygienists adopting their use in clinical practice. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Computer-assisted learning and simulation systems in dentistry--a challenge to society.

PubMed

Welk, A; Splieth, Ch; Wierinck, E; Gilpatrick, R O; Meyer, G

2006-07-01

Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted learning (CAL) and computer-assisted simulation (CAS) systems still appear to be underutilized in dental education. Advantages, challenges, problems, and solutions of computer-assisted learning and simulation in dentistry are discussed by means of MEDLINE, open Internet platform searches, and key results of a study among German dental schools. The advantages of computer-assisted learning are seen for example in self-paced and self-directed learning and increased motivation. It is useful for both objective theoretical and practical tests and for training students to handle complex cases. CAL can lead to more structured learning and can support training in evidence-based decision-making. The reasons for the still relatively rare implementation of CAL/CAS systems in dental education include an inability to finance, lack of studies of CAL/CAS, and too much effort required to integrate CAL/CAS systems into the curriculum. To overcome the reasons for the relative low degree of computer technology use, we should strive for multicenter research and development projects monitored by the appropriate national and international scientific societies, so that the potential of computer technology can be fully realized in graduate, postgraduate, and continuing dental education.

Practical Assessment, Research & Evaluation, 2000-2001.

ERIC Educational Resources Information Center

Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

2001-01-01

This document consists of papers published in the electronic journal "Practical Assessment, Research & Evaluation" during 2000-2001: (1) "Advantages of Hierarchical Linear Modeling" (Jason W. Osborne); (2) "Prediction in Multiple Regression" (Jason W. Osborne); (3) Scoring Rubrics: What, When, and How?"…

Practices participating in a dental PBRN have substantial and advantageous diversity even though as a group they have much in common with dentists at large

PubMed Central

Makhija, Sonia K; Gilbert, Gregg H; Rindal, D Brad; Benjamin, Paul; Richman, Joshua S; Pihlstrom, Daniel J; Qvist, Vibeke

2009-01-01

Background Practice-based research networks offer important opportunities to move recent advances into routine clinical practice. If their findings are not only generalizable to dental practices at large, but can also elucidate how practice characteristics are related to treatment outcome, their importance is even further elevated. Our objective was to determine whether we met a key objective for The Dental Practice-Based Research Network (DPBRN): to recruit a diverse range of practitioner-investigators interested in doing DPBRN studies. Methods DPBRN participants completed an enrollment questionnaire about their practices and themselves. To date, more than 1100 practitioners from the five participating regions have completed the questionnaire. The regions consist of: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates, and Scandinavia (Denmark, Norway, and Sweden). We tested the hypothesis that there are statistically significant differences in key characteristics among DPBRN practices, based on responses from dentists who participated in DPBRN's first network-wide study (n = 546). Results There were statistically significant, substantive regional differences among DPBRN-participating dentists, their practices, and their patient populations. Conclusion Although as a group, participants have much in common with practices at large; their substantial diversity offers important advantages, such as being able to evaluate how practice differences may affect treatment outcomes, while simultaneously offering generalizability to dentists at large. This should help foster knowledge transfer in both the research-to-practice and practice-to-research directions. PMID:19832991

Social Work Practice in the Digital Age: Therapeutic E-Mail as a Direct Practice Methodology

ERIC Educational Resources Information Center

Mattison, Marian

2012-01-01

The author addresses the risks and benefits of incorporating therapeutic e-mail communication into clinical social work practice. Consumer demand for online clinical services is growing faster than the professional response. E-mail, when used as an adjunct to traditional meetings with clients, offers distinct advantages and risks. Benefits include…

Using a Class to Conduct a Carbon Inventory: A Case Study with Practical Results at Macalester College

ERIC Educational Resources Information Center

Wells, Christopher W.; Savanick, Suzanne; Manning, Christie

2009-01-01

Purpose: The purpose of this paper is to discuss the practical realities of using a college seminar to fulfill the carbon audit requirement for signatories to the American College and University Presidents Climate Commitment (ACUPCC) and presents evidence of this approach's advantages as an educational and practical tool.…

Is the Self Always Better than a Friend? Self-Face Recognition in Christians and Atheists

PubMed Central

Ma, Yina; Han, Shihui

2012-01-01

Early behavioral studies found that human adults responded faster to their own faces than faces of familiar others or strangers, a finding referred to as self-face advantage. Recent research suggests that the self-face advantage is mediated by implicit positive association with the self and is influenced by sociocultural experience. The current study investigated whether and how Christian belief and practice affect the processing of self-face in a Chinese population. Christian and Atheist participants were recruited for an implicit association test (IAT) in Experiment 1 and a face-owner identification task in Experiment 2. Experiment 1 found that atheists responded faster to self-face when it shared the same response key with positive compared to negative trait adjectives. This IAT effect, however, was significantly reduced in Christians. Experiment 2 found that atheists responded faster to self-face compared to a friend’s face, but this self-face advantage was significantly reduced in Christians. Hierarchical regression analyses further showed that the IAT effect positively predicted self-face advantage in atheists but not in Christians. Our findings suggest that Christian belief and practice may weaken implicit positive association with the self and thus decrease the advantage of the self over a friend during face recognition in the believers. PMID:22662231

Is the self always better than a friend? Self-face recognition in Christians and atheists.

PubMed

Ma, Yina; Han, Shihui

2012-01-01

Early behavioral studies found that human adults responded faster to their own faces than faces of familiar others or strangers, a finding referred to as self-face advantage. Recent research suggests that the self-face advantage is mediated by implicit positive association with the self and is influenced by sociocultural experience. The current study investigated whether and how Christian belief and practice affect the processing of self-face in a Chinese population. Christian and Atheist participants were recruited for an implicit association test (IAT) in Experiment 1 and a face-owner identification task in Experiment 2. Experiment 1 found that atheists responded faster to self-face when it shared the same response key with positive compared to negative trait adjectives. This IAT effect, however, was significantly reduced in Christians. Experiment 2 found that atheists responded faster to self-face compared to a friend's face, but this self-face advantage was significantly reduced in Christians. Hierarchical regression analyses further showed that the IAT effect positively predicted self-face advantage in atheists but not in Christians. Our findings suggest that Christian belief and practice may weaken implicit positive association with the self and thus decrease the advantage of the self over a friend during face recognition in the believers.

Exploring the advantages of using social network sites (SNSs) in dental medicine organisations.

PubMed

Franco, Mário; Pais, Leonor

2017-05-08

Purpose The purpose of this paper is to deepen and contribute to knowledge of the use of social network sites (SNSs) in organisations, and more precisely, identify the advantages. Design/methodology/approach To reach this objective, a cross-section study was adopted based on application of a questionnaire, the final sample consisting of 78 dental medicine organisations in Portugal. Findings The results obtained lead to the conclusion that a great number of the organisations studied are connected to SNSs, particularly Facebook. The advantages associated with marketing tools and breaking down barriers between the organisation and the world are those highlighted most in this study. Practical implications According to the empirical evidence obtained, organisations are found to use these sites for other purposes, such as communicating with clients/patients and receiving feedback on the service provided to increase satisfaction and improve the quality of services. Originality/value The study contributes to advancing theory in the field of internet research strategic. More precisely, this study is associated with the creation of a theoretical framework that shows the advantages of using SNSs in an innovative context: dental medicine organisations. A categorisation of these advantages and some implications for theory and practice are also some contributions of this study.

A systematic review of the collaborative clinical education model to inform speech-language pathology practice.

PubMed

Briffa, Charmaine; Porter, Judi

2013-12-01

A shortage of clinical education placements for allied health students internationally has led to the need to explore innovative models of clinical education. The collaborative model where one clinical educator supervises two or more students completing a clinical placement concurrently is one model enabling expansion of student placements. The aims of this review were to investigate advantages and disadvantages of the collaborative model and to explore its implementation across allied health. A systematic search of the literature was conducted using three electronic databases (CINAHL, Medline, and Embase). Two independent reviewers evaluated studies for methodological quality. Seventeen studies met inclusion/exclusion criteria. Advantages and disadvantages identified were consistent across disciplines. A key advantage of the model was the opportunity afforded for peer learning, whilst a frequently reported disadvantage was reduced time for individual supervision of students. The methodological quality of many included studies was poor, impacting on interpretation of the evidence base. Insufficient data were provided on how the model was implemented across studies. There is a need for high quality research to guide implementation of this model across a wider range of allied health disciplines and to determine educational outcomes using reliable and validated measures.

Performance review using sequential sampling and a practice computer.

PubMed

Difford, F

1988-06-01

The use of sequential sample analysis for repeated performance review is described with examples from several areas of practice. The value of a practice computer in providing a random sample from a complete population, evaluating the parameters of a sequential procedure, and producing a structured worksheet is discussed. It is suggested that sequential analysis has advantages over conventional sampling in the area of performance review in general practice.

Marketing the gastrointestinal practice: strategic considerations.

PubMed

Berkowitz, Eric N

2006-10-01

The health care marketplace is changing rapidly with increasing competition, changing reimbursement, and greater shifting of cost to patients making them more price sensitive. To be financially viable, the successful gastrointestinal practice must be more market responsive in its approach to planning, develop a unique advantage that will be of value to referral sources, and understand how customers evaluate alternative competing practices. This article focuses on these elements of practice success.

Fuzzy logic and neural network technologies

NASA Technical Reports Server (NTRS)

Villarreal, James A.; Lea, Robert N.; Savely, Robert T.

1992-01-01

Applications of fuzzy logic technologies in NASA projects are reviewed to examine their advantages in the development of neural networks for aerospace and commercial expert systems and control. Examples of fuzzy-logic applications include a 6-DOF spacecraft controller, collision-avoidance systems, and reinforcement-learning techniques. The commercial applications examined include a fuzzy autofocusing system, an air conditioning system, and an automobile transmission application. The practical use of fuzzy logic is set in the theoretical context of artificial neural systems (ANSs) to give the background for an overview of ANS research programs at NASA. The research and application programs include the Network Execution and Training Simulator and faster training algorithms such as the Difference Optimized Training Scheme. The networks are well suited for pattern-recognition applications such as predicting sunspots, controlling posture maintenance, and conducting adaptive diagnoses.

The role of peer-assisted learning in building evaluative judgement: opportunities in clinical medical education.

PubMed

Tai, Joanna Hong-Meng; Canny, Benedict J; Haines, Terry P; Molloy, Elizabeth K

2016-08-01

This study explored the contribution of peer-assisted learning (PAL) in the development of evaluative judgement capacity; the ability to understand work quality and apply those standards to appraising performance. The study employed a mixed methods approach, collecting self-reported survey data, observations of, and reflective interviews with, the medical students observed. Participants were in their first year of clinical placements. Data were thematically analysed. Students indicated that PAL contributed to both the comprehension of notions of quality, and the practice of making comparisons between a given performance and the standards. Emergent themes included peer story-telling, direct observation of performance, and peer-based feedback, all of which helped students to define 'work quality'. By participating in PAL, students were required to make comparisons, therefore using the standards of practice and gaining a deeper understanding of them. The data revealed tensions in that peers were seen as less threatening than supervisors with the advantage of increasing learners' appetites for thoughtful 'intellectual risk taking'. Despite this reported advantage of peer engagement, learners still expressed a preference for feedback from senior teachers as more trusted sources of clinical knowledge. While this study suggests that PAL already contributes to the development of evaluative judgement, further steps could be taken to formalise PAL in clinical placements to improve learners' capacity to make accurate judgements on the performance of self and others. Further experimental studies are necessary to confirm the best methods of using PAL to develop evaluative judgement. This may include both students and educators as instigators of PAL in the workplace.

Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review.

PubMed

Carey, Stephanie L; Lura, Derek J; Highsmith, M Jason

2015-01-01

The choice of a myoelectric or body-powered upper-limb prosthesis can be determined using factors including control, function, feedback, cosmesis, and rejection. Although body-powered and myoelectric control strategies offer unique functions, many prosthesis users must choose one. A systematic review was conducted to determine differences between myoelectric and body-powered prostheses to inform evidence-based clinical practice regarding prescription of these devices and training of users. A search of 9 databases identified 462 unique publications. Ultimately, 31 of them were included and 11 empirical evidence statements were developed. Conflicting evidence has been found in terms of the relative functional performance of body-powered and myoelectric prostheses. Body-powered prostheses have been shown to have advantages in durability, training time, frequency of adjustment, maintenance, and feedback; however, they could still benefit from improvements of control. Myoelectric prostheses have been shown to improve cosmesis and phantom-limb pain and are more accepted for light=intensity work. Currently, evidence is insufficient to conclude that either system provides a significant general advantage. Prosthetic selection should be based on a patient's individual needs and include personal preferences, prosthetic experience, and functional needs. This work demonstrates that there is a lack of empirical evidence regarding functional differences in upper-limb prostheses.

How dentists account for social responsibility: economic imperatives and professional obligations.

PubMed

Dharamsi, Shafik; Pratt, Daniel D; MacEntee, Michael I

2007-12-01

This study explores how dentists explain the concept of social responsibility and its relationship to issues affecting access to oral health care by vulnerable segments of the population. Analysis of open-ended interviews with thirty-four dentists, including dental educators, and administrators and officials of dental public health programs in Canada and the United States revealed that four main themes-economics, professionalism, individual choice, and politics-influenced the respondents' sense of social responsibility in dentistry. There was a belief that social responsibility in dentistry is dominated by economic imperatives that impact negatively on the policies and practices directing access to care. Yet, despite the highly critical stance on dentistry as a business, there was practical recognition of the economic realities of dental practice. Nevertheless, those who focused on social responsibility as a professional obligation highlighted the privileges of self-governance along with the accompanying duty to serve the welfare of everyone and not just those who are socioeconomically advantaged.

Some Applied Research Concerns Using Multiple Linear Regression Analysis.

ERIC Educational Resources Information Center

Newman, Isadore; Fraas, John W.

The intention of this paper is to provide an overall reference on how a researcher can apply multiple linear regression in order to utilize the advantages that it has to offer. The advantages and some concerns expressed about the technique are examined. A number of practical ways by which researchers can deal with such concerns as…

Women's Guide to Overseas Living. Second Edition.

ERIC Educational Resources Information Center

Piet-Pelon, Nancy J.; Hornby, Barbara

This book examines issues critical to women and their families who go abroad to live. In advising how to cope effectively with the problems that arise, the book illuminates the advantages of living overseas and offers practical suggestions and guidelines that help women take advantage of the opportunity to share in another culture. Divided into 13…

Rivastigmine From Capsules to Patch: Therapeutic Advances in the Management of Alzheimer’s Disease and Parkinson’s Disease Dementia

PubMed Central

Micca, Joseph L.; Grossberg, George T.; Velting, Drew M.

2014-01-01

Objective: To discuss the pharmacology, mechanism of action, and chemical properties of the cholinesterase inhibitor (ChEI) rivastigmine; to provide a rationale for transdermal delivery and supportive clinical data, along with practical guidance on rivastigmine patch use in Alzheimer’s disease and Parkinson’s disease dementia. Data Sources: Pivotal studies of rivastigmine capsules and patch were identified using PubMed and the rivastigmine US prescribing information. PubMed searches were performed in 2013 using rivastigmine as a keyword. Study Selection: English-language articles related to rivastigmine considered of relevance to primary care physicians were included. Data Synthesis: Pharmacologic differences exist between rivastigmine and ChEIs. Clinical studies demonstrate symptomatic efficacy of oral rivastigmine across all stages of Alzheimer’s disease and mild-to-moderate Parkinson’s disease dementia. However, gastrointestinal adverse events limit access to optimal therapeutic doses. Strategies that lower maximum plasma concentrations (Cmax) and prolong time to Cmax, ie, transdermal delivery, may improve tolerability. Clinical registration studies have demonstrated improved tolerability of rivastigmine 9.5-mg/24-h patch versus 6-mg twice-daily capsules in mild-to-moderate Alzheimer’s disease, and a positive benefit-risk profile of 13.3-mg/24-h versus 9.5-mg/24-h patch in patients needing enhanced efficacy. Clinical data comparing 13.3-mg/24-h versus 4.6-mg/24-h patch in severe Alzheimer’s disease demonstrated efficacy on cognition and activities of daily living. These data led to approval of rivastigmine patch in severe Alzheimer’s disease. Transdermal delivery also has practical advantages, including simple, once-daily administration and a visual indicator of compliance. Potential application site reactions can be minimized and need not be a barrier to treatment. Conclusions: In addition to practical advantages, rivastigmine patch may improve clinical outcomes throughout the course of Alzheimer’s disease by providing access to high-dose efficacy without compromising tolerability. PMID:25667813

Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies.

PubMed

Shoemaker, Sarah J; Staub-DeLong, Leah; Wasserman, Melanie; Spranca, Mark

2013-01-01

Pharmacies are key sources of medication information for patients, yet few effectively serve patients with low health literacy. The Agency for Healthcare Research and Quality (AHRQ) supported the development of four health literacy tools for pharmacists to address this problem, and to help assess and improve pharmacies' health literacy practices. This study aimed to understand the facilitators and barriers to the adoption and implementation of AHRQ's health literacy tools, particularly a tool to assess a pharmacy's health literacy practices. We conducted a comparative, multiple-case study of eight pharmacies, guided by an adaptation of Rogers's Diffusion of Innovations model. Data were collected and triangulated through interviews, site visit observations, and the review of documents, and analyzed on the factors affecting pharmacies' adoption decisions and implementation of the tools. Factors important to pharmacies' decision to adopt the health literacy tools included awareness of health literacy; a culture of innovation; a change champion; the relative advantage and compatibility of the tools; and an invitation to utilize and receive support to use the tools. The barriers included a lack of leadership support, limited staff time, and a perception of the tools as complex with limited value. For implementation, the primary facilitators were buy-in from leadership, qualified staff, college-affiliated change champions, the adaptability and organization of the tool, and support. Barriers to implementation were limited leadership buy-in, prioritization of other activities, lack of qualified staff, and tool complexity. If pharmacists are provided tools that could ultimately improve their health literacy practices and patient-centered services; and the tools have a clear relative advantage, are simple as well adaptable, and the pharmacists are supported in their efforts - either by colleagues or by collaborating with colleges of pharmacy-then there could be important progress toward achieving the goals of the National Action Plan for Health Literacy. Copyright © 2013 Elsevier Inc. All rights reserved.

The advantages, disadvantages, and policies for part-time radiologists: report of the ACR Commission on Human Resources.

PubMed

Harolds, Jay A; Coleman, Beverly G; Recht, Michael P; Bluth, Edward I

2014-07-01

The employment of part-time radiologists (PTRs) has both advantages and disadvantages in various practice settings. The authors examine the pros and cons of PTRs and review the literature regarding PTRs both within and outside the specialty of radiology. The complexity of this issue is manifested in our inability to reach consensus on many policy issues for PTRs. Nevertheless, this article should be helpful in offering an objective, nonbiased background to initiating a discussion on employing PTRs in various radiology practices. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Bringing functions together with fusion enzymes--from nature's inventions to biotechnological applications.

PubMed

Elleuche, Skander

2015-02-01

It is a mammoth task to develop a modular protein toolbox enabling the production of posttranslational organized multifunctional enzymes that catalyze reactions in complex pathways. However, nature has always guided scientists to mimic evolutionary inventions in the laboratory and, nowadays, versatile methods have been established to experimentally connect enzymatic activities with multiple advantages. Among the oldest known natural examples is the linkage of two or more juxtaposed proteins catalyzing consecutive, non-consecutive, or opposing reactions by a native peptide bond. There are multiple reasons for the artificial construction of such fusion enzymes including improved catalytic activities, enabled substrate channelling by proximity of biocatalysts, higher stabilities, and cheaper production processes. To produce fused proteins, it is either possible to genetically fuse coding open reading frames or to connect proteins in a posttranslational process. Molecular biology techniques that have been established for the production of end-to-end or insertional fusions include overlap extension polymerase chain reaction, cloning, and recombination approaches. Depending on their flexibility and applicability, these methods offer various advantages to produce fusion genes in high throughput, different orientations, and including linker sequences to maximize the flexibility and performance of fusion partners. In this review, practical techniques to fuse genes are highlighted, enzymatic parameters to choose adequate enzymes for fusion approaches are summarized, and examples with biotechnological relevance are presented including a focus on plant biomass-degrading glycosyl hydrolases.

Integrating aesthetics into advanced practice mental health nursing: commercial film as a suggested modality.

PubMed

Raingruber, Bonnie

2003-01-01

The purpose of this study was to explore the advantages and disadvantages of using feature films in teaching advanced practice mental health nursing. A phenomenological investigation was conducted of 11 master's student perspectives regarding the use of movies in an on-line course. According to the students, the disadvantages of movies were that films are time consuming to watch and often more dramatic than real-life situations. The advantages of using movies were that films are effective in promoting reflection and enhancing empathy. Students noted that movies poignantly portray emotional issues and are engaging in addition to being a good way both to present educational content and introduce ethical dilemmas. Using movies also may be effective with select clients as a once-removed way to introduce therapeutic discussions in outpatient practice.

Using Sustainable Development as a Competitive Strategy

NASA Astrophysics Data System (ADS)

Spearman, Pat

Sustainable development reduces construction waste by 43%, generating 50% cost savings. Residential construction executives lacking adequate knowledge regarding the benefits of sustainable development practices are at a competitive disadvantage. Drawing from the diffusion of innovation theory, the purpose of this qualitative case study was to explore knowledge acquisition within the bounds of sustainable residential construction. The purposive sample size of 11 executive decision makers fulfilled the sample size requirements and enabled the extraction of meaningful data. Participants were members of the National Home Builders Association and had experience of a minimum of 5 years in residential construction. The research question addressed how to improve knowledge acquisition relating to the cost benefits of building green homes and increase the adoption rate of sustainable development among residential builders. Data were collected via semistructured telephone interviews, field observation, and document analysis. Transcribed data were validated via respondent validation, coded into 5 initial categories aligned to the focus of the research, then reduced to 3 interlocking themes of environment, competitive advantage, and marketing. Recommendations include developing comprehensive public policies, horizontal and vertical communications networks, and green banks to capitalize sustainable development programs to improve the diffusion of green innovation as a competitive advantage strategy. Business leaders could benefit from this data by integrating sustainable development practices into their business processes. Sustainable development reduces operational costs, increases competitive advantage for builders, and reduces greenhouse gas emissions. Implications for social change increase energy independence through conservation and developing a legislative policy template for comprehensive energy strategies. A comprehensive energy strategy promotes economic development, technological gains in all business sectors within the energy industry, and reduces energy costs for consumers.

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

PubMed

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

2016-02-16

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

Four-dimensional MRI using an internal respiratory surrogate derived by dimensionality reduction

NASA Astrophysics Data System (ADS)

Uh, Jinsoo; Ayaz Khan, M.; Hua, Chiaho

2016-11-01

This study aimed to develop a practical and accurate 4-dimensional (4D) magnetic resonance imaging (MRI) method using a non-navigator, image-based internal respiratory surrogate derived by dimensionality reduction (DR). The use of DR has been previously suggested but not implemented for reconstructing 4D MRI, despite its practical advantages. We compared multiple image-acquisition schemes and refined a retrospective-sorting process to optimally implement a DR-derived surrogate. The comparison included an unconventional scheme that acquires paired slices alternately to mitigate the internal surrogate’s dependency on a specific slice location. We introduced ‘target-oriented sorting’, as opposed to conventional binning, to quantify the coherence in retrospectively sorted images, thereby determining the minimal scan time needed for sufficient coherence. This study focused on evaluating the proposed method using digital phantoms which provided unequivocal gold standard. The evaluation indicated that the DR-based respiratory surrogate is highly accurate: the error in amplitude percentile of the surrogate signal was less than 5% with the optimal scheme. Acquiring alternating paired slices was superior to the conventional scheme of acquiring individual slices; the advantage of the unconventional scheme was more pronounced when a substantial phase shift occurred across slice locations. The analysis of coherence across sorted images confirmed the advantage of higher sampling efficiencies in non-navigator respiratory surrogates. We determined that a scan time of 20 s per imaging slice was sufficient to achieve a mean coherence error of less than 1% for the tested respiratory patterns. The clinical applicability of the proposed 4D MRI has been demonstrated with volunteers and patients. The diaphragm motion in 4D MRI was consistent with that in dynamic 2D imaging which was regarded as the gold standard (difference within 1.8 mm on average).

Knowledge Typologies for Professional Learning: Educators' (Re)Generation of Knowledge When Learning Open Educational Practice

ERIC Educational Resources Information Center

Hood, Nina; Littlejohn, Allison

2017-01-01

Open education resources (OER) and accompanying open education practices (OEP), are changing the education landscape. For educators to take full advantage of the opportunities OER offer they must engage in learning activities to facilitate the extension and adaption of their practice. This paper forms part of a larger study exploring how adult…

What can the past of pay-for-performance tell us about the future of Value-Based Purchasing in Medicare?

PubMed

Ryan, Andrew M; Damberg, Cheryl L

2013-06-01

The Medicare program has implemented pay-for-performance (P4P), or Value-Based Purchasing, for inpatient care and for Medicare Advantage plans, and plans to implement a program for physicians in 2015. In this paper, we review evidence on the effectiveness of P4P and identify design criteria deemed to be best practice in P4P. We then assess the extent to which Medicare's existing and planned Value-Based Purchasing programs align with these best practices. Of the seven identified best practices in P4P program design, the Hospital Value-Based Purchasing program is strongly aligned with two of the best practices, moderately aligned with three, weakly aligned with one, and has unclear alignment with one best practice. The Physician Value-Based Purchasing Modifier is strongly aligned with two of the best practices, moderately aligned with one, weakly aligned with three, and has unclear alignment with one of the best practices. The Medicare Advantage Quality Bonus Program is strongly aligned with four of the best practices, moderately aligned with two, and weakly aligned with one of the best practices. We identify enduring gaps in P4P literature as it relates to Medicare's plans for Value-Based Purchasing and discuss important issues in the future of these implementations in Medicare. Copyright © 2013 Elsevier Inc. All rights reserved.

New entity for conducting group practice offers new potential.

PubMed

Rich, H I

1994-01-01

A new form of entity, the limited liability company (LLC), may be used by physicians to conduct group practices with the tax advantages of a partnership and insulation from liability for copractitioner's acts. The author reviews the New Jersey Limited Liability Company Act.

External Science Courses: The Practicals Problem.

ERIC Educational Resources Information Center

Kember, David

1982-01-01

Describes three methods for offering practical work for external science courses: residential sessions on campus, local centers, and use of home laboratory kits. The advantages and disadvantages of each are discussed and examples of each in operation are given. A 21-item bibliography is provided. (EAO)

Regional forestry practices and forest management certification

Treesearch

Steverson O. Moffat; Frederick W. Cubbage; Matthew H. Pelkki

2001-01-01

Under a "mandated" management scenario, landowners in states with comprehensive forest practices laws meet more sustainable forestry standards and certification programs' guidelines than do owners in states with other regulatory approaches. This confers certification advantages to landowners in the Pacific Northwest where comprehensive forest laws...

Organic and low input farming: Pros and cons for soil health

USDA-ARS?s Scientific Manuscript database

Organic and low input farming practices have both advantages and disadvantages in building soil health and maintaining productivity. Examining the effects of farming practices on soil health parameters can aid in developing whole system strategies that promote sustainability. Application of specific...

Training vs practice: A tale of opposition in acute cholecystitis.

PubMed

Patel, Purvi P; Daly, Shaun C; Velasco, Jose M

2015-10-18

Acute cholecystitis is one of the most common surgical diagnoses encountered by general surgeons. Despite its high incidence there remains a range of treatment of approaches. Current practices in biliary surgery vary as to timing, intraoperative utilization of biliary imaging, and management of bile duct stones despite growing evidence in the literature defining best practice. Management of patients with acute cholecystitis with early laparoscopic cholecystectomy (LC) results in better patient outcomes when compared with delayed surgical management techniques including antibiotic therapy or percutaneous cholecystostomy. Regardless of this data, many surgeons still prefer to utilize antibiotic therapy and complete an interval LC to manage acute cholecystitis. The use of intraoperative biliary imaging by cholangiogram or laparoscopic ultrasound has been demonstrated to facilitate the safe completion of cholecystectomy, minimizing the risk for inadvertent injury to surrounding structures, and lowering conversion rates, however it is rarely utilized. Choledocholithiasis used to be a diagnosis managed exclusively by surgeons but current practice favors referral to gastroenterologists for performance of preoperative endoscopic removal. Yet, there is evidence that intraoperative laparoscopic stone extraction is safe, feasible and may have added advantages. This review aims to highlight the differences between existing management of acute cholecystitis and evidence supported in the literature regarding best practice with the goal to change surgical practice to adopt these current recommendations.

Training vs practice: A tale of opposition in acute cholecystitis

PubMed Central

Patel, Purvi P; Daly, Shaun C; Velasco, Jose M

2015-01-01

Acute cholecystitis is one of the most common surgical diagnoses encountered by general surgeons. Despite its high incidence there remains a range of treatment of approaches. Current practices in biliary surgery vary as to timing, intraoperative utilization of biliary imaging, and management of bile duct stones despite growing evidence in the literature defining best practice. Management of patients with acute cholecystitis with early laparoscopic cholecystectomy (LC) results in better patient outcomes when compared with delayed surgical management techniques including antibiotic therapy or percutaneous cholecystostomy. Regardless of this data, many surgeons still prefer to utilize antibiotic therapy and complete an interval LC to manage acute cholecystitis. The use of intraoperative biliary imaging by cholangiogram or laparoscopic ultrasound has been demonstrated to facilitate the safe completion of cholecystectomy, minimizing the risk for inadvertent injury to surrounding structures, and lowering conversion rates, however it is rarely utilized. Choledocholithiasis used to be a diagnosis managed exclusively by surgeons but current practice favors referral to gastroenterologists for performance of preoperative endoscopic removal. Yet, there is evidence that intraoperative laparoscopic stone extraction is safe, feasible and may have added advantages. This review aims to highlight the differences between existing management of acute cholecystitis and evidence supported in the literature regarding best practice with the goal to change surgical practice to adopt these current recommendations. PMID:26483868

Branding your practice: twelve practical steps to creating lifelong patient relationships.

PubMed

Neely, Melinda Hinson

2005-01-01

The concept of branding is not limited to large companies. It can be successfully applied in medical practices to those individuals or groups that wish to establish a distinct identity in the marketplace. Branding a medical practice establishes a competitive advantage, ensures a more predictable flow of patients, and ultimately enhances patient satisfaction. This article conceptualizes the branding process and provides guidelines for implementation that are applicable to a variety of budgets.

Stem Cells for Skeletal Muscle Tissue Engineering.

PubMed

Pantelic, Molly N; Larkin, Lisa M

2018-04-19

Volumetric muscle loss (VML) is a debilitating condition wherein muscle loss overwhelms the body's normal physiological repair mechanism. VML is particularly common among military service members who have sustained war injuries. Because of the high social and medical cost associated with VML and suboptimal current surgical treatments, there is great interest in developing better VML therapies. Skeletal muscle tissue engineering (SMTE) is a promising alternative to traditional VML surgical treatments that use autogenic tissue grafts, and rather uses isolated stem cells with myogenic potential to generate de novo skeletal muscle tissues to treat VML. Satellite cells are the native precursors to skeletal muscle tissue, and are thus the most commonly studied starting source for SMTE. However, satellite cells are difficult to isolate and purify, and it is presently unknown whether they would be a practical source in clinical SMTE applications. Alternative myogenic stem cells, including adipose-derived stem cells, bone marrow-derived mesenchymal stem cells, perivascular stem cells, umbilical cord mesenchymal stem cells, induced pluripotent stem cells, and embryonic stem cells, each have myogenic potential and have been identified as possible starting sources for SMTE, although they have yet to be studied in detail for this purpose. These alternative stem cell varieties offer unique advantages and disadvantages that are worth exploring further to advance the SMTE field toward highly functional, safe, and practical VML treatments. The following review summarizes the current state of satellite cell-based SMTE, details the properties and practical advantages of alternative myogenic stem cells, and offers guidance to tissue engineers on how alternative myogenic stem cells can be incorporated into SMTE research.

Clinician Perceptions Related to the Use of the CBT-I Coach Mobile App.

PubMed

Miller, Katherine E; Kuhn, Eric; Owen, Jason E; Taylor, Katherine; Yu, Jessica S; Weiss, Brandon J; Crowley, Jill J; Trockel, Mickey

2017-11-09

Clinicians' perceptions of CBT-I Coach, a patient-facing mobile app for cognitive-behavioral therapy for insomnia (CBT-I), are critical to its adoption and integration into practice. Diffusion of innovations theory emphasizes the influence of perceptions, including the relative advantage to current practice, the compatibility to clinicians' needs, the complexity, the innovation's trialability, and observability. This study intended to evaluate the use and perceptions of CBT-I Coach among Veterans Affairs (VA)-trained CBT-I clinicians. Clinicians (N = 108) were surveyed about their use, feedback, and perceptions of CBT-I Coach a year after the app became available. Overall perceptions of CBT-I Coach were favorable. Fifty percent of clinicians reported using CBT-I Coach, with 98% intending to continue use. The app was perceived to increase sleep diary completion and homework compliance. Clinicians viewed the app as providing accessibility to helpful tools and improving patient engagement. Of those not using the app, 83% endorsed intention to use it. Reasons for nonuse were lack of patient access to smart phones, not being aware of the app, not having time to learn it, and inability to directly access app data. Those who reported using CBT-I Coach had more favorable perceptions across all constructs (p < .01 - p < .001), except relative advantage, compared to nonusers. Users perceived it as less complex and more compatible with their practice than nonusers. Continued efforts are needed to increase adoption and enhance use of CBT-I Coach, as well as study if reported benefits can be evidenced more directly.

Local ablation therapy with contrast-enhanced ultrasonography for hepatocellular carcinoma: a practical review

PubMed Central

Kim, Tae Kyoung; Khalili, Korosh; Jang, Hyun-Jung

2015-01-01

A successful program for local ablation therapy for hepatocellular carcinoma (HCC) requires extensive imaging support for diagnosis and localization of HCC, imaging guidance for the ablation procedures, and post-treatment monitoring. Contrast-enhanced ultrasonography (CEUS) has several advantages over computed tomography/magnetic resonance imaging (CT/MRI), including real-time imaging capability, sensitive detection of arterial-phase hypervascularity and washout, no renal excretion, no ionizing radiation, repeatability, excellent patient compliance, and relatively low cost. CEUS is useful for image guidance for isoechoic lesions. While contrast-enhanced CT/MRI is the standard method for the diagnosis of HCC and post-ablation monitoring, CEUS is useful when CT/MRI findings are indeterminate or CT/MRI is contraindicated. This article provides a practical review of the role of CEUS in imaging algorithms for pre- and post-ablation therapy for HCC. PMID:26169081

Fear of birth in clinical practice: A structured review of current measurement tools.

PubMed

Richens, Yana; Smith, Debbie M; Lavender, Dame Tina

2018-06-01

To identify measurement tools which screen for the presence of fear of birth (FOB) and to determine the most effective tool/s for use in clinical practice. Fear or birth (FOB) is internationally recognised as a cause for increasing concern, despite a lack of consensus on a definition or optimal measure of assessment. There is a wide array of FOB measurement tools, however little clarity on which tool should be used to screen for FOB in clinical practice. This review explores the use of tools that are used to screen for FOB and discusses the perceived effectiveness of such tools. A structured literature review was undertaken. Electronic databases were searched in July 2017 and manuscripts reviewed for quality. The review included 46 papers. The majority of studies were undertaken in Scandinavia (n = 29) and a range of tools were used to measure FOB. The most widely used tool was the Wijma Delivery Expectancy Experience Questionnaire' (W-DEQ). Inconsistencies were found in the way this tool was used, including variations in assessment cut-off points, implementation and use across a range of cultural settings and women of varying gestations. Moreover, the tool may be too lengthy to use in clinical practice. The Fear of Birth Scale (FOBS) has been shown to be as effective as W-DEQ but has the advantage of being short and easy to administer. The inconsistencies in tools reflect the difficulties in defining FOB. A clear consensus definition of FOB would aid comparisons across practice and research. The W-DEQ is not used in clinical practice; this may be due to its length and complexity. The FOBS is likely to be a more versatile tool that can be used in clinical practice. Copyright © 2018 Elsevier B.V. All rights reserved.

On the placement of practice questions during study.

PubMed

Weinstein, Yana; Nunes, Ludmila D; Karpicke, Jeffrey D

2016-03-01

Retrieval practice improves retention of information on later tests. A question remains: When should retrieval occur during learning-interspersed throughout study or at the end of each study period? In a lab experiment, an online experiment, and a classroom study, we aimed to determine the ideal placement (interspersed vs. at-the-end) of retrieval practice questions. In the lab experiment, 64 subjects viewed slides about APA style and answered short-answer practice questions about the content or restudied the slides (restudy condition). The practice questions either appeared 1 every 1-2 slides (interspersed condition), or all at the end of the presentation (at-the-end condition). One week later, subjects returned and answered the same questions on a final test. In the online experiment, 175 subjects completed the same procedure. In the classroom study, 62 undergraduate students took quizzes as part of class lectures. Short-answer practice questions appeared either throughout the lectures (interspersed condition) or at the end of the lectures (at-the-end condition). Nineteen days after the last quiz, students were given a surprise final test. Results from the 3 experiments converge in demonstrating an advantage for interspersing practice questions on the initial tests, but an absence of this advantage on the final test. (c) 2016 APA, all rights reserved).

CAD-supported university course on photonics and fiber optic communications

NASA Astrophysics Data System (ADS)

Chan, David K. C.; Richter, Andre

2002-05-01

The highly competitive global photonics industry has created a significant demand for professional Photonic Design Automation (PDA) tools and personnel trained to use them effectively. In such a dynamic field, CAD-supported courses built around widely used industrial PDA tools provide many advantages, especially when offered through tertiary education institutions (which are ideally suited to producing the future workforce of the Photonics industry). An objective of VPIsystems' University program is to develop tertiary level courses based on VPIsystems' WDM transmission and component modeling software tools. Advantages offered by such courses include: visualizing and aiding the understanding of complex physical problems encountered in the design of fiber-optic communication systems; virtual laboratory exercises that can accurately reproduce the behavior of real systems and components without the prohibitive infrastructure and maintenance costs of real laboratories; flexibility in studying interrelated physical effects individually or in combination to facilitate learning; provide expertise and practical insights in areas, including industry-focused topics, that are not generally covered in traditional tertiary courses; provide exposure to, currently, the most widely used PDA tools in the industry. In this paper, details of VPIsystems' University program and its CAD-supported Photonics courses will be presented.

Advantages and limitations of Internet-based interventions for common mental disorders

PubMed Central

Andersson, Gerhard; Titov, Nickolai

2014-01-01

Several Internet interventions have been developed and tested for common mental disorders, and the evidence to date shows that these treatments often result in similar outcomes as in face-to-face psychotherapy and that they are cost-effective. In this paper, we first review the pros and cons of how participants in Internet treatment trials have been recruited. We then comment on the assessment procedures often involved in Internet interventions and conclude that, while online questionnaires yield robust results, diagnoses cannot be determined without any contact with the patient. We then review the role of the therapist and conclude that, although treatments including guidance seem to lead to better outcomes than unguided treatments, this guidance can be mainly practical and supportive rather than explicitly therapeutic in orientation. Then we briefly describe the advantages and disadvantages of treatments for mood and anxiety disorders and comment on ways to handle comorbidity often associated with these disorders. Finally we discuss challenges when disseminating Internet interventions. In conclusion, there is now a large body of evidence suggesting that Internet interventions work. Several research questions remain open, including how Internet interventions can be blended with traditional forms of care. PMID:24497236

Practical application to composite materials of a portable digital ultrasound device controlled by a microprocessor

NASA Astrophysics Data System (ADS)

Castel, J. G.; Husarek, V.

1987-06-01

The usefulness of a portable microprocessor-controlled ultrasound device for the periodic assessment of aircraft parts made of composite materials is shown. The performance of the device is demonstrated with the examples of a metallic honeycomb with a carbon-fiber skin, a phenolic honeycomb with a carbon skin, and a phenolic honeycomb with a Kevlar skin. Also considered are assessments of homogeneous carbon-fiber parts, including the study of artificial defects consisting of 1-2 mm diameter holes, and the assessment of the behavior of a carbon-titanium interface with separated zones. Advantages of the device include ease of adjustment, automated evaluation of the depth of defects, and the nearly-absolute reproducibility of adjustments.

[Therapeutic education didactic techniques].

PubMed

Valverde, Maite; Vidal, Mercè; Jansa, Margarida

2012-10-01

This article includes an introduction to the role of Therapeutic Education for Diabetes treatment according to the recommendations of the American Diabetes Association (ADA), the Diabetes Education Study Group (DESG) of the "European Association for Study of Diabetes (EASD) and the clinical Practice Guidelines (CPG) of the Spanish Ministry of Health. We analyze theoretical models and the differences between teaching vs. learning as well as current trends (including Internet), that can facilitate meaningful learning of people with diabetes and their families and relatives. We analyze the differences, similarities, advantages and disadvantages of individual and group education. Finally, we describe different educational techniques (metaplan, case method, brainstorming, role playing, games, seminars, autobiography, forums, chats,..) applicable to individual, group or virtual education and its application depending on the learning objective.

Molecular Markers Useful for Intraspecies Subtyping and Strain Differentiation of Dermatophytes.

PubMed

Mochizuki, Takashi; Takeda, Kiminobu; Anzawa, Kazushi

2017-02-01

Dermatophytosis is a very common skin disorder and the most frequent infection encountered by practicing dermatologists. The identification, pathogenicity, biology, and epidemiology of dermatophytes, the causative agents of dermatophytosis, are of interest for both dermatologists and medical mycologists. Recent advances in molecular methods have provided new techniques for identifying dermatophytes, including intraspecies variations. Intraspecies subtyping and strain differentiation have made possible the tracking of infections, the identification of common sources of infections, recurrence or reinfection after treatment, and analysis of strain virulence and drug resistance. This review describes molecular methods of intraspecies subtyping and strain differentiation, including analyses of mitochondrial DNA and non-transcribed spacer regions of ribosomal RNA genes, random amplification of polymorphic DNA, and microsatellite markers, along with their advantages and limitations.

Pharmacogenetics of novel oral anticoagulants: a review of identified gene variants & future perspectives.

PubMed

Ašić, Adna; Marjanović, Damir; Mirat, Jure; Primorac, Dragan

2018-05-16

Novel oral anticoagulants (NOACs) are becoming a therapy of choice in everyday clinical practice after almost 50 years during which warfarin and related coumarin derivatives were used as the main anticoagulants. Advantages of NOACs over standard anticoagulants include their predictable pharmacodynamics and pharmacokinetics, stable plasma concentrations and less drug-drug and food-drug interactions. However, pharmacogenetics has its place in administration of NOACs, as considerable interindividual variations have been detected. In this review, previous findings in pharmacogenetics of dabigatran, rivaroxaban, apixaban and edoxaban are summarized, along with recommendations for studying genes encoding metabolically important enzymes for four selected NOACs. Future directions include identification of clinically relevant SNPs, and change in optimum dosage for patients who are carriers of significant variants.

Lunar oxygen and metal for use in near-earth space - Magma electrolysis

NASA Technical Reports Server (NTRS)

Colson, Russell O.; Haskin, Larry A.

1990-01-01

The unique conditions on the moon, such as vacuum, absence of many reagents common on the earth, and presence of very nontraditional 'ores', suggest that a unique and nontraditional process for extracting materials from the ores may prove the most practical. An investigation has begun into unfluxed silicate electrolysis as a method for extracting oxygen, Fe, and Si from lunar regolith. The advantages of the process include simplicity of concept, absence of need to supply reagents from the earth, and low power and mass requirements for the processing plant. Disadvantages include the need for uninterrupted high temperature and the highly corrosive nature of the high-temperature silicate melts, which has made identifying suitable electrode and container materials difficult.

Advances in metabolome information retrieval: turning chemistry into biology. Part II: biological information recovery.

PubMed

Tebani, Abdellah; Afonso, Carlos; Bekri, Soumeya

2018-05-01

This work reports the second part of a review intending to give the state of the art of major metabolic phenotyping strategies. It particularly deals with inherent advantages and limits regarding data analysis issues and biological information retrieval tools along with translational challenges. This Part starts with introducing the main data preprocessing strategies of the different metabolomics data. Then, it describes the main data analysis techniques including univariate and multivariate aspects. It also addresses the challenges related to metabolite annotation and characterization. Finally, functional analysis including pathway and network strategies are discussed. The last section of this review is devoted to practical considerations and current challenges and pathways to bring metabolomics into clinical environments.

Quantum solution to a class of two-party private summation problems

NASA Astrophysics Data System (ADS)

Shi, Run-Hua; Zhang, Shun

2017-09-01

In this paper, we define a class of special two-party private summation (S2PPS) problems and present a common quantum solution to S2PPS problems. Compared to related classical solutions, our solution has advantages of higher security and lower communication complexity, and especially it can ensure the fairness of two parties without the help of a third party. Furthermore, we investigate the practical applications of our proposed S2PPS protocol in many privacy-preserving settings with big data sets, including private similarity decision, anonymous authentication, social networks, secure trade negotiation, secure data mining.

Approximate string matching algorithms for limited-vocabulary OCR output correction

NASA Astrophysics Data System (ADS)

Lasko, Thomas A.; Hauser, Susan E.

2000-12-01

Five methods for matching words mistranslated by optical character recognition to their most likely match in a reference dictionary were tested on data from the archives of the National Library of Medicine. The methods, including an adaptation of the cross correlation algorithm, the generic edit distance algorithm, the edit distance algorithm with a probabilistic substitution matrix, Bayesian analysis, and Bayesian analysis on an actively thinned reference dictionary were implemented and their accuracy rates compared. Of the five, the Bayesian algorithm produced the most correct matches (87%), and had the advantage of producing scores that have a useful and practical interpretation.

Practical adaptive quantum tomography

NASA Astrophysics Data System (ADS)

Granade, Christopher; Ferrie, Christopher; Flammia, Steven T.

2017-11-01

We introduce a fast and accurate heuristic for adaptive tomography that addresses many of the limitations of prior methods. Previous approaches were either too computationally intensive or tailored to handle special cases such as single qubits or pure states. By contrast, our approach combines the efficiency of online optimization with generally applicable and well-motivated data-processing techniques. We numerically demonstrate these advantages in several scenarios including mixed states, higher-dimensional systems, and restricted measurements. http://cgranade.com complete data and source code for this work are available online [1], and can be previewed at https://goo.gl/koiWxR.

A new image encryption algorithm based on the fractional-order hyperchaotic Lorenz system

NASA Astrophysics Data System (ADS)

Wang, Zhen; Huang, Xia; Li, Yu-Xia; Song, Xiao-Na

2013-01-01

We propose a new image encryption algorithm on the basis of the fractional-order hyperchaotic Lorenz system. While in the process of generating a key stream, the system parameters and the derivative order are embedded in the proposed algorithm to enhance the security. Such an algorithm is detailed in terms of security analyses, including correlation analysis, information entropy analysis, run statistic analysis, mean-variance gray value analysis, and key sensitivity analysis. The experimental results demonstrate that the proposed image encryption scheme has the advantages of large key space and high security for practical image encryption.

Effects of biotechnology on biodiversity: herbicide-tolerant and insect-resistant GM crops.

PubMed

Ammann, Klaus

2005-08-01

Biodiversity is threatened by agriculture as a whole, and particularly also by traditional methods of agriculture. Knowledge-based agriculture, including GM crops, can reduce this threat in the future. The introduction of no-tillage practices, which are beneficial for soil fertility, has been encouraged by the rapid spread of herbicide-tolerant soybeans in the USA. The replacement of pesticides through Bt crops is advantageous for the non-target insect fauna in test-fields. The results of the British Farm Scale experiment are discussed. Biodiversity differences can mainly be referred to as differences in herbicide application management.

Executive functions in mono- and bilingual children with language impairment - issues for speech-language pathology.

PubMed

Sandgren, Olof; Holmström, Ketty

2015-01-01

The clinical assessment of language impairment (LI) in bilingual children imposes challenges for speech-language pathology services. Assessment tools standardized for monolingual populations increase the risk of misinterpreting bilingualism as LI. This Perspective article summarizes recent studies on the assessment of bilingual LI and presents new results on including non-linguistic measures of executive functions in the diagnostic assessment. Executive functions shows clinical utility as less subjected to language use and exposure than linguistic measures. A possible bilingual advantage, and consequences for speech-language pathology practices and future research are discussed.

Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, and Pitfalls.

PubMed

Leischik, Roman; Littwitz, Henning; Dworrak, Birgit; Garg, Pankaj; Zhu, Meihua; Sahn, David J; Horlitz, Marc

2015-01-01

Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.

Symmetrical Josephson vortex interferometer as an advanced ballistic single-shot detector

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

Soloviev, I. I., E-mail: isol@phys.msu.ru; Lukin Scientific Research Institute of Physical Problems, 124460 Zelenograd, Moscow; Laboratory of Cryogenic Nanoelectronics, Nizhny Novgorod State Technical University n.a. R.E. Alekseev, 603950 Nizhny Novgorod

2014-11-17

We consider a ballistic detector formed in an interferometer manner which operational principle relies on Josephson vortex scattering at a measurement potential. We propose an approach to symmetrize the detector scheme and explore arising advantages in the signal-to-noise ratio and in the back-action on a measured object by means of recently presented numerical and analytical methods for modeling of a soliton scattering dynamics in the presence of thermal fluctuations. The obtained characteristics for experimentally relevant parameters reveal practical applicability of the considered schemes including possibility of coupling with standard digital rapid single flux quantum circuits.

Current concepts in the use of lasers in periodontal and implant dentistry

PubMed Central

Romanos, Georgios

2015-01-01

Lasers have various periodontal applications including calculus removal (Er: YAG, Er, Cr: YSGG lasers); soft tissue excision, incision and ablation; decontamination of root and implant surfaces; biostimulation; bacteria reduction; and osseous surgery. This paper reviews some of the major opportunities for using lasers in periodontal and implant specialty practices. The literature relating to the use of lasers for removal of the pocket epithelium, root conditioning, bacterial reduction and decontamination of infected implant surfaces is discussed, and a summary of the advantages and disadvantages of using lasers for periodontal treatment is provided. PMID:26644712

The impact of union elections on human resources management practices in hospitals.

PubMed

Deshpande, Satish P

2002-06-01

The purpose of this article is to explore top management's perceptions of how various human resources management (HRM) practices changed in hospitals (n = 101) after union elections. Significant increases in many HRM practices that are believed to lead to competitive advantage through human resources were reported in firms in which unions lost elections but not in firms where unions were certified.

Advantages and Disadvantages of Transtibial, Anteromedial Portal, and Outside-In Femoral Tunnel Drilling in Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Robin, Brett N; Jani, Sunil S; Marvil, Sean C; Reid, John B; Schillhammer, Carl K; Lubowitz, James H

2015-07-01

Controversy exists regarding the best method for creating the knee anterior cruciate ligament (ACL) femoral tunnel or socket. The purpose of this study was to systematically review the risks, benefits, advantages, and disadvantages of the endoscopic transtibial (TT) technique, anteromedial portal technique, outside-in technique, and outside-in retrograde drilling technique for creating the ACL femoral tunnel. A PubMed search of English-language studies published between January 1, 2000, and February 17, 2014, was performed using the following keywords: "anterior cruciate ligament" AND "femoral tunnel." Included were studies reporting risks, benefits, advantages, and/or disadvantages of any ACL femoral technique. In addition, references of included articles were reviewed to identify potential studies missed in the original search. A total of 27 articles were identified through the search. TT technique advantages include familiarity and proven long-term outcomes; disadvantages include the risk of nonanatomic placement because of constrained (TT) drilling. Anteromedial portal technique advantages include unconstrained anatomic placement; disadvantages include technical challenges, short tunnels or sockets, and posterior-wall blowout. Outside-in technique advantages include unconstrained anatomic placement; disadvantages include the need for 2 incisions. Retrograde drilling technique advantages include unconstrained anatomic placement, as well as all-epiphyseal drilling in skeletally immature patients; disadvantages include the need for fluoroscopy for all-epiphyseal drilling. There is no one, single, established "gold-standard" technique for creation of the ACL femoral socket. Four accepted techniques show diverse and subjective advantages, disadvantages, risks, and benefits. Level V, systematic review of Level II through V evidence. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Position and speed control of brushless DC motors using sensorless techniques and application trends.

PubMed

Gamazo-Real, José Carlos; Vázquez-Sánchez, Ernesto; Gómez-Gil, Jaime

2010-01-01

This paper provides a technical review of position and speed sensorless methods for controlling Brushless Direct Current (BLDC) motor drives, including the background analysis using sensors, limitations and advances. The performance and reliability of BLDC motor drivers have been improved because the conventional control and sensing techniques have been improved through sensorless technology. Then, in this paper sensorless advances are reviewed and recent developments in this area are introduced with their inherent advantages and drawbacks, including the analysis of practical implementation issues and applications. The study includes a deep overview of state-of-the-art back-EMF sensing methods, which includes Terminal Voltage Sensing, Third Harmonic Voltage Integration, Terminal Current Sensing, Back-EMF Integration and PWM strategies. Also, the most relevant techniques based on estimation and models are briefly analysed, such as Sliding-mode Observer, Extended Kalman Filter, Model Reference Adaptive System, Adaptive observers (Full-order and Pseudoreduced-order) and Artificial Neural Networks.

Home advantage in southern hemisphere rugby union: national and international.

PubMed

Morton R, Hugh

2006-05-01

This study evaluates home advantages both for national (Super 12) and international (Tri-nations) rugby union teams from South Africa, Australia and New Zealand, over the five-year period 2000 - 2004 using linear modelling. These home advantages are examined for statistical and practical significance, for variability between teams, for stability over time and for inter-correlation. These data reveal that the overall home advantage in elite rugby union has a mean of +6.7 points, and that this changes little from year to year. Closer scrutiny nevertheless reveals a high degree of variability. Different teams can and do have different home advantages, which ranges from a low of -0.7 to a high of +28.3 points in any one year. Furthermore, some team home advantages change up or down from one year to the next, by as much as -36.5 to +31.4 points at the extremes. There is no evidence that the stronger teams have the higher home advantages, or that a high home advantage leads to a superior finishing position in the competition.

Imaging Techniques in Endodontics: An Overview

PubMed Central

Deepak, B. S.; Subash, T. S.; Narmatha, V. J.; Anamika, T.; Snehil, T. K.; Nandini, D. B.

2012-01-01

This review provides an overview of the relevance of imaging techniques such as, computed tomography, cone beam computed tomography, and ultrasound, to endodontic practice. Many limitations of the conventional radiographic techniques have been overcome by the newer methods. Advantages and disadvantages of various imaging techniques in endodontic practice are also discussed. PMID:22530184

"Managed" Teacher Turnover: A Strategy for School Improvement

ERIC Educational Resources Information Center

Lewis, Jessica L.; London, Tim D.

2009-01-01

Given the negative implications of unmanaged teacher attrition for student learning and the potential of leadership actions to affect this dynamic, this article highlights the practices of one principal in the Chicago Public School (CPS) system who used teacher attrition to her school's advantage. Her actions reveal leadership practices that can…

Competency-Based Teaching of Shakespeare: How to Master "King Lear"

ERIC Educational Resources Information Center

Ribes, Purificación

2011-01-01

Shakespeare's hypotext has invited so many hypertextual transformations over the last four hundred years that twenty-first century students deserve the chance of digging into this rich mine of information and dramatic possibilities. The practical approach of a competency-based teaching method offers great advantages over traditional practices in…

Benefits of Reflective Practice

ERIC Educational Resources Information Center

Wagner, Kathi

2006-01-01

In this article, the author discusses what she was able to learn from an exercise in self-reflection regarding her teaching. She also discusses the advantages of reflection for administrators: First, a reflective practice is data-driven, making it a more valid way to evaluate administrators' knowledge and skills. Second, a reflective practice…

5 CFR 1830.6 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... unfair competitive advantage or diminish the utility of established examination procedures. OSC also... prohibited personnel practice, unlawful political activity, whistleblower disclosure, Uniformed Services...

High-frequency imaging radar for robotic navigation and situational awareness

NASA Astrophysics Data System (ADS)

Thomas, David J.; Luo, Changan; Knox, Robert

2011-05-01

With increasingly available high frequency radar components, the practicality of imaging radar for mobile robotic applications is now practical. Navigation, ODOA, situational awareness and safety applications can be supported in small light weight packaging. Radar has the additional advantage of being able sense through aerosols, smoke and dust that can be difficult for many optical systems. The ability to directly measure the range rate of an object is also an advantage in radar applications. This paper will explore the applicability of high frequency imaging radar for mobile robotics and examine a W-band 360 degree imaging radar prototype. Indoor and outdoor performance data will be analyzed and evaluated for applicability to navigation and situational awareness.

Non-Foster Circuits for High Performance Antennas: Advantages and Practical Limitations

NASA Astrophysics Data System (ADS)

Jacob, Minu Mariam

The demand for miniaturized, broadband communication systems has created a need for electrically small, broadband antennas. However, all passive electrically small antennas have a fundamental gain-bandwidth limitation related to their electrical size, as first described by Wheeler and Chu. This limitation can be overcome using active non-Foster circuits (negative inductors and/or negative capacitors), which can deliver a broadband input match with active matching techniques, or can help reduce phase dispersion using negative delay effects. This thesis will illustrate the advantages of non-Foster circuits in obtaining broadband small antennas, in addition to examining their practical limitations due to noise in receive applications, and nonlinearity in transmit applications.

Bar code, good for industry and trade--how does it benefit the dentist?

PubMed

Oehlmann, H

2001-10-01

Every dentist who attentively follows the change in product labelling can easily see that the HIBC bar code is on the increase. In fact, according to information from FIDE/VDDI and ADE/BVD, the dental industry and trade are firmly resolved to apply the HIBC bar code to all products used internationally in dental practices. Why? Indeed, at first it looks like extra expense to additionally print a bar code on the packages. Good reasons can only lie in advantages which manufacturers and the trade expect from the HIBC bar code, Indications in dental technician circles are that the HIBC bar code is coming. If there are advantages, what are these, and can the dentist also profit from them? What does HIBC bar code mean and what items of interest does it include? What does bar code cost and does only one code exist? This is explained briefly, concentrating on the benefits bar code can bring for different users.

From Athletes to Astrophysicists: Gender Differences in Patterns and Predictors of Career Aspirations in Pre-Adolescence

PubMed Central

Perry, Brea L.; Morris, Edward W.; Link, Tanja C.; Leukefeld, Carl

2017-01-01

This paper adds to research on girls’ growing educational advantage by examining gender differences in career paths. Using baseline data from an intervention study (TRY-IT!) targeting 265 sixth-graders in Title I schools, our research traces adolescent career aspirations by gender, race and class. Additionally, we investigate whether girls and boys exhibit differential sensitivity to environmental risk and protective factors that shape career and educational aspirations. We find that the career choices of boys vary more widely by social context, including socioeconomic status, race, and academic resources. Specifically, among youth with fewer social and academic advantages, girls aspire to more practical careers and careers which require higher levels of educational attainment relative to boys. The findings reveal how sources of inequality such as race and class shape gendered aspirations and complicate gender inequality. We reason that boys’ choices are more volatile and socially contingent because of the emphasis on high-status careers as a signifier of masculinity. PMID:28540079

Synthesis of Conformal Phased Antenna Arrays With A Novel Multiobjective Invasive Weed Optimization Algorithm

NASA Astrophysics Data System (ADS)

Li, Wen Tao; Hei, Yong Qiang; Shi, Xiao Wei

2018-04-01

By virtue of the excellent aerodynamic performances, conformal phased arrays have been attracting considerable attention. However, for the synthesis of patterns with low/ultra-low sidelobes of the conventional conformal arrays, the obtained dynamic range ratios of amplitude excitations could be quite high, which results in stringent requirements on various error tolerances for practical implementation. Time-modulated array (TMA) has the advantages of low sidelobe and reduced dynamic range ratio requirement of amplitude excitations. This paper takes full advantages of conformal antenna arrays and time-modulated arrays. The active-element-pattern, including element mutual coupling and platform effects, is employed in the whole design process. To optimize the pulse durations and the switch-on instants of the time-modulated elements, multiobjective invasive weed optimization (MOIWO) algorithm based on the nondominated sorting of the solutions is proposed. A S-band 8-element cylindrical conformal array is designed and a S-band 16-element cylindrical-parabolic conformal array is constructed and tested at two different steering angles.

A wireless trust model for healthcare.

PubMed

Wickramasinghe, Nilmini; Misra, Santosh K

2004-01-01

In today's context of escalating costs, managed care, regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and a technology savvy patient, the healthcare industry can no longer be complacent regarding embracing technologies to enable better, more effective and efficient practice management. In such an environment, many healthcare organisations are turning to m-commerce or wireless solutions. These solutions, in particular the mobile electronic patient record, have many advantages over their wired counterparts, including significant cost advantages, higher levels of physician acceptance, more functionalities as well as enabling easy accessibility to healthcare in remote geographic regions, however, they also bring with them challenges of their own. One such major challenge is security. To date, few models exist that help establish an appropriate framework, in the context of wireless in healthcare, in which to understand and evaluate all the security issues let alone facilitate the development of systematic and robust solutions. Our paper addresses this need by outlining an appropriate mobile trust model for such a scenario in healthcare organisations.

Wavelet Packet Feature Assessment for High-Density Myoelectric Pattern Recognition and Channel Selection toward Stroke Rehabilitation.

PubMed

Wang, Dongqing; Zhang, Xu; Gao, Xiaoping; Chen, Xiang; Zhou, Ping

2016-01-01

This study presents wavelet packet feature assessment of neural control information in paretic upper limb muscles of stroke survivors for myoelectric pattern recognition, taking advantage of high-resolution time-frequency representations of surface electromyogram (EMG) signals. On this basis, a novel channel selection method was developed by combining the Fisher's class separability index and the sequential feedforward selection analyses, in order to determine a small number of appropriate EMG channels from original high-density EMG electrode array. The advantages of the wavelet packet features and the channel selection analyses were further illustrated by comparing with previous conventional approaches, in terms of classification performance when identifying 20 functional arm/hand movements implemented by 12 stroke survivors. This study offers a practical approach including paretic EMG feature extraction and channel selection that enables active myoelectric control of multiple degrees of freedom with paretic muscles. All these efforts will facilitate upper limb dexterity restoration and improved stroke rehabilitation.

Family presence during resuscitation: A descriptive study with Iranian nurses and patients' family members.

PubMed

Zali, Mahnaz; Hassankhani, Hadi; Powers, Kelly A; Dadashzadeh, Abbas; Rajaei Ghafouri, Rouzbeh

2017-09-01

Family presence during resuscitation (FPDR) has advantages for the patients' family member to be present at the bedside. However, FPDR is not regularly practiced by nurses, especially in low to middle income countries. The purpose of this study was to determine Iranian nurses' and family members' attitudes towards FPDR. In a descriptive study, data was collected from the random sample of 178 nurses and 136 family members in four hospitals located in Iran. A 27-item questionnaire was used to collect data on attitudes towards FPDR, and descriptive and correlational analyses were conducted. Of family members, particularly the women, 57.2% (n=78) felt it is their right to experience FPDR and that it has many advantages for the family; including the ability to see that everything was done and worry less. However, 62.5% (n=111) of the nurses disagreed with an adult implementation of FPDR. Nurses perceived FPDR to have many disadvantages. Family members becoming distressed and interfering with the patient which may prolong the resuscitation effort. Nurses with prior education on FPDR were more willing to implement it. FPDR was desired by the majority of family members. To meet their needs, it is important to improve Iranian nurses' views about the advantages of the implementation of FPDR. Education on FPDR is recommended to improve Iranian nurses' views about the advantages of the implementation of FPDR. Copyright © 2017 Elsevier Ltd. All rights reserved.

Function Biomedical Informatics Research Network Recommendations for Prospective Multi-Center Functional Magnetic Resonance Imaging Studies

PubMed Central

Glover, Gary H.; Mueller, Bryon A.; Turner, Jessica A.; van Erp, Theo G.M.; Liu, Thomas T.; Greve, Douglas N.; Voyvodic, James T.; Rasmussen, Jerod; Brown, Gregory G.; Keator, David B.; Calhoun, Vince D.; Lee, Hyo Jong; Ford, Judith M.; Mathalon, Daniel H.; Diaz, Michele; O’Leary, Daniel S.; Gadde, Syam; Preda, Adrian; Lim, Kelvin O.; Wible, Cynthia G.; Stern, Hal S.; Belger, Aysenil; McCarthy, Gregory; Ozyurt, Burak; Potkin, Steven G.

2011-01-01

This report provides practical recommendations for the design and execution of Multi-Center functional Magnetic Resonance Imaging (MC-fMRI) studies based on the collective experience of the Function Biomedical Informatics Research Network (FBIRN). The paper was inspired by many requests from the fMRI community to FBIRN group members for advice on how to conduct MC-fMRI studies. The introduction briefly discusses the advantages and complexities of MC-fMRI studies. Prerequisites for MC-fMRI studies are addressed before delving into the practical aspects of carefully and efficiently setting up a MC-fMRI study. Practical multi-site aspects include: (1) establishing and verifying scan parameters including scanner types and magnetic fields, (2) establishing and monitoring of a scanner quality program, (3) developing task paradigms and scan session documentation, (4) establishing clinical and scanner training to ensure consistency over time, (5) developing means for uploading, storing, and monitoring of imaging and other data, (6) the use of a traveling fMRI expert and (7) collectively analyzing imaging data and disseminating results. We conclude that when MC-fMRI studies are organized well with careful attention to unification of hardware, software and procedural aspects, the process can be a highly effective means for accessing a desired participant demographics while accelerating scientific discovery. PMID:22314879

Trazodone Addition to Paroxetine and Mirtazapine in a Patient with Treatment-Resistant Depression: The Pros and Cons of Combining Three Antidepressants

PubMed Central

Alves, José Carlos; Rego, Raquel Garcia

2016-01-01

Dual antidepressant combination for treatment-resistant depression is a strategy well supported by literature and accepted in clinical practice. Rather, the usefulness of the combination of more than two antidepressants is controversial. This may be related to the possibility of higher side-effect burden and to doubts about its pharmacological effectiveness and therapeutic advantage compared to other standard treatment options. We report a relapse of moderate-to-severe depressive symptoms with insomnia that successfully remitted after the addition of trazodone to a dual combination of paroxetine and mirtazapine (in standard effective doses) in a patient with treatment-resistant depression. We also review the literature and discuss the utility of triple antidepressant combination in treatment-resistant depression. This clinical case highlights the utility of combining trazodone as a third antidepressant for the relapse of depressive symptoms after the failure of a dual antidepressant combination. Trazodone may be advantageous in patients presenting recurrence of moderate-to-severe depressive symptoms that include sleep problems and/or insomnia and may be particularly useful when benzodiazepines are not recommended. Although its use may be controversial and associated with higher risk of side-effects, more investigation is needed to determine the efficacy and safety for triple antidepressant combinations as reliable strategies for treatment-resistant depression in clinical practice. PMID:27807450

The Good Clinical Practice guideline and its interpretation - perceptions of clinical trial teams in sub-Saharan Africa.

PubMed

Vischer, N; Pfeiffer, C; Joller, A; Klingmann, I; Ka, A; Kpormegbe, S K; Burri, C

2016-08-01

To explore the advantages and challenges of working with the Good Clinical Practice (GCP)-International Conference of Harmonization (ICH) E6 guideline and its interpretation from the perspective of clinical trial teams based in sub-Saharan Africa. We conducted 60 key informant interviews with clinical trial staff at different levels in clinical research centres in Kenya, Ghana, Burkina Faso and Senegal and thematically analysed the responses. Clinical trial teams perceived working with ICH-GCP as highly advantageous and regarded ICH-GCP as applicable to their setting and efficiently applied. Only for informed consent did some clinical trial staff (one-third) perceive the guideline as insufficiently applicable. Specific challenges included meeting the requirements for written and individual consent, conditions for impartial witnesses for illiterates or legally acceptable representatives for children, guaranteeing voluntary participation and ensuring full understanding of the consent given. It was deemed important to have ICH-GCP compliance monitored by relevant ethics committees and regulatory authorities, without having guidelines applied overcautiously. Clinical trial teams in sub-Saharan Africa perceived GCP as a helpful guideline, despite having been developed by northern organisations and despite the high administrative burden of implementing it. To mitigate consent challenges, we suggest adapting GCP and making use of the flexibility it offers. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

An Experiment on Prediction Markets in Science

PubMed Central

Almenberg, Johan; Kittlitz, Ken; Pfeiffer, Thomas

2009-01-01

Prediction markets are powerful forecasting tools. They have the potential to aggregate private information, to generate and disseminate a consensus among the market participants, and to provide incentives for information acquisition. These market functionalities can be very valuable for scientific research. Here, we report an experiment that examines the compatibility of prediction markets with the current practice of scientific publication. We investigated three settings. In the first setting, different pieces of information were disclosed to the public during the experiment. In the second setting, participants received private information. In the third setting, each piece of information was private at first, but was subsequently disclosed to the public. An automated, subsidizing market maker provided additional incentives for trading and mitigated liquidity problems. We find that the third setting combines the advantages of the first and second settings. Market performance was as good as in the setting with public information, and better than in the setting with private information. In contrast to the first setting, participants could benefit from information advantages. Thus the publication of information does not detract from the functionality of prediction markets. We conclude that for integrating prediction markets into the practice of scientific research it is of advantage to use subsidizing market makers, and to keep markets aligned with current publication practice. PMID:20041139

Sustaining Competitive Advantage: Mental Models and Organizational Learning for Future Marines

DTIC Science & Technology

2007-01-01

Soft Systems Methodology : Other Voices.” Systemic Practice and Action Research. 13, no. 6, (2000): 773. Larsen, Kai R. T., Claire McInerney...30. Mingers, John. “An Idea Ahead of Its Time: The History and Development of Soft Systems Methodology .” Systemic Practice and Action...Soft System Dynamics Methodology (SSDM): Combinging Soft Systems Methodology (SSM) and System Dynamics (SD).” Systemic Practice and Action

Dirt and diarrhoea: formative research in hygiene promotion programmes.

PubMed

Curtis, V; Kanki, B; Cousens, S; Sanou, A; Diallo, I; Mertens, T

1997-06-01

Investment in the promotion of better hygiene for the prevention of diarrhoeal diseases and as a component of water and sanitation programmes is increasing. Before designing programmes capable of sustainably modifying hygiene behaviour in large populations, valid answers to a number of basic questions concerning the site and the intended beneficiaries have to be obtained. Such questions include 'what practices favour the transmission of enteric pathogens?', 'what advantages will be perceived by those who adopt safe practices?' and 'what channels of communication are currently employed by the target population?' A study of hygiene and diarrhoea in Bobo-Dioulasso, Burkina Faso, used a mixture of methods to address such questions. This paper draws on that experience to propose a plan of preliminary research using a variety of techniques which could be implemented over a period of a few months by planners of hygiene promotion programmes. The techniques discussed include structured observation, focus group discussions and behavioural trials. Modest investment in such systematic formative research with clear and limited goals is likely to be repaid many times over in the increased effectiveness of hygiene promotion programmes.

Positive feelings during pregnancy, early feeding practices, and infant health.

PubMed

McManus, Melissa A; Khalessi, Ali A; Lin, Joyce; Ashraf, Jahanzeb; Reich, Stephanie M

2017-05-01

Early parenting practices, such as infant feeding, can affect children's physical health. Additionally, negative prenatal maternal affect can influence feeding choices, such as breast-feeding, and can have a detrimental effect on children's health. Little is known, however, about the contribution of positive maternal affect during pregnancy on feeding practices and children's health. This study explored whether positive prenatal feelings influenced children's health during the first 18 months, and whether early feeding practices mediated the relationship between these two variables. Low-income, ethnically diverse, primiparous women (n = 114) reported their feelings of pregnancy uplifts and hassles during their third trimester. These women were interviewed again at 2, 4, 6, 9, 12, and 18 months post-partum about their feeding practices. A retrospective audit of their infants' medical charts was completed from birth to 18 months. Using structural equation modeling, having more uplifts than hassles during pregnancy was associated with longer breast-feeding duration and greater adherence to recommended schedules for introducing fruits and vegetables, solids, and baby cereal. These feeding practices were linked to better child health outcomes, including reduced risk of upper respiratory tract infections, conjunctivitis, otitis media, and thrush. Positive maternal feelings during pregnancy were associated with better feeding practices, and these better feeding practices were associated with fewer common childhood illnesses. Helping expectant women focus on the positive aspects of their pregnancy may lead to postnatal care methods that are fiscally advantageous, preventive of detrimental postnatal choices, and medically beneficial for children. © 2016 Japan Pediatric Society.

Accessible magnetic resonance imaging.

PubMed

Kaufman, L; Arakawa, M; Hale, J; Rothschild, P; Carlson, J; Hake, K; Kramer, D; Lu, W; Van Heteren, J

1989-10-01

The cost of magnetic resonance imaging (MRI) is driven by magnetic field strength. Misperceptions as to the impact of field strength on performance have led to systems that are more expensive than they need to be. Careful analysis of all the factors that affect diagnostic quality lead to the conclusion that field strength per se is not a strong determinant of system performance. Freed from the constraints imposed by high-field operation, it is possible to exploit a varied set of opportunities afforded by low-field operation. In addition to lower costs and easier siting, we can take advantage of shortened T1 times, higher contrast, reduced sensitivity to motion, and reduced radiofrequency power deposition. These conceptual advantages can be made to coalesce onto practical imaging systems. We describe a low-cost MRI system that utilizes a permanent magnet of open design. Careful optimization of receiving antennas and acquisition sequences permit performance levels consistent with those needed for an effective diagnostic unit. Ancillary advantages include easy access to the patient, reduced claustrophobia, quiet and comfortable operation, and absence of a missile effect. The system can be sited in 350 sq ft and consumes a modest amount of electricity. MRI equipment of this kind can widen the population base than can access this powerful and beneficial diagnostic modality.

Risk-sharing agreements, present and future

PubMed Central

Gonçalves, Francisco R; Santos, Susana; Silva, Catarina; Sousa, Gabriela

2018-01-01

Risk-sharing agreements between pharmaceutical companies and payers stand out as a recent practice, the use of which has been increasing in the case of innovative medicines, particularly in the field of oncology, which aims to ensure better budgetary control and a lower risk of spending on medicinal products without full evidence of clinical benefit. In this article, the authors discuss the types of existing agreements, as well as those used in Portugal, their advantages, disadvantages and future challenges of implementation, as well as their potential role in access to therapeutic innovation, namely medicines for cancer treatment. For this purpose, a nonsystematic review of indexed and nonconventional literature was carried out. There is a tendency for the risk-sharing agreements established between payers and pharmaceutical companies to include a component of monitoring the use of medicines and outcomes measurement, involving real life data collection. Portugal is no exception and, although most agreements are still financial in nature, there is already a strong desire for other agreements, in particular clinical outcomes based. It is concluded that there is not yet a gold standard methodology in relation to the type of agreements to be practiced. Moreover, its opportunity cost, including the cost of implementation, remains to be scrutinised. However, regardless of the type of agreement, the advantages of adopting these agreements are well known, inevitably related with challenges of implementation. The need for an infrastructure to support information sharing is undisputed and urgent. The future of therapeutic innovation and increased pressure on health budgets will require alternative, more flexible models, personalized reimbursement models that allow alignment of medicines prices with the value they deliver in treating the several diseases. PMID:29743943

Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

PubMed

Kogi, Kazutaka

2006-01-01

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

Mixed-methods research in pharmacy practice: basics and beyond (part 1).

PubMed

Hadi, Muhammad Abdul; Alldred, David Phillip; Closs, S José; Briggs, Michelle

2013-10-01

This is the first of two papers which explore the use of mixed-methods research in pharmacy practice. In an era of evidence-based medicine and policy, high-quality research evidence is essential for the development of effective pharmacist-led services. Over the past decade, the use of mixed-methods research has become increasingly common in healthcare, although to date its use has been relatively limited in pharmacy practice research. In this article, the basic concepts of mixed-methods research including its definition, typologies and advantages in relation to pharmacy practice research are discussed. Mixed-methods research brings together qualitative and quantitative methodologies within a single study to answer or understand a research problem. There are a number of mixed-methods designs available, but the selection of an appropriate design must always be dictated by the research question. Importantly, mixed-methods research should not be seen as a 'tool' to collect qualitative and quantitative data, rather there should be some degree of 'integration' between the two data sets. If conducted appropriately, mixed-methods research has the potential to generate quality research evidence by combining strengths and overcoming the respective limitations of qualitative and quantitative methodologies. © 2012 Royal Pharmaceutical Society.

Implementation of Audio Computer-Assisted Interviewing Software in HIV/AIDS Research

PubMed Central

Pluhar, Erika; Yeager, Katherine A.; Corkran, Carol; McCarty, Frances; Holstad, Marcia McDonnell; Denzmore-Nwagbara, Pamela; Fielder, Bridget; DiIorio, Colleen

2007-01-01

Computer assisted interviewing (CAI) has begun to play a more prominent role in HIV/AIDS prevention research. Despite the increased popularity of CAI, particularly audio computer assisted self-interviewing (ACASI), some research teams are still reluctant to implement ACASI technology due to lack of familiarity with the practical issues related to using these software packages. The purpose of this paper is to describe the implementation of one particular ACASI software package, the Questionnaire Development System™ (QDS™), in several nursing and HIV/AIDS prevention research settings. We present acceptability and satisfaction data from two large-scale public health studies in which we have used QDS with diverse populations. We also address issues related to developing and programming a questionnaire, discuss practical strategies related to planning for and implementing ACASI in the field, including selecting equipment, training staff, and collecting and transferring data, and summarize advantages and disadvantages of computer assisted research methods. PMID:17662924

Endoscopic submucosal dissection in the West: Current status and future directions.

PubMed

Ma, Michael X; Bourke, Michael J

2018-05-01

Endoscopic submucosal dissection (ESD) was first conceptually described almost 30 years ago in Japan and is now widely practiced throughout East Asia. ESD expands the boundaries of endoscopic resection (ER) by allowing en bloc resection of large early neoplastic lesions within the gastrointestinal tract (GIT). This offers advantages over other ER techniques by facilitating definitive histological staging and curative treatment of early cancer in selected cases. Indeed, the experience of ESD in Eastern countries is significant, and excellent outcomes from high-volume centers are reported. The potential benefits of ESD are recognized by Western endoscopists, but its adoption has been limited. A number of factors contribute to this, including epidemiological differences in GIT neoplasia between Western and Eastern populations and limitations in training opportunities. In this review, we discuss the role of ESD, its current status and the future in Western endoscopic practice. © 2017 Japan Gastroenterological Endoscopy Society.

ACR-SPR-STR Practice Parameter for the Performance of Cardiac Positron Emission Tomography - Computed Tomography (PET/CT) Imaging.

PubMed

Subramaniam, Rathan M; Janowitz, Warren R; Johnson, Geoffrey B; Lodge, Martin A; Parisi, Marguerite T; Ferguson, Mark R; Hellinger, Jeffrey C; Gladish, Gregory W; Gupta, Narainder K

2017-12-01

This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death. Optimum utility of cardiac PET/CT is achieved when images are interpreted in conjunction with clinical information and laboratory data. Measurement of myocardial blood flow, coronary flow reserve and detection of balanced ischemia are significant advantages of cardiac PET perfusion studies. Increasingly cardiac PET/CT is used in diagnosis and treatment response assessment for cardiac sarcoidosis.

[Reflection of the evidence-based medicine's principles in the Russian consensus documents on angiology and vascular surgery].

PubMed

Pokrovskiĭ, A V; Sapelkin, S V

2009-01-01

Analysed herein are the consensus documents concerning angiology and vascular surgery worked out and adopted in Russia. This is followed by a detailed description of the methodology used while their development, underlying their significance for medical practice and pointing out their strict compliance with the principles of evidence-based medicine. Emphasis is laid on the thesis that the consensus guidelines worked out by the leading specialists, like any rules and norms, contribute favourably to making appropriate decisions by the practicing clinical physicians and may serve as a basis for creation of the branch standards. Also shown are advantages and shortcomings of the adopted documents in angiology, including phlebology, and finally announced is a forthcoming meeting of the Russian experts, devoted to the development of the consensus document entitled "Russian Clinical Guidelines on Diagnosis and Treatment of Chronic Venous Diseases".

Entanglement-enhanced quantum metrology in a noisy environment

NASA Astrophysics Data System (ADS)

Wang, Kunkun; Wang, Xiaoping; Zhan, Xiang; Bian, Zhihao; Li, Jian; Sanders, Barry C.; Xue, Peng

2018-04-01

Quantum metrology overcomes standard precision limits and plays a central role in science and technology. Practically, it is vulnerable to imperfections such as decoherence. Here we demonstrate quantum metrology for noisy channels such that entanglement with ancillary qubits enhances the quantum Fisher information for phase estimation but not otherwise. Our photonic experiment covers a range of noise for various types of channels, including for two randomly alternating channels such that assisted entanglement fails for each noisy channel individually. We simulate noisy channels by implementing space-multiplexed dual interferometers with quantum photonic inputs. We demonstrate the advantage of entanglement-assisted protocols in a phase estimation experiment run with either a single-probe or multiprobe approach. These results establish that entanglement with ancillae is a valuable approach for delivering quantum-enhanced metrology. Our approach to entanglement-assisted quantum metrology via a simple linear-optical interferometric network with easy-to-prepare photonic inputs provides a path towards practical quantum metrology.

Evaluating knowledge transfer practices among construction organization in Malaysia

NASA Astrophysics Data System (ADS)

Zaidi, Mohd Azian; Baharuddin, Mohd Nurfaisal; Bahardin, Nur Fadhilah; Yasin, Mohd Fadzil Mat; Nawi, Mohd Nasrun Mohd; Deraman, Rafikullah

2016-08-01

The aims of this paper is to identify a key dimension of knowledge transfer component to improve construction organization performance. It investigates the effectiveness of present knowledge transfer practices currently adopted by the Malaysian construction organizations and examines the relationship between knowledge transfer factors and organizational factors. A survey among 151 respondents including a different contractor registration grade was employed for the study. The survey shows that a seven-teen (17) factors known as creating shared awareness for information sharing, communication, personal skills,individual attitude,training, organizational culture, information technology,motivation, monitoring and supervision, service quality,information accessibility, information supply, socialization process,knowledge tools, coaching and monitoring, staff briefing and information sharing were identify as a key dimension for knowledge transfer success. This finding suggest that through improvement of each factor, the recognition of the whole strategic knowledge transfer process can be increase thus helping to strengthen the Malaysian construction organization for competitive advantages.

A practical guide and perspectives on the use of experimental pain modalities with children and adolescents

PubMed Central

Birnie, Kathryn A; Caes, Line; Wilson, Anna C; Williams, Sara E; Chambers, Christine T

2014-01-01

SUMMARY Use of experimental pain is vital for addressing research questions that would otherwise be impossible to examine in the real world. Experimental induction of pain in children is highly scrutinized given the potential for harm and lack of direct benefit to a vulnerable population. However, its use has critically advanced our understanding of the mechanisms, assessment and treatment of pain in both healthy and chronically ill children. This article introduces various experimental pain modalities, including the cold pressor task, the water load symptom provocation test, thermal pain, pressure pain and conditioned pain modulation, and discusses their application for use with children and adolescents. It addresses practical implementation and ethical issues, as well as the advantages and disadvantages offered by each task. The incredible potential for future research is discussed given the array of experimental pain modalities now available to pediatric researchers. PMID:24641434

Family and cultural influences on sleep development.

PubMed

Giannotti, Flavia; Cortesi, Flavia

2009-10-01

Sleep is a biopsychosocial process that is influenced by the complex interaction of biologic rhythms, including sleep homeostatic mechanisms, chronobiologic factors, parenting, and temperament. However, family structure, culturally specific values, and beliefs are all elements that impact the ecology of a child's sleep. Dramatic demographic changes in many countries have been witnessed in recent years, which have resulted in health professionals and pediatricians being confronted with families of widely differing cultural origins. Attitudes and beliefs on infant sleeping strongly influence whether or not infant sleep behavior is perceived as problematic. Thus, it is advantageous to explore a child's sleep behavior in a multicultural setting. Cultural comparisons are of intrinsic value because they allow not only a better understanding of sleep in different contexts but also an evaluation of the eventual benefits and consequences of different cultural sleep practices. This article provides an overview of some specific sleep-related behaviors and practices highly influenced by different cultural contexts.

Volumetric modulated arc therapy: a review of current literature and clinical use in practice

PubMed Central

Teoh, M; Clark, C H; Wood, K; Whitaker, S; Nisbet, A

2011-01-01

Volumetric modulated arc therapy (VMAT) is a novel radiation technique, which can achieve highly conformal dose distributions with improved target volume coverage and sparing of normal tissues compared with conventional radiotherapy techniques. VMAT also has the potential to offer additional advantages, such as reduced treatment delivery time compared with conventional static field intensity modulated radiotherapy (IMRT). The clinical worldwide use of VMAT is increasing significantly. Currently the majority of published data on VMAT are limited to planning and feasibility studies, although there is emerging clinical outcome data in several tumour sites. This article aims to discuss the current use of VMAT techniques in practice and review the available data from planning and clinical outcome studies in various tumour sites including prostate, pelvis (lower gastrointestinal, gynaecological), head and neck, thoracic, central nervous system, breast and other tumour sites. PMID:22011829

Travel medicine and general practice: a suitable case for audit?

PubMed Central

Sloan, D S

1993-01-01

Travel medicine becomes more important with the continual expansion of international travel and the increased popularity of exotic holiday destinations. In the United Kingdom general practitioners provide the bulk of travel health advice and immunisation and there is growing interest in providing these services. While their armamentarium has been expanded with attractive but expensive new vaccines, the need for health service advice has never been more vital, with the risks of HIV infection and drug resistant malaria. Advantages of a general practice based travel medicine service include maintaining continuity of care for the patient, but a disadvantage might be that the general practitioner sees too few patients to acquire enough skill in the subject. Furthermore, there may be a conflict of interest between time devoted to the "vaccination ritual" and giving health advice. Overall there seems to be a case for both audit and support by the health authorities. Images p616-a PMID:8401022

Implementing portfolio in postgraduate general practice training. Benefits and recommendations.

PubMed

Alotaibi, Fawaz S

2012-10-01

This paper presents a review to explore the literature focusing on portfolio in postgraduate general practice (GP) training, and to examine the impact of implementation of portfolio on learning process, as well as proposing recommendations for its implementation in postgraduate GP training. An electronic search was carried out on several databases for studies addressing portfolio in postgraduate GP training. Six articles were included to address specifically the effectiveness of portfolio in postgraduate GP training. Five of them described successful experiences of portfolio-based learning implementation. Only one article addressed portfolio-based assessment in postgraduate GP training. The existing evidence provides various benefits of professional portfolio-based learning. It does appear to have advantages of stimulating reflective learning, promoting proactive learning, and bridging the hospital experiences of the learners to GP. Moreover, the challenges to implementation of portfolio-based learning are often based on orientation and training of stakeholders.

Researching health inequalities with Community Researchers: practical, methodological and ethical challenges of an 'inclusive' research approach.

PubMed

Salway, Sarah; Chowbey, Punita; Such, Elizabeth; Ferguson, Beverly

2015-01-01

Public health research sometimes uses members of communities as researchers. These are called Community Researchers. The advantage of using Community Researchers is that it enables people who live in communities to participate in research by designing the research, gathering data and being involved in analysis. This 'participatory' approach also has the potential to reach communities that might otherwise not be included in research. There are few studies that report the experiences of Community Researchers who take part in such research. This study helps fill this gap by exploring the issues and challenges faced by Community Researchers involved in a study of health and poverty in ethnically mixed areas of east London, UK. Through the accounts of 12 researchers, the study reveals that being a community 'insider' had advantages: many felt they had been able to gain the trust of respondents and access people for the research that would have otherwise been missed. The role of Community Researcher was, however, difficult to manage with some researchers feeling burdened by their role and the increased knowledge they had about the lives of those in their community. In addition to the personal challenges for the Community Researchers, the findings raise various ethical and methodological issues that need consideration in participatory research. Background Inclusive research approaches are increasingly employed by public health researchers. Recent methodological development includes the engagement of Community Researchers (CRs), who use their knowledge and networks to facilitate research with the community with which they identify. Few studies have explored the experiences of CRs in the research process, an important element of any comprehensive assessment of the pros and cons of such research endeavours. We report here on the experiences of CRs engaged in a study of health inequalities and poverty in ethnically diverse and disadvantaged areas of London, UK. Methods We draw on the experiences of 12 CRs. Two sets of data were generated, analysed and integrated: debriefing/active reflection exercises throughout the 18-month research process and individual qualitative interviews with CRs, conducted at the end of the project ( n  = 9). Data were organised using NVivo10 and coded line-by-line using a framework developed iteratively. Synthesis and interpretation were achieved through a series of reflective team exercises involving input from 4 of the CRs. Final consolidation of key themes was conducted by SS and ES. Results Being an 'insider' to the communities brought distinct advantages to the research process but also generated complexities. CRs highlighted how 'something would be lost' without their involvement but still faced challenges in gathering and analysing data. Some CRs found it difficult to practice reflexivity, and problems of ethnic stereotyping were revealed. Conflict between roles as community members and investigators was at times problematic. The approach promoted some aspects of personal empowerment, but CRs were frustrated by the limited impact of the research at the local level. Conclusions Working with CRs offers distinct practical, ethical and methodological advantages to public health researchers, but these are limited by a range of challenges related to 'closeness', orthodox research structures and practices and the complexities of dynamic identities. For research of this type to meet its full potential and avoid harm, there is a need for careful support to CRs and long-term engagement between funders, research institutions and communities.

The Effects of Practice with Prescribed Reading Glasses on Students with Low Vision.

ERIC Educational Resources Information Center

Smith, Janice K.; Erin, Jane N.

2002-01-01

A study investigated effects of regular instruction and practice with prescription reading glasses with three adolescents with low vision. Two students demonstrated no advantage in reading large print and one student experienced a decreased reading rate using standard print and reading glasses. Students preferred reading standard print with…

Retrieval Practice Makes Procedure from Remembering: An Automatization Account of the Testing Effect

ERIC Educational Resources Information Center

Racsmány, Mihály; Szollosi, Ágnes; Bencze, Dorottya

2018-01-01

The "testing effect" refers to the striking phenomenon that repeated retrieval practice is one of the most effective learning strategies, and certainly more advantageous for long-term learning, than additional restudying of the same information. How retrieval can boost the retention of memories is still without unanimous explanation. In…

14 CFR 1274.504 - Competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... alert to organizational conflicts of interest as well as noncompetitive practices among contractors that... contractor performance and eliminate unfair competitive advantage, contractors that develop or draft...

Balancing bioethics by sensing the aesthetic.

PubMed

Macneill, Paul

2017-10-01

This article is critical of "bioethics" as it is widely understood and taught, noting in particular an emphasis given to philosophical justification, reason and rationality. It is proposed that "balancing" bioethics be achieved by giving greater weight to practice and the aesthetic: Defined in terms of sensory perception, emotion and feeling. Each of those three elements is elaborated as a non-cognitive capacity and, when taken together, comprise aesthetic sensitivity and responsiveness. This is to recognise the aesthetic as a productive element in bioethics as practice. Contributions from the philosophy of art and aesthetics are drawn into the discussion to bring depth to an understanding of "the aesthetic". This approach is buttressed by philosophers - including Foucault and 18th century German philosophers (in particular Kant) - who recognized a link between ethics and aesthetics. The article aims to give substance to a claim that bioethics necessarily comprises a cognitive component, relating to reason, and a non-cognitive component that draws on aesthetic sensibility and relates to practice. A number of advantages of bioethics, understood to explicitly acknowledge the aesthetic, are proffered. Having defined bioethics in conventional terms, there is discussion of the extent to which other approaches to bioethics (including casuistry, virtue ethics, and narrative ethics) recognize aesthetic sensitivity in their practice. It is apparent that they do so to varying extents although not always explicitly. By examining this aspect of applied ethics, the paper aims to draw attention to aesthetic sensitivity and responsiveness as integral to ethical and effective health care. © 2017 John Wiley & Sons Ltd.

A practical guide for performing arthrography under fluoroscopic or ultrasound guidance.

PubMed

Lungu, Eugen; Moser, Thomas P

2015-12-01

We propose a practical approach for performing arthrography with fluoroscopic or ultrasound guidance. Different approaches to the principal joints of the upper limb (shoulder, elbow, wrist and fingers), lower limb (hip, knee, ankle and foot) as well as the facet joints of the spine are discussed and illustrated with numerous drawings. Whenever possible, we emphasise the concept of targeting articular recesses, which offers many advantages over traditional techniques aiming at the joint space. • Arthrography remains a foremost technique in musculoskeletal radiology • Most joints can be successfully accessed by targeting the articular recess • Targeting the recess offers several advantages over traditional approaches • Ultrasound-guidance is now favoured over fluoroscopy and targeting the recess is equally applicable.

Out-Phased Array Linearized Signaling (OPALS): A Practical Approach to Physical Layer Encryption

DTIC Science & Technology

2015-10-26

Out-Phased Array Linearized Signaling ( OPALS ): A Practical Approach to Physical Layer Encryption Eric Tollefson, Bruce R. Jordan Jr., and Joseph D... OPALS ) which provides a practical approach to physical-layer encryption through spatial masking. Our approach modifies just the transmitter to employ...of the channel. With Out-Phased Array Linearized Signaling ( OPALS ), we propose a new masking technique that has some advantages of each of the

A Practical Note on Transferring Ideas and Methods from Consultancy Practice to the MPA Classroom: A Personal Account from a Danish Case Study

ERIC Educational Resources Information Center

Nielsen, J. C. Ry; Quinn, Brid

2016-01-01

At the lead author's home institution--Copenhagen Business School (CBS)--the combination of theory and practice is seen as very important in teaching. Research-based teaching is the slogan. In this respect, CBS has the same ambition as other universities. But it seems as if CBS has an advantage at the master's level, because students come with a…

A Mixed Methods Approach to Equity and Justice Research: Insights from Research on Children's Reasoning About Economic Inequality.

PubMed

Mistry, Rashmita S; White, Elizabeth S; Chow, Kirby A; Griffin, Katherine M; Nenadal, Lindsey

2016-01-01

Mixed methods research approaches are gaining traction across various social science disciplines, including among developmental scientists. In this chapter, we discuss the utility of a mixed methods research approach in examining issues related to equity and justice. We incorporate a brief overview of quantitative and qualitative monomethod research approaches in our larger discussion of the advantages, procedures, and considerations of employing a mixed methods design to advance developmental science from an equity and justice perspective. To better illustrate the theoretical and practical significance of a mixed methods research approach, we include examples of research conducted on children and adolescents' conceptions of economic inequality as one example of developmental science research with an equity and justice frame. © 2016 Elsevier Inc. All rights reserved.

Ultrasound Guidance for Botulinum Neurotoxin Chemodenervation Procedures.

PubMed

Alter, Katharine E; Karp, Barbara I

2017-12-28

Injections of botulinum neurotoxins (BoNTs) are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US) based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.

Extraction of gravitational waves in numerical relativity.

PubMed

Bishop, Nigel T; Rezzolla, Luciano

2016-01-01

A numerical-relativity calculation yields in general a solution of the Einstein equations including also a radiative part, which is in practice computed in a region of finite extent. Since gravitational radiation is properly defined only at null infinity and in an appropriate coordinate system, the accurate estimation of the emitted gravitational waves represents an old and non-trivial problem in numerical relativity. A number of methods have been developed over the years to "extract" the radiative part of the solution from a numerical simulation and these include: quadrupole formulas, gauge-invariant metric perturbations, Weyl scalars, and characteristic extraction. We review and discuss each method, in terms of both its theoretical background as well as its implementation. Finally, we provide a brief comparison of the various methods in terms of their inherent advantages and disadvantages.

Applied Electronics and Optical Laboratory: an optimized practical course for comprehensive training on optics and electronics

NASA Astrophysics Data System (ADS)

Wang, Kaiwei; Wang, Xiaoping

2017-08-01

In order to enhance the practical education and hands-on experience of optoelectronics and eliminate the overlapping contents that previously existed in the experiments section adhering to several different courses, a lab course of "Applied Optoelectronics Laboratory" has been established in the College of Optical Science and Engineering, Zhejiang University. The course consists of two sections, i.e., basic experiments and project design. In section 1, basic experiments provide hands-on experience with most of the fundamental concept taught in the corresponding courses. These basic experiments including the study of common light sources such as He-Ne laser, semiconductor laser and solid laser and LED; the testing and analysis of optical detectors based on effects of photovoltaic effect, photoconduction effect, photo emissive effect and array detectors. In section 2, the course encourages students to build a team and establish a stand-alone optical system to realize specific function by taking advantage of the basic knowledge learned from section 1. Through these measures, students acquired both basic knowledge and the practical application skills. Moreover, interest in science has been developed among students.

Evidence-Based Practice in Liposuction.

PubMed

Collins, Patrick S; Moyer, Kurtis E

2018-06-01

The goal of this study is to examine the existing peer reviewed literature comparing modern adjunctive techniques in liposuction including laser-assisted liposuction (LAL) and ultrasound-assisted liposuction (UAL) to standard suction-assisted liposuction (SAL). We intend to interpret these findings into a literature-based clinical application to influence practice patterns. A literature review was conducted using a keyword search in PubMed. Keyword search items included liposuction, lipoplasty, suction assisted liposuction, ultrasound assisted liposuction, laser assisted liposuction, tumescent, liposuction comparison, liposuction review, and combinations therein. Exclusion criteria included articles with a primary focus on histologic effects of energy devices, primary animal models, primary opinion papers with no reference to available data, and industry-sponsored publications. Inclusion criteria included articles with direct comparison of liposuction modalities, randomized or blinded studies, and studies with objective outcomes. Twenty-five articles that met the inclusion criteria comparing SAL to UAL or LAL out of 9972 articles identified were obtained. The selected literature was assigned into 3 categories: evidence demonstrating an advantage of 1 modality (SAL, UAL, or LAL) over another, evidence that showed no benefit of 1 modality over another, and evidence that demonstrated risks of complications of 1 modality over another. The benefits of UAL and LAL over SAL include the following: (1) UAL over SAL in the treatment of gynecomastia, (2) LAL and UAL over SAL with decreased hemoglobin/hematocrit in high-volume lipoaspirates, and (3) LAL over SAL with skin tightening in select areas specifically the submental area. Otherwise, the literature demonstrates equivocal results among the described techniques with no clear benefit to set one apart from the other. There appears to be no demonstrable added benefit to the addition of either UAL or LAL that would urge a change in practice patterns outside the exceptions listed.

Who will be the Radiologists of Tomorrow? A survey of radiology during the "Practical Year" in Germany.

PubMed

Dettmer, Sabine; Fischer, Volkhard; Paeßens, Carolin; Meyer, Simone; Wacker, Frank K; Rodt, Thomas

2017-10-01

Purpose  Aim of our study was to evaluate the motivation of medical students in their final year of medical school to choose radiology for further specialization by means of a Germany-wide survey. Materials and Methods  The survey was performed during the 2015/16 semester among German medical students in their four months radiology elective during the final year. Invitations for the study were distributed by the Student Secretariats of each university. The survey was web-based with EvaSys 7.0 software. Questions on radiology contents during medical studies and "practical year" were part of the survey. Plans for residency and possible advantages and disadvantages of radiology as medical specialty were inquired. Descriptive statistics and group comparisons were used as analysis methods. Results  89 students participated in the survey at the beginning and 60 students at the end of the practical year. Of these 39 students could be identified who answered both questionnaires. Most students were satisfied with their final year radiology elective (mean 1.8 on a range from 1 to 5). Nevertheless, they criticized mentoring during routine work (mean 2.1) and a lack of educational courses (mean 2.1). Most students (83 %) were uncertain about their residency choice at the beginning of their "practical year" and about one fifth changed their plans. From the students' point of view main advantages of radiology included contact with many other clinical disciplines (87 %) and the working conditions (68 %). The reduced patient contact (42 %), the large amount of work at a computer (43 %), and the dependency on referring physicians (42 %) were regarded as the main disadvantages. The students regarded the way radiology is taught during the studies as not practical enough. With regard to radiology the majority of students (63 %) felt poorly prepared for their future work. Conclusion  The "practical year" is important regarding the choice of future specialization. There was a high degree of satisfaction with the "practical year" in radiology. The mentoring during routine work and a lack of educational courses was mildly criticized. These factors provide room for improvement to foster students' interest in radiology. Key Points   · The "practical year" is important regarding the choice of further specialization.. · Criticisms of radiology in the "practical year" were mentoring and courses.. · Students feel poorly prepared for their future work regarding practical radiological skills.. Citation Format · Dettmer S, Fischer V, Paeßens C et al. Who will be the Radiologists of Tomorrow? A survey of radiology during the "Practical Year" in Germany. Fortschr Röntgenstr 2017; 189: 967 - 976. © Georg Thieme Verlag KG Stuttgart · New York.

Stationary microfluidics: molecular diagnostic assays by moving magnetic beads through non-moving liquids

NASA Astrophysics Data System (ADS)

Becker, Holger; Carstens, Cornelia; Kuhlmeier, Dirk; Sandetskaya, Natalia; Schröter, Nicole; Zilch, Christian; Gärtner, Claudia

2013-03-01

Commonly, microfluidic devices are based on the movement of fluids. For molecular diagnostics assays which often include steps like PCR, this practically always involves a more or less complicated set of external pumps, valves and liquid controls. In the presented paper, we follow a different approach in which the fluid after sample introduction remains stationary and the main bioactive sample molecules are moved through a chain of reaction compartments which contain the different reagents necessary for the assay. The big advantage of this concept is the lack of any external fluid actuation/control. Results on sample carry-over experiments and complete assays will be given.

Second order optical nonlinearity of graphene due to electric quadrupole and magnetic dipole effects.

PubMed

Cheng, J L; Vermeulen, N; Sipe, J E

2017-03-06

We present a practical scheme to separate the contributions of the electric quadrupole-like and the magnetic dipole-like effects to the forbidden second order optical nonlinear response of graphene, and give analytic expressions for the second order optical conductivities, calculated from the independent particle approximation, with relaxation described in a phenomenological way. We predict strong second order nonlinear effects, including second harmonic generation, photon drag, and difference frequency generation. We discuss in detail the controllability of these effects by tuning the chemical potential, taking advantage of the dominant role played by interband optical transitions in the response.

Ultrasound in Arthritis.

PubMed

Sudoł-Szopińska, Iwona; Schueller-Weidekamm, Claudia; Plagou, Athena; Teh, James

2017-09-01

Ultrasound is currently performed in everyday rheumatologic practice. It is used for early diagnosis, to monitor treatment results, and to diagnose remission. The spectrum of pathologies seen in arthritis with ultrasound includes early inflammatory features and associated complications. This article discusses the spectrum of ultrasound features of arthritides seen in rheumatoid arthritis and other connective tissue diseases in adults, such as Sjögren syndrome, lupus erythematosus, dermatomyositis, polymyositis, and juvenile idiopathic arthritis. Ultrasound findings in spondyloarthritis, osteoarthritis, and crystal-induced diseases are presented. Ultrasound-guided interventions in patients with arthritis are listed, and the advantages and disadvantages of ultrasound are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

MRI for Iron Overload in Thalassemia.

PubMed

Fernandes, Juliano Lara

2018-04-01

MRI is a key tool in the current management of patients with thalassemia. Given its capability of assessing iron overload in different organs noninvasively and without contrast, it has significant advantages over other metrics, including serum ferritin. Liver iron concentration can be measured either with relaxometry methods T2*/T2 or signal intensity ratio techniques. Myocardial iron can be assessed in the same examination through T2* imaging. In this review, we focus on showing how MRI evaluates iron in both organs and the clinical applications as well as practical approaches to using this tool by clinicians taking care of patients with thalassemia. Copyright © 2017 Elsevier Inc. All rights reserved.

Speed up of XML parsers with PHP language implementation

NASA Astrophysics Data System (ADS)

Georgiev, Bozhidar; Georgieva, Adriana

2012-11-01

In this paper, authors introduce PHP5's XML implementation and show how to read, parse, and write a short and uncomplicated XML file using Simple XML in a PHP environment. The possibilities for mutual work of PHP5 language and XML standard are described. The details of parsing process with Simple XML are also cleared. A practical project PHP-XML-MySQL presents the advantages of XML implementation in PHP modules. This approach allows comparatively simple search of XML hierarchical data by means of PHP software tools. The proposed project includes database, which can be extended with new data and new XML parsing functions.

Method for technology-delivered healthcare measures.

PubMed

Kramer-Jackman, Kelli Lee; Popkess-Vawter, Sue

2011-12-01

Current healthcare literature lacks development and evaluation methods for research and practice measures administered by technology. Researchers with varying levels of informatics experience are developing technology-delivered measures because of the numerous advantages they offer. Hasty development of technology-delivered measures can present issues that negatively influence administration and psychometric properties. The Method for Technology-delivered Healthcare Measures is designed to systematically guide the development and evaluation of technology-delivered measures. The five-step Method for Technology-delivered Healthcare Measures includes establishment of content, e-Health literacy, technology delivery, expert usability, and participant usability. Background information and Method for Technology-delivered Healthcare Measures steps are detailed.

Composite scores in comparative effectiveness research: counterbalancing parsimony and dimensionality in patient-reported outcomes.

PubMed

Schwartz, Carolyn E; Patrick, Donald L

2014-07-01

When planning a comparative effectiveness study comparing disease-modifying treatments, competing demands influence choice of outcomes. Current practice emphasizes parsimony, although understanding multidimensional treatment impact can help to personalize medical decision-making. We discuss both sides of this 'tug of war'. We discuss the assumptions, advantages and drawbacks of composite scores and multidimensional outcomes. We describe possible solutions to the multiple comparison problem, including conceptual hierarchy distinctions, statistical approaches, 'real-world' benchmarks of effectiveness and subgroup analysis. We conclude that comparative effectiveness research should consider multiple outcome dimensions and compare different approaches that fit the individual context of study objectives.

Continuous quality improvement for the clinical decision unit.

PubMed

Mace, Sharon E

2004-01-01

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

Application of wave mechanics theory to fluid dynamics problems: Fundamentals

NASA Technical Reports Server (NTRS)

Krzywoblocki, M. Z. V.

1974-01-01

The application of the basic formalistic elements of wave mechanics theory is discussed. The theory is used to describe the physical phenomena on the microscopic level, the fluid dynamics of gases and liquids, and the analysis of physical phenomena on the macroscopic (visually observable) level. The practical advantages of relating the two fields of wave mechanics and fluid mechanics through the use of the Schroedinger equation constitute the approach to this relationship. Some of the subjects include: (1) fundamental aspects of wave mechanics theory, (2) laminarity of flow, (3) velocity potential, (4) disturbances in fluids, (5) introductory elements of the bifurcation theory, and (6) physiological aspects in fluid dynamics.

“I think we’ve got too many tests!”: Prenatal providers’ reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening

PubMed Central

Gammon, B.L.; Kraft, S.A.; Michie, M.; Allyse, M.

2016-01-01

Background The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expected to revolutionize prenatal testing. cfDNA screening for fetal aneuploidy has demonstrated higher test sensitivity and specificity for some conditions than conventional serum screening and can be conducted early in the pregnancy. However, it is not clear whether and how clinical practices are assimilating this new type of testing into their informed consent and counselling processes. Since the introduction of cfDNA screening into practice in 2011, the uptake and scope have increased dramatically. Prenatal care providers are under pressure to stay up to date with rapidly changing cfDNA screening panels, manage increasing patient demands, and keep up with changing test costs, all while attempting to use the technology responsibly and ethically. While clinical literature on cfDNA screening has shown benefits for specific patient populations, it has also identified significant misunderstandings among providers and patients alike about the power of the technology. The unique features of cfDNA screening, in comparison to established prenatal testing technologies, have implications for informed decision-making and genetic counselling that must be addressed to ensure ethical practice. Objectives This study explored the experiences of prenatal care providers at the forefront of non-invasive genetic screening in the United States to understand how this testing changes the practice of prenatal medicine. We aimed to learn how the experience of providing and offering this testing differs from established prenatal testing methodologies. These differences may necessitate changes to patient education and consent procedures to maintain ethical practice. Methods We used the online American Congress of Obstetricians and Gynecologists Physician Directory to identify a systematic sample of five prenatal care providers in each U.S. state and the District of Columbia. Beginning with the lowest zip code in each state, we took every fifth name from the directory, excluding providers who were retired, did not currently practice in the state in which they were listed, or were not involved in a prenatal specialty. After repeating this step twice and sending a total of 461 invitations, 37 providers expressed interest in participating, and we completed telephone interviews with 21 providers (4.6%). We developed a semi-structured interview guide including questions about providers’ use of and attitudes toward cfDNA screening. A single interviewer conducted and audio-recorded all interviews by telephone, and the interviews lasted approximately 30 minutes each. We collaboratively developed a codebook through an iterative process of transcript review and code application, and a primary coder coded all transcripts. Results Prenatal care providers have varying perspectives on the advantages of cfDNA screening and express a range of concerns regarding the implementation of cfDNA screening in practice. While providers agreed on several advantages of cfDNA, including increased accuracy, earlier return of results, and decreased risk of complications, many expressed concern that there is not enough time to adequately counsel and educate patients on their prenatal screening and testing options. Providers also agreed that demand for cfDNA screening has increased and expressed a desire for more information from professional societies, labs, and publications. Providers disagreed about the healthcare implications and future of cfDNA screening. Some providers anticipated that cfDNA screening would decrease healthcare costs when implemented widely and expressed optimism for expanded cfDNA screening panels. Others were concerned that cfDNA screening would increase costs over time and questioned whether the expansion to include microdeletions could be done ethically. Conclusions The perspectives and experiences of the providers in this study allow insight into the clinical benefit, burden on prenatal practice, and potential future of cfDNA screening in clinical practice. Given the likelihood that the scope and uptake of cfDNA screening will continue to increase, it is essential to consider how these changes will affect frontline prenatal care providers and, in turn, patients. Providers’ requests for additional guidance and data as well as their concerns with the lack of time available to explain screening and testing options indicate significant potential issues with patient care. It is important to ensure that the clinical integration of cfDNA screening is managed responsibly and ethically before it expands further, exacerbating pre-existing issues. As prenatal screening evolves, so should informed consent and the resources available to women making decisions. The field must take steps to maximize the advantages of cfDNA screening and responsibly manage its ethical issues. PMID:28180146

"I think we've got too many tests!": Prenatal providers' reflections on ethical and clinical challenges in the practice integration of cell-free DNA screening.

PubMed

Gammon, B L; Kraft, S A; Michie, M; Allyse, M

2016-01-01

The recent introduction of cell-free DNA-based non-invasive prenatal screening (cfDNA screening) into clinical practice was expected to revolutionize prenatal testing. cfDNA screening for fetal aneuploidy has demonstrated higher test sensitivity and specificity for some conditions than conventional serum screening and can be conducted early in the pregnancy. However, it is not clear whether and how clinical practices are assimilating this new type of testing into their informed consent and counselling processes. Since the introduction of cfDNA screening into practice in 2011, the uptake and scope have increased dramatically. Prenatal care providers are under pressure to stay up to date with rapidly changing cfDNA screening panels, manage increasing patient demands, and keep up with changing test costs, all while attempting to use the technology responsibly and ethically. While clinical literature on cfDNA screening has shown benefits for specific patient populations, it has also identified significant misunderstandings among providers and patients alike about the power of the technology. The unique features of cfDNA screening, in comparison to established prenatal testing technologies, have implications for informed decision-making and genetic counselling that must be addressed to ensure ethical practice. This study explored the experiences of prenatal care providers at the forefront of non-invasive genetic screening in the United States to understand how this testing changes the practice of prenatal medicine. We aimed to learn how the experience of providing and offering this testing differs from established prenatal testing methodologies. These differences may necessitate changes to patient education and consent procedures to maintain ethical practice. We used the online American Congress of Obstetricians and Gynecologists Physician Directory to identify a systematic sample of five prenatal care providers in each U.S. state and the District of Columbia. Beginning with the lowest zip code in each state, we took every fifth name from the directory, excluding providers who were retired, did not currently practice in the state in which they were listed, or were not involved in a prenatal specialty. After repeating this step twice and sending a total of 461 invitations, 37 providers expressed interest in participating, and we completed telephone interviews with 21 providers (4.6%). We developed a semi-structured interview guide including questions about providers' use of and attitudes toward cfDNA screening. A single interviewer conducted and audio-recorded all interviews by telephone, and the interviews lasted approximately 30 minutes each. We collaboratively developed a codebook through an iterative process of transcript review and code application, and a primary coder coded all transcripts. Prenatal care providers have varying perspectives on the advantages of cfDNA screening and express a range of concerns regarding the implementation of cfDNA screening in practice. While providers agreed on several advantages of cfDNA, including increased accuracy, earlier return of results, and decreased risk of complications, many expressed concern that there is not enough time to adequately counsel and educate patients on their prenatal screening and testing options. Providers also agreed that demand for cfDNA screening has increased and expressed a desire for more information from professional societies, labs, and publications. Providers disagreed about the healthcare implications and future of cfDNA screening. Some providers anticipated that cfDNA screening would decrease healthcare costs when implemented widely and expressed optimism for expanded cfDNA screening panels. Others were concerned that cfDNA screening would increase costs over time and questioned whether the expansion to include microdeletions could be done ethically. The perspectives and experiences of the providers in this study allow insight into the clinical benefit, burden on prenatal practice, and potential future of cfDNA screening in clinical practice. Given the likelihood that the scope and uptake of cfDNA screening will continue to increase, it is essential to consider how these changes will affect frontline prenatal care providers and, in turn, patients. Providers' requests for additional guidance and data as well as their concerns with the lack of time available to explain screening and testing options indicate significant potential issues with patient care. It is important to ensure that the clinical integration of cfDNA screening is managed responsibly and ethically before it expands further, exacerbating pre-existing issues. As prenatal screening evolves, so should informed consent and the resources available to women making decisions. The field must take steps to maximize the advantages of cfDNA screening and responsibly manage its ethical issues.

Exploiting Quantum Resonance to Solve Combinatorial Problems

NASA Technical Reports Server (NTRS)

Zak, Michail; Fijany, Amir

2006-01-01

Quantum resonance would be exploited in a proposed quantum-computing approach to the solution of combinatorial optimization problems. In quantum computing in general, one takes advantage of the fact that an algorithm cannot be decoupled from the physical effects available to implement it. Prior approaches to quantum computing have involved exploitation of only a subset of known quantum physical effects, notably including parallelism and entanglement, but not including resonance. In the proposed approach, one would utilize the combinatorial properties of tensor-product decomposability of unitary evolution of many-particle quantum systems for physically simulating solutions to NP-complete problems (a class of problems that are intractable with respect to classical methods of computation). In this approach, reinforcement and selection of a desired solution would be executed by means of quantum resonance. Classes of NP-complete problems that are important in practice and could be solved by the proposed approach include planning, scheduling, search, and optimal design.

Family history in public health practice: a genomic tool for disease prevention and health promotion.

PubMed

Valdez, Rodolfo; Yoon, Paula W; Qureshi, Nadeem; Green, Ridgely Fisk; Khoury, Muin J

2010-01-01

Family history is a risk factor for many chronic diseases, including cancer, cardiovascular disease, and diabetes. Professional guidelines usually include family history to assess health risk, initiate interventions, and motivate behavioral changes. The advantages of family history over other genomic tools include a lower cost, greater acceptability, and a reflection of shared genetic and environmental factors. However, the utility of family history in public health has been poorly explored. To establish family history as a public health tool, it needs to be evaluated within the ACCE framework (analytical validity; clinical validity; clinical utility; and ethical, legal, and social issues). Currently, private and public organizations are developing tools to collect standardized family histories of many diseases. Their goal is to create family history tools that have decision support capabilities and are compatible with electronic health records. These advances will help realize the potential of family history as a public health tool.

Targeting multiple heterogeneous hardware platforms with OpenCL

NASA Astrophysics Data System (ADS)

Fox, Paul A.; Kozacik, Stephen T.; Humphrey, John R.; Paolini, Aaron; Kuller, Aryeh; Kelmelis, Eric J.

2014-06-01

The OpenCL API allows for the abstract expression of parallel, heterogeneous computing, but hardware implementations have substantial implementation differences. The abstractions provided by the OpenCL API are often insufficiently high-level to conceal differences in hardware architecture. Additionally, implementations often do not take advantage of potential performance gains from certain features due to hardware limitations and other factors. These factors make it challenging to produce code that is portable in practice, resulting in much OpenCL code being duplicated for each hardware platform being targeted. This duplication of effort offsets the principal advantage of OpenCL: portability. The use of certain coding practices can mitigate this problem, allowing a common code base to be adapted to perform well across a wide range of hardware platforms. To this end, we explore some general practices for producing performant code that are effective across platforms. Additionally, we explore some ways of modularizing code to enable optional optimizations that take advantage of hardware-specific characteristics. The minimum requirement for portability implies avoiding the use of OpenCL features that are optional, not widely implemented, poorly implemented, or missing in major implementations. Exposing multiple levels of parallelism allows hardware to take advantage of the types of parallelism it supports, from the task level down to explicit vector operations. Static optimizations and branch elimination in device code help the platform compiler to effectively optimize programs. Modularization of some code is important to allow operations to be chosen for performance on target hardware. Optional subroutines exploiting explicit memory locality allow for different memory hierarchies to be exploited for maximum performance. The C preprocessor and JIT compilation using the OpenCL runtime can be used to enable some of these techniques, as well as to factor in hardware-specific optimizations as necessary.

The best way to bring a dentist into your practice.

PubMed

Christensen, Gordon J

2003-03-01

Solo practice is the most common practice mode in dentistry. It probably will remain so for a long time to come. However, numerous advantages and some disadvantages are present for those dentists wanting or needing to have another practitioner in their practices. Finding the right employee dentist, associate or partner is a difficult task, but the success of many multidentist practices has shown that it can be done. Also, having another trusted dentist in the practice can facilitate exiting from the practice at retirement, allowing the retiring dentist to turn over his or her patients to the other dentist without the worry or anxiety of selling to an unknown party.

76 FR 14691 - Delphi Steering, Including On-Site Leased Workers From Acro Service Corporation, Aerotek, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Health Care and Advantage Technical Resourcing, Saginaw, MI; Amended Certification Regarding Eligibility... on-site leased workers from Advantage Technical Resourcing were employed on-site at the Saginaw... Department is amending this certification to include workers leased from Advantage Technical Resourcing...

VET Retention in Remote Aboriginal and Torres Strait Islander Communities. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2017

2017-01-01

This good practice guide is based on the research project "Enhancing training advantage for remote Aboriginal and Torres Strait Islander learners" by John Guenther et al. on behalf of Ninti One Limited. The project examines five unique and successful vocational education and training (VET) programs in remote areas and identifies how…

Perspectives--Talking with Practitioners: How to Integrate Best Practices with Evidence-Based Treatment

ERIC Educational Resources Information Center

Cohen, Richard

2012-01-01

Evidence-based treatments are increasingly important and necessary parts of many disciplines when working with very young children and their families. In using them, it is advantageous to be grounded in the principles and practices that research has shown are critical to children's healthy development, particularly the importance of supporting the…

The Role of School Design in Shaping Healthy Eating-Related Attitudes, Practices, and Behaviors among School Staff

ERIC Educational Resources Information Center

Frerichs, Leah; Brittin, Jeri; Intolubbe-Chmil, Loren; Trowbridge, Matthew; Sorensen, Dina; Huang, Terry T.-K.

2016-01-01

Background: Schools have increasing responsibility to address healthy eating, but physical barriers influence their ability to adopt and sustain recommended strategies. We took advantage of a natural experiment to investigate the role of the physical environment in shaping healthy eating attitudes and practices among school staff members. Methods:…

The Competitive Advantage of Organizational Learning.

ERIC Educational Resources Information Center

Appelbaum, Steven H.; Gallagher, John

2000-01-01

Explores theories of organizational learning and identifies the implications of the following for learning organizations: the new economy, strategic planning, management practices, and communication. (Contains 32 references.) (SK)

Static internal performance evaluation of several thrust reversing concepts for 2D-CD nozzles

NASA Technical Reports Server (NTRS)

Rowe, R. K.; Duss, D. J.; Leavitt, L. D.

1984-01-01

Recent performance testing of the two-dimensional convergent-divergent (2D-CD) nozzle has established the concept as a viable alternative to the axisymmetric nozzle for advanced technology aircraft. This type of exhaust system also offers potential integration and performance advantages in the areas of thrust reversing and vectoring over axi-symmetric nozzles. These advantages include the practical integration of thrust reversers which operate not only to reduce landing roll but also operate in-flight for enhanced maneuvering and thrust spoiling. To date there is a very limited data base available from which criteria can be developed for the design and evaluation of this type of thrust reverser system. For this reason, a static scale model test was conducted in which five different thrust reverser designs were evaluated. Each of the five models had varying performance/integration requirements which dictated the five different designs. Some of the parameters investigated in this test included; variable angle external cascade vanes, fixed angle internal cascade vanes, variable position inner doors, external slider doors and internal slider valves. In addition, normal force and yawing moment generation was investigated using the thrust reverser system. Selected results from this test will be presented and discussed in this paper.

Functionalized graphene and other two-dimensional materials for photovoltaic devices: device design and processing.

PubMed

Liu, Zhike; Lau, Shu Ping; Yan, Feng

2015-08-07

Graphene is the thinnest two-dimensional (2D) carbon material and has many advantages including high carrier mobilities and conductivity, high optical transparency, excellent mechanical flexibility and chemical stability, which make graphene an ideal material for various optoelectronic devices. The major applications of graphene in photovoltaic devices are for transparent electrodes and charge transport layers. Several other 2D materials have also shown advantages in charge transport and light absorption over traditional semiconductor materials used in photovoltaic devices. Great achievements in the applications of 2D materials in photovoltaic devices have been reported, yet numerous challenges still remain. For practical applications, the device performance should be further improved by optimizing the 2D material synthesis, film transfer, surface functionalization and chemical/physical doping processes. In this review, we will focus on the recent advances in the applications of graphene and other 2D materials in various photovoltaic devices, including organic solar cells, Schottky junction solar cells, dye-sensitized solar cells, quantum dot-sensitized solar cells, other inorganic solar cells, and perovskite solar cells, in terms of the functionalization techniques of the materials, the device design and the device performance. Finally, conclusions and an outlook for the future development of this field will be addressed.

Science-Economy-Technology Concordance Matrix for Development and Implementation of Regional Smart Specializations in the Silesian Voivodeship, Poland

PubMed Central

Smoliński, Adam; Bondaruk, Jan; Pichlak, Magdalena; Trząski, Leszek; Uszok, Elżbieta

2015-01-01

The regional smart specializations include the innovative activities within a common science-economy-technology sector, which open the opportunities to gain a competitive advantage. The original procedure of science-economy-technology concordance matrix development on an example of smart specializations of the Silesian Voivodeship was presented in the paper. The procedure developed includes recognition of the research and economic components of the regional smart specialization and the connection between the economic components of the regional specialization and the technological innovation through the international patent classification. It also comprises recognition of key enabling technologies (KETs) and high technologies (of high R&D intensity) other than KET in the economic and technological dimensions of innovation as well as the high R&D intensity services in the economic dimension of innovation. The in-depth expert analyses with the application of the Delphi method were also taken into account. The methodological approach developed and the visualization method applied are both of cognitive and practical importance since they contribute significantly to the creation of efficient development policies, to the enhancement and facilitation of cross-sectoral cooperation, and to the focusing on the fields of key importance in terms of the competitive advantage of a region. PMID:26697528

A look back at 2009: one step forward, two steps back.

PubMed

2010-04-01

In 2009, we examined 104 new brand name products or new indications for existing products in the French edition of Prescrire. Only 3 of these 104 "innovations" provided some therapeutic advantage, while 19 had clearly unfavourable risk-benefit balances. Marketing authorisations are failing to adequately protect patients. A number of cheaper generic versions of useful drugs were introduced to the market, while BigPharma's anticompetitive practices were aimed at slowing the growth of generics manufacturers. The quality of over-the-counter drugs marketed for self-medication, especially "umbrella" brands, left much to be desired. Consumer protection is clearly not the primary concern of the European (EMA) and French (Afssaps) drug regulatory agencies. They remain too financially dependent on drug companies; hesitate to withdraw dangerous drugs from the market; and withhold drug safety data. Other signs of drug companies' excessive influence, at patients' expense, include drug pricing that bears little relation to therapeutic advantage (in oncology, for example); the financial dependence of many patient groups on drug companies; the European Commission's attempts to authorise direct-to-consumer advertising and to allow the pharmaceutical sector to tighten its grip on health information, including pharmacovigilance data. Governments must assume their responsibilities, and patients and the healthcare profession must resist BigPharma's increasing involvement in all spheres of patient care.

Science-Economy-Technology Concordance Matrix for Development and Implementation of Regional Smart Specializations in the Silesian Voivodeship, Poland.

PubMed

Smoliński, Adam; Bondaruk, Jan; Pichlak, Magdalena; Trząski, Leszek; Uszok, Elżbieta

2015-01-01

The regional smart specializations include the innovative activities within a common science-economy-technology sector, which open the opportunities to gain a competitive advantage. The original procedure of science-economy-technology concordance matrix development on an example of smart specializations of the Silesian Voivodeship was presented in the paper. The procedure developed includes recognition of the research and economic components of the regional smart specialization and the connection between the economic components of the regional specialization and the technological innovation through the international patent classification. It also comprises recognition of key enabling technologies (KETs) and high technologies (of high R&D intensity) other than KET in the economic and technological dimensions of innovation as well as the high R&D intensity services in the economic dimension of innovation. The in-depth expert analyses with the application of the Delphi method were also taken into account. The methodological approach developed and the visualization method applied are both of cognitive and practical importance since they contribute significantly to the creation of efficient development policies, to the enhancement and facilitation of cross-sectoral cooperation, and to the focusing on the fields of key importance in terms of the competitive advantage of a region.

Omni-Purpose Stretchable Strain Sensor Based on a Highly Dense Nanocracking Structure for Whole-Body Motion Monitoring.

PubMed

Jeon, Hyungkook; Hong, Seong Kyung; Kim, Min Seo; Cho, Seong J; Lim, Geunbae

2017-12-06

Here, we report an omni-purpose stretchable strain sensor (OPSS sensor) based on a nanocracking structure for monitoring whole-body motions including both joint-level and skin-level motions. By controlling and optimizing the nanocracking structure, inspired by the spider sensory system, the OPSS sensor is endowed with both high sensitivity (gauge factor ≈ 30) and a wide working range (strain up to 150%) under great linearity (R 2 = 0.9814) and fast response time (<30 ms). Furthermore, the fabrication process of the OPSS sensor has advantages of being extremely simple, patternable, integrated circuit-compatible, and reliable in terms of reproducibility. Using the OPSS sensor, we detected various human body motions including both moving of joints and subtle deforming of skin such as pulsation. As specific medical applications of the sensor, we also successfully developed a glove-type hand motion detector and a real-time Morse code communication system for patients with general paralysis. Therefore, considering the outstanding sensing performances, great advantages of the fabrication process, and successful results from a variety of practical applications, we believe that the OPSS sensor is a highly suitable strain sensor for whole-body motion monitoring and has potential for a wide range of applications, such as medical robotics and wearable healthcare devices.

Hollow Core Optical Fiber Gas Lasers: Toward Novel and Practical Systems in Fused Silica

DTIC Science & Technology

2017-05-18

Hollow core Optically pumped Fiber Gas LASer’s (HOFGLAS’s) based on population inversion combine advantages of fiber lasers such as long interaction...polarization dependent fiber properties. Preliminary experiments were performed toward simultaneous lasing in the visible and near infrared; lasing in...words) Hollow core Optically pumped Fiber Gas LASer’s (HOFGLAS’s) based on population inversion combine advantages of fiber lasers such as long

Medical Student Dissection of Cadavers Improves Performance on Practical Exams but not on the NBME Anatomy Subject Exam.

PubMed

Sargent Jones, Leslie; Paulman, Lance E; Thadani, Raj; Terracio, Louis

2001-12-01

We have examined whether cadaver dissection by first year medical students (MIs) affected their performance in two test measures: the NBME Gross Anatomy and Embryology Subject Exam (dissection-relevant questions only), and practical exams given at the end of each major section within the course. The dissections for the entire course were divided into 18 regional dissection units and each student was assigned to dissect one third of the regional units; the other two-thirds of the material was learned from the partner-prosected cadavers. Performance for each student on the exams was then assessed as a function of the regions those students actually dissected. While the results indicated a small performance advantage for MIs answering questions on material they had dissected on the NBME Subject Exam questions relevant to dissection (78-88% of total exam), the results were not statistically significant. However, a similar, small performance advantage on the course practical exams was highly significant.

Counselling in general practice

PubMed Central

Waydenfeld, Danuta; Waydenfeld, Stefan W.

1980-01-01

The results of a two-year study of counselling in nine general practices in North London are reported. The study involved nine counsellors, 35 general practitioners, and 99 counselled clients (out of the combined practice population of 79,500 patients). Data were collected by means of questionnaires, and the study was concluded by interviews with doctors and discussions with counsellors. The findings of the study and the advantages and disadvantages of surgery counselling compared with marriage guidance centre counselling are discussed. PMID:7463405

Smart device-based testing for medical students in Korea: satisfaction, convenience, and advantages.

PubMed

Lim, Eun Young; Yim, Mi Kyoung; Huh, Sun

2017-01-01

The aim of this study was to investigate respondents' satisfaction with smart device-based testing (SBT), as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M) score (M= 3.75, standard deviation [SD]= 0.69), while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07). No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer.

INTELLECTUAL PROPERTY IN THE TWENTY-FIRST CENTURY: WILL THE DEVELOPING COUNTRIES LEAD OR FOLLOW?

PubMed Central

Reichman, Jerome H.

2010-01-01

Developing countries, particularly the BRIC countries of Brazil, Russia, India, and China, should accommodate their national systems of innovation to the worldwide intellectual property (IP) regime emerging after the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) in a way that maximizes global economic welfare in the foreseeable future. As many developed countries’ experience demonstrates, badly configured, over-protectionist IP regimes stifle innovation by making inputs to future innovation too costly and too cumbersome to sustain over time. More carefully considered IP regimes, however, are an important way to protect innovative small- and medium-sized firms from predatory, larger competitors. The challenge is for emerging economies to capture the benefits of IP without importing the serious problems that developed countries have themselves failed to solve. Emerging economies can attain this balance by pursuing a policy of counter-harmonization in which they take advantage of existing exemptions in international agreements governing IP to establish regional, local, and international practices that promote more innovative, flexible uses of IP. Such practices include a research exemption for experimental uses of IP, government imposed nonexclusive licensing, anti-blocking provisions, an essential facilities doctrine, and compulsory licenses. Additional tools include an ex ante regime of compensatory liability rules for small scale innovation and sensible exceptions, particularly for science as well as general fair use provisions, to the exclusive rights of domestic copyright laws. Emerging economies will have to overcome strong economic pressure to accept more restrictive IP regimes as part of free trade agreements as well as a lack of technical expertise and internal government coordination. However, emerging economies have already accrued enough experience to be aware of the strengths and weaknesses of various IP schemes and their own ability to tailor IP to local needs. Developing countries will need to take advantage of that experience and defend innovative practices at international dispute resolution forums. Through creative, determined efforts, the developing countries can avoid other countries’ IP excesses while establishing the kind of IP norms that address the real conditions of creativity and innovation in today’s digitally empowered universe of scientific discourse. PMID:21423816

INTELLECTUAL PROPERTY IN THE TWENTY-FIRST CENTURY: WILL THE DEVELOPING COUNTRIES LEAD OR FOLLOW?

PubMed

Reichman, Jerome H

2009-01-31

Developing countries, particularly the BRIC countries of Brazil, Russia, India, and China, should accommodate their national systems of innovation to the worldwide intellectual property (IP) regime emerging after the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) in a way that maximizes global economic welfare in the foreseeable future. As many developed countries' experience demonstrates, badly configured, over-protectionist IP regimes stifle innovation by making inputs to future innovation too costly and too cumbersome to sustain over time. More carefully considered IP regimes, however, are an important way to protect innovative small- and medium-sized firms from predatory, larger competitors. The challenge is for emerging economies to capture the benefits of IP without importing the serious problems that developed countries have themselves failed to solve. Emerging economies can attain this balance by pursuing a policy of counter-harmonization in which they take advantage of existing exemptions in international agreements governing IP to establish regional, local, and international practices that promote more innovative, flexible uses of IP. Such practices include a research exemption for experimental uses of IP, government imposed nonexclusive licensing, anti-blocking provisions, an essential facilities doctrine, and compulsory licenses. Additional tools include an ex ante regime of compensatory liability rules for small scale innovation and sensible exceptions, particularly for science as well as general fair use provisions, to the exclusive rights of domestic copyright laws. Emerging economies will have to overcome strong economic pressure to accept more restrictive IP regimes as part of free trade agreements as well as a lack of technical expertise and internal government coordination. However, emerging economies have already accrued enough experience to be aware of the strengths and weaknesses of various IP schemes and their own ability to tailor IP to local needs. Developing countries will need to take advantage of that experience and defend innovative practices at international dispute resolution forums. Through creative, determined efforts, the developing countries can avoid other countries' IP excesses while establishing the kind of IP norms that address the real conditions of creativity and innovation in today's digitally empowered universe of scientific discourse.

Innovation characteristics and intention to adopt sustainable facilities management practices.

PubMed

Lee, So Young; Kang, Mihyun

2013-01-01

Sustainable facilities management (SFM) is important because typical buildings consume more resources and energy than necessary, negatively impact the environment and generate lots of waste (US Department of Energy, 2003, Green Buildings). This study examined innovation characteristics that relate to facility managers' intention to adopt SFM practices. Based on the diffusion of innovations theory (Rogers 1962, 1995, Diffusion of Innovations. 4th ed. New York: The Free Press), an SFM innovation and adoption model was proposed. A survey was conducted with a convenience sample of 240 public facilities managers in 25 facilities management divisions in Seoul, Korea, and its metropolitan areas. Structural equation modelling was employed to analyse the data. The results showed that economic advantage and human comfort aspects are predictors for the intention of SFM adoption. Observability is positively relevant to the intention of SFM adoption. Complexity, however, is not a significant predictor for the intention of SFM adoption. Practical implications for sustainable products and systems and the built environment are suggested. To incorporate an innovation like sustainable practices, it is required to meet the needs of potential adopters. Innovation characteristics that influence facility managers' intention to adopt sustainable facilities management were examined. A survey was conducted. Economic advantage, human comfort and observability are predictors for the intention of adoption of sustainable practice.

Transitioning to digital radiography.

PubMed

Drost, Wm Tod

2011-04-01

To describe the different forms of digital radiography (DR), image file formats, supporting equipment and services required for DR, storage of digital images, and teleradiology. Purchasing a DR system is a major investment for a veterinary practice. Types of DR systems include computed radiography, charge coupled devices, and direct or indirect DR. Comparison of workflow for analog and DR is presented. On the surface, switching to DR involves the purchase of DR acquisition hardware. The X-ray machine, table and grids used in analog radiography are the same for DR. Realistically, a considerable infrastructure supports the image acquisition hardware. This infrastructure includes monitors, computer workstations, a robust computer network and internet connection, a plan for storage and back up of images, and service contracts. Advantages of DR compared with analog radiography include improved image quality (when used properly), ease of use (more forgiving to the errors of radiographic technique), speed of making a complete study (important for critically ill patients), fewer repeat radiographs, less time looking for imaging studies, less physical storage space, and the ability to easily send images for consultation. With an understanding of the infrastructure requirements, capabilities and limitations of DR, an informed veterinary practice should be better able to make a sound decision about transitioning to DR. © Veterinary Emergency and Critical Care Society 2011.

Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis

PubMed Central

Mathijssen, Elke GE; Vriezekolk, Johanna E; Eijsbouts, Agnes MM; van den Hoogen, Frank HJ; van den Bemt, Bart JF

2018-01-01

Objective The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA) regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs. Methods Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes). Results The following three themes that described support needs of patients with RA for medication use were identified in the data: 1) informational support; 2) practical support; and 3) emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient–health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients’ support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent. Conclusion Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients’ perspective, eHealth technologies may have the potential to address these needs. However, these technologies are regarded as a complement to, rather than a replacement of, current practices. PMID:29563778

Culturally relevant model program to prevent and reduce agricultural injuries.

PubMed

Helitzer, D L; Hathorn, G; Benally, J; Ortega, C

2014-07-01

Limited research has explored pesticide injury prevention among American Indian farmers. In a five-year agricultural intervention, a university-community partnership, including the University of New Mexico School of Medicine, New Mexico State University, Shiprock Area Cooperative Extension Service, and Navajo Nation communities, used a culturally relevant model to introduce and maintain safe use of integrated pest management techniques. We applied the Diffusion of Innovations theory and community-based approaches to tailor health promotion strategies for our intervention. In a longitudinal study with repeated measures, we trained six "model farmers" to be crop management experts in pesticide safety, application, and control. Subsequently, these model farmers worked with 120 farm families randomized into two groups: intervention (Group 1) and delayed intervention (Group 2). Measurements included a walk-through analysis, test of knowledge and attitudes, and yield analysis. Both groups demonstrated improvements in pesticide storage behaviors after training. Test scores regarding safety practices improved significantly: from 57.3 to 72.4 for Group 1 and from 52.6 to 76.3 for Group 2. Group 1 maintained their knowledge and safety practices after the intervention. Attitudes about pesticides and communication of viewpoints changed across the study years. With pesticides and fertilizer, the number of corn ears increased by 56.3% and yield (kg m(-2)) of alfalfa increased by 41.2%. The study combined traditional farming practices with culturally relevant approaches and behavior change theory to affect knowledge, safety practices, attitudes, communication channels, and crop yield. Storage behaviors, use of pesticides and safety and application equipment, and safety practice knowledge changed significantly, as did attitudes about social networking, social support, and the compatibility and relative advantage of pesticides for farms.

To observe or not to observe peers when learning physical examination skills; that is the question

PubMed Central

2013-01-01

Background Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination. Methods The study included 185 2nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student’s performance was used as a measure of learning. Results Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05). Conclusions The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling. PMID:23594455

To observe or not to observe peers when learning physical examination skills; that is the question.

PubMed

Martineau, Bernard; Mamede, Sílvia; St-Onge, Christina; Rikers, Remy M J P; Schmidt, Henk G

2013-04-17

Learning physical examination skills is an essential element of medical education. Teaching strategies include practicing the skills either alone or in-group. It is unclear whether students benefit more from training these skills individually or in a group, as the latter allows them to observing their peers. The present study, conducted in a naturalistic setting, investigated the effects of peer observation on mastering psychomotor skills necessary for physical examination. The study included 185 2nd-year medical students, participating in a regular head-to-toe physical examination learning activity. Students were assigned either to a single-student condition (n = 65), in which participants practiced alone with a patient instructor, or to a multiple-student condition (n = 120), in which participants practiced in triads under patient instructor supervision. The students subsequently carried out a complete examination that was videotaped and subsequently evaluated. Student's performance was used as a measure of learning. Students in the multiple-student condition learned more than those who practiced alone (81% vs 76%, p < 0.004). This result possibly derived from a positive effect of observing peers; students who had the possibility to observe a peer (the second and third students in the groups) performed better than students who did not have this possibility (84% vs 76%, p <. 001). There was no advantage of observing more than one peer (83.7% vs 84.1%, p > .05). The opportunity to observe a peer during practice seemed to improve the acquisition of physical examination skills. By using small groups instead of individual training to teach physical examination skills, health sciences educational programs may provide students with opportunities to improve their performance by learning from their peers through modelling.

Experiences of hand hygiene among acute care nurses: An interpretative phenomenological analysis

PubMed Central

Chatfield, Sheryl L; Nolan, Rachael; Crawford, Hannah; Hallam, Jeffrey S

2016-01-01

Objective: Occurrences of healthcare-associated infections are associated with substantial direct and indirect costs. Improvement in hand hygiene among acute care nurses has potential to reduce incidence of healthcare-associated infections. Findings from reviews of intervention research have not conclusively identified components that are more or less efficient or effective. Much prior qualitative research has focused on descriptive analysis of policies and practices rather than providing interpretive explorations of how individuals’ perceptions of hygiene might drive practices. Methods: We conducted qualitative interview research with eight nurses in the United States who were employed in various patient-care roles. We analyzed the data using an interpretative phenomenological analysis methodology to explore how nurses described their perceptions of, and experiences with, hygiene. We developed themes that explored individual, workplace, and management influences on perception of hygiene. Results: Developed themes include practical hygiene, risky business, and hygiene on trial; the latter theme described the conflict between how nurses perceived their own hygiene practices and how they felt hospital management perceived these practices. Other findings included that participants distinguished between policy-mandated use of sanitizer and a personal sense of cleanliness; the latter was more likely to be associated with scrubbing or removal of contaminants than with use of protectants. Conclusion: While participants asserted support for facility hand hygiene policies, their behavior in certain instances might be mediated by broadly defined emergent situations and a belief that it is not currently possible to establish a causal link between an healthcare-associated infections and a specific individual or occurrence. Researchers and infection prevention practitioners might consider soliciting greater input from nurses in planning hand hygiene improvement interventions, to encourage ownership, and emphasizing detailed cases as training content to take advantage of individuals’ sensory responses to hygiene. PMID:27803809

Simulating changes in cropping practices in conventional and glyphosate-resistant maize. II. Weed impacts on crop production and biodiversity.

PubMed

Colbach, Nathalie; Darmency, Henri; Fernier, Alice; Granger, Sylvie; Le Corre, Valérie; Messéan, Antoine

2017-05-01

Overreliance on the same herbicide mode of action leads to the spread of resistant weeds, which cancels the advantages of herbicide-tolerant (HT) crops. Here, the objective was to quantify, with simulations, the impact of glyphosate-resistant (GR) weeds on crop production and weed-related wild biodiversity in HT maize-based cropping systems differing in terms of management practices. We (1) simulated current conventional and probable HT cropping systems in two European regions, Aquitaine and Catalonia, with the weed dynamics model FLORSYS; (2) quantified how much the presence of GR weeds contributed to weed impacts on crop production and biodiversity; (3) determined the effect of cultural practices on the impact of GR weeds and (4) identified which species traits most influence weed-impact indicators. The simulation study showed that during the analysed 28 years, the advent of glyphosate resistance had little effect on plant biodiversity. Glyphosate-susceptible populations and species were replaced by GR ones. Including GR weeds only affected functional biodiversity (food offer for birds, bees and carabids) and weed harmfulness when weed effect was initially low; when weed effect was initially high, including GR weeds had little effect. The GR effect also depended on cultural practices, e.g. GR weeds were most detrimental for species equitability when maize was sown late. Species traits most harmful for crop production and most beneficial for biodiversity were identified, using RLQ analyses. None of the species presenting these traits belonged to a family for which glyphosate resistance was reported. An advice table was built; the effects of cultural practices on crop production and biodiversity were synthesized, explained, quantified and ranked, and the optimal choices for each management technique were identified.

[New intensifying screens in clinical radiology. II. Examinations in clinical practice].

PubMed

Freyschmidt, J; Saure, D; Hagemann, G

1976-09-01

A clinically applicable procedure for testing new intensifying rare earth screens, as well as the special Siemens' screen is described. The results are related to universal screens. The film-screen combination alpha 4XD (gadolinium oxysulphide with normal, green sensitive film) results in a reduction of radiation dose to half with detail comparable with universal screens. The Siemens' special screen has similar advantages. Screens with a higher intensification factor and reduction of the mAs to one sixth results in loss of detail. This does not necessarily reduce their clinical use if they are used for appropriate purposes. The results of this clinically orientated technique agreed well with physically objective methods using lead grids. The advantages of the new screens are discussed in terms of their practical application.

Reconciling Data from Different Sources: Practical Realities of Using Mixed Methods to Identify Effective High School Practices

ERIC Educational Resources Information Center

Smith, Thomas M.; Cannata, Marisa; Haynes, Katherine Taylor

2016-01-01

Background/Context: Mixed methods research conveys multiple advantages to the study of complex phenomena and large organizations or systems. The benefits are derived from drawing on the strengths of qualitative methods to answer questions about how and why a phenomenon occurs and those of quantitative methods to examine how often a phenomenon…

Children's Exposure to Sustainability Practices during the Transition from Preschool into School and Their Learning and Socioemotional Development

ERIC Educational Resources Information Center

Benner, Aprile D.; Thornton, Anna; Crosnoe, Robert

2017-01-01

Evidence that the learning gains of preschool fade as children transition into elementary school has led to increased efforts to sustain preschool advantages during this key transitional period. This study explores whether the observed benefits of sustainability practices for a range of child outcomes are explained and/or moderated by family and…

Position and Speed Control of Brushless DC Motors Using Sensorless Techniques and Application Trends

PubMed Central

Gamazo-Real, José Carlos; Vázquez-Sánchez, Ernesto; Gómez-Gil, Jaime

2010-01-01

This paper provides a technical review of position and speed sensorless methods for controlling Brushless Direct Current (BLDC) motor drives, including the background analysis using sensors, limitations and advances. The performance and reliability of BLDC motor drivers have been improved because the conventional control and sensing techniques have been improved through sensorless technology. Then, in this paper sensorless advances are reviewed and recent developments in this area are introduced with their inherent advantages and drawbacks, including the analysis of practical implementation issues and applications. The study includes a deep overview of state-of-the-art back-EMF sensing methods, which includes Terminal Voltage Sensing, Third Harmonic Voltage Integration, Terminal Current Sensing, Back-EMF Integration and PWM strategies. Also, the most relevant techniques based on estimation and models are briefly analysed, such as Sliding-mode Observer, Extended Kalman Filter, Model Reference Adaptive System, Adaptive observers (Full-order and Pseudoreduced-order) and Artificial Neural Networks. PMID:22163582

Does the benefit of testing depend on lag, and if so, why? Evaluating the elaborative retrieval hypothesis.

PubMed

Rawson, Katherine A; Vaughn, Kalif E; Carpenter, Shana K

2015-05-01

Despite the voluminous literatures on testing effects and lag effects, surprisingly few studies have examined whether testing and lag effects interact, and no prior research has directly investigated why this might be the case. To this end, in the present research we evaluated the elaborative retrieval hypothesis (ERH) as a possible explanation for why testing effects depend on lag. Elaborative retrieval involves the activation of cue-related information during the long-term memory search for the target. If the target is successfully retrieved, this additional information is encoded with the cue-target pair to yield a more elaborated memory trace that enhances target access on a later memory test. The ERH states that the degree of elaborative retrieval during practice is greater when testing takes place after a long rather than a short lag (whereas elaborative retrieval during restudy is minimal at either lag). Across two experiments, final-test performance was greater following practice testing than following restudy only, and this memorial advantage was greater with long-lag than with short-lag practice. The final test also included novel cue conditions used to diagnose the degree of elaborative retrieval during practice. The overall pattern of performance in these conditions provided consistent evidence for the ERH, with more extensive elaborative retrieval during long- than during short-lag practice testing.

Connecting intentional learning and cardiac specialty practice: The experiences of bachelor of science in nursing students.

PubMed

Rush, Kathy L; Wilson, Ryan; Costigan, Jeannine; Bannerman, Maggie; Donnelly, Sarah

2016-09-01

Internationally pre-registration education programs have ranged from entirely specialist to entirely generalist with varying degrees of specialty preparation in between. Students in generalist programs with specialty practice options may benefit from novel pedagogical approaches, such as intentional learning, to ease the transition from generalist to specialist practice. The purpose of this qualitative descriptive study was to understand undergraduate students' experiences of intentional learning in a 4-week consolidated cardiac specialty practicum. Eight students (7 females, 1 male) participated in a combination of weekly Blackboard discussions and an end-of-practicum focus group and completed a competency self-rating. Students had marred expectations about the integration of intentional learning in their specialty practice experience. They reflected advantages and disadvantages of both intentional and total patient care learning models but worked with their instructor to find the right balance that maximized learning. Students identified features that maximized intentional learning including open-ended questions, using learning versus workspaces, receiving feedback, and integrating peer interaction. Despite advancing their confidence and competence in specialty practice students remained anxious about their ability to assume the role of the graduate nurse in a years' time. Preparing a generalist nurse for the workforce needs to be balanced with meeting students' needs and increasing professional demands for specialty experiences in undergraduate nurse education programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Targeting “hardly reached” people with chronic illness: a feasibility study of a person-centered self-management education approach

PubMed Central

Torenholt, Rikke; Helms Andersen, Tue; Møller, Birgitte Lund; Willaing, Ingrid

2018-01-01

Background Self-management education is critical to the development of successful health behavior changes related to chronic illness. However, people in high-risk groups attend less frequently or benefit less from patient education programs than do people with more socioeconomic advantages. Aim The aim was to test the feasibility of a participatory person-centered education approach and tool-kit targeting self-management of chronic illness in hardly reached people. Methods After participating in a training program, educators (n=77) tested the approach in practice. Data collection included online questionnaires for educators (n=65), observations of education sessions (n=7), and interviews with educators (n=11) and participants (n=22). Descriptive statistics were calculated. Transcripts of interviews and observations were analyzed using systematic text condensation. Feasibility was examined in terms of practicality, integration, suitability, and efficacy. Results Educators had a positive response to the approach and found that the tools supported involving participants in education and support. Participant satisfaction varied, depending on the ability of educators to integrate the tools into programs in a meaningful way. The tools provided time for reflection in the education process that benefited participants and educators alike. Educators found it challenging to allow participants to help set the agenda and to exchange experiences without educator control. Barriers to use reported by educators included lack of time for both training and preparation. Limitations The testing included varied groups of participants, some groups included members of hardly reached populations and others did not. Also, some tools were only tried in practice by a few educators. Conclusion The approach was feasible in terms of practicality, integration, acceptability, and efficacy and perceived by educators as suitable for both hardly reached participants and those who are less disadvantaged. Implementation of the approach requires time for training and preparation. PMID:29497283

Health disparities and health equity: concepts and measurement.

PubMed

Braveman, Paula

2006-01-01

There is little consensus about the meaning of the terms "health disparities," "health inequalities," or "health equity." The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. Health disparities/inequalities do not refer to all differences in health. A health disparity/inequality is a particular type of difference in health (or in the most important influences on health that could potentially be shaped by policies); it is a difference in which disadvantaged social groups-such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination-systematically experience worse health or greater health risks than more advantaged social groups. ("Social advantage" refers to one's relative position in a social hierarchy determined by wealth, power, and/or prestige.) Health disparities/inequalities include differences between the most advantaged group in a given category-e.g., the wealthiest, the most powerful racial/ethnic group-and all others, not only between the best- and worst-off groups. Pursuing health equity means pursuing the elimination of such health disparities/inequalities.

Trojan horse attacks on counterfactual quantum key distribution

NASA Astrophysics Data System (ADS)

Yang, Xiuqing; Wei, Kejin; Ma, Haiqiang; Sun, Shihai; Du, Yungang; Wu, Lingan

2016-04-01

There has been much interest in ;counterfactual quantum cryptography; (T.-G. Noh, 2009 [10]). It seems that the counterfactual quantum key distribution protocol without any photon carrier through the quantum channel provides practical security advantages. However, we show that it is easy to break counterfactual quantum key distribution systems in practical situations. We introduce the two types of Trojan horse attacks that are available for the two-way protocol and become possible for practical counterfactual systems with our eavesdropping schemes.

Evaluation of semiconductor devices for Electric and Hybrid Vehicle (EHV) ac-drive applications, volume 1

NASA Technical Reports Server (NTRS)

Lee, F. C.; Chen, D. Y.; Jovanovic, M.; Hopkins, D. C.

1985-01-01

The results of evaluation of power semiconductor devices for electric hybrid vehicle ac drive applications are summarized. Three types of power devices are evaluated in the effort: high power bipolar or Darlington transistors, power MOSFETs, and asymmetric silicon control rectifiers (ASCR). The Bipolar transistors, including discrete device and Darlington devices, range from 100 A to 400 A and from 400 V to 900 V. These devices are currently used as key switching elements inverters for ac motor drive applications. Power MOSFETs, on the other hand, are much smaller in current rating. For the 400 V device, the current rating is limited to 25 A. For the main drive of an electric vehicle, device paralleling is normally needed to achieve practical power level. For other electric vehicle (EV) related applications such as battery charger circuit, however, MOSFET is advantageous to other devices because of drive circuit simplicity and high frequency capability. Asymmetrical SCR is basically a SCR device and needs commutation circuit for turn off. However, the device poses several advantages, i.e., low conduction drop and low cost.

GaAs VLSI for aerospace electronics

NASA Technical Reports Server (NTRS)

Larue, G.; Chan, P.

1990-01-01

Advanced aerospace electronics systems require high-speed, low-power, radiation-hard, digital components for signal processing, control, and communication applications. GaAs VLSI devices provide a number of advantages over silicon devices including higher carrier velocities, ability to integrate with high performance optical devices, and high-resistivity substrates that provide very short gate delays, good isolation, and tolerance to many forms of radiation. However, III-V technologies also have disadvantages, such as lower yield compared to silicon MOS technology. Achieving very large scale integration (VLSI) is particularly important for fast complex systems. At very short gate delays (less than 100 ps), chip-to-chip interconnects severely degrade circuit clock rates. Complex systems, therefore, benefit greatly when as many gates as possible are placed on a single chip. To fully exploit the advantages of GaAs circuits, attention must be focused on achieving high integration levels by reducing power dissipation, reducing the number of devices per logic function, and providing circuit designs that are more tolerant to process and environmental variations. In addition, adequate noise margin must be maintained to ensure a practical yield.

Sagnac interferometry with coherent vortex superposition states in exciton-polariton condensates

NASA Astrophysics Data System (ADS)

Moxley, Frederick Ira; Dowling, Jonathan P.; Dai, Weizhong; Byrnes, Tim

2016-05-01

We investigate prospects of using counter-rotating vortex superposition states in nonequilibrium exciton-polariton Bose-Einstein condensates for the purposes of Sagnac interferometry. We first investigate the stability of vortex-antivortex superposition states, and show that they survive at steady state in a variety of configurations. Counter-rotating vortex superpositions are of potential interest to gyroscope and seismometer applications for detecting rotations. Methods of improving the sensitivity are investigated by targeting high momentum states via metastable condensation, and the application of periodic lattices. The sensitivity of the polariton gyroscope is compared to its optical and atomic counterparts. Due to the large interferometer areas in optical systems and small de Broglie wavelengths for atomic BECs, the sensitivity per detected photon is found to be considerably less for the polariton gyroscope than with competing methods. However, polariton gyroscopes have an advantage over atomic BECs in a high signal-to-noise ratio, and have other practical advantages such as room-temperature operation, area independence, and robust design. We estimate that the final sensitivities including signal-to-noise aspects are competitive with existing methods.

Robotic Surgery in Gynecology

PubMed Central

Bouquet de Joliniere, Jean; Librino, Armando; Dubuisson, Jean-Bernard; Khomsi, Fathi; Ben Ali, Nordine; Fadhlaoui, Anis; Ayoubi, J. M.; Feki, Anis

2016-01-01

Minimally invasive surgery (MIS) can be considered as the greatest surgical innovation over the past 30 years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D) monitor reduction in-depth perception, camera instability, limited range of motion, and steep learning curves. The surgeon has a low force feedback, which allows simple gestures, respect for tissues, and more effective treatment of complications. Since the 1980s, several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon’s skills, achieve accuracy and high precision during complex surgery, and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision. PMID:27200358

Resonant Magnetic Field Sensors Based On MEMS Technology.

PubMed

Herrera-May, Agustín L; Aguilera-Cortés, Luz A; García-Ramírez, Pedro J; Manjarrez, Elías

2009-01-01

Microelectromechanical systems (MEMS) technology allows the integration of magnetic field sensors with electronic components, which presents important advantages such as small size, light weight, minimum power consumption, low cost, better sensitivity and high resolution. We present a discussion and review of resonant magnetic field sensors based on MEMS technology. In practice, these sensors exploit the Lorentz force in order to detect external magnetic fields through the displacement of resonant structures, which are measured with optical, capacitive, and piezoresistive sensing techniques. From these, the optical sensing presents immunity to electromagnetic interference (EMI) and reduces the read-out electronic complexity. Moreover, piezoresistive sensing requires an easy fabrication process as well as a standard packaging. A description of the operation mechanisms, advantages and drawbacks of each sensor is considered. MEMS magnetic field sensors are a potential alternative for numerous applications, including the automotive industry, military, medical, telecommunications, oceanographic, spatial, and environment science. In addition, future markets will need the development of several sensors on a single chip for measuring different parameters such as the magnetic field, pressure, temperature and acceleration.

Resonant Magnetic Field Sensors Based On MEMS Technology

PubMed Central

Herrera-May, Agustín L.; Aguilera-Cortés, Luz A.; García-Ramírez, Pedro J.; Manjarrez, Elías

2009-01-01

Microelectromechanical systems (MEMS) technology allows the integration of magnetic field sensors with electronic components, which presents important advantages such as small size, light weight, minimum power consumption, low cost, better sensitivity and high resolution. We present a discussion and review of resonant magnetic field sensors based on MEMS technology. In practice, these sensors exploit the Lorentz force in order to detect external magnetic fields through the displacement of resonant structures, which are measured with optical, capacitive, and piezoresistive sensing techniques. From these, the optical sensing presents immunity to electromagnetic interference (EMI) and reduces the read-out electronic complexity. Moreover, piezoresistive sensing requires an easy fabrication process as well as a standard packaging. A description of the operation mechanisms, advantages and drawbacks of each sensor is considered. MEMS magnetic field sensors are a potential alternative for numerous applications, including the automotive industry, military, medical, telecommunications, oceanographic, spatial, and environment science. In addition, future markets will need the development of several sensors on a single chip for measuring different parameters such as the magnetic field, pressure, temperature and acceleration. PMID:22408480

Freestanding heart hospitals is the end near?

PubMed

Ronning, Philip L; Nugent, Michael

2004-09-01

Freestanding heart hospitals are not enjoying the same competitive advantages they have in recent years for several reasons: Regulatory policy seems to be turning against them. They no longer enjoy the same cost structure advantage. Technology shifts mean lower payment rates and higher costs for cardiac services. Their access to capital is diminished. Traditional hospitals are mounting more effective competitive responses, while entrepreneurial physician practice executives are pursuing alternative strategies that may lead to more competition for heart hospitals.

Slotted Polyimide-Aerogel-Filled-Waveguide Arrays

NASA Technical Reports Server (NTRS)

Rodriguez-Solis, Rafael A.; Pacheco, Hector L.; Miranda, Felix A.; Meador, Mary Ann B.

2013-01-01

This presentation discussed the potential advantages of developing Slotted Waveguide Arrays using polyimide aerogels. Polyimide (PI) aerogels offer great promise as an enabling technology for lightweight aerospace antenna systems. PI aerogels are highly porous solids possessing low density and low dielectric permittivity combined with good mechanical properties. For slotted waveguide array applications, there are significant advantages in mass that more than compensate for the slightly higher loss of the aerogel filled waveguide when compared to state of practice commercial waveguide.

Virtual lab for learning equipment and treatment of experimental measurements of rainfall, runoff and erosion in small rural catchments

NASA Astrophysics Data System (ADS)

Ángel Bajo, José; Redel-Macías, María Dolores; Nichols, Mary; Pérez, Rafael; Bellido, Francisco; Marín-Moreno, Víctor; Taguas, Encarnación V.

2017-04-01

A virtual lab for learning to use devices and to treat experimental measurements of hydrological and erosive processes in small agricultural catchments was created to support the practical content of the subject Restoration of Forest Ecosystems of the Master of Forest Engineer (University of Cordoba). The objective was to build a virtual place representing a real site equipped to make measurements of rainfall, runoff and sediment concentration. The virtual lab included pictures, videos and explanations that facilitate learning. Moreover, some practical cases were proposed to apply the explained terms. The structure of menu consisted of: Experimental measurements in catchments; Gallery of videos; Equipment; Practical case; Glossary and Additional Information. Their contents were carefully carried out by professors and scientists of Hydrology and Electronics. The main advantages of the virtual lab were its compatibility with on-line platforms such as Moodle and the presentation of examples for the direct analysis as a basis for solving the proposed practical cases. It has been successfully used for two years and was well-values by the students due the opportunities offered by self-access learning tools. In addition, constraints associated with field trips such as logistical complexity and economic aspects are removed.

Mindfulness practice: A promising approach to reducing the effects of clinician implicit bias on patients.

PubMed

Burgess, Diana J; Beach, Mary Catherine; Saha, Somnath

2017-02-01

Like the population at large, health care providers hold implicit racial and ethnic biases that may contribute to health care disparities. Little progress has been made in identifying and implementing effective strategies to address these normal but potentially harmful unconscious cognitive processes. We propose that meditation training designed to increase healthcare providers' mindfulness skills is a promising and potentially sustainable way to address this problem. Emerging evidence suggests that mindfulness practice can reduce the provider contribution to healthcare disparities through several mechanisms including: reducing the likelihood that implicit biases will be activated in the mind, increasing providers' awareness of and ability to control responses to implicit biases once activated, increasing self-compassion and compassion toward patients, and reducing internal sources of cognitive load (e.g., stress, burnout, and compassion fatigue). Mindfulness training may also have advantages over current approaches to addressing implicit bias because it focuses on the development of skills through practice, promotes a nonjudgmental approach, can circumvent resistance some providers feel when directly confronted with evidence of racism, and constitutes a holistic approach to promoting providers' well-being. We close with suggestions for how a mindfulness approach can be practically implemented and identify potential challenges and research gaps to be addressed. Published by Elsevier B.V.

University-Based Teleradiology in the United States.

PubMed

Hunter, Tim B; Krupinski, Elizabeth A

2014-04-15

This article reviews the University of Arizona's more than 15 years of experience with teleradiology and provides an overview of university-based teleradiology practice in the United States (U.S.). In the U.S., teleradiology is a major economic enterprise with many private for-profit companies offering national teleradiology services (i.e., professional interpretation of radiologic studies of all types by American Board of Radiology certified radiologists). The initial thrust for teleradiology was for after-hours coverage of radiologic studies, but teleradiology has expanded its venue to include routine full-time or partial coverage for small hospitals, clinics, specialty medical practices, and urgent care centers. It also provides subspecialty radiologic coverage not available at smaller medical centers and clinics. Many U.S. university-based academic departments of radiology provide teleradiology services usually as an additional for-profit business to supplement departmental income. Since academic-based teleradiology providers have to compete in a very demanding marketplace, their success is not guaranteed. They must provide timely, high-quality professional services for a competitive price. Academic practices have the advantage of house officers and fellows who can help with the coverage, and they have excellent subspecialty expertise. The marketplace is constantly shifting, and university-based teleradiology practices have to be nimble and adjust to ever-changing situations.

The main challenges that remain in applying high-throughput sequencing to clinical diagnostics.

PubMed

Loeffelholz, Michael; Fofanov, Yuriy

2015-01-01

Over the last 10 years, the quality, price and availability of high-throughput sequencing instruments have improved to the point that this technology may be close to becoming a routine tool in the diagnostic microbiology laboratory. Two groups of challenges, however, have to be resolved in order to move this powerful research technology into routine use in the clinical microbiology laboratory. The computational/bioinformatics challenges include data storage cost and privacy concerns, requiring analysis to be performed without access to cloud storage or expensive computational infrastructure. The logistical challenges include interpretation of complex results and acceptance and understanding of the advantages and limitations of this technology by the medical community. This article focuses on the approaches to address these challenges, such as file formats, algorithms, data collection, reporting and good laboratory practices.

Tangible interactive system for document browsing and visualisation of multimedia data

NASA Astrophysics Data System (ADS)

Rytsar, Yuriy; Voloshynovskiy, Sviatoslav; Koval, Oleksiy; Deguillaume, Frederic; Topak, Emre; Startchik, Sergei; Pun, Thierry

2006-01-01

In this paper we introduce and develop a framework for document interactive navigation in multimodal databases. First, we analyze the main open issues of existing multimodal interfaces and then discuss two applications that include interaction with documents in several human environments, i.e., the so-called smart rooms. Second, we propose a system set-up dedicated to the efficient navigation in the printed documents. This set-up is based on the fusion of data from several modalities that include images and text. Both modalities can be used as cover data for hidden indexes using data-hiding technologies as well as source data for robust visual hashing. The particularities of the proposed robust visual hashing are described in the paper. Finally, we address two practical applications of smart rooms for tourism and education and demonstrate the advantages of the proposed solution.

Network influences on dissemination of evidence-based guidelines in state tobacco control programs.

PubMed

Luke, Douglas A; Wald, Lana M; Carothers, Bobbi J; Bach, Laura E; Harris, Jenine K

2013-10-01

Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's Best Practices for Comprehensive Tobacco Control Programs, are effectively and efficiently disseminated to intended stakeholders. To determine the organizational and network predictors of dissemination among state tobacco control programs, interviews with members of tobacco control networks across eight states were conducted between August 2009 and September 2010. Measures included partner attributes (e.g., agency type) and relationships among network members (frequency of contact, extent of collaboration, and dissemination of Best Practices). Exponential random graph modeling was used to examine attribute and structural predictors of collaboration and dissemination among partners in each network. Although density and centralization of dissemination ties varied across states, network analyses revealed a consistent prediction pattern across all eight states. State tobacco control dissemination networks were less dense but more centralized compared with organizational contact and collaboration networks. Tobacco control partners in each state were more likely to disseminate the Best Practices guidelines if they also had existing contact and collaboration relationships with one another. Evidence-based guidelines in public health need to be efficiently and broadly disseminated if we hope to translate science into practice. This study suggests that funders, advocacy groups, and public health agencies can take advantage of existing public health organizational relationships to support the communication and dissemination of evidence-based practices and policies.

The Swiss Master in Chiropractic Medicine Curriculum: Preparing Graduates to Work Together With Medicine to Improve Patient Care.

PubMed

Humphreys, B Kim; Peterson, Cynthia K

2016-12-01

In 2007, chiropractic became 1 of the 5 medical professions in Switzerland. This required a new chiropractic program that was fully integrated within a Swiss medical school. The purpose of this article was to discuss the Master in Chiropractic Medicine (MChiroMed) program at the University of Zürich, including advantages, opportunities, and challenges. In 2008, the MChiroMed program began with its first student cohort. The MChiroMed program is a 6-year Bologna model 2-cycle (bachelor and master) "spiral curriculum," with the first 4 years being fully integrated within the medical curriculum. A review of the main features of the curriculum revealed the advantages, opportunities, and challenges of this program in comparison with other contemporary chiropractic educational programs. Advantages and opportunities include an integrated curriculum within a university, medical school, and musculoskeletal hospital, with their associated human and physical resources. Many opportunities exist for high-level research collaborations. The rigorous entrance qualifications and small student cohorts result in bright, motivated, and enthusiastic students; appropriate assessments; and timely feedback on academic and clinical subjects. Early patient contact in hospitals and clinical facilities encourages the integration of academic theory and clinical practice. The main challenges faced by this program include difficulty recruiting a sufficient number of students because of the rigorous entrance requirements and curriculum overload resulting from undertaking a full medical curriculum and chiropractic modules. The MChiroMed program is a unique chiropractic curriculum that integrates medical and chiropractic education within a spiral curriculum at a world-class Swiss university medical school. The expectation is that graduates, with their expanded diagnostic and therapeutic knowledge, skills, and experience, will become future experts in primary spine care in Switzerland. It is hoped that this curriculum model will be adopted by other countries and jurisdictions seeking to enhance the role of chiropractic in health care.

Best Practices Guide for PPGs and the States

EPA Pesticide Factsheets

The guide is designed to help the U.S. Environmental Protection Agency (EPA) and stateofficials understand and take full advantage of the features and benefits of PerformancePartnership Grants (PPGs).

Flipping the classroom to teach Millennial residents medical leadership: a proof of concept.

PubMed

Lucardie, Alicia T; Berkenbosch, Lizanne; van den Berg, Jochem; Busari, Jamiu O

2017-01-01

The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners' preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education.

Flipping the classroom to teach Millennial residents medical leadership: a proof of concept

PubMed Central

Lucardie, Alicia T; Berkenbosch, Lizanne; van den Berg, Jochem; Busari, Jamiu O

2017-01-01

Introduction The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. Evidence The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Discussion Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners’ preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education. PMID:28144170

An online community of practice to support evidence-based physiotherapy practice in manual therapy.

PubMed

Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

2014-01-01

The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Engineering water repellency in granular materials for ground applications

NASA Astrophysics Data System (ADS)

Lourenco, Sergio; Saulick, Yunesh; Zheng, Shuang; Kang, Hengyi; Liu, Deyun; Lin, Hongjie

2017-04-01

Synthetic water repellent granular materials are a novel technology for constructing water-tight barriers and fills that is both inexpensive and reliant on an abundant local resource - soils. Our research is verifying its stability, so that perceived risks to practical implementation are identified and alleviated. Current ground stabilization measures are intrusive and use concrete, steel, and glass fibres as reinforcement elements (e.g. soil nails), so more sustainable approaches that require fewer raw materials are strongly recommended. Synthetic water repellent granular materials, with persistent water repellency, have been tested for water harvesting and proposed as landfill and slope covers. By chemically, physically and biologically adjusting the magnitude of water repellency, they offer the unique advantage of controlling water infiltration and allow their deployment as semi-permeable or impermeable materials. Other advantages include (1) volumetric stability, (2) high air permeability and low water permeability, (3) suitability for flexible applications (permanent and temporary usage), (4) improved adhesion aggregate-bitumen in pavements. Application areas include hydraulic barriers (e.g. for engineered slopes and waste containment), pavements and other waterproofing systems. Chemical treatments to achieve water repellency include the use of waxes, oils and silicone polymers which affect the soil particles at sub-millimetric scales. To date, our research has been aimed at demonstrating their use as slope covers and establishing the chemical compounds that develop high and stable water repellency. Future work will determine the durability of the water repellent coatings and the mechanics and modelling of processes in such soils.

Photonic Switching Devices Using Light Bullets

NASA Technical Reports Server (NTRS)

Goorjian, Peter M. (Inventor)

1999-01-01

A unique ultra-fast, all-optical switching device or switch is made with readily available, relatively inexpensive, highly nonlinear optical materials. which includes highly nonlinear optical glasses, semiconductor crystals and/or multiple quantum well semiconductor materials. At the specified wavelengths. these optical materials have a sufficiently negative group velocity dispersion and high nonlinear index of refraction to support stable light bullets. The light bullets counter-propagate through, and interact within the waveguide to selectively change each others' directions of propagation into predetermined channels. In one embodiment, the switch utilizes a rectangularly planar slab waveguide. and further includes two central channels and a plurality of lateral channels for guiding the light bullets into and out of the waveguide. An advantage of the present all-optical switching device lies in its practical use of light bullets, thus preventing the degeneration of the pulses due to dispersion and diffraction at the front and back of the pulses. Another advantage of the switching device is the relative insensitivity of the collision process to the time difference in which the counter-propagating pulses enter the waveguide. since. contrary to conventional co-propagating spatial solitons, the relative phase of the colliding pulses does not affect the interaction of these pulses. Yet another feature of the present all-optical switching device is the selection of the light pulse parameters which enables the generation of light bullets in nonlinear optical materials. including highly nonlinear optical glasses and semiconductor materials such as semiconductor crystals and/or multiple quantum well semiconductor materials.

Measurement Matters: Assessing Personal Qualities Other Than Cognitive Ability for Educational Purposes

PubMed Central

Duckworth, Angela L.; Yeager, David Scott

2016-01-01

There has been perennial interest in personal qualities other than cognitive ability that determine success, including self-control, grit, growth mindset, and many others. Attempts to measure such qualities for the purposes of educational policy and practice, however, are more recent. In this article, we identify serious challenges to doing so. We first address confusion over terminology, including the descriptor “non-cognitive.” We conclude that debate over the optimal name for this broad category of personal qualities obscures substantial agreement about the specific attributes worth measuring. Next, we discuss advantages and limitations of different measures. In particular, we compare self-report questionnaires, teacher-report questionnaires, and performance tasks, using self-control as an illustrative case study to make the general point that each approach is imperfect in its own way. Finally, we discuss how each measure’s imperfections can affect its suitability for program evaluation, accountability, individual diagnosis, and practice improvement. For example, we do not believe any available measure is suitable for between-school accountability judgments. In addition to urging caution among policymakers and practitioners, we highlight medium-term innovations that may make measures of these personal qualities more suitable for educational purposes. PMID:27134288

Practical challenges related to point of care testing.

PubMed

Shaw, Julie L V

2016-04-01

Point of care testing (POCT) refers to laboratory testing that occurs near to the patient, often at the patient bedside. POCT can be advantageous in situations requiring rapid turnaround time of test results for clinical decision making. There are many challenges associated with POCT, mainly related to quality assurance. POCT is performed by clinical staff rather than laboratory trained individuals which can lead to errors resulting from a lack of understanding of the importance of quality control and quality assurance practices. POCT is usually more expensive than testing performed in the central laboratory and requires a significant amount of support from the laboratory to ensure the quality testing and meet accreditation requirements. Here, specific challenges related to POCT compliance with accreditation standards are discussed along with strategies that can be used to overcome these challenges. These areas include: documentation of POCT orders, charting of POCT results as well as training and certification of individuals performing POCT. Factors to consider when implementing connectivity between POCT instruments and the electronic medical record are also discussed in detail and include: uni-directional versus bidirectional communication, linking patient demographic information with POCT software, the importance of positive patient identification and considering where to chart POCT results in the electronic medical record.

Epidemiology of mixed martial arts and youth violence in an ethnically diverse sample.

PubMed

Hishinuma, Earl S; Umemoto, Karen N; Nguyen, Toan Gia; Chang, Janice Y; Bautista, Randy Paul M

2012-01-01

Mixed martial arts' (MMAs) growing international popularity has rekindled the discussion on the advantages (e.g., exercise) and disadvantages (e.g., possible injury) of contact sports. This study was the first of its kind to examine the psychosocial aspects of MMA and youth violence using an epidemiologic approach with an Asian American and Pacific Islander (AAPI) adolescent sample (N = 881). The results were consistent with the increased popularity of MMA with 52% (adolescent males = 73%, adolescent females = 39%) enjoying watching MMA and 24% (adolescent males = 39%, adolescent females = 13%) practicing professional fight moves with friends. Although statistically significant ethnic differences were found for the two MMA items on a bivariate level, these findings were not statistically significant when considering other variables in the model. The bivariate results revealed a cluster of risk-protective factors. Regarding the multiple regression findings, although enjoying watching MMA remained associated with positive attitudes toward violence and practicing fight moves remained associated with negative out-group orientation, the MMA items were not associated with unique variances of youth violence perpetration and victimization. Implications included the need for further research that includes other diverse samples, more comprehensive and objective MMA and violence measures, and observational and intervention longitudinal studies.

Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency.

PubMed

Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

2008-02-02

Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms "compliance, persistence and adherence" with reference to medication use is central not only for monitoring patients' drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence.

Medical management of primary open-angle glaucoma: Best practices associated with enhanced patient compliance and persistency

PubMed Central

Kulkarni, Sadhana V; Damji, Karim F; Buys, Yvonne M

2008-01-01

Primary open angle glaucoma is a chronic optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of glaucoma associated visual impairment on the overall quality of life eg, fear of blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms “compliance, persistence and adherence” with reference to medication use is central not only for monitoring patients’ drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence. PMID:19920977

Net one, net two: the primary care network income statement.

PubMed

Halley, M D; Little, A W

1999-10-01

Although hospital-owned primary care practices have been unprofitable for most hospitals, some hospitals are achieving competitive advantage and sustainable practice operations. A key to the success of some has been a net income reporting tool that separates practice operating expenses from the costs of creating and operating a network of practices to help healthcare organization managers, physicians, and staff to identify opportunities to improve the network's financial performance. This "Net One, Net Two" reporting allows operations leadership to be held accountable for Net One expenses and strategic leadership to be held accountable for Net Two expenses.

Colostomy irrigation: current knowledge and practice of WOC nurses.

PubMed

Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S

2015-01-01

This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for ostomy nurses unprepared and/or unfamiliar with CI, as well as staff nurses in acute care units who could offer accurate information and additional resources to patients to increase their informed decisions.

Job Sharing--A New Way to Work

ERIC Educational Resources Information Center

Olmsted, Barney

1977-01-01

Describes the concept of job sharing, discusses the advantages and disadvantages to employees and employers, examines how widespread the practice is, and suggests ways that interested employers can implement this option. (SH)

Modern roundabouts for Oregon

DOT National Transportation Integrated Search

1998-06-01

This report reviews current research and practice on modern roundabouts, both in the US and other countries. The report compares the advantages and disadvantages of roundabouts, summarizes safety implications, and discusses pedestrian and bicyclist c...

Advantage of resonant power conversion in aerospace applications

NASA Technical Reports Server (NTRS)

Hansen, I. G.

1983-01-01

An ultrasonic, sinusoidal aerospace power distribution system is shown to have many advantages over other candidate power systems. These advantages include light weight, ease of fault clearing, versatility in handling many loads including motors, and the capability of production within the limits of present technology. References are cited that demonstrate the state of resonant converter technology and support these conclusions.

Comparison of provider and plan-based targeting strategies for disease management.

PubMed

Annis, Ann M; Holtrop, Jodi Summers; Tao, Min; Chang, Hsiu-Ching; Luo, Zhehui

2015-05-01

We aimed to describe and contrast the targeting methods and engagement outcomes for health plan-delivered disease management with those of a provider-delivered care management program. Health plan epidemiologists partnered with university health services researchers to conduct a quasi-experimental, mixed-methods study of a 2-year pilot. We used semi-structured interviews to assess the characteristics of program-targeting strategies, and calculated target and engagement rates from clinical encounter data. Five physician organizations (POs) with 51 participating practices implemented care management. Health plan member lists were sent monthly to the practices to accept patients, and then the practices sent back data reports regarding targeting and engagement in care management. Among patients accepted by the POs, we compared those who were targeted and engaged by POs with those who met health plan targeting criteria. The health plan's targeting process combined claims algorithms and employer group preferences to identify candidates for disease management; on the other hand, several different factors influenced PO practices' targeting approaches, including clinical and personal knowledge of the patients, health assessment information, and availability of disease-relevant programs. Practices targeted a higher percentage of patients for care management than the health plan (38% vs 16%), where only 7% of these patients met the targeting criteria of both. Practices engaged a higher percentage of their targeted patients than the health plan (50% vs 13%). The health plan's claims-driven targeting approach and the clinically based strategies of practices both provide advantages; an optimal model may be to combine the strengths of each approach to maximize benefits in care management.

Examples of current radar technology and applications, chapter 5, part B

NASA Technical Reports Server (NTRS)

1975-01-01

Basic principles and tradeoff considerations for SLAR are summarized. There are two fundamental types of SLAR sensors available to the remote sensing user: real aperture and synthetic aperture. The primary difference between the two types is that a synthetic aperture system is capable of significant improvements in target resolution but requires equally significant added complexity and cost. The advantages of real aperture SLAR include long range coverage, all-weather operation, in-flight processing and image viewing, and lower cost. The fundamental limitation of the real aperture approach is target resolution. Synthetic aperture processing is the most practical approach for remote sensing problems that require resolution higher than 30 to 40 m.

[Characteristics of heavy metals enrichment in algae ano its application prospects].

PubMed

Lu, Kaixing; Tang, Jian-jun; Jiang, De'an

2006-01-01

Using algae to bio-remedy heavy metals-contaminated waters has become an available and practical approach for environmental restoration. Because of its special cell wall structure, high capacity of heavy metal-enrichment, and easy to desorption, algae has been considered as an ideal biological adsorbent. This paper briefly introduced the structural and metabolic characteristics adapted for heavy metals enrichment of algae, including functional groups on cell wall, extracellular products, and intracellular heavy metals-chelating proteins, discussed the enrichment capability of living, dead and immobilized algae as well as the simple and convenient ways for desorption, and analyzed the advantages and disadvantages of using algae for bioremediation of polluted water, and its application prospects.

Characterization of Lubricants on Ball Bearings by FT-IR Using an Integrating Sphere

NASA Technical Reports Server (NTRS)

Street, K. W.; Pepper, S. V.; Wright, A. A.; Grady, B.

2007-01-01

Fourier Transform-Infrared reflectance microspectroscopy has been used extensively for the examination of coatings on nonplanar surfaces such as ball bearings. While this technique offers considerable advantages, practical application has many drawbacks, some of which are easily overcome by the use of integrating sphere technology. This paper describes the use of an integrating sphere for the quantification of thin layers of lubricant on the surface of ball bearings and the parameters which require optimization in order to obtain reliable data. Several applications of the technique are discussed including determination of lubricant load on 12.7 mm steel ball bearings and the examination of degraded lubricant on post mortem specimens.

Consumer-driven healthcare marketing: using the web to get up close and personal.

PubMed

Rooney, Keila

2009-01-01

This essay examines the emergence of consumer-driven healthcare marketing, including its operational definition, how it has been used in the past, and how it has evolved. Specifically, marketing practices in other industries are inspected to understand the factors that have contributed to their successes and to determine the relevance of these efforts to healthcare marketing. The advantages of new, technology-enabled marketing opportunities are considered as well, such as stealth ads, blogs, podcasts, and corporate participation in social networks. The implications of the regulation on healthcare websites, along with the work-around strategies used, are analyzed. Lastly, the essay submits recommendations for the healthcare executive when implementing a consumer-driven healthcare marketing plan.

Effective learner-centered strategies for teaching adults: using visual media to engage the adult learner.

PubMed

Myers, Dennis R; Sykes, Catherine; Myers, Scott

2008-01-01

This article offers practical guidance for educators as they prepare specialists to enhance the lives and communities of older persons through the strategic use of visual media in age-related courses. Advantages and disadvantages of this learning innovation are provided as well as seven approaches for enriching instruction. Resources are included for locating effective visual media, matching course content with video resources, determining fair use of copyrighted media, and inserting video clips into PowerPoint presentations. Strategies for accessing assistive services for implementing visual media in the classroom are also addressed. This article promotes the use of visual media for the purpose of enriching gerontological and geriatrics instruction for the adult learner.

Direct modeling parameter signature analysis and failure mode prediction of physical systems using hybrid computer optimization

NASA Technical Reports Server (NTRS)

Drake, R. L.; Duvoisin, P. F.; Asthana, A.; Mather, T. W.

1971-01-01

High speed automated identification and design of dynamic systems, both linear and nonlinear, are discussed. Special emphasis is placed on developing hardware and techniques which are applicable to practical problems. The basic modeling experiment and new results are described. Using the improvements developed successful identification of several systems, including a physical example as well as simulated systems, was obtained. The advantages of parameter signature analysis over signal signature analysis in go-no go testing of operational systems were demonstrated. The feasibility of using these ideas in failure mode prediction in operating systems was also investigated. An improved digital controlled nonlinear function generator was developed, de-bugged, and completely documented.

Lasers in private dermatologic practice.

PubMed

Eastern, J S

1986-04-01

The author has collected and evaluated data from 464 cutaneous laser procedures performed on 315 patients over two and one-half years. All procedures were performed under local anesthesia in a private dermatology office. The quality of results obtained, the advantages and disadvantages of laser treatment for the treatment of cutaneous problems, comparison with more conventional therapies, and the future of the laser in dermatologic private practice are discussed.

Blending Face-to-Face and Distance Learning Methods in Adult and Career-Technical Education. Practice Application Brief No. 23.

ERIC Educational Resources Information Center

Wonacott, Michael E.

Both face-to-face and distance learning methods are currently being used in adult education and career and technical education. In theory, the advantages of face-to-face and distance learning methods complement each other. In practice, however, both face-to-face and information and communications technology (ICT)-based distance programs often rely…

Skin whitening among Cameroonian female university students: knowledge, attitudes, practices and motivations.

PubMed

Kouotou, Emmanuel Armand; Nansseu, Jobert Richie N; Adegbidi, Hugues; Zoa Mebara, Theophane Christel Joel; Ndjitoyap Ndam, Elie Claude

2017-04-17

Lack of data on skin whitening (SW) among Cameroonian female university students prompted us to undertake the present study which aimed at assessing the knowledge, attitudes, practices and motivations of female university students vis-a-vis SW. This was a cross-sectional study conducted from January to April 2013 in 4 university campuses of Yaoundé, Cameroon. Any female student regularly registered in one of the study sites, who was present at the campus when the investigator visited and volunteered to participate in the study was enrolled. Overall, we recruited 620 female students, their ages ranging from 16 to 46 years with a mean of 21.3 ± 2.9 years. Only 87 participants (14%) found that SW was a good practice. One hundred and sixty nine respondents (27.3%) were currently practicing SW with no age difference when compared to their counterparts (p = 0.09). The desire to have a uniform body skin color was the prevailing reason motivating the practice of SW (39.1%), followed by the need to have a soft skin (29%). Assessment of levels of knowledge regarding advantages of the black skin and deleterious effects of SW showed excellent scores (≥75% of good answers) only in 6.1 and 0.5% of cases respectively, with no difference between those practicing SW or not (all p values > 0.05). The practice of SW is common among Cameroonian female university students who should therefore be educated on the advantages of the black skin and the harmful effects of SW.

Use of piezoelectric multicomponent force measuring devices in fluid mechanics

NASA Technical Reports Server (NTRS)

Richter, A.; Stefan, K.

1979-01-01

The characterisitics of piezoelectric multicomponent transducers are discussed, giving attention to the advantages of quartz over other materials. The main advantage of piezoelectric devices in aerodynamic studies is their ability to indicate rapid changes in the values of physical parameters. Problems in the accuracy of measurments by piezoelectric devices can be overcome by suitable design approaches. A practical example is given of how such can be utilized to measure rapid fluctuations of fluid forces exerted on a circular cylinder mounted in a water channel.

On increasing the spectral efficiency and transmissivity in the data transmission channel on the spacecraft-ground tracking station line

NASA Astrophysics Data System (ADS)

Andrianov, M. N.; Kostenko, V. I.; Likhachev, S. F.

2018-01-01

The algorithms for achieving a practical increase in the rate of data transmission on the space-craft-ground tracking station line has been considered. This increase is achieved by applying spectral-effective modulation techniques, the technology of orthogonal frequency compression of signals using millimeterrange radio waves. The advantages and disadvantages of each of three algorithms have been revealed. A significant advantage of data transmission in the millimeter range has been indicated.

Simulators for corporate pilot training and evaluation

NASA Technical Reports Server (NTRS)

Treichel, Curt

1992-01-01

Corporate aviation relies heavily on simulation to meet training and evaluation requirements. It appreciates the savings in fuel, money, noise, and time, and the added safety it provides. Also, simulation provides opportunities to experience many emergencies that cannot be safely practiced in the aircraft. There is a need to focus on the advantages of simulator training over aircraft training and to provide appropriate changes in the regulations to allow the community to make it possible for users to take full advantage of simulation.

Bayesian networks and statistical analysis application to analyze the diagnostic test accuracy

NASA Astrophysics Data System (ADS)

Orzechowski, P.; Makal, Jaroslaw; Onisko, A.

2005-02-01

The computer aided BPH diagnosis system based on Bayesian network is described in the paper. First result are compared to a given statistical method. Different statistical methods are used successfully in medicine for years. However, the undoubted advantages of probabilistic methods make them useful in application in newly created systems which are frequent in medicine, but do not have full and competent knowledge. The article presents advantages of the computer aided BPH diagnosis system in clinical practice for urologists.

Counselling for depression in primary care.

PubMed

Rowland, N; Bower, P; Mellor, C; Heywood, P; Godfrey, C

2001-01-01

There is wide clinician and patient support for counselling in primary care, particularly in the UK. This review examines the effectiveness and cost effectiveness of counselling for psychological and psychosocial problems in the primary care setting. To assess the effects of counselling in primary care by reviewing cost and outcome data for patients with psychological and psychosocial problems considered suitable for counselling. The search strategy included electronic searching of databases (including the CCDAN Register of RCTs and CCTs) along with handsearching of a specialist journal. Published and unpublished sources (clinical trials, books, dissertations, agency reports etc.) were searched, and their reference lists scanned. Contact was made with subject experts and CCDAN members. Randomised and controlled patient preference trials comparing counselling in primary care with usual general practitioner care for patients with psychological and psychosocial problems considered suitable for counselling. Trials completed before the end of April 1998 were included in the review. Trials were independently assessed by at least two reviewers for appropriateness of inclusion and methdological quality. Four trials, involving 678 participants, of whom 487 were followed up, were included. Data for psychological symptom levels (four trials) were pooled statistically. Patients receiving counselling had significantly better psychological symptom levels post intervention than patients receiving usual general practitioner care (standardised mean difference -0.30, 95% CI, (-0.49 to - 0.11). The effect remained statistically significant when the results from studies with less rigorous methodology were excluded in a sensitivity analysis. Patients who received counselling tended to be more satisfied with their treatment (three trials). Health service utilisation data were reported in all trials reviewed, but only one trial undertook a cost analysis. No clear cost advantage was associated with either counselling or usual general practice care. Patients who received counselling were more likely to have improved psychological symptom levels than those who did not receive counselling. Levels of satisfaction with counselling were high. There is limited information about the cost effectiveness of counselling, with one study reporting no clear cost advantage with either counselling or general practice care. The four trials included in this review were all pragmatic trials of counselling in primary care in the UK, which reflect the reality of clinical provision in this context. There were methdological weaknesses identified in the studies, which should be taken into account when considering the results. The evidence base will be extended by trials of counselling which are nearing completion.

Put a Short-Wave Radio in Your Foreign Language Classroom

ERIC Educational Resources Information Center

Oksenholt, Svein

1977-01-01

Advantages of the short-wave radio as a supplement to foreign language instruction as well as practical hints on wavelength, antenna, and techniques for use are provided. Selective annotated bibliography. (STS)

Mindfulness meditation practice and executive functioning: Breaking down the benefit.

PubMed

Gallant, Sara N

2016-02-01

This paper focuses on evidence for mindfulness meditation-related benefits to executive functioning, processes important for much of human volitional behaviour. Miyake et al. (2000) have shown that executive functions can be fractionated into three distinct domains including inhibition, working memory updating, and mental set shifting. Considering these separable domains, it is important to determine whether the effects of mindfulness can generalize to all three sub-functions or are specific to certain domains. To address this, the current review applied Miyake et al.'s (2000) fractionated model of executive functioning to the mindfulness literature. Empirical studies assessing the benefits of mindfulness to measures tapping the inhibition, updating, and shifting components of executive functioning were examined. Results suggest a relatively specific as opposed to general benefit resulting from mindfulness, with consistent inhibitory improvement, but more variable advantages to the updating and shifting domains. Recommendations surrounding application of mindfulness practice and future research are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Manufacture of Third-Generation Lentivirus for Preclinical Use, with Process Development Considerations for Translation to Good Manufacturing Practice.

PubMed

Gándara, Carolina; Affleck, Valerie; Stoll, Elizabeth Ann

2018-02-01

Lentiviral vectors are used in laboratories around the world for in vivo and ex vivo delivery of gene therapies, and increasingly clinical investigation as well as preclinical applications. The third-generation lentiviral vector system has many advantages, including high packaging capacity, stable gene expression in both dividing and post-mitotic cells, and low immunogenicity in the recipient organism. Yet, the manufacture of these vectors is challenging, especially at high titers required for direct use in vivo, and further challenges are presented by the process of translating preclinical gene therapies toward manufacture of products for clinical investigation. The goals of this paper are to report the protocol for manufacturing high-titer third-generation lentivirus for preclinical testing and to provide detailed information on considerations for translating preclinical viral vector manufacture toward scaled-up platforms and processes in order to make gene therapies under Good Manufacturing Practice that are suitable for clinical trials.

Implementation of audio computer-assisted interviewing software in HIV/AIDS research.

PubMed

Pluhar, Erika; McDonnell Holstad, Marcia; Yeager, Katherine A; Denzmore-Nwagbara, Pamela; Corkran, Carol; Fielder, Bridget; McCarty, Frances; Diiorio, Colleen

2007-01-01

Computer-assisted interviewing (CAI) has begun to play a more prominent role in HIV/AIDS prevention research. Despite the increased popularity of CAI, particularly audio computer-assisted self-interviewing (ACASI), some research teams are still reluctant to implement ACASI technology because of lack of familiarity with the practical issues related to using these software packages. The purpose of this report is to describe the implementation of one particular ACASI software package, the Questionnaire Development System (QDS; Nova Research Company, Bethesda, MD), in several nursing and HIV/AIDS prevention research settings. The authors present acceptability and satisfaction data from two large-scale public health studies in which they have used QDS with diverse populations. They also address issues related to developing and programming a questionnaire; discuss practical strategies related to planning for and implementing ACASI in the field, including selecting equipment, training staff, and collecting and transferring data; and summarize advantages and disadvantages of computer-assisted research methods.

Advanced lighting guidelines: 1993. Final report

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

Eley, C.; Tolen, T.M.; Benya, J.R.

1993-12-31

The 1993 Advanced Lighting Guidelines document consists of twelve guidelines that provide an overview of specific lighting technologies and design application techniques utilizing energy-efficient lighting practice. Lighting Design Practice assesses energy-efficient lighting strategies, discusses lighting issues, and explains how to obtain quality lighting design and consulting services. Luminaires and Lighting Systems surveys luminaire equipment designed to take advantage of advanced technology lamp products and includes performance tables that allow for accurate estimation of luminaire light output and power input. The additional ten guidelines -- Computer-Aided Lighting Design, Energy-Efficient Fluorescent Ballasts, Full-Size Fluorescent Lamps, Compact Fluorescent Lamps, Tungsten-Halogen Lamps, Metal Halidemore » and HPS Lamps, Daylighting and Lumen Maintenance, Occupant Sensors, Time Scheduling Systems, and Retrofit Control Technologies -- each provide a product technology overview, discuss current products on the lighting equipment market, and provide application techniques. This document is intended for use by electric utility personnel involved in lighting programs, lighting designers, electrical engineers, architects, lighting manufacturers` representatives, and other lighting professionals.« less

Manufacture of Third-Generation Lentivirus for Preclinical Use, with Process Development Considerations for Translation to Good Manufacturing Practice

PubMed Central

Gándara, Carolina; Affleck, Valerie; Stoll, Elizabeth Ann

2018-01-01

Lentiviral vectors are used in laboratories around the world for in vivo and ex vivo delivery of gene therapies, and increasingly clinical investigation as well as preclinical applications. The third-generation lentiviral vector system has many advantages, including high packaging capacity, stable gene expression in both dividing and post-mitotic cells, and low immunogenicity in the recipient organism. Yet, the manufacture of these vectors is challenging, especially at high titers required for direct use in vivo, and further challenges are presented by the process of translating preclinical gene therapies toward manufacture of products for clinical investigation. The goals of this paper are to report the protocol for manufacturing high-titer third-generation lentivirus for preclinical testing and to provide detailed information on considerations for translating preclinical viral vector manufacture toward scaled-up platforms and processes in order to make gene therapies under Good Manufacturing Practice that are suitable for clinical trials. PMID:29212357

Training Psychiatry Residents in Psychotherapy: The Role of Manualized Treatments.

PubMed

Pagano, Joshua; Kyle, Brandon N; Johnson, Toni L; Saeed, Sy Atezaz

2017-06-01

Evidence-based treatment and manualized psychotherapy have a recent but rich history. As interest and research have progressed, defining the role of treatment manuals in resident training and clinical practice has become more important. Although there is not a universal definition of treatment manual, most clinicians and researchers agree that treatment manuals are an essential piece of evidence-based therapy, and that despite several limitations, they offer advantages in training residents in psychotherapy. Requirements for resident training in psychotherapy have changed over the years, and treatment manuals offer a simple and straightforward way to meet training requirements. In a search limited to only depression, two treatment manuals emerged with the support of research regarding both clinical practice and resident training. In looking toward the future, it will be important for clinicians to remain updated on further advances in evidence based manualized treatment as a tool for training residents in psychotherapy, including recent developments in online and smartphone based treatments.

Training at altitude in practice.

PubMed

Dick, F W

1992-10-01

There can be little doubt that training at altitude is fundamental to preparing an athlete for competition at altitude. However the value of training at altitude for competition at sea level appears on the one hand to lack total acceptance amongst sports scientists; and on the other to hold some cloak of mystery for coaches who have yet to enjoy first hand experience. The fact is that very few endurance athletes will ignore the critical edge which altitude training affords. Each fraction of a percentage of performance advantage gained through methods which are within the rules of fair play in sport, may shift the balance between failure and achievement. Moreover, there is growing support for application of training at altitude for speed-related disciplines. This paper aims to demystify the subject by dealing with practical aspects of training at altitude. Such aspects include a checklist of what should and should not be done at altitude, when to use altitude relative to target competitions, and specific training examples.

Pharmaceutical Additive Manufacturing: a Novel Tool for Complex and Personalized Drug Delivery Systems.

PubMed

Zhang, Jiaxiang; Vo, Anh Q; Feng, Xin; Bandari, Suresh; Repka, Michael A

2018-06-25

Inter-individual variability is always an issue when treating patients of different races, genders, ages, pharmacogenetics, and pharmacokinetic characteristics. However, the development of novel dosage forms is limited by the huge investments required for production line modifications and dosages diversity. Additive manufacturing (AM) or 3D printing can be a novel alternative solution for the development of controlled release dosages because it can produce personalized or unique dosage forms and more complex drug-release profiles. The primary objective of this manuscript is to review the 3D printing processes that have been used in the pharmaceutical area, including their general aspects, materials, and the operation of each AM technique. Advantages and shortcomings of the technologies are discussed with respect to practice and practical applications. Thus, this review will provide an overview and discussion on advanced pharmaceutical AM technologies, which can be used to produce unique controlled drug delivery systems and personalized dosages for the future of personalized medicine.

Towards an Ethical Framework for Publishing Twitter Data in Social Research: Taking into Account Users’ Views, Online Context and Algorithmic Estimation

PubMed Central

Williams, Matthew L; Burnap, Pete; Sloan, Luke

2017-01-01

New and emerging forms of data, including posts harvested from social media sites such as Twitter, have become part of the sociologist’s data diet. In particular, some researchers see an advantage in the perceived ‘public’ nature of Twitter posts, representing them in publications without seeking informed consent. While such practice may not be at odds with Twitter’s terms of service, we argue there is a need to interpret these through the lens of social science research methods that imply a more reflexive ethical approach than provided in ‘legal’ accounts of the permissible use of these data in research publications. To challenge some existing practice in Twitter-based research, this article brings to the fore: (1) views of Twitter users through analysis of online survey data; (2) the effect of context collapse and online disinhibition on the behaviours of users; and (3) the publication of identifiable sensitive classifications derived from algorithms. PMID:29276313

Towards Optical Partial Discharge Detection with Micro Silicon Photomultipliers

PubMed Central

Ren, Ming; Song, Bo; Dong, Ming

2017-01-01

Optical detection is reliable in intrinsically characterizing partial discharges (PDs). Because of the great volume and high-level power supply of the optical devices that can satisfy the requirements in photosensitivity, optical PD detection can merely be used in laboratory studies. To promote the practical application of the optical approach in an actual power apparatus, a silicon photomultiplier (SiPM)-based PD sensor is introduced in this paper, and its basic properties, which include the sensitivity, pulse resolution, correlation with PD severity, and electromagnetic (EM) interference immunity, are experimentally evaluated. The stochastic phase-resolved PD pattern (PRPD) for three typical insulation defects are obtained by SiPM PD detector and are compared with those obtained using a high-frequency current transformer (HFCT) and a vacuum photomultiplier tube (PMT). Because of its good performances in the above aspects and its additional advantages, such as the small size, low power supply, and low cost, SiPM offers great potential in practical optical PD monitoring. PMID:29125544

Towards Optical Partial Discharge Detection with Micro Silicon Photomultipliers.

PubMed

Ren, Ming; Zhou, Jierui; Song, Bo; Zhang, Chongxing; Dong, Ming; Albarracín, Ricardo

2017-11-10

Optical detection is reliable in intrinsically characterizing partial discharges (PDs). Because of the great volume and high-level power supply of the optical devices that can satisfy the requirements in photosensitivity, optical PD detection can merely be used in laboratory studies. To promote the practical application of the optical approach in an actual power apparatus, a silicon photomultiplier (SiPM)-based PD sensor is introduced in this paper, and its basic properties, which include the sensitivity, pulse resolution, correlation with PD severity, and electromagnetic (EM) interference immunity, are experimentally evaluated. The stochastic phase-resolved PD pattern (PRPD) for three typical insulation defects are obtained by SiPM PD detector and are compared with those obtained using a high-frequency current transformer (HFCT) and a vacuum photomultiplier tube (PMT). Because of its good performances in the above aspects and its additional advantages, such as the small size, low power supply, and low cost, SiPM offers great potential in practical optical PD monitoring.

Highly Turbulent Counterflow Flames: A Laboratory Scale Benchmark for Practical Combustion Systems

NASA Astrophysics Data System (ADS)

Gomez, Alessandro

2013-11-01

Since the pioneering work of Weinberg's group at Imperial College in the `60s, the counterflow system has been the workhorse of laminar flame studies. Recent developments have shown that it is also a promising benchmark for highly turbulent (Ret ~ 1000) nonpremixed and premixed flames of direct relevance to gasturbine combustion. Case studies will demonstrate the versatility of the system in mimicking real flame effects, such as heat loss and flame stratification in premixed flames, and the compactness of the combustion region. The system may offer significant advantages from a computational viewpoint, including: a) aerodynamic flame stabilization near the interface between the two opposed jets, with ensuing simplifications in the prescription of boundary conditions; b) a fiftyfold reduction of the domain of interest as compared to conventional nonpremixed jet flames at the same Reynolds number; and c) millisecond mean residence times, which is particularly useful for DNS/LES computational modeling, and for soot suppression in the combustion of practical fuels.

A task force model for statewide change in nursing education: building quality and safety.

PubMed

Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

2013-01-01

The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

Experience inheritance from famous specialists based on real-world clinical research paradigm of traditional Chinese medicine.

PubMed

Song, Guanli; Wang, Yinghui; Zhang, Runshun; Liu, Baoyan; Zhou, Xuezhong; Zhou, Xiaji; Zhang, Hong; Guo, Yufeng; Xue, Yanxing; Xu, Lili

2014-09-01

The current modes of experience inheritance from famous specialists in traditional Chinese medicine (TCM) include master and disciple, literature review, clinical-epidemiology-based clinical research observation, and analysis and data mining via computer and database technologies. Each mode has its advantages and disadvantages. However, a scientific and instructive experience inheritance mode has not been developed. The advent of the big data era as well as the formation and practice accumulation of the TCM clinical research paradigm in the real world have provided new perspectives, techniques, and methods for inheriting experience from famous TCM specialists. Through continuous exploration and practice, the research group proposes the innovation research mode based on the real-world TCM clinical research paradigm, which involves the inheritance and innovation of the existing modes. This mode is formulated in line with its own development regularity of TCM and is expected to become the main mode of experience inheritance in the clinical field.

Towards an Ethical Framework for Publishing Twitter Data in Social Research: Taking into Account Users' Views, Online Context and Algorithmic Estimation.

PubMed

Williams, Matthew L; Burnap, Pete; Sloan, Luke

2017-12-01

New and emerging forms of data, including posts harvested from social media sites such as Twitter, have become part of the sociologist's data diet. In particular, some researchers see an advantage in the perceived 'public' nature of Twitter posts, representing them in publications without seeking informed consent. While such practice may not be at odds with Twitter's terms of service, we argue there is a need to interpret these through the lens of social science research methods that imply a more reflexive ethical approach than provided in 'legal' accounts of the permissible use of these data in research publications. To challenge some existing practice in Twitter-based research, this article brings to the fore: (1) views of Twitter users through analysis of online survey data; (2) the effect of context collapse and online disinhibition on the behaviours of users; and (3) the publication of identifiable sensitive classifications derived from algorithms.

[[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

PubMed

Mabika, Hines

2015-01-01

It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.

[Overdenture supported by natural teeth: analysis of clinical advantages].

PubMed

Scotti, R; Melilli, D; Pizzo, G

2003-05-01

Hybrid prosthesis supported by natural teeth (overdenture) is widely used in clinical practice and should be executed whenever the clinical conditions suggest it. Through a critical review of the literature, the anatomical, functional, psychological and clinical advantages are emphasized. Among the first ones, the prophylaxis of residual anatomical components, due to the limitation of bone resorption, and the preservation of sensorial proprioception are relevant. Important advantages are also represented by a better crown-root ratio of residual teeth supporting overdenture, with the consequent improvement of the longitudinal prognosis of such teeth. The greater retention and stability of overdenture in comparison with complete denture greatly improve the masticatory efficacy. The psychological advantages resulting from the dental anchorage, which allows the patient to be more confident in social life, are also relevant. Finally, when the dental support is lost, converting overdenture into complete denture is simple and quick, and makes easier the longitudinal clinical maintenance of the denture.

A review of the factors affecting the survival of donkeys in semi-arid regions of sub-Saharan Africa.

PubMed

Smith, D G; Pearson, R A

2005-11-01

The large fluctuations seen in cattle populations during periods of drought in sub-Saharan Africa are not evident in the donkey population. Donkeys appear to have a survival advantage over cattle that is increasingly recognized by smallholder farmers in their selection of working animals. The donkey's survival advantages arise from both socioeconomic and biological factors. Socioeconomic factors include the maintenance of a low sustainable population of donkeys owing to their single-purpose role and their low social status. Also, because donkeys are not usually used as a meat animal and can provide a regular income as a working animal, they are not slaughtered in response to drought, as are cattle. Donkeys have a range of physiological and behavioural adaptations that individually provide small survival advantages over cattle but collectively may make a large difference to whether or not they survive drought. Donkeys have lower maintenance costs as a result of their size and spend less energy while foraging for food; lower energy costs result in a lower dry matter intake (DMI) requirement. In donkeys, low-quality diets are digested almost as efficiently as in ruminants and, because of a highly selective feeding strategy, the quality of diet obtained by donkeys in a given pasture is higher than that obtained by cattle. Lower energy costs of walking, longer foraging times per day and ability to tolerate thirst may allow donkeys to access more remote, under-utilized sources of forage that are inaccessible to cattle on rangeland. As donkeys become a more popular choice of working animal for farmers, specific management practices need to be devised that allow donkeys to fully maximize their natural survival advantages.

Service user involvement in the assessment of a practice competency in mental health nursing - stakeholders' views and recommendations.

PubMed

Speers, Janey

2008-03-01

Competence in building therapeutic relationships is essential for student mental health nurses and therefore requires robust assessment. However, the assessment of such complex skills is problematic. Following policy directives exhorting increased service user involvement in general, there have been recent suggestions that service users could contribute to the assessment of practice. This paper outlines a research project which investigated the views of 24 stakeholders (service users, lecturers, mentors, ex-students and student nurses) about the potential involvement of service users in the assessment of student mental health nurses' competence in forming therapeutic relationships. The findings revealed that service users interviewed had a largely positive attitude towards this potential development. Nurse participants were more ambivalent. Despite citing several key advantages, nurses also expressed some important reservations about how such a proposal could be implemented in practice. Nevertheless, on balance, they were in favour in principle. Key recommendations for the implementation of this potential development included strategies to enable anonymity and freedom of choice for service users. A range of options for obtaining service user feedback were put forward, along with some ideas about how the fairness of the assessment might be protected.

Design and Development of a Course in Professionalism and Ethics for CDIO Curriculum in China.

PubMed

Fan, Yinghui; Zhang, Xingwei; Xie, Xinlu

2015-10-01

At Shantou University (STU) in 2008, a stand-alone engineering ethics course was first included within a Conceive-Design-Implement-Operate (CDIO) curriculum to address the scarcity of engineering ethics education in China. The philosophy of the course design is to help students to develop an in-depth understanding of social sustainability and to fulfill the obligations of engineers in the twenty-first century within the context of CDIO engineering practices. To guarantee the necessary cooperation of the relevant parties, we have taken advantage of the top-down support from the STU administration. Three themes corresponding to contemporary issues in China were chosen as the course content: engineers' social obligations, intellectual property and engineering safety criteria. Some popular pedagogies are used for ethics instruction such as case studies and group discussions through role-playing. To impart the diverse expertise of the practical professional practice, team teaching is adopted by interdisciplinary instructors with strong qualifications and industrial backgrounds. Although the assessment of the effectiveness of the course in enhancing students' sense of ethics is limited to assignment reports and class discussions, our endeavor is seen as positive and will continue to sustain the CDIO reform initiatives of STU.

Adaptive tracking control for active suspension systems with non-ideal actuators

NASA Astrophysics Data System (ADS)

Pan, Huihui; Sun, Weichao; Jing, Xingjian; Gao, Huijun; Yao, Jianyong

2017-07-01

As a critical component of transportation vehicles, active suspension systems are instrumental in the improvement of ride comfort and maneuverability. However, practical active suspensions commonly suffer from parameter uncertainties (e.g., the variations of payload mass and suspension component parameters), external disturbances and especially the unknown non-ideal actuators (i.e., dead-zone and hysteresis nonlinearities), which always significantly deteriorate the control performance in practice. To overcome these issues, this paper synthesizes an adaptive tracking control strategy for vehicle suspension systems to achieve suspension performance improvements. The proposed control algorithm is formulated by developing a unified framework of non-ideal actuators rather than a separate way, which is a simple yet effective approach to remove the unexpected nonlinear effects. From the perspective of practical implementation, the advantages of the presented controller for active suspensions include that the assumptions on the measurable actuator outputs, the prior knowledge of nonlinear actuator parameters and the uncertain parameters within a known compact set are not required. Furthermore, the stability of the closed-loop suspension system is theoretically guaranteed by rigorous mathematical analysis. Finally, the effectiveness of the presented adaptive control scheme is confirmed using comparative numerical simulation validations.

A comparison of results of empirical studies of supplementary search techniques and recommendations in review methodology handbooks: a methodological review.

PubMed

Cooper, Chris; Booth, Andrew; Britten, Nicky; Garside, Ruth

2017-11-28

The purpose and contribution of supplementary search methods in systematic reviews is increasingly acknowledged. Numerous studies have demonstrated their potential in identifying studies or study data that would have been missed by bibliographic database searching alone. What is less certain is how supplementary search methods actually work, how they are applied, and the consequent advantages, disadvantages and resource implications of each search method. The aim of this study is to compare current practice in using supplementary search methods with methodological guidance. Four methodological handbooks in informing systematic review practice in the UK were read and audited to establish current methodological guidance. Studies evaluating the use of supplementary search methods were identified by searching five bibliographic databases. Studies were included if they (1) reported practical application of a supplementary search method (descriptive) or (2) examined the utility of a supplementary search method (analytical) or (3) identified/explored factors that impact on the utility of a supplementary method, when applied in practice. Thirty-five studies were included in this review in addition to the four methodological handbooks. Studies were published between 1989 and 2016, and dates of publication of the handbooks ranged from 1994 to 2014. Five supplementary search methods were reviewed: contacting study authors, citation chasing, handsearching, searching trial registers and web searching. There is reasonable consistency between recommended best practice (handbooks) and current practice (methodological studies) as it relates to the application of supplementary search methods. The methodological studies provide useful information on the effectiveness of the supplementary search methods, often seeking to evaluate aspects of the method to improve effectiveness or efficiency. In this way, the studies advance the understanding of the supplementary search methods. Further research is required, however, so that a rational choice can be made about which supplementary search strategies should be used, and when.

Selecting the Right Courseware for Your Online Learning Program.

ERIC Educational Resources Information Center

O'Mara, Heather

2000-01-01

Presents criteria for selecting courseware for online classes. Highlights include ease of use, including navigation; assessment tools; advantages of Java-enabled courseware; advantages of Oracle databases, including scalability; future possibilities for multimedia technology; and open architecture that will integrate with other systems. (LRW)

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.

Consumer focus can spur group practice turnaround.

PubMed

Foreman, M S; Draper, A

2001-06-01

Many healthcare organizations have lost money on their employed group practices. The solution to this dilemma is not necessarily divestment of the group practices. Instead, some healthcare organizations should view their physicians as an asset. Healthcare organizations and physicians need to develop a new framework for their relationship to optimize their competitive advantage. Three guiding principles that will help accomplish this objective are to recast the healthcare organization-physician relationship to focus on the consumer, reconfigure the economic model to exceed consumer demands, and restructure the group practice to encourage fiscal and service excellence. In developing a new relationship framework, the stakeholders need to define the group practice's mission, strategic direction, composition, infrastructure, compensation model, and structure.

Did Babe Ruth Have a Comparative Advantage as a Pitcher?

ERIC Educational Resources Information Center

Scahill, Edward M.

1990-01-01

Advocates using baseball statistics to illustrate the advantages of specialization in production. Using Babe Ruth's record as an analogy, suggests a methodology for determining a player's comparative advantage as a teaching illustration. Includes the team's statistical profile in five tables to explain comparative advantage and profit maximizing.…

Opportunities and methodological challenges in EEG and MEG resting state functional brain network research.

PubMed

van Diessen, E; Numan, T; van Dellen, E; van der Kooi, A W; Boersma, M; Hofman, D; van Lutterveld, R; van Dijk, B W; van Straaten, E C W; Hillebrand, A; Stam, C J

2015-08-01

Electroencephalogram (EEG) and magnetoencephalogram (MEG) recordings during resting state are increasingly used to study functional connectivity and network topology. Moreover, the number of different analysis approaches is expanding along with the rising interest in this research area. The comparison between studies can therefore be challenging and discussion is needed to underscore methodological opportunities and pitfalls in functional connectivity and network studies. In this overview we discuss methodological considerations throughout the analysis pipeline of recording and analyzing resting state EEG and MEG data, with a focus on functional connectivity and network analysis. We summarize current common practices with their advantages and disadvantages; provide practical tips, and suggestions for future research. Finally, we discuss how methodological choices in resting state research can affect the construction of functional networks. When taking advantage of current best practices and avoid the most obvious pitfalls, functional connectivity and network studies can be improved and enable a more accurate interpretation and comparison between studies. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Using discrete choice experiments within a cost-benefit analysis framework: some considerations.

PubMed

McIntosh, Emma

2006-01-01

A great advantage of the stated preference discrete choice experiment (SPDCE) approach to economic evaluation methodology is its immense flexibility within applied cost-benefit analyses (CBAs). However, while the use of SPDCEs in healthcare has increased markedly in recent years there has been a distinct lack of equivalent CBAs in healthcare using such SPDCE-derived valuations. This article outlines specific issues and some practical suggestions for consideration relevant to the development of CBAs using SPDCE-derived benefits. The article shows that SPDCE-derived CBA can adopt recent developments in cost-effectiveness methodology including the cost-effectiveness plane, appropriate consideration of uncertainty, the net-benefit framework and probabilistic sensitivity analysis methods, while maintaining the theoretical advantage of the SPDCE approach. The concept of a cost-benefit plane is no different in principle to the cost-effectiveness plane and can be a useful tool for reporting and presenting the results of CBAs.However, there are many challenging issues to address for the advancement of CBA methodology using SPCDEs within healthcare. Particular areas for development include the importance of accounting for uncertainty in SPDCE-derived willingness-to-pay values, the methodology of SPDCEs in clinical trial settings and economic models, measurement issues pertinent to using SPDCEs specifically in healthcare, and the importance of issues such as consideration of the dynamic nature of healthcare and the resulting impact this has on the validity of attribute definitions and context.

Unicellular eukaryotes as models in cell and molecular biology: critical appraisal of their past and future value.

PubMed

Simon, Martin; Plattner, Helmut

2014-01-01

Unicellular eukaryotes have been appreciated as model systems for the analysis of crucial questions in cell and molecular biology. This includes Dictyostelium (chemotaxis, amoeboid movement, phagocytosis), Tetrahymena (telomere structure, telomerase function), Paramecium (variant surface antigens, exocytosis, phagocytosis cycle) or both ciliates (ciliary beat regulation, surface pattern formation), Chlamydomonas (flagellar biogenesis and beat), and yeast (S. cerevisiae) for innumerable aspects. Nowadays many problems may be tackled with "higher" eukaryotic/metazoan cells for which full genomic information as well as domain databases, etc., were available long before protozoa. Established molecular tools, commercial antibodies, and established pharmacology are additional advantages available for higher eukaryotic cells. Moreover, an increasing number of inherited genetic disturbances in humans have become elucidated and can serve as new models. Among lower eukaryotes, yeast will remain a standard model because of its peculiarities, including its reduced genome and availability in the haploid form. But do protists still have a future as models? This touches not only the basic understanding of biology but also practical aspects of research, such as fund raising. As we try to scrutinize, due to specific advantages some protozoa should and will remain favorable models for analyzing novel genes or specific aspects of cell structure and function. Outstanding examples are epigenetic phenomena-a field of rising interest. © 2014 Elsevier Inc. All rights reserved.

Assessment of online continuing dental education in North Carolina.

PubMed

Francis, B; Mauriello, S M; Phillips, C; Englebardt, S; Grayden, S K

2000-01-01

Dental professionals are discovering the unique advantages of asynchronous lifelong learning through continuing dental education (CDE) opportunities offered online. The purpose of this study was to evaluate both the process and outcomes of online CDE in North Carolina. The assessment was designed to provide a better understanding of practicing dental professionals experiences with online CDE and to determine the effectiveness of this learning strategy. Dental professionals from four North Carolina Area Health Education Centers regions evaluated two pilot online CDE modules in 1998. Thirty-one participants were recruited and subsequently enrolled with 23 completing at least one module. Each module included objectives, a multiple-choice pretest, interactive core material, and a post-test. Participants completed three online surveys measuring individual demographics and computer skill level, module design, and use and overall reaction to online learning. Most participants agreed that the modules were comprehensive, were pleasing in appearance, provided clear instructions, provided adequate feedback, and were easy to navigate. Most participants agreed that knowledge of the material increased. This was validated by a significant increase in mean pre- to post-test scores (p = .0001). Participants agreed that convenience was a definite advantage, and they would choose online courses again to meet their CDE needs. The least-liked aspects included technical and formatting issues. Participants were enthusiastic about online learning and learned effectively with this teaching strategy, but desired much more interactivity than existed in the current design.

Best practices for rural smart growth.

DOT National Transportation Integrated Search

2010-07-01

Smart growth is a development strategy that encompasses economic, environmental and social objectives to manage : the growth of a community. The basic principles of smart growth are to: : Mix land uses. : Take advantage of compact building de...

Health Insurance in the Public Sector.

ERIC Educational Resources Information Center

Rubin, Richard S.

1980-01-01

In general, this survey of six midwest states revealed that health insurance plans for state government employees have moved toward employer funding, comprehensive benefits, and some recognition of the advantages of prepaid group practice plans. (Author/IRT)

Field Evaluation of Fracture Control in Tunnel Blasting

DOT National Transportation Integrated Search

1979-12-01

The objective of this research was to implement fracture control procedures in a tunnel project and to assess the practicality, advantages, disadvantages, performance and cost effectiveness of fracture control methods against smooth blasting procedur...

Collaboration: integrating practice and research in public health nursing.

PubMed

Henry, V; Schmitz, K; Reif, L; Rudie, P

1992-12-01

The need to integrate clinical practice and research has been stressed for many years in both public health and nursing. This article describes such a collaborative project between two rural upper Midwest public health nursing agencies and public health nursing faculty from a small, liberal arts, baccalaureate nursing program. The high-risk prenatal research project provided an opportunity for nursing staff and faculty research consultants to work together on a clinical study. A model for collaborative research is illustrated, and advantages and disadvantages for practice, administration, and research are discussed.

Best Practices for the Identification of Elder Abuse and Neglect in Home Health.

PubMed

Pickering, Carolyn E Z; Ridenour, Kimberly; Salaysay, Zachary

2016-04-01

Elder abuse and neglect (EA/N) affects over 1 million older adults each year, and disproportionately affects persons with dementia and older women. Home healthcare professionals are in an advantageous position to assess for, identify, and report EA/N. Lack of knowledge on EA/N risk factors, assessment tools, and mandatory reporting guidelines often prevent professionals from identifying and reporting EA/N. This article provides practical guidance on EA/N risk factors, assessment tools, and reporting responsibilities that can easily be implemented in practice.

Modernizing Distribution System Restoration to Achieve Grid Resiliency Against Extreme Weather Events: An Integrated Solution

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

Chen, Chen; Wang, Jianhui; Ton, Dan

Recent severe power outages caused by extreme weather hazards have highlighted the importance and urgency of improving the resilience of the electric power grid. As the distribution grids still remain vulnerable to natural disasters, the power industry has focused on methods of restoring distribution systems after disasters in an effective and quick manner. The current distribution system restoration practice for utilities is mainly based on predetermined priorities and tends to be inefficient and suboptimal, and the lack of situational awareness after the hazard significantly delays the restoration process. As a result, customers may experience an extended blackout, which causes largemore » economic loss. On the other hand, the emerging advanced devices and technologies enabled through grid modernization efforts have the potential to improve the distribution system restoration strategy. However, utilizing these resources to aid the utilities in better distribution system restoration decision-making in response to extreme weather events is a challenging task. Therefore, this paper proposes an integrated solution: a distribution system restoration decision support tool designed by leveraging resources developed for grid modernization. We first review the current distribution restoration practice and discuss why it is inadequate in response to extreme weather events. Then we describe how the grid modernization efforts could benefit distribution system restoration, and we propose an integrated solution in the form of a decision support tool to achieve the goal. The advantages of the solution include improving situational awareness of the system damage status and facilitating survivability for customers. The paper provides a comprehensive review of how the existing methodologies in the literature could be leveraged to achieve the key advantages. The benefits of the developed system restoration decision support tool include the optimal and efficient allocation of repair crews and resources, the expediting of the restoration process, and the reduction of outage durations for customers, in response to severe blackouts due to extreme weather hazards.« less

A pill for the partner via the chlamydia patient? Results from a mixed method study among sexual health care providers in the Netherlands.

PubMed

Nanhoe, Anita C; Visser, Maartje; Omlo, Jurriaan J; Watzeels, Anita J C M; van den Broek, Ingrid V; Götz, Hannelore M

2018-05-29

Chlamydia prevalence in the Netherlands remains high despite targeted efforts. Effective Partner Notification (PN) and Partner Treatment (PT) can interrupt transmission and prevent re-infections. Patient Initiated Partner Treatment (PIPT) may strengthen chlamydia control. This study explores the current practice of PN and PT, and benefits of, and barriers and facilitators for PIPT among professionals in sexual health care in the Netherlands. A qualitative study was performed among GPs, GP-assistants (GPAs), physicians and nurses working at Sexual Health Clinics (SHC) and key-informants on ethnical diversity using topic lists in focus groups (N = 40) and semi-structured questionnaires in individual interviews (N = 9). Topics included current practices regarding PN and PT, attitude regarding PIPT, and perceived barriers and facilitators for PIPT. Interviews were taped, transcribed verbatim, and coded using ATLAS.ti. A quantitative online questionnaire on the same topics was sent to all physicians and nurses employed at Dutch SHC (complete response rate 26% (84/321)). The qualitative study showed that all professionals support the need for more attention to PN, and that they saw advantages in PIPT. Mentioned barriers included unwilling PN-behaviour, Dutch legislation, several medical considerations and inadequate skills of GPs. Also, concerns about limited knowledge of cultural sensitivity around PN and PT were raised. Mentioned facilitators of PIPT were reliable home based test-kits, phone-contact between professionals and notified partners, more consultation time for GPs or GPAs and additional training. The online questionnaire showed that SHC employees agreed that partners should be treated as soon as possible, but also that they were reluctant towards PIPT without counselling and testing. Professionals saw advantages in PIPT, but they also identified barriers hampering the potential introduction of PIPT. Improving PN and counselling skills with specific focus on cultural sensitivity is needed. PIPT could be considered for specific partners. PIPT in combination with home based testing and using e-healthcare should be further explored and developed.

The Role of Coherent Detection

NASA Technical Reports Server (NTRS)

Zmuidzinas, J.

2004-01-01

Many interesting astronomical objects, such as galaxies, molecular clouds, PDRs, star - forming regions, protostars, evolved stars, planets, and comets, have rich submillimeter spectra. In order to avoid line blending, and to be able to resolve the line shape, it is often necessary to measure these spectra at high resolution. This paper discusses the relative advantages and limitations of coherent and direct detection for high resolution spectroscopy in the submillimeter and far - infrared. In principle, direct detection has a fundamental sensitivity advantage. In practice, it is di.cult to realize this advantage given the sensitivities of existing detectors and reasonable constraints on the instrument volume. Thus, coherent detection can be expected to play an important role in submillimeter and far - infrared astrophysics well into the future.

Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions

PubMed Central

DiFranco, Joyce T.; Romano, Amy M.; Keen, Ruth

2007-01-01

This updated edition of Care Practice Paper #5 presents the evidence for the benefits of spontaneous pushing in upright or gravity-neutral positions during labor. Various pushing positions and techniques are described, and the advantages and disadvantages are reviewed. Women are encouraged to push when and how their bodies tell them to and to choose the positions for birth that are the most comfortable. PMID:18566649

The current status of 3D imaging in dental practice.

PubMed

McNamara, Clare; House, Kate; Davies, Rebecca; Barker, Chris S; Chawla, Ourvinder; Sandy, Jonathan R; Ireland, Anthony J

2011-12-01

This article aims to describe the current status of 3-dimensional (3D) imaging in dental practice. Advances in this field have made 3D imaging far more accessible in all dental fields. This paper describes methods of imaging dental hard and soft tissues and their clinical uses. In addition, the potential advantages and disadvantages of various systems are discussed, as well as expected future developments.

Secondary Schools in a County in Kenya Seem to Be Taking Advantages of the Cost Sharing Policy: Understanding Its Practice and Implications

ERIC Educational Resources Information Center

Makori, Andrew; Chepchieng, Gideon; Misoi, Pauline; Kiplagat, Rotich

2015-01-01

The study set out to research on parents' views regarding the practice of cost sharing policy in secondary schools in Kenya in relation to form one entry items requirement and fee payment. This article reports on its findings. The study adopted a quantitative survey and employed a questionnaire (both closed and open-ended) to collect data. The…

Proposal for a quantitative index of flood disasters.

PubMed

Feng, Lihua; Luo, Gaoyuan

2010-07-01

Drawing on calculations of wind scale and earthquake magnitude, this paper develops a new quantitative method for measuring flood magnitude and disaster intensity. Flood magnitude is the quantitative index that describes the scale of a flood; the flood's disaster intensity is the quantitative index describing the losses caused. Both indices have numerous theoretical and practical advantages with definable concepts and simple applications, which lend them key practical significance.

Chinese medicine in Malaysia and Singapore: the business of healing.

PubMed

Ooi, G L

1993-01-01

Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical practice in Malaysia and Singapore with the aim of understanding their implications for the persistence of this medical tradition.

The roles of talent, physical precocity and practice in the development of soccer expertise.

PubMed

Helsen, W F; Hodges, N J; Van Winckel, J; Starkes, J L

2000-09-01

Here we consider the potential contributions of talent, physical precocity and deliberate practice in the development of soccer expertise. After presenting a working definition of 'talent', we examine how coaches perceive and select potential talent. Our findings suggest that much of what coaches see as early talent may be explained by physical precocity associated with a relative age advantage. Finally, as a test of the model of Deliberate Practice, we review the results of studies that assessed the progress of international, national and provincial players based on accumulated practice, amount of practice per week and relative importance and demands of various practice and everyday activities. A positive linear relationship was found between accumulated individual plus team practice and skill. Various practical suggestions can be made to improve talent detection and selection and to optimize career practice patterns in soccer.

Sexual harassment in the work place: Its impact on gynecologic oncology and women's health.

PubMed

von Gruenigen, Vivian E; Karlan, Beth Y

2018-05-01

For the last few months, media and news outlets have exposed prominent professionals in many settings who have taken advantage of their status of power and influence to engage in sexual harassment and discrimination in the workplace. In medicine, harassment may include many types of health professionals including physicians, nurses, medical students, colleagues and even patients. Programs for sexual harassment prevention, education and training vary between industries, workplaces, medical schools and hospitals. It is imperative to engage men and women in awareness, education, empowerment of the bystander and movement for cultural change. A grass roots effort should be started by each of us to reach out to our academic institutions, health systems and private practices to review policy, education and codes of conduct. We have the ability to embrace improvement around gender and diversity in our words and actions. Copyright © 2018. Published by Elsevier Inc.

Integration and Test of Shuttle Small Payloads

NASA Technical Reports Server (NTRS)

Wright, Michael R.

2003-01-01

Recommended approaches for space shuttle small payload integration and test (I&T) are presented. The paper is intended for consideration by developers of shuttle small payloads, including I&T managers, project managers, and system engineers. Examples and lessons learned are presented based on the extensive history of NASA's Hitchhiker project. All aspects of I&T are presented, including: (1) I&T team responsibilities, coordination, and communication; (2) Flight hardware handling practices; (3) Documentation and configuration management; (4) I&T considerations for payload development; (5) I&T at the development facility; (6) Prelaunch operations, transfer, orbiter integration and interface testing; (7) Postflight operations. This paper is of special interest to those payload projects that have small budgets and few resources: that is, the truly faster, cheaper, better projects. All shuttle small payload developers are strongly encouraged to apply these guidelines during I&T planning and ground operations to take full advantage of today's limited resources and to help ensure mission success.

System engineering toolbox for design-oriented engineers

NASA Technical Reports Server (NTRS)

Goldberg, B. E.; Everhart, K.; Stevens, R.; Babbitt, N., III; Clemens, P.; Stout, L.

1994-01-01

This system engineering toolbox is designed to provide tools and methodologies to the design-oriented systems engineer. A tool is defined as a set of procedures to accomplish a specific function. A methodology is defined as a collection of tools, rules, and postulates to accomplish a purpose. For each concept addressed in the toolbox, the following information is provided: (1) description, (2) application, (3) procedures, (4) examples, if practical, (5) advantages, (6) limitations, and (7) bibliography and/or references. The scope of the document includes concept development tools, system safety and reliability tools, design-related analytical tools, graphical data interpretation tools, a brief description of common statistical tools and methodologies, so-called total quality management tools, and trend analysis tools. Both relationship to project phase and primary functional usage of the tools are also delineated. The toolbox also includes a case study for illustrative purposes. Fifty-five tools are delineated in the text.

Performance modeling of optical refrigerators

NASA Astrophysics Data System (ADS)

Mills, Gary; Mord, Allan

2006-02-01

Optical refrigeration using anti-Stokes fluorescence in solids has several advantages over more conventional techniques including low mass, low volume, low cost and no vibration. It also has the potential of allowing miniature cryocoolers on the scale of a few cubic centimeters. It has been the topic of analysis and experimental work by several organizations. In 2003, we demonstrated the first optical refrigerator. We have developed a comprehensive system-level performance model of optical refrigerators. Our current version models the refrigeration cycle based on the fluorescent material emission and absorption data at ambient and reduced temperature for the Ytterbium-ZBLAN glass (Yb:ZBLAN) cooling material. It also includes the heat transfer into the refrigerator cooling assembly due to radiation and conduction. In this paper, we report on modeling results which reveal the interplay between size, power input, and cooling load. This interplay results in practical size limitations using Yb:ZBLAN.

Imaging of femoroacetabular impingement-current concepts

PubMed Central

Albers, Christoph E.; Wambeek, Nicholas; Hanke, Markus S.; Schmaranzer, Florian; Prosser, Gareth H.; Yates, Piers J.

2016-01-01

Following the recognition of femoroacetabular impingement (FAI) as a clinical entity, diagnostic tools have continuously evolved. While the diagnosis of FAI is primarily made based on the patients’ history and clinical examination, imaging of FAI is indispensable. Routine diagnostic work-up consists of a set of plain radiographs, magnetic resonance imaging (MRI) and MR-arthrography. Recent advances in MRI technology include biochemically sensitive sequences bearing the potential to detect degenerative changes of the hip joint at an early stage prior to their appearance on conventional imaging modalities. Computed tomography may serve as an adjunct. Advantages of CT include superior bone to soft tissue contrast, making CT applicable for image-guiding software tools that allow evaluation of the underlying dynamic mechanisms causing FAI. This article provides a summary of current concepts of imaging in FAI and a review of the literature on recent advances, and their application to clinical practice. PMID:29632685

High Tensile Strength Amalgams for In-Space Fabrication and Repair

NASA Technical Reports Server (NTRS)

Grugel, Richard N.

2006-01-01

Amalgams are well known for their use in dental practice as a tooth filling material. They have a number of useful attributes that include room temperature fabrication, corrosion resistance, dimensional stability, and very good compressive strength. These properties well serve dental needs but, unfortunately, amalgams have extremely poor tensile strength, a feature that severely limits other potential applications. Improved material properties (strength and temperature) of amalgams may have application to the freeform fabrication of repairs or parts that might be necessary during an extended space mission. Advantages would include, but are not limited to: the ability to produce complex parts, a minimum number of processing steps, minimum crew interaction, high yield - minimum wasted material, reduced gravity compatibility, minimum final finishing, safety, and minimum power consumption. The work presented here shows how the properties of amalgams can be improved by changing particle geometries in conjunction with novel engineering metals.

Building of communication system for nuclear accident emergency disposal based on IP multimedia subsystem

NASA Astrophysics Data System (ADS)

Wang, Kang; Gao, Guiqing; Qin, Yuanli; He, Xiangyong

2018-05-01

The nuclear accident emergency disposal must be supported by an efficient, real-time modularization and standardization communication system. Based on the analysis of communication system for nuclear accident emergency disposal which included many functions such as the internal and external communication, multiply access supporting and command center. Some difficult problems of the communication system were discussed such as variety access device type, complex composition, high mobility, set up quickly, multiply business support, and so on. Taking full advantages of the IP Multimedia Subsystem (IMS), a nuclear accident emergency communication system was build based on the IMS. It was studied and implemented that some key unit and module functions of communication system were included the system framework implementation, satellite access, short-wave access, load/vehicle-mounted communication units. The application tests showed that the system could provide effective communication support for the nuclear accident emergency disposal, which was of great practical value.

Transcranial Alternating Current Stimulation (tACS) Mechanisms and Protocols

PubMed Central

Tavakoli, Amir V.; Yun, Kyongsik

2017-01-01

Perception, cognition and consciousness can be modulated as a function of oscillating neural activity, while ongoing neuronal dynamics are influenced by synaptic activity and membrane potential. Consequently, transcranial alternating current stimulation (tACS) may be used for neurological intervention. The advantageous features of tACS include the biphasic and sinusoidal tACS currents, the ability to entrain large neuronal populations, and subtle control over somatic effects. Through neuromodulation of phasic, neural activity, tACS is a powerful tool to investigate the neural correlates of cognition. The rapid development in this area requires clarity about best practices. Here we briefly introduce tACS and review the most compelling findings in the literature to provide a starting point for using tACS. We suggest that tACS protocols be based on functional brain mechanisms and appropriate control experiments, including active sham and condition blinding. PMID:28928634

The current status of beta blockers’ use in the management of hypertension

PubMed Central

Akbar, Shahid; Alorainy, Mohammad S.

2014-01-01

The invention of beta (β)-blockers culminated in a new era in the treatment of cardiovascular diseases (CD), and changed the course of pharmacology research for years to come. Since the introduction of propranolol into clinical practice in 1964, β-blockers enjoyed a special place in the clinicians’ armamentarium against CDs, especially for patients with ischemic heart diseases, and are still one of the most extensively used therapeutic drugs in both cardiac and non-cardiac ailments. Current uses of β-blockers in CDs include ischemic heart diseases, hypertension, cardiac arrhythmias, and heart failure. Other substantial non-cardiac uses include glaucoma, migraine, situational anxiety, benign essential tremors, and cardiac symptoms of thyrotoxicosis. This review covers some of the evolutionary changes of clinical uses of β-blockers, the rationale for their use, some recent controversies surrounding their use for treatment of hypertension, and advantages of newer additions to the group. PMID:25399206

A Systematic Review of Assessment Tools Measuring Interprofessional Education Outcomes Relevant to Pharmacy Education.

PubMed

Shrader, Sarah; Farland, Michelle Z; Danielson, Jennifer; Sicat, Brigitte; Umland, Elena M

2017-08-01

Objective. To identify and describe the available quantitative tools that assess interprofessional education (IPE) relevant to pharmacy education. Methods. A systematic approach was used to identify quantitative IPE assessment tools relevant to pharmacy education. The search strategy included the National Center for Interprofessional Practice and Education Resource Exchange (Nexus) website, a systematic search of the literature, and a manual search of journals deemed likely to include relevant tools. Results. The search identified a total of 44 tools from the Nexus website, 158 abstracts from the systematic literature search, and 570 abstracts from the manual search. A total of 36 assessment tools met the criteria to be included in the summary, and their application to IPE relevant to pharmacy education was discussed. Conclusion. Each of the tools has advantages and disadvantages. No single comprehensive tool exists to fulfill assessment needs. However, numerous tools are available that can be mapped to IPE-related accreditation standards for pharmacy education.

How small is small enough? Role of robotics in paediatric urology

PubMed Central

Ganpule, Arvind P.; Sripathi, Venkat

2015-01-01

The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series. PMID:25598599

How small is small enough? Role of robotics in paediatric urology.

PubMed

Ganpule, Arvind P; Sripathi, Venkat

2015-01-01

The well-known advantages of robotic surgery include improved dexterity, three-dimensional operating view and an improved degree of freedom. Robotic surgery is performed for a wide range of surgeries in urology, which include radical prostatectomy, radical cystectomy, and ureteric reimplantation. Robotic paediatric urology is evolving. The major hindrance in the development of paediatric robotics is, first, the differences in practice patterns in paediatric urology compared with adult urology thereby making development of expertise difficult and secondly it is challenging to conduct proper studies in the paediatric population because of the paucity of cases. The difficulties in conducting these studies include difficulty in designing a proper randomised study, difficulties with blinding, and finally, the ethical issues involved, finally the instruments although in the phase of evolution require a lot of improvement. In this article, we review the relevant articles for paediatric robotic surgery. We emphasise on the technical aspects and results in contemporary paediatric robotic case series.

Knowledge, attitude and skills of dental practitioners of Puducherry on minimally invasive dentistry concepts: A questionnaire survey

PubMed Central

Rayapudi, Jasmine; Usha, Carounanidy

2018-01-01

Background: Minimally invasive dentistry (MID) encompasses early caries diagnosis through caries risk assessment (CRA), early detection of incipient carious lesion including primary and secondary prevention based on scientific evidence that remineralization of demineralized enamel and dentin is possible if detected early. Although the dental curriculum focuses on the advantages of MID in tooth preservation, this science is not usually translated into practice. Aim: This study aimed to evaluate the knowledge, attitude, and skills of dental practitioners of Puducherry regarding the concepts of MID. Subjects and Methods: Data were collected through an online survey questionnaire based on awareness and practice of MID. Statistical evaluation was done on SPSS by Chi-square test. Results: A total of 126 dentists responded of which only 55% were trained in MID during their undergraduate and internship period, mainly through lectures (49.6%). Nearly 81% agreed that CRA should be conducted for all patients. Almost 42.7% had heard about International Caries Detection and Assessment System, but only 25.9% used a blunt explorer for caries detection. About 13.7% use magnification (loupes/microscope), but majority (84.7%) use radiographs. More than 70% were unaware of newer methods of caries detection. Statistically significant differences were found (P < 0.05) regarding qualification and experience about the effectiveness of Atraumatic Restorative Treatment and sandwich technique for treatment of caries in permanent teeth and high caries-risk children. Conclusion: Although there is knowledge about advantages of MID among dentists of Puducherry, it does not benefit patients, as many practitioners still follow the traditional principles of total caries removal. PMID:29899626

Comparing Differences in ADL Outcomes for the STOMP Intervention for Dementia in the Natural Home Environment Versus a Clinic Environment.

PubMed

Ciro, C A; Poole, J L; Skipper, B; Hershey, L A

2014-01-01

Few studies have examined structured rehabilitation techniques for improving activities of daily living in people with mild-moderate dementia. We sought to examine the advantages to delivering the Skill-building through Task-Oriented Motor Practice (STOMP) intervention in the home environment (versus the clinic), hypothesizing that ADL improvement would be significantly better, time to meeting goals would be faster and fewer displays of behavior would be noted. Compared results of two quasi-experimental studies of STOMP, one completed in the home, one completed previously in a clinic. Participants were English-speaking; community dwelling adults aged 50-90 diagnosed with mild-moderate dementia who could participate in an intensive rehabilitation program (5 days/week, 3 hours/day, for 2 weeks). Outcome measurements include examiner-observation of performance and proxy-report of performance and satisfaction with performance in patient-selected goals. No differences existed in the sociodemographic characteristics between the home and clinic groups where the groups were primarily white, married, had > high school education and had mild-moderate dementia. Results from the home group indicate that participants made significant improvement in ADL which was generally retained at the 90 day follow-up. These results were not significantly different than the clinic group. No significant advantages were noted for the home group in terms of time to meeting goals or exhibition of fewer behaviors. The STOMP intervention appeared to work equally as well in the home and in the clinic. Future studies should continue to examine the benefits of massed practice using high-dose regimens.

Measuring physical activity in children and adolescents for dietary surveys: practicalities, problems and pitfalls.

PubMed

Mindell, Jennifer S; Coombs, Ngaire; Stamatakis, Emmanuel

2014-05-01

Physical inactivity is an important risk factor for many chronic diseases and contributes to obesity and poor mental well-being. The present paper describes the main advantages and disadvantages, practical problems, suggested uses, and future developments regarding self-reported and objective data collection in the context of dietary surveys. In dietary surveys, physical activity is measured primarily to estimate energy expenditure. Energy expenditure surveillance is important for tracking changes over time, particularly given the debates over the role of the relative importance of energy intake and expenditure changes in the aetiology of obesity. It is also important to assess the extent of underreporting of dietary intake in these surveys. Physical activity data collected should include details on the frequency, duration and relative intensity of activity for each activity type that contributes considerably to overall activity and energy expenditure. Problems of validity and reliability, associated with inaccurate assessment, recall bias, and social desirability bias, are well-known; children under 10 years cannot report their activities accurately. However, despite such limitations, questionnaires are still the dominant method of physical activity assessment in dietary surveys due to their low cost and relatively low participant burden. Objective, time-stamped measures that monitor heart rate and/or movement can provide more comprehensive, quantitative assessment of physical activity but at greater cost and participant burden. Although overcoming many limitations of questionnaires, objective measures also have drawbacks, including technical, practical and interpretational issues.

Online learning for faculty development: a review of the literature.

PubMed

Cook, David A; Steinert, Yvonne

2013-11-01

With the growing presence of computers and Internet technologies in personal and professional lives, it seems prudent to consider how online learning has been and could be harnessed to promote faculty development. Discuss advantages and disadvantages of online faculty development, synthesize what is known from studies involving health professions faculty members, and identify next steps for practice and future research. We searched MEDLINE for studies describing online instruction for developing teaching, leadership, and research skills among health professions faculty, and synthesized these in a narrative review. We found 20 articles describing online faculty development initiatives for health professionals, including seven quantitative comparative studies, four studies utilizing defined qualitative methods, and nine descriptive studies reporting anecdotal lessons learned. These programs addressed diverse topics including clinical teaching, educational assessment, business administration, financial planning, and research skills. Most studies enrolled geographically-distant learners located in different cities, provinces, or countries. Evidence suggests that online faculty development is at least comparable to traditional training, but learner engagement and participation is highly variable. It appears that success is more likely when the course addresses a relevant need, facilitates communication and social interaction, and provides time to complete course activities. Although we identified several practical recommendations for success, the evidence base for online faculty development is sparse and insubstantial. Future research should include rigorous, programmatic, qualitative and quantitative investigations to understand the principles that govern faculty member engagement and success.

Ready or not? Pharmacist perceptions of a changing injection scope of practice before it happens

PubMed Central

Foong, Esther Ai-Leng; Edwards, David J.; Houle, Sherilyn; Grindrod, Kelly A.

2017-01-01

Background: Since 2012, Ontario pharmacists have been authorized to administer the influenza vaccine. In April 2016, the Ontario College of Pharmacists (OCP) proposed to expand the Pharmacy Act to allow pharmacists to vaccinate against 13 additional conditions. The OCP held an online public consultation and invited pharmacists, members of the public and organizations to weigh in on the proposed changes. Our objective was to explore the factors influencing how Ontario pharmacists may adopt or reject an expanding scope of practice, using data from the public consultation. Methods: We coded the responses to the public consultation in 2 ways: 1) sentiment analysis and 2) an integrative approach to coding using Rogers’s diffusion of innovations theory across 5 domains: relative advantage, compatibility, complexity, trialability and observability. Results: Responses from pharmacists, the public and organizations were moderately positive on average. Pharmacists most commonly mentioned relative advantages, including benefits for patients, pharmacists, physicians and the health system. Positive responses focused on accessibility for patients, improved vaccine coverage, lower health care spending and freed physician time but cited lack of prescribing privileges as a barrier to the proposed changes. Negative responses focused on increased workload, patient safety concerns and the complexity of travel medicine. Conclusions: The expanded immunization services are likely to be well received by most pharmacists. Convenience and accessibility for patients were commonly cited benefits, but the changes will be only a slight improvement over the current system unless pharmacists can prescribe these vaccines. Although employers responded positively, the question remains whether they will support pharmacists in a way that aligns with pharmacists’ values and expectations. Decision makers must pay close attention to the pharmacy infrastructure and how this will affect uptake of these services. Recognition of this, combined with pharmacists’ positive perceptions of the expanded scope, will facilitate smooth integration of this legislation into Ontario pharmacy practice. PMID:29123598

Leveraging Carbon Cycling in Coastal Wetlands for Habitat Conservation: Blue Carbon Policy Opportunities (Invited)

NASA Astrophysics Data System (ADS)

Sutton-Grier, A.

2013-12-01

Recent scientific studies suggest that the carbon sequestered and stored in coastal wetlands (specifically mangroves, salt marshes, and seagrass meadows) is an important, previously not well-recognized service provided by these ecosystems. Coastal wetlands have unique characteristics that make them incredibly efficient, natural carbon sinks with most carbon stored belowground in soils. Based on this new scientific evidence, there is growing interest in leveraging the carbon services of these habitats (termed 'blue carbon') to develop new policy opportunities to protect and restore coastal wetlands around the globe. The overall goal is to take full advantage of the carbon services of these habitats in order to ensure and maintain the many benefits provided to society by these habitats - including natural climate, food security, and storm protection benefits - and to enhance the resiliency of coastal communities and economies around the world. This presentation will give an update on some of the policy opportunities including: (1) examining how the implementation of U.S. federal policies can be expanded to include carbon services of ecosystems in order to improve management and decision making; (2) developing an international blue carbon community of science and practice to provide best practice guidance for protection and restoration of blue carbon habitats; and (3) developing innovative financing mechanisms for coastal conservation including carbon market credits for wetlands. Finally, the presentation will conclude by highlighting some of the most pressing blue carbon scientific gaps that need to be filled in order to support these developing policies.

Platelet-rich preparations to improve healing. Part I: workable options for every size practice.

PubMed

Davis, Vicki L; Abukabda, Alaeddin B; Radio, Nicholas M; Witt-Enderby, Paula A; Clafshenkel, William P; Cairone, J Vito; Rutkowski, James L

2014-08-01

Numerous studies have demonstrated that platelet-rich preparations applied to surgical sites, injuries, or wounds are a safe and effective way to promote soft tissue healing and bone growth. Various protocols have been developed for preparing platelet-rich preparations, with subtle but important differences between them. Unfortunately, only a minority of clinicians use platelet-rich preparations, such as platelet-rich plasma and platelet-rich fibrin, in their practice, possibly due to confusion about the different methods and their advantages and disadvantages. Therefore, the different types of preparations are described to help guide the selection of the best method for any size practice. Classic methods generally require large volumes of blood and can be expensive, complicated, and time-intensive. Simpler protocols have been developed recently, which require relatively inexpensive equipment and small blood volumes and, thus, may be more applicable for small clinical practices. Platelet-rich preparations accelerate healing at earlier time points to reduce discomfort and the potential for adverse outcomes, including infection, poor wound closure, and delays in forming strong bone for subsequent procedures (such as implants). However, platelet-rich preparations may also improve long-term outcomes in patients expected to have impaired healing, such as with lifestyle choices (eg, smoking), medications (eg, steroids), diseases (eg, diabetes, osteoporosis, atherosclerosis), and aging, by supplementing the deficient wound environment to restore proper healing. Therefore, both large and small clinical practices would benefit from utilizing platelet-rich preparations to enhance healing in their patients.

The effects of bilingualism on conflict monitoring, cognitive control, and garden-path recovery.

PubMed

Teubner-Rhodes, Susan E; Mishler, Alan; Corbett, Ryan; Andreu, Llorenç; Sanz-Torrent, Monica; Trueswell, John C; Novick, Jared M

2016-05-01

Bilinguals demonstrate benefits on non-linguistic tasks requiring cognitive control-the regulation of mental activity to resolve information-conflict during processing. This "bilingual advantage" has been attributed to the consistent management of two languages, yet it remains unknown if these benefits extend to sentence processing. In monolinguals, cognitive control helps detect and revise misinterpretations of sentence meaning. Here, we test if the bilingual advantage extends to parsing and interpretation by comparing bilinguals' and monolinguals' syntactic ambiguity resolution before and after practicing N-back, a non-syntactic cognitive-control task. Bilinguals outperformed monolinguals on a high-conflict but not a no-conflict version of N-back and on sentence comprehension, indicating that the advantage extends to language interpretation. Gains on N-back conflict trials also predicted comprehension improvements for ambiguous sentences, suggesting that the bilingual advantage emerges across tasks tapping shared cognitive-control procedures. Because the overall task benefits were observed for conflict and non-conflict trials, bilinguals' advantage may reflect increased cognitive flexibility. Copyright © 2016 Elsevier B.V. All rights reserved.

The Primary Physician

PubMed Central

Sadler, Paul

1969-01-01

Dr Paul Sadler takes another point of view and describes the successful division of his housing-estate practice into four specialist departments: pxediatrics, geriatrics, obstetrics and general medicine. He further details the organization and advantages of his own department, pediatrics. PMID:5816896

The Alternative Workplace: Changing Where and How People Work.

ERIC Educational Resources Information Center

Apgar, Mahlon, IV

1998-01-01

Discusses the alternative workplace, the combination of nontraditional work practices, settings, and locations that is beginning to supplement traditional offices. Looks at myths and realities, options, advantages and disadvantages, and implementation of alternative workplaces. (JOW)

Leaders with heart.

PubMed

Heck, Susan

2005-02-01

Although cardiovascular care is typically a lucrative service line, competition from other providers is often fierce. To gain market advantage, providers should follow best practices of top-performing organizations and use benchmarking data to identify areas in need of process improvement.

16 CFR 1031.9 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION...) This subpart sets forth the Consumer Product Safety Commission's criteria and requirements governing... development bodies. (b) The Commission realizes there are advantages and benefits afforded by greater...

PubMed Central

Xénos, John B.; Lafortune, Marthe

1978-01-01

The importance and advantages of organizing an occupational health service are demonstrated. A practical three point health program is described. The family physician is shown to be ideally prepared to head the health team. A brief description of the physical resources follows. PMID:21301506

Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization.

PubMed

Casalino, Lawrence P; Chenven, Norman

2017-03-01

Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs. We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA. The IPAs studied vary in size and sophistication, but overall are performing well and are highly regarded by hospital and health plan executives. IPAs can grow rapidly without the cost of purchasing and operating physician practices and make it possible for physicians to remain independent in their own practices while providing the scale and care management infrastructure to make it possible to succeed in VBP. However, it can be difficult for IPAs to gain cooperation from hundreds to thousands of independent physicians, and the need for capital for growth and care management infrastructure is increasing as VBP becomes more prevalent and more demanding. Some IPAs are succeeding at VBP. As VBP raises the performance bar, IPAs will have to demonstrate that they can achieve results equal to more highly capitalized and tightly structured large medical groups and hospital-owned practices. Physicians should be aware of IPAs as a potential option for participating in VBP. Payers are aware of IPAs; the Medicare ACO program and health insurer ACO programs include many IPAs. Copyright © 2016 Elsevier Inc. All rights reserved.

Design of low SWaP optical terminals for free space optical communications

NASA Astrophysics Data System (ADS)

Shubert, P.; Cline, A.; McNally, J.; Pierson, R.

2017-02-01

Along with advantages in higher data rates, spectrum contention, and security, free space optical communications can provide size, weight, and power (SWaP) advantages over radio frequency (RF) systems. SWaP is always an issue in space systems and can be critical in applying free space optical communications to small satellite platforms. The system design of small space-based free space optical terminals with Gbps data rates is addressed. System architectures and requirements are defined to ensure the terminals are capable of acquisition, establishment and maintenance of a free space optical communications link. Design trades, identification of blocking technologies, and performance analyses are used to evaluate the practical limitations to terminal SWaP. Small terminal design concepts are developed to establish their practicality and feasibility. Techniques, such as modulation formats and capacity approaching encoding, are considered to mitigate the disadvantages brought by SWaP limitations, and performance as a function of SWaP is evaluated.

Integration of scanned document management with the anatomic pathology laboratory information system: analysis of benefits.

PubMed

Schmidt, Rodney A; Simmons, Kim; Grimm, Erin E; Middlebrooks, Michael; Changchien, Rosy

2006-11-01

Electronic document management systems (EDMSs) have the potential to improve the efficiency of anatomic pathology laboratories. We implemented a novel but simple EDMS for scanned documents as part of our laboratory information system (AP-LIS) and collected cost-benefit data with the intention of discerning the value of such a system in general and whether integration with the AP-LIS is advantageous. We found that the direct financial benefits are modest but the indirect and intangible benefits are large. Benefits of time savings and access to data particularly accrued to pathologists and residents (3.8 h/d saved for 26 pathologists and residents). Integrating the scanned document management system (SDMS) into the AP-LIS has major advantages in terms of workflow and overall simplicity. This simple, integrated SDMS is an excellent value in a practice like ours, and many of the benefits likely apply in other practice settings.

Role of nuclear medicine in clinical urology and nephrology

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

Blaufox, M.D.; Fine, E.; Lee, H.B.

The application of radionuclide studies to nephrologic and urologic practice has reached a measurable degree of maturity during the past several years. In spite of this, the utilization of these techniques in many institutions in the United States continues to be far less frequent than one would expect from the clinical advantages. The aim of this editorial is to try to place the role of nuclear medicine in urology and nephrology in perspective. At the present time, in spite of the large number of renal agents that have been developed, there is no practical ideal radiopharmaceutical that can serve asmore » a universal agent. Arbitrarily, one may reduce the chief armamentarium to only four radiopharmaceuticals; technetium-99m DTPA, I-131 OIH (orthoiodohippurate), technetium-99m glucoheptonate and technetium-99m DMSA. These agents are discussed with their relative advantages and disadvantages.« less

Experimental plug and play quantum coin flipping.

PubMed

Pappa, Anna; Jouguet, Paul; Lawson, Thomas; Chailloux, André; Legré, Matthieu; Trinkler, Patrick; Kerenidis, Iordanis; Diamanti, Eleni

2014-04-24

Performing complex cryptographic tasks will be an essential element in future quantum communication networks. These tasks are based on a handful of fundamental primitives, such as coin flipping, where two distrustful parties wish to agree on a randomly generated bit. Although it is known that quantum versions of these primitives can offer information-theoretic security advantages with respect to classical protocols, a demonstration of such an advantage in a practical communication scenario has remained elusive. Here we experimentally implement a quantum coin flipping protocol that performs strictly better than classically possible over a distance suitable for communication over metropolitan area optical networks. The implementation is based on a practical plug and play system, developed by significantly enhancing a commercial quantum key distribution device. Moreover, we provide combined quantum coin flipping protocols that are almost perfectly secure against bounded adversaries. Our results offer a useful toolbox for future secure quantum communications.

Performance study of sugar-yeast-ethanol bio-hybrid fuel cells

NASA Astrophysics Data System (ADS)

Jahnke, Justin P.; Mackie, David M.; Benyamin, Marcus; Ganguli, Rahul; Sumner, James J.

2015-05-01

Renewable alternatives to fossil hydrocarbons for energy generation are of general interest for a variety of political, economic, environmental, and practical reasons. In particular, energy from biomass has many advantages, including safety, sustainability, and the ability to be scavenged from native ecosystems or from waste streams. Microbial fuel cells (MFCs) can take advantage of microorganism metabolism to efficiently use sugar and other biomolecules as fuel, but are limited by low power densities. In contrast, direct alcohol fuel cells (DAFCs) take advantage of proton exchange membranes (PEMs) to generate electricity from alcohols at much higher power densities. Here, we investigate a novel bio-hybrid fuel cell design prepared using commercial off-the-shelf DAFCs. In the bio-hybrid fuel cells, biomass such as sugar is fermented by yeast to ethanol, which can be used to fuel a DAFC. A separation membrane between the fermentation and the DAFC is used to purify the fermentate while avoiding any parasitic power losses. However, shifting the DAFCs from pure alcohol-water solutions to filtered fermented media introduces complications related to how the starting materials, fermentation byproducts, and DAFC waste products affect both the fermentation and the long-term DAFC performance. This study examines the impact of separation membrane pore size, fermentation/fuel cell byproducts, alcohol and salt concentrations, and load resistance on fuel cell performance. Under optimized conditions, the performance obtained is comparable to that of a similar DAFC run with a pure alcohol-water mixture. Additionally, the modified DAFC can provide useable amounts of power for weeks.

3D-printing techniques in a medical setting: a systematic literature review.

PubMed

Tack, Philip; Victor, Jan; Gemmel, Paul; Annemans, Lieven

2016-10-21

Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.