Texas Chiropractic College Practice Management Education: The Patient's Point of View.

ERIC Educational Resources Information Center

Waigandt, Alex; And Others

A survey was conducted to determine the patient's perception of treatment received from clinicians at the Texas Chiropractic College Clinic in Pasadena, Texas. A questionnaire designed to assess various aspects of the school's clinical and dispensary services was administered to 79 patients who had completed their treatment prescriptions. The…

Some practical aspects of designing a large inventory

Treesearch

Kim Iles

2000-01-01

Designing a large multiresource inventory is horribly difficult, it is not work for faint hearts, and the 250,000,000-acre size of British Columbia is not a trivial problem. Completion of the details (as opposed to stopping the work) is a process prone to collapse. After that point, implementation is also likely to fail.

Online Peer Observation: An Exploration of a Cross-Discipline Observation Project

ERIC Educational Resources Information Center

Nicolson, Margaret; Harper, Felicity

2014-01-01

In this article the authors compare two phases of an ongoing, annual online peer observation project at the Open University. Adopting a non-managerialist approach, the project aims to give teachers a renewed sense of collegiality, allowing them to take responsibility for aspects of their professional development and share practice points. While…

The European Union and the Comprehensive Civil-Military Approach in Euro-Atlantic Security: Matching Reality to Rhetoric

DTIC Science & Technology

2010-01-01

aspects below the political PSC level. This practically guaranteed inco - herence and disunity as an institutional inheritance. Second, and equally as...central point of emphasis that “defense and diplomacy are no longer discrete choices . . . but must complement one another throughout the messy process

Ethical Aspects of the Hippocratic Corpus text De arte.

PubMed

Konstantinidou, Meropi K

2016-12-01

The practice of medicine is a complex situation from an ethical point of view in the modern Western societies. But some very simple principles could help the immediate and effective response, at least to a percentage of the problems encountered. Such assistance can be derived from the writings of the Hippocratic Corpus, not only from the so-called ethical or theoretical texts. In this direction, the book titled De arte contains remarks about the right way of practicing medicine and the skills needed by the doctor.

Putting the Common European Framework of Reference to Good Use

ERIC Educational Resources Information Center

North, Brian

2014-01-01

This paper recapitulates the aims of the CEFR and highlights three aspects of good practice in exploiting it: firstly, taking as a starting point the real-world language ability that is the aim of all modern language learners; secondly, the exploitation of good descriptors as transparent learning objectives in order to involve and empower the…

AGARD Flight Test Instrumentation Series. Volume 13. Practical Aspects of Instrumentation System Installation

DTIC Science & Technology

1981-09-01

III I’ CANOWN" AA HNE Figure 3.3-4 Rzxsqle. Block Diagrami 24 PI LOT AIRBORNE IGROUND AGC AMPLIFIER AGC AMPLIFIER BASE • FM BASEBAND LINKE SQUARE I OO...in that T 0- •,~ ao •, _4 U- - & - @ Figure 3.3-6 Point to Point Inter- Connect Diagram. 25 the wires are merged, or joined, into no @ Lot ".U~ AFT...result in a " bottoning -out" of the isolators during high amplitude vibration. For a properly selected rubber mount, the wearing should be conservative

An innovative use of instant messaging technology to support a library's single-service point.

PubMed

Horne, Andrea S; Ragon, Bart; Wilson, Daniel T

2012-01-01

A library service model that provides reference and instructional services by summoning reference librarians from a single service point is described. The system utilizes Libraryh3lp, an open-source, multioperator instant messaging system. The selection and refinement of this solution and technical challenges encountered are explored, as is the design of public services around this technology, usage of the system, and best practices. This service model, while a major cultural and procedural change at first, is now a routine aspect of customer service for this library.

Becoming a general practitioner - Which factors have most impact on career choice of medical students?

PubMed Central

2011-01-01

Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase the number of aspirants for general practice. PMID:21549017

Becoming a general practitioner--which factors have most impact on career choice of medical students?

PubMed

Kiolbassa, Kathrin; Miksch, Antje; Hermann, Katja; Loh, Andreas; Szecsenyi, Joachim; Joos, Stefanie; Goetz, Katja

2011-05-09

In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase the number of aspirants for general practice.

Considerations Regarding Embryo Culture Conditions: From Media to Epigenetics.

PubMed

Simopoulou, Mara; Sfakianoudis, Konstantinos; Rapani, Anna; Giannelou, Polina; Anifandis, George; Bolaris, Stamatis; Pantou, Agni; Lambropoulou, Maria; Pappas, Athanasios; Deligeoroglou, Efthimios; Pantos, Konstantinos; Koutsilieris, Michael

2018-01-01

There are numerous reports on embryo culture media and conditions in the laboratory, as the subject is multifaceted and complex, reflecting the variation in practice. In this scoping review, we attempt to approach the topic of culture media and conditions from the practitioners' perspective aiming to highlight, in a comprehensive fashion, important aspects regarding the options available, introduce points of debate and controversy, while maintaining the viewpoint of the practicing embryologist's concerns. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Using ICT to Teach "Hard to Teach" Topics in Science

ERIC Educational Resources Information Center

Oakes, Malcolm

2009-01-01

Science is a wonderful subject to teach. Often characterised as "hard", it is a subject that has evolved constantly over the years by adopting new practices. In recent years, these have included many aspects of ICT, which was the starting point for the author and his team's project. The basic principles of the project were that: (1) subject…

Languaging in the Twenty-First Century: Exploring Varieties and Modalities in Literacies inside and outside Learning Spaces

ERIC Educational Resources Information Center

Gynne, Annaliina; Bagga-Gupta, Sangeeta

2015-01-01

The study presented in this paper focuses on young people's languaging, or ways-with-being-with-words, including literacies, in everyday practices that stretch across formal and informal learning spaces. Taking sociocultural and ethnographic points of departure, the aim of the study is to investigate aspects of young people's situated and…

John Dewey's Conception of Education: Finding Common Ground with R. S. Peters and Paulo Freire

ERIC Educational Resources Information Center

Beckett, Kelvin

2018-01-01

John Dewey adopted a child-centered point of view to illuminate aspects of education he believed teacher-centered educators were neglecting, but he did so self-consciously and self-critically, because he also believed that "a new order of conceptions leading to new modes of practice" was needed. Dewey introduced his new conceptions in…

Partners in research: building academic-practice partnerships to educate and mentor advanced practice nurses.

PubMed

Harbman, Patricia; Bryant-Lukosius, Denise; Martin-Misener, Ruth; Carter, Nancy; Covell, Christine L; Donald, Faith; Gibbins, Sharyn; Kilpatrick, Kelley; McKinlay, James; Rawson, Krista; Sherifali, Diana; Tranmer, Joan; Valaitis, Ruta

2017-04-01

Clinical practice is the primary focus of advanced practice nursing (APN) roles. However, with unprecedented needs for health care reform and quality improvement (QI), health care administrators are seeking new ways to utilize all dimensions of APN expertise, especially related to research and evidence-based practice. International studies reveal research as the most underdeveloped and underutilized aspect of these roles. To improve patient care by strengthening the capacity of advanced practice nurses to integrate research and evidence-based practice activities into their day-to-day practice. An academic-practice partnership was created among hospital-based advanced practice nurses, nurse administrators, and APN researchers to create an innovative approach to educate and mentor advanced practice nurses in conducting point-of-care research, QI, or evidence-based practice projects to improve patient, provider, and/or system outcomes. A practice-based research course was delivered to 2 cohorts of advanced practice nurses using a range of teaching strategies including 1-to-1 academic mentorship. All participants completed self-report surveys before and after course delivery. Through participation in this initiative, advanced practice nurses enhanced their knowledge, skills, and confidence in the design, implementation, and/or evaluation of research, QI, and evidence-based practice activities. Evaluation of this initiative provides evidence of the acceptability and feasibility of academic-practice partnerships to educate and mentor point-of-care providers on how to lead, implement, and integrate research, QI and evidence-based activities into their practices. © 2016 John Wiley & Sons, Ltd.

[Skills lab from the surgical point of view. Experiences from the Magdeburg Medical School--The University of Magdeburg].

PubMed

Reschke, K; Werwick, K; Mersson, L; Clasen, K; Urbach, D; Haß, H J; Meyer, F

2013-10-01

For the acquisition of practical skills, the separate learning atmosphere of a skills lab(oratory) is very suitable. Numerous educational objectives of surgical teaching can be pursued using phantoms, manikins or mutual training among students prior to real practical use during clinical traineeships or internships. This article provides a compact, systematic overview of the skills lab concept, based on published aspects in selected and relatively recent topic-related references from PubMed® including our own approaches, as well as comments and experiences with regard to its further development. In particular, the Magdeburg concept to use the local skills lab MAMBA for surgical teaching within the practical training is demonstrated, which has developed step by step from a basically pure bedside teaching and which includes student tutors in practical teaching in surgery. By founding the Magdeburg educational and training center options for a practical education, in particular, in surgery were created. The great majority of students accepted the conceptual idea and it has so far been well received. As a first step several well selected topics of practical training during human medical studies were increasingly taught by students who received a didactic course of instruction which also included aspects of the educational objectives. For the future tutorials led by students are planned going beyond the teaching contents of the practical courses and can, thus, lead to a networking with educational objectives of other disciplines. There are not only curricular but also facultative courses in MAMBA which have been steadily optimized since the beginning. This Magdeburg's concept is planned to be further developed for which there is enough room for development with regard to organizational aspects (personnel and room).

The Sticking Point in the Bench Press, the Squat, and the Deadlift: Similarities and Differences, and Their Significance for Research and Practice.

PubMed

Kompf, Justin; Arandjelović, Ognjen

2017-04-01

Since it was first observed, and especially so in recent years, the phenomenon of the so-called "sticking point" in resistance training has attracted a substantial amount of sports and exercise science research. Broadly speaking, the sticking point is understood as the position in the range of motion of a lift at which a disproportionately large increase in the difficulty associated with continuing the lift is experienced. Hence the sticking point is inherently the performance bottleneck, and is also associated with an increased chance of exercise form deterioration or breakdown. Understanding the aspects of lifting performance which should be analysed in order to pinpoint the cause of a specific sticking point and therefore devise an effective training strategy to overcome it is of pervasive importance to strength practitioners, and is conducive to injury avoidance and continued progress. In this paper, we survey a range of physiological and biomechanical mechanisms which contribute to the development of sticking points, and then, led by this insight, review and analyse the findings of the existing observational research on the occurrence of sticking points in three ubiquitous exercises: the bench press, the squat, and the deadlift. The findings of our analysis should be used to inform future research and current resistance training practice.

Logistics in the cell: cargoes and transportation.

PubMed

Nadezhdina, E S

2014-09-01

Eukaryotic cells are large and thus require a vesicular transport system. The system involves the formation of membrane transport containers, their short- and long-distance movements, recognition of destination points, and fusion with other membranes. Understanding the molecular mechanisms of these processes is of theoretical and practical significance. This special issue of Biochemistry (Moscow) collects surveys and experimental articles describing various aspects of vesicular transport.

Burnout syndrome prevalence in physiotherapists.

PubMed

González-Sánchez, Blanca; López-Arza, María Victoria González; Montanero-Fernández, Jesús; Varela-Donoso, Enrique; Rodríguez-Mansilla, Juan; Mingote-Adán, José Carlos

2017-04-01

To evaluate burnout syndrome in its three aspects, jointly as well as independently, in physiotherapists from the Extremadura region (Spain). Analytic descriptive epidemiological transversal trial in primary care and institutional practice, with physiotherapists practicing in Extremadura who met the inclusion criteria, after having signed an informed consent form. Emotional exhaustion, depersonalization and low professional accomplishment were the outcomes measured. Physiotherapists from Extremadura show a 65.23 point level of burnout syndrome, according to the Maslach Burnout Inventory questionnaire. Therefore, they are positioned in the middle of the rating scale for the syndrome, and very near to the high level at starting score of 66 points. Physiotherapists in Extremadura present moderate scores for the three dimensions of burnout syndrome, namely, emotional exhaustion, depersonalization and low professional accomplishment. For this reason, they are in the moderate level of the syndrome and very near to the high level, which starts at a score of 66 points. No relation between burnout syndrome and age has been found in our study.

Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study

PubMed Central

Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

2015-01-01

Objectives To examine the effectiveness of the quality management programme—European Practice Assessment—in primary care in Switzerland. Design Longitudinal study with three points of measurement. Setting Primary care practices in Switzerland. Participants In total, 45 of 91 primary care practices completed European Practice Assessment three times. Outcomes The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: ‘infrastructure’, ‘information’, ‘finance’, and ‘quality and safety’ to examine changes over time. Results Significant improvements were found in three of four domains: ‘quality and safety’ (F=22.81, p<0.01), ‘information’ (F=27.901, p<0.01) and ‘finance’ (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). Conclusions The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. PMID:25900466

[Current Research Activities on Person-Centered Medicine in Academic Institutes of General Practice in Germany and Austria].

PubMed

Weber, Annemarie; Schelling, Jörg; Kohls, Niko; van Dyck, Marcus; Poggenburg, Stephanie; Vajda, Christian; Hirsch, Jameson; Sirois, Fuschia; Toussaint, Loren; Offenbächer, Martin

2017-10-11

Aim of study Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM). Methods A search was conducted (September-December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP. Results 541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15). Conclusion The vast majority of research projects investigated conventional medical topics. The percentage of research activities in the field of PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be implemented to a greater extent in general practice. © Georg Thieme Verlag KG Stuttgart · New York.

A longitudinal study of aspects of a hospital's family-centred nursing: changing practice through data translation.

PubMed

White, Chris; Wilson, Valerie

2015-01-01

To examine how results and data from multiple Family Centred Nursing Index surveys help the development of family-centred nursing at organizational and ward levels. A critical analysis of survey data. The Family Centred Nursing Index provides a valid and reliable assessment of aspects of nursing, through a comprehensive survey of traditional indicators of practice development and a broader range of aspects of practice. A survey with 113 questions, each to be answered on 7-point Likert scale conducted six times in the last 7 years. Surveys have been in 2006, 2008, 2009, 2010, 2011/2012 and 2012/2013. All nurses employed by the organization can participate. These are reported as means across 19 constructs linked to five key domains and their significance is examined by year and (in the clinical settings) and compared against the organizational (whole population) averages. Ongoing survey and analysis of nurses' views of their work is providing a valuable source of developmental data. The results show unexpected associations between constructs e.g. - a high level of work stress does not correlate with a lower level of job satisfaction (and vice versa). A clear historical picture of many elements of developing family-centred care is emerging at both the organizational and individual-ward levels. This study provides insights into aspects of organizational and wards working environment for nurses and how these aspects of nurses' work interact in unexpected ways. It is appropriate for providing information to organizations and ward teams in relation to their development towards family-centred cultures. © 2014 Commonwealth of Australia. Journal of Advanced Nursing © 2014 John Wiley & Sons Ltd.

Practical aspects of NGS-based pathways analysis for personalized cancer science and medicine

PubMed Central

Paleeva, Anna; Kremenetskaya, Olga; Vinogradov, Dmitriy

2016-01-01

Nowadays, the personalized approach to health care and cancer care in particular is becoming more and more popular and is taking an important place in the translational medicine paradigm. In some cases, detection of the patient-specific individual mutations that point to a targeted therapy has already become a routine practice for clinical oncologists. Wider panels of genetic markers are also on the market which cover a greater number of possible oncogenes including those with lower reliability of resulting medical conclusions. In light of the large availability of high-throughput technologies, it is very tempting to use complete patient-specific New Generation Sequencing (NGS) or other “omics” data for cancer treatment guidance. However, there are still no gold standard methods and protocols to evaluate them. Here we will discuss the clinical utility of each of the data types and describe a systems biology approach adapted for single patient measurements. We will try to summarize the current state of the field focusing on the clinically relevant case-studies and practical aspects of data processing. PMID:27191992

Object extraction in photogrammetric computer vision

NASA Astrophysics Data System (ADS)

Mayer, Helmut

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

[Patient safety and a culture of responsibility in ambulatory care: strategies for improving practice].

PubMed

Lichte, Thomas; Klement, Andreas; Herrmann, Markus

2009-01-01

The development of a medical safety culture is spreading beyond the hospital into the ambulatory setting. Patient safety defined as "absence of unwanted events" (primum non nocere) can serve as a starting point for the advancement of our ambulatory medical care system. Error analyses conducted in GP and specialist practices will identify gaps and traps in the system and provide ideas for the development and implementation of new safety strategies in ambulatory patient care. In the light of the structures and processes of GP medical care aspects of patient safety will be correlated to the outcome quality and examples will be discussed. Possible strategies for the improvement of patient safety in GP practice will be presented from the perspective of both patient- and practice individuality.

Study on Detailing Design of Precast Concrete Frame Structure

NASA Astrophysics Data System (ADS)

Lida, Tian; Liming, Li; Kang, Liu; Jiao, Geng; Ming, Li

2018-03-01

Taking a certain precast concrete frame structure as an example, this paper introduces the general procedures and key points in detailing design of emulative cast-in-place prefabricated structure from the aspects of structural scheme, precast element layout, shop drawing design and BIM 3D modelling. This paper gives a practical solution for the detailing design of precast concrete frame structure under structural design codes in China.

Clinical practice: vocal nodules in dysphonic children.

PubMed

Martins, Regina Helena Garcia; Branco, Anete; Tavares, Elaine Lara Mendes; Gramuglia, Andrea Cristina Jóia

2013-09-01

Common among children, vocal symptoms are a cause of concern for parents who seek elucidation of their diagnosis and treatment. Vocal nodules are the major cause of dysphonias in children and are related to vocal abuse. We conducted a literature review considering clinical, physiopathological, epidemiological, and histological aspects of vocal nodules, as well as diagnostic methods, highlighting the main studies addressing this issue. The controversial points of treatments were also discussed.

25th anniversary article: key points for high-mobility organic field-effect transistors.

PubMed

Dong, Huanli; Fu, Xiaolong; Liu, Jie; Wang, Zongrui; Hu, Wenping

2013-11-20

Remarkable progress has been made in developing high performance organic field-effect transistors (OFETs) and the mobility of OFETs has been approaching the values of polycrystalline silicon, meeting the requirements of various electronic applications from electronic papers to integrated circuits. In this review, the key points for development of high mobility OFETs are highlighted from aspects of molecular engineering, process engineering and interface engineering. The importance of other factors, such as impurities and testing conditions is also addressed. Finally, the current challenges in this field for practical applications of OFETs are further discussed. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Does a quality management system improve quality in primary care practices in Switzerland? A longitudinal study.

PubMed

Goetz, Katja; Hess, Sigrid; Jossen, Marianne; Huber, Felix; Rosemann, Thomas; Brodowski, Marc; Künzi, Beat; Szecsenyi, Joachim

2015-04-21

To examine the effectiveness of the quality management programme--European Practice Assessment--in primary care in Switzerland. Longitudinal study with three points of measurement. Primary care practices in Switzerland. In total, 45 of 91 primary care practices completed European Practice Assessment three times. The interval between each assessment was around 36 months. A variance analyses for repeated measurements were performed for all 129 quality indicators from the domains: 'infrastructure', 'information', 'finance', and 'quality and safety' to examine changes over time. Significant improvements were found in three of four domains: 'quality and safety' (F=22.81, p<0.01), 'information' (F=27.901, p<0.01) and 'finance' (F=4.073, p<0.02). The 129 quality indicators showed a significant improvement within the three points of measurement (F=33.864, p<0.01). The European Practice Assessment for primary care practices thus provides a functioning quality management programme, focusing on the sustainable improvement of structural and organisational aspects to promote high quality of primary care. The implementation of a quality management system which also includes a continuous improvement process would give added value to provide good care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Child and adolescent psychopathology: spiritual and religious perspectives.

PubMed

Mabe, P Alex; Josephson, Allan M

2004-01-01

This article addresses the relationship between children's religious beliefs and spiritual practices and the presence of psychopathology. Study of this subject represents a formidable task due to the complexity and diversity of the constructs involved, heterogeneity in religious beliefs and practices, and the difficulty in discriminating between the independent effects of religion and culture. Nevertheless, broad links between child psychopathology and spiritual/religious beliefs and practices are proposed. On the whole, the available empiric data suggest that religion is primarily health promoting in direct, positive benefits for children and in indirect, positive effects through parent and family functioning, although there are isolated exceptions. When spirituality and religious beliefs/practices are associated with negative mental health outcomes in children or their families, evidence points to "poorness-of-fit," based on an interaction between the child's psychopathology and aspects and religious beliefs/practice. Clinical implications of the findings and proposels are outlined.

Expanding the Repertoire: An Anthology of Practical Approaches for the Teaching of Writing (Reading-to-Write Report No. 11). Technical Report No. 30.

ERIC Educational Resources Information Center

McCormick, Kathleen; And Others

This study is the 11th and last report from the Reading-to-Write Project, a collaborative study of students' cognitive processes at one critical point of entry into academic performance. The report consists of an Introduction and seven essays, each of which discusses ways to teach a variety of aspects of reading and writing which have been tried…

The matrix approach to mental health care: Experiences in Florianopolis, Brazil.

PubMed

Soares, Susana; de Oliveira, Walter Ferreira

2016-03-01

This article reports on the experience of a matrix approach to mental health in primary health care. Professionals who work in the Family Health Support Nuclei, Núcleos de Apoio à Saúde da Família, pointed to challenges of this approach, especially regarding the difficulties of introducing pedagogic actions in the health field and problems related to work relationships. As the matrix approach and its practice are new aspects of the Brazilian Unified Health System, the academic knowledge must walk hand in hand with everyday professional practice to help improve the quality of the services offered in this context. © The Author(s) 2016.

From scientific literacy to sustainability literacy: An ecological framework for education

NASA Astrophysics Data System (ADS)

Colucci-Gray, Laura; Camino, Elena; Barbiero, Giuseppe; Gray, Donald

2006-03-01

In this paper, we report some reflections on science and education, in relation to teaching and research in the field of complex and controversial socio-environmental issues. Starting from an examination of the literature on the epistemological aspects of the science of controversial issues, and introducing the perspective of complexity, the article argues for a complexity of content, context, and method in understanding current problems. Focusing on a model of learning which includes dialogical and reflective approaches, the final part of the article reports on aspect of the authors' experimental practice with role-play for dealing with complex issues. The review of the literature and our experience of action-research introduce a view of education which promotes young people's awareness of multiple points of view, an ability to establish relationships between processes, scales, and contexts which may be nonlinearly related, and practice with creative and nonviolent forms of interrelations with others. Such an approach in science education is coherent with a scenario of planet sustainability based on ecological webs and equity principles.

An analysis of the influence of framework aspects on the study design of health economic modeling evaluations.

PubMed

Gurtner, Sebastian

2013-04-01

Research and practical guidelines have many implications for how to structure a health economic study. A major focus in recent decades has been the quality of health economic research. In practice, the factors influencing a study design are not limited to the quest for quality. Moreover, the framework of the study is important. This research addresses three major questions related to these framework aspects. First, we want to know whether the design of health economic studies has changed over time. Second, we want to know how the subject of a study, whether it is a process or product innovation, influences the parameters of the study design. Third, one of the most important questions we will answer is whether and how the study's source of funding has an impact on the design of the research. To answer these questions, a total of 234 health economic studies were analyzed using a correspondence analysis and a logistic regression analysis. All three categories of framework factors have an influence on the aspects of the study design. Health economic studies have evolved over time, leading to the use of more advanced methods like complex sensitivity analyses. Additionally, the patient's point of view has increased in importance. The evaluation of product innovations has focused more on utility concepts. On the other hand, the source of funding may influence only a few aspects of the study design, such as the use of evaluation methods, the source of data, and the use of certain utility measures. The most important trends in health care, such as the emphasis on the patients' point of view, become increasingly established in health economic evaluations with the passage of time. Although methodological challenges remain, modern information and communication technologies provide a basis for increasing the complexity and quality of health economic studies if used frequently.

Ethical aspects on rare diseases.

PubMed

Barrera, Luis A; Galindo, Gilberto Cely

2010-01-01

In this chapter we discuss several of the most relevant subjects related to ethics on Rare Diseases. Some general aspects are discussed such as the socio-psychological problems that confront the patients and their families that finally lead to marginalization and exclusion of patients affected by these diseases from the health programs, even in wealthy countries. Then we address problems related to diagnosis and some ethical aspects of newborn screening, prenatal, pre-implantation diagnosis and reference centers, as well as some conditions that should be met by the persons and institutions performing such tasks. Alternatives of solutions for the most critical situations are proposed. Subsequently the orphan drugs subject is discussed not only from the availability point of view, prizes, industrial practices, and purchasing power in developed and developing societies. The research related to rare disease in children and other especially vulnerable conditions, the need for informed consent, review boards or ethics comities, confidentiality of the information, biobanks and pharmacogenetics are discussed.

Conceptualising and managing trade-offs in sustainability assessment

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

Morrison-Saunders, Angus, E-mail: A.Morrison-Saunders@murdoch.edu.au; School of Environmental Science, Murdoch University; Pope, Jenny

One of the defining characteristics of sustainability assessment as a form of impact assessment is that it provides a forum for the explicit consideration of the trade-offs that are inherent in complex decision-making processes. Few sustainability assessments have achieved this goal though, and none has considered trade-offs in a holistic fashion throughout the process. Recent contributions such as the Gibson trade-off rules have significantly progressed thinking in this area by suggesting appropriate acceptability criteria for evaluating substantive trade-offs arising from proposed development, as well as process rules for how evaluations of acceptability should occur. However, there has been negligible uptakemore » of these rules in practice. Overall, we argue that there is inadequate consideration of trade-offs, both process and substantive, throughout the sustainability assessment process, and insufficient considerations of how process decisions and compromises influence substantive outcomes. This paper presents a framework for understanding and managing both process and substantive trade-offs within each step of a typical sustainability assessment process. The framework draws together previously published literature and offers case studies that illustrate aspects of the practical application of the framework. The framing and design of sustainability assessment are vitally important, as process compromises or trade-offs can have substantive consequences in terms of sustainability outcomes delivered, with the choice of alternatives considered being a particularly significant determinant of substantive outcomes. The demarcation of acceptable from unacceptable impacts is a key aspect of managing trade-offs. Offsets can be considered as a form of trade-off within a category of sustainability that are utilised to enhance preferred alternatives once conditions of impact acceptability have been met. In this way they may enable net gains to be delivered; another imperative for progress to sustainability. Understanding the nature and implications of trade-offs within sustainability assessment is essential to improving practice. - Highlights: Black-Right-Pointing-Pointer A framework for understanding trade-offs in sustainability assessment is presented. Black-Right-Pointing-Pointer Trade-offs should be considered as early as possible in any sustainability assessment process. Black-Right-Pointing-Pointer Demarcation of acceptable from unacceptable impacts is needed for effective trade-off management. Black-Right-Pointing-Pointer Offsets in place, time or kind can ensure and attain a net benefit outcome overall. Black-Right-Pointing-Pointer Gibson's trade-off rules provide useful acceptability criteria and process guidance.« less

General practitioners uses and perceptions of voluntary electronic feedback on treatment outcomes - a qualitative study.

PubMed

Lippert, Maria Laura; Kousgaard, Marius Brostrøm; Bjerrum, Lars

2014-11-30

Currently, there is a strong focus on the diffusion and implementation of indicator-based technologies for assessing and improving the quality of care in general practice. The aim of this study was to explore how and for what purposes indicator-based feedback is used by the general practitioners (GPs) and how they perceive it to contribute to their work. Qualitative interviews with nine GPs in two regions in Denmark. The main selection criterion was that the informants had experience with retrieving electronic feedback. The data generation was explorative and open-ended and the analysis took an iterative approach with continuous refinement of themes that emerged from the data. The study identified two main uses of feedback: i) Administration of a regular disease control schedule for patients with chronic disease and ii) Routine monitoring of outcomes for purposes of resource prioritisation and medication management. Both uses were deemed valuable by the GPs, but also as an additional extra to the clinical core task. All the GPs experienced the feedback to be of limited relevance to the most central and challenging aspects of clinical work understood as the care for individuals. This led to different reactions: Some GPs would use the feedback as a point of departure for broader deliberations about individual patient needs and treatment approaches. For others, the perceived limitations decreased their overall motivation to seek feedback. The study points to the importance of clarifying limitations as well as possibilities with respect to different aspects of clinical quality when introducing indicator-based technologies to practitioners. The results also emphasize that an indicator-based approach to quality improvement should not stand alone in general practice since some of the most central and challenging aspects of clinical work are not covered by this approach.

Mothers' perceptions of Melbourne InFANT Program: informing future practice.

PubMed

Lunn, Priscilla L; Roberts, Sanae; Spence, Alison; Hesketh, Kylie D; Campbell, Karen J

2016-09-01

Intervention programs to prevent childhood obesity are more likely to be successful when mothers are involved and engaged. Yet programs that involve mothers do not often employ process evaluation to identify aspects of the intervention that participants enjoyed or viewed as useful. The aims of this study were to describe how participants of the Melbourne InFANT Program-an early childhood obesity prevention intervention-engaged in the program and perceived its usefulness. Process evaluation data were collected at multiple time points during and after the intervention, using mixed methods drawing upon both quantitative and qualitative data. Results from short surveys (n = 271) and interview transcripts (n = 26) revealed that the Melbourne InFANT Program was perceived as useful and relevant by most (82-93%) participants. The formats through which the knowledge and skills were delivered were considered concise and effective, and aspects considered particularly useful included group sessions and advice on practical strategies to minimize stress around mealtimes. Findings from this study are important to inform future practice and the development of interventions which are well received by participants. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Marginal Loss Calculations for the DCOPF

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

Eldridge, Brent; O'Neill, Richard P.; Castillo, Andrea R.

2016-12-05

The purpose of this paper is to explain some aspects of including a marginal line loss approximation in the DCOPF. The DCOPF optimizes electric generator dispatch using simplified power flow physics. Since the standard assumptions in the DCOPF include a lossless network, a number of modifications have to be added to the model. Calculating marginal losses allows the DCOPF to optimize the location of power generation, so that generators that are closer to demand centers are relatively cheaper than remote generation. The problem formulations discussed in this paper will simplify many aspects of practical electric dispatch implementations in use today,more » but will include sufficient detail to demonstrate a few points with regard to the handling of losses.« less

The "group" in obstetric psychoprophylaxis.

PubMed

Volpe, B; Tenaglia, F; Fede, T; Cerutti, R

1983-01-01

In the practice of obstetric psychoprophylaxis every method employed considered always the group both from a psychological and a pedagogic point of view. Today the group of pregnant women (or couples) is considered under various aspects: - psychological: the group as a support for members with regard to maternal and parental emotional feelings; - anthropological: the group fills up an empty vital space and becomes a "rite de passage" from a state of social identity to another one; - social: the group is a significative cultural intermediary between health services and the women-patient. The knowledge of these aspects becomes an important methodological support for group conductors. We present an analysis of our experience with groups and how this has affected the Psychoprophylaxis in the last years.

Software Aspects of IEEE Floating-Point Computations for Numerical Applications in High Energy Physics

ScienceCinema

Arnold, Jeffrey

2018-05-14

Floating-point computations are at the heart of much of the computing done in high energy physics. The correctness, speed and accuracy of these computations are of paramount importance. The lack of any of these characteristics can mean the difference between new, exciting physics and an embarrassing correction. This talk will examine practical aspects of IEEE 754-2008 floating-point arithmetic as encountered in HEP applications. After describing the basic features of IEEE floating-point arithmetic, the presentation will cover: common hardware implementations (SSE, x87) techniques for improving the accuracy of summation, multiplication and data interchange compiler options for gcc and icc affecting floating-point operations hazards to be avoided. About the speaker: Jeffrey M Arnold is a Senior Software Engineer in the Intel Compiler and Languages group at Intel Corporation. He has been part of the Digital->Compaq->Intel compiler organization for nearly 20 years; part of that time, he worked on both low- and high-level math libraries. Prior to that, he was in the VMS Engineering organization at Digital Equipment Corporation. In the late 1980s, Jeff spent 2½ years at CERN as part of the CERN/Digital Joint Project. In 2008, he returned to CERN to spent 10 weeks working with CERN/openlab. Since that time, he has returned to CERN multiple times to teach at openlab workshops and consult with various LHC experiments. Jeff received his Ph.D. in physics from Case Western Reserve University.

Microwave power - An energy transmission alternative for the year 2000

NASA Technical Reports Server (NTRS)

Nalos, E.; Sperber, R.

1980-01-01

Recent technological advances related to the feasibility of efficient RF-dc rectification make it likely that by the year 2000 the transmission of power through space will have become a practical reality. Proposals have been made to power helicopters, aircraft, balloons, and rockets remotely. Other proposals consider the transfer of power from point to point on earth via relay through space or a transmission of power from large power sources in space. Attention has also been given to possibilities regarding the transmission of power between various points in the solar system. An outline is provided of the microwave power transmission system envisaged for the solar power satellite, taking into account the transmitting antenna, the receiver on earth, aspects of beam formation and control, transmitter options, the receiving antenna design, and cost and efficiency considerations.

Safety, risk and mental health: decision-making processes prescribed by Australian mental health legislation.

PubMed

Smith-Merry, Jennifer; Caple, Andrew

2014-03-01

Adverse events in mental health care occur frequently and cause significant distress for those who experience them, derailing treatment and sometimes leading to death. These events are clustered around particular aspects of care and treatment and are therefore avoidable if practices in these areas are strengthened. The research reported in this article takes as its starting point coronial recommendations made in relation to mental health. We report on those points and processes in treatment and discharge where coronial recommendations are most frequently made. We then examine the legislative requirements around these points and processes in three Australian States. We find that the key areas that need to be strengthened to avoid adverse events are assessment processes, communication and information transfer, documentation, planning and training. We make recommendations for improvements in these key areas.

Remote sensing of subsurface water temperature by Raman scattering.

PubMed

Leonard, D A; Caputo, B; Hoge, F E

1979-06-01

The application of Raman scattering to remote sensing of subsurface water temperature and salinity is considered, and both theoretical and experimental aspects of the technique are discussed. Recent experimental field measurements obtained in coastal waters and on a trans-Atlantic/Mediterranean research cruise are correlated with theoretical expectations. It is concluded that the Raman technique for remote sensing of subsurface water temperature has been brought from theoretical and laboratory stages to the point where practical utilization can now be developed.

[Internationalization and innovation of abdominal acupuncture].

PubMed

Wang, Yong-Zhou

2013-09-01

Characteristics of abdominal acupuncture are analyzed through three aspects of inheriting and innovation, collaborated research as well as international visual field. It is pointed that abdominal acupuncture is based on clinical practice, focuses on enhancing the therapeutic effect and expending the clinical application. It also promots the thinking on how to recall the tradition and how to inherit tradition availably. The modern medical problems should be studied and innovation resolutions should be searched, which can help the internationalization and modernization of abdominal acupuncture.

Diagnostic problems in thyroid FNAs.

PubMed

Galera-Davidson, H

1997-12-01

The use of FNA cytology to diagnose pathologic conditions of the thyroid has increased considerably in recent years, particularly since it has reduced by half the number of patients undergoing surgery. On the one hand, this diagnostic technique has attracted a certain amount of well justified criticism, but on the other, recent cytohistologic correlations and new scientific knowledge are continually improving its application. We shall discuss the latter aspect in more detail and deal with some simple but informative points which the pathologist may find useful in daily practice.

Device for data-acquisition from transient signals: kinetic considerations

PubMed Central

Sampedro, A. Sanchez; Vives, S. Sagrado

1990-01-01

This paper reports on the evaluation and testing of a home-made device. Data-acquisition, treatment of transient signals and the hardware and software involved are discussed. Some practical aspects are developed in order to power the autonomy of procedures using the device. Kinetic and multi-signal calculations are considered in order to cover the actual tendencies in continuous-flow analysis. Somepractical advantages versus the use of classical chart recorders or commercial computerized-instrument devices are pointed out. PMID:18925275

View Points of an Ecologist on Practical Environmental Ethic: Socioecology, Common-Pool Resources and Conservation.

PubMed

Castilla, Juan Carlos

2016-01-01

The paper centers on environmental practical ethic point of views according to a professional ecologist. Ecology and the science of Socio-ecology are defined. The framework of the Millennium Ecosystem Assessment initiative (MA 2003), including the use of ecosystems as the environmental unit of analysis, ecosystem services and human well-being as the center for assessment are discussed. Common-pool resources (CPR) and the allegory of the tragedy of the commons are used to illustrate main scientific and ethical environmental approaches, and above all to highlight the case of climate change, considering ″air-atmosphere″ as a CPR. The need to adopt practical personal environmental ethical positions is highlighted. Furthermore, on climate change, a discussion on the need to develop environmental and socio-ecological polycentric approaches: top-down and bottom-up, is included. An updated discussion on the concept of conservation, including main scientific and ethic points of view, is presented. Pope Francis's Encyclical, Laudato Si', is used to highlight environmental, socio-ecological and ethical aspects behind the comprehensive concept of Integral Ecology. The paper ends with a short synthesis on Earth modern unseen and astonishing environmental and socio-ecological rates of changes, and identifying the main barriers for personal environmental engagement. A call is done regarding the urgent need for socio-environmental ethic personal engagement and collective actions.

Self-perceived mental well-being amongst Malaysian dentists.

PubMed

Ab-Murat, Norintan; Mason, Lydia; Kadir, Rahimah Abdul; Yusoff, Noriah

2018-06-01

To assess Malaysian dentists' perceptions of their mental well-being. A self-administered questionnaire was developed based on a conceptual framework of mental health and well-being model. Two aspects were assessed, namely the physiological (two domains) and the psychological (six domains). Participants were asked to rate their experiences of the aforementioned aspects using a 5-point Likert scale ranging from all the time to never. The response rate was 81%. Most of the dentists (61.7%) perceived having positive mental well-being. Under the physiological aspect, most respondents reported that they were 'generally happy' (93.3%), but about 30% stated they were 'stressed physically and emotionally'. Of the six domains under the psychological aspect, positive well-being was observed in the 'sense of coherence' and 'behavioural stress' domains. Participants who were above 40 years old, married and had children reported having a more positive mental well-being when compared with their counterparts. Overall, most Malaysian dentists perceived having a positive mental well-being. It is crucial, however, to closely monitor and initiate early interventions for those with negative symptoms to ensure the safe practice of dentistry.

[Practical guidelines for the diagnosis and treatment of obstructive sleep apnea syndrome].

PubMed

Nogueira, Facundo; Nigro, Carlos; Cambursano, Hugo; Borsini, Eduardo; Silio, Julio; Avila, Jorge

2013-01-01

Obstructive sleep apnoea syndrome (OSAS) is one of the most relevant chronic respiratory pathologies due to its high prevalence and impact in morbidity and mortality. In 2001, the Asociación Argentina de Medicina Respiratoria (AAMR) published the first Argentinean Consensus on Sleep-Related breathing Disorders. Since then, wide new scientific evidence has emerged, increasing significantly the knowledge about this pathology. According to this, the Sleep-Related breathing Disorders and Oxygen Therapy Section of the AAMR, decided to update its Consensus, developing this Practical Guidelines on Management of patients with OSAS. A working group was created with members belonging to the section, experts in OSAS. They extensively reviewed the literature and wrote these guidelines, orientated to practical resolution of clinical problems and giving answers to questions emerged from dealing with patients who suffer from this syndrome. The document defines OSAS and describes the diagnosis and severity criteria, as well as the risk factors, ways of presentation and epidemiology. Clinical consequences, mainly on cognition, cardiovascular system and metabolism are pointed out. Different diagnostic methods, with their indications and technical aspects for validation and interpretation are detailed. Finally, we describe therapeutic alternatives, as well as practical aspects of their implementation. The authors' aim was to generate an accessible tool for teaching and spreading the knowledge on these disorders, which have a great impact in public health.

[Knowledge of asthma: educational intervention with the 2014 GINA guide in primary care physicians].

PubMed

Pozo-Beltrán, César Fireth; Navarrete-Rodríguez, Elsy Maureen; Fernández-Soto, Roberto; Navarro-Munguía, Jazmín; Hall-Mondragón, Margareth Sharon; Sienra-Monge, Juan José; Del Río-Navarro, Blanca Estela

2016-01-01

Asthma is a public health problem in the world, so updating the guidelines for the diagnosis and treatment of asthma is based primarily on the practice of primary care physicians. Educational interventions are useful for increasing knowledge. To compare the level of knowledge of asthma before and after an educational intervention. A quasi-experimental prospective study was conducted in general and family practitioners and pediatricians who attended a training workshop on general aspects of asthma and current guidelines for diagnosis and treatment (GINA 2014). A questionnaire consisting of 11 multiple choice questions relating to fundamental aspects of the disease and diagnosis, classification, treatment and management of attacks, was used in two assessments, baseline and post-intervention. A total of 178 patients participated in the study, with knowledge pre-intervention at 25.5 points and post-intervention at 97.5 points on a scale of 100, with p < 0.05. Educational interventions are inexpensive and effective tools to increase the knowledge of health professionals, and they have an impact on improving patient care.

Considering Subcontractors in Distributed Scrum Teams

NASA Astrophysics Data System (ADS)

Rudzki, Jakub; Hammouda, Imed; Mikkola, Tuomas; Mustonen, Karri; Systä, Tarja

In this chapter we present our experiences with working with subcontractors in distributed Scrum teams. The context of our experiences is a medium size software service provider company. We present the way the subcontractors are selected and how Scrum practices can be used in real-life projects. We discuss team arrangements and tools used in distributed development teams highlighting aspects that are important when working with subcontractors. We also present an illustrative example where different phases of a project working with subcontractors are described. The example also provides practical tips on work in such projects. Finally, we present a summary of our data that was collected from Scrum and non-Scrum projects implemented over a few years. This chapter should provide a practical point of view on working with subcontractors in Scrum teams for those who are considering such cooperation.

[Learn new version of Preferred Practice Pattern to further standardize the diagnosis and treatment of amblyopia].

PubMed

Zhao, Kanxing; Shi, Xuefeng

2014-07-01

The introduction of Preferred Practice Patterns (PPP) into China has given ophthalmologists in China more opportunities to acquaint themselves with international clinical guidelines for eye care, including its developing principles, methods and the application value. It had brought significant effects on the fast improvement of clinical eye care and standardization of diagnosis and treatment of eye diseases in China, and promoted the international academic exchanges. The 2nd Chinese version of PPPs translated by Prof. Jialiang Zhao was officially published in November, 2013. The new version of PPP for amblyopia adopted the newest standard for grading of evidence strength and recommendation assessment, and emphasizes the practicability based on evidence. New explanations of the definition of amblyopia are added according to the recent research progresses in amblyopia. The diagnostic criteria of best visual acuity for bilateral amblyopia at different ages is given with new specifications. Comprehensive and practical suggestions on the examination methods for amblyopia are provided from the qualitative assessment of visual acuity, the choice of eye chart, to the use of cycloplegic agents. In the aspect of the treatment of amblyopia, based on the findings of recent multi-central random controlled clinical trials, not only strong recommendations are provided, but also the insufficiency of evidence supporting for some choices of therapy is pointed out. The necessity of the follow-up evaluation after the cessation of the treatment of amblyopia is emphasized too. In the aspect of the prevention of amblyopia, the new amblyopia PPP points out the importance of the early-period screening of amblyopia, and that the healthcare insurance plans should cover timely screening, treatment, and monitoring for recurrence of amblyopia. This article deciphers the essential contents of the new version of Chinese PPP for amblyopia, and aims to promote the standardization of the diagnosis and treatment of amblyopia with our ophthalmic colleagues in China.

[The shutdown point and the output volume limit (OVL) in the present situation of healthcare in Hungary (or a little economics for practicing physicians)].

PubMed

Gresz, Miklós

2008-09-07

In the present situation of health care, financing has become so complicated that the treating doctor has to know not only his profession but also has to consider the different regulations, laws and book of rules. The work of the physician cannot be carried out only through the fact that he is a master of his art, that is healing. All healing practice, diagnostic abilities, intuition, empathy and other things are in vain: if he is not familiar with the basics of financing he can lead his institution to insolvency. This article tries to give a view of a small part of financing, the output volume limit (OVL) from another aspect. According to the basics of economy and general rules of leadership it tries to show up the practical difficulties of the output volume limit. The study enlightens that by defining the output volume limit one has to consider the shutdown point of the hospital and knowing this, the actual output volume limit should be defined in the way that it does not make the proper activity of the hospital completely impossible.

Methods of albumin estimation in clinical biochemistry: Past, present, and future.

PubMed

Kumar, Deepak; Banerjee, Dibyajyoti

2017-06-01

Estimation of serum and urinary albumin is routinely performed in clinical biochemistry laboratories. In the past, precipitation-based methods were popular for estimation of human serum albumin (HSA). Currently, dye-binding or immunochemical methods are widely practiced. Each of these methods has its limitations. Research endeavors to overcome such limitations are on-going. The current trends in methodological aspects of albumin estimation guiding the field have not been reviewed. Therefore, it is the need of the hour to review several aspects of albumin estimation. The present review focuses on the modern trends of research from a conceptual point of view and gives an overview of recent developments to offer the readers a comprehensive understanding of the subject. Copyright © 2017 Elsevier B.V. All rights reserved.

Tai Chi exercise and the improvement of health and well-being in older adults.

PubMed

Yau, Matthew Kwai-sang

2008-01-01

Activity participation has a positive impact on both quantity and quality of life (QOL). Regular participations in physical, social, and cultural activities are associated with successful aging. There is considerable evidence that Tai Chi has positive health benefits; physical, psychosocial and therapeutic. Furthermore, Tai Chi does not only consist of a physical component, but also sociocultural, meditative components that are believed to contribute to overall well-being. This chapter describes the benefits of Tai Chi exercise for the older adults, particularly in terms of the psychosocial aspect. The perceived meanings, associated values and well-being, as well as the impact on QOL, of Tai Chi practice among the older adults in Hong Kong are also discussed. Tai Chi exercise is chosen by the elderly participants for its gentle and soft movements. Besides the physical aspect, the benefits they describe include lifestyle issues, as well as psychological and social benefits. Evidence points out that the improvements in physical and mental health through the practice of Tai Chi among the older adults are related to their perceived level of QOL. Findings from numerous studies support the belief that the practice of Tai Chi has multiple benefits to practitioners that are not only physical in nature. It is recommended as a strategy to promote successful aging.

[Consent and confidentiality in occupational health practice: balance between legal requirements and ethical values].

PubMed

Mora, Erika; Franco, G

2010-01-01

The recently introduced Italian law on the protection of workers' health states that the occupational health physician (competent physician) is required to act according to the Code of Ethics of the International Commission on Occupational Health (ICOH). This paper aims at examining the articles of legislative decree 81/2008 dealing with informed consent and confidentiality compared with the corresponding points of the ICOH Ethics Code. Analysis of the relationship between articles 25 and 39 (informed consent) and 18, 20 and 39 (confidentiality) of the decree shows that there are some points of disagreement between the legal requirements and the Code of Ethics, in particular concerning prescribed health surveillance, consent based on appropriate information (points 8, 10 and 12 of the Code) and some aspects of confidentiality (points 10, 20, 21, 22 and 23 of the Code). Although the competent physician is required to act according to the law, the decisional process could lead to a violation of workers' autonomy.

Evaluation of multiple emission point facilities

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

Miltenberger, R.P.; Hull, A.P.; Strachan, S.

In 1970, the New York State Department of Environmental Conservation (NYSDEC) assumed responsibility for the environmental aspect of the state's regulatory program for by-product, source, and special nuclear material. The major objective of this study was to provide consultation to NYSDEC and the US NRC to assist NYSDEC in determining if broad-based licensed facilities with multiple emission points were in compliance with NYCRR Part 380. Under this contract, BNL would evaluate a multiple emission point facility, identified by NYSDEC, as a case study. The review would be a nonbinding evaluation of the facility to determine likely dispersion characteristics, compliance withmore » specified release limits, and implementation of the ALARA philosophy regarding effluent release practices. From the data collected, guidance as to areas of future investigation and the impact of new federal regulations were to be developed. Reported here is the case study for the University of Rochester, Strong Memorial Medical Center and Riverside Campus.« less

Practical aspects in surface biopotential electrode placement for smart clothing: A simulation study

NASA Astrophysics Data System (ADS)

Mulyadi, Indra H.; Haueisen, Jens; Supriyanto, Eko

2017-02-01

In addition to physiological aspects, placement of surface biopotential electrodes for smart clothing should consider practical aspects due to their dynamic application environment. This study is aimed at finding the best places to put the electrode on areas where the measurement is practically reliable. Calculation was performed by using three practical aspects: 1) skin-shirt gap; 2) shirt movement, and 4) regional sweat rate. We employed 3DS Max software to simulate shirt behavior. The simulation result showed that generally practical satisfaction degrees are higher in the posterior. The quantitative approach may help smart clothing designers to choose the locations to place electrodes.

The Relationship Between Personality Traits, Flow-Experience, and Different Aspects of Practice Behavior of Amateur Vocal Students

PubMed Central

Heller, Katharina; Bullerjahn, Claudia; von Georgi, Richard

2015-01-01

Most of the existing studies on musical practice are concerned with instrumentalists only. Since singers are seldom considered in research, the present study is based on an online-sample of amateur vocal students (N = 120; 92 female, 28 male). The study investigated the correlations between personality traits, flow-experience and several aspects of practice characteristics. Personality was represented by the three personality dimensions extraversion, neuroticism and psychoticism, assessed by Eysenck’s Personality Profiler as well as the trait form of the Positive and Negative Affect Schedule. ‘Flow-experience,’ ‘self-congruence’ and ‘fear of losing control over concentration,’ assessed by the Practice Flow Inventory, served as variables for flow-experience. The practice motivation was measured by the Practice Motivation Questionnaire in four categories (‘self,’ ‘group,’ ‘audience,’ ‘teacher’). In addition, the Practice Behavior Questionnaire was used to provide an insight into the practice situation and behavior of singing students. The results show significant correlations: participants with high extraversion-scores experience significantly more flow than less extraverted persons, whereas lesser flow-experience seems to be related to high neuroticism-scores. Nevertheless, there is no influence in flow-experience concerning singing style (‘classical’ or ‘popular’). The longer the practicing time, the more likely students are to achieve flow-experience. However, older singers tend to have less flow-experience. Consequently, singers seem to differ in their personality and practice behavior compared to other musicians. Most of the findings show that having control over one’s instrument is decisive for achieving a performance of high quality, especially for singers. On the other hand, certainty in handling an instrument is essential to arouse a flow-feeling. However, flow-experience seems to be common mainly with amateur singers. In conclusion, this offers a starting point for new research on the psychology of vocalists in greater depth. PMID:26733904

The Relationship Between Personality Traits, Flow-Experience, and Different Aspects of Practice Behavior of Amateur Vocal Students.

PubMed

Heller, Katharina; Bullerjahn, Claudia; von Georgi, Richard

2015-01-01

Most of the existing studies on musical practice are concerned with instrumentalists only. Since singers are seldom considered in research, the present study is based on an online-sample of amateur vocal students (N = 120; 92 female, 28 male). The study investigated the correlations between personality traits, flow-experience and several aspects of practice characteristics. Personality was represented by the three personality dimensions extraversion, neuroticism and psychoticism, assessed by Eysenck's Personality Profiler as well as the trait form of the Positive and Negative Affect Schedule. 'Flow-experience,' 'self-congruence' and 'fear of losing control over concentration,' assessed by the Practice Flow Inventory, served as variables for flow-experience. The practice motivation was measured by the Practice Motivation Questionnaire in four categories ('self,' 'group,' 'audience,' 'teacher'). In addition, the Practice Behavior Questionnaire was used to provide an insight into the practice situation and behavior of singing students. The results show significant correlations: participants with high extraversion-scores experience significantly more flow than less extraverted persons, whereas lesser flow-experience seems to be related to high neuroticism-scores. Nevertheless, there is no influence in flow-experience concerning singing style ('classical' or 'popular'). The longer the practicing time, the more likely students are to achieve flow-experience. However, older singers tend to have less flow-experience. Consequently, singers seem to differ in their personality and practice behavior compared to other musicians. Most of the findings show that having control over one's instrument is decisive for achieving a performance of high quality, especially for singers. On the other hand, certainty in handling an instrument is essential to arouse a flow-feeling. However, flow-experience seems to be common mainly with amateur singers. In conclusion, this offers a starting point for new research on the psychology of vocalists in greater depth.

[Theoretical origin and clinical application of wrist-ankle acupuncture therapy].

PubMed

Wang, Qiong; Zhou, Qinghui

2017-05-12

The theory of wrist-ankle acupuncture is consistent with traditional meridian-collateral theory. For example, the body divisions of wrist-ankle acupuncture are corresponding to the distribution of 12 cutaneous regions of meridians, the needling sites of it are to the running courses of 12 meridians; the indications of it are to those of 12 meridians. The needling sites of wrist-ankle acupuncture are relevant with some special acupoints of acupuncture theory. For example, the 12-needling sites of wrist-ankle acupuncture are located similar to those of 12 meridian points and have very similar indications. The needling sites of it are located in the wrist and ankle regions, in which the five- shu points are located nearby, for meridian disorders. Most luo -connecting points are located near to the needling sites of wrist-ankle acupuncture or the needle tip points to. Additionally, the needling method of wrist-ankle acupuncture is consistent with some of the subcutaneous needling methods in traditional acupuncture therapy. On the basis of the aspects mentioned above, it is explained that wrist-ankle acupuncture is the development of traditional acupuncture and cannot be independent from the traditional theories of acupuncture and meridians. It is necessary to seek for the evidence from the traditional theories of TCM. The traditional theories of TCM are summarized from clinical practice, which can be newly verified from the practice of wrist-ankle acupuncture.

Meeting the religious needs of residents with dementia.

PubMed

Higgins, Patricia

2013-11-01

This article considers practical strategies to help nurses working in care homes meet the religious needs of people with dementia, including attending services in homes or churches, supporting them in private prayer and at the end of life. It also considers the characteristics of person-centred care for such residents and how the Mental Capacity Act 2005 may be called on to support religious needs as dementia advances. To achieve good practice in all these aspects, staff in care homes should work in partnership with local faith communities and ensure they are aware of residents' life histories and preferences, including their faith practices. The focus of the article is on meeting the needs of Christian residents. For residents from other faith groups living in care homes not affiliated to their faith, the same general approach to meeting religious needs could be adopted as a starting point.

A Cognitive Framework for Battlefield Commanders’ Situation Assessment

DTIC Science & Technology

1994-07-01

27 , • -- i--i i i•’ i i • -i• ’• i i i 1 i • |_!_! Stressors (1) j7- Actake space In ~ (2) maike la, demands onr ~ retrival a Increase I - ctual...structures to encode new data. A key point is that retrieval cues are associated with the new material in the encoding stage. With practice in a specific...that match the retrieval cues even after long periods of time. We suspect that aspects of skilled memory characterize expertise in a variety of

Journal of Air Transportation World Wide, Volume 5, No. 1. Volume 5

NASA Technical Reports Server (NTRS)

Bowen, Brent D. (Editor)

2000-01-01

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

How medical doctors and students should use Social Media: a review of the main guidelines for proposing practical recommendations.

PubMed

Mayer, Miguel Angel; Leis, Angela; Mayer, Alex; Rodriguez-Gonzalez, Alejandro

2012-01-01

Social Media has grown exponentially and in the last few years there has been an increasing use amongst medical doctors and students. There is intense debate about the complexities of ensuring medical professionalism in the digital age and especially on using open and massive online services. The objectives of this paper are: first, to gather the main recommendations on using Social Media platforms and websites by medical doctors and students, which are proposed by several international organizations, institutions and universities of reference and second, to propose a set of practical recommendations, based on the comparison of the statements and items of the guidelines, in order to find agreements and differences among them and select the most common and practical items stated. A Decalogue of good practices has been drawn up, pointing out the most important aspects that should be considered, highlighting the relevance of maintaining professional behavior in these environments, taking into account the advantages and drawbacks when using them.

Exploring Learning Progressions of New Science Teachers

NASA Astrophysics Data System (ADS)

Krise, Kelsy Marie

First-, second- and third-year teachers can be considered novice teachers with a solid foundation. The beginning years of teaching are intense times for learning, in which teachers can build upon their foundational knowledge. However, traditional mentoring programs often focus on technical advice and emotional support to help teachers survive the first years. This study set out to understand new science teachers' pedagogical content knowledge (PCK) in order to identify how their learning progresses. Understanding teachers' ideas will allow one to think about the development of educative mentoring practices that promote the advancement of teachers' knowledge. To investigate teachers' learning progressions, the following research questions guided this study: What is the nature of pedagogical content knowledge of first-, second- and third-year science teachers at various points across the school year? To which aspects of pedagogical content knowledge do first-, second- and third-year teachers pay attention at various points across the school year? Which aspects of pedagogical content knowledge are challenging for first-, second- and third-year teachers at various points across the school year? First-, second- and third-year teachers were interviewed, observed, and their teaching artifacts were collected across the school year. Data were examined to uncover learning progressions, when ideas became more sophisticated across first-, second-, and third-year teachers. The findings of this study contribute to an understanding of how teachers' learning progresses and allows for a trajectory of learning to be described. The trajectory can be used to inform the design of university-based mentoring programs for new teachers. The descriptions of the nature of teachers' PCK and the aspects of PCK to which teachers pay attention and find challenging shed light on the support necessary to promote continued teacher learning.

[Quality of life - methodology and clinical practice aspects with a focus on ocular medicine].

PubMed

Franke, G H; Gall, C

2008-08-01

Due to the demographic development in western industrialised countries, the proportion of visually impaired persons is likely to increase in the future. Currently there is a shift in scientific recognition from relative neglect of psychopathological distress in the visually impaired to better notice of disease-related subjective impairments that are detectable with specific questionnaire measures. Visual acuity primarily determines the subjective rating of visual functioning independent from the eye disease. Ophthalmic patients who show only mild symptoms from a medical point of view normally suffer considerably diminished vision-related quality of life with respect to physical, functional, mental, and social aspects. Treatment effects have been shown using vision-related quality-of-life measures for different ophthalmic diseases, particularly cataract surgery. Assessment of vision-related quality of life provides a meaningful complement to objective data.

Application of hazard analysis and critical control point methodology and risk-based grading to consumer food safety surveys.

PubMed

Røssvoll, Elin Halbach; Ueland, Øydis; Hagtvedt, Therese; Jacobsen, Eivind; Lavik, Randi; Langsrud, Solveig

2012-09-01

Traditionally, consumer food safety survey responses have been classified as either "right" or "wrong" and food handling practices that are associated with high risk of infection have been treated in the same way as practices with lower risks. In this study, a risk-based method for consumer food safety surveys has been developed, and HACCP (hazard analysis and critical control point) methodology was used for selecting relevant questions. We conducted a nationally representative Web-based survey (n = 2,008), and to fit the self-reported answers we adjusted a risk-based grading system originally developed for observational studies. The results of the survey were analyzed both with the traditional "right" and "wrong" classification and with the risk-based grading system. The results using the two methods were very different. Only 5 of the 10 most frequent food handling violations were among the 10 practices associated with the highest risk. These 10 practices dealt with different aspects of heat treatment (lacking or insufficient), whereas the majority of the most frequent violations involved storing food at room temperature for too long. Use of the risk-based grading system for survey responses gave a more realistic picture of risks associated with domestic food handling practices. The method highlighted important violations and minor errors, which are performed by most people and are not associated with significant risk. Surveys built on a HACCP-based approach with risk-based grading will contribute to a better understanding of domestic food handling practices and will be of great value for targeted information and educational activities.

Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study

PubMed Central

West, Robert; Rushforth, Bruno; Stokes, Tim; Glidewell, Liz; Carder, Paul; Faulkner, Simon; Foy, Robbie

2017-01-01

Background There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected ‘big data’ in the evaluation of healthcare. We developed a set of evidence-based ‘high impact’ quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). Methods Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89). The QIs covered aspects of care (including processes and intermediate clinical outcomes) in relation to diabetes, hypertension, atrial fibrillation, myocardial infarction, chronic kidney disease (CKD) and ‘risky’ prescribing combinations. Regression models explored the impact of practice and patient characteristics. Clustering within practice was accounted for by including a random intercept for practice. Results Median practice achievement of the QIs ranged from 43.2% (diabetes control) to 72.2% (blood pressure control in CKD). Considerable between-practice variation existed for all indicators: the difference between the highest and lowest performing practices was 26.3 percentage points for risky prescribing and 100 percentage points for anticoagulation in atrial fibrillation. Odds ratios associated with the random effects for practices emphasised this; there was a greater than ten-fold difference in the likelihood of achieving the hypertension indicator between the lowest and highest performing practices. Patient characteristics, in particular age, gender and comorbidity, were consistently but modestly associated with indicator achievement. Statistically significant practice characteristics were identified less frequently in adjusted models. Conclusions Despite various policy and improvement initiatives, there are enduring inappropriate variations in the delivery of evidence-based care. Much of this variation is not explained by routinely collected patient or practice variables, and is likely to be attributable to differences in clinical and organisational behaviour. PMID:28704407

Differences in Game Statistics Between Winning and Losing Rugby Teams in the Six Nations Tournament

PubMed Central

Ortega, Enrique; Villarejo, Diego; Palao, José M.

2009-01-01

The objective of the present study was to analyze the differences in rugby game statistics between winning and losing teams. The data from 58 games of round robin play from the Six Nations tournament from the 2003-2006 seasons were analyzed. The groups of variables studied were: number of points scored, way in which the points were scored; way teams obtained the ball and how the team used it; and technical and tactical aspects of the game. A univariate (t-test) and multivariate (discriminant) analysis of data was done. Winning teams had average values that were significantly higher in points scored, conversions, successful drops, mauls won, line breaks, possessions kicked, tackles completed, and turnovers won. Losing teams had significantly higher averages for the variables scrums lost and line-outs lost. The results showed that: a) in the phases of obtaining the ball and more specifically in scrummage and line-out, winning teams lose fewer balls than losing teams (winning teams have an efficacy of 90% in both actions); b) the winning team tends to play more with their feet when they obtain the ball, to utilize the maul as a way of attacking, and to break the defensive line more often than the losing team does; and c) On defence, winning teams recovered more balls and completed more tackles than losing teams, and the percentage of tackles completed by winning teams was 94%. The value presented could be used as a reference for practice and competition in peak performance teams. Key points This paper increases the knowledge about rugby match analysis. Give normative values to establish practice and match goals. Give applications ideas to connect research with coaches practice. PMID:24149592

Who's afraid of EBM? Medical professionalism from the perspective of evidence-based medicine.

PubMed

Salloch, Sabine

2017-03-01

Evidence-based medicine (EBM) and medical professionalism are two prominent notions in current medical debates. However, proponents of professionalism fear a restriction in doctors' freedom to make their best decisions for individual patients caused by the influence of EBM and highly standardised decision procedures. The challenge which EBM allegedly poses to physicians' discretion forms the starting point for an analysis of the relationship between professionalism, as an inherent value system of medical practice, and EBM, as an approach to optimise the decision-making for individual patients. The analysis starts with a brief conceptual clarification of the ambiguous term "professionalism". It then focuses on three key aspects of medical professionalism which may come into conflict with the basic tenets of EBM. The potential tensions between (a) professional autonomy and clinical practice guidelines, (b) individualised care and standardisation, and (c) esoteric authority and public accountability are analysed and a suggestion for reconcilement regarding each point is made. The article closes with a summary on how a better reflection on medical professionalism may help towards a fuller understanding of EBM and vice versa.

Societal constraints related to environmental remediation and decommissioning programmes.

PubMed

Perko, Tanja; Monken-Fernandes, Horst; Martell, Meritxell; Zeleznik, Nadja; O'Sullivan, Patrick

2017-06-20

The decisions related to decommissioning or environmental remediation projects (D/ER) cannot be isolated from the socio-political and cultural environment. Experiences of the IAEA Member States point out the importance of giving due attention to the societal aspects in project planning and implementation. The purpose of this paper is threefold: i) to systematically review societal constraints that some organisations in different IAEA Member States encounter when implementing D/ER programmes, ii) to identify different approaches to overcome these constraints and iii) to collect examples of existing practices related to the integration of societal aspects in D/ER programmes worldwide. The research was conducted in the context of the IAEA project Constraints to Decommissioning and Environmental Remediation (CIDER). The research results show that societal constraints arise mostly as a result of the different perceptions, attitudes, opinions and concerns of stakeholders towards the risks and benefits of D/ER programmes and due to the lack of stakeholder involvement in planning. There are different approaches to address these constraints, however all approaches have common points: early involvement, respect for different views, mutual understanding and learning. These results are relevant for all on-going and planned D/ER programmes. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Self-instructional Model to Teach Systems-based Practice and Practice-based Learning and Improvement

PubMed Central

Kimura, Joe; Ladden, MaryJoan D.; March, Elizabeth; Moore, Gordon T.

2008-01-01

Background When mandated as resident competencies in 1999, systems-based practice (SBP) and practice-based learning and improvement (PBLI) were new concepts to many. Objective To describe and evaluate a 4-week clinical elective (Achieving Competence Today—ACT) to teach residents SBP and PBLI. Design ACT consisted of a four-week active learning course and follow-up teaching experience, guided and supported by web-based materials. The curriculum included readings, scheduled activities, work products including an improvement project, and weekly meetings with a non-expert preceptor. The evaluation used a before–after cross-comparison of ACT residents and their peers. Participants Seventy-eight residents and 42 faculty in 18 US Internal Medicine residency programs participated between 2003 and 2005. Results and Main Measurements All residents and faculty preceptors responded to a knowledge test, survey of attitudes, and self-assessment of competency to do 15 tasks related to SBP/PBLI. All measures were normalized to a 100-point scale. Each program’s principal investigator (PI) identified aspects of ACT that were most and least effective in enhancing resident learning. ACT residents’ gains in knowledge (4.4 on a 100-point scale) and self-assessed competency (11.3) were greater than controls’ (−1.9, −8.0), but changes in attitudes were not significantly different. Faculty preceptors’ knowledge scores did not change, but their attitudes became more positive (15.8). PIs found a ready-to-use curriculum effective (rated 8.5 on a 10-point scale). Conclusions ACT increased residents’ knowledge and self-assessment of their own competency and raised faculty’s assessment of the importance of residents’ learning SBP/PBLI. Faculty content expertise is not required for residents to learn SBP/PBLI. PMID:18612719

A self-instructional model to teach systems-based practice and practice-based learning and improvement.

PubMed

Peters, Antoinette S; Kimura, Joe; Ladden, Maryjoan D; March, Elizabeth; Moore, Gordon T

2008-07-01

When mandated as resident competencies in 1999, systems-based practice (SBP) and practice-based learning and improvement (PBLI) were new concepts to many. To describe and evaluate a 4-week clinical elective (Achieving Competence Today-ACT) to teach residents SBP and PBLI. ACT consisted of a four-week active learning course and follow-up teaching experience, guided and supported by web-based materials. The curriculum included readings, scheduled activities, work products including an improvement project, and weekly meetings with a non-expert preceptor. The evaluation used a before-after cross-comparison of ACT residents and their peers. Seventy-eight residents and 42 faculty in 18 US Internal Medicine residency programs participated between 2003 and 2005. RESULTS AND MAIN MEASUREMENTS: All residents and faculty preceptors responded to a knowledge test, survey of attitudes, and self-assessment of competency to do 15 tasks related to SBP/PBLI. All measures were normalized to a 100-point scale. Each program's principal investigator (PI) identified aspects of ACT that were most and least effective in enhancing resident learning. ACT residents' gains in knowledge (4.4 on a 100-point scale) and self-assessed competency (11.3) were greater than controls' (-1.9, -8.0), but changes in attitudes were not significantly different. Faculty preceptors' knowledge scores did not change, but their attitudes became more positive (15.8). PIs found a ready-to-use curriculum effective (rated 8.5 on a 10-point scale). ACT increased residents' knowledge and self-assessment of their own competency and raised faculty's assessment of the importance of residents' learning SBP/PBLI. Faculty content expertise is not required for residents to learn SBP/PBLI.

The Fundamentals of Care Framework as a Point-of-Care Nursing Theory.

PubMed

Kitson, Alison L

Nursing theories have attempted to shape the everyday practice of clinical nurses and patient care. However, many theories-because of their level of abstraction and distance from everyday caring activity-have failed to help nurses undertake the routine practical aspects of nursing care in a theoretically informed way. The purpose of the paper is to present a point-of-care theoretical framework, called the fundamentals of care (FOC) framework, which explains, guides, and potentially predicts the quality of care nurses provide to patients, their carers, and family members. The theoretical framework is presented: person-centered fundamental care (PCFC)-the outcome for the patient and the nurse and the goal of the FOC framework are achieved through the active management of the practice process, which involves the nurse and the patient working together to integrate three core dimensions: establishing the nurse-patient relationship, integrating the FOC into the patient's care plan, and ensuring that the setting or context where care is transacted and coordinated is conducive to achieving PCFC outcomes. Each dimension has multiple elements and subelements, which require unique assessment for each nurse-patient encounter. The FOC framework is presented along with two scenarios to demonstrate its usefulness. The dimensions, elements, and subelements are described, and next steps in the development are articulated.

Factors influencing pharmacy students’ attitudes towards pharmacy practice research and strategies for promoting research interest in pharmacy practice

PubMed Central

Kritikos, Vicky S.; Saini, Bandana; Carter, Stephen; Moles, Rebekah J.; Krass, Ines

2015-01-01

Objectives: To (1) investigate the relationships between students’ characteristics and their (a) perceptions of research in general and (b) attitudes towards pharmacy practice research; (2) identify strategies that could be used by pharmacy educators to promote research interest in pharmacy practice; and (3) identify perceived barriers to the pursuit or completion of a pharmacy practice research degree. Methods: A survey was administered to all students enrolled in each year of the four-year pharmacy undergraduate program, University of Sydney, Australia. Perceptions of research in general were measured using 4 items on a five-point semantic-differential scale and attitudes towards pharmacy practice research were measured using 16 items on a five-point Likert scale. Student characteristics were also collected as were responses to open-ended questions which were analysed using content analysis. Results: In total 853 students participated and completed the survey (83% response rate). Participants’ characteristics were associated with some but not all aspects of research and pharmacy practice research. It appeared that positive attitudes and perspectives were influenced strongly by exposure to the ‘research’ process through projects, friends or mentors, previous degrees or having future intentions to pursue a research degree. Results from both the quantitative and qualitative analyses suggest positive attitudes and perceptions of research can be nurtured through the formal inclusion in research processes, particularly the utility of practice research in clinical practice across the four years of study. Participants indicated there was a lack of awareness of the needs, benefits and career opportunities associated with pharmacy practice research and voiced clear impediments in their career path with respect to the choice of practice research-related careers. Conclusions: Future research should investigate changes in perceptions and attitudes in a single cohort over the four-year degree, other factors influencing students’ perceptions and attitudes, and evaluate the effectiveness of research promoting strategies and programs. PMID:26445620

A new Heritage Impact Assessment matrix for sustainability and resilience to hazards- from water heritage point of view

NASA Astrophysics Data System (ADS)

Chen, Otto; Han, Dawei

2017-04-01

Understanding the significance of an historic asset and the possible impact of the proposed scheme on this significance is the key to good heritage conservation practice. In order to comply with the principle and advice set out in many statutory documents, from international charters to local regulations, the proposers are required to provide a description of the significance of the heritage. This needs to be presented in the form of a Heritage Impact Assessment (HIA). HIA is to protect the value of the heritage affected, by mitigating and minimizing the impact. The ignorance and inadequacy of HIA may lead to the development plan being made unapproved. Therefore, when dealing with changes on historic built environment, engineers and stakeholders without the participation of heritage profession are increasingly facing the relevant issues of HIA in recent decades, and are getting more aware of its importance and inevitable trend in the field, especially in the heritage-centred European environment. Although HIA has been globally recognized and applied as a well-developed tool, its merely focus on the 'value' aspect is rather limited. The lack of consideration on natural environment reflects the issue of sustainable environment development, hence merits further discussion. This study reviews HIA from the theory of international heritage conservation, to the statutory practice of the UK, then proposes a new matrix framework from the water heritage point of view, by integrating two aspects - sustainability and resilience to natural hazards (e.g., shocks and stressors) into the conventional framework, for the purpose of contributing to the dual protection of natural and historic environment.

Tailored motivational message generation: A model and practical framework for real-time physical activity coaching.

PubMed

Op den Akker, Harm; Cabrita, Miriam; Op den Akker, Rieks; Jones, Valerie M; Hermens, Hermie J

2015-06-01

This paper presents a comprehensive and practical framework for automatic generation of real-time tailored messages in behavior change applications. Basic aspects of motivational messages are time, intention, content and presentation. Tailoring of messages to the individual user may involve all aspects of communication. A linear modular system is presented for generating such messages. It is explained how properties of user and context are taken into account in each of the modules of the system and how they affect the linguistic presentation of the generated messages. The model of motivational messages presented is based on an analysis of existing literature as well as the analysis of a corpus of motivational messages used in previous studies. The model extends existing 'ontology-based' approaches to message generation for real-time coaching systems found in the literature. Practical examples are given on how simple tailoring rules can be implemented throughout the various stages of the framework. Such examples can guide further research by clarifying what it means to use e.g. user targeting to tailor a message. As primary example we look at the issue of promoting daily physical activity. Future work is pointed out in applying the present model and framework, defining efficient ways of evaluating individual tailoring components, and improving effectiveness through the creation of accurate and complete user- and context models. Copyright © 2015 Elsevier Inc. All rights reserved.

Renal replacement therapy in adult and pediatric intensive care : Recommendations by an expert panel from the French Intensive Care Society (SRLF) with the French Society of Anesthesia Intensive Care (SFAR) French Group for Pediatric Intensive Care Emergencies (GFRUP) the French Dialysis Society (SFD).

PubMed

Vinsonneau, Christophe; Allain-Launay, Emma; Blayau, Clarisse; Darmon, Michael; Ducheyron, Damien; Gaillot, Theophile; Honore, Patrick M; Javouhey, Etienne; Krummel, Thierry; Lahoche, Annie; Letacon, Serge; Legrand, Matthieu; Monchi, Mehran; Ridel, Christophe; Robert, René; Schortgen, Frederique; Souweine, Bertrand; Vaillant, Patrick; Velly, Lionel; Osman, David; Van Vong, Ly

2015-12-01

Acute renal failure (ARF) in critically ill patients is currently very frequent and requires renal replacement therapy (RRT) in many patients. During the last 15 years, several studies have considered important issues regarding the use of RRT in ARF, like the time to initiate the therapy, the dialysis dose, the types of catheter, the choice of technique, and anticoagulation. However, despite an abundant literature, conflicting results do not provide evidence on RRT implementation. We present herein recommendations for the use of RRT in adult and pediatric intensive care developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of French Intensive Care Society (SRLF), with the participation of the French Society of Anesthesia and Intensive Care (SFAR), the French Group for Pediatric Intensive Care and Emergencies (GFRUP), and the French Dialysis Society (SFD). The recommendations cover 4 fields: criteria for RRT initiation, technical aspects (access routes, membranes, anticoagulation, reverse osmosis water), practical aspects (choice of the method, peritoneal dialysis, dialysis dose, adjustments), and safety (procedures and training, dialysis catheter management, extracorporeal circuit set-up). These recommendations have been designed on a practical point of view to provide guidance for intensivists in their daily practice.

Placing ecosystem sustainability within the context of dynamic earth systems

NASA Astrophysics Data System (ADS)

Sidle, R. C.

2013-12-01

Because the concept of ecosystem sustainability and the practice of sustainable land management both have long-term foci, it is necessary to view these from the perspective of dynamic rather than static systems. In addition to the typical static system approach for assessing ecosystem sustainability, three additional perspectives are presented. These are resilient systems, systems where tipping points occur, and systems subject to episodic geophysical resetting. Ecosystem resilience accommodates both natural and anthropogenic stressors and should be considered to properly frame many ecosystem assessments. A more complex problem emerges when stressors push systems to tipping points, causing a regime shift. Both chronic anthropogenic activities (e.g., over-grazing, forest conversion, poor irrigation practices) and natural changes (e.g., climate anomalies, geochemical weathering, tectonic uplift, vegetative succession) can exhaust ecosystem resilience leading to a rapid change in state. Anthropogenic perturbations can also lower the initiation threshold and increase the magnitude and frequency of certain natural disasters, increasing the likelihood of ecosystem change. Furthermore, when major episodic geophysical events (e.g., large earthquakes, tsunami, and floods; widespread volcanic activity and landslides) exceed thresholds of ecosystem resilience they may reset the attributes of entire systems or landscapes. Large disasters can initiate a cascade of linked events, as in the 2011 Great East Japan Earthquake, where tsunami, fires, landslides, artificial fillslope collapses, radioactive releases, and associated health effects occurred. Understanding the potential for natural change (both chronic and episodic) in ecosystems is essential not only to the environmental aspect of sustainability but also to economic and social aspects. Examples are presented for: (1) ecosystems vulnerable to tipping points (Yunnan, China) and (2) ecosystems reset by earthquakes and tsunami (Papua New Guinea and eastern Japan). While these geophysical perturbations and shifts in ecosystems are individually recognized, they are not fully embraced by contemporary sustainability thinking or decision management.

Mapping with Small UAS: A Point Cloud Accuracy Assessment

NASA Astrophysics Data System (ADS)

Toth, Charles; Jozkow, Grzegorz; Grejner-Brzezinska, Dorota

2015-12-01

Interest in using inexpensive Unmanned Aerial System (UAS) technology for topographic mapping has recently significantly increased. Small UAS platforms equipped with consumer grade cameras can easily acquire high-resolution aerial imagery allowing for dense point cloud generation, followed by surface model creation and orthophoto production. In contrast to conventional airborne mapping systems, UAS has limited ground coverage due to low flying height and limited flying time, yet it offers an attractive alternative to high performance airborne systems, as the cost of the sensors and platform, and the flight logistics, is relatively low. In addition, UAS is better suited for small area data acquisitions and to acquire data in difficult to access areas, such as urban canyons or densely built-up environments. The main question with respect to the use of UAS is whether the inexpensive consumer sensors installed in UAS platforms can provide the geospatial data quality comparable to that provided by conventional systems. This study aims at the performance evaluation of the current practice of UAS-based topographic mapping by reviewing the practical aspects of sensor configuration, georeferencing and point cloud generation, including comparisons between sensor types and processing tools. The main objective is to provide accuracy characterization and practical information for selecting and using UAS solutions in general mapping applications. The analysis is based on statistical evaluation as well as visual examination of experimental data acquired by a Bergen octocopter with three different image sensor configurations, including a GoPro HERO3+ Black Edition, a Nikon D800 DSLR and a Velodyne HDL-32. In addition, georeferencing data of varying quality were acquired and evaluated. The optical imagery was processed by using three commercial point cloud generation tools. Comparing point clouds created by active and passive sensors by using different quality sensors, and finally, by different commercial software tools, provides essential information for the performance validation of UAS technology.

Assessing the Immeasurables of Practice

ERIC Educational Resources Information Center

Higgs, Joy

2014-01-01

This paper examines a significant challenge facing students and educators in work-integrated learning (WIL), the learning and assessment of practice immeasurables. Often student assessment focuses on the overt and those aspects of practice that are readily observable and measurable. Educators also need to look at those aspects of practice which…

A Review of High-Order and Optimized Finite-Difference Methods for Simulating Linear Wave Phenomena

NASA Technical Reports Server (NTRS)

Zingg, David W.

1996-01-01

This paper presents a review of high-order and optimized finite-difference methods for numerically simulating the propagation and scattering of linear waves, such as electromagnetic, acoustic, or elastic waves. The spatial operators reviewed include compact schemes, non-compact schemes, schemes on staggered grids, and schemes which are optimized to produce specific characteristics. The time-marching methods discussed include Runge-Kutta methods, Adams-Bashforth methods, and the leapfrog method. In addition, the following fourth-order fully-discrete finite-difference methods are considered: a one-step implicit scheme with a three-point spatial stencil, a one-step explicit scheme with a five-point spatial stencil, and a two-step explicit scheme with a five-point spatial stencil. For each method studied, the number of grid points per wavelength required for accurate simulation of wave propagation over large distances is presented. Recommendations are made with respect to the suitability of the methods for specific problems and practical aspects of their use, such as appropriate Courant numbers and grid densities. Avenues for future research are suggested.

Development of soils and communities of plants and arbuscular mycorrhizal fungi on West Virginia surface mines.

PubMed

Levy, Michael A; Cumming, Jonathan R

2014-11-01

Surface mining followed by reclamation to pasture is a major driver of land use and cover change in Appalachia. Prior research suggests that many aspects of ecosystem recovery are either slow or incomplete. We examined ecosystem structure-including soil physical and chemical properties, arbuscular mycorrhizal fungal (AMF) infectivity and community composition, and plant diversity and community composition-on a chronosequence of pasture-reclaimed surface mines and a non-mined pasture in northern West Virginia. Surface mining and reclamation dramatically altered ecosystem structure. Some aspects of ecosystem structure, including many measures of soil chemistry and infectivity of AMF, returned rapidly to levels found on the non-mined reference site. Other aspects of ecosystem structure, notably soil physical properties and AMF and plant communities, showed incomplete or no recovery over the short-to-medium term. In addition, invasive plants were prevalent on reclaimed mine sites. The results point to the need for investigation on how reclamation practices could minimize establishment of exotic invasive plant species and reduce the long-term impacts of mining on ecosystem structure and function.

Development of Soils and Communities of Plants and Arbuscular Mycorrhizal Fungi on West Virginia Surface Mines

NASA Astrophysics Data System (ADS)

Levy, Michael A.; Cumming, Jonathan R.

2014-11-01

Surface mining followed by reclamation to pasture is a major driver of land use and cover change in Appalachia. Prior research suggests that many aspects of ecosystem recovery are either slow or incomplete. We examined ecosystem structure—including soil physical and chemical properties, arbuscular mycorrhizal fungal (AMF) infectivity and community composition, and plant diversity and community composition—on a chronosequence of pasture-reclaimed surface mines and a non-mined pasture in northern West Virginia. Surface mining and reclamation dramatically altered ecosystem structure. Some aspects of ecosystem structure, including many measures of soil chemistry and infectivity of AMF, returned rapidly to levels found on the non-mined reference site. Other aspects of ecosystem structure, notably soil physical properties and AMF and plant communities, showed incomplete or no recovery over the short-to-medium term. In addition, invasive plants were prevalent on reclaimed mine sites. The results point to the need for investigation on how reclamation practices could minimize establishment of exotic invasive plant species and reduce the long-term impacts of mining on ecosystem structure and function.

Belonging, believing, bonding, and behaving: the relationship between religion and business ownership at the country level.

PubMed

Hoogendoorn, Brigitte; Rietveld, Cornelius A; van Stel, André

2016-01-01

This cross-country study adopts a competing theories approach in which both a value perspective and a social capital perspective are used to understand the relation between religion and a country's business ownership rate. We distinguish among four dimensions of religion: belonging to a religious denomination, believing certain religious propositions, bonding to religious practices, and behaving in a religious manner. An empirical analysis of data from 30 OECD countries with multiple data points per country covering the period 1984-2010 suggests a positive relationship between religion and business ownership based on those dimensions that reflect the internal aspects of religiosity (i.e., believing and behaving). We do not observe a significant association for those dimensions that reflect more external aspects of religion (i.e., belonging and bonding). These results suggest that the social capital perspective prevails the value perspective, at least when internal aspects of religiosity are concerned. More generally, our study demonstrates the importance of distinguishing between different dimensions of religion when investigating the link between religion and entrepreneurship.

Aspects of operational radiation protection during dismantling of nuclear facilities relevant for the estimation of internal doses.

PubMed

Labarta, T

2007-01-01

Operational radiation protection of workers during the dismantling of nuclear facilities is based on the same radiation protection principles as that applied in its exploitation period with the objective of ensuring proper implementation of the as-low-as-reasonably-achievable (ALARA) principle. These principles are: prior determination of the nature and magnitude of radiological risk; classification of workplaces and workers depending on the risks; implementation of control measures; monitoring of zones and working conditions, including, if necessary, individual monitoring. From the experiences and the lessons learned during the dismantling processes carried out in Spain, several important aspects in the practical implementation of these principles that directly influence and ensure an adequate prevention of exposures and the estimation of internal doses are pointed out, with special emphasis on the estimation of internal doses due to transuranic intakes.

"Our Only Child Has Died"-A Study of Bereaved Older Chinese Parents.

PubMed

Zheng, Yongqiang; Lawson, Thomas R; Anderson Head, Barbara

2017-03-01

Long and complicated grief is a relevant factor contributing to the deterioration of the older adults' later life quality. In China, the unintentional consequence of the one-child policy has emerged. There, the group of older adults who lost their only child is called shiduers. The current study compared 42 older adults who lost their only child to 33 older adults who have a child, in term of their physical and mental health, and social support. The results confirmed the general deteriorating trend in those aspects of the bereaved Chinese parents' life after their only child's death. The results also revealed the impairments on the shiduers' physical, mental, and social aspects were significant, compared to the clinical diagnosis cutoff points used in Western countries. Unique policy and cultural characteristics are the main factors contributing to the severe impairment of shiduers. Results have implications for policy advocacy and practice intervention in specific cultural environments.

Evidence based medicine guidelines: a solution to rationing or politics disguised as science?

PubMed

Saarni, S I; Gylling, H A

2004-04-01

"Evidence based medicine" (EBM) is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism.

A technical investigation on tools and concepts for sustainable management of the subsurface in The Netherlands.

PubMed

Griffioen, Jasper; van Wensem, Joke; Oomes, Justine L M; Barends, Frans; Breunese, Jaap; Bruining, Hans; Olsthoorn, Theo; Stams, Alfons J M; van der Stoel, Almer E C

2014-07-01

In response to increasing use of the subsurface, there is a need to modernise policies on sustainable use of the subsurface. This holds in particular for the densely populated Netherlands. We aimed to analyse current practice of subsurface management and the associated pressure points and to establish a conceptual overview of the technical issues related to sustainable management of the subsurface. Case studies on the exploitation of subsurface resources (including spatial use of the subsurface) were analysed, examining social relevance, environmental impact, pressure points and management solutions. The case studies ranged from constructing underground garages to geothermal exploitation. The following issues were identified for the technological/scientific aspects: site investigation, suitability, risk assessment, monitoring and measures in the event of failure. Additionally, the following general issues were identified for the administrative aspects: spatial planning, option assessment, precaution, transparency, responsibility and liability. These issues were explored on their technological implications within the framework of sustainable management of the subsurface. This resulted into the following key aspects: (1) sustainability assessment, (2) dealing with uncertainty and (3) policy instruments and governance. For all three aspects, different options were identified which might have a legal, economic or ethical background. The technological implications of these backgrounds have been identified. A set of recommendations for sustainable management of the subsurface resources (incl. space) was established: (1) management should be driven by scarcity, (2) always implement closed loop monitoring when the subsurface activities are high-risk, (3) when dealing with unknown features and heterogeneity, apply the precautionary principle, (4) responsibility and liability for damage must be set out in legislation and (5) sustainability should be incorporated in all relevant legislation and not only in environmental legislation. Other aspects to be considered are the reversibility of the impacts from subsurface activities and the abandonment of installations. Copyright © 2014 Elsevier B.V. All rights reserved.

Investigation of some formal aspects of the boson expansion technique in nuclear theory

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

Pedrocchi, V.G.

1982-01-01

The use of the boson expansion theory (BET) in nuclear physics now has about twenty years history, and a large number of papers is available in the literature. Some of them emphasize BET's practical use, successfully showing that it is in fact a very powerful, practical tool to understand the collective properties in nuclei. Others, on the other hand, concentrated more on formal aspects of the BET, and it is these formal aspects we deal with in this dissertation. The BET is not unique, and thus a variety of methods has been proposed. It was felt that it was desirablemore » to see whether they were in fact different theories, or the difference was only apparent. Actually, at the surface, many theories look different from each other, having various merits and demerits. However, it is possible that they are more closely related than they appear; and, if so, it may be attempted to unify them in such a way that a new BET can be constructed which embodies all the merits of the various theories that have been known so far. With this goal in mind, every detailed comparison of two methods was explored: the commutator method (CM) and the Marumori-Yamamura-Tokunaga (MYT) method, which have been discussed most popularly in the past, though often with controversy. It was found that they are, in fact, equivalent theories if looked at from a particular point of view, although they are not necessarily exactly the same in every aspect. Similar comparison was also made with the generalized Holstein-Primakoff (GHP) and the Dyson methods.« less

Increasing medical student interest in general practice in New Zealand: where to from here?

PubMed

Poole, Phillippa; Bourke, David; Shulruf, Boaz

2010-05-28

To meet increasing health demands, increasing the proportion of local graduates entering general practice is imperative. Students entering or exiting The University of Auckland's medical programme from 2006 to 2008 were invited to complete a tracking project survey. Levels of interest in general practice were determined along with characteristics associated with a greater or lesser interest in this career. 712 students replied--a response rate of 80%. At entry, 40% of students had a strong interest in a career in general practice, and at exit, 29% (P =0.003). A quarter at each time point had no interest. The proportion of domestic students born outside NZ or Australia was 160/376 (42.5%). There were significantly higher levels of interest in general practice among females, students born in NZ, and those from outside Auckland--especially rural origin. Flexibility in career was more important to students with a strong interest in general practice than those with no interest. Auckland medical students have levels of interest in general practice comparable with international data. Increasing this interest further may require admission of a greater proportion of students from those groups with higher interest levels, greater emphasis on the positive aspects of general practice, and on GPs as equals to other specialists.

Patients' priorities in assessing organisational aspects of a general dental practice.

PubMed

Sonneveld, Rutger E; Brands, Wolter G; Bronkhorst, Ewald M; Welie, Jos V M; Truin, Gert-Jan

2013-02-01

To explore which organisational aspects are considered most important by patients when assessing a general dental practice, and which patients' characteristics influence their views on these aspects by a paper questionnaire. The questionnaire was handed out to a sample of 5,000 patients in the Netherlands. The response rate was 63%. Six organisational aspects out of a list of 41 aspects were valued as most important by at least 50%. In decreasing order of importance, these were: accessibility by telephone; continuing education for general dental practitioners; Dutch-speaking general dental practitioners; in-office waiting times; information about treatments offered; and waiting lists. For four out of these six aspects, respondents' age and education significantly influenced their preferences. Aspects concerning the infrastructure of a general dental practice were chosen more often than aspects such as working to professional standards, working according to protocols and guidelines, quality assessment and guaranteed treatment outcomes. The findings will enable organisations to increase the transparency of health-care delivery systems to focus on those organisational aspects of dental practices that patients themselves consider most important. These findings can also assist general dental practitioners in adapting their organisational services to the preferences of patients or specific patient groups. © 2013 FDI World Dental Federation.

VIEWIT: computation of seen areas, slope, and aspect for land-use planning

Treesearch

Michael R. Travis; Gary H. Elsner; Wayne D. Iverson; Christine G. Johnson

1975-01-01

This user's guide provides instructions for using VIEWIT--a computerized technique for delineating the terrain visible from a single point or from multiple observer points, and for doing slope and aspect analyses. Results are in tabular or in overlay map form. VIEWIT can do individual view-area, slope, or aspect analyses or combined analyses, and can produce...

Journal of Air Transportation, Volume 10, No. 1

NASA Technical Reports Server (NTRS)

Bowen, Brent D. (Editor); Kabashkin, Igor (Editor); Lucas, Sarah (Editor); Scarpellini-Metz, Nanette (Editor)

2005-01-01

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

Journal of Air Transportation World Wide, Volume 3, No. 1. Volume 3

NASA Technical Reports Server (NTRS)

Bowen, Brent D. (Editor)

1998-01-01

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

Is Piaget's epistemic subject dead?

NASA Astrophysics Data System (ADS)

Lawson, Anton E.

Niaz (1990) presents arguments in favor of the retention of Piaget's epistemic subject as a theoretical construct to guide research and practice in science education and psychology. The intent of this article is to point out the weaknesses of those arguments and to suggest that the weight of evidence argues against the existence of the logical thinker postulated by Piaget. Therefore, contrary to Niaz's conclusion that the acceptance of Piaget's epistemic subject will facilitate the development of cognitive theories with greater explanatory power, the conclusion is reached that Piaget's epistemic subject is dead and that continued acceptance of this aspect of Piagetian theory would be counterproductive.

Experience and convergence in spiritual direction.

PubMed

Evans, Jean

2015-02-01

The practice of spiritual direction concerns the human experience of God. As praxis, spiritual direction has a long tradition in Western Christianity. It is a process rooted in spirituality with theology as its foundation. This paper explores the convergences between aspects of philosophy (contemplative awareness), psychology (Rogerian client-centered approach) and phenomenology. There are significant points of convergence between phenomenology and spiritual direction: first, in Ignatius of Loyola's phenomenological approach to his religious experience; second, in the appropriation by spiritual directors of concepts of epochē and empathy; third, in the process of "unpacking" religious experience within a spiritual direction interview.

[Research progress on wetland ecotourism].

PubMed

Wang, Li-Long; Lu, Lin

2009-06-01

Wetland is rich in biodiversity and cultural diversity, possessing higher tourism value and environmental education and community participation functions. Wetland ecotourism reflects the sustainable development of tourism economy and wetland protection, having received great concern from governments and scholars at home and abroad. This paper summarized the related theories and practices, discussed the research advances in wetland ecotourism from the aspects of significance, progress, contents, methods and results, and pointed out the important research fields in the future, aimed to accelerate the development of wetland ecotourism research and to provide reference about the resources exploitation, environment protection, and scientific administration of wetland and related scenic areas.

Journal of Air Transportation World Wide, Volume 5, No. 2. Volume 5, No. 2

NASA Technical Reports Server (NTRS)

Browen, Brent D.

2000-01-01

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

Advanced Trauma Life Support®. ABCDE from a radiological point of view

PubMed Central

Blickman, Johan G.

2007-01-01

Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support® (ATLS®) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS®, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS® is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious attention to defining the indications and limitations pertaining to diagnostic imaging. PMID:17564732

Journal of Air Transportation World Wide, Volume 4, No. 2. Volume 4

NASA Technical Reports Server (NTRS)

Bowen, Brent D. (Editor); Kabashkin, Igor (Editor)

1999-01-01

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

Journal of Air Transportation, Volume 11, No. 3

NASA Technical Reports Server (NTRS)

Bowen, Brent (Editor); Kabashkin, Igor (Editor); Fink, Mary (Editor)

2007-01-01

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

Compact collimators designed with a modified point approximation for light-emitting diodes

NASA Astrophysics Data System (ADS)

Luo, Tao; Wang, Gang

2017-09-01

We present a novel freeform lens design method for an application to LED collimating illumination. The method is derived from a basic geometric-optics analysis and construction approach. By using this method, a compact collimated lenses with Aspect Ratio = 0.219 is presented. Moreover, the utility efficiency (UE) inside the angle defined by ideal concentrator hypothesis with different lens-to-LED size ratios for both this lens and TIR lens are presented. A prototype of the collimator lens is also made to verify the practical performance of the lens, which has light distribution very compatible with the simulation results.

Journal of Air Transportation; Volume 9, No. 3

NASA Technical Reports Server (NTRS)

Bowen, Brent D. (Editor); Kabashkin, Igor (Editor)

2004-01-01

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

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

NASA Technical Reports Server (NTRS)

Bowen, Brent (Editor)

1997-01-01

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

Views on computer program documentation and automation

NASA Technical Reports Server (NTRS)

Grosch, H. R.

1970-01-01

Various aspects of the problem of program documentation and description are discussed. Particular emphasis is placed on the problem of semantics. It is pointed out that the information produced by documentation of a program, if presented to several different groups, may mean entirely different things to these groups. Recognition of the fact that people look at problems differently is proposed as a more practical approach to the problem of documentation rather than extensive use of standards or strict formatting. The difficulties involved in searching for ways to provide a common ground for the transmission and use of information are discussed.

Baseball Throwing Mechanics as They Relate to Pathology and Performance - A Review

PubMed Central

Whiteley, Rod

2007-01-01

It is a commonly held perception amongst biomechanists, sports medicine practitioners, baseball coaches and players, that an individual baseball player's style of throwing or pitching influences their performance and susceptibility to injury. With the results of a series of focus groups with baseball managers and pitching coaches in mind, the available scientific literature was reviewed regarding the contribution of individual aspects of pitching and throwing mechanics to potential for injury and performance. After a discussion of the limitations of kinematic and kinetic analyses, the individual aspects of pitching mechanics are discussed under arbitrary headings: Foot position at stride foot contact; Elbow flexion; Arm rotation; Arm horizontal abduction; Arm abduction; Lead knee position; Pelvic orientation; Deceleration-phase related issues; Curveballs; and Teaching throwing mechanics. In general, popular opinion of baseball coaching staff was found to be largely in concordance with the scientific investigations of biomechanists with several notable exceptions. Some difficulties are identified with the practical implementation of analyzing throwing mechanics in the field by pitching coaches, and with some unquantified aspects of scientific analyses. Key pointsBiomechanical analyses including kinematic and kinetic analyses allow for estimation of pitching performance and potential for injury.Some difficulties both theoretic and practical exist for the implementation and interpretation of such analyses.Commonly held opinions of baseball pitching authorities are largely held to concur with biomechanical analyses.Recommendations can be made regarding appropriate pitching and throwing technique in light of these investigations. PMID:24149219

The use of lithium for the treatment of bipolar disorder: Recommendations from clinical practice guidelines.

PubMed

Malhi, Gin S; Gessler, Danielle; Outhred, Tim

2017-08-01

Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency. In order to inform clinicians of optimal lithium therapy for bipolar disorder, we compared and synthesized recommendations for the treatment of bipolar disorder made by recognized CPGs internationally. We conducted a search of the literature and extracted guidance across multiple clinical issues, including clinical indications, disorder subtypes, additional uses, special populations, practical aspects, and side effects. Collectively, CPGs consider lithium most robustly as a first-line intervention for maintenance treatment of bipolar disorder and strongly for the treatment of mania, with relatively modest support for the management of acute bipolar depression. Additionally, there is consensus across the CPGs that lithium tangibly reduces the risk of suicide. Generally, CPGs provide guidance on the many facets of initiating and maintaining patients on lithium therapy, but individually the CPGs varied in terms of depth and practical guidance they provide across these areas. However, consensus was established across many key areas of practice such as the ideal lithium plasma concentration for maintenance and monitoring (0.6-0.8mmol/L), along with the need for regular monitoring of renal and endocrine function. However, with more complex aspects (e.g., atypical presentations) and in special populations (e.g., youth; pregnancy and post-partum; older adults), guidance varied considerably and clear consensus recommendations were more difficult to achieve. In younger adults desirable plasma lithium levels of 0.6-0.8mmol/L can perhaps be achieved with comparatively lower doses and in the very elderly it may be prudent to target lower plasma levels in the first instance. These are important practical points for consideration that, along with many others offered throughout the article, should assist clinicians in dissecting the more complex aspects of management with greater precision. This review was limited to CPGs written in English. CPGs are themselves limited by reliance on evidence that often has little resemblance to real-world presentations. An important area that is not sufficiently addressed in the CPGs is clear guidance on the cessation of lithium therapy. Further research is needed on many aspects of lithium therapy and this alongside existing knowledge needs to be used more consistently to inform CPGs, which should also incorporate empirical evidence and clinical experience. The recommendations in this paper provide a useful synthesis of guidance available currently. Copyright © 2017 Elsevier B.V. All rights reserved.

Flexible rotor balancing by the influence coefficient method. Part 1: Evaluation of the exact point-speed and least squares procedures

NASA Technical Reports Server (NTRS)

Tessarzik, J. M.

1972-01-01

The practical aspects of balancing real, flexible rotors were investigated through inclusion of rotor out-of-roundness data at the measurement probe locations. The computer program was demonstrated to be fully capable of handling out-of-roundness data in the investigation. Testing was performed predominantly with a machine having a 41-inch long, 126-pound rotor. This rotor was operated over a speed range encompassing three rotor-bearing system critical speeds. Both balancing procedures were evaluated for several different conditions of initial rotor unbalance. Safe (and slow) passage through all the critical speeds was obtained after two or three balancing runs in most cases. The Least Squares procedure was found to be generally equivalent in capability to the Exact Point-Speed procedure for the configurations studies. (U)

Cause and Cure - Deterioration in Accuracy of CFD Simulations with Use of High-Aspect-Ratio Triangular/Tetrahedral Grids

NASA Technical Reports Server (NTRS)

Chang, Sin-Chung; Chang, Chau-Lyan; Venkatachari, Balaji Shankar

2017-01-01

Traditionally high-aspect ratio triangular/tetrahedral meshes are avoided by CFD researchers in the vicinity of a solid wall, as it is known to reduce the accuracy of gradient computations in those regions. Although for certain complex geometries, the use of high-aspect ratio triangular/tetrahedral elements in the vicinity of a solid wall can be replaced by quadrilateral/prismatic elements, ability to use triangular/tetrahedral elements in such regions without any degradation in accuracy can be beneficial from a mesh generation point of view. The benefits also carry over to numerical frameworks such as the space-time conservation element and solution element (CESE), where simplex elements are the mandatory building blocks. With the requirement of the CESE method in mind, a rigorous mathematical framework that clearly identifies the reason behind the difficulties in use of such high-aspect ratio simplex elements is formulated using two different approaches and presented here. Drawing insights from the analysis, a potential solution to avoid that pitfall is also provided as part of this work. Furthermore, through the use of numerical simulations of practical viscous problems involving high-Reynolds number flows, how the gradient evaluation procedures of the CESE framework can be effectively used to produce accurate and stable results on such high-aspect ratio simplex meshes is also showcased.

Acute care teaching in the undergraduate nursing curriculum.

PubMed

McGaughey, Jennifer

2009-01-01

To incorporate basic aspects of acute care into the undergraduate nursing programme by providing an opportunity for the development of knowledge and skills in the early recognition and assessment of deteriorating patients on general hospital wards. Acute care initiatives implemented in the hospital setting to improve the identification and management of 'at risk' patients have focused on the provision of education for trained or qualified staff. However, to ensure student nurses are 'fit to practice' at the point of registration, it has been recommended that acute care theory and skills are incorporated into the undergraduate nursing curriculum. PRACTICE DEVELOPMENT INITIATIVE: An 'Integrated Nursing Care' module was incorporated into year 3 of the undergraduate nursing programme to introduce students to acute care theory and practice. Module content focuses on the early detection and management of acute deterioration in patients with respiratory, cardiac, neurological or renal insufficiencies. We used a competency-based framework to ensure the application of theory to practice through the use of group seminars. High-fidelity patient-simulated clinical scenarios were a key feature. The United Kingdom Resuscitation Council Intermediate Life Support course is also an important component of the module. Incorporating the Integrated Nursing Care module into the undergraduate nursing curriculum provides pre-registration students the opportunity to develop their knowledge and skills in acute care. The provision of undergraduate education in care of the acutely ill patient in hospital is essential to improve nurses' competence and confidence in assessing and managing deteriorating patients in general wards at the point of registration.

Why does it run in families? Explaining family similarity in help-seeking behaviour by shared circumstances, socialisation and selection.

PubMed

Cardol, Mieke; Groenewegen, Peter P; Spreeuwenberg, Peter; Van Dijk, Liset; Van Den Bosch, Wil J H M; De Bakker, Dinny H

2006-08-01

Why do contact frequencies with general practice of family members resemble each other? Many aspects related to the clustering of health-care utilisation within families have been studied, but the underlying mechanisms have not been addressed. This article considers whether family similarity in contact frequency with general practice can be explained as (a) a result of shared circumstances, (b) through socialisation, and (c) through homogeneity of background characteristics. Data from the second Dutch national survey of general practice were used to test these mechanisms empirically. This survey recorded all consultations in 2001 for 104 general practices in the Netherlands, serving 385,461 patients. Information about socio-demographic characteristics was collected by means of a patient survey. In a random sample, an extended health interview took place (n=12,699). Overall, we were able to show that having determinants in common through socialisation and shared circumstances can explain similarity in contact frequencies within families, but not all hypotheses could be confirmed. In specific terms, this study shows that resemblances in contact frequencies within families can be best explained by spending more time together (socialisation) and parents and children consulting a general practitioner simultaneously (circumstances of the moment). For general practitioners, the mechanisms identified can serve as a framework for a family case history. The importance of the mechanism of socialisation in explaining similarities in help-seeking behaviour between family members points to the significance of knowledge and health beliefs underlying consultation behaviour. An integrated framework including these aspects can help to better explain health behaviour.

4D Model on Assessing Psychomotor Aspect in Continental Food Processing Practice

NASA Astrophysics Data System (ADS)

Nurafiati, P.; Ana, A.; Ratnasusanti, H.; Maulana, I.

2018-02-01

This research aims to develop and find out the response of observers for the assessment instrument of student’s psychomotor aspect on continental food processing practice. This research belongs to development research with 4P model that confined till the definition, design, and development stages. The data that gained during the research is analyzed descriptively. Research’s product is assessment instrument rubric form that consists of performance’s aspect which should be assessed and performance’s quality which stated in gradation score with 0-4 level and performance description that completed with picture illustration in every single score. Product was validate and responded based on material, construction, language, objectively, systematic, and practicability aspects. The result show that assessment instrument of student’s psychomotor aspect on continental food processing practice which developed gain very good response with percentage of 84,47%.

If a Student Takes Control: Facilitator's Tasks and Responsibilities

NASA Astrophysics Data System (ADS)

Väljataga, Terje

This paper presents initial research results of an intervention into higher educational teaching and studying practices from facilitators‘ point of view. The intervention was implemented into an international Master’s level online course mediated by landscapes of social media tools and services. In this course more emphasis was put on a shift of control from a facilitator to a student or a group of students in the following aspects: setting up one’s study goals, choosing activities, selecting appropriate resources, including technology and defining one’s evaluation criteria. The initial analysis showed that the facilitators gained a lot in terms of understanding the benefits of exploiting social media tools and services for their teaching practices, perceiving a need of having a different role as well as the shortages and problems while being a facilitator in such a course.

Chronic Subdural Hematoma: A Questionnaire Survey of Management Practice in India and Review of Literature.

PubMed

Avanali, Raghunath; Bhadran, Biju; Krishna Kumar, P; Vijayan, Abhishek; Arun, S; Musthafa, Aneeze M; Panchal, Sunil; Gopal, Vinu V

2016-12-01

To identify the current management modalities practiced by neurosurgeons in India for chronic subdural hematoma. A questionnaire was prepared for the survey and sent via e-mail to neurosurgeons. It covered the following aspects of managing chronic subdural hematoma: 1) demographic and institutional details; 2) choice of surgical procedure; 3) surgical adjutants such as placing a subdural drain; 4) pre- and postoperative care; and 5) recurrences and management. Responses obtained were entered in a SPSS data sheet and analyzed. Response rate of the survey was 9.3%. The majority of neurosurgeons (75%) preferred to do burr whole drainage for primary chronic subdural hematoma and also for recurrences. Only one third of routinely placed a subdural drain. Considerable practice variations exist for medical and perioperative management. Bedside twist drill drainage, which is effective and less costly than operative room procedures, has not gained popularity in practice. The present survey points towards the importance of making management guidelines for this common neurosurgical entity. Copyright © 2016 Elsevier Inc. All rights reserved.

Civil Forensic Psychiatry - part 3: practical aspects of managing a medico-legal practice.

PubMed

Samuels, Anthony H

2018-06-01

This is the third in a series of papers on Civil Forensic Psychiatry and provides practical advice for forensic psychiatrists, general psychiatrists and trainees who are expanding or contemplating a medico-legal aspect to their practice. Attention to the practice setting, office layout, recording of information, management of documentation, screening of briefs and proper timetabling can improve safety, quality, reliability and workload manageability.

How to use PRICE treatment for soft tissue injuries.

PubMed

Norton, Cormac

2016-08-24

Rationale and key points This article assists nurses to use the acronym PRICE (protection, rest, ice, compression and elevation) to guide the treatment of patients with uncomplicated soft tissue injuries to their upper or lower limbs. » Treatment of soft tissue injuries to limbs is important to reduce complications following injury, alleviate pain and ensure normal limb function is restored promptly. » Nurses should have an understanding of the rationale and evidence base supporting PRICE treatment of soft tissue injuries. » Providing accurate information to patients and carers about the management of soft tissue injuries and anticipated recovery time is an important aspect of treatment. » Further research is required to develop best practice in the treatment of soft tissue injuries. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might change your practice when managing patients with soft tissue injuries to upper or lower limbs. 2. Positive elements of your current practice and those that could be enhanced. Subscribers can upload their reflective accounts at: rcni.com/portfolio.

[Nursing knowledge: the evolution of scientific philosophies and paradigm trends].

PubMed

Hung, Hsuan-Man; Wang, Hui-Ling; Chang, Yun-Hsuan; Chen, Chung-Hey

2010-02-01

Different aspects of philosophy are derived from different paradigms that contain various main points, some of which are repeated or overlap. Belief and practice are two components of a paradigm that provide perspective and framework and lead to nursing research. Changes in healthcare have popularized empirical and evidence-based research in the field of nursing research. However, the evidence-base study approach has given rise to a certain level of debate. Until now, no standard paradigm has been established for the nursing field, as different professionals use different paradigms in their studies. Such provides certain limitations as well as advantages. The quantitative aspects of a nursing paradigm were developed by Peplau and Henderson (1950) and Orem (1980). Such remained the standard until 1990, when Guba and Parse proposed qualitative viewpoints in contextual features. Therefore, the nursing paradigm has made great contributions to the development of knowledge in nursing care, although debate continues due to incomplete knowledge attributable to the presentation of knowledge and insight within individually developed paradigms. It is better to apply multiple paradigms to different research questions. It is suggested that better communication amongst experts regarding their individual points of view would help nursing members to integrate findings within the global pool of knowledge and allow replication over multiple studies.

Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

PubMed Central

Lood, Qarin; Ivanoff, Synneve Dahlin; Dellenborg, Lisen; Mårtensson, Lena

2014-01-01

Objective For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals' experiences of facilitators and barriers for their possibilities to support a healthy ageing in the context of migration. Methods Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with the guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results Five different conditions were found to influence supporting healthy ageing in the context of migration: Sense of belonging through significant others, Emotional bonds to a place called home, Expectations on health and support during the ageing process, Mutual understanding as a means for communication and Heterogeneity as a point of departure. The one comprehensive theme complexity describes how those aspects are interrelated in a complex and unpredictable way. Conclusions The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice. PMID:24605072

Practical aspects of telehealth: financial considerations.

PubMed

Loh, P K; Sabesan, S; Allen, D; Caldwell, P; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O; Withnall, D

2013-07-01

The second in a series of articles about the practical aspects of telehealth, this paper includes information and a case history on the cost-benefits for patients and practitioners using telehealth. The case history demonstrates that telehealth can save travel time for patients, carers and specialists, and can reduce out-of-pocket expenses. The practical aspects of telehealth article series considers the contextual, clinical, technical and ethical components of online video consultations. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

We-ness and the Cultivation of Wisdom in Couple Therapy.

PubMed

Skerrett, Karen

2016-03-01

Wisdom has played a key role in the attempt to understand the positive nature of human behavior since the time of Aristotle. In the past decade, psychology and related fields have experienced an expanding interest in the empirical and theoretical pursuit of wisdom. The relational dimension of wisdom has received less attention, although it may be viewed as embedded in the practice of all couple therapists. This article integrates previous work on resilience and positive functioning in committed partnerships and proposes relational wisdom to be a master virtue of relationship development, one that can be cultivated across the lifespan of the partnership. The aspects of relational wisdom such as self-reflection, attunement to self and other, balancing conflicting partner aims, the interpretation of rules and principles in light of the uniqueness of each situation and the capacity to learn from experience point to couples therapy as an ideal context for such skill building. Wisdom is built through dialog and the resulting individual and couple stories can serve as touchstones to what is most precious and vital in the relationship as well as guides for action through challenges and conflict. A clinical case is described to illustrate selected aspects of relational wisdom and implications for therapeutic practice. © 2015 Family Process Institute.

Introducing Kuhn et al.'s paper "Informatics and medicine: from molecules to populations" and invited papers on this special topic.

PubMed

Kulikowski, C A

2008-01-01

To introduce the paper by Kuhn et al. "Informatics and Medicine: From Molecules to Populations" and the papers that follow on this special topic in this issue of Methods of Information in Medicine, which opens a debate on the Kuhn et al. paper's assertions by an international panel of invited researchers in biomedical informatics. An introductory summary and comparative review of the Kuhn et al. paper and the debate papers, with some personal observations. The Kuhn et al. paper makes a strong case for interdisciplinary education in biomedical informatics across institutions at the graduate level, which could be strengthened by analysis of previous relevant interdisciplinary experiences elsewhere, and the challenges they have faced, which point to more pervasive and earlier-stage needs for both education and practice bridging the research and healthcare communities. The experts debating the Kuhn et al. paper strongly and broadly support the key recommendation of developing graduate education in biomedical informatics in a more comprehensive way, yet at the same time make some incisive comments about the limitations of the "positivistic" and excessively technological orientation of the paper, which could benefit from greater attention to the narrative and care-giving aspects of health practice, with more emphasis on its human and social aspects.

Measuring the construct of executive control in schizophrenia: defining and validating translational animal paradigms for discovery research.

PubMed

Gilmour, Gary; Arguello, Alexander; Bari, Andrea; Brown, Verity J; Carter, Cameron; Floresco, Stan B; Jentsch, David J; Tait, David S; Young, Jared W; Robbins, Trevor W

2013-11-01

Executive control is an aspect of cognitive function known to be impaired in schizophrenia. Previous meetings of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) group have more precisely defined executive control in terms of two constructs: "rule generation and selection", and "dynamic adjustments of control". Next, human cognitive tasks that may effectively measure performance with regard to these constructs were identified to be developed into practical and reliable measures for use in treatment development. The aim of this round of CNTRICS meetings was to define animal paradigms that have sufficient promise to warrant further investigation for their utility in measuring these constructs. Accordingly, "reversal learning" and the "attentional set-shifting task" were nominated to assess the construct of rule generation and selection, and the "stop signal task" for the construct of dynamic adjustments of control. These tasks are described in more detail here, with a particular focus on their utility for drug discovery efforts. Presently, each assay has strengths and weaknesses with regard to this point and increased emphasis on improving practical aspects of testing, understanding predictive validity, and defining biomarkers of performance represent important objectives in attaining confidence in translational validity here. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

The roles of integration in molecular systems biology.

PubMed

O'Malley, Maureen A; Soyer, Orkun S

2012-03-01

A common way to think about scientific practice involves classifying it as hypothesis- or data-driven. We argue that although such distinctions might illuminate scientific practice very generally, they are not sufficient to understand the day-to-day dynamics of scientific activity and the development of programmes of research. One aspect of everyday scientific practice that is beginning to gain more attention is integration. This paper outlines what is meant by this term and how it has been discussed from scientific and philosophical points of view. We focus on methodological, data and explanatory integration, and show how they are connected. Then, using some examples from molecular systems biology, we will show how integration works in a range of inquiries to generate surprising insights and even new fields of research. From these examples we try to gain a broader perspective on integration in relation to the contexts of inquiry in which it is implemented. In today's environment of data-intensive large-scale science, integration has become both a practical and normative requirement with corresponding implications for meta-methodological accounts of scientific practice. We conclude with a discussion of why an understanding of integration and its dynamics is useful for philosophy of science and scientific practice in general. Copyright © 2011 Elsevier Ltd. All rights reserved.

Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine.

PubMed

Mola, Ernesto; De Bonis, Judith A; Giancane, Raffaele

2008-01-01

Efforts to improve the quality of healthcare for patients with chronic conditions have resulted in growing evidence supporting the inclusion of patient empowerment as a key ingredient of care. In 2002, WONCA Europe issued the European Definition of General Practice/Family Medicine, which is currently considered the point of reference for European health institutions and general medical practice. Patient empowerment does not appear among the 11 characteristics of the discipline. The aim of this study is to show that many characteristics of general practice are already oriented towards patient empowerment. Therefore, promoting patient empowerment and self-management should be included as a characteristic of the discipline. The following investigation was conducted: analysing the concept and approach to empowerment as applied to healthcare in the literature; examining whether aspects of empowerment are already part of general medical practice; and identifying reasons why the European definition of general practice/family medicine should contain empowerment as a characteristic of the discipline. General practice/family medicine is the most suitable setting for promoting patient empowerment, because many of its characteristics are already oriented towards encouraging it and because its widespread presence can ensure the generalization of empowerment promotion and self-management education to the totality of patients and communities. "Promoting patient empowerment and self-management" should be considered one of the essential characteristics of general practice/family medicine and should be included in its definition.

Practical aspects of the use of three-phase alternating current electric machines in electricity storage system

NASA Astrophysics Data System (ADS)

Ciucur, Violeta

2015-02-01

Of three-phase alternating current electric machines, it brings into question which of them is more advantageous to be used in electrical energy storage system by pumping water. The two major categories among which are given dispute are synchronous and the asynchronous machine. To consider the synchronous machine with permanent magnet configuration because it brings advantages compared with conventional synchronous machine, first by removing the necessary additional excitation winding. From the point of view of loss of the two types of machines, the optimal adjustment of the magnetic flux density is obtained to minimize the copper loss by hysteresis and eddy currents.

Cultural relativism and psychiatric illness.

PubMed

Fabrega, H

1989-07-01

Psychiatry has had a long-standing association with sociology and, especially, cultural anthropology. These social sciences have been influential in developing the concept of cultural relativism and applying it to psychiatry, sometimes in a challenging way and with much detriment. The concept has been used by some antipsychiatrists in attempts to discredit psychiatric practice. Contemporary psychiatrists endorsing a form of biological determinism have tended to either disregard the concept or judge it as trivial if not nonsensical. This study describes the concept of cultural relativism, reviews its applications to illness, and analyzes its implications from a historical and theoretical point of view. Its varied aspects, power, and limitations are discussed.

[Critical evaluation of the first draft of DSM-V].

PubMed

Frances, A

2011-02-16

Critical evaluation of DSM-V first draft This is an evaluation of the first DSM-V (Diagnostic and Statistical Manual of Mental Disorders-V) draft from the DSM-IV chairman. First, a brief history of DSM is reported. Then, major reasons for present controversies and the threat they raise to APA leadership in the field are discussed. Third point is careful recollection of the several conflicting aspects of the DSM-V draft, paying attention to drawbacks and their implications for future clinical practice, research and forensic activity. Comment is finally provided about APA (American Psychiatric Association) decisions aimed at reaching more consensus about this basic instrument of American psychiatry.

[Quality of life in dysphonia].

PubMed

Rosanowski, F; Grässel, E; Hoppe, U; Köllner, V

2009-09-01

Quality of life is multidimensional and comprises physical, emotional, and social aspects. It has always been the implicit focus of medical work. However, since the 1980s it has been possible to measure it explicitly. Quality of life is impaired in dysphonic patients; this finding is supported by specific studies on self-reported physical, emotional, and social well-being. For practical application of these data, it is recommended to measure all three domains. From a therapeutic point of view, verbal intervention following the PLISSIT model (permission, limited information, special suggestions, intensive therapy) has been proven to enhance patient satisfaction. Therefore, this clinical procedure is recommended for routine application in dysphonic patients.

Ultrahigh-Density Nanowire Arrays Grown in Self-Assembled Diblock Copolymer Templates

NASA Astrophysics Data System (ADS)

Thurn-Albrecht, T.; Schotter, J.; Kästle, G. A.; Emley, N.; Shibauchi, T.; Krusin-Elbaum, L.; Guarini, K.; Black, C. T.; Tuominen, M. T.; Russell, T. P.

2000-12-01

We show a simple, robust, chemical route to the fabrication of ultrahigh-density arrays of nanopores with high aspect ratios using the equilibrium self-assembled morphology of asymmetric diblock copolymers. The dimensions and lateral density of the array are determined by segmental interactions and the copolymer molecular weight. Through direct current electrodeposition, we fabricated vertical arrays of nanowires with densities in excess of 1.9 × 1011 wires per square centimeter. We found markedly enhanced coercivities with ferromagnetic cobalt nanowires that point toward a route to ultrahigh-density storage media. The copolymer approach described is practical, parallel, compatible with current lithographic processes, and amenable to multilayered device fabrication.

Review of environmental enrichment for broiler chickens.

PubMed

Riber, A B; van de Weerd, H A; de Jong, I C; Steenfeldt, S

2018-02-01

Welfare problems are commonly found in both conventional and organic production of broiler chickens. In order to reduce the extent of welfare problems, it has been suggested to provide stimulating, enriched environments. The aim of the present paper is to provide a review of the effect on behavior and welfare of the different kinds of environmental enrichments in the production of broilers that have been described in the scientific literature. Environmental enrichment is defined as an improvement of the environment of captive animals, which increases the behavioral opportunities of the animal and leads to improvements of the biological function. This definition has been broadened to include practical and economic aspects, as any enrichment strategy that adversely affects the health of animals or that has too many economic or practical constraints will never be implemented on commercial farms and thus never benefit animals. Environmental enrichment for broilers often has the purpose of satisfying behavioral needs and/or stimulating the broilers to an increased level of activity, which among others will reduce the occurrence of leg problems. Potentially successful environmental enrichments for broiler chickens are elevated resting-places, panels, barriers, and bales of straw ("point-source enrichment"), as well as covered verandas and outdoor ranges ("complex enriched environments"). Many of the ideas for environmental enrichment for broilers need to be further developed and studied, preferably in commercial trials, with respect to the use, the effect on behavior and on other welfare aspects such as leg health, and the interaction with genotype, production system, stocking density, light, and flock size. In addition, information on the practical application and the economics of the production system is often lacking, although it is important for application in practice. © 2017 Poultry Science Association Inc.

Assessment of Emotional Experience and Emotional Recognition in Complicated Grief

PubMed Central

Fernández-Alcántara, Manuel; Cruz-Quintana, Francisco; Pérez-Marfil, M. N.; Catena-Martínez, Andrés; Pérez-García, Miguel; Turnbull, Oliver H.

2016-01-01

There is substantial evidence of bias in the processing of emotion in people with complicated grief (CG). Previous studies have tended to assess the expression of emotion in CG, but other aspects of emotion (mainly emotion recognition, and the subjective aspects of emotion) have not been addressed, despite their importance for practicing clinicians. A quasi-experimental design with two matched groups (Complicated Grief, N = 24 and Non-Complicated Grief, N = 20) was carried out. The Facial Expression of Emotion Test (emotion recognition), a set of pictures from the International Affective Picture System (subjective experience of emotion) and the Symptom Checklist 90 Revised (psychopathology) were employed. The CG group showed lower scores on the dimension of valence for specific conditions on the IAPS, related to the subjective experience of emotion. In addition, they presented higher values of psychopathology. In contrast, statistically significant results were not found for the recognition of emotion. In conclusion, from a neuropsychological point of view, the subjective aspects of emotion and psychopathology seem central in explaining the experience of those with CG. These results are clinically significant for psychotherapists and psychoanalysts working in the field of grief and loss. PMID:26903928

Effective domain-dependent reuse in medical knowledge bases.

PubMed

Dojat, M; Pachet, F

1995-12-01

Knowledge reuse is now a critical issue for most developers of medical knowledge-based systems. As a rule, reuse is addressed from an ambitious, knowledge-engineering perspective that focuses on reusable general purpose knowledge modules, concepts, and methods. However, such a general goal fails to take into account the specific aspects of medical practice. From the point of view of the knowledge engineer, whose goal is to capture the specific features and intricacies of a given domain, this approach addresses the wrong level of generality. In this paper, we adopt a more pragmatic viewpoint, introducing the less ambitious goal of "domain-dependent limited reuse" and suggesting effective means of achieving it in practice. In a knowledge representation framework combining objects and production rules, we propose three mechanisms emerging from the combination of object-oriented programming and rule-based programming. We show these mechanisms contribute to achieve limited reuse and to introduce useful limited variations in medical expertise.

Multiscale Structure of UXO Site Characterization: Spatial Estimation and Uncertainty Quantification

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

Ostrouchov, George; Doll, William E.; Beard, Les P.

2009-01-01

Unexploded ordnance (UXO) site characterization must consider both how the contamination is generated and how we observe that contamination. Within the generation and observation processes, dependence structures can be exploited at multiple scales. We describe a conceptual site characterization process, the dependence structures available at several scales, and consider their statistical estimation aspects. It is evident that most of the statistical methods that are needed to address the estimation problems are known but their application-specific implementation may not be available. We demonstrate estimation at one scale and propose a representation for site contamination intensity that takes full account of uncertainty,more » is flexible enough to answer regulatory requirements, and is a practical tool for managing detailed spatial site characterization and remediation. The representation is based on point process spatial estimation methods that require modern computational resources for practical application. These methods have provisions for including prior and covariate information.« less

A coach's political use of video-based feedback: a case study in elite-level academy soccer.

PubMed

Booroff, Michael; Nelson, Lee; Potrac, Paul

2016-01-01

This paper examines the video-based pedagogical practices of Terry (pseudonym), a head coach of a professional junior academy squad. Data were collected through 6 in-depth, semi-structured interviews and 10 field observations of Terry's video-based coaching in situ. Three embracing categories were generated from the data. These demonstrated that Terry's video-based coaching was far from apolitical. Rather, Terry strategically used performance analysis technologies to help fulfil various objectives and outcomes that he understood to be expected of him within the club environment. Kelchtermans' micropolitical perspective, Callero's work addressing role and Groom et al.'s grounded theory were primarily utilised to make sense of Terry's perceptions and actions. The findings point to the value of developing contextually grounded understandings of coaches' uses of video-based performance analysis technology. Doing so could better prepare coaches for this aspect of their coaching practice.

Maintaining Perioperative Normothermia: Sustaining an Evidence-Based Practice Improvement Project.

PubMed

Levin, Rona F; Wright, Fay; Pecoraro, Kathleen; Kopec, Wendy

2016-02-01

Unintentional perioperative hypothermia has been shown to cause serious patient complications and, thus, to increase health care costs. In 2009, an evidence-based practice improvement project produced a significant decrease in unintentional perioperative hypothermia in colorectal surgical patients through monitoring of OR ambient room temperature. Project leaders engaged all interdisciplinary stakeholders in the original project, which facilitated the sustainability of the intervention method. An important aspect of sustainability is ongoing monitoring and evaluation of a new intervention method. Therefore, continued evaluation of outcomes of the protocol developed in 2009 was scheduled at specific time points after the initial small test of change with colorectal patients. This article focuses on how attention to sustainability factors during implementation of an improvement project led to the sustainability of a protocol for monitoring OR ambient room temperature with all types of surgical patients five years after the initial project. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Implementing a good practice guide for CBRC: perspectives from the ESHRE Cross-Border Reproductive Care Taskforce.

PubMed

Shenfield, Françoise

2011-11-01

This article sets out views about cross-border reproductive care (CBRC) from the point of view of a professional clinicians' group. After publishing the first international European dataset measuring the phenomenon of CBRC in six European countries in June 2010, the European Society for Human Reproduction and Embryology (ESHRE) Taskforce on CBRC set out to write a good practice guide, which aims at advising clinicians and professionals dealing with patients interested in seeking fertility treatment outside their country of residence. The background, outline and possible means of implementation of this guide are discussed here. The aims of the guide are to ensure quality of care and safety for all concerned, from patients to their future offspring, via gamete donors and surrogates if involved. Patient centredness is also an important aspect, as well as fair treatment of all parties, based on appropriate and intelligible information. Copyright © 2011. Published by Elsevier Ltd.

The art of consultation.

PubMed

Bhangoo, Kulwant S

2014-05-01

Sophisticated marketing and practice-enhancing strategies can help bring patients to a surgeon's practice. However, the ability to retain these patients and also convert the consultations into surgical procedures depends on the art of consultation. This very important aspect of clinical practice is seldom taught in the medical school. In this paper, the author discusses many aspects of the art of consultation, which he has learned in his practice over the years.

The Bobath concept - a model to illustrate clinical practice.

PubMed

Michielsen, Marc; Vaughan-Graham, Julie; Holland, Ann; Magri, Alba; Suzuki, Mitsuo

2017-12-17

The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath concept in terms of contemporary neurological rehabilitation. The utilisation of a framework to illustrate the clinical application of the Bobath concept provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The development process culminating in the model of Bobath clinical practice is described. The use of the model in clinical practice is illustrated using two cases: a client with a chronic incomplete spinal cord injury and a client with a stroke. This article describes the clinical application of the Bobath concept in terms of the integration of posture and movement with respect to the quality of task performance, applying the Model of Bobath Clinical Practice. Facilitation, a key aspect of Bobath clinical practice, was utilised to positively affect motor control and perception in two clients with impairment-related movement problems due to neurological pathology and associated activity limitations and participation restrictions - the outcome measures used to reflect the individual clinical presentation. Implications for Rehabilitation The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath-concept. The model of Bobath clinical practice provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The clinical application of the Bobath-concept highlights the integration of posture and movement with respect to the quality of task performance. Facilitation, a key aspect of Bobath clinical practice, positively affects motor control, and perception.

Facilitating awareness of philosophy of science, ethics and communication through manual skills training in undergraduate education.

PubMed

Kordahl, Hilde Lund; Fougner, Marit

2017-03-01

Professional health science education includes a common theoretical basis concerning the theory of science, ethics and communication. Former evaluations by first-year students of the bachelor physiotherapy program at Oslo and Akershus University College of Applied Sciences (HiOA) show that they find it hard to understand the relation between these particular topics and future professional practice. This challenge is the starting point for a pedagogical development project that aims to develop learning contexts that highlight the relevance of these theoretical concepts. The aim of the study is to explore and present findings on the value of using Sykegrep manual skills classes as an arena in which students can be encouraged to think about, reflect on and appreciate the role and value of the philosophical perspectives that inform their practice and contributes to practise knowledge. A qualitative study with data collection through focus groups was performed and analyzed using thematic content analysis. Eighteen first-year undergraduate students, who had completed the manual skills course, participated in the study. Analysis of the data yielded three categories of findings that can be associated with aspects of philosophy of science, ethics and communication. These are as follows: 1) preconceived understanding of physiotherapy; 2) body knowledge perspectives; and 3) relational aspects of interactions. Undergraduate students' understanding and experience of philosophy of science, ethics and communication may be facilitated by peer collaboration, reflection on intimacy and touch and the ethical aspects of interaction during manual skills training. Practical classes in Sykegrep provide a basis for students' discussions about the body as well as their experiences with the body in the collaborative learning context. The students' reflections on their expectations of manual skills in physiotherapy and experiences of touch and being touched can facilitate an awareness of philosophy of science, ethics and communication. Our study will be an incitement to further develop a manual skills teaching program that incorporates philosophy of science, ethics and communication in undergraduate education.

Ideas of and Attitudes towards Projects and Changing Practices: Voices of Four Teachers

ERIC Educational Resources Information Center

Shome, Saurav; Natarajan, Chitra

2013-01-01

The paper reports a study of the project practices of four Indian middle school teachers, elicited through semi-structured interviews of individual teachers. The teachers also responded to a proposal to modify four aspects of existing project practices, viz. subject integration, assessment, group work, and management of resources. The aspects were…

Documentation of polio eradication initiative best practices: Experience from WHO African Region.

PubMed

Okeibunor, Joseph; Nshimirimana, Deo; Nsubuga, Peter; Mutabaruka, Evariste; Tapsoba, Leonard; Ghali, Emmanuel; Kabir, Shaikh Humayun; Gassasira, Alex; Mihigo, Richard; Mkanda, Pascal

2016-10-10

The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries with number of best practice. The application of the process for the documentation of polio best practices in the African Region brought out a number of advantages. The triangulation of data collected using multiple methods and the collection of data from all levels of the programme proved useful as it provided opportunity for data verification and corroboration. It also helped to overcome some of the data challenge. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Optical biosensor technologies for molecular diagnostics at the point-of-care

NASA Astrophysics Data System (ADS)

Schotter, Joerg; Schrittwieser, Stefan; Muellner, Paul; Melnik, Eva; Hainberger, Rainer; Koppitsch, Guenther; Schrank, Franz; Soulantika, Katerina; Lentijo-Mozo, Sergio; Pelaz, Beatriz; Parak, Wolfgang; Ludwig, Frank; Dieckhoff, Jan

2015-05-01

Label-free optical schemes for molecular biosensing hold a strong promise for point-of-care applications in medical research and diagnostics. Apart from diagnostic requirements in terms of sensitivity, specificity, and multiplexing capability, also other aspects such as ease of use and manufacturability have to be considered in order to pave the way to a practical implementation. We present integrated optical waveguide as well as magnetic nanoparticle based molecular biosensor concepts that address these aspects. The integrated optical waveguide devices are based on low-loss photonic wires made of silicon nitride deposited by a CMOS compatible plasma-enhanced chemical vapor deposition (PECVD) process that allows for backend integration of waveguides on optoelectronic CMOS chips. The molecular detection principle relies on evanescent wave sensing in the 0.85 μm wavelength regime by means of Mach-Zehnder interferometers, which enables on-chip integration of silicon photodiodes and, thus, the realization of system-on-chip solutions. Our nanoparticle-based approach is based on optical observation of the dynamic response of functionalized magneticcore/ noble-metal-shell nanorods (`nanoprobes') to an externally applied time-varying magnetic field. As target molecules specifically bind to the surface of the nanoprobes, the observed dynamics of the nanoprobes changes, and the concentration of target molecules in the sample solution can be quantified. This approach is suitable for dynamic real-time measurements and only requires minimal sample preparation, thus presenting a highly promising point-of-care diagnostic system. In this paper, we present a prototype of a diagnostic device suitable for highly automated sample analysis by our nanoparticle-based approach.

Effects of Aspect on Clonal Reproduction and Biomass Allocation of Layering Modules of Nitraria tangutorum in Nebkha Dunes

PubMed Central

Li, Qinghe; Xu, Jun; Li, Huiqing; Wang, Saixiao; Yan, Xiu; Xin, Zhiming; Jiang, Zeping; Wang, Linlong; Jia, Zhiqing

2013-01-01

The formation of many nebkha dunes relies on the layering of clonal plants. The microenvironmental conditions of such phytogenic nebkha are heterogeneous depending on the aspect and slope. Exploring the effects of aspect on clonal reproduction and biomass allocation can be useful in understanding the ecological adaptation of species. We hypothesized that on the windward side layering propagation would be promoted, that biomass allocation to leaves and stems of ramets would increase, and that the effects of aspect would be greater in the layering with larger biomass. To test these hypotheses, we surveyed the depth of germination points of axillary buds, the rate of ramet sprouting, the density of adventitious root formation points, and the biomass of modules sprouting from layering located on the NE, SE, SW and NW, aspects of Nitraria tangutorum nebkhas. The windward side was located on the NW and SW aspects. The results indicated that conditions of the NW aspect were more conducive to clonal reproduction and had the highest rate of ramet sprouting and the highest density of adventitious formation points. For the modules sprouting from layering on the SW aspect, biomass allocation to leaves and stems was greatest with biomass allocation to adventitious roots being lowest. This result supported our hypothesis. Contrary to our hypothesis, the effects of aspect were greater in layering of smaller biomass. These results support the hypothesis that aspect does affect layering propagation capacity and biomass allocation in this species. Additionally, clonal reproduction and biomass allocation of modules sprouting from layering with smaller biomass was more affected by aspect. These results suggest that the clonal growth of N. tangutorum responses to the microenvironmental heterogeneity that results from aspect of the nebkha. PMID:24205391

Effects of aspect on clonal reproduction and biomass allocation of layering modules of Nitraria tangutorum in nebkha dunes.

PubMed

Li, Qinghe; Xu, Jun; Li, Huiqing; Wang, Saixiao; Yan, Xiu; Xin, Zhiming; Jiang, Zeping; Wang, Linlong; Jia, Zhiqing

2013-01-01

The formation of many nebkha dunes relies on the layering of clonal plants. The microenvironmental conditions of such phytogenic nebkha are heterogeneous depending on the aspect and slope. Exploring the effects of aspect on clonal reproduction and biomass allocation can be useful in understanding the ecological adaptation of species. We hypothesized that on the windward side layering propagation would be promoted, that biomass allocation to leaves and stems of ramets would increase, and that the effects of aspect would be greater in the layering with larger biomass. To test these hypotheses, we surveyed the depth of germination points of axillary buds, the rate of ramet sprouting, the density of adventitious root formation points, and the biomass of modules sprouting from layering located on the NE, SE, SW and NW, aspects of Nitraria tangutorum nebkhas. The windward side was located on the NW and SW aspects. The results indicated that conditions of the NW aspect were more conducive to clonal reproduction and had the highest rate of ramet sprouting and the highest density of adventitious formation points. For the modules sprouting from layering on the SW aspect, biomass allocation to leaves and stems was greatest with biomass allocation to adventitious roots being lowest. This result supported our hypothesis. Contrary to our hypothesis, the effects of aspect were greater in layering of smaller biomass. These results support the hypothesis that aspect does affect layering propagation capacity and biomass allocation in this species. Additionally, clonal reproduction and biomass allocation of modules sprouting from layering with smaller biomass was more affected by aspect. These results suggest that the clonal growth of N. tangutorum responses to the microenvironmental heterogeneity that results from aspect of the nebkha.

Adapting the helpful responses questionnaire to assess communication skills involved in delivering contingency management: preliminary psychometrics.

PubMed

Hartzler, Bryan

2015-08-01

A paper/pencil instrument, adapted from Miller and colleagues' (1991) Helpful Responses Questionnaire (HRQ), was developed to assess clinician skill with core communicative aspects involved in delivering contingency management (CM). The instrument presents a single vignette consisting of six points of client dialogue to which respondents write 'what they would say next.' In the context of an implementation/effectiveness hybrid trial, 19 staff clinicians at an opiate treatment program completed serial training outcome assessments before, following, and three months after CM training. Assessments included this adaptation of the HRQ, a multiple-choice CM knowledge test, and a recorded standardized patient encounter scored for CM skillfulness. Study results reveal promising psychometric properties for the instrument, including strong scoring reliability, internal consistency, concurrent and predictive validity, test-retest reliability and sensitivity to training effects. These preliminary findings suggest the instrument is a viable, practical method to assess clinician skill in communicative aspects of CM delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Toward youth self-report of health and quality of life in population monitoring.

PubMed

Topolski, Tari D; Edwards, Todd C; Patrick, Donald L

2004-01-01

This paper addresses population monitoring of youth health and quality of life, including the concepts used, methodological and practical criteria for indicators, and existing surveys and measures. Current population surveys of youth generally focus on poor health, such as disability or health-risk behaviors. Although these are important end points, indicators of illness or risk do not reflect the health or life perspective of the majority of youth who do not experience health problems. The measures used to monitor youth health should be appropriate and sensitive to future needs and capture the perspectives of youths. Two potential concepts for this "scorecard" are self-perceived health and quality of life, which have been shown to be useful in adults. For youth, the quality of life framework seems particularly relevant as it incorporates both positive and negative aspects of health and well-being and also captures salient aspects of health other than physical health, such as sense of self, social relationships, environment and culture, and life satisfaction.

A detailed model for simulation of catchment scale subsurface hydrologic processes

NASA Technical Reports Server (NTRS)

Paniconi, Claudio; Wood, Eric F.

1993-01-01

A catchment scale numerical model is developed based on the three-dimensional transient Richards equation describing fluid flow in variably saturated porous media. The model is designed to take advantage of digital elevation data bases and of information extracted from these data bases by topographic analysis. The practical application of the model is demonstrated in simulations of a small subcatchment of the Konza Prairie reserve near Manhattan, Kansas. In a preliminary investigation of computational issues related to model resolution, we obtain satisfactory numerical results using large aspect ratios, suggesting that horizontal grid dimensions may not be unreasonably constrained by the typically much smaller vertical length scale of a catchment and by vertical discretization requirements. Additional tests are needed to examine the effects of numerical constraints and parameter heterogeneity in determining acceptable grid aspect ratios. In other simulations we attempt to match the observed streamflow response of the catchment, and we point out the small contribution of the streamflow component to the overall water balance of the catchment.

[Health insurance dentists' subjective perceptions of quality when implementing quality management in practice - results from a nationwide survey].

PubMed

Kettler, Nele; Chenot, Regine; Jordan, A Rainer

2015-01-01

Statutory health insurance dentists working in private practice have a duty to maintain and improve the quality of dental care. An individual practice's approach to quality management (QM) can be made to reflect the practice's philosophy on quality and standards and can be adapted to the specific requirements of the practice setting they are meant to serve. This study set out to collect data on the subjective perceptions of quality that exist among German dentists, and to canvass their views on the process and benefits of implementing QM systems. In doing so, this study aimed to identify the incentives and obstacles that currently exist in relation to the implementation and further development of practice-based QM systems. As part of a nationally representative cross-sectional study, a random sample of 2,084 dentists was asked to complete a questionnaire on perceptions of quality and QM. The response rate was 40.3 % (n=838). The study's primary end point was defined as the surveyed dentists' interpretative description of quality. The study's secondary end point was defined as the dentists' subjective evaluations of the benefits of QM in the day-to-day management of their own practices. Responses to open-ended questions were analysed using content analysis, while quantitative questions were analysed using descriptive univariate analysis. When analysing respondents' subjective perceptions of quality (primary end point), the following dimensions were revealed as highly significant: patient (mentioned by 31.4 % of the responders), quality of treatment (29.5 %) and staff (14.8 %). As far as the benefits of QM in the day-to-day management of the respondent's own practices (secondary end point) were concerned, these appeared to be linked to the ease of implementation of the organizational tools offered by QM systems: managing emergencies, team meetings and procedural check lists were ranked as "can be implemented to a reasonable degree" and "can be fully implemented" by 82.3 %, 80.2 % and 79.9 % of respondents, respectively. There appeared to be a disconnect between the respondents' subjective perceptions of quality and the benefits of QM as part of day-to-day practice management, with QM systems failing to reflect the respondents' subjective views on quality. The perceptions of QM among German statutory health insurance dentists are generally positive but marked by a disconnect between aspects of quality currently measured by QM systems and the dentists' views on what is required in order to assess quality standards in relation to the dimensions "patient", "quality of treatment" and "staff". A targeted review of the tools offered by QM systems may lead to improved ease of implementation. If QM is to form an integral part of clinical practice, all future developments need to consider the dentists' subjective perceptions of quality and their attitudes towards QM. Copyright © 2015. Published by Elsevier GmbH.

Quality assurance of laboratory work and clinical use of laboratory tests in general practice in norway: a survey.

PubMed

Thue, Geir; Jevnaker, Marianne; Gulstad, Guri Andersen; Sandberg, Sverre

2011-09-01

Virtually all the general practices in Norway participate in the Norwegian Quality Improvement of Laboratory Services in Primary Care, NOKLUS. In order to assess and develop NOKLUS's services, it was decided to carry out an investigation in the largest participating group, general practices. In autumn 2008 a questionnaire was sent to all Norwegian general practices asking for feedback on different aspects of NOKLUS's main services: contact with medical laboratory technologists, sending of control materials, use and maintenance of practice-specific laboratory binders, courses, and testing of laboratory equipment. In addition, attitudes were elicited towards possible new services directed at assessing other technical equipment and clinical use of tests. Responses were received from 1290 of 1552 practices (83%). The great majority thought that the frequency of sending out control material should continue as at present, and they were pleased with the feedback reports and follow-up by the laboratory technologists in the counties. Even after many years of practical experience, there is still a need to update laboratory knowledge through visits to practices, courses, and written information. Practices also wanted quality assurance of blood pressure meters and spirometers, and many doctors wanted feedback on their use of laboratory tests. Services regarding quality assurance of point-of-care tests, guidance, and courses should be continued. Quality assurance of other technical equipment and of the doctor's clinical use of laboratory tests should be established as part of comprehensive quality assurance.

Competency-based teacher training: A systematic revision of a proven programme in medical didactics.

PubMed

Griewatz, Jan; Simon, Melanie; Lammerding-Koeppel, Maria

2017-01-01

Objectives: Competency-based medical education (CBME) requires factual knowledge to be practically applied together with skills and attitudes. With the National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) representing a strong official demand for competence-orientation, it is generally important to explicitly outline its characteristics and review its realisation in teacher trainings. Further requirements are given by the core competencies for medical teachers (KLM). As an example the MQ programme ("Medizindidaktische Qualifikation") in Baden-Wuerttemberg, a long established and well-accepted training, has been critically revised on this basis, concerning its suitability for the demands of CBME, its needs for adjustment and the efforts to be undertaken for its implementation. Methods: In a systematic quality management process the MQ curriculum and its organisational framing were analysed and further developed in a step-wise comprehensive approach, using the six-step cycle by Kern. The procedures included a thorough needs assessment (e.g. literature research, programme mapping), strategic decisions on structure and content, piloting and evaluation. During the process essential elements of project and change management were considered. Results: The experiences of the MQ example revealed helpful information for key factors to be considered in the pending change process any training provider will be confronted with. Guiding questions were developed related to the process phases. Our analyses showed persistent key points of proven value as stable foundation for change, as well as components needing special consideration to foster competence-oriented aims and transfer into practice: reflection, feedback, application-oriented methods and transparent competence development. These aspects have to be consciously perceived and experienced by participants. Taking this into account, we re-designed the course evidence-based. Besides visualising competencies and their progress, the occasions for reflection and feedback as well as the number of typical, practice-oriented tasks were extended to facilitate self-directed learning, critical self-reflection and individualised solutions. It is shown at what point, in what form and with which purpose these aspects were integrated in the MQ programme. Piloting showed good acceptance by participants, trainers. Preliminary assessment of the outcome is promising. Conclusion: Respecting the high workload, most likely medical teachers will not put CBME concepts into practice without impulses and support. Therefore, in didactical trainings, medical teachers should practice in a competency-based teaching setting and reflect themselves in different professional roles to be able to transfer the experiences to their own educational approach. Trainers and training can serve as models for CBME realisation.

Competency-based teacher training: A systematic revision of a proven programme in medical didactics

PubMed Central

Griewatz, Jan; Simon, Melanie; Lammerding-Koeppel, Maria

2017-01-01

Objectives: Competency-based medical education (CBME) requires factual knowledge to be practically applied together with skills and attitudes. With the National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) representing a strong official demand for competence-orientation, it is generally important to explicitly outline its characteristics and review its realisation in teacher trainings. Further requirements are given by the core competencies for medical teachers (KLM). As an example the MQ programme (“Medizindidaktische Qualifikation”) in Baden-Wuerttemberg, a long established and well-accepted training, has been critically revised on this basis, concerning its suitability for the demands of CBME, its needs for adjustment and the efforts to be undertaken for its implementation. Methods: In a systematic quality management process the MQ curriculum and its organisational framing were analysed and further developed in a step-wise comprehensive approach, using the six-step cycle by Kern. The procedures included a thorough needs assessment (e.g. literature research, programme mapping), strategic decisions on structure and content, piloting and evaluation. During the process essential elements of project and change management were considered. Results: The experiences of the MQ example revealed helpful information for key factors to be considered in the pending change process any training provider will be confronted with. Guiding questions were developed related to the process phases. Our analyses showed persistent key points of proven value as stable foundation for change, as well as components needing special consideration to foster competence-oriented aims and transfer into practice: reflection, feedback, application-oriented methods and transparent competence development. These aspects have to be consciously perceived and experienced by participants. Taking this into account, we re-designed the course evidence-based. Besides visualising competencies and their progress, the occasions for reflection and feedback as well as the number of typical, practice-oriented tasks were extended to facilitate self-directed learning, critical self-reflection and individualised solutions. It is shown at what point, in what form and with which purpose these aspects were integrated in the MQ programme. Piloting showed good acceptance by participants, trainers. Preliminary assessment of the outcome is promising. Conclusion: Respecting the high workload, most likely medical teachers will not put CBME concepts into practice without impulses and support. Therefore, in didactical trainings, medical teachers should practice in a competency-based teaching setting and reflect themselves in different professional roles to be able to transfer the experiences to their own educational approach. Trainers and training can serve as models for CBME realisation. PMID:29085888

Treatment adherence and real-life effectiveness of topical therapy in patients with mild or moderate psoriasis: uptake of scientific evidence in clinical practice and dermatologists' preferences for alternative treatment options.

PubMed

Neri, L; Miracapillo, A

2015-02-01

Topical corticosteroids and the vitamin D analogue calcipotriol are the cornerstone of therapy for patients with mild-to-moderate plaque psoriasis. Lack of patients' adherence leads to suboptimal effectiveness of topical therapy in real-life practice. The fixed combination betamethasone/calcipotriol gel is more effective and safe than the administration of single components and may enhance patients' adherence. We aimed at evaluating the pattern of care and dermatologists' expert opinion toward the available topical treatments for the management of mild-to-moderate psoriasis in Italy. We enrolled 242 Italian dermatologists and collected information related to their practice pattern and opinion toward available topical treatments with a face-to-face structured interview. We evaluated dermatologists' ratings of therapy with 16 items tapping their opinion toward the relevance and satisfaction toward 8 therapy attributes in clinical practices which tapped aspects of real-life effectiveness, adherence promotion, toxicity, convenience of use. Ratings occurred along a 10-point scale. We compared single-attribute and weighted overall therapy ratings across alternative treatment options with random-intercept linear models to account for ratings clustering within dermatologists. There was a wide variation in practice patterns: 1/3 of dermatologist had seen more than 30 patients with psoriasis while around 1/4 had seen less than 10 patients. The fixed combination betamethasone/calcipotriol gel was considered superior to monotherapies in all the eight attributes considered which tapped aspects of real-life effectiveness, adherence promotion, toxicity, convenience of use. Participant dermatologists' strongly preferred the fixed betamethasone/calcipotriol combination gel over both the fixed combination ointment formulation and corticosteroid or vitamin D analogues monotherapies. Such findings are in line with evidence from randomized controlled trials and few observational studies demonstrating superior clinical outcomes, quality of life, tolerability and lower risk of side effect in patients treated with the fixed combination of betamethasone/calcipotriol gel.

Marxism, social psychology, and the sociology of mental health.

PubMed

Brown, P

1984-01-01

The political activism of the 1960s brought with it activism in the mental health field, broadly defined as antipsychiatry. Included in this social phenomenon are R.D. Laing and his colleagues, mental patients' rights activists, movements against psycho-technological abuses such as psychosurgery, Marxist and radical critiques of mainstream psychiatric practices, and feminist therapy. Some aspects of this broad movement have been influenced or even directed by Marxist perspectives. When Marxist influences have not predominated, antipsychiatric points of view still have much affinity with Marxism. This broad-based criticism of mental health practices and ideologies not only influences the mental health field, but also affects general Marxist social theory, adding to traditional Marxism a concern with feminist issues and the politics of personal and family life. This article explores the progress made by these antipsychiatric perspectives, and examines their limitations as well. Four schools of thought in Marxist psychology--Freudo-Marxism, orthodox-economist Marxism, see Marxist medical model, and "ideology-critique"--are explored to see how they can contribute to the further production of Marxist psychological theory and practice.

Avoid problems during distillation column startups

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

Sloley, A.W.

1996-07-01

The startup of a distillation column is the end product of the design process. Indeed, startup is the culmination of the theory and practice of designing the column to meet the process objectives. The author will direct most of this discussion towards column revamps due to their inherent complexity; however, the points apply equally to new columns, as well. The most important question that must be answered prior to a startup is how will the distillation system changes affect initial startup, process control of the system, and normal day-to-day operations? How will the operators run the system? Steady-state distillation-column simulationsmore » alone cannot provide an authoritative answer and, indeed, engineers` over-reliance on software too often has led them to ignore many practical aspects. Computer modeling, while an important engineering tool, is not reality. Distillation columns are real functioning pieces of equipment that require practical skills to successfully modify. They are not steady-state solutions that result from converged computer simulations. Early planning, coupled with thorough inspections and comprehensive reviews of instrumentation and procedures, can play a key role in assuring smooth startups.« less

Practical wavelength calibration considerations for UV-visible Fourier-transform spectroscopy.

PubMed

Salit, M L; Travis, J C; Winchester, M R

1996-06-01

The intrinsic wavelength scale in a modern reference laser-controlled Michelson interferometer-sometimes referred to as the Connes advantage-offers excellent wavelength accuracy with relative ease. Truly superb wavelength accuracy, with total relative uncertainty in line position of the order of several parts in 10(8), should be within reach with single-point, multiplicative calibration. The need for correction of the wavelength scale arises from two practical effects: the use of a finite aperture, from which off-axis rays propagate through the interferometer, and imperfect geometric alignment of the sample beam with the reference beam and the optical axis of the moving mirror. Although an analytical correction can be made for the finite-aperture effect, calibration with a trusted wavelength standard is typically used to accomplish both corrections. Practical aspects of accurate calibration of an interferometer in the UV-visible region are discussed. Critical issues regarding accurate use of a standard external to the sample source and the evaluation and selection of an appropriate standard are addressed. Anomalous results for two different potential wavelength standards measured by Fabry-Perot interferometry (Ar II and (198)Hg I) are observed.

The practicality of using ozone with fruit and vegetables.

PubMed

Glowacz, Marcin; Rees, Deborah

2016-11-01

The fresh produce industry is constantly growing as a result of increasing consumer demand. Food quality and safety management are still major issues for the supply chain. The use of ozone has been identified as a feasible solution to reduce microorganisms present in food, in this way extending the shelf-life of fresh produce. A number of factors that may affect the efficiency of ozone treatment have been identified, e.g. microbial populations, ozone concentration and time of exposure, type of produce, temperature, relative humidity and packaging material, and they are briefly discussed. Furthermore, practical information derived from studies with ozone conducted by the authors and from their knowledge of the subject directs the reader's attention to the key aspects of ozone use under commercial conditions, i.e. from the practical point of view. Finally, one possible direction for future research with the postharvest use of ozone, i.e. the important role of fruit cuticle in response to this postharvest treatment, is indicated. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Selection criteria for water disinfection techniques in agricultural practices.

PubMed

Haute, Sam van; Sampers, Imca; Jacxsens, Liesbeth; Uyttendaele, Mieke

2015-01-01

This paper comprises a selection tool for water disinfection methods for fresh produce pre- and postharvest practices. A variety of water disinfection technologies is available on the market and no single technology is the best choice for all applications. It can be difficult for end users to choose the technology that is best fit for a specific application. Therefore, the different technologies were characterized in order to identify criteria that influence the suitability of a technology for pre- or postharvest applications. Introduced criteria were divided into three principal components: (i) criteria related to the technology and which relate to the disinfection efficiency, (ii) attention points for the management and proper operation, and (iii) necessities in order to sustain the operation with respect to the environment. The selection criteria may help the end user of the water disinfection technology to obtain a systematic insight into all relevant aspects to be considered for preliminary decision making on which technologies should be put to feasibility testing for water disinfection in pre- and postharvest practices of the fresh produce chain.

Extracorporeal blood treatment (EBT) methods in SIRS/Sepsis.

PubMed

Bellomo, R; Honoré, P M; Matson, J; Ronco, C; Winchester, J

2005-05-01

Extracorporeal blood purification treatment (EBT) methods have been used in the treatment of experimental and human SIRS/Sepsis in a variety of settings and with variable reports of efficacy and safety. Their role in the management of SIRS/Sepsis remains controversial. To develop consensus statements regarding important aspects of research, practice and technical management concerning EBT. Systematic review of published study. Evidence-based grading of information available. Consensus development regarding fundamental questions about EBT. Consensus was achieved on all questions posed during the conference. It was agreed that there is currently a clear biological rational for EBT in SIRS and Sepsis. It was agreed that conventional CVVH has sufficiently been shown not to be effective in SIRS/Sepsis in the absence of concomitant ARF and that other therapies such as plasmapheresis or high-volume hemofiltration or coupled plasma filtration adsorption appear more promising and should be tested in multicentre randomized controlled trials. Patients with ARF and SIRS/Sepsis should be treated differently from those with ARF alone even though current practice in this field is not well known. Patients with refractory septic shock should be considered for EBT. Appropriate end points for clinical trials can be defined and chosen according to the goals of the trial. Different technologies exist for EBT and better understanding of the merits and safety of each is needed as well as better standardization of methodology and dose. Broad consensus can be achieved on several aspects of EBT and can be used to inform clinical practice and to help guide the establishment of a future research agenda.

Training gaps for pediatric residents planning a career in primary care: a qualitative and quantitative study.

PubMed

Rosenberg, Adam A; Kamin, Carol; Glicken, Anita Duhl; Jones, M Douglas

2011-09-01

Resident training in pediatrics currently entails similar training for all residents in a fragmented curriculum with relatively little attention to the career plans of individual residents. To explore strengths and gaps in training for residents planning a career in primary care pediatrics and to present strategies for addressing the gaps. Surveys were sent to all graduates of the University of Colorado Denver Pediatric Residency Program (2003-2006) 3 years after completion of training. Respondents were asked to evaluate aspects of their training, using a 5-point Likert scale and evaluating each item ranging from "not at all well prepared" to "extremely well prepared" for their future career. In addition, focus groups were conducted with practitioners in 8 pediatric practices in Colorado. Sessions were transcribed and hand coded by 2 independent coders. Survey data identified training in behavior and development (mean score, 3.72), quality improvement and patient safety strategies (mean, 3.57), and practice management (mean, 2.46) as the weakest aspects of training. Focus groups identified deficiencies in training in mental health, practice management, behavioral medicine, and orthopedics. Deficiencies noted in curriculum structure were lack of residents' long-term continuity of relationships with patients; the need for additional training in knowledge, skills, and attitudes needed for primary care (perhaps even a fourth year of training); and a training structure that facilitates greater resident autonomy to foster development of clinical capability and self-confidence. Important gaps were identified in the primary care training of pediatric residents. These data support the need to develop more career-focused training.

Mise au point d'un bouchon d'oreille "intelligent"

NASA Astrophysics Data System (ADS)

Voix, Jeremie

Many workers are exposed to noise levels high enough to put them at risk of losing their hearing. However, noise reduction at the source, when technically feasible, is often difficult to implement for economical reasons. Therefore, individual hearing protection remains the most widespread solution in practice. Unfortunately, the hearing protectors currently available on the market are seldom worn continuously as they should be (because they are not very comfortable or must be removed to communicate) and do not match the worker's need for protection (because their actual attenuation is generally unknown). This doctorate thesis work, carried out in close collaboration with SONOMAX HEARING HEALTHCARE I NC., had the general objective to develop a smart earplug that would solve the problems associated with current hearing protection devices thereby effectively preventing noise induced hearing loss in the industrial environment. The issues associated to this development have been formulated in details under the Health and Safety aspect (non-continuous wearing of the hearing protector and un-adapted protection), technical aspects (development of an earplug that is comfortable both from the physical and sound perception points of view and whose performances are measurable) and scientific aspects (modeling of physical systems, signal processing, instrumentation and measurement techniques). The technical developments have resulted in a custom earplug that is instantly fitted to the wearer's ear by silicone injection. Its acoustical performance can be measured using a microphone probe while the attenuation can be adapted to the user's need by the insertion through the earplug of passive acoustical filters. The scientific developments have resulted in the prediction of the attenuation of the earplug from the Noise Reduction measurement and in the prediction of the filtered earplug attenuation.

Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

PubMed

Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

2015-12-01

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

Creating Learning Environment Connecting Engineering Design and 3D Printing

NASA Astrophysics Data System (ADS)

Pikkarainen, Ari; Salminen, Antti; Piili, Heidi

Engineering education in modern days require continuous development in didactics, pedagogics and used practical methods. 3D printing provides excellent opportunity to connect different engineering areas into practice and produce learning by doing applications. The 3D-printing technology used in this study is FDM (Fused deposition modeling). FDM is the most used 3D-printing technology by commercial numbers at the moment and the qualities of the technology makes it popular especially in academic environments. For achieving the best result possible, students will incorporate the principles of DFAM (Design for additive manufacturing) into their engineering design studies together with 3D printing. This paper presents a plan for creating learning environment for mechanical engineering students combining the aspects of engineering design, 3D-CAD learning and AM (additive manufacturing). As a result, process charts for carrying out the 3D printing process from technological point of view and design process for AM from engineering design point of view were created. These charts are used in engineering design education. The learning environment is developed to work also as a platform for Bachelor theses, work-training environment for students, prototyping service centre for cooperation partners and source of information for mechanical engineering education in Lapland University of Applied Sciences.

DFT investigation on the electronic structure of Faujasite

NASA Astrophysics Data System (ADS)

Popeneciu, Horea; Calborean, Adrian; Tudoran, Cristian; Buimaga-Iarinca, Luiza

2013-11-01

We report here first-principle pseudopotential DFT calculations to investigate relevant aspects of the electronic structure of zeolites based FAU. Fundamental molecular issues of the band-gap and electronic population analysis were reviewed under GGA/RPBE level of theory, corroborated with a DZP basis set and Troullier-Martins norm conserving pseudo-potentials. The atom-projected density of states and the analysis of HOMO-LUMO frontier orbitals at Gamma point were performed. Their electronic transfers are discussed through the alignment and relative positions of orbitals in order to determine the way that the molecule interacts with adsorbed molecules and other practical applications. Mulliken population analysis was employed for describing atomic charge distribution in the chosen systems.

World Stem Cell Summit 2014. 3-5 December 2014, San Antonio, TX, USA.

PubMed

Hasegawa, Kouichi; Asada, Takashi; Sengoku, Shintaro; Nakatsuji, Norio

2015-05-01

Among the many international conferences in the field of stem cells and regenerative medicine, WSCS is distinct in focusing its efforts to serve as the meeting point by multisector communities of research, clinics, industry, regulation, policy making and ethics. All are aiming at advancing stem cell innovation and new therapies, under the banner of 'connect, collaborate and cure'. As same as past years, presenters and attendees included not only researchers but also clinicians, funding agencies, government officials, industries and patients. Thus, many sessions focused on the clinical translation from basic research. Another important agenda were industrial and social aspects, and problems to be solved before realization of practical and sustainable stem cell-based therapies.

Vision in our three-dimensional world

PubMed Central

2016-01-01

Many aspects of our perceptual experience are dominated by the fact that our two eyes point forward. Whilst the location of our eyes leaves the environment behind our head inaccessible to vision, co-ordinated use of our two eyes gives us direct access to the three-dimensional structure of the scene in front of us, through the mechanism of stereoscopic vision. Scientific understanding of the different brain regions involved in stereoscopic vision and three-dimensional spatial cognition is changing rapidly, with consequent influences on fields as diverse as clinical practice in ophthalmology and the technology of virtual reality devices. This article is part of the themed issue ‘Vision in our three-dimensional world’. PMID:27269595

Pleasure, power, and inequality: incorporating sexuality into research on contraceptive use.

PubMed

Higgins, Jenny A; Hirsch, Jennifer S

2008-10-01

We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one. Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception.

Patient pathway: the ideal approach.

PubMed

Corless, Lynsey; Brew, Iain

2018-02-07

Hepatic encephalopathy (HE) can be a devastating complication of cirrhosis, affecting patients and their families. Multidisciplinary community and specialist teams must work together with patients and their families to recognise HE, identify and treat problems early, and minimise time spent unwell or in hospital. Primary care provides an ideal setting for patient education and reinforcement of the salient points on self-care. In the acute setting, the use of care pathways can ensure that the critical aspects of pharmacological, dietetic and supportive care are offered in a timely fashion to reduce morbidity and mortality. This article discusses strategies that can be used in primary and secondary care to help teams deliver excellent practice in HE management.

Coherent perfect absorption in one-sided reflectionless media

PubMed Central

Wu, Jin-Hui; Artoni, M.; La Rocca, G. C.

2016-01-01

In optical experiments one-sided reflectionless (ORL) and coherent perfect absorption (CPA) are unusual scattering properties yet fascinating for their fundamental aspects and for their practical interest. Although these two concepts have so far remained separated from each other, we prove that the two phenomena are indeed strictly connected. We show that a CPA–ORL connection exists between pairs of points lying along lines close to each other in the 3D space-parameters of a realistic lossy atomic photonic crystal. The connection is expected to be a generic feature of wave scattering in non-Hermitian optical media encompassing, as a particular case, wave scattering in parity-time (PT) symmetric media. PMID:27759020

Ultrahigh-density nanowire arrays grown in self-assembled diblock copolymer templates.

PubMed

Thurn-Albrecht, T; Schotter, J; Kästle, G A; Emley, N; Shibauchi, T; Krusin-Elbaum, L; Guarini, K; Black, C T; Tuominen, M T; Russell, T P

2000-12-15

We show a simple, robust, chemical route to the fabrication of ultrahigh-density arrays of nanopores with high aspect ratios using the equilibrium self-assembled morphology of asymmetric diblock copolymers. The dimensions and lateral density of the array are determined by segmental interactions and the copolymer molecular weight. Through direct current electrodeposition, we fabricated vertical arrays of nanowires with densities in excess of 1.9 x 10(11) wires per square centimeter. We found markedly enhanced coercivities with ferromagnetic cobalt nanowires that point toward a route to ultrahigh-density storage media. The copolymer approach described is practical, parallel, compatible with current lithographic processes, and amenable to multilayered device fabrication.

MEDICAL ERROR: CIVIL AND LEGAL ASPECT.

PubMed

Buletsa, S; Drozd, O; Yunin, O; Mohilevskyi, L

2018-03-01

The scientific article is focused on the research of the notion of medical error, medical and legal aspects of this notion have been considered. The necessity of the legislative consolidation of the notion of «medical error» and criteria of its legal estimation have been grounded. In the process of writing a scientific article, we used the empirical method, general scientific and comparative legal methods. A comparison of the concept of medical error in civil and legal aspects was made from the point of view of Ukrainian, European and American scientists. It has been marked that the problem of medical errors is known since ancient times and in the whole world, in fact without regard to the level of development of medicine, there is no country, where doctors never make errors. According to the statistics, medical errors in the world are included in the first five reasons of death rate. At the same time the grant of medical services practically concerns all people. As a man and his life, health in Ukraine are acknowledged by a higher social value, medical services must be of high-quality and effective. The grant of not quality medical services causes harm to the health, and sometimes the lives of people; it may result in injury or even death. The right to the health protection is one of the fundamental human rights assured by the Constitution of Ukraine; therefore the issue of medical errors and liability for them is extremely relevant. The authors make conclusions, that the definition of the notion of «medical error» must get the legal consolidation. Besides, the legal estimation of medical errors must be based on the single principles enshrined in the legislation and confirmed by judicial practice.

The forensic aspects of sexual violence.

PubMed

Newton, Mary

2013-02-01

Complainants of sexual assault may disclose to different agencies, the police and health professionals being the most likely. It is possible for certain evidence types to be collected before a clinical forensic assessment takes place that do not require the need for a Forensic Medical Practitioner. If the time frames after the incident and the nature of assault warrant the need for a forensic medical examination of either a complainant or a suspect, this should only be conducted by doctors and nurses who have received relevant, up-to-date specialist theoretical and practical training. Clear evidence shows that few other criminal offences require as extensive an examination and collection of forensic evidence as that of a sexual assault. The forensic evidence in a case may identify an assailant, eliminate a nominated suspect(s), and assist in the prosecution of a case. The elements of forensic medical examination, reviewed in this chapter, are those that are the most varied across jurisdictions around the world currently. Key focus points of this chapter are considerations for early evidence collection, utilising dedicated medical examination facilities for sample collection, contamination issues associated with evidence collection and certain practical aspects of forensic sampling methods which have evolved given results identified by Forensic Scientists processing evidential samples in sexual assault cases, Some of the problems encountered by the forensic science provider will also be discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Website for rhinoplasty and facial plastic surgery.

PubMed

Becker, Daniel G

2006-02-01

The Internet has become an important avenue for facial plastic surgeons to make potential patients aware of their practice. It is important for the facial plastic surgeon to understand how the Internet is used by patients and how it can complement a physician's practice. The website unavoidably has a marketing aspect. Although there are no statistics available, certainly a substantial number of patients use the Internet as a primary source for both learning about cosmetic surgical procedures and also to locate a physician. A practice website can provide potential patients with important logistical information; it also provides an opportunity to educate the potential patient about the surgical procedures provided. A website can be an important aspect of the overall practice image. An increasing number of individuals visit the website of their physician or potential physician, so it is important that attention is given to this aspect of a practice.

Observing Classroom Practice

ERIC Educational Resources Information Center

Danielson, Charlotte

2012-01-01

Classroom observation is a crucial aspect of any system of teacher evaluation. No matter how skilled a teacher is in other aspects of teaching--such as careful planning, working well with colleagues, and communicating with parents--if classroom practice is deficient, that individual cannot be considered a good teacher. Classroom observations can…

Nurse's Awareness on Ethico-legal Aspects of Nursing Profession.

PubMed

Paudel Subedi, Krishna Kumari; Timalsina, Kalpana; Bhele, Raja Laxmi

2018-03-13

Nursing practice amicably includes practical efficacy and ethics. Now a days legal and ethical problems associated with client care are arising day by day. Therefore, nurses should have adequate understanding of basic legal concepts and issues relevant to nursing profession in order to protect the rights of the clients and the nurses. A cross sectional descriptive design was adopted for the study. 142 nurses were included by using purposive sampling technique. Data was collected with self-administered structured questionnaire. Descriptive statistics was used to reveal demographic information. Kruskal Wallis and Mann Whitney test were used to find out association of selected demographic variables and ethico legal aspects of nursing. Majority of participants were belonging to 20-29 years of age. More than half nurses had complete bachelor's degree and had less than 10 year's experiences. Majority of participants reported that they did not encounter any legal issues in their professional life till date. Similarly, majority of participants had average level knowledge and equate level of practice. Years of experiences and education level did not affect in knowledge level and existing practice related to ethico legal aspect of nursing. There was no significant relationship between level of knowledge and existing practice. Nurses have average knowledge and practice on ethico legal aspects. There is positive relationship between knowledge and practice though it is not statistically significant.

Electronic health records and patient safety: co-occurrence of early EHR implementation with patient safety practices in primary care settings.

PubMed

Tanner, C; Gans, D; White, J; Nath, R; Pohl, J

2015-01-01

The role of electronic health records (EHR) in enhancing patient safety, while substantiated in many studies, is still debated. This paper examines early EHR adopters in primary care to understand the extent to which EHR implementation is associated with the workflows, policies and practices that promote patient safety, as compared to practices with paper records. Early adoption is defined as those who were using EHR prior to implementation of the Meaningful Use program. We utilized the Physician Practice Patient Safety Assessment (PPPSA) to compare primary care practices with fully implemented EHR to those utilizing paper records. The PPPSA measures the extent of adoption of patient safety practices in the domains: medication management, handoffs and transition, personnel qualifications and competencies, practice management and culture, and patient communication. Data from 209 primary care practices responding between 2006-2010 were included in the analysis: 117 practices used paper medical records and 92 used an EHR. Results showed that, within all domains, EHR settings showed significantly higher rates of having workflows, policies and practices that promote patient safety than paper record settings. While these results were expected in the area of medication management, EHR use was also associated with adoption of patient safety practices in areas in which the researchers had no a priori expectations of association. Sociotechnical models of EHR use point to complex interactions between technology and other aspects of the environment related to human resources, workflow, policy, culture, among others. This study identifies that among primary care practices in the national PPPSA database, having an EHR was strongly empirically associated with the workflow, policy, communication and cultural practices recommended for safe patient care in ambulatory settings.

Investigation of the capillary flow through open surface microfluidic structures

NASA Astrophysics Data System (ADS)

Taher, Ahmed; Jones, Benjamin; Fiorini, Paolo; Lagae, Liesbet

2017-02-01

The passive nature of capillary microfluidics for pumping and actuation of fluids is attractive for many applications including point of care medical diagnostics. For such applications, there is often the need to spot dried chemical reagents in the bottom of microfluidic channels after device fabrication; it is often more practical to have open surface devices (i.e., without a cover or lid). However, the dynamics of capillary driven flow in open surface devices have not been well studied for many geometries of interest. In this paper, we investigate capillary flow in an open surface microchannel with a backward facing step. An analytical model is developed to calculate the capillary pressure as the liquid-vapor interface traverses a backward facing step in an open microchannel. The developed model is validated against results from Surface Evolver liquid-vapor surface simulations and ANSYS Fluent two-phase flow simulations using the volume of fluid approach. Three different aspect ratios (inlet channel height by channel width) were studied. The analytical model shows good agreement with the simulation results from both modeling methods for all geometries. The analytical model is used to derive an expression for the critical aspect ratio (the minimum channel aspect ratio for flow to proceed across the backward facing step) as a function of contact angle.

Changing Practices in Chinese Cultures of Learning

ERIC Educational Resources Information Center

Jin, Lixian; Cortazzi, Martin

2006-01-01

This paper analyses some changing aspects of learning and "cultures of learning" in China: these are related to meeting the needs of Chinese learners studying in higher education in the UK. We use the term "cultures of learning" to draw attention to the socio-cultural aspects of key practices, expectations and interpretations…

Behavioral Aspects of Marijuana Use.

ERIC Educational Resources Information Center

Paulson, Patricia

This paper examines the behavioral aspects of marijuana use. The focus of the study was to investigate the attitudes and practices toward drugs by users and non-users and the relationship of these attitudes and practices to selected psychosocial factors. A survey instrument in the form of an anonymous questionnaire was developed and administered…

Developmental Dyslexia as Developmental and Linguistic Variation: Editor's Commentary.

ERIC Educational Resources Information Center

Leong, Che Kan

2002-01-01

This commentary reviews forthcoming articles on the scientific study of dyslexia, genetic and neurophysiological aspects of dyslexia, cross-linguistic aspects of literacy development and dyslexia, and theory-based practice. It concludes that educators should continue to strive to promote theory-based research and evidence-based practice to achieve…

The Practical Aspects of Online Counseling: Ethics, Training, Technology, and Competency

ERIC Educational Resources Information Center

Mallen, Michael J.; Vogel, David L.; Rochlen, Aaron B.

2005-01-01

This article addresses the practical aspects of online counseling, including ethics, training, supervision, technology, and competency issues. The authors discuss online counseling's strengths and limitations and present guidelines for what types of clients and counseling psychologists may be appropriate for online counseling. To illustrate the…

Enhancing Teachers' Technological Knowledge and Assessment Practices to Enhance Student Learning in Technology: A Two-year Classroom Study

NASA Astrophysics Data System (ADS)

Moreland, Judy; Jones, Alister; Northover, Ann

2001-02-01

This paper reports on a two-year classroom investigation of primary school (Years 1-8) technology education. The first year of the project explored emerging classroom practices in technology. In the second year intervention strategies were developed to enhance teaching, learning and assessment practices. Findings from the first year revealed that assessment was often seen in terms of social and managerial aspects, such as teamwork, turn taking and co-operative skills, rather than procedural and conceptual technological aspects. Existing formative interactions with students distorted the learning away from the procedural and conceptual aspects of the subject. The second year explored the development of teachers' technological knowledge in order to enhance formative assessment practices in technology, to inform classroom practice in technology, and to enhance student learning. Intervention strategies were designed to enhance the development of procedural, conceptual, societal and technical aspects of technology for teachers and students. The results from this intervention were very positive. This paper highlights the importance of developing teacher expertise pertaining to broad concepts of technology, detailed concepts in different technological areas and general pedagogical knowledge. The findings from this research therefore have implications for thinking about teaching, learning and assessment in technology.

Gender in medical ethics: re-examining the conceptual basis of empirical research.

PubMed

Conradi, Elisabeth; Biller-Andorno, Nikola; Boos, Margarete; Sommer, Christina; Wiesemann, Claudia

2003-01-01

Conducting empirical research on gender in medical ethics is a challenge from a theoretical as well as a practical point of view. It still has to be clarified how gender aspects can be integrated without sustaining gender stereotypes. The developmental psychologist Carol Gilligan was among the first to question ethics from a gendered point of view. The notion of care introduced by her challenged conventional developmental psychology as well as moral philosophy. Gilligan was criticised, however, because her concept of 'two different voices' may reinforce gender stereotypes. Moreover, although Gilligan stressed relatedness, this is not reflected in her own empirical approach, which still focuses on individual moral reflection. Concepts from social psychology can help overcome both problems. Social categories like gender shape moral identity and moral decisions. If morality is understood as being lived through actions of persons in social relationships, gender becomes a helpful category of moral analysis. Our findings will provide a conceptual basis for the question how empirical research in medical ethics can successfully embrace a gendered perspective.

Motivational and evolutionary aspects of a physical exercise training program: a longitudinal study

PubMed Central

Rosa, João P. P.; de Souza, Altay A. L.; de Lima, Giscard H. O.; Rodrigues, Dayane F.; de Aquino Lemos, Valdir; da Silva Alves, Eduardo; Tufik, Sergio; de Mello, Marco T.

2015-01-01

Several studies have indicated that motivational level and prior expectations influence one’s commitment to physical activity. Moreover, these aspects are not properly described in terms of proximal (SDT, Self Determination Theory) and distal (evolutionary) explanations in the literature. This paper aims to verify if level of motivation (BREQ-2, Behavioral Regulation in Exercise Questionnaire-2) and expectations regarding regular physical exercise (IMPRAF-54) before starting a 1-year exercise program could determine likelihood of completion. Ninety-four volunteers (53 women) included a completed protocol group (CPG; n = 21) and drop-out group (n = 73). The IMPRAF-54 scale was used to assess six different expectations associated with physical activity, and the BREQ-2 inventory was used to assess the level of motivation in five steps (from amotivation to intrinsic motivation). Both questionnaires were assessed before starting a regular exercise program. The CPG group presented higher sociability and lower pleasure scores according to IMPRAF-54 domains. A logistic regression analysis showed that a one-point increment on sociability score increased the chance of completing the program by 10%, and the same one-point increment on pleasure score reduced the chance of completing the protocol by 16%. ROC curves were also calculated to establish IMPRAF-54 cutoffs for adherence (Sociability – 18.5 points – 81% sensibility/50% specificity) and dropout (Pleasure – 25.5 points – 86% sensibility/20% specificity) of the exercise protocol. Our results indicate that an expectation of social interaction was a positive factor in predicting adherence to exercise. Grounded in SDT and its innate needs (competence, autonomy, relatedness), physical exercise is not an end; it is a means to achieve autonomy and self-cohesion. The association of physical activity with social practices, as occurs in hunter-gathering groups, can engage people to be physically active and can provide better results in adherence exercise programs for the general population. PMID:26042076

Comparison of private versus academic practice for general surgeons: a guide for medical students and residents.

PubMed

Schroen, Anneke T; Brownstein, Michelle R; Sheldon, George F

2003-12-01

Medical students and residents often make specialty and practice choices with limited exposure to aspects of professional and personal life in general surgery. The purpose of this study was to portray practice composition, career choices, professional experiences, job satisfaction, and personal life characteristics specific to practicing general surgeons in the United States. A 131-question survey was mailed to all female members (n = 1,076) and a random 2:1 sample of male members (n = 2,152) of the American College of Surgeons in three mailings between September 1998 and March 1999. Respondents who were not actively practicing general surgery in the United States and both trainees and surgeons who did not fit the definition of private or academic practice were excluded. Detailed questions regarding practice attributes, surgical training, professional choices, harassment, malpractice, career satisfaction, and personal life characteristics were included. Separate five-point Likert scales were designed to measure influences on career choices and satisfaction with professional and personal matters. Univariate analyses were used to analyze responses by surgeon age, gender, and practice type. A response rate of 57% resulted in 1,532 eligible responses. Significant differences between private and academic practice were noted in case composition, practice structure, and income potential; no major differences were seen in malpractice experience. Propensity for marriage and parenthood differed significantly between men and women surgeons. Overall career satisfaction was very high regardless of practice type. Some differences by surgeon gender in perceptions of equal career advancement opportunities and of professional isolation were noted. This study offers a comprehensive view of general surgery to enable more informed decisions among medical students and residents regarding specialty choice or practice opportunities.

Cause and Cure - Deterioration in Accuracy of CFD Simulations With Use of High-Aspect-Ratio Triangular Tetrahedral Grids

NASA Technical Reports Server (NTRS)

Chang, Sin-Chung; Chang, Chau-Lyan; Venkatachari, Balaji Shankar

2017-01-01

Traditionally high-aspect ratio triangular/tetrahedral meshes are avoided by CFD re-searchers in the vicinity of a solid wall, as it is known to reduce the accuracy of gradient computations in those regions and also cause numerical instability. Although for certain complex geometries, the use of high-aspect ratio triangular/tetrahedral elements in the vicinity of a solid wall can be replaced by quadrilateral/prismatic elements, ability to use triangular/tetrahedral elements in such regions without any degradation in accuracy can be beneficial from a mesh generation point of view. The benefits also carry over to numerical frameworks such as the space-time conservation element and solution element (CESE), where triangular/tetrahedral elements are the mandatory building blocks. With the requirement of the CESE method in mind, a rigorous mathematical framework that clearly identities the reason behind the difficulties in use of such high-aspect ratio triangular/tetrahedral elements is presented here. As will be shown, it turns out that the degree of accuracy deterioration of gradient computation involving a triangular element is hinged on the value of its shape factor Gamma def = sq sin Alpha1 + sq sin Alpha2 + sq sin Alpha3, where Alpha1; Alpha2 and Alpha3 are the internal angles of the element. In fact, it is shown that the degree of accuracy deterioration increases monotonically as the value of Gamma decreases monotonically from its maximal value 9/4 (attained by an equilateral triangle only) to a value much less than 1 (associated with a highly obtuse triangle). By taking advantage of the fact that a high-aspect ratio triangle is not necessarily highly obtuse, and in fact it can have a shape factor whose value is close to the maximal value 9/4, a potential solution to avoid accuracy deterioration of gradient computation associated with a high-aspect ratio triangular grid is given. Also a brief discussion on the extension of the current mathematical framework to the tetrahedral-grid case along with some of the practical results of this extension is also provided. Furthermore, through the use of numerical simulations of practical viscous problems involving high-Reynolds number flows, the effectiveness of the gradient evaluation procedures within the CESE framework (that have their basis on the analysis presented here) to produce accurate and stable results on such high-aspect ratio meshes is also showcased.

The influence of logical positivism on nursing practice.

PubMed

Whall, A L

1989-01-01

While logical positivism has been said to have had major influence on the development of nursing theory, whether this influence pervades other aspects of the discipline has not been discussed. One central aspect of logical positivism, the verificationist perspective, was used to examine texts, curricular guides and standards of practice that guided nursing practice in the decades in which logical positivism had influence on nursing theory construction. This review of the literature does not support the influence of logical positivism, as exemplified by the verificationist perspective, on nursing practice guidelines.

Guidelines for point-of-care testing: haematology.

PubMed

Briggs, Carol; Guthrie, David; Hyde, Keith; Mackie, Ian; Parker, Norman; Popek, Mary; Porter, Neil; Stephens, Clare

2008-09-01

This guideline provides a framework for the arrangement of point-of-care testing (POCT) services, previously known as near patient testing (patient self-testing not covered). POCT is defined as any analytical test performed outside the laboratory. Primary users are often non-laboratory healthcare workers. The guidance applies to units within hospitals as well as general practioner surgeries, community clinics and pharmacies. The head of the haematology laboratory or a point of care coordinator must take responsibility for all aspects of the POCT service, including quality and training. Depending on the size and nature of the POCT practice, a local POCT manager may also be required. Equipment selected should have received a successful independent performance evaluation. If an independent evaluation has not been performed the purchaser should assess the device according to the protocol in this document. POCT devices should generate results that are comparable to those of the local laboratory. An accredited external quality assessment programme and internal quality control system must be established. Manufacturers promoting POCT devices designed for non-laboratory sites, e.g. pharmacies, should undertake training and annual competency assessment, perhaps using a web-based system. A diagram to illustrate the stages for the implementation of a POCT service is illustrated.

Aerial multi-camera systems: Accuracy and block triangulation issues

NASA Astrophysics Data System (ADS)

Rupnik, Ewelina; Nex, Francesco; Toschi, Isabella; Remondino, Fabio

2015-03-01

Oblique photography has reached its maturity and has now been adopted for several applications. The number and variety of multi-camera oblique platforms available on the market is continuously growing. So far, few attempts have been made to study the influence of the additional cameras on the behaviour of the image block and comprehensive revisions to existing flight patterns are yet to be formulated. This paper looks into the precision and accuracy of 3D points triangulated from diverse multi-camera oblique platforms. Its coverage is divided into simulated and real case studies. Within the simulations, different imaging platform parameters and flight patterns are varied, reflecting both current market offerings and common flight practices. Attention is paid to the aspect of completeness in terms of dense matching algorithms and 3D city modelling - the most promising application of such systems. The experimental part demonstrates the behaviour of two oblique imaging platforms in real-world conditions. A number of Ground Control Point (GCP) configurations are adopted in order to point out the sensitivity of tested imaging networks and arising block deformations. To stress the contribution of slanted views, all scenarios are compared against a scenario in which exclusively nadir images are used for evaluation.

Not quite dead: why Egyptian doctors refuse the diagnosis of death by neurological criteria.

PubMed

Hamdy, Sherine

2013-04-01

Drawing on two years of ethnographic fieldwork in Egypt focused on organ transplantation, this paper examines the ways in which the "scientific" criteria of determining death in terms of brain function are contested by Egyptian doctors. Whereas in North American medical practice, the death of the "person" is associated with the cessation of brain function, in Egypt, any sign of biological life is evidence of the persistence, even if fleeting, of the soul. I argue that this difference does not exemplify an irresolvable culture clash but points to an unsettling aspect of cadaveric organ procurement that has emerged wherever organ transplantation is practiced. Further, I argue that a misdiagnosis of the problem, as one about "religious extremism" or a "civilizational clash," has obfuscated unresolved concerns about fairness, access, and justice within Egyptian medical spheres. This misdiagnosis has led to the suspension of a cadaveric procurement program for over 30 years, despite Egypt's pioneering efforts in kidney transplantation.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2003-01-01

This report presents the recommendations of an international group of experts convened by the World Health Organization to consider matters concerning the quality assurance of pharmaceuticals and specifications for drug substances and dosage forms. Of particular relevance to drug regulatory authorities and pharmaceutical manufacturers, the report discusses activities related to the development of The International Pharmacopoeia and basic tests for pharmaceutical substances and dosage forms, as well as quality control of reference materials, good manufacturing practices (GMP), stability studies, inspection, hazard analysis, procurement, storage and other aspects of quality assurance of pharmaceuticals, and regulatory issues. The report is complemented by a number of annexes, including recommendations on the risk of transmitting animal spongiform encephalopathy agents via medicinal products, guidelines on GMP for pharmaceutical products, a model certificate for GMP and guidance on a GMP inspection report. The final annexes provide guidance on the application of Hazard Analysis and Critical Control Point (HACCP) method to pharmaceuticals, good storage practices and a procedure for assessing acceptability of pharmaceutical products for purchase by United Nations agencies.

Bioethics in Mediterranean culture: the Spanish experience.

PubMed

Busquets, Ester; Roman, Begoña; Terribas, Núria

2012-11-01

This article presents a view of bioethics in the Spanish context. We may identify several features common to Mediterranean countries because of their relatively similar social organisation. Each country has its own distinguishing features but we would point two aspects which are of particular interest: the Mediterranean view of autonomy and the importance of Catholicism in Mediterranean culture. The Spanish experience on bioethics field has been marked by these elements, trying to build a civic ethics alternative, with the law as an important support. So, Spanish bioethics has been developed in two parallel levels: in the academic and policy maker field (University and Parliament) and in clinical practice (hospitals and healthcare ethics committees), with different paces and methods. One of the most important changes in the paternalistic mentality has been promoted through the recognition by law of the patient's rights and also through the new generation of citizens, clearly aware on the exercise of autonomy. Now, the healthcare professionals have a new challenge: adapt their practice to this new paradigm.

Design of High Quality Chemical XOR Gates with Noise Reduction.

PubMed

Wood, Mackenna L; Domanskyi, Sergii; Privman, Vladimir

2017-07-05

We describe a chemical XOR gate design that realizes gate-response function with filtering properties. Such gate-response function is flat (has small gradients) at and in the vicinity of all the four binary-input logic points, resulting in analog noise suppression. The gate functioning involves cross-reaction of the inputs represented by pairs of chemicals to produce a practically zero output when both are present and nearly equal. This cross-reaction processing step is also designed to result in filtering at low output intensities by canceling out the inputs if one of the latter has low intensity compared with the other. The remaining inputs, which were not reacted away, are processed to produce the output XOR signal by chemical steps that result in filtering at large output signal intensities. We analyze the tradeoff resulting from filtering, which involves loss of signal intensity. We also discuss practical aspects of realizations of such XOR gates. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

The Impact of Action Learning Experience on Reflective Practice

ERIC Educational Resources Information Center

Harris, Nicole S.

2012-01-01

This case study examines the changes that occur with respect to reflective practices as a result of participating in an action learning group through the identification of aspects/activities of action learning that contribute to such changes and the impact these aspects/activities had on the program participants at a department of the federal…

A Conceptual Model for Developing Mindsets for Strategic Insight under Conditions of Complexity and High Uncertainty

ERIC Educational Resources Information Center

Yorks, Lyle; Nicolaides, Aliki

2012-01-01

This article addresses an important, yet often underattended to, aspect of the strategy development process: fostering the use of strategic learning practices in the simultaneous practice of developing strategy and cultivating strategic mindset awareness. The need for addressing this aspect of the strategy development process is increasingly…

Creative Educational Practices for Inclusion

ERIC Educational Resources Information Center

Piske, Fernanda Hellen Ribeiro; Stoltz, Tania; Machado, Jarci

2014-01-01

Inclusion of gifted students depends on several aspects to happen in the school context, and one of the most important aspects to include these children at school is creative educational practices. Teaching with art is a good possibility to make children feel motivated to attend school. In the school context, the inclusion of these children could…

Are Graduating Students Ready for Financial Aspects of Social Work Practice?

ERIC Educational Resources Information Center

Birkenmaier, Julie M.; Loke, Vernon; Hageman, Sally A.

2016-01-01

Graduating students must be prepared with knowledge and skills for the financial aspects of social work practice. This study examines graduating students' attitudes and perceptions about client finances, as well as their financial knowledge. Internet survey results (n = 116) of BSW and MSW graduating students indicate that respondents (a) perceive…

A qualitative study of science education in nursing school: Narratives of Hispanic female nurses' sense of identity and participation in science learning

NASA Astrophysics Data System (ADS)

Gensemer, Patricia S.

The purpose of this qualitative study was to learn from Hispanic nursing students regarding their experiences as participants in science learning. The participants were four female nursing students of Hispanic origin attending a small, rural community college in a southeastern state. The overarching question of this study was "In what ways does being Hispanic mediate the science-related learning and practices of nursing students?" The following questions more specifically provided focal points for the research: (1) In what ways do students perceive being Hispanic as relevant to their science education experiences? (a) What does it mean to be Hispanic in the participants' home community? (b) What has it meant to be Hispanic in the science classroom? (2) In what ways might students' everyday knowledge (at home) relate to the knowledge or ways of knowing they practice in the nursing school community? The study took place in Alabama, which offered a rural context where Hispanic populations are rapidly increasing. A series of four interviews was conducted with each participant, followed by one focus group interview session. Results of the study were re presented in terms of portrayals of participant's narratives of identity and science learning, and then as a thematic interpretation collectively woven across the individuals' narratives. Portraitures of each participant draw upon the individual experiences of the four nursing students involved in this study in order to provide a beginning point towards exploring "community" as both personal and social aspects of science practices. Themes explored broader interpretations of communities of practice in relation to guiding questions of the study. Three themes emerged through the study, which included the following: Importance of Science to Nurses, Crossing with a Nurturing and Caring Identity, and Different Modes of Participation. Implications were discussed with regard to participation in a community of practice and rethinking scientific literacy in terms of different modes of participation that are brought to the community of science learning.

[Activating therapeutic care in geriatrics : Evaluation of a practice concept].

PubMed

Acklau, Stefanie; Gödecker, Lisa; Kaden, Andrea; Jahn, Patrick

2016-10-01

The special feature of the concept of activating therapeutic care in geriatrics (ATP-G) is based on the focus of nursing and therapeutic elements specifically related to the elderly. Further significance lies in the bottom-up development of this concept, which shows a close proximity to the nursing practice. The research project targeted the characteristics of ATP-G from a nursing point of view. Furthermore, the resulting elements of professional nursing care understanding for inpatient geriatric rehabilitation were used to build a scientific and theoretical foundation of the ATP-G concept. In this study 12 semi-structured interviews with professional caregivers were realized. The data collection was undertaken in three different facilities of inpatient geriatric (early) rehabilitation, chosen by lot. The data analysis was based on the methodology of qualitative content analysis according to Mayring. The research project showed that the basic elements described in the ATP-G concept are consistent with the view of nursing practitioners and therefore reflect the characteristic features of routine daily practice; nonetheless, some new aspects were found, primarily the importance of interdisciplinary teamwork in geriatric settings. There were also difficulties related to the ATP-G concept which were experienced as restraints by the questioned professionals. Further research should therefore investigate the structures for optimal implementation of the ATP-G concept into standard practice.

Training and action for patient safety: embedding interprofessional education for patient safety within an improvement methodology.

PubMed

Slater, Beverley L; Lawton, Rebecca; Armitage, Gerry; Bibby, John; Wright, John

2012-01-01

Despite an explosion of interest in improving safety and reducing error in health care, one important aspect of patient safety that has received little attention is a systematic approach to education and training for the whole health care workforce. This article describes an evaluation of an innovative multiprofessional, team-based training program that embeds patient safety within quality improvement methods. Kirkpatrick's "levels of evaluation" model was adopted to evaluate the program in health organizations across one city in the north of England. Questionnaires were used to assess reaction of participants to the program (Level 1). Improvements in patient safety knowledge and patient safety culture (Level 2) were assessed using a 12-item multiple-choice questionnaire and a culture questionnaire. Interviews and project-specific quantitative measurements were used to assess changes in professional practice and patient outcomes (Levels 3 and 4). All aspects of the program were positively received by participants. Few participants completed the MCQ at both time points, but those who did showed improvement in knowledge. There were some small but significant improvements in patient safety culture. Interviews revealed a number of additional benefits beyond the specific problems addressed. Most importantly, 8 of the 11 teams showed improvements in patient safety practices and/or outcomes. This program is an example of interprofessional education in practice and demonstrates that team-based learning using quality improvement methods is feasible and can be effective in improving patient safety, but requires time and space for participants. Alignment with continuing education arrangements could support mainstream adoption of this approach within organizations. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Simulation-based training in brain death determination.

PubMed

MacDougall, Benjamin J; Robinson, Jennifer D; Kappus, Liana; Sudikoff, Stephanie N; Greer, David M

2014-12-01

Despite straightforward guidelines on brain death determination by the American Academy of Neurology (AAN), substantial practice variability exists internationally, between states, and among institutions. We created a simulation-based training course on proper determination based on the AAN practice parameters to address and assess knowledge and practice gaps at our institution. Our intervention consisted of a didactic course and a simulation exercise, and was bookended by before and after multiple-choice tests. The 40-min didactic course, including a video demonstration, covered all aspects of the brain death examination. Simulation sessions utilized a SimMan 3G manikin and involved a complete examination, including an apnea test. Possible confounders and signs incompatible with brain death were embedded throughout. Facilitators evaluated performance with a 26-point checklist based on the most recent AAN guidelines. A senior neurologist conducted all aspects of the course, including the didactic session, simulation, and debriefing session. Ninety physicians from multiple specialties have participated in the didactic session, 38 of whom have completed the simulation. Pre-test scores were poor (41.4 %), with attendings scoring higher than residents (46.6 vs. 40.4 %, p = 0.07), and neurologists and neurosurgeons significantly outperforming other specialists (53.9 vs. 38.9 %, p = 0.003). Post-test scores (73.3 %) were notably higher than pre-test scores (45.4 %). Participant feedback has been uniformly positive. Baseline knowledge of brain death determination among providers was low but improved greatly after the course. Our intervention represents an effective model that can be replicated at other institutions to train clinicians in the determination of brain death according to evidence-based guidelines.

Discourses of student orientation to medical education programs

PubMed Central

Ellaway, Rachel H.; Cooper, Gerry; Al-Idrissi, Tracy; Dubé, Tim; Graves, Lisa

2014-01-01

Background Although medical students’ initial orientation is an important point of transition in medical education, there is a paucity of literature on the subject and major variations in the ways that different institutions orient incoming medical students to their programs. Methods We conducted a discourse analysis of medical education orientation in the literature and on data from a survey of peer institutions’ approaches to orientation. Results These two discourses of orientation had clear similarities, in particular, the critical role of ceremony and symbols, and the focus on developing professionalism and physician identities. There were also differences between them, in particular, in the way that the discourse in the literature focused on the symbolic and professional aspects of orientation; something we have called ‘cultural orientation’. Meanwhile, those who were responsible for orientation in their own institutions tended to focus on the practical and social dimensions. Conclusion By examining how orientation has been described and discussed, we identify three domains of orientation: cultural, social, and practical. These domains are relatively distinct in terms of the activities associated with them, and in terms of who is involved in organizing and running these activities. We also describe orientation as a liminal activity system on the threshold of medical school where incoming students initially cross into the profession. Interestingly, this state of ambiguity also extends to the scholarship of orientation with only some of its aspects attracting formal enquiry, even though there is a growing interest in transitions in medical education as a whole. We hope, therefore, that this study can help to legitimize enquiry into orientation in all its forms and that it can begin to situate the role of orientation more firmly within the firmament of medical education practice and research. PMID:24646440

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.

Characteristics of Japanese medical students associated with their intention for rural practice.

PubMed

Kawamoto, Ryuichi; Uemoto, Asuka; Ninomiya, Daisuke; Hasegawa, Youichi; Ohtsuka, Nobuyuki; Kusunoki, Tomo; Kumagi, Teru; Abe, Masanori

2015-01-01

In Japan, the maldistribution of physicians between urban and rural areas is increasing. It is important to know the practice location expectations of future physicians. The study was designed as a cross-sectional survey. In 2009-2013, students at a medical school in Japan completed a questionnaire containing 50 items with four-point Likert scales. The students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to state their intention to practice in a rural area. The study sample consisted of 368 students (88.2% response rate). Significant variables that were associated with a positively motivated intent for rural practice were 'presence of a role model' (odds ratio (OR), 5.42; 95% confidence interval (CI), 1.58-18.5), 'admission by school recommendation' (OR, 7.68; 95%CI, 2.14-27.6), 'growing up in a rural area' (OR, 6.16; 95%CI, 1.01-37.6), 'general medicine/family medicine as the first career choice' (OR, 5.88; 95%CI, 2.43-14.2), 'interest in the targeted population' (OR, 16.7; 95%CI, 3.97-69.9), 'memorable experience at a class or clinical rotation' (OR, 3.94; 95%CI, 3.73-416), and 'location of their medical school' (OR, 11.4; 95%CI, 2.79-46.2). The present study suggests that medical schools might recruit students with characteristics associated with intention for rural practice.

Emerging Role of Quality Indicators in Physical Therapist Practice and Health Service Delivery

PubMed Central

Klemm, Alexandria; Li, Linda C.; Jones, C. Allyson

2016-01-01

Quality-based care is a hallmark of physical therapy. Treatment effectiveness must be evident to patients, managers, employers, and funders. Quality indicators (QIs) are tools that specify the minimum acceptable standard of practice. They are used to measure health care processes, organizational structures, and outcomes that relate to aspects of high-quality care of patients. Physical therapists can use QIs to guide clinical decision making, implement guideline recommendations, and evaluate and report treatment effectiveness to key stakeholders, including third-party payers and patients. Rehabilitation managers and senior decision makers can use QIs to assess care gaps and achievement of benchmarks as well as to guide quality improvement initiatives and strategic planning. This article introduces the value and use of QIs to guide clinical practice and health service delivery specific to physical therapy. A framework to develop, select, report, and implement QIs is outlined, with total joint arthroplasty rehabilitation as an example. Current initiatives of Canadian and American physical therapy associations to develop tools to help clinicians report and access point-of-care data on patient progress, treatment effectiveness, and practice strengths for the purpose of demonstrating the value of physical therapy to patients, decision makers, and payers are discussed. Suggestions on how physical therapists can participate in QI initiatives and integrate a quality-of-care approach in clinical practice are made. PMID:26089040

Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

PubMed

Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

2014-10-01

The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

Systems biology-based diagnostic principles as pillars of the bridge between Chinese and Western medicine.

PubMed

van der Greef, Jan; van Wietmarschen, Herman; Schroën, Jan; Wang, Mei; Hankemeier, Thomas; Xu, Guowang

2010-12-01

Innovative systems approaches to develop medicine and health care are emerging from the integration of Chinese and Western medicine strategies, philosophies and practices. The two medical systems are highly complementary as the reductionist aspects of Western medicine are favourable in acute disease situations and the holistic aspects of Chinese medicine offer more opportunities in chronic conditions and for prevention. In this article we argue that diagnosis plays a key role in building the bridge between Chinese and Western medicine. Recent advances in the study of health, healing, placebo effects and patient-physician interactions will be discussed pointing out the development of a system-based diagnosis. Especially, a system biology-based diagnosis can be used to capture phenotype information, leading towards a scientific basis for a more refined patient characterization, new diagnostic tools and personalized heath strategies. Subtyping of rheumatoid arthritis patients based on Chinese diagnostic principles is discussed as an example. New insights from this process of integrating Western and Chinese medicine will pave the way for a patient-centred health care ecosystem. © Georg Thieme Verlag KG Stuttgart · New York.

Impact of use of oral anticancer drugs on activity of Italian oncology practices: results of a survey conducted by the Italian Society of Medical Oncology (AIOM).

PubMed

Gori, Stefania; Di Maio, Massimo; Pinto, Carmine; Alabiso, Oscar; Baldini, Editta; Barbato, Enrico; Beretta, Giordano Domenico; Bravi, Stefano; Caffo, Orazio; Canobbio, Luciano; Carrozza, Francesco; Cinieri, Saverio; Cruciani, Giorgio; Dinota, Angelo; Gebbia, Vittorio; Giustini, Lucio; Graiff, Claudio; Molino, Annamaria; Muggiano, Antonio; Pandoli, Giuliano; Puglisi, Fabio; Tagliaferri, Pierosandro; Tomao, Silverio; Lunardi, Gianluigi; Venturini, Marco

2013-01-01

In recent years, the number of oral anticancer drugs used in clinical practice has rapidly increased. The Italian Society of Medical Oncology (AIOM) conducted a survey to describe the impact of the use of oral anticancer drugs on the daily activity of Italian oncology practices. A survey questionnaire was distributed to the coordinators of the regional sections of AIOM. A 6-month period was considered, from January 1, 2010 to June 30, 2010. The survey addressed (1) quantitative aspects of the use of oral anticancer drugs; (2) practical aspects in the management of patients treated with these drugs; (3) issues related to treatment costs and reimbursement procedures. Thirty-six questionnaires were received from institutions distributed throughout the Italian territory. Oral anticancer drugs (both chemotherapy and molecularly targeted agents) accounted for a significant proportion (17%) of prescribed treatments. Among the responding institutions, there were different dispensation procedures of oral drugs to patients: drugs were dispensed by the pharmacist (57%) or directly by the medical oncologist (23%) or nurse (20%). The medical oncologist played a major role in the communication with patients (73% alone and a further 24% in cooperation with other professional figures) and was the point of reference in the event of side effects in 97% of cases. In most cases, the reimbursement of drug costs was separated ("File F" procedure) from the flat fare received by the hospital for outpatient visits or day-hospital access. Optimal organization of oral anticancer treatment warrants the cooperation and integration of multiple professional figures. At least three figures are involved in patient management in the hospital: the medical oncologist, the nurse, and the hospital pharmacist. Oral anticancer treatments are associated with specific reimbursement issues: in the majority of cases, the cost of the drug is reimbursed separately from the cost of patient access.

Very Similar Spacing-Effect Patterns in Very Different Learning/Practice Domains

PubMed Central

Kornmeier, Jürgen; Spitzer, Manfred; Sosic-Vasic, Zrinka

2014-01-01

Temporally distributed (“spaced”) learning can be twice as efficient as massed learning. This “spacing effect” occurs with a broad spectrum of learning materials, with humans of different ages, with non-human vertebrates and also invertebrates. This indicates, that very basic learning mechanisms are at work (“generality”). Although most studies so far focused on very narrow spacing interval ranges, there is some evidence for a non-monotonic behavior of this “spacing effect” (“nonlinearity”) with optimal spacing intervals at different time scales. In the current study we focused both the nonlinearity aspect by using a broad range of spacing intervals and the generality aspect by using very different learning/practice domains: Participants learned German-Japanese word pairs and performed visual acuity tests. For each of six groups we used a different spacing interval between learning/practice units from 7 min to 24 h in logarithmic steps. Memory retention was studied in three consecutive final tests, one, seven and 28 days after the final learning unit. For both the vocabulary learning and visual acuity performance we found a highly significant effect of the factor spacing interval on the final test performance. In the 12 h-spacing-group about 85% of the learned words stayed in memory and nearly all of the visual acuity gain was preserved. In the 24 h-spacing-group, in contrast, only about 33% of the learned words were retained and the visual acuity gain dropped to zero. The very similar patterns of results from the two very different learning/practice domains point to similar underlying mechanisms. Further, our results indicate spacing in the range of 12 hours as optimal. A second peak may be around a spacing interval of 20 min but here the data are less clear. We discuss relations between our results and basic learning at the neuronal level. PMID:24609081

DFT investigation on the electronic structure of Faujasite

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

Popeneciu, Horea; Calborean, Adrian; Tudoran, Cristian

2013-11-13

We report here first-principle pseudopotential DFT calculations to investigate relevant aspects of the electronic structure of zeolites based FAU. Fundamental molecular issues of the band-gap and electronic population analysis were reviewed under GGA/RPBE level of theory, corroborated with a DZP basis set and Troullier-Martins norm conserving pseudo-potentials. The atom-projected density of states and the analysis of HOMO-LUMO frontier orbitals at Gamma point were performed. Their electronic transfers are discussed through the alignment and relative positions of orbitals in order to determine the way that the molecule interacts with adsorbed molecules and other practical applications. Mulliken population analysis was employed formore » describing atomic charge distribution in the chosen systems.« less

[Value(s)].

PubMed

Vanbelle, G

2006-01-01

After a short explanation of the word value, the (cultural) value of teeth, the economic evaluation of dentistry and the payment criteria are being presented. The specific situation of health care as a service which deviates in quite a few aspects from the standard demand-supply model is being pointed out. Attention is drawn to key characteristics of the liberal professions such as the obligation to perform to the best of one's ability, not to a specific result. Function classification appears to offer possibilities for cataloguing the wide variation in practice settings. The well-known wage calculation of Professor De Lembre is being reviewed. Subsequently the analysis of cost variation and induced demand by extra services and profile shaping is being elaborated. Cost-benefit-analysis is the concluding item.

Pleasure, Power, and Inequality: Incorporating Sexuality Into Research on Contraceptive Use

PubMed Central

Hirsch, Jennifer S.

2008-01-01

We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one. Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception. PMID:18703457

Juridical and ethical peculiarities in doping policy.

PubMed

McNamee, Mike J; Tarasti, Lauri

2010-03-01

Criticisms of the ethical justification of antidoping legislation are not uncommon in the literatures of medical ethics, sports ethics and sports medicine. Critics of antidoping point to inconsistencies of principle in the application of legislation and the unjustifiability of ethical postures enshrined in the World Anti-Doping Code, a new version of which came into effect in January 2009. This article explores the arguments concerning the apparent legal peculiarities of antidoping legislation and their ethically salient features in terms of: notions of culpability, liability and guilt; aspects of potential duplication of punishments and the limitations of athlete privacy in antidoping practice and policy. It is noted that tensions still exist between legal and ethical principles and norms that require further critical attention.

Cost-effectiveness analyses: Beauty and the beast?

PubMed

Cutter, Gary R; Wang, Guoqiao

2013-10-01

In this issue of Neurology ® Clinical Practice , Young et al. 1 discuss 5 things to consider in reading a cost-effectiveness or decision analysis study. Such studies are necessary as the medical profession wrestles with caring for patients and paying for that care. The approaches discussed by Young et al. are important to digest as this type of study will be more prevalent as pressures mount in all aspects of clinical and comprehensive care. Young et al. point out the need to interpret the models and understand the meaning of the data presented. Their article provides an excellent summary of the tools and approaches widely used by policymakers and researchers, bringing some systematic evaluation to the pressures of cost vs the benefits of therapy.

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

PubMed

Luther, Vera P; Crandall, Sonia J

2011-07-01

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

[Sleep disturbances and suicidality: relationships and clinical implications].

PubMed

Norra, C; Richter, N

2013-10-01

Besides several risk factors for suicide, there is a recent increase in clinical and epidemiological studies pointing to a potential relationship between sleep loss or sleep disturbances and suicidality. This work, based on a systematic literature research, gives an overview on the findings of relationships between suicidality (i. e., suicidal thoughts, suicide attempts, suicides) and sleep disturbances, especially insomnia, nightmares, but also hypersomnia and nocturnal panic attacks. There is evidence that sleep disturbances in suicidal insomniacs with comorbid psychiatric disorder are independently predictive for suicidality, too. Shared aspects of pathogenesis of the two entities and therapeutic options are also discussed. Recognition of sleep disturbances is essential for suicide prevention in clinical practice. © Georg Thieme Verlag KG Stuttgart · New York.

Enhancing Validity When Researching the "Other": Insights from Pierre Bourdieu's Theory of Social Science Research Practice

ERIC Educational Resources Information Center

Naidoo, Devika

2014-01-01

This article explores aspects of Pierre Bourdieu's theory of social science research practice and discusses their relevance for enhancing validity when researching the "other." Aspects such as: a relational way of thinking about concepts, epistemology and methodology; the rigorous construction of the object of research; and…

Connecting Instructional and Cognitive Aspects of an LE: A Study of the Global Seminar Project

ERIC Educational Resources Information Center

Savelyeva, Tamara

2012-01-01

My research problem is based on the lack of unifying conceptual cohesion between the discourses concerning cognitive and instructional aspects of learning environments (LE). I contrast that lack with practical developments of LE studies connected at the level of practical implementation and evaluation. Next, I briefly review the LE boundaries,…

Gender in clinical neuropsychology: practice survey trends and comparisons outside the specialty.

PubMed

Sweet, Jerry J; Lee, Catherine; Guidotti Breting, Leslie M; Benson, Laura M

2018-02-01

This paper describes gender-related trends within clinical neuropsychology, based primarily on recurrent practice surveys within the specialty and, to a lesser extent, job-related information from medical specialties and the general U.S. labor market. Chronological and cross-sectional analyses of professional practice survey data from 2005, 2010, and 2015 relevant to gender. As is common with survey data, descriptive analysis and independent samples t-tests were conducted. Longitudinal data allowed for examination of gender trends, as well as observations of change and stability of factors associated with gender, over time. Women have become dominant in number in clinical neuropsychology, and also comprise a vast majority of practitioners entering the specialty. Gender differences are noted in professional identity, work status, work settings, types of career satisfaction, and retirement expectations. Women are more likely to identify work environment and personal/family obstacles to aspects of career satisfaction. A gender pay gap was found at all time points and is not narrowing. As is true nationally, multiple factors appear related to the gender pay gap in clinical neuropsychology. Women in neuropsychology are now dominant in number, and their presence is strongly associated with specific practice patterns, such as greater institutional employment, less involvement in forensic practice, and strong involvement in pediatric practice, which may be maintaining the sizeable gender pay gap in neuropsychology. As the proportion of women neuropsychologists continues to increase, flexible work hours, and alternative means of remuneration may be needed to offset current disproportionate family-related responsibilities.

Guidelines for the development of social marketing programmes for sun protection among adolescents and young adults.

PubMed

Johnson, K M; Jones, S C; Iverson, D

2009-09-01

To formulate 'best practice' guidelines for social marketing programmes for adolescents' and young adults' sun protection. A Delphi consensus process. Eleven experts in sun protection and social marketing participated in a Delphi consensus process, where they were asked to provide up to 10 key points, based on their knowledge and practical experience, which they felt were most important in developing social marketing interventions for the primary prevention of skin cancer among adolescents and young adults. After reaching consensus, the evidence base for each guideline was determined and graded via the Scottish Intercollegiate Guideline Network grading system. Participants were then asked to indicate how strongly they rated the finalized 15 recommendations based on all aspects relating to their knowledge and practical opinion, as well as the research evidence, on a visual analogue scale. The resultant 15 guidelines offer general principles for sun protection interventions utilizing a social marketing approach. This method of guideline development brought the expertise of practitioners to the forefront of guideline development, whilst still utilizing established methods of evidence confirmation. It thus offers a useful method for guideline development in a public health context.

Physical Activity Design Guidelines for School Architecture

PubMed Central

Brittin, Jeri; Sorensen, Dina; Trowbridge, Matthew; Lee, Karen K.; Breithecker, Dieter; Frerichs, Leah; Huang, Terry

2015-01-01

Increasing children’s physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students’ physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment’s impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards. PMID:26230850

Commercial Impact and Optimum Capacity Determination of Pumped Storage Hydro Plant for a Practical Power System

NASA Astrophysics Data System (ADS)

Latha, P. G.; Anand, S. R.; Imthias, Ahamed T. P.; Sreejith, P. S., Dr.

2013-06-01

This paper attempts to study the commercial impact of pumped storage hydro plant on the operation of a stressed power system. The paper further attempts to compute the optimum capacity of the pumped storage scheme that can be provided on commercial basis for a practical power system. Unlike the analysis of commercial aspects of pumped storage scheme attempted in several papers, this paper is presented from the point of view of power system management of a practical system considering the impact of the scheme on the economic operation of the system. A realistic case study is presented as the many factors that influence the pumped storage operation vary widely from one system to another. The suitability of pumped storage for the particular generation mix of a system is well explored in the paper. To substantiate the economic impact of pumped storage on the system, the problem is formulated as a short-term hydrothermal scheduling problem involving power purchase which optimizes the quantum of power to be scheduled and the duration of operation. The optimization model is formulated using an algebraic modeling language, AMPL, which is then solved using the advanced MILP solver CPLEX.

Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting.

PubMed

Hanson, C M; Hilde, E

1989-01-01

As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.

Cultures of simulations vs. cultures of calculations? The development of simulation practices in meteorology and astrophysics

NASA Astrophysics Data System (ADS)

Sundberg, Mikaela

While the distinction between theory and experiment is often used to discuss the place of simulation from a philosophical viewpoint, other distinctions are possible from a sociological perspective. Turkle (1995) distinguishes between cultures of calculation and cultures of simulation and relates these cultures to the distinction between modernity and postmodernity, respectively. What can we understand about contemporary simulation practices in science by looking at them from the point of view of these two computer cultures? What new questions does such an analysis raise for further studies? On the basis of two case studies, the present paper compares and discusses simulation activities in astrophysics and meteorology. It argues that simulation practices manifest aspects of both of these cultures simultaneously, but in different situations. By employing the dichotomies surface/depth, play/seriousness, and extreme/reasonable to characterize and operationalize cultures of calculation and cultures of simulation as sensitizing concepts, the analysis shows how simulation code work shifts from development to use, the importance of but also resistance towards too much visualizations, and how simulation modelers play with extreme values, yet also try to achieve reasonable results compared to observations.

Physical Activity Design Guidelines for School Architecture.

PubMed

Brittin, Jeri; Sorensen, Dina; Trowbridge, Matthew; Lee, Karen K; Breithecker, Dieter; Frerichs, Leah; Huang, Terry

2015-01-01

Increasing children's physical activity at school is a national focus in the U.S. to address childhood obesity. While research has demonstrated associations between aspects of school environments and students' physical activity, the literature currently lacks a synthesis of evidence to serve as a practical, spatially-organized resource for school designers and decision-makers, as well as to point to pertinent research opportunities. This paper describes the development of a new practical tool: Physical Activity Design Guidelines for School Architecture. Its aims are to provide architects and designers, as well as school planners, educators, and public health professionals, with strategies for making K-12 school environments conducive to healthy physical activity, and to engage scientists in transdisciplinary perspectives toward improved knowledge of the school environment's impact. We used a qualitative review process to develop evidence-based and theory-driven school design guidelines that promote increased physical activity among students. The design guidelines include specific strategies in 10 school design domains. Implementation of the guidelines is expected to enable students to adopt healthier physical activity behaviors. The tool bridges a translational gap between research and environmental design practice, and may contribute to setting new industry and education standards.

An Interactive Ambulatory Nephrology Curriculum for Internal Medicine Interns: Design, Implementation, and Participant Feedback.

PubMed

Gomez, Alexis C; Warburton, Karen M; Miller, Rachel K; Negoianu, Dan; Cohen, Jordana B

2017-09-01

While diminishing nephrology fellow recruitment is a known issue, more work is needed to evaluate possible interventions to reverse this trend. We designed and implemented a curriculum to increase exposure to ambulatory nephrology among internal medicine interns. The curriculum focused on key aspects of outpatient nephrology practice, including supervised clinic visits, formal themed didactic content, and an online interactive forum with assigned evidence-based readings and small-group responses to relevant cases. We obtained postcourse surveys from all participating interns. Of the 43 interns who took part in the first year of the ambulatory nephrology curriculum, 100% reported a positive didactic experience and 91% reported a positive interactive online experience. 77% reported an improvement in their familiarity with clinical nephrology practice (median 2-point increase in familiarity score on a 7-point scale, P<0.001 by signed rank testing). Qualitative feedback included praise for the high-yield topics covered by the lectures and energizing teachers. In conclusion, we successfully implemented an ambulatory nephrology curriculum using a framework that integrated formal didactics, interactive online learning, and key clinical components of outpatient nephrology care. Future investigation will evaluate whether early implementation of this curriculum is associated with increased pursuit of nephrology as a career. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Buying a Laser - Tips and Pearls

PubMed Central

Aurangabadkar, Sanjeev J; Mysore, Venkataram; Ahmed, E Suhail

2014-01-01

Lasers and aesthetic procedures have transformed dermatology practice. They have aided in the treatment of hitherto untreatable conditions and allowed better financial remuneration to the physician. The availability of a variety of laser devices of different makes, specifications and pricing has lead to confusion and dilemma in the mind of the buying physician. There are presently no guidelines available for buying a laser. Since purchase of a laser involves large investments, careful consideration to laser specifications, training, costing, warranty, availability of spares, and reliability of service are important prerequisites. This article describes various factors that are needed to be considered and also attempts to lay down criteria to be assessed while buying a laser system that will be useful to physicians before investing in a laser machine. Practice points Meticulous planning of the type of machine, specifications, financial aspects, maintenance and warranties is important.It is wise to sign a contract or agreement between the buyer and seller before purchase of a laser which covers key aspects of installation, after sales service and maintenance of the machine.Adequate training is essential; understanding laser physics and laser-tissue interaction goes a long way in getting the best out of the machine.The credibility of the dealer and company should be ascertained in order to be assured of after-sales service.Buying used machines, sharing of equipment to offset high initial investments is a good option but even more care is required to ensure proper functioning and maintenance. PMID:25136218

Benchmarking: applications to transfusion medicine.

PubMed

Apelseth, Torunn Oveland; Molnar, Laura; Arnold, Emmy; Heddle, Nancy M

2012-10-01

Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine-related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal. Copyright © 2012 Elsevier Inc. All rights reserved.

Perineal trauma: prevention and treatment.

PubMed

McCandlish, R

2001-01-01

This article examines two aspects of routine midwifery practice: management of the perineum at the end of the second stage of labor and management and repair of perineal injury. Although some aspects of perineal management and repair have been researched and there is reliable evidence on which to base practice, there remains a considerable and urgent collaborative clinical research agenda that midwives should actively pursue.

Leadership Aspects of Hidden Curriculum Students Practice in Nigerian Universities: A Preview of Students' Union Government Contributions in University Governance

ERIC Educational Resources Information Center

Emesini, Nnenna Orieoma

2016-01-01

The paper examined the leadership aspect of Hidden Curriculum that students practice in Nigerian Universities and their contributions to university governance. Four research questions guided the study and Ex-Post-Facto Method was adopted as the design. Unstructured interviews with staff/students officials cum critical analysis of Students' Union…

Photogrammetric DSM denoising

NASA Astrophysics Data System (ADS)

Nex, F.; Gerke, M.

2014-08-01

Image matching techniques can nowadays provide very dense point clouds and they are often considered a valid alternative to LiDAR point cloud. However, photogrammetric point clouds are often characterized by a higher level of random noise compared to LiDAR data and by the presence of large outliers. These problems constitute a limitation in the practical use of photogrammetric data for many applications but an effective way to enhance the generated point cloud has still to be found. In this paper we concentrate on the restoration of Digital Surface Models (DSM), computed from dense image matching point clouds. A photogrammetric DSM, i.e. a 2.5D representation of the surface is still one of the major products derived from point clouds. Four different algorithms devoted to DSM denoising are presented: a standard median filter approach, a bilateral filter, a variational approach (TGV: Total Generalized Variation), as well as a newly developed algorithm, which is embedded into a Markov Random Field (MRF) framework and optimized through graph-cuts. The ability of each algorithm to recover the original DSM has been quantitatively evaluated. To do that, a synthetic DSM has been generated and different typologies of noise have been added to mimic the typical errors of photogrammetric DSMs. The evaluation reveals that standard filters like median and edge preserving smoothing through a bilateral filter approach cannot sufficiently remove typical errors occurring in a photogrammetric DSM. The TGV-based approach much better removes random noise, but large areas with outliers still remain. Our own method which explicitly models the degradation properties of those DSM outperforms the others in all aspects.

Surgical innovation: the ethical agenda: A systematic review.

PubMed

Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

2016-06-01

The aim of the present article was to systematically review the ethics of surgical innovation and introduce the components of the learning health care system to guide future research and debate on surgical innovation.Although the call for evidence-based practice in surgery is increasingly high on the agenda, most surgeons feel that the format of the randomized controlled trial is not suitable for surgery. Innovation in surgery has aspects of, but should be distinguished from both research and clinical care and raises its own ethical challenges.To answer the question "What are the main ethical aspects of surgical innovation?", we systematically searched PubMed and Embase. Papers expressing an opinion, point of view, or position were included, that is, normative ethical papers.We included 59 studies discussing ethical aspects of surgical innovation. These studies discussed 4 major themes: oversight, informed consent, learning curve, and vulnerable patient groups. Although all papers addressed the ethical challenges raised by surgical innovation, surgeons hold no uniform view of surgical innovation, and there is no agreement on the distinction between innovation and research. Even though most agree to some sort of oversight, they offer different alternatives ranging from the formation of new surgical innovation committees to establishing national registries. Most agree that informed consent is necessary for innovative procedures and that surgeons should be adequately trained to assure their competence to tackle the learning curve problem. All papers agree that in case of vulnerable patients, alternatives must be found for the informed consent procedure.We suggest that the concept of the learning health care system might provide guidance for thinking about surgical innovation. The underlying rationale of the learning health care system is to improve the quality of health care by embedding research within clinical care. Two aspects of a learning health care system might particularly enrich the necessary future discussion on surgical innovation: integration of research and practice and a moral emphasis on "learning activities." Future research should evaluate whether the learning health care system and its adjacent moral framework provides ethical guidance for evidence-based surgery.

49 CFR 236.783 - Point, stop-indication.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION... roadway signals, a point where a signal displaying an aspect requiring a stop would be located. ...

Utilizing research in practice and generating evidence from practice.

PubMed

Learmonth, A M

2000-12-01

This paper gives an overview of evidence-based practice in health promotion, with reference mainly to the National Health Service (NHS) context within the UK, but with wider international relevance. It starts by looking at the tensions raised at the interface of the two activities of research and health promotion. It goes on to explore two aspects of evidence-based practice: incorporating research evidence into health promotion activity and developing robustly evaluated practice in such a way as to feed the developing research agenda. Each of these two aspects is explored using a specific example, from within the UK. Finally, the paper goes on to make eight recommendations that taken together would help create an iterative process contributing to the development of health promotion theory and practice.

Consensus on surgical aspects of managing osteomyelitis in the diabetic foot

PubMed Central

Allahabadi, Sachin; Haroun, Kareem B.; Musher, Daniel M.; Lipsky, Benjamin A.; Barshes, Neal R.

2016-01-01

Background The aim of this study was to develop consensus statements that may help share or even establish ‘best practices’ in the surgical aspects of managing diabetic foot osteomyelitis (DFO) that can be applied in appropriate clinical situations pending the publication of more high-quality data. Methods We asked 14 panelists with expertise in DFO management to participate. Delphi methodology was used to develop consensus statements. First, a questionnaire elicited practices and beliefs concerning various aspects of the surgical management of DFO. Thereafter, we constructed 63 statements for analysis and, using a nine-point Likert scale, asked the panelists to indicate the extent to which they agreed or disagreed with the statements. We defined consensus as a mean score of greater than 7.0. Results The panelists reached consensus on 38 items after three rounds. Among these, seven provide guidance on initial diagnosis of DFO and selection of patients for surgical management. Another 15 statements provide guidance on specific aspects of operative management, including the timing of operations and the type of specimens to be obtained. Ten statements provide guidance on postoperative management, including wound closure and offloading, and six statements summarize the panelists’ agreement on general principles for surgical management of DFO. Conclusions Consensus statement on the perioperative management of DFO were formed with an expert panel comprised of a variety of surgical specialties. We believe these statements may serve as ‘best practice’ guidelines until properly performed studies provide more robust evidence to support or refute specific surgical management steps in DFO. PMID:27414481

Individual Differences in Social, Cognitive, and Morphological Aspects of Infant Pointing

ERIC Educational Resources Information Center

Liszkowski, Ulf; Tomasello, Michael

2011-01-01

Little is known about the origins of the pointing gesture. We sought to gain insight into its emergence by investigating individual differences in the pointing of 12-month-old infants in two ways. First, we looked at differences in the communicative and interactional uses of pointing and asked how different hand shapes relate to point frequency,…

A practical grinding-assisted dry synthesis of nanocrystalline NiMoO{sub 4} polymorphs for oxidative dehydrogenation of propane

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

Chen Miao, E-mail: chenmiao@sinochem.com; Zhejiang Chemical Industry Research Institute, Hangzhou 310023; Wu Jialing

2011-12-15

A practical two-stage reactive grinding-assisted pathway waste-free and cost-effective for the synthesis of NiMoO{sub 4} has been successfully developed. It was demonstrated that proper design in synthetic strategy for grinding plays a crucial role in determining the ultimate polymorph of NiMoO{sub 4}. Specifically, direct grinding (DG) of MoO{sub 3} and NiO rendered {alpha}-NiMoO{sub 4} after annealing, whereas sequential grinding (SG) of the two independently pre-ground oxides followed by annealing generated {beta}-NiMoO{sub 4} solid solution. Characterizations in terms of Raman and X-ray diffraction suggest the creation of {beta}-NiMoO{sub 4} precursor in the latter alternative is the key aspect for the formationmore » of {beta}-NiMoO{sub 4}. The DG-derived {alpha}-NiMoO{sub 4} tested by oxidative dehydrogenation of propane exhibited superior activity in contrast to its analog synthesized via conventional coprecipitation. It is suggested that the favorable chemical composition facilely obtained via grinding in contrast to that by coprecipitation was essential for achieving a more selective production of propylene. - Graphical Abstract: Grinding-assisted synthesis of NiMoO{sub 4} offers higher and more reproducible activities in contrast to coprecipitation for oxidative dehydrogenation of propane, and both {alpha}- and {beta}-NiMoO{sub 4} can be synthesized. Highlights: Black-Right-Pointing-Pointer NiMoO{sub 4} was prepared through grinding-assisted pathway. Black-Right-Pointing-Pointer Direct/sequential grinding rendered {alpha}-, {beta}-NiMoO{sub 4}, respectively. Black-Right-Pointing-Pointer Grinding-derived {alpha}-NiMoO{sub 4} showed high and reproducible activity for oxidative dehydrogenation of propane.« less

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Inviting Queer Ideas into the Science Classroom: Studying Sexuality Education from a Queer Perspective

ERIC Educational Resources Information Center

Lundin, Mattias

2014-01-01

Science education has been pointed out as fact-based and built on reliable knowledge. Nevertheless, there are areas that include other aspects. Sexual education is, according to the Swedish syllabus, such an example and it involves aspects as love, sexuality and relations. These aspects suggest a possible tension between the biological and…

From bed to bench: bridging from informatics practice to theory: an exploratory analysis.

PubMed

Haux, R; Lehmann, C U

2014-01-01

In 2009, Applied Clinical Informatics (ACI)--focused on applications in clinical informatics--was launched as a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of the International Medical Informatics Association. To explore which congruencies and interdependencies exist in publications from theory to practice and from practice to theory and to determine existing gaps. Major topics discussed in ACI and MIM were analyzed. We explored if the intention of publishing companion journals to provide an information bridge from informatics theory to informatics practice and vice versa could be supported by this model. In this manuscript we will report on congruencies and interdependences from practice to theory and on major topics in MIM. Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 were indexed and analyzed. Hundred and ninety-six publications were analyzed (ACI 87, MIM 109). In MIM publications, modelling aspects as well as methodological and evaluation approaches for the analysis of data, information, and knowledge in biomedicine and health care were frequently raised - and often discussed from an interdisciplinary point of view. Important themes were ambient-assisted living, anatomic spatial relations, biomedical informatics as scientific discipline, boosting, coding, computerized physician order entry, data analysis, grid and cloud computing, health care systems and services, health-enabling technologies, health information search, health information systems, imaging, knowledge-based decision support, patient records, signal analysis, and web science. Congruencies between journals could be found in themes, but with a different focus on content. Interdependencies from practice to theory, found in these publications, were only limited. Bridging from informatics theory to practice and vice versa remains a major component of successful research and practice as well as a major challenge.

Veterinary public health in a problem-based learning curriculum at the Western University of Health Sciences.

PubMed

Schmidt, Peggy L; Trevejo, Rosalie T; Tkalcic, Suzana

2008-01-01

As detailed in the Association of Schools of Public Health / Association of American Veterinary Medical Colleges 2007 Joint Symposium on Veterinary Public Health, veterinary public health (VPH) can no longer be viewed as a unique sub-specialty of veterinary medicine. Rather, its practice pervades nearly every aspect of the veterinary profession, regardless of whether the practitioner is engaged in small-animal, large-animal, research, corporate, or military practice. In congruence with the practice of VPH, the teaching of VPH should also pervade nearly every aspect of veterinary education. Accordingly, at Western University of Health Sciences, College of Veterinary Medicine (WU-CVM), public health is not simply taught as an individual course but, rather, is interwoven into almost every aspect of the curriculum, continually emphasizing the relevance of this discipline to the practice of veterinary medicine. This article outlines the teaching philosophy of WU-CVM, provides an overview of the curriculum, and describes the integral nature of public health throughout all four years of the educational program.

Orientations to Reflective Practice.

ERIC Educational Resources Information Center

Wellington, Bud; Austin, Patricia

1996-01-01

Delineates five orientations to reflective practice: immediate, technical, deliberative, dialectic, and transpersonal, each reflecting different social science bases and beliefs and values about education. Views them as interactive, interdependent, noncompeting, aspects of reflective practice. (SK)

21 CFR 26.19 - Information relating to quality aspects.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Information relating to quality aspects. 26.19... relating to quality aspects. The authorities will establish an appropriate means of exchanging information... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM...

21 CFR 26.19 - Information relating to quality aspects.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Information relating to quality aspects. 26.19... relating to quality aspects. The authorities will establish an appropriate means of exchanging information... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM...

21 CFR 26.19 - Information relating to quality aspects.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Information relating to quality aspects. 26.19... relating to quality aspects. The authorities will establish an appropriate means of exchanging information... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM...

21 CFR 26.19 - Information relating to quality aspects.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Information relating to quality aspects. 26.19... relating to quality aspects. The authorities will establish an appropriate means of exchanging information... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM...

Lensing of the CMB: non-Gaussian aspects.

PubMed

Zaldarriaga, M

2001-06-01

We compute the small angle limit of the three- and four-point function of the cosmic microwave background (CMB) temperature induced by the gravitational lensing effect by the large-scale structure of the universe. We relate the non-Gaussian aspects presented in this paper with those in our previous studies of the lensing effects. We interpret the statistics proposed in previous work in terms of different configurations of the four-point function and show how they relate to the statistic that maximizes the S/N.

Economic Statistical Design of Integrated X-bar-S Control Chart with Preventive Maintenance and General Failure Distribution

PubMed Central

Caballero Morales, Santiago Omar

2013-01-01

The application of Preventive Maintenance (PM) and Statistical Process Control (SPC) are important practices to achieve high product quality, small frequency of failures, and cost reduction in a production process. However there are some points that have not been explored in depth about its joint application. First, most SPC is performed with the X-bar control chart which does not fully consider the variability of the production process. Second, many studies of design of control charts consider just the economic aspect while statistical restrictions must be considered to achieve charts with low probabilities of false detection of failures. Third, the effect of PM on processes with different failure probability distributions has not been studied. Hence, this paper covers these points, presenting the Economic Statistical Design (ESD) of joint X-bar-S control charts with a cost model that integrates PM with general failure distribution. Experiments showed statistically significant reductions in costs when PM is performed on processes with high failure rates and reductions in the sampling frequency of units for testing under SPC. PMID:23527082

Radical constructivism: Between realism and solipsism

NASA Astrophysics Data System (ADS)

Martínez-Delgado, Alberto

2002-11-01

This paper criticizes radical constructivism of the Glasersfeld type, pointing out some contradictions between the declared radical principles and their theoretical and practical development. These contradictions manifest themselves in a frequent oscillation between solipsism and realism, despite constructivist claims to be an anti-realist theory. The paper also points out the contradiction between the relativism of the radical constructivist principles and the constructivist exclusion of other epistemological or educational paradigms. It also disputes the originality and importance of the radical constructivist paradigm, suggesting the idea of an isomorphism between radical constructivist theory and contemplative realism. In addition, some pedagogical and scientific methodological aspects of the radical constructivist model are examined. Although radical constructivism claims to be a rational theory and advocates deductive thinking, it is argued that there is no logical deductive connection between the radical principles of constructivism and the radical constructivist ideas about scientific research and learning. The paper suggests the possibility of an ideological substratum in the construction and hegemonic success of subjective constructivism and, finally, briefly advances an alternative realist model to epistemological and educational radical constructivism.

Aristotelian Physics in the Context of Teaching Science: A Historical-Philosophical Approach

NASA Astrophysics Data System (ADS)

Lombardi, Olimpia

Nowadays in the community of researchers there is a practically unanimous consensus about the relevance of the history of science to the educational process. In this context, Aristotelian physics was rediscovered and reassessed for didactic purposes. But unfortunately, it is very often presented in a rather fragmentary and oversimplified way that distorts the true meaning of Aristotelian concepts. Facing this problem, the purpose of the present paper is to point out some blunders that originate in the partial reading of Aristotle's work. Particularly, it intends to contribute to the following points: (i) to warn against a hurried identification of pre-scientific notions and Aristotelian physical concepts; (ii) to promote an epistemologically not naïve and historiographically not anachronic interpretation of Aristotle's work on physics, both in the theoretical and in the methodological aspects; (iii) to warn against the interpretative confusion that arises from projecting the conceptual frame of contemporary science on Aristotelian physics, ignoring Aristotle's natural philosophy as a whole; (iv) to show the need of understanding the metaphysical foundations of the Aristotelian system; (v) to promote a return to the reading of the original texts.

A universal data access and protocol integration mechanism for smart home

NASA Astrophysics Data System (ADS)

Shao, Pengfei; Yang, Qi; Zhang, Xuan

2013-03-01

With the lack of standardized or completely missing communication interfaces in home electronics, there is no perfect solution to address every aspect in smart homes based on existing protocols and technologies. In addition, the central control unit (CCU) of smart home system working point-to-point between the multiple application interfaces and the underlying hardware interfaces leads to its complicated architecture and unpleasant performance. A flexible data access and protocol integration mechanism is required. The current paper offers a universal, comprehensive data access and protocol integration mechanism for a smart home. The universal mechanism works as a middleware adapter with unified agreements of the communication interfaces and protocols, offers an abstraction of the application level from the hardware specific and decoupling the hardware interface modules from the application level. Further abstraction for the application interfaces and the underlying hardware interfaces are executed based on adaption layer to provide unified interfaces for more flexible user applications and hardware protocol integration. This new universal mechanism fundamentally changes the architecture of the smart home and in some way meets the practical requirement of smart homes more flexible and desirable.

Monitoring clinical standards in a chronic peritoneal dialysis program.

PubMed

Leung, Dora K C

2009-02-01

Multiple factors may influence the effectiveness of a chronic peritoneal dialysis program. Continuous monitoring of various aspects of clinical standards with reviews enhances opportunities for bridging the gap between existing practice and good practice, and good practice to best practice.

Mobilising Open Access to Research Data: Recommendations from the RECODE project

NASA Astrophysics Data System (ADS)

Finn, Rachel; Sveinsdottir, Thordis

2015-04-01

This paper will introduce the findings and policy recommendations from the FP7 project RECODE (Policy RECommendations for Open Access to Research Data in Europe) which aims to leverage existing networks, communities and projects to address challenges within the open access and data dissemination and preservation sector. We will introduce the key recommendations, which provide solutions relevant to opening access to PSI. The project is built on case study research of five scientific disciplines with the aim of recognizing and working with disciplinary fragmentation associated with open access to research data. The RECODE findings revealed that the mobilisation of open access to research data requires a partnership approach for developing a coherent and flexible ecosystem that is easy and transparent to embed in research practice and process. As such, the development of open access to research data needs to be: • Informed by research practices and processes in different fields • Supported by an integrated institutional and technological data infrastructure and guided by ethical and regulatory frameworks • Underpinned by infrastructure and guiding frameworks that allow for differences in disciplinary research and data management practices • Characterised by a partnership approach involving the key stakeholders, researchers, and institutions The proposed presentation will examine each of these aspects in detail and use information and good practices from the RECODE project to consider how stakeholders within the PSI movement might action each of these points. It will also highlight areas where RECODE findings and good practice recommendations have clear relevance for the PSI sector.

Traditional practices, beliefs and uses of medicinal plants in relation to maternal-baby health of Criollo woman in central Argentina.

PubMed

Martínez, Gustavo J

2008-12-01

to present information on traditional practices and medicinal uses of plants for treating health diseases related to the reproductive cycle of Criollo women living in the hills of the province of Córdoba; and to interpret these uses in the context of this population's folk medicine. data were collected during several field trips to the study area based on the guidelines of a research project that included ethnographic and ethnobotanical aspects of the study area. a rural community of central Argentina. a total of 62 peasants were interviewed on the basis of a semi-structured system. Repeated open and extensive interviews were also undertaken with seven women who had previously worked as midwives in areas of difficult access. this study found that 12 different female diseases and complaints are treated using a total of 48 plant species belonging to 27 botanical families, with 71 different medicinal uses. The traditional beliefs and practices associated with maternal-baby health care in rural areas highlights the existing combination of principles reformulated from humoral medicine, the use of analogical reasoning, and ontological and functional interpretations of morbid processes. The principle of Hypocratical opposition and hot-cold categorisation are significant criteria that rule over the practices of mother and child health care during birth and puerperium. consequences of traditional knowledge on the health care of peasant women are discussed, based on the analysis of traditional practices from a peasant's point of view.

The contemporary mindfulness movement and the question of nonself1.

PubMed

Samuel, Geoffrey

2015-08-01

Mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and other "mindfulness"-based techniques have rapidly gained a significant presence within contemporary society. Clearly these techniques, which derive or are claimed to derive from Buddhist meditational practices, meet genuine human needs. However, questions are increasingly raised regarding what these techniques meant in their original context(s), how they have been transformed in relation to their new Western and global field of activity, what might have been lost (or gained) on the way, and how the entire contemporary mindfulness phenomenon might be understood. The article points out that first-generation mindfulness practices, such as MBSR and MBCT, derive from modernist versions of Buddhism, and omit or minimize key aspects of the Buddhist tradition, including the central Buddhist philosophical emphasis on the deconstruction of the self. Nonself (or no self) fits poorly into the contemporary therapeutic context, but is at the core of the Buddhist enterprise from which contemporary "mindfulness" has been abstracted. Instead of focussing narrowly on the practical efficacy of the first generation of mindfulness techniques, we might see them as an invitation to explore the much wider range of practices available in the traditions from which they originate. Rather, too, than simplifying and reducing these practices to fit current Western conceptions of knowledge, we might seek to incorporate more of their philosophical basis into our Western adaptations. This might lead to a genuine and productive expansion of both scientific knowledge and therapeutic possibilities. © The Author(s) 2014.

Synchronistic mind-matter correlations in therapeutic practice: a commentary on Connolly (2015).

PubMed

Atmanspacher, Harald; Fach, Wolfgang

2016-02-01

This commentary adds some ideas and refinements to the inspiring discussion in a recent paper by Connolly () that makes use of a dual-aspect framework developed by us earlier. One key point is that exceptional experiences (of which synchronicities are a special case) cannot in general be identified with experiences of non-categorial or acategorial mental states. In fact, most exceptional experiences reported in the literature are experiences of categorial states. Conversely, there are non-categorial and acategorial states whose experience is not exceptional. Moreover, the psychodynamics of a synchronistic experience contain a subtle mesh of interacting processes pertaining to categorial, non-categorial and acategorial domains. We outline how this mesh may be addressed in particular cases of synchronicity described by Connolly. © 2016, The Society of Analytical Psychology.

Are we paying too much attention to cardio-pulmonary nematodes and neglecting old-fashioned worms like Trichuris vulpis?

PubMed

Traversa, Donato

2011-03-08

Trichuris vulpis, the dog whipworm, causes an intestinal parasitosis of relevance in current canine veterinary practice. Its occurrence is well-known in pets, kennelled dogs and stray animals, and its eggs contaminate the ground in urban areas all over the world. Moreover, T. vulpis has been occasionally incriminated, though not convincingly substantiated, as a cause of zoonosis. This nematode is erroneously considered an "old-fashioned" pathogen with a consequent lack of up- to- date knowledge on several aspects of the infection. These, in turn, are still controversial and need to be studied in greater depth. This article reviews current knowledge of T. vulpis, together with a discussion of critical points in epidemiology, zoonotic hazard, diagnosis and treatment of canine trichurosis.

Are we paying too much attention to cardio-pulmonary nematodes and neglecting old-fashioned worms like Trichuris vulpis?

PubMed Central

2011-01-01

Trichuris vulpis, the dog whipworm, causes an intestinal parasitosis of relevance in current canine veterinary practice. Its occurrence is well-known in pets, kennelled dogs and stray animals, and its eggs contaminate the ground in urban areas all over the world. Moreover, T. vulpis has been occasionally incriminated, though not convincingly substantiated, as a cause of zoonosis. This nematode is erroneously considered an "old-fashioned" pathogen with a consequent lack of up- to- date knowledge on several aspects of the infection. These, in turn, are still controversial and need to be studied in greater depth. This article reviews current knowledge of T. vulpis, together with a discussion of critical points in epidemiology, zoonotic hazard, diagnosis and treatment of canine trichurosis. PMID:21385441

Optimization of thermoelectric performance of SrSi2-based alloys via the modification in band structure and phonon-point-defect scattering

PubMed Central

Kuo, Yung-Kang; Ramachandran, Balakrishnan; Lue, Chin-Shan

2014-01-01

Thermoelectric properties of alkaline-earth-metal disilicides are strongly dependent on their electronic band structure in the vicinity of the Fermi level. In particular, the strontium disilicide, SrSi2 with a narrow band gap of about few tens of meV is composed of non-toxic, naturally abundant elements, and its thermoelectric properties are very sensitive to the substitution/alloying with third elements. In this article, we summarize the thermoelectric performance of substituted and Sr-deficient/Sr-rich SrSi2 alloys to realize the high thermoelectric figure-of-merit (ZT) for practical applications in the electronic and thermoelectric aspects, and also to explore the alternative routes to further improve its ZT value. PMID:25505784

A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.

PubMed

Chenneville, Tiffany; Menezes, Lynette; Kosambiya, Jayendrakumar; Baxi, Rajendra

2016-12-01

Assessing the resources and functioning of research ethics committees (RECs) in low-resource settings poses many challenges. We conducted a case study of two medical college RECs (A and B) in Western India utilizing the Research Ethics Committee Quality Assurance Self-Assessment Tool (RECQASAT) as well as in-depth interviews with representative members to evaluate REC effectiveness. REC A and B obtained 62% and 67% of allowable points on the RECQASAT. These scores together with findings from the in-depth interviews suggest the need for significant improvement in REC effectiveness particularly in the areas of membership and educational training, organizational aspects, recording minutes, communicating decisions, and REC resources. Developing evidence-based best practices and strengthening infrastructure are essential to enhancing REC efficacy in low-resource countries.

A Spiral of Transitions Leading to Broader Influence and Action.

PubMed

Benton, David C

This article describes lessons learned through a reflective analysis of job transitions experienced by a registered nurse from the time of entry into the profession until the current point where the nurse is engaged in state, national, and international policy development work. The centrality and symbiotic nature of the link between policy and practice and the importance of evidence and leadership have emerged as key aspects of the expanding spiral of influence traversed as a result of various career moves. At every stage, lessons have been learned. Some of these are professional in nature, but on occasion, the lessons have been more personal. The importance of mentors cannot be underestimated in terms of the support and guidance they offer but also the challenges they bring to existing patterns of thought and behavior.

Modulation Index Adjustment for Recovery of Pure Wavelength Modulation Spectroscopy Second Harmonic Signal Waveforms.

PubMed

Wei, Wei; Chang, Jun; Wang, Qiang; Qin, Zengguang

2017-01-15

A new technique of modulation index adjustment for pure wavelength modulation spectroscopy second harmonic signal waveforms recovery is presented. As the modulation index is a key parameter in determining the exact form of the signals generated by the technique of wavelength modulation spectroscopy, the method of modulation index adjustment is applied to recover the second harmonic signal with wavelength modulation spectroscopy. By comparing the measured profile with the theoretical profile by calculation, the relationship between the modulation index and average quantities of the scanning wavelength can be obtained. Furthermore, when the relationship is applied in the experimental setup by point-by-point modulation index modification for gas detection, the results show good agreement with the theoretical profile and signal waveform distortion (such as the amplitude modulation effect caused by diode laser) can be suppressed. Besides, the method of modulation index adjustment can be used in many other aspects which involve profile improvement. In practical applications, when the amplitude modulation effect can be neglected and the stability of the detection system is limited by the sampling rate of analog-to-digital, modulation index adjustment can be used to improve detection into softer inflection points and solve the insufficient sampling problem. As a result, measurement stability is improved by 40%.

Opening new institutional spaces for grappling with uncertainty: A constructivist perspective

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

Duncan, Ronlyn, E-mail: Ronlyn.Duncan@lincoln.ac.nz

In the context of an increasing reliance on predictive computer simulation models to calculate potential project impacts, it has become common practice in impact assessment (IA) to call on proponents to disclose uncertainties in assumptions and conclusions assembled in support of a development project. Understandably, it is assumed that such disclosures lead to greater scrutiny and better policy decisions. This paper questions this assumption. Drawing on constructivist theories of knowledge and an analysis of the role of narratives in managing uncertainty, I argue that the disclosure of uncertainty can obscure as much as it reveals about the impacts of amore » development project. It is proposed that the opening up of institutional spaces that can facilitate the negotiation and deliberation of foundational assumptions and parameters that feed into predictive models could engender greater legitimacy and credibility for IA outcomes. - Highlights: Black-Right-Pointing-Pointer A reliance on supposedly objective disclosure is unreliable in the predictive model context in which IA is now embedded. Black-Right-Pointing-Pointer A reliance on disclosure runs the risk of reductionism and leaves unexamined the social-interactive aspects of uncertainty. Black-Right-Pointing-Pointer Opening new institutional spaces could facilitate deliberation on foundational predictive model assumptions.« less

Modulation Index Adjustment for Recovery of Pure Wavelength Modulation Spectroscopy Second Harmonic Signal Waveforms

PubMed Central

Wei, Wei; Chang, Jun; Wang, Qiang; Qin, Zengguang

2017-01-01

A new technique of modulation index adjustment for pure wavelength modulation spectroscopy second harmonic signal waveforms recovery is presented. As the modulation index is a key parameter in determining the exact form of the signals generated by the technique of wavelength modulation spectroscopy, the method of modulation index adjustment is applied to recover the second harmonic signal with wavelength modulation spectroscopy. By comparing the measured profile with the theoretical profile by calculation, the relationship between the modulation index and average quantities of the scanning wavelength can be obtained. Furthermore, when the relationship is applied in the experimental setup by point-by-point modulation index modification for gas detection, the results show good agreement with the theoretical profile and signal waveform distortion (such as the amplitude modulation effect caused by diode laser) can be suppressed. Besides, the method of modulation index adjustment can be used in many other aspects which involve profile improvement. In practical applications, when the amplitude modulation effect can be neglected and the stability of the detection system is limited by the sampling rate of analog-to-digital, modulation index adjustment can be used to improve detection into softer inflection points and solve the insufficient sampling problem. As a result, measurement stability is improved by 40%. PMID:28098842

Secondary science teachers' use of laboratory activities: Linking epistemological beliefs, goals, and practices

NASA Astrophysics Data System (ADS)

Kang, Nam-Hwa; Wallace, Carolyn S.

2005-01-01

The purpose of this study was to explore how science teachers' epistemological beliefs and teaching goals are related to their use of lab activities. Research questions include (a) What are the teachers' epistemological beliefs pertaining to lab activities? (b) Why do the science teachers use lab activities? (c) How are the teachers' epistemological beliefs and instructional goals related to teaching actions? Two major aspects of epistemologies guided this study: ontological aspect (certainty/diversity of truth) and relational aspect (relationship between the knower and the known). The ontological aspect addresses whether one views knowledge as one certain truth or as tentative multiple truths. The relational aspect addresses whether one views him/herself as a receiver of prescribed knowledge separating self from knowledge construction or as an active meaning maker connecting self to the knowledge construction processes. More sophisticated epistemological beliefs include the acknowledgement of multiple interpretations of the same phenomena and active role of the knower in knowledge construction. Three experienced secondary science teachers were interviewed and observed throughout an academic course. The findings illustrate that a teacher's naïve epistemological beliefs are clearly reflected in the teacher's teaching practices. However, a teacher's sophisticated epistemological beliefs are not always clearly connected to the practice. This seems to be related to the necessary negotiation among their epistemological beliefs, teaching contexts, and instructional goals. Ontological and relational beliefs seem to be connected to different facets of teaching practices. Findings indicate that various syntheses of different aspects of epistemological beliefs and instructional goals are linked to teachers' diverse ways of using lab activities. Implications for research and teacher education are discussed.

Things you never thought of that make a difference: personal goals, common sense, and good behavior in practice.

PubMed

Watson, J Tracy

2011-12-01

There are many aspects of your practice that you never think of when you first get into your new practice environment. You have spent the better part of your life training in a rigorous surgical residency and possibly fellowship. You have worked hard to get to this station in life. Because of your training and the obvious fact that you are a hard-driving individual, there are certain subtleties to a successful practice that you might have overlooked or never thought about during your training years. In many ways, it is the "little things" that you never learned or never thought of that will affect your overall long-term practice success, personal happiness, and relationships the most. This article reviews aspects of practice that at first glance are merely good common sense.

‘Toning’ up hypotonia assessment: A proposal and critique

PubMed Central

Joubert, Robin W.E.

2016-01-01

Background Clinical assessment of hypotonia is challenging due to the subjective nature of the initial clinical evaluation. This poses dilemmas for practitioners in gaining accuracy, given that the presentation of hypotonia can be either a non-threatening or malevolent sign. The research question posed was how clinical assessment can be improved, given the current contentions expressed in the scientific literature. Objectives This paper describes the development and critique of a clinical algorithm to aid the assessment of hypotonia. Methods An initial exploratory sequential phase, consisting of a systematic review, a survey amongst clinicians and a Delphi process, assisted in the development of the algorithm, which is presented within the framework of the International Classification of Functioning, Disability and Health. The ensuing critique followed a qualitative emergent–systematic focus group design with a purposive sample of 59 clinicians. Data were analysed using semantical content analysis and are presented thematically with analytical considerations. Results This study culminated in the development of an evidence-based clinical algorithm for practice. The qualitative critique of the algorithm considered aspects such as inadequacies, misconceptions and omissions; strengths; clinical use; resource implications; and recommendations. Conclusions The first prototype and critique of a clinical algorithm to assist the clinical assessment of hypotonia in children has been described. Barriers highlighted include aspects related to knowledge gaps of clinicians, issues around user-friendliness and formatting concerns. Strengths identified by the critique included aspects related to the evidence-based nature of the criteria within the algorithm, the suitability of the algorithm in being merged or extending current practice, the potential of the algorithm in aiding more accurate decision-making, the suitability of the algorithm across age groups and the logical flow. These findings provide a starting point towards ascertaining the clinical utility of the algorithm as an essential step towards evidence-based praxis. PMID:28730054

[A review of measures taken to improve organizational wellbeing in Italy].

PubMed

Bentivenga, Rosina; Deitinger, Patrizia; Ghelli, Monica

2014-01-01

The Italian Decree Law D. Lgs. no. 81 dated 9 April 2008, dealing with the implementation of Article 1 of Law No. 123 dated 3 August 2007, on the topic of health and safety in the workplace, indicated that work-related stress (art. 28, section 1) was to be assessed in accordance with the European Agreement of 8 October 2004. It recalled the employer's legal obligation to safeguard workers' health and safety, and included psychosocial risk, in order to improve their wellbeing at work. The Decree Law specified that when risks had been assessed the employer could take all necessary measures, with reference to the "good practice", defined in the Law as organizational or procedural solutions coherent with current regulations and good technical rules, adopted voluntarily with the aim of promoting safety and health in the workplace by reducing risk and improving working conditions [...]" (art. 2, section 1 v); the practical solutions identified were to aim at eliminating, or at least reducing, psychosocial risk in the enterprise. On the basis of the studies most widely accepted in Europe and the indications issued by the European Agency for Safety and Health at Work, we identified the good practice measures adopted by companies in Italy and other countries. The aim was to make known some of the practical solutions regarding psychosocial risk that companies can put in place with a view to improving their workers' health and wellbeing. We examined measures related to the content and context of work. Measures affecting the work content mainly involved the workplace itself and equipment, work planning and working hours. For the work context the measures centered mostly on organizational function and culture, career progress, and home/work interface. In accordance with good safety practice, the practical measures taken by the enterprises examined cantered on some potentially stressful features of work, indicating the growing attention being paid to workers' wellbeing. However, organizational wellbeing is a multifaceted concept and the European Agency points out that measures taken must cover all the aspects of the work that appear particularly critical in risk assessment; from the primary prevention viewpoint, this means all the organizational aspects that might affect a person's wellbeing. As we become increasingly aware of the problems, and of the measures that have proved successful, it is to be hoped that further solutions will be identified and developed in organizations.

Psychological Aspects of Genetic Approach to Teaching Mathematics

ERIC Educational Resources Information Center

Safuanov, Ildar S.

2004-01-01

In this theoretical essay the psychological aspects of genetic approach to teaching mathematics (mainly at universities) are discussed. Analysis of the history and modern state of genetic teaching shows that its psychological aspects may be explained using both Vygotskian and Piagetian frameworks. Experience of practice of mathematical education…

Strengthening care teams to improve adherence in cystic fibrosis: a qualitative practice assessment and quality improvement initiative.

PubMed

Gardner, Allison J; Gray, Alice L; Self, Staci; Wagener, Jeffrey S

2017-01-01

Treatment regimens for patients with cystic fibrosis (CF) are complex, time consuming, and burdensome, and adherence to CF treatment is suboptimal. CF care teams play a critical role in supporting patients' chronic self-management skills, but there is no uniform method for assessing patients' adherence to treatment or standard interventions to help patients improve when necessary. Between May 2015 and March 2016, care team members from 10 CF centers in the USA participated in a practice assessment and quality improvement (QI) initiative. The intervention included a baseline practice assessment survey, personalized continuing medical education (CME)-certified Webconferences with expert study faculty, targeted reinforcement of key practice points, and follow-up online survey and telephone interviews to evaluate the benefits and limitations of the intervention. Responses to the baseline practice assessment survey were received from 50 multidisciplinary care team members representing 10 CF centers. Primary barriers to adherence-related aspects of care in their clinics were motivating patients and caregivers to improve adherence and obtaining accurate information about adherence from patients. At the conclusion of the initiative, participants reported improvements in communication within their care team, implementation of new approaches to asking about adherence, and a renewed commitment to asking patients and caregivers about adherence at each clinic visit. Structured QI interventions that bring multidisciplinary care teams together to reflect on clinic processes and elicit objective insights from outside faculty have the potential to improve practice patterns related to the assessment and improvement of patient adherence in CF.

Guarding against land-expropriation-related mass incidents (LERMIs): Practical evidence from China's local governments

NASA Astrophysics Data System (ADS)

Tan, Shukui; Wang, Siliang

2017-04-01

China is faced with serious challenges brought by large-scale social protests in the period of rapid urbanization and profound social transition. In rural areas, the vast majority of mass incidents were related with land expropriation. In this paper, we intend to show how China's local governments guard against land-expropriation-related mass incidents (LERMIs) at the practical level. We first construct a comprehensive three-dimensional theoretic framework to define the boundary, to uncover the incentives, and to recognize the features of involved practices, then, on the basis of description evidenced by detailed data and/or cases, break various local practices down into two categories, the common local practices which refer to the nationwide top-down responses to the unified deployment by the central authority that aims to mitigate discontentment of land-deprived peasants and reduce the probabilities of conflicts through regulating land expropriation behavior and safeguarding economic interests and participation rights of affected peasants, and the specific local practices which point to the innovative local government behaviors with heterogeneity, in general, the tactical approaches to reduce the probabilities of disputes or conflicts evolving into group actions. We further argue that both of them follow a central tenet of instrumental orientation. As to the former, it is corroborated by local governments' paying more attention to promote the stylization and quantification in the aspects of regulating procedure, formulating and renewing compensation standards, resolving disputes, and evaluating risks, while the latter is mainly reflected from the outcome-orientation organization strategies to maintain overall stability in a relatively short term.

Foot roll-over evaluation based on 3D dynamic foot scan.

PubMed

Samson, William; Van Hamme, Angèle; Sanchez, Stéphane; Chèze, Laurence; Van Sint Jan, Serge; Feipel, Véronique

2014-01-01

Foot roll-over is commonly analyzed to evaluate gait pathologies. The current study utilized a dynamic foot scanner (DFS) to analyze foot roll-over. The right feet of ten healthy subjects were assessed during gait trials with a DFS system integrated into a walkway. A foot sole picture was computed by vertically projecting points from the 3D foot shape which were lower than a threshold height of 15 mm. A 'height' value of these projected points was determined; corresponding to the initial vertical coordinates prior to projection. Similar to pedobarographic analysis, the foot sole picture was segmented into anatomical regions of interest (ROIs) to process mean height (average of height data by ROI) and projected surface (area of the projected foot sole by ROI). Results showed that these variables evolved differently to plantar pressure data previously reported in the literature, mainly due to the specificity of each physical quantity (millimeters vs Pascals). Compared to plantar pressure data arising from surface contact by the foot, the current method takes into account the whole plantar aspect of the foot, including the parts that do not make contact with the support surface. The current approach using height data could contribute to a better understanding of specific aspects of foot motion during walking, such as plantar arch height and the windlass mechanism. Results of this study show the underlying method is reliable. Further investigation is required to validate the DFS measurements within a clinical context, prior to implementation into clinical practice. Copyright © 2013 Elsevier B.V. All rights reserved.

Comparison of Effects of Different Forms of Presentation on the Recall and Retrieval of Information.

ERIC Educational Resources Information Center

Jonassen, David H.; Pace, Ann Jaffe

A study compared the relative effects of typographically cued or mapped text, intact text with signaling, and intact text without signaling on the recall and retrieval of information from prose passages. (Signaling, a noncontent aspect of prose, emphasizes certain aspects of the semantic content or points out aspects of the structure of content.)…

A practical guide for short-term pediatric surgery global volunteers.

PubMed

Meier, Donald E; Fitzgerald, Tamara N; Axt, Jason R

2016-08-01

The tremendous need for increasing the quantity and quality of global pediatric surgical care in underserved areas has been well documented. Concomitantly there has been a significant increase in interest by pediatric surgeons in helping to relieve this problem through surgical volunteerism. The intent of the article is to serve as a practical guide for pediatric surgeons contemplating or planning a short-term global volunteer endeavor. The article is based on the authors' personal experiences and on the published experiences of other volunteers. The following aspects of volunteerism are discussed: ethical considerations, where and how to go, what and whom to take with you, what to expect in your volunteer locale, and what to do and what to avoid in order to enhance the volunteer experience. The points discussed in this guide will hopefully make the volunteer activity one that results in greatly improved immediate and long term surgical care for children and improves the chances that the activity will be a meaningful, pleasant, and productive experience for both the volunteer and the host physician. Copyright © 2016 Elsevier Inc. All rights reserved.

Changing our minds: a commentary on `Conceptual change: a discussion of theoretical, methodological and practical challenges for science education'

NASA Astrophysics Data System (ADS)

Mercer, Neil

2008-07-01

This paper begins with a consideration of some important themes dealt with in the paper by Treagust and Duit. These include the relationship between research on conceptual change and educational practice, the significance of emotion and identity in the process of conceptual change, and role of cognitive conflict in motivating change. I then argue that the authors implicitly assert the importance of spoken dialogue as a motor for conceptual change, but do not give it the proper, explicit recognition that it deserves. I first use their own data of transcribed talk to make this point, and then go on to elaborate my case by drawing on other research. Talk amongst students and teacher-student talk are both considered. My conclusion is that while more empirical research is needed to understand how dialogue is involved in conceptual change, available evidence shows very clearly that the role of talk and social interaction is so significant that it cannot be ignored. It is therefore necessary for theoretical accounts to deal with both social (i.e. communicative) and cognitive aspects of conceptual change.

Bridging the gap between the neurocognitive lab and the addiction clinic.

PubMed

Franken, Ingmar H A; van de Wetering, Ben J M

2015-05-01

In the past decennium there has been an enormous increase in new insights in cognitive mechanisms of addiction and their neural substrates. These candidate neurocognitive mechanisms, particularly those associated with "drive" and "control" aspects of addiction, are clearly involved in substance use problems but do not yet provide a full explanation. The neurocognitive mechanisms addressed in the present perspective are attentional bias, reward processing (both drive aspects) and error-processing and cognitive control (both control aspects). The time has come to transfer these recent insights more consistently to clinical practice by studying their relevance for diagnosis and treatment in patient samples. The present perspective echoes the development of recent initiatives such as the RDoC system to integrate developments in neuroscience into clinical practice. The aim of this article is to open new vistas for addiction diagnosis and treatment and to discuss why and how these neurocognitive aspects of addictive behavior can be used in clinical practice. In addition, present problematic issues and a future research agenda are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

Alternator control for battery charging

DOEpatents

Brunstetter, Craig A.; Jaye, John R.; Tallarek, Glen E.; Adams, Joseph B.

2015-07-14

In accordance with an aspect of the present disclosure, an electrical system for an automotive vehicle has an electrical generating machine and a battery. A set point voltage, which sets an output voltage of the electrical generating machine, is set by an electronic control unit (ECU). The ECU selects one of a plurality of control modes for controlling the alternator based on an operating state of the vehicle as determined from vehicle operating parameters. The ECU selects a range for the set point voltage based on the selected control mode and then sets the set point voltage within the range based on feedback parameters for that control mode. In an aspect, the control modes include a trickle charge mode and battery charge current is the feedback parameter and the ECU controls the set point voltage within the range to maintain a predetermined battery charge current.

SOME ASPECTS OF HEALTH CARE IN MEDIEVAL INDIA

PubMed Central

Rao, B. Rama

1992-01-01

It appears that from medieval period onwards the subjects having practical application were given more importance than the philosophical and theoretical aspects. But the physicians were keen observes and new drugs and information were added and the effect of religion, astrology and other systems is also seen. While the womenfolk used to collect from the nearby forests, drugs that were useful for common ailments, some drugs were also imported from other countries. Specialization in certain diseases or practices was prevalent and the physicians enjoyed a high status and respect in the society. Several such other aspects are dealt with in this article. PMID:22556577

Distortion of Dynamical Systems in the Context of Focusing the Chaos Around the Point

NASA Astrophysics Data System (ADS)

Pawlak, Ryszard J.

In the paper, we examine local aspects of chaos for self-functions on topological manifolds. For this purpose, issues related to focal entropy points and homoclinic points are used. We consider also distortion of dynamical systems which is a theoretical analogue to wave interference.

From the Editor: An Introduction to the JSLHR Supplement on Implementation Science.

PubMed

Paul, Rhea

2015-12-01

The JSLHR Supplement on Implementation Science is aimed at providing discussion and examples of research in implementation science, the study of methods designed to promote the incorporation of research findings into clinical practice. Practitioners in the language science area were invited to submit articles that address their experience with various aspects of implementation science. Six articles from several research groups comprise this supplement. Implementation science is an aspect of intervention research that merits consideration by communication disorders scientists. More extensive practice of implementation science will improve uptake of evidence-based practice in the clinical community.

Health systems strengthening: a common classification and framework for investment analysis

PubMed Central

Shakarishvili, George; Lansang, Mary Ann; Mitta, Vinod; Bornemisza, Olga; Blakley, Matthew; Kley, Nicole; Burgess, Craig; Atun, Rifat

2011-01-01

Significant scale-up of donors’ investments in health systems strengthening (HSS), and the increased application of harmonization mechanisms for jointly channelling donor resources in countries, necessitate the development of a common framework for tracking donors’ HSS expenditures. Such a framework would make it possible to comparatively analyse donors’ contributions to strengthening specific aspects of countries’ health systems in multi-donor-supported HSS environments. Four pre-requisite factors are required for developing such a framework: (i) harmonization of conceptual and operational understanding of what constitutes HSS; (ii) development of a common set of criteria to define health expenditures as contributors to HSS; (iii) development of a common HSS classification system; and (iv) harmonization of HSS programmatic and financial data to allow for inter-agency comparative analyses. Building on the analysis of these aspects, the paper proposes a framework for tracking donors’ investments in HSS, as a departure point for further discussions aimed at developing a commonly agreed approach. Comparative analysis of financial allocations by the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance for HSS, as an illustrative example of applying the proposed framework in practice, is also presented. PMID:20952397

Art therapy and mindfulness with survivors of political violence: A qualitative study.

PubMed

Kalmanowitz, Debra L; Ho, Rainbow T H

2017-08-01

This study's objective was to understand how art therapy and mindfulness meditation could be integrated together in the context of different cultures and political violence and in work with asylum seekers suffering from trauma. We conducted a qualitative phenomenological study based on the social construction paradigm. Twelve participants took part in 4 intensive full-day art therapy and mindfulness workshops. The study's setting was an art therapy and mindfulness studio ( Inhabited Studio ) in Hong Kong where participants engaged in art making and in mindfulness-meditation practice. Different aspects of the Inhabited Studio appealed to participants based on each individual's worldview, culture, religion, and coping style. Responses to the Inhabited Studio were organized into 7 thematic clusters. Five themes were categorized into 2 broad categories composed of personal elements (memory, identity) and mediating aspects (emotional/self-regulation, communication, and imagination). The final 2, resilience and worldview, spanned both areas. Participants found the Inhabited Studio culturally compatible and some of the skills they learned helpful in times of stress. This points to how this combination can contribute to building resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Materials for Microfluidic Immunoassays: A Review.

PubMed

Mou, Lei; Jiang, Xingyu

2017-08-01

Conventional immunoassays suffer from at least one of these following limitations: long processing time, high costs, poor user-friendliness, technical complexity, poor sensitivity and specificity. Microfluidics, a technology characterized by the engineered manipulation of fluids in channels with characteristic lengthscale of tens of micrometers, has shown considerable promise for improving immunoassays that could overcome these limitations in medical diagnostics and biology research. The combination of microfluidics and immunoassay can detect biomarkers with faster assay time, reduced volumes of reagents, lower power requirements, and higher levels of integration and automation compared to traditional approaches. This review focuses on the materials-related aspects of the recent advances in microfluidics-based immunoassays for point-of-care (POC) diagnostics of biomarkers. We compare the materials for microfluidic chips fabrication in five aspects: fabrication, integration, function, modification and cost, and describe their advantages and drawbacks. In addition, we review materials for modifying antibodies to improve the performance of the reaction of immunoassay. We also review the state of the art in microfluidic immunoassays POC platforms, from the laboratory to routine clinical practice, and also commercial products in the market. Finally, we discuss the current challenges and future developments in microfluidic immunoassays. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Clinical evolutional aspects of chronic subdural haematomas – literature review

PubMed Central

Iliescu, IA; Constantinescu, AI

2015-01-01

Apparently trivial, one of the most frequent pathologies in neurosurgical practice, chronic subdural haematoma, continues to be a challenge for the neurosurgeons both from the therapeutic and postoperatory complications point of view, taking into account that it is frequently met in elders, who usually present a complex pathology. The fact that, by definition, there is a latent period between the moment the brain injury, usually minor, occurs and the appearance of clinical symptomatology, frequently makes the trauma be ignored, this complicating the diagnosis and most of the times delaying the application of the adequate treatment. Developing slowly in time, in weeks or months, the aspect that chronic subdural haematoma usually occurs in elders should not be neglected, its clinical symptomatology often debuting with memory and attention disorders, so that the patient is usually referred to psychiatrists or neurologists, only a paraclinical investigation (CT scan or MRI) being able to establish the diagnosis. Even the appearance of the lateral signs is subjected to many diagnosis confusions because patients deny the existence of a trauma in over 50% of the cases. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, CSDH = chronic subdural haematoma, HMW = high molecular weight, F = frontal, T = temporal, P = parietal PMID:26361507

Potential for recycling of slightly radioactive metals arising from decommissioning within nuclear sector in Slovakia.

PubMed

Hrncir, Tomas; Strazovec, Roman; Zachar, Matej

2017-09-07

The decommissioning of nuclear installations represents a complex process resulting in the generation of large amounts of waste materials containing various concentrations of radionuclides. Selection of an appropriate strategy of management of the mentioned materials strongly influences the effectiveness of decommissioning process keeping in mind safety, financial and other relevant aspects. In line with international incentives for optimization of radioactive material management, concepts of recycling and reuse of materials are widely discussed and applications of these concepts are analysed. Recycling of some portion of these materials within nuclear sector (e.g. scrap metals or concrete rubble) seems to be highly desirable from economical point of view and may lead to conserve some disposal capacity. However, detailed safety assessment along with cost/benefit calculations and feasibility study should be developed in order to prove the safety, practicality and cost effectiveness of possible recycling scenarios. Paper discussed the potential for recycling of slightly radioactive metals arising from decommissioning of NPPs within nuclear sector in Slovakia. Various available recycling scenarios are introduced and method for overall assessment of various recycling scenarios is outlined including the preliminary assessment of safety and financial aspects. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

PubMed

Chiaravalli, M; Guzzetti, Laura; Tavani, M

2007-01-01

The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

Foucault's notion of problematization: a methodological discussion of the application of Foucault's later work to nursing research.

PubMed

Frederiksen, Kirsten; Lomborg, Kirsten; Beedholm, Kirsten

2015-09-01

This study takes its point of departure in an oft-voiced critique that the French philosopher Michel Foucault gives discourse priority over practice, thereby being deterministic and leaving little space for the individual to act as an agent. Based on an interpretation of the latter part of Foucault's oeuvre, we argue against this critique and provide a methodological discussion of the perception that Foucault's method constitutes, primarily, discourse analysis. We argue that it is possible to overcome this critique of Foucault's work by the application of methodological tools adapted from Foucault's later writings and his diagnosis of his own work as studies of forms of problematization. To shed light on the possibilities that this approach offers to the researcher, we present a reading of aspects of Foucault's work, with a focus on his notion of forms of problematization. Furthermore, we elaborate on concepts from his so-called genealogical period, namely 'the dispositive', strategy and tactics. Our interpretation is supported by examples from a study of the emergence of Danish nursing education, which is based on an analytical framework that we developed in the light of an interpretation of aspects of Foucault's work. © 2015 John Wiley & Sons Ltd.

[Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

PubMed

Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

2017-01-01

Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their successful cooperation. © Georg Thieme Verlag KG Stuttgart · New York.

The virtual asthma guideline e-learning program: learning effectiveness and user satisfaction.

PubMed

Kang, Sung-Yoon; Kim, Sae-Hoon; Kwon, Yong-Eun; Kim, Tae-Bum; Park, Hye-Kyung; Park, Heung-Woo; Chang, Yoon-Seok; Jee, Young-Koo; Moon, Hee-Bom; Min, Kyung-Up; Cho, Sang-Heon

2018-05-01

Effective educational tools are important for increasing adherence to asthma guidelines and clinical improvement of asthma patients. We developed a computer-based interactive education program for asthma guideline named the Virtual Learning Center for Asthma Management (VLCAM). We evaluated the usefulness of program in terms of its effects on user awareness of asthma guideline and level of satisfaction. Physicians-in-training at tertiary hospitals in Korea were enrolled in a cross-sectional questionnaire survey. The e-learning program on asthma guideline was conducted over a 2-week period. We investigated changes in the awareness of asthma guideline using 35-item self-administered questionnaire aiming at assessing physicians' knowledge, attitude, and practice. Satisfaction with the program was scored on 4-point Likert scales. A total of 158 physicians-in-training at six tertiary hospitals completed the survey. Compared with baseline, the overall awareness obtained from the scores of knowledge, attitude, and practice was improved significantly. Participants were satisfied with the VLCAM program in the following aspects: helpfulness, convenience, motivation, effectiveness, physicians' confidence, improvement of asthma management, and willingness to recommend. All items in user satisfaction questionnaires received high scores over 3 points. Moreover, the problem-based learning with a virtual patient received the highest user satisfaction among all parts of the program. Our computer-based e-learning program is useful for improving awareness of asthma management. It could improve adherence to asthma guidelines and enhance the quality of asthma care.

Teaching the basics of echocardiography in the undergraduate: Students as mentors.

PubMed

Arias Felipe, A; Doménech García, J; Sánchez Los Arcos, I; Luordo, D; García Sánchez, F J; Villanueva Martínez, J; Forero de la Sotilla, A; Villena Garrido, V; Torres Macho, J; García de Casasola Sánchez, G

To analyse the ability of medical students to incorporate the practical teaching of basic echocardiography planes using a peer mentoring design. Thirty-six medical students previously trained in obtaining echocardiography planes (mentors) taught the other 5th-year students (n=126). The teaching methodology included three stages: theory (online course), basic training (three 15h sessions of practical experience in ultrasound and at least 20 echocardiographic studies per mentor) and objective structured clinical assessment (OSCA), which scored the appropriateness of the basic ultrasound planes and the correct identification of 16 cardiac structures. The students' weighted mean score in the OSCA was 8.66±1.98 points (out of 10). Only 10 students (8.4%) scored less than 5, and 15 (12.6%) scored less than 7. Fifty students (42%) scored 10 points. The most easily identified structure was the left ventricle in the short-axis parasternal plane, with 89.9% of correct answers. The most poorly identified structure was the mitral valve in the subxiphoid plane, with 69.7% of correct answers. Peer mentoring-based teaching achieves an appropriate level of training in obtaining basic echocardiography planes. The training period is relatively short. The peer mentoring system can facilitate the implementation of teaching on basic aspects of ultrasound to a large number of undergraduate students. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Adolescent online cyberbullying in Greece: the impact of parental online security practices, bonding, and online impulsiveness.

PubMed

Floros, Georgios D; Siomos, Konstantinos E; Fisoun, Virginia; Dafouli, Evaggelia; Geroukalis, Dimitrios

2013-06-01

The introduction of new technological media worldwide has had a number of unfortunate side effects for some adolescents, including cases of bullying others through the new media (cyberbullying) and over-involvement to the point of addiction. We examine the epidemiology of cyberbullying in a Greek setting, compare it with earlier data, determine the impact of any related psychosocial factors, and propose measures to combat the phenomenon. A cross-sectional study of the entire adolescent high-school student population of the island of Kos examined the relationship between their experiences of Internet cyberbullying and respective parental characteristics, including aspects of psychological bonding and online security measures. The sample consisted of 2017 students (51.8% boys, 48.2% girls). Comparisons are made with results obtained from an earlier survey in the same setting, 2 years earlier. There was a significant rise in reported experiences of Internet cyberbullying over the 2-year period. Security practices exercised by parents had a protective role with regards to whether a child had been cyberbullied, yet failed to prevent the perpetration of online victimization. A regression model indicated that impulsive use of the Internet and related online activities were predictive of whether an adolescent victimized others online. Cyberbullying frequency with regards to both victims and victimizers was high and associated with online impulsiveness, pointing to the possible existence of some commonalities. Further research is necessary to ascertain common underlying psychological factors and neurobiology. © 2013, American School Health Association.

Considerations for choosing an electronic medical record for an ophthalmology practice.

PubMed

DeBry, P W

2001-04-01

To give a brief overview of issues pertinent to selecting an ophthalmic electronic medical record (EMR) program and to outline the company demographics and software capabilities of the major vendors in this area. Software companies shipping an EMR package were contacted to obtain information on their software and company demographics. The focus was on companies selectively marketing to ophthalmology practices, and, therefore, most were selected based on their representation at the 1998 and/or 1999 American Academy of Ophthalmology meeting. Software companies that responded to repeated inquiries in a timely fashion were included. Sixteen companies were evaluated. Electronic medical records packages ranged from $3000 to $80 000 (mean, approximately $30 000). Company demographics revealed a range from 1 to 1600 employees (mean, 204). Most of these companies have been in business for 6 years or less (range, 1-15 years; mean, 6 years). My opinions concerning various aspects of the EMR are presented. There is a wide range of EMR products available for the ophthalmology practice. Computer technology has matured to a point at which the graphical demands of the ophthalmology EMR can be satisfied. Weaknesses do exist in the inherent difficulty of recording an ophthalmology encounter, the relative adolescence of software companies, and the lack of standards in the industry.

Introduction to fragment-based drug discovery.

PubMed

Erlanson, Daniel A

2012-01-01

Fragment-based drug discovery (FBDD) has emerged in the past decade as a powerful tool for discovering drug leads. The approach first identifies starting points: very small molecules (fragments) that are about half the size of typical drugs. These fragments are then expanded or linked together to generate drug leads. Although the origins of the technique date back some 30 years, it was only in the mid-1990s that experimental techniques became sufficiently sensitive and rapid for the concept to be become practical. Since that time, the field has exploded: FBDD has played a role in discovery of at least 18 drugs that have entered the clinic, and practitioners of FBDD can be found throughout the world in both academia and industry. Literally dozens of reviews have been published on various aspects of FBDD or on the field as a whole, as have three books (Jahnke and Erlanson, Fragment-based approaches in drug discovery, 2006; Zartler and Shapiro, Fragment-based drug discovery: a practical approach, 2008; Kuo, Fragment based drug design: tools, practical approaches, and examples, 2011). However, this chapter will assume that the reader is approaching the field with little prior knowledge. It will introduce some of the key concepts, set the stage for the chapters to follow, and demonstrate how X-ray crystallography plays a central role in fragment identification and advancement.

Toxicologists in public health--Following the path of Louis Roche (based on the Louis Roche lecture "An accidental toxicologist in public health", Bordeaux, 2010).

PubMed

Dawson, Andrew H; Buckley, Nicholas A

2011-02-01

The global burden of clinical toxicology suggests a natural partnership with public health. This article reflects the content of a Louis Roche lecture given in 2010. HISTORICAL CONTEXT: Our practice and research in clinical toxicology has evolved from clinical cases to toxico-epidemiology to public health. This evolution in practice was initially unplanned but gained momentum and impact as we placed it more formally in a public health framework. This perspective is implicit in Louis Roche's call to "examine all aspects of the poisoning problem" and still provides a valuable starting point for any clinical toxicologist. Clinical toxicology has always had a patient centered focus but its greatest successes have been related to public health interventions. Our early failures and later success in pubic health toxicology correlated with our understanding of the importance of partnerships outside our field. The most rapid dissemination and implementation of information derived from research occur through apriori partnerships with other agencies and international partners. Addressing both local and global need has a number of bilateral synergies. Repositioning clinical toxicology into a public health framework increases access to strategic partnerships, research funds, and policy implementation while still addressing questions that are important to clinical practice.

`Does it answer the question or is it French fries?': an exploration of language supports for scientific argumentation

NASA Astrophysics Data System (ADS)

González-Howard, María; McNeill, Katherine L.; Marco-Bujosa, Lisa M.; Proctor, C. Patrick

2017-03-01

Reform initiatives around the world are reconceptualising science education by stressing student engagement in science practices. Yet, science practices are language-intensive, requiring students to have strong receptive and productive language proficiencies. It is critical to address these rigorous language demands to ensure equitable learning opportunities for all students, including English language learners (ELLs). Little research has examined how to specifically support ELL students' engagement in science practices, such as argumentation. Using case-study methodology, we examined one middle school science teacher's instructional strategies as she taught an argumentation-focused curriculum in a self-contained ELL classroom. Findings revealed that three trends characterized the teacher's language supports for the structural and dialogic components of argumentation: (1) more language supports focused on argument structure, (2) dialogic interactions were most often facilitated by productive language supports, and (3) some language supports offered a rationale for argumentation. Findings suggest a need to identify and develop supports for the dialogic aspects of argumentation. Furthermore, engaging students in argumentation through productive language functions could be leveraged to support dialogic interactions. Lastly, our work points to the need for language supports that make the rationale for argumentation explicit since such transparency could further increase access for all students.

Building Systems from Scratch: an Exploratory Study of Students Learning About Climate Change

NASA Astrophysics Data System (ADS)

Puttick, Gillian; Tucker-Raymond, Eli

2018-01-01

Science and computational practices such as modeling and abstraction are critical to understanding the complex systems that are integral to climate science. Given the demonstrated affordances of game design in supporting such practices, we implemented a free 4-day intensive workshop for middle school girls that focused on using the visual programming environment, Scratch, to design games to teach others about climate change. The experience was carefully constructed so that girls of widely differing levels of experience were able to engage in a cycle of game design. This qualitative study aimed to explore the representational choices the girls made as they took up aspects of climate change systems and modeled them in their games. Evidence points to the ways in which designing games about climate science fostered emergent systems thinking and engagement in modeling practices as learners chose what to represent in their games, grappled with the realism of their respective representations, and modeled interactions among systems components. Given the girls' levels of programming skill, parts of systems were more tractable to create than others. The educational purpose of the games was important to the girls' overall design experience, since it influenced their choice of topic, and challenged their emergent understanding of climate change as a systems problem.

Medical students' clinical performance in general practice - Triangulating assessments from patients, teachers and students.

PubMed

Braend, Anja Maria; Gran, Sarah Frandsen; Frich, Jan C; Lindbaek, Morten

2010-01-01

Formative assessment of medical students' clinical performance during general practice clerkship is necessary to learn consultation skills. Our aim was to triangulate feedback using patient questionnaires, written self-assessment and teachers' observation-based assessment, and to describe the content of this feedback. We developed StudentPEP, a 15-item version of EUROPEP, a tool for measuring patients' evaluation of quality in general practice. The teacher and student forms consisted of five StudentPEP-items and open-ended questions asking for approval and improvement needed on four aspects. Quantitative scores were analyzed statistically. Free-text comments were analyzed and categorized into 'specific and concrete' versus 'general and unspecific'. One hundred seventy-three students returned data from 2643 consultations. Mean patients' scores for 15 items were 4.3-4.8 on a five-point Likert scale. Mean teacher scores were 4.4 on five items, while students' mean self-assessments were 3.6-3.8. In an analysis of 380 consultations, students were more specific and concrete in their self-evaluation compared with teachers (p < 0.01). Patients scored students' performance high compared with students' self-assessments. Teachers' scores were in accordance with patients' scores. Teachers' written evaluations of students were often general. There is a potential for improving teachers' feedback in terms of more specific and concrete comments.

[Management Competence in Leading Positions in Clinical Surgery - What Does a Surgeon Need to Know?

PubMed

Hellmann, W; Meyer, F

2016-12-01

Background: Surgeons, more than other specialists, are required to combine high medical expertise with management competence. This is due to changing environments, new demands with respect to quality, the ongoing discussion on increased performance in the context of questionable target agreements, an increasing tendency of university hospitals and other departments and clinics to recruit leading personnel in medicine with management competence, but also to the understanding of one's own role and surgeons' distinguished public reputation. Aim: This narrative review describes the changing environments for surgeons in leading positions in hospitals and provides an overview on the practical use of management skills in surgery. In addition, it advises on how to acquire management competence and presents an educational concept appropriate for surgeons in leading positions. Key points: 1. The management of new challenges in the healthcare system - also in clinical surgery - requires management skills, which are indispensable for a surgeon in a leading position. 2. Management skills in surgery comprise aspects such as communication ability, social competence, cooperation and leadership skills, knowledge on business administration aspects and legal certainty. 3. The necessary knowledge can be acquired in courses leading to a certificate (e.g. "MHM® Medical Hospital Manager") or by earning a "Master of Business Administration" (MBA). Conclusion: Management competence is essential in leading positions in clinical surgery today. The use of these skills is challenging in daily practice. Successfully applied, management competence not only guarantees comprehensive patient care and leadership of employees, but also provides satisfaction in leading positions of a surgical department. Georg Thieme Verlag KG Stuttgart · New York.

A pragmatic cluster randomised controlled trial to evaluate the safety, clinical effectiveness, cost effectiveness and satisfaction with point of care testing in a general practice setting - rationale, design and baseline characteristics.

PubMed

Laurence, Caroline; Gialamas, Angela; Yelland, Lisa; Bubner, Tanya; Ryan, Philip; Willson, Kristyn; Glastonbury, Briony; Gill, Janice; Shephard, Mark; Beilby, Justin

2008-08-06

Point of care testing (PoCT) may be a useful adjunct in the management of chronic conditions in general practice (GP). The provision of pathology test results at the time of the consultation could lead to enhanced clinical management, better health outcomes, greater convenience and satisfaction for patients and general practitioners (GPs), and savings in costs and time. It could also result in inappropriate testing, increased consultations and poor health outcomes resulting from inaccurate results. Currently there are very few randomised controlled trials (RCTs) in GP that have investigated these aspects of PoCT. The Point of Care Testing in General Practice Trial (PoCT Trial) was an Australian Government funded multi-centre, cluster randomised controlled trial to determine the safety, clinical effectiveness, cost effectiveness and satisfaction of PoCT in a GP setting.The PoCT Trial covered an 18 month period with the intervention consisting of the use of PoCT for seven tests used in the management of patients with diabetes, hyperlipidaemia and patients on anticoagulant therapy. The primary outcome measure was the proportion of patients within target range, a measure of therapeutic control. In addition, the PoCT Trial investigated the safety of PoCT, impact of PoCT on patient compliance to medication, stakeholder satisfaction, cost effectiveness of PoCT versus laboratory testing, and influence of geographic location. The paper provides an overview of the Trial Design, the rationale for the research methodology chosen and how the Trial was implemented in a GP environment. The evaluation protocol and data collection processes took into account the large number of patients, the broad range of practice types distributed over a large geographic area, and the inclusion of pathology test results from multiple pathology laboratories.The evaluation protocol developed reflects the complexity of the Trial setting, the Trial Design and the approach taken within the funding provided. The PoCT Trial is regarded as a pragmatic RCT, evaluating the effectiveness of implementing PoCT in GP and every effort was made to ensure that, in these circumstances, internal and external validity was maintained. 12612605000272695.

Legal aspects of therapist-driven protocols. Do therapist-driven protocols place therapists in a legally compromising position?

PubMed

Meehan, M J

1996-03-01

The recent introduction of therapist-driven protocols has given the appearance of restricting the professional judgment of respiratory therapists with decision-tree robotics while contemporaneously catapulting them into the practice of medicine. This is happening in the midst of a spiraling litigation climate. This article examines the legal aspects--from malpractice to licensure--of this exciting new practice known as therapist-driven respiratory protocols.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

Aberrated electron probes for magnetic spectroscopy with atomic resolution: Theory and practical aspects

DOE PAGES

Rusz, Ján; Idrobo, Juan Carlos

2016-03-24

It was recently proposed that electron magnetic circular dichroism (EMCD) can be measured in scanning transmission electron microscopy (STEM) with atomic resolution by tuning the phase distribution of a electron beam. Here, we describe the theoretical and practical aspects for the detection of out-of-plane and in-plane magnetization utilizing atomic size electron probes. Here we present the calculated optimized astigmatic probes and discuss how to achieve them experimentally.

European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy.

PubMed

van Schaik, I N; Bouche, P; Illa, I; Léger, J-M; Van den Bergh, P; Cornblath, D R; Evers, E M A; Hadden, R D M; Hughes, R A C; Koski, C L; Nobile-Orazio, E; Pollard, J; Sommer, C; van Doorn, P A

2006-08-01

Several diagnostic criteria for multifocal motor neuropathy have been proposed in recent years and a beneficial effect of intravenous immunoglobulin (IVIg) and various other immunomodulatory drugs has been suggested in several trials and uncontrolled studies. The objectives were to prepare consensus guidelines on the definition, investigation and treatment of multifocal motor neuropathy. Disease experts and a patient representative considered references retrieved from MEDLINE and the Cochrane Library in July 2004 and prepared statements which were agreed in an iterative fashion. The Task Force agreed good practice points to define clinical and electrophysiological diagnostic criteria for multifocal motor neuropathy and investigations to be considered. The principal recommendations and good practice points were: (i) IVIg (2 g/kg given over 2-5 days) should be considered as the first line treatment (level A recommendation) when disability is sufficiently severe to warrant treatment. (ii) Corticosteroids are not recommended (good practice point). (iii) If initial treatment with IVIg is effective, repeated IVIg treatment should be considered (level C recommendation). The frequency of IVIg maintenance therapy should be guided by the individual response (good practice point). Typical treatment regimens are 1 g/kg every 2-4 weeks or 2 g/kg every 4-8 weeks (good practice point). (iv) If IVIg is not or not sufficiently effective then immunosuppressive treatment may be considered. Cyclophosphamide, ciclosporin, azathioprine, interferon beta1a, or rituximab are possible agents (good practice point). (v) Toxicity makes cyclophosphamide a less desirable option (good practice point).

Reflective Practice and Inquiry: Let's Talk More about Inquiry

ERIC Educational Resources Information Center

Earl, Kerry; Ussher, Bill

2016-01-01

Reflective practice and inquiry are aspects of teacher professional practice that characterise teachers as learners. Reflective practice in some form is considered in contemporary education as an essential activity for teachers and teacher educators. "Inquiry as professional development" and "inquiry as research", on the other…

First impressions and beyond: marketing your practice in touch points--Part II.

PubMed

Bisera, Cheryl

2012-01-01

When calling in a marketing expert to boost a practice's numbers, administrators and providers are usually looking for external marketing strategies--ways to attract new patients to the practice. However, one of the most important, yet often overlooked, elements to successfully marketing a practice is the very important work of retaining current patients and turning them into enthusiastic referrers. When new patients are simply filling the place of previous patients that have moved on, you are not building solid practice growth. You can create an atmosphere of loyal referring patients by providing positive touch points that fulfill the needs of your patients. This article will cover touch points that occur before a patient has chosen your practice. Laying the groundwork for positive touch points will give your marketing efforts a snowball effect, build growth, and deliver the most bang for your marketing bucks.

Retention of Mastoidectomy Skills After Virtual Reality Simulation Training.

PubMed

Andersen, Steven Arild Wuyts; Konge, Lars; Cayé-Thomasen, Per; Sørensen, Mads Sølvsten

2016-07-01

The ultimate goal of surgical training is consolidated skills with a consistently high performance. However, surgical skills are heterogeneously retained and depend on a variety of factors, including the task, cognitive demands, and organization of practice. Virtual reality (VR) simulation is increasingly being used in surgical skills training, including temporal bone surgery, but there is a gap in knowledge on the retention of mastoidectomy skills after VR simulation training. To determine the retention of mastoidectomy skills after VR simulation training with distributed and massed practice and to investigate participants' cognitive load during retention procedures. A prospective 3-month follow-up study of a VR simulation trial was conducted from February 6 to September 19, 2014, at an academic teaching hospital among 36 medical students: 19 from a cohort trained with distributed practice and 17 from a cohort trained with massed practice. Participants performed 2 virtual mastoidectomies in a VR simulator a mean of 3.2 months (range, 2.4-5.0 months) after completing initial training with 12 repeated procedures. Practice blocks were spaced apart in time (distributed), or all procedures were performed in 1 day (massed). Performance of the virtual mastoidectomy as assessed by 2 masked senior otologists using a modified Welling scale, as well as cognitive load as estimated by reaction time to perform a secondary task. Among 36 participants, mastoidectomy final-product skills were largely retained at 3 months (mean change in score, 0.1 points; P = .89) regardless of practice schedule, but the group trained with massed practice took more time to complete the task. The performance of the massed practice group increased significantly from the first to the second retention procedure (mean change, 1.8 points; P = .001), reflecting that skills were less consolidated. For both groups, increases in reaction times in the secondary task (distributed practice group: mean pretraining relative reaction time, 1.42 [95% CI, 1.37-1.47]; mean end of training relative reaction time, 1.24 [95% CI, 1.16-1.32]; and mean retention relative reaction time, 1.36 [95% CI, 1.30-1.42]; massed practice group: mean pretraining relative reaction time, 1.34 [95% CI, 1.28-1.40]; mean end of training relative reaction time, 1.31 [95% CI, 1.21-1.42]; and mean retention relative reaction time, 1.39 [95% CI, 1.31-1.46]) indicated that cognitive load during the virtual procedures had returned to the pretraining level. Mastoidectomy skills acquired under time-distributed practice conditions were retained better than skills acquired under massed practice conditions. Complex psychomotor skills should be regularly reinforced to consolidate both motor and cognitive aspects. Virtual reality simulation training provides the opportunity for such repeated training and should be integrated into training curricula.

DrivAbility: teaching medical aspects of driving.

PubMed

Gibson, Jeremy; Whiteman, Liz

2012-06-01

Teaching medical aspects of fitness to drive (FTD) is currently inconsistent across UK medical schools, with almost one-third of UK medical schools offering no tuition on medical aspects of FTD. It is, therefore, not surprising to find that medical students and doctors tend to lack confidence regarding the medical aspects of FTD and Driver and Vehicle Licensing Agency (DVLA) medical standards. In response to this inconsistency we developed an innovative new learning module to teach our medical students the importance of giving appropriate advice to patients about driving, the role of the DVLA regarding medical aspects of FTD, how to recognise when patients should be referred to a driving assessment centre and what adaptations are available to allow patients with physical disabilities to drive safely. As far as we are aware Derby is the first centre in the world to incorporate the practical experience of driving adapted vehicles (at a driving assessment centre) into the undergraduate medical curriculum as an aid to teaching medical aspects of FTD. This practical learning module has proven popular with the students. Driving these adapted vehicles has allowed our students to appreciate some of the practical difficulties disabled drivers experience when learning new driving techniques. However, as only 18 driving assessment centres exist within the UK, an exact replication of this learning module will be limited elsewhere. Nevertheless, we would encourage other medical schools to evaluate the local resources that could enhance the delivery of their undergraduate curricula. © Blackwell Publishing Ltd 2012.

47 CFR 68.105 - Minimum point of entry (MPOE) and demarcation point.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be either the closest practicable point to where the wiring crosses a property line or the closest practicable point to where the wiring enters a multiunit building or buildings. The reasonable and... situations. (c) Single unit installations. For single unit installations existing as of August 13, 1990, and...

The promotion of mental health through cultural values, institutions, and practices: a reflection on some aspects of botswana culture.

PubMed

Sabone, Motshedisi B

2009-12-01

Botswana has seen rapid socioeconomic development since the 1970s that has contributed to the erosion of the values, institutions, and practices that are believed to be supportive of mental health. In this paper, the author argues that the aspects of culture that are supportive of mental health have been diluted by the process of urbanization and the interactions of Batswana (the indigenous people of Botswana) with other cultural groups, particularly those from the western hemisphere. The paper further highlights some of the values, institutions, and practices native to Botswana and describes how they promote mental health. Lastly, recommendations for reviving the cultural values, institutions, and practices of Botswana are discussed.

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

PubMed

Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

2006-11-01

Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting, academic physicians found variety, teaching, and research to be more important (P = .0027, P = .0001, and P = .0001, respectively). In contrast, private practice physicians found autonomy, physician-patient relationship, coworkers, and geographic location to be more important (P = .0005, P = .0001, P = .0035, and P = .0016, respectively). Academic and private practice physicians are equally satisfied with their careers. However, teaching, research and variety contribute more to academic satisfaction, whereas autonomy, physician-patient relationship, and coworkers contribute more to satisfaction for the physician in private practice. This study may be used when counseling residents concerning their career options.

49 CFR 236.303 - Control circuits for signals, selection through circuit controller operated by switch points or...

Code of Federal Regulations, 2010 CFR

2010-10-01

... circuit controller operated by switch points or by switch locking mechanism. 236.303 Section 236.303... § 236.303 Control circuits for signals, selection through circuit controller operated by switch points or by switch locking mechanism. The control circuit for each aspect with indication more favorable...

49 CFR 236.303 - Control circuits for signals, selection through circuit controller operated by switch points or...

Code of Federal Regulations, 2012 CFR

2012-10-01

... circuit controller operated by switch points or by switch locking mechanism. 236.303 Section 236.303... § 236.303 Control circuits for signals, selection through circuit controller operated by switch points or by switch locking mechanism. The control circuit for each aspect with indication more favorable...

49 CFR 236.303 - Control circuits for signals, selection through circuit controller operated by switch points or...

Code of Federal Regulations, 2013 CFR

2013-10-01

... circuit controller operated by switch points or by switch locking mechanism. 236.303 Section 236.303... § 236.303 Control circuits for signals, selection through circuit controller operated by switch points or by switch locking mechanism. The control circuit for each aspect with indication more favorable...

49 CFR 236.303 - Control circuits for signals, selection through circuit controller operated by switch points or...

Code of Federal Regulations, 2014 CFR

2014-10-01

... circuit controller operated by switch points or by switch locking mechanism. 236.303 Section 236.303... § 236.303 Control circuits for signals, selection through circuit controller operated by switch points or by switch locking mechanism. The control circuit for each aspect with indication more favorable...

49 CFR 236.303 - Control circuits for signals, selection through circuit controller operated by switch points or...

Code of Federal Regulations, 2011 CFR

2011-10-01

... circuit controller operated by switch points or by switch locking mechanism. 236.303 Section 236.303... § 236.303 Control circuits for signals, selection through circuit controller operated by switch points or by switch locking mechanism. The control circuit for each aspect with indication more favorable...

Statistical Aspects of Point Count Sampling

Treesearch

Richard J. Barker; John R. Sauer

1995-01-01

The dominant feature of point counts is that they do not census birds, but instead provide incomplete counts of individuals present within a survey plot. Considering a simple model for point count sampling, we demonstrate that use of these incomplete counts can bias estimators and testing procedures, leading to inappropriate conclusions. A large portion of the...

Using Naming Practices in the Developmental English Classroom

ERIC Educational Resources Information Center

Behrens, Susan

2010-01-01

Linguistic behavior often reveals cultural practices. In fact, sociolinguistics is dedicated to researching how language use intersects with cultural and social identity (e.g., Coupland. and Jaworski, 2009). One aspect of language use that sociolinguistics focuses on is naming practices. The study of such practices is called onomastics. While…

Ethical aspects in placental perfusion studies: views of the researchers.

PubMed

Halkoaho, A; Pietilä, A-M; Vähäkangas, K

2011-07-01

Within the EU-project NewGeneris human placental perfusion has been used for predicting fetal exposure to food carcinogens. Within the work package of ethical aspects of the research, we studied opinions of the researchers (n = 23) who carried out perfusions of human placenta. Data were collected by focus group interviews (n = 12) and an open-ended questionnaire (n =19 of which 8 were also attending the group session) from scientists representing 9 different nationalities. Both types of data were analysed together thematically and with data triangulation. Studied researchers considered communication between all stakeholders extremely important. Good communication was considered a prerequisite for the recruitment of mothers to donate the placenta, as well as for the process of getting the informed consent. Voluntariness, confidentiality and societal meaning were mentioned as important by all studied researchers. Educating the hospital personnel was regarded as essential in order to provide the best possible information to the mothers. The researchers also pointed out that cultural aspects should be respected, and that in Western thinking placenta is mostly considered as waste. Some researchers suggested that current guidelines and processes for obtaining informed consent should be reviewed also from a cultural perspective. With the development of biobanks, the use of human tissues, including placenta will most probably increase in the future, and the awareness of ethical considerations both in legislation and in practice need support. Thus, continuous effort for better research ethics is essential and requires research on research ethics. Copyright © 2011 Elsevier Ltd. All rights reserved.

Climate Change and Morality: Students' perspectives on the individual and society

NASA Astrophysics Data System (ADS)

Sternäng, Li; Lundholm, Cecilia

2011-05-01

There is a growing interest in addressing moral aspects in the research and education of socio-scientific issues. This paper investigates students' interpretations of climate change from a moral perspective. The students were 14 years old, studying at Green Schools in the Beijing area, China. The study was based on semi-structured group interviews and the data were analysed from an intentional perspective, which means that both cognitive and situational aspects were taken into consideration in the analysis. Previous research has revealed a close relation between morality and socio-scientific issues and also advocated the need for addressing ethical aspects in science education. However, empirical studies exploring the question of what students' moral reasoning might look like at the individual level have not yet generated enough attention. In this study this is the core focus of interest. The findings show that the students conceptualise the solutions to mitigating climate change in relation to two different stances. That is, they contextualise the problems and solutions by addressing the individual, where the individual is either 'myself' or 'someone else'. The different notions of the individual become crucial as the students' views and considerations for the environment, as well as society, change according to the different contexts. From a moral point of view, the students seem quite unaware of their varying consideration for others, the environment and society. The paper ends with a discussion of implications for practice and research.

Patient education programmes in obstructive airway disease. The Ingelheim Model for promoting health through patient education.

PubMed

Klein, K; Troglauer, K G; Ahlstich, G; Schunke, B; Theissen, E; Voss, H W; Clausen, V

1992-06-01

Chronic obstructive airway diseases (COAD) can be regarded as one of the major health problems needing environmental actions and screening programs for early detection and intensive patient education programs to cope with the needs of tertiary prevention. On the basis of our epidemiological study focused on COAD carried out in FRG (sample size August 1988: 63,000 participants) a patient education program has been developed and evaluated. In cooperation with general practitioners and pneumologists the program has been installed at practice and community level. The need for a patient education program has been assessed during the three years of the PNEUMOBIL-Project. It is not just a matter of cutting costs, but to a large extent a matter of the wellbeing of the patients and of reducing side effects to a minimum. The objective of the project can be split into three dimensions: (1) The cognitive aspect. Here significant lack of knowledge has to be overcome. At this point it has to be stated clearly that at the present time the medical community is not able to solve this problem on their own. (2) The psychomotoric aspect. Here the competent use of medication has to be trained. (3) The emotional aspect. The patient has to be motivated and integrated into the therapeutic process in a way that his compliance contributes significantly. The didactical concept consists of modules that can be used in varying sequences according to the needs of the target audience.(ABSTRACT TRUNCATED AT 250 WORDS)

[Risk management--a new aspect of quality assessment in intensive care medicine: first results of an analysis of the DIVI's interdisciplinary quality assessment research group].

PubMed

Stiletto, R; Röthke, M; Schäfer, E; Lefering, R; Waydhas, Ch

2006-10-01

Patient security has become one of the major aspects of clinical management in recent years. The crucial point in research was focused on malpractice. In contradiction to the economic process in non medical fields, the analysis of errors during the in-patient treatment time was neglected. Patient risk management can be defined as a structured procedure in a clinical unit with the aim to reduce harmful events. A risk point model was created based on a Delphi process and founded on the DIVI data register. The risk point model was evaluated in clinically working ICU departments participating in the register data base. The results of the risk point evaluation will be integrated in the next data base update. This might be a step to improve the reliability of the register to measure quality assessment in the ICU.

Promoting access to innovation for frail old persons. IAGG (International Association of Gerontology and Geriatrics), WHO (World Health Organization) and SFGG (Société Française de Gériatrie et de Gérontologie) Workshop--Athens January 20-21, 2012.

PubMed

Berrut, G; Andrieu, S; Araujo de Carvalho, I; Baeyens, J P; Bergman, H; Cassim, B; Cerreta, F; Cesari, M; Cha, H B; Chen, L K; Cherubini, A; Chou, M Y; Cruz-Jentoft, A J; De Decker, L; Du, P; Forette, B; Forette, F; Franco, A; Guimaraes, R; Guttierrez-Robledo, L M; Jauregui, J; Khavinson, V; Lee, W J; Peng, L N; Perret-Guillaume, C; Petrovic, M; Retornaz, F; Rockwood, K; Rodriguez-Manas, L; Sieber, C; Spatharakis, G; Theou, O; Topinkova, E; Vellas, B; Benetos, A

2013-01-01

Frailty tends to be considered as a major risk for adverse outcomes in older persons, but some important aspects remain matter of debate. The purpose of this paper is to present expert's positions on the main aspects of the frailty syndrome in the older persons. Workshop organized by International Association of Gerontology and Geriatrics (IAGG), World Health Organization (WHO) and Société Française de Gériatrie et de Gérontologie (SFGG). Frailty is widely recognized as an important risk factor for adverse health outcomes in older persons. This can be of particular value in evaluating non-disabled older persons with chronic diseases but today no operational definition has been established. Nutritional status, mobility, activity, strength, endurance, cognition, and mood have been proposed as markers of frailty. Another approach calculates a multidimensional score ranging from "very fit" to "severely frail", but it is difficult to apply into the medical practice. Frailty appears to be secondary to multiple conditions using multiple pathways leading to a vulnerability to a stressor. Biological (inflammation, loss of hormones), clinical (sarcopenia, osteoporosis etc.), as well as social factors (isolation, financial situation) are involved in the vulnerability process. In clinical practice, detection of frailty is of major interest in oncology because of the high prevalence of cancer in older persons and the bad tolerance of the drug therapies. Presence of frailty should also be taken into account in the definition of the cardiovascular risks in the older population. The experts of the workshop have listed the points reached an agreement and those must to be a priority for improving understanding and use of frailty syndrome in practice. Frailty in older adults is a syndrome corresponding to a vulnerability to a stressor. Diagnostic tools have been developed but none can integrate at the same time the large spectrum of factors and the simplicity asked by the clinical practice. An agreement with an international common definition is necessary to develop screening and to reduce the morbidity in older persons.

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

Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity

PubMed Central

Speakman, John R.; Levitsky, David A.; Allison, David B.; Bray, Molly S.; de Castro, John M.; Clegg, Deborah J.; Clapham, John C.; Dulloo, Abdul G.; Gruer, Laurence; Haw, Sally; Hebebrand, Johannes; Hetherington, Marion M.; Higgs, Susanne; Jebb, Susan A.; Loos, Ruth J. F.; Luckman, Simon; Luke, Amy; Mohammed-Ali, Vidya; O’Rahilly, Stephen; Pereira, Mark; Perusse, Louis; Robinson, Tom N.; Rolls, Barbara; Symonds, Michael E.; Westerterp-Plantenga, Margriet S.

2011-01-01

The close correspondence between energy intake and expenditure over prolonged time periods, coupled with an apparent protection of the level of body adiposity in the face of perturbations of energy balance, has led to the idea that body fatness is regulated via mechanisms that control intake and energy expenditure. Two models have dominated the discussion of how this regulation might take place. The set point model is rooted in physiology, genetics and molecular biology, and suggests that there is an active feedback mechanism linking adipose tissue (stored energy) to intake and expenditure via a set point, presumably encoded in the brain. This model is consistent with many of the biological aspects of energy balance, but struggles to explain the many significant environmental and social influences on obesity, food intake and physical activity. More importantly, the set point model does not effectively explain the ‘obesity epidemic’ – the large increase in body weight and adiposity of a large proportion of individuals in many countries since the 1980s. An alternative model, called the settling point model, is based on the idea that there is passive feedback between the size of the body stores and aspects of expenditure. This model accommodates many of the social and environmental characteristics of energy balance, but struggles to explain some of the biological and genetic aspects. The shortcomings of these two models reflect their failure to address the gene-by-environment interactions that dominate the regulation of body weight. We discuss two additional models – the general intake model and the dual intervention point model – that address this issue and might offer better ways to understand how body fatness is controlled. PMID:22065844

Promoting cultures of thinking: transforming nursing education to transform nursing practice.

PubMed

Freed, Patricia E; McLaughlin, Dorcas E

2013-01-01

Contemporary nursing education is highly invested in the development of the academic, critical, and empirical aspects of education that represent the science of nursing, and concomitantly less attentive to the development of the creative, interpersonal aspects of education typically associated with the art of nursing. This represents a reversal of historic patterns in nursing education, but the pendulum may have swung so far that there could be costs to nursing practice unless the creative, interpersonal aspects of education can be reclaimed and balanced. Ideas and suggestions regarding how nurse educators might foster the creation of cultures of thinking, which represent whole-brain, integrated teaching approaches that are based on emerging neurocognitive evidence, are discussed.

Multilingual Aspects of Speech Sound Disorders in Children. Communication Disorders across Languages

ERIC Educational Resources Information Center

McLeod, Sharynne; Goldstein, Brian

2012-01-01

Multilingual Aspects of Speech Sound Disorders in Children explores both multilingual and multicultural aspects of children with speech sound disorders. The 30 chapters have been written by 44 authors from 16 different countries about 112 languages and dialects. The book is designed to translate research into clinical practice. It is divided into…

Marked point process for modelling seismic activity (case study in Sumatra and Java)

NASA Astrophysics Data System (ADS)

Pratiwi, Hasih; Sulistya Rini, Lia; Wayan Mangku, I.

2018-05-01

Earthquake is a natural phenomenon that is random, irregular in space and time. Until now the forecast of earthquake occurrence at a location is still difficult to be estimated so that the development of earthquake forecast methodology is still carried out both from seismology aspect and stochastic aspect. To explain the random nature phenomena, both in space and time, a point process approach can be used. There are two types of point processes: temporal point process and spatial point process. The temporal point process relates to events observed over time as a sequence of time, whereas the spatial point process describes the location of objects in two or three dimensional spaces. The points on the point process can be labelled with additional information called marks. A marked point process can be considered as a pair (x, m) where x is the point of location and m is the mark attached to the point of that location. This study aims to model marked point process indexed by time on earthquake data in Sumatra Island and Java Island. This model can be used to analyse seismic activity through its intensity function by considering the history process up to time before t. Based on data obtained from U.S. Geological Survey from 1973 to 2017 with magnitude threshold 5, we obtained maximum likelihood estimate for parameters of the intensity function. The estimation of model parameters shows that the seismic activity in Sumatra Island is greater than Java Island.

Organisational aspects of dental practices: do dental students think like patients or like general dental practitioners?

PubMed

Sonneveld, R E; Brands, W G; Bronkhorst, E M; Welie, J V M; Truin, G J

2013-02-01

In view of transparency in health care, the widespread desire for more patient-centred care, and in an attempt to facilitate educational programmes that effectively respond to these changes, two research questions are formulated: (i) How do dental students rate the importance of various organisational aspects of dental practices compared with dental patients and general dental practitioners (GDPs), and what prescripts, defined as specific operational responsibilities of GDPs in these matters, do dental students propose? and (ii) In doing so, do students resemble patients or GDPs? In two survey studies, dental students (n = 198), patients (n = 3127) and GDPs (n = 303) were asked to rate by questionnaire the importance of 41 organisational aspects of a general dental practice and proposed specific operational responsibilities ('prescripts'). Seven of 41 aspects were rated as important by the majority of the students. Although in a different rank order, three aspects were predominantly selected by all three groups: continuing education, accessibility by telephone and Dutch-speaking GDP. For most aspects, significant differences were found between the prescripts proposed by students and those proposed by patients, and few differences were found between students and GDPs. The findings do not permit the general conclusion that the views of dental students resemble those of patients or GPDs. Looking at the overall rank order, the three respondent groups showed a great resemblance although significant differences were found for specific aspects. With regard to the proposed prescripts, students showed realistic views and the majority wants to participate in continuing education and work with protocols and guidelines. In this, they tend to resemble GDPs more than they resemble patients. © 2012 John Wiley & Sons A/S.

Alternate Careers for Physicists: Science Policy and Government Relations

NASA Astrophysics Data System (ADS)

Mack, Gregory

While physics is an investigation of the world around us, physicists and the practice of physics research exist within the world in combination with aspects of society. This means that physicists and physics research are subject to federal policies and regulations that affect how physics is done. Who decides or influences those policies? Who speaks up on our behalf? Who investigates policy issues from a physics point of view? As physicists, we can lend our expertise and insight in order to ensure a fruitful future for physics and science more broadly, whether it be an occasional policy action taken or a career in science policy and government relations. In this talk I'll share the story of my transition from academia to a policy-focused career at APS and what it means to be a physicist on the frontlines of government relations.

Cultivating the scientific research ability of undergraduate students in teaching of genetics.

PubMed

Xing, Wan-jin; Morigen, Morigen

2016-11-20

The classroom is the main venue for undergraduate teaching. It is worth pondering how to cultivate undergraduate's research ability in classroom teaching. Here we introduce the practices and experiences in teaching reform in genetics for training the research quality of undergraduate students from six aspects: (1) constructing the framework for curriculum framework systematicaly, (2) using the teaching content to reflect research progress, (3) explaining knowledge points with research activities, (4) explaining the scientific principles and experiments with PPT animation, (5) improving English reading ability through bilingual teaching, and (6) testing students' analysing ability through examination. These reforms stimulate undergraduate students' enthusiasm for learning, cultivate their ability to find, analyze and solve scientific problems, and improve their English reading and literature reviewing capacity, which lay a foundation for them to enter the field of scientific research.

Enjoyment and its discontents: Ecclesiastes in dialogue with Freud on the stewardship of joy.

PubMed

Browning Helsel, Philip

2010-03-01

The book of Ecclesiastes has frequently been mischaracterized as a cynical or pessimistic work. Instead, this article recommends Ecclesiastes, following Eunny P. Lee, as contributing to pastoral theology through its embodied and pragmatic theology of enjoyment in which practices of joy revitalize the human spirit. However, there are some who are unable to experience satisfaction. The absence of reflection on this problem in Ecclesiastes scholarship is considered the starting point of pastoral theology, and is addressed by a turn to the frequently misunderstood passage in 7:16-18, bringing it into conversation with the structural [corrected] model of the human person developed by Freud. At the same time, the interpersonal aspects of enjoyment found in Ecclesiastes critique Freud by suggesting how the fragmented parts of self-experience can be held together in an interpersonal context.

SuperJet International case study: a business network start-up in the aeronautics industry

NASA Astrophysics Data System (ADS)

Corallo, Angelo; de Maggio, Marco; Storelli, Davide

This chapter presents the SuperJet International case study, a start-up in the aeronautics industry characterized by a process-oriented approach and a complex and as yet evolving network of partnerships and collaborations. The chapter aims to describe the key points of the start-up process, highlighting common factors and differences compared to the TEKNE Methodology of Change, with particular reference to the second and third phase, namely, the design and deployment of new techno-organizational systems. The SuperJet International startup is presented as a case study where strategic and organizational aspects have been jointly conceived from a network-driven perspective. The chapter compares some of the guidelines of the TEKNE Methodology of Change with experiences and actual practices deriving from interviews with key players in SJI's start-up process.

What Are We Doing When We Translate from Quantitative Models?

PubMed Central

Critchfield, Thomas S; Reed, Derek D

2009-01-01

Although quantitative analysis (in which behavior principles are defined in terms of equations) has become common in basic behavior analysis, translational efforts often examine everyday events through the lens of narrative versions of laboratory-derived principles. This approach to translation, although useful, is incomplete because equations may convey concepts that are difficult to capture in words. To support this point, we provide a nontechnical introduction to selected aspects of quantitative analysis; consider some issues that translational investigators (and, potentially, practitioners) confront when attempting to translate from quantitative models; and discuss examples of relevant translational studies. We conclude that, where behavior-science translation is concerned, the quantitative features of quantitative models cannot be ignored without sacrificing conceptual precision, scientific and practical insights, and the capacity of the basic and applied wings of behavior analysis to communicate effectively. PMID:22478533

Review of corruption in the health sector: theory, methods and interventions.

PubMed

Vian, Taryn

2008-03-01

There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and various aspects of management, financing and governance. Behavioural scientists and anthropologists also point to individual and social characteristics which influence the behaviour of government agents and clients. This article presents a comprehensive framework and a set of methodologies for describing and measuring how opportunities, pressures and rationalizations influence corruption in the health sector. The article discusses implications for intervention, and presents examples of how theory has been applied in research and practice. Challenges of tailoring anti-corruption strategies to particular contexts, and future directions for research, are addressed.

Nursing education: training evaluation by graduates, employers and teachers.

PubMed

Meira, Maria Dyrce Dias; Kurcgant, Paulina

2016-01-01

to support the assessment and the necessary changes in the curriculum of an undergraduate degree in Nursing. it is a descriptive study developed in two stages as an action research. In the first stage, the speeches of 19 graduates and 15 employers were interviewed and analyzed; in the second stage, five teachers participated in the focus group. For processing the data, the content analysis was adopted. based on the assessment of the actors, an action plan was created with suggestions regarding the curriculum flexibility, content resizing, continuing education, practice enhancement, active methodologies and autonomy of the student. the participation of actors participants of the training process and performance of professional nurses in the evaluation of a curriculum pointed aspects to realignment and provided concrete benefits to improving the quality of undergraduate course curriculum, scenario of this study.

Impact of Evidence-Based Dentistry Workshops on Educators' Use of Evidence in Teaching and Practice: A Pilot Study.

PubMed

Moreira, Narjara C F; Leonardi-Dutra, Kamile; Feres, Murilo F N; Colangelo, Erica A M; Balevi, Ben; Matthews, Debora; Flores-Mir, Carlos

2018-06-01

The aims of this pilot study were to evaluate the short-term impact of evidence-based dentistry (EBD) workshops on educators' use of clinical evidence in their clinical practice and educational activities and to identify barriers they encountered in implementing evidence in their teaching and clinical practice. Between April 2012 and January 2014, a series of EBD workshops was delivered to 31 dental faculty members and postdoctoral students at three Canadian dental schools. Survey I, assessing participants' perceptions of various aspects of the workshops, was administered immediately following the workshops. Survey II, evaluating the impact of the workshops on participants' EBD implementation, was conducted 10 to 31 months after their completion. Survey I was completed by all 31 participants (100% response rate); their mean scores ranged from 3.94 to 4.65 on a five-point scale. Survey II was completed by 20 participants (64.5% response rate; five postdoctoral students and 15 faculty members), using an online 20-item questionnaire. Of the respondents, 19 (95%) reported implementing EBD in their professional activities at that time, and 14 (70%) stated that the workshops had positively helped with EBD implementation. Eight respondents (40%) reported having experienced barriers to EBD implementation, while 15 (75%) reported that their patients/students welcomed use of EBD. The respondents reported believing that strategies such as increasing EBD education and dissemination and improving quality and accessibility of evidence would facilitate the transition to EBD practice. Reported barriers to EBD implementation included resistance and criticism from colleagues, difficulty in changing current practice model, and lack of time.

The Computer Student Worksheet Based Mathematical Literacy for Statistics

NASA Astrophysics Data System (ADS)

Manoy, J. T.; Indarasati, N. A.

2018-01-01

The student worksheet is one of media teaching which is able to improve teaching an activity in the classroom. Indicators in mathematical literacy were included in a student worksheet is able to help the students for applying the concept in daily life. Then, the use of computers in learning can create learning with environment-friendly. This research used developmental research which was Thiagarajan (Four-D) development design. There are 4 stages in the Four-D, define, design, develop, and disseminate. However, this research was finish until the third stage, develop stage. The computer student worksheet based mathematical literacy for statistics executed good quality. This student worksheet is achieving the criteria if able to achieve three aspects, validity, practicality, and effectiveness. The subject in this research was the students at The 1st State Senior High School of Driyorejo, Gresik, grade eleven of The 5th Mathematics and Natural Sciences. The computer student worksheet products based mathematical literacy for statistics executed good quality, while it achieved the aspects for validity, practical, and effectiveness. This student worksheet achieved the validity aspects with an average of 3.79 (94.72%), and practical aspects with an average of 2.85 (71.43%). Besides, it achieved the effectiveness aspects with a percentage of the classical complete students of 94.74% and a percentage of the student positive response of 75%.

[Using an employee survey as a means of quality assurance in newborn hearing screening].

PubMed

Depenbrock, A; Matulat, P; am Zehnhoff-Dinnesen, A

2013-03-01

Studies drawing information not only from technical data but also from surveying human resources behind the universal newborn hearing screening (UNHS) appear to be a rarity. This study aims at showing how the state of both knowledge and practical skills among the screening staff are essential aspects in future quality management. A self-developed questionnaire was sent to hospital staff addressing a total of 710 nurses who were registered as having undertaken a UNHS training course. Questions were aimed at aspects of organization, personal practical skills, current problems and improvement possibilities. High rates of occupancy, lack of trained personnel, technical issues and background noise disturbances were considered to be factors that increased time pressure and slowed down procedures. Of the participants 16 % considered communicating a "refer" result to parents a difficult step and 8 % felt insecure when explaining the aims and procedures to parents. There was a high interest in further training sessions. This survey served well to reveal aspects of improvement in screening procedures and meeting staff needs. The training sessions should outline practical aspects of conducting screening and also professional, sensitive communication to parents.

Aspects and the Overlap Function.

ERIC Educational Resources Information Center

Levine, Marilyn M.; Levine, Leonard P.

1984-01-01

Presents system for automatic handling of ordered sets, states based on these sets, and differing points of view regarding Universe of Discourse. Aspects are represented by new logical "overlap" function with examples taken from Ranganathan's horse and carriage parable and several books involving four main concepts (history, geography,…

Does a higher 'quality points' score mean better care in stroke? An audit of general practice medical records.

PubMed

Williams, Peter Huw; de Lusignan, Simon

2006-01-01

The Royal College of Physicians (RCP) have produced guidelines for stroke management in primary care; this guidance is taken to be the gold standard for the care of people with stroke. UK general practitioners now have a quality-based contract which includes a Quality and Outcomes Framework (QOF). This consists of financially remunerated 'quality points' for specific disease areas, including stroke. Achievement of these quality points is measured by extracting a limited list of computer codes from practice computer systems. To investigate whether a high stroke quality score is associated with adherence to RCP guidelines. Examination of computer and written medical records of all patients with a diagnosis of stroke. Two general practices, one in southwest London, one in Surrey, with a combined practice population of over 20 000. Both practices had a similar age-sex profile and prevalence of stroke. One practice scored 93.5% (29/31) of the available stroke quality points. The other practice achieved 73.4% (22.75/31), and only did better in one stroke quality target. However, the practice scoring fewer quality points had much better adherence to RCP guidance: 96% of patients were assessed in secondary care compared with 79% (P=0.001); 64% of stroke patients were seen the same day, compared with 44%; 56% received rehabilitation compared with 37%. Higher quality points did not reflect better adherence to RCP guidance. This audit highlights a gap between relatively simplistic measures of quality in the QOF, dependent on the recording of a narrow range of computer codes, and the actual standard of care being delivered. Research is needed to see whether this finding is generalisable and how the Quality and Outcomes Framework might be better aligned with delivering best practice.

[Forgoing treatments: a kind of euthanasia? A scientific approach to the debate about end of life decisions].

PubMed

Riccioni, Luigi; Busca, Maria Teresa; Busatta, Lucia; Orsi, Luciano; Gristina, Giuseppe R

2016-03-01

In the last decade an extensive debate on the topic of end of life decisions has developed in western countries, obtaining a worldwide media relevance. Philosophers, theologians, legal experts and doctors, focus their attention on the three thorny issues of the topic: forgoing treatments, euthanasia and assisted suicide. A thorough and respectful discussion on these issues should include all stakeholders - above all palliative care physicians - and should be encouraged in order to understand the views in favor or against the three practices, checking the different moral positions, and analyzing the cultural, social and legal aspects in the background on one hand, and, on the other, their impact on the health care systems. At present, in the fields of communications and politics, the debate related to the topic of these end of life practices is characterized by a confusion of terms and meanings. As an outcome, the term "euthanasia" is misused as a "container" including forgoing treatments, euthanasia and assisted suicide, while palliative sedation is wrongly considered as a procedure to cause death. This confusing approach does not permit to understand the real issues at the stake, keeping the debate at the tabloid level. Conversely, sharing the precise meaning of the words is the only way to provide tools to make rational, autonomous and responsible decisions, allowing individual informed choices in compliance with the principle of autonomy. This article is not aimed to take a moral stand in favor or against forgoing treatments, euthanasia and assisted suicide. Through an analysis based on scientific criteria, the authors firstly review the definitions of these three practices, examining the concepts enclosed in each term; secondly, they offer a glance on the legal approach to end of life issues in western countries; lastly, they investigate the relationship between these practices and palliative care culture in light of the medical societies official statements. The authors chosen to examine the topic of forgoing treatments, euthanasia and assisted suicide from a scientific point of view, because the clinical approach, taking into account the biological context of disease related to the human and social domains, seems to be able to better gather all the aspects of end of life practices, providing useful information to deal with them also in a philosophical or juridical perspective.

State of the practice on data access, sharing, and integration.

DOT National Transportation Integrated Search

2016-12-01

The purpose of this state-of-the-practice review was to lay both technical and institutional foundation for all aspects of the development of the Virtual Data Access Framework. The review focused on current data sharing and integration practices amon...

Palliative sedation in Germany: factors and treatment practices associated with different sedation rate estimates in palliative and hospice care services.

PubMed

Stiel, Stephanie; Nurnus, Mareike; Ostgathe, Christoph; Klein, Carsten

2018-03-13

Clinical practice of Palliative Sedation (PS) varies between institutions worldwide and sometimes includes problematic practices. Little available research points at different definitions and frameworks which may contribute to uncertainty of healthcare professionals in the application of PS. This analysis investigates what demographic factors and characteristics of treatment practices differ between institutions with high versus low sedation rates estimates in Palliative and Hospice Care in Germany. Data sets from 221 organisations from a prior online survey were separated into two sub-groups divided by their estimated sedation rate A) lower/equal to 16% (n = 187; 90.8%) and B) higher than 16% (n = 19; 9.2%) for secondary analysis. Demographic factors and characteristics of PS treatment practices between the two groups were compared using T-Tests and Chi 2 / Fisher Exact Tests and considered significant (*) at two-sided p < .05. Organisations in group B report that they discuss PS for a higher proportion of patients (38.5%/10.2%, p < 0.000**), rate agitation more often as an indications for PS (78.9%/ 53.5%, p = 0.050*), and are more likely to use Lorazepam (63.2%/ 37.4%, p = 0.047*), Promethazin (26.3%/ 9.6%, p = 0.044*), and (Es-)Ketamin (31.6%/ 12.8%, p = 0.039*) than representatives in group A. Both groups differ significantly in their allocation of three case scenarios to different types of PS. Both definitions and patterns of clinical practice between palliative and hospice care representatives show divergence, which may be influenced one by another. A comprehensive framework considering conceptual, clinical, ethical, and legal aspects of different definitions of PS could help to better distinguish between different types and nuances of PS.

Grounding our practice in nursing professional development.

PubMed

Dickerson, Pamela S

2014-07-01

The Nursing Professional Development: Scope and Standards of Practice is foundational to the work of nurses in a continuing professional development role. Use of the practice and professional performance aspects of the standards supports both quality of learning activities and the continuous growth process of nurses engaged in this area of practice. Copyright 2014, SLACK Incorporated.

Spoken Grammar Practice and Feedback in an ASR-Based CALL System

ERIC Educational Resources Information Center

de Vries, Bart Penning; Cucchiarini, Catia; Bodnar, Stephen; Strik, Helmer; van Hout, Roeland

2015-01-01

Speaking practice is important for learners of a second language. Computer assisted language learning (CALL) systems can provide attractive opportunities for speaking practice when combined with automatic speech recognition (ASR) technology. In this paper, we present a CALL system that offers spoken practice of word order, an important aspect of…

Professional Learning in Human Resource Management: Problematising the Teaching of Reflective Practice

ERIC Educational Resources Information Center

Griggs, V.; Holden, R.; Rae, J.; Lawless, A.

2015-01-01

Reflection and reflective practice are much discussed aspects of professional education. This paper conveys our efforts to problematise teaching reflective practice in human resources (HR) education. The research, on which the paper is based, engages with stakeholders involved in the professional learning and education of reflective practice in…

Teaching Euclid in a Practical Context: Linear Perspective and Practical Geometry

ERIC Educational Resources Information Center

Camerota, Filippo

2006-01-01

This article explores the transmission of practical knowledge in the XV and XVI centuries. According to cosmographer Egnatio Danti, optics and other mathematical sciences had "been banished" from the main philosophical schools of his period, and "the little which remains to us is limited to some practical aspects learned from the mechanical…

Impact of the "Guidelines for infection prevention in dentistry" (2006) by the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch-Institute (KRINKO) on hygiene management in dental practices - analysis of a survey from 2009.

PubMed

Hübner, Nils-Olaf; Handrup, Stephan; Meyer, Georg; Kramer, Axel

2012-01-01

To assess trends in hygiene management in dental practices in comparison to an earlier survey in 2002/2003 and to point out key aspects for future efforts. The infection prevention management of all dental practices in Greifswald (n=35) was determined by a questionnaire in a personal interview in 2008/2009. 26% of the dentists did not use sufficient personal protective equipment during the general examination of the patient. In conservative and prosthetic dentistry, 15% still did not use adequate measures and 9% did not even in surgical interventions. Vaccination coverage was clearly too low, as only 35% of dentists were vaccinated against influenza and coverage with other vaccinations was also quite low. 11% of the dentists did not perform a documented anamnesis and in 29% of the dental practices no appointment system for risk patients existed.There were significant deficiencies in the reprocessing of medical devices and in the equipment needed for reprocessing. The opportunity to participate in further training in this field was rejected by 23% of the dentists.In 10 dental practices, the colony count in the dental unit water-conducting system was five times higher than the limit. A contamination with P. aeruginosa was discovered in 4 practices. All units were renovated. Overall, both the hygiene management and hygiene equipment in the practices have improved considerably compared to the previous survey in 2002/2003. This demonstrates the positive effect of the KRINKO guidelines from 2006. However, the survey again showed relevant deficiences in the hygiene management of dental practices, which agrees with a Germany-wide online survey from 2009. While the study revealed persistent deficiencies in hygiene management, especially in reprocessing, it confirms that the KRINKO guidelines for dental practices from 2006 led to significant improvements in hygiene management. Doubts about the impact of the guidelines are not backed by evidence.

Military family physician attitudes toward treating obesity.

PubMed

Warner, Christopher H; Warner, Carolynn M; Morganstein, Joshua; Appenzeller, George N; Rachal, James; Grieger, Thomas

2008-10-01

The goal was to examine current knowledge, attitudes, and treatment practices of family practitioners regarding obesity. A cross-sectional, anonymous, self-report survey of active members of the Uniformed Services Chapter of the American Academy of Family Physicians was performed. Measures included demographic information, attitudes toward obese patients, knowledge of associated health risks, and treatment recommendations, rated on a 5-point Likert scale. Results were compared with previous similar studies, and associations between demographic variables, physician body mass index, and attitudes and behaviors were examined by using multivariate regression analysis. Of the 1,186 members invited to participate, 477 (40.2%) responded. Compared with previous studies, there was increased awareness of obesity-associated health risks and physicians' sense of obligation to counsel patients. There were minimal changes in physician comfort and gratification with obesity counseling. Stereotypical attitudes of physicians toward obese patients were increased. Treatment recommendations were increased in all fields, including exercise, diet/nutrition counseling, and behavioral modification, but the most notable increases were seen in the use of prescription medications, diet center programs, and surgical referrals. Age, physician gender, physician weight status, practice location, and current training status were each associated with some aspect of physician attitudes and treatment practices. Physicians are better able to identify obesity and its associated health risks, but some negative stereotypical attitudes persist. These attitudes affect current treatment practices. Increased awareness, training, and study are required to combat the continuing increase in obesity rates.

Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.

PubMed

Hajjaj, F M; Salek, M S; Basra, M K A; Finlay, A Y

2010-05-01

This article reviews an aspect of daily clinical practice which is of critical importance in virtually every clinical consultation, but which is seldom formally considered. Non-clinical influences on clinical decision-making profoundly affect medical decisions. These influences include patient-related factors such as socioeconomic status, quality of life and patient's expectations and wishes, physician-related factors such as personal characteristics and interaction with their professional community, and features of clinical practice such as private versus public practice as well as local management policies. This review brings together the different strands of knowledge concerning non-clinical influences on clinical decision-making. This aspect of decision-making may be the biggest obstacle to the reality of practising evidence-based medicine. It needs to be understood in order to develop clinical strategies that will facilitate the practice of evidence-based medicine.

[Sport as a profession: medical and social aspects].

PubMed

Izmerov, N F

2011-01-01

The author analyses possible use of methods and achievements of industrial medicine in solving problems of acme in sports. The article covers theoretic, methodologic and practical basis for possible integration of industrial medicine and sports medicine. Mechanisms of such interdisciplinary integration include current legal basis, scientific research (mostly, concept of occupational risk, norm and pathology concept, doctrine of preventive medicine, etc), practical experience accumulated in this country and abroad. Some aspects of public health preservation in contemporary Russia are also tackled.

Innovative Method of Analysis of Actual Cost of Work in Progress

NASA Astrophysics Data System (ADS)

Fil, O.; Terentev, V.

2017-11-01

The article focuses on the basic theory and practical aspects of improving the strategic management in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at selecting an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research and the experimental data obtained in the experiment

Housing Operation Taking into Account Obsolescence and Physical Deterioration

NASA Astrophysics Data System (ADS)

Petrenko, L.; Manjilevskaja, S.

2017-11-01

The article focuses on the basic theory and practical aspects of improving the strategic management in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at selecting an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research and the experimental data obtained in the experiment

Some anatomical and physiological aspects of anal sexual practices.

PubMed

Agnew, J

1985-01-01

Anal manipulation and penetration produce stimulation enjoyed as sexual by some people. Although this type of sexual activity is not new, the current social climate of sexual freedom and experimentation has brought it out into the open. This paper reviews some of the anatomical, physiological, and behavioral aspects of this variation of human sexual gratification, and provides the practicing professional, who has to deal with questions on anal sexuality, with information on the subject and suitable background material and literature references for further study.

Gastrointestinal cancers in the era of theranostics: Updates and future perspectives

PubMed Central

Ghosn, Marwan; Kourie, Hampig Raphael; Tabchi, Samer

2015-01-01

Theranostics are one of the practical aspects of personalized medicine. This concept was designed to describe a material combining diagnosis, treatment and follow up of a disease. It evolved and included molecular targeting and nanotechnologies that incorporate both diagnosis and therapeutics. In this editorial, we are presenting briefly the concept and evolution of theranostics, highlighting many applications of theranostics in daily practice and discussing future perspectives and aspects of this model in gastro-intestincal cancers. PMID:26229391

Preparation of HCPT-Loaded Nanoneedles with Pointed Ends for Highly Efficient Cancer Chemotherapy

NASA Astrophysics Data System (ADS)

Wu, Shichao; Yang, Xiangrui; Li, Yang; Wu, Hongjie; Huang, Yu; Xie, Liya; Zhang, Ying; Hou, Zhenqing; Liu, Xiangyang

2016-06-01

The high-aspect-ratio nanoparticles were proved to be internalized much more rapidly and efficiently by cancer cells than the nanoparticles with an equal aspect ratio. Herein, a kind of high-aspect ratio, pointed-end nanoneedles (NDs) with a high drug loading (15.04 %) and the prolonged drug release profile were fabricated with an anti-tumor drug—10-hydroxycamptothecin (HCPT)—via an ultrasound-assisted emulsion crystallization technique. It is surprising to see that the cellular internalization of NDs with an average length of 5 μm and an aspect ratio of about 12:1 was even much faster and higher than that of nanorods with the same size and the nanospheres with a much smaller size of 150 nm. The results further validated that cellular internalization of the nanoparticles exhibited a strong shape-dependent effect, and cellular uptake may favor the particles with sharp ends as well as a high-aspect ratio instead of particle size. The NDs with enhanced cytotoxicity would lead to a promising sustained local drug delivery system for highly efficient anticancer therapy. More importantly, the fabrication of NDs opens a door to design new formulations of nanoneedle drug delivery systems for highly efficient cancer.

MOOCs--Theoretical and Practical Aspects: Comparison of Selected Research Results: Poland, Russia, Ukraine, and Australia

ERIC Educational Resources Information Center

Smyrnova-Trybulska, Eugenia; Ogrodzka-Mazur, Ewa; Szafranska-Gajdzica, Anna; Morze, Nataliia; Makhachashvili, Rusudan; Noskova, Tatiana; Pavlova, Tatiana; Yakovleva, Olga; Issa, Tomayess; Issa, Theodora

2016-01-01

Many higher education students are interested in MOOCs. At the same time, numerous questions are still without answers: formal aspects of participation in MOOCs, the type of motivation on the part of students for participation in MOOCs, quality of MOOCs, students' opinions about type, structure, contents, communication in MOOCs and other aspects.…

The equilibrium-point hypothesis--past, present and future.

PubMed

Feldman, Anatol G; Levin, Mindy F

2009-01-01

This chapter is a brief account of fundamentals of the equilibrium-point hypothesis or more adequately called the threshold control theory (TCT). It also compares the TCT with other approaches to motor control. The basic notions of the TCT are reviewed with a major focus on solutions to the problems of multi-muscle and multi-degrees of freedom redundancy. The TCT incorporates cognitive aspects by explaining how neurons recognize that internal (neural) and external (environmental) events match each other. These aspects as well as how motor learning occurs are subjects of further development of the TCT hypothesis.

d-Neighborhood system and generalized F-contraction in dislocated metric space.

PubMed

Kumari, P Sumati; Zoto, Kastriot; Panthi, Dinesh

2015-01-01

This paper, gives an answer for the Question 1.1 posed by Hitzler (Generalized metrics and topology in logic programming semantics, 2001) by means of "Topological aspects of d-metric space with d-neighborhood system". We have investigated the topological aspects of a d-neighborhood system obtained from dislocated metric space (simply d-metric space) which has got useful applications in the semantic analysis of logic programming. Further more we have generalized the notion of F-contraction in the view of d-metric spaces and investigated the uniqueness of fixed point and coincidence point of such mappings.

A Mentee and his Mentor Speak their Minds

NASA Astrophysics Data System (ADS)

Bank, C. G.; Papadimitrios, K. S.

2015-12-01

An academic mentoring relationship can develop organically from joint experiences as a student-teacher team involved in undergraduate research projects. The mentor rarely has been trained for this role, and the mentee may not have actively searched for a mentor at first. Once the relationship is recognized the mentor may struggle with conflicting roles, aspects of fairness to other students, recognizing what is best for the mentee (and allowing them to figure something out on their own rather than imposing a viewpoint), and questioning the value of advice because of differences in age, culture, and own career path. The mentee does not want to disappoint, can feel ashamed to ask questions (sometimes more than once), may not want to share their own opinion - let alone challenge their mentor! - and may also be afraid that they rely to much on their mentor rather than searching for answers on their own. Both parties thus face similar challenges but from different perspectives. In our opinion a good mentoring relationship is built on honesty and respect as well as mutual trust where we can point out strengths or weaknesses in one another and recognize our vulnerabilities. Our conversations have touched on many aspects of our lives (including academic, home, soft skills, and personal development). We have asked questions neither of us could answer at first but which challenged each other for further learning. Our experience has resulted in a two-way support, revealed new points of view, and allowed for development of leadership skills for both. In this presentation we will report on our journey so far, assumptions we brought along, expectations we shared, and challenges we have faced individually or together. By sharing the perceptions of both parties in our unique mentorship relationship we want to help define best mentoring practices.

Use of the challenge point framework to guide motor learning of stepping reactions for improved balance control in people with stroke: a case series.

PubMed

Pollock, Courtney L; Boyd, Lara A; Hunt, Michael A; Garland, S Jayne

2014-04-01

Stepping reactions are important for walking balance and community-level mobility. Stepping reactions of people with stroke are characterized by slow reaction times, poor coordination of motor responses, and low amplitude of movements, which may contribute to their decreased ability to recover their balance when challenged. An important aspect of rehabilitation of mobility after stroke is optimizing the motor learning associated with retraining effective stepping reactions. The Challenge Point Framework (CPF) is a model that can be used to promote motor learning through manipulation of conditions of practice to modify task difficulty, that is, the interaction of the skill of the learner and the difficulty of the task to be learned. This case series illustrates how the retraining of multidirectional stepping reactions may be informed by the CPF to improve balance function in people with stroke. Four people (53-68 years of age) with chronic stroke (>1 year) and mild to moderate motor recovery received 4 weeks of multidirectional stepping reaction retraining. Important tenets of motor learning were optimized for each person during retraining in accordance with the CPF. Participants demonstrated improved community-level walking balance, as determined with the Community Balance and Mobility Scale. These improvements were evident 1 year later. Aspects of balance-related self-efficacy and movement kinematics also showed improvements during the course of the intervention. The application of CPF motor learning principles in the retraining of stepping reactions to improve community-level walking balance in people with chronic stroke appears to be promising. The CPF provides a plausible theoretical framework for the progression of functional task training in neurorehabilitation.

Aspects of dento/medico-legal report writing.

PubMed

Wood, Geoff D

2014-03-01

This paper offers some guidance on aspects of dento/medico-legal report writing, citing anonymized examples from the author's caseload for clarification of the points made, and also serves to illustrate that sometimes not everything is as straightforward as it may initially appear. It provides reference to the current Civil Procedure Rules in England and Wales and its relevance in report writing. To provide guidance on aspects of dento/medico-legal report writing.

Games, Gaming, and Gamification: Some Aspects of Motivation

ERIC Educational Resources Information Center

Hanson-Smith, Elizabeth

2016-01-01

Unsupported claims have been made for the use of games in education and the gamification (game-like aspects, such as scores and point goals) of various learning elements. This brief article examines what may be the motivational basis of gaming and how it can affect students' behavior and ultimate success.

Ontogeny and Phylogeny from an Epigenetic Point of View.

ERIC Educational Resources Information Center

Lovtrup, Soren

1984-01-01

The correlation between ontogeny and phylogeny is analyzed through the discussion of four theories on the reality, history, epigenetic, and ecological aspects of the mechanism of evolution. Also discussed are historical and creative aspects of evolution and three epigenetic mechanisms instantiated in the case of the amphibian embryo. (Author/RH)

Beyond Tradition: Preparing the Teachers of Tomorrow's Workforce.

ERIC Educational Resources Information Center

Hartley, Nancy K., Ed.; Wentling, Tim L., Ed.

This monograph contains eight papers examining vocational teacher education theory and practice within the context of new teacher education reforms and practices. Various theoretical and practical aspects of preparing vocational teachers for tomorrow's workplace are discussed, including the following: challenges/opportunities affecting the field;…

Shape Comparison Between 0.4–2.0 and 20–60 lm Cement Particles

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

Holzer, L.; Flatt, R; Erdogan, S

Portland cement powder, ground from much larger clinker particles, has a particle size distribution from about 0.1 to 100 {micro}m. An important question is then: does particle shape depend on particle size? For the same cement, X-ray computed tomography has been used to examine the 3-D shape of particles in the 20-60 {micro}m sieve range, and focused ion beam nanotomography has been used to examine the 3-D shape of cement particles found in the 0.4-2.0 {micro}m sieve range. By comparing various kinds of computed particle shape data for each size class, the conclusion is made that, within experimental uncertainty, bothmore » size classes are prolate, but the smaller size class particles, 0.4-2.0 {micro}m, tend to be somewhat more prolate than the 20-60 {micro}m size class. The practical effect of this shape difference on the set-point was assessed using the Virtual Cement and Concrete Testing Laboratory to simulate the hydration of five cement powders. Results indicate that nonspherical aspect ratio is more important in determining the set-point than are the actual shape details.« less

Implementation of a Parallel Kalman Filter for Stratospheric Chemical Tracer Assimilation

NASA Technical Reports Server (NTRS)

Chang, Lang-Ping; Lyster, Peter M.; Menard, R.; Cohn, S. E.

1998-01-01

A Kalman filter for the assimilation of long-lived atmospheric chemical constituents has been developed for two-dimensional transport models on isentropic surfaces over the globe. An important attribute of the Kalman filter is that it calculates error covariances of the constituent fields using the tracer dynamics. Consequently, the current Kalman-filter assimilation is a five-dimensional problem (coordinates of two points and time), and it can only be handled on computers with large memory and high floating point speed. In this paper, an implementation of the Kalman filter for distributed-memory, message-passing parallel computers is discussed. Two approaches were studied: an operator decomposition and a covariance decomposition. The latter was found to be more scalable than the former, and it possesses the property that the dynamical model does not need to be parallelized, which is of considerable practical advantage. This code is currently used to assimilate constituent data retrieved by limb sounders on the Upper Atmosphere Research Satellite. Tests of the code examined the variance transport and observability properties. Aspects of the parallel implementation, some timing results, and a brief discussion of the physical results will be presented.

Astronomical aspects of cosmic threats: new problems and approaches to asteroid—comet hazard following the chelyabinsk event of February 15, 2013

NASA Astrophysics Data System (ADS)

Shustov, B. M.; Shugarov, A. S.; Naroenkov, S. A.; Prokhorov, M. E.

2015-10-01

A new definition of hazardous celestial bodies (HCBs) is introduced, in which the lower limit of the size of a HCB is reduced to 10 m. A new definition for threatening and collisional orbits of DCBs is introduced. The main astronomical factors that must be taken into account when creating systems for the detection of HCBs are analyzed. The most important of these are the uniformity of the distribution of points (regions) for the appearance of HCBs on the celestial sphere in near-Earth space and the practical limit for the velocity of approach of a HCB of 20 km/s (for 90% of bodies). It is shown that the creation of a system for the nearby detection of asteroids and comets arriving from the daytime sky requires the use of a space-based system. A concept for such a system, in which one or several optical telescopes are placed in the vicinity of the libration point L1 for the Sun—Earth system, is developed. Preliminary plans for such a system, called the System for the Detection of Daytime Asteroids (SDDA), are briefly described.

Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices.

PubMed

Hoff, Timothy; DePuccio, Matthew

2018-07-01

The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.

Tagging as a Social Literacy Practice

ERIC Educational Resources Information Center

MacGillivray, Laurie; Curwen, Margaret Sauceda

2007-01-01

Tagging is not simply an act of vandalism or violence; it is a social practice with its own rules and codes--a literacy practice imbued with intent and meaning. Three aspects of tagging reflect its nature as a literate practice: (1) The purpose of tagging to achieve particular social goals and group affiliations; (2) The role of talent to be…

Karate cicatrices.

PubMed

Adams, B B; Mutasim, D F

2001-06-01

A 46-year-old male presented with linear scars on the dorsal aspects of both hands. The lesions were caused by trauma occurring during the practice of karate. Sports-related scars should be included in the differential diagnosis of scars on the dorsal aspects of the hands.

Spiritual Reflective Practice in Preservice Art Education

ERIC Educational Resources Information Center

Campbell, Laurel H.

2005-01-01

Spirituality is becoming an increasingly significant aspect of contemporary art education theory. The manner in which one conceives of holistic art education curricula is partially shaped by one's understanding of a more spiritual approach to reflective thinking and practice in teacher education. Definitions of reflective practice and…

Professional Practice Schools: Building a Model. Volume II.

ERIC Educational Resources Information Center

Levine, Marsha, Ed.

This collection of papers addresses three important aspects of professional practice schools: student learning, teacher development, and implementation issues related to collaboration among institutions and state policy environment. The first paper, "The Child as Meaning Maker: The Organizing Theme of Professional Practice Schools" (Ellen M.…

African American Homeschooling Practices: Empirical Evidence

ERIC Educational Resources Information Center

Mazama, Ama

2016-01-01

Despite a significant increase in scholarly interest for homeschooling, some of its most critical aspects, such as instructional daily practices, remain grossly understudied. This essay thus seeks to fill that void by presenting empirical evidence regarding the homeschooling practices of a specific group, African Americans. Most specifically, the…

Perceptions of business skill development by graduates of the University of Michigan Dental School.

PubMed

Barber, Michael; Wiesen, Robert; Arnold, Sara; Taichman, Russell S; Taichman, Linda Susan

2011-04-01

Many graduating dentists leave dental school feeling that they are not prepared to start and run a dental practice. The aim of this pilot study was to explore the knowledge and perceptions dental graduates have in the area of practice management. A twenty-item survey was mailed in the fall of 2008 to nearly half of the University of Michigan dental school alumni who had graduated between the years of 1997 and 2007. Respondents were asked about their demographics, practice characteristics, and perceptions of knowledge/experience regarding practice management skills at the present time as well as at graduation. Data were analyzed using descriptive and inferential statistics. The majority of respondents were general practitioners (84 percent) aged thirty to thirty-nine practicing between six and ten years with practice incomes reported to be greater than $300,000 per year (79 percent). Most dentists reported being either an owner or co-owner of the practice (57 percent), and 33 percent reported being an associate in the practice. Upon graduation, 7 percent of the respondents felt that they had a strong knowledge of accounting or human resource issues; this perception increased to 47 percent at the present time. Similarly, less than 6 percent of respondents felt they understood issues pertaining to dental insurance upon graduation; this perception increased to 68 percent after having spent time in the workforce. In contrast to the large increase in knowledge/experience in business aspects of dentistry that had accrued since graduation, most alumni reported only a 7 percent increase in their knowledge of the legal aspects of dental practice. Results from this study indicate that interventions are needed to increase graduating dentists' knowledge of practice management and close the gap between their knowledge and its application in real life. The majority of alumni believed there is a need to improve the curriculum focused on these aspects of dental practice.

Readiness of Primary Care Practices for Medical Home Certification

PubMed Central

Clark, Sarah J.; Sakshaug, Joseph W.; Chen, Lena M.; Hollingsworth, John M.

2013-01-01

OBJECTIVES: To assess the prevalence of medical home infrastructure among primary care practices for children and identify practice characteristics associated with medical home infrastructure. METHODS: Cross-sectional analysis of restricted data files from 2007 and 2008 of the National Ambulatory Medical Care Survey. We mapped survey items to the 2011 National Committee on Quality Assurance’s Patient-Centered Medical home standards. Points were awarded for each “passed” element based on National Committee for Quality Assurance scoring, and we then calculated the percentage of the total possible points met for each practice. We used multivariate linear regression to assess associations between practice characteristics and the percentage of medical home infrastructure points attained. RESULTS: On average, pediatric practices attained 38% (95% confidence interval 34%–41%) of medical home infrastructure points, and family/general practices attained 36% (95% confidence interval 33%–38%). Practices scored higher on medical home elements related to direct patient care (eg, providing comprehensive health assessments) and lower in areas highly dependent on health information technology (eg, computerized prescriptions, test ordering, laboratory result viewing, or quality of care measurement and reporting). In multivariate analyses, smaller practice size was significantly associated with lower infrastructure scores. Practice ownership, urban versus rural location, and proportion of visits covered by public insurers were not consistently associated with a practice’s infrastructure score. CONCLUSIONS: Medical home programs need effective approaches to support practice transformation in the small practices that provide the vast majority of the primary care for children in the United States. PMID:23382438

Evaluation of dental students’ perception and self-confidence levels regarding endodontic treatment

PubMed Central

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-01-01

Objectives: The aim of this study was to obtain information about senior dental students’ perceptions and self-confidence levels regarding endodontic practice. Materials and Methods: Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. Results: The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). Conclusions: The results showing students’ lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment. PMID:24883030

Evaluation of dental students' perception and self-confidence levels regarding endodontic treatment.

PubMed

Tanalp, Jale; Güven, Esra Pamukçu; Oktay, Inci

2013-04-01

The aim of this study was to obtain information about senior dental students' perceptions and self-confidence levels regarding endodontic practice. Anonymous survey forms were handed out to senior students at Yeditepe University, Faculty of Dentistry. The students were asked to score their level of confidence using a 5-point scale and comment about future practices. The response rate of the survey was 88%. 11.9% expressed endodontics as the first branch in terms of difficulty. The majority (90.5%) indicated they would perform root canal treatments within their expertise limit in the future but refer difficult cases to an endodontist. Bleaching of endodontically treated teeth, managing flare-ups, placement of a rubber dam were procedures in which students reported the lowest confidence (2.55 ± 1.17, 3.24 ± 0.96, 3.24 ± 1.19, respectively). On the other hand, students felt the lowest confidence in the treatment of maxillary molars followed by mandibular molars (3.43 ± 1.02 and 3.93 ± 0.97, respectively). Students also reported the lowest confidence in root resorptions, endo-perio lesions, traumas, retreatments and apexifications (2.93 ± 1.16, 3.07 ± 0.89, 3.24 ± 0.85, 3.33 ± 1.7 and 3.36 ± 1.1, respectively). The results showing students' lower confidence in more challenging aspects of dentistry may be related with the attitude of dental schools to refer these cases to post graduate students and instilling information about these cases on a theoretical basis only. Though there seems to be a tendency for students to refer challenging cases to a specialist in future, authorities should give priority to enhance the way information and experience is conveyed regarding various aspects of endodontic treatment.

'Haven of safety' and 'secure base': a qualitative inquiry into factors affecting child attachment security in Nairobi, Kenya.

PubMed

Polkovnikova-Wamoto, Anastasia; Mathai, Muthoni; Stoep, Ann Vander; Kumar, Manasi

2016-01-01

Secure attachment in childhood and adolescence protects children from engagement in high risk behaviors and development of mental health problems over the life span. Poverty has been shown to create impoverishment in certain aspects of caregiving and correspondingly to compromise development of secure attachment in children. Nineteen children 8 to 14 years old from two schools in a middle income area and an urban informal settlement area of Nairobi were interviewed using an adapted Child Attachment Interview (CAI) protocol. CAI was developed to provide a glimpse into the 'meta-theories' children have about themselves, parents, parenting and their attachment ties with parents and extended family members. Narratives obtained with the CAI were analyzed using thematic analysis. Both Bowlby's idea of 'secure base' as well as Bronfrenbrenner's 'ecological niche' are used as reference points to situate child attachment and parenting practices in the larger Kenyan context. We found that with slight linguistic alterations CAI can be used to assess attachment security of Kenyan children in this particular age range. We also found that the narration ability in both groups of children was generally good such that formal coding was possible, despite cultural differences. Our analysis suggested differences in narrative quality across the children from middle class and lower socio-economic class schools on specific themes such as: sensitivity of parenting (main aspects of sensitivity were associated with disciplinary methods and child's access to education), birth order , parental emotional availability , and severity of inter-parental conflicts and child's level of exposure. The paper puts in context a few cultural practices such as greater household responsibility accorded to the eldest child and stern to harsh disciplinary methods adopted by parents in the Kenyan setting.

[Survey among academic teachers about psychiatric training in France].

PubMed

van Effenterre, A; Hanon, C; Llorca, P-M

2014-06-01

Given the results of resident psychiatrists' surveys conducted in France over the past 3 years, it has become essential to also examine the opinion of the academic psychiatrists in charge of psychiatry education. To study the teachers point of view on psychiatric training in France, the weaknesses and strengths of the training, recent improvements and problems, and to compare their opinion with that of the residents. A survey was conducted in April 2012 among 125 academic teachers professors hospital practitioners (PU-PH), in child & adolescent psychiatry and adult psychiatry. An anonymous online questionnaire including seven parts and three open questions was sent to the PU-PH. The questionnaire was answered by 79/125 psychiatric PU-PH (63%). Results show that a majority of PU-PH (78%) were willing to maintain a single training pathway including adult psychiatry and child psychiatry with a single diploma, with the addition of a DESC (specific and additional Diploma) in forensic psychiatry (72%) and old age psychiatry (62%). Almost all respondents suggested the implementation of an assessment of teaching and a formal mentorship program. Some aspects of training included more controversial issues: such as the length of the training, the opening of training to private practice physicians, or the European harmonization. The survey stressed some areas of improvement: such training in psychotherapy and research, access to supervision as well as barriers to improved training including an insufficient number of academic practitioners. Compared with other surveys, it emphasized that in addition to the need of diversifying the theoretical (thematic, interactive media and teaching, teachers, etc.) and the practical aspect (training sites), it is essential according to trainees and PU-PH, to implement an efficient supervision during residency. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Personal dignity in the terminally ill from the perspective of caregivers: a survey among trained volunteers and physicians.

PubMed

Albers, Gwenda; de Vet, Henrica C W; Pasman, H Roeline W; Deliens, Luc; Onwuteaka-Philipsen, Bregje D

2013-09-01

Although dignity is increasingly considered a goal of palliative care, little research has evaluated the understanding of dignity at the end of life from a caregiver's perspective. The study objective was to investigate and compare the views of trained volunteers and SCEN physicians on maintaining dignity for patients reaching the end of life. The study is a survey questionnaire study. Subjects were two groups of caregivers involved in care for dying patients: trained volunteers (n=236) and end-of-life consultants (SCEN physicians; n=427). Measurement was done via the Dutch version of the 22-item Patient Dignity Inventory on symptoms and experiences that have been shown to influence the sense of dignity in terminally ill patients. Respondents were asked to rate on a five-point scale the extent to which they considered the items as influential on dignity in terminally ill patients, and as problematic in practice in maintaining dignity for patients in the last phase of life. Overall, volunteers indicated items more frequently as influential to dignity and as problematic in maintaining dignity at the end of life, compared to SCEN physicians. Volunteers gave significantly higher ratings than SCEN physicians to most of the social items, and to half of the psychological and existential items. It seems that SCEN physicians consider the physical aspects of suffering to be most influential and problematic in practice in preserving dignity, while volunteers think psychosocial aspects are most important in preserving dignity at the end of life. These findings suggest that the role and responsibilities of caregivers involved in care for terminally ill patients affect the factors that they think influence dignity.

Gender, sexuality and the participatory dimensions of a comparative life history policy study.

PubMed

Macdonnell, Judith A

2011-12-01

Gender, sexuality and the participatory dimensions of a comparative life history policy study In this paper, I explore how a critical feminist lens was a crucial element in creating a participatory policy study which used a qualitative design and comparative life history methodology. This study focused on Canadian nurses' political practice related to advocacy for lesbian health. Findings show that the combination of the gender lens and life history approach offers potential to create knowledge in ways aligned with health-promoting and emancipatory outcomes. However, the nature of participation and interaction by researcher and participants is contexualized and contested given complex dynamics of power that shape all aspects of this doctoral study process. The critical feminist lens with its focus on reflexivity informed the content and process of knowledge production in this study and shaped key turning points: the ways in which this policy study was conceptualized, the choice of comparative life history methodology, ethical considerations, data collection and analysis and representation of findings. Life history is unlikely to be the methodology that first comes to mind when undertaking a policy study. Its historical roots are associated with biographical, oral history and narrative approaches, which typically aim to elicit understanding of lived experience. Yet, it was this very aspect, this focus on lived experience, which rendered life history methodology fitting as I contemplated how to examine the relationship between nurses and policy. I was interested in understanding nurses' political practice, how policy influenced nurses' capacity to advocate in their everyday lives, as well as nurses' impacts on policy processes and their larger social worlds. © 2011 Blackwell Publishing Ltd.

Surgical anatomy of the radial nerve at the elbow.

PubMed

Artico, M; Telera, S; Tiengo, C; Stecco, C; Macchi, V; Porzionato, A; Vigato, E; Parenti, A; De Caro, R

2009-02-01

An anatomical study of the brachial portion of the radial nerve with surgical implications is proposed. Thirty specimens of arm from 20 fresh cadavers (11 male, 9 female) were used to examine the topographical relations of the radial nerve with reference to the following anatomical landmarks: acromion angle, medial and lateral epicondyles, point of division between the lateral and long heads of the triceps brachii, lateral intermuscular septum, site of division of the radial nerve into its superficial and posterior interosseous branches and entry and exit point of the posterior interosseous branch into the supinator muscle. The mean distances between the acromion angle and the medial and lateral levels of crossing the posterior aspect of the humerus were 109 (+/-11) and 157 (+/-11) mm, respectively. The mean length and calibre of the nerve in the groove were 59 (+/-4) and 6 (+/-1) mm, respectively. The division of the lateral and long heads of the triceps was found at a mean distance of 126 (+/-13) mm from the acromion angle. The mean distances between the lateral point of crossing the posterior aspect of the humerus and the medial and lateral epicondyles were 125 (+/-13) and 121 (+/-13) mm, respectively. The mean distance between the lateral point of crossing the posterior aspect of the humerus and the entry point in the lateral intermuscular septum (LIS) was 29 (+/-6) mm. The mean distances between the entry point of the nerve in the LIS and the medial and lateral epicondyles were 133 (+/-14) and 110 (+/-23) mm, respectively. Our study provides reliable and objective data of surgical anatomy of the radial nerve which should be always kept in mind by surgeons approaching to the surgery of the arm, in order to avoid iatrogenic injuries.

Integrated Bio-Search: challenges and trends for the integration, search and comprehensive processing of biological information

PubMed Central

2014-01-01

Many efforts exist to design and implement approaches and tools for data capture, integration and analysis in the life sciences. Challenges are not only the heterogeneity, size and distribution of information sources, but also the danger of producing too many solutions for the same problem. Methodological, technological, infrastructural and social aspects appear to be essential for the development of a new generation of best practices and tools. In this paper, we analyse and discuss these aspects from different perspectives, by extending some of the ideas that arose during the NETTAB 2012 Workshop, making reference especially to the European context. First, relevance of using data and software models for the management and analysis of biological data is stressed. Second, some of the most relevant community achievements of the recent years, which should be taken as a starting point for future efforts in this research domain, are presented. Third, some of the main outstanding issues, challenges and trends are analysed. The challenges related to the tendency to fund and create large scale international research infrastructures and public-private partnerships in order to address the complex challenges of data intensive science are especially discussed. The needs and opportunities of Genomic Computing (the integration, search and display of genomic information at a very specific level, e.g. at the level of a single DNA region) are then considered. In the current data and network-driven era, social aspects can become crucial bottlenecks. How these may best be tackled to unleash the technical abilities for effective data integration and validation efforts is then discussed. Especially the apparent lack of incentives for already overwhelmed researchers appears to be a limitation for sharing information and knowledge with other scientists. We point out as well how the bioinformatics market is growing at an unprecedented speed due to the impact that new powerful in silico analysis promises to have on better diagnosis, prognosis, drug discovery and treatment, towards personalized medicine. An open business model for bioinformatics, which appears to be able to reduce undue duplication of efforts and support the increased reuse of valuable data sets, tools and platforms, is finally discussed. PMID:24564249

Behavioral Aspects of Marihuana Use

ERIC Educational Resources Information Center

Paulson, Patricia

1973-01-01

The purpose of the study was to investigate the attitudes and practices toward drugs by users and nonusers at Queensborough Community College and the relationship of these attitudes and practices to selected psychosocial factors. (Author)

Precision GPS ephemerides and baselines

NASA Technical Reports Server (NTRS)

1991-01-01

Based on the research, the area of precise ephemerides for GPS satellites, the following observations can be made pertaining to the status and future work needed regarding orbit accuracy. There are several aspects which need to be addressed in discussing determination of precise orbits, such as force models, kinematic models, measurement models, data reduction/estimation methods, etc. Although each one of these aspects was studied at CSR in research efforts, only points pertaining to the force modeling aspect are addressed.

Determinants of sustainability in solid waste management - The Gianyar Waste Recovery Project in Indonesia

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

Zurbruegg, Christian, E-mail: zurbrugg@eawag.ch; Gfrerer, Margareth, E-mail: margareth.gfrerer@gmx.net; Ashadi, Henki, E-mail: henki@eng.ui.ac.id

2012-11-15

Highlights: Black-Right-Pointing-Pointer Our assessment tool helps evaluate success factors in solid waste projects. Black-Right-Pointing-Pointer Success of the composting plant in Indonesia is linked to its community integration. Black-Right-Pointing-Pointer Appropriate technology is not a main determining success factor for sustainability. Black-Right-Pointing-Pointer Structured assessment of 'best practices' can enhance replication in other cities. - Abstract: According to most experts, integrated and sustainable solid waste management should not only be given top priority, but must go beyond technical aspects to include various key elements of sustainability to ensure success of any solid waste project. Aside from project sustainable impacts, the overall enabling environmentmore » is the key feature determining performance and success of an integrated and affordable solid waste system. This paper describes a project-specific approach to assess typical success or failure factors. A questionnaire-based assessment method covers issues of: (i) social mobilisation and acceptance (social element), (ii) stakeholder, legal and institutional arrangements comprising roles, responsibilities and management functions (institutional element); (iii) financial and operational requirements, as well as cost recovery mechanisms (economic element). The Gianyar Waste Recovery Project in Bali, Indonesia was analysed using this integrated assessment method. The results clearly identified chief characteristics, key factors to consider when planning country wide replication but also major barriers and obstacles which must be overcome to ensure project sustainability. The Gianyar project consists of a composting unit processing 60 tons of municipal waste per day from 500,000 inhabitants, including manual waste segregation and subsequent composting of the biodegradable organic fraction.« less

Controversy and consensus on a clinical pharmacist in primary care in the Netherlands.

PubMed

Hazen, Ankie C M; Wal, Aletta W van der; Sloeserwij, Vivianne M; Zwart, Dorien L M; Gier, Johan J de; Wit, Niek J de; Leendertse, Anne J; Bouvy, Marcel L; Bont, Antoinette A de

2016-10-01

Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and consensus. Primary health care in the Netherlands. Method Q methodology. 163 participants rank-ordered statements on issues concerning the integration of a non-dispensing pharmacist in primary care practice. Stakeholder perspectives on the role of the non-dispensing pharmacist and pharmaceutical care in primary care. Results This study identified the consensus on various features of the non-dispensing pharmacist role as well as the financial, organisational and collaborative aspects of integrating a non-dispensing pharmacist in primary care practice. Q factor analysis revealed four perspectives: "the independent community pharmacist", "the independent clinical pharmacist", "the dependent clinical pharmacist" and "the medication therapy management specialist". These four perspectives show controversies to do with the level of professional independency of the non-dispensing pharmacist and the level of innovation of task performance. Conclusion Despite the fact that introducing new professional roles in healthcare can lead to controversy, the results of this Q study show the potential of a non-dispensing pharmacist as a pharmaceutical care provider and the willingness for interprofessional collaboration. The results from the POINT intervention study in the Netherlands will be an important next step in resolving current controversies.

[Support to spiritual needs in hospital care. Integration perspective in modern hospitals].

PubMed

Proserpio, Tullio; Piccinelli, Claudia; Arice, Carmine; Petrini, Massimo; Mozzanica, Mario; Veneroni, Laura; Clerici, Carlo Alfredo

2014-01-01

Within the course of medical care in the most advanced health care settings, an increasing attention is being paid to the so-called care humanization. According to this perspective, we try to integrate the usual care pathways with aspects related to the spiritual and religious dimension of all people and their families, as well as the employees themselves. It is clearly important to establish this kind of practices on the basis of scientific evidences. That is the reason why it's a necessity to improve the knowledge about the importance that spiritual assistance can offer within the current health service. The aim of this work is to show the relevance of the integration of spiritual perspectives in the hospital setting according to a multidisciplinary point of view. In this work many data that emerge from the international scientific literature, as well as the definition that is given to the concept of "spirituality" are analyzed; about this definition in fact there is not unanimous consent even today. It is also analyzed the legal situation in force within the European territory according to the different laws and social realities. Finally, the possible organizational practices related to spiritual support are described and the opportunity to specific accreditation pathways and careful training of chaplains able to integrate traditional religious practices with modern spiritual perspectives is discussed.

Elements of analytic style: Bion's clinical seminars.

PubMed

Ogden, Thomas H

2007-10-01

The author finds that the idea of analytic style better describes significant aspects of the way he practices psychoanalysis than does the notion of analytic technique. The latter is comprised to a large extent of principles of practice developed by previous generations of analysts. By contrast, the concept of analytic style, though it presupposes the analyst's thorough knowledge of analytic theory and technique, emphasizes (1) the analyst's use of his unique personality as reflected in his individual ways of thinking, listening, and speaking, his own particular use of metaphor, humor, irony, and so on; (2) the analyst's drawing on his personal experience, for example, as an analyst, an analysand, a parent, a child, a spouse, a teacher, and a student; (3) the analyst's capacity to think in a way that draws on, but is independent of, the ideas of his colleagues, his teachers, his analyst, and his analytic ancestors; and (4) the responsibility of the analyst to invent psychoanalysis freshly for each patient. Close readings of three of Bion's 'Clinical seminars' are presented in order to articulate some of the elements of Bion's analytic style. Bion's style is not presented as a model for others to emulate or, worse yet, imitate; rather, it is described in an effort to help the reader consider from a different vantage point (provided by the concept of analytic style) the way in which he, the reader, practices psychoanalysis.

Tracing organizing principles: learning from the history of systems biology.

PubMed

Green, Sara; Wolkenhauer, Olaf

2013-01-01

With the emergence of systems biology, the identification of organizing principles is being highlighted as a key research aim. Researchers attempt to "reverse engineer" the functional organization of biological systems using methodologies from mathematics, engineering and computer science while taking advantage of data produced by new experimental techniques. While systems biology is a relatively new approach, the quest for general principles of biological organization dates back to systems theoretic approaches in early and mid-twentieth century. The aim of this paper is to draw on this historical background in order to increase the understanding of the motivation behind the search for general principles and to clarify different epistemic aims within systems biology. We pinpoint key aspects of earlier approaches that also underlie the current practice. These are i) the focus on relational and system-level properties, ii) the inherent critique of reductionism and fragmentation of knowledge resulting from overspecialization, and iii) the insight that the ideal of formulating abstract organizing principles is complementary to, rather than conflicting with, the aim of formulating detailed explanations of biological mechanisms. We argue that looking back not only helps us understand the current practice but also points to possible future directions for systems biology.

[Theoretical and practical considerations in rational polytherapy for epilepsy].

PubMed

Rajna, Péter

2011-11-30

Author analyses the consideration of rational polytherapy for epilepsy. Among the theoretical aspects he points the different effect of seizure inhibitory drugs on the epilepsy models but didn't find data enough for the basis of any successful combination. Combinations of compounds having different way of action are more promising. Rational polytherapy can serve also the epileptic patients' tailored therapy in the daily routine. There have already been some proved synergisms concerning drug interactions. Based on detailed analysis of side effects a possibility occurs for neutralization of side effects when anticonvulsants with side effects of opposite nature are combined. Considering both the side effect profiles and the different (somatic and psychic) habits of the patients we can create a special list of favourable combinations. Co-morbid states and their treatments play a significant role in the application of rational polytherapy. Combination of anticonvulsants of lower potential but without drug-interactions can be the choice in these cases. The non-epileptic indications of the anticonvulsants can also be utilized in polymorbid patients. Based on the theoretical and practical considerations the author defines the ten-step-cognitive-preparation-process in planning the optimal (poly)therapy. On speculative basis he suggests eight beneficial versions of seizure inhibitory rational polytherapy.

Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives.

PubMed

Mosher, Catherine E; Adams, Rebecca N; Helft, Paul R; O'Neil, Bert H; Shahda, Safi; Rattray, Nicholas A; Champion, Victoria L

2016-05-01

Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers. Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis. In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms. Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.

Strategic performance evaluation in cancer centers.

PubMed

Delgado, Rigoberto I; Langabeer, James R

2009-01-01

Most research in healthcare strategy has focused on formulating or implementing organizational plans and strategies, and little attention has been dedicated to the post-implementation control and evaluation of strategy, which we contend is the most critical aspect of achieving organizational goals. The objective of this study was to identify strategic control approaches used by major cancer centers in the country and to relate these practices to financial performance. Our intent was to expand the theory and practice of healthcare strategy to focused services, such as oncology. We designed a 17-question survey to capture elements of strategy and performance from our study sample, which comprised major cancer hospitals in the United States and shared similar mandates and resource constraints. The results suggest that high-performing cancer centers use more sophisticated analytical approaches, invest greater financial resources in performance analysis, and conduct more frequent performance reviews than do low-performing organizations. Our conclusions point to the need for a more robust approach to strategic assessment. In this article, we offer a number of recommendations for management to achieve strategic plans and goals on the basis of our research. To our knowledge, this study is one of the first to concentrate on the area of strategic control.

Trichinella diagnostics and control: mandatory and best practices for ensuring food safety.

PubMed

Gajadhar, Alvin A; Pozio, Edoardo; Gamble, H Ray; Nöckler, Karsten; Maddox-Hyttel, Charlotte; Forbes, Lorry B; Vallée, Isabelle; Rossi, Patrizia; Marinculić, Albert; Boireau, Pascal

2009-02-23

Because of its role in human disease, there are increasing global requirements for reliable diagnostic and control methods for Trichinella in food animals to ensure meat safety and to facilitate trade. Consequently, there is a need for standardization of methods, programs, and best practices used in the control of Trichinella and trichinellosis. This review article describes the biology and epidemiology of Trichinella, and describes recommended test methods as well as modified and optimized procedures that are used in meat inspection programs. The use of ELISA for monitoring animals for infection in various porcine and equine pre- and post-slaughter programs, including farm or herd certification programs is also discussed. A brief review of the effectiveness of meat processing methods, such as freezing, cooking and preserving is provided. The importance of proper quality assurance and its application in all aspects of a Trichinella diagnostic system is emphasized. It includes the use of international quality standards, test validation and standardization, critical control points, laboratory accreditation, certification of analysts and proficiency testing. Also described, are the roles and locations of international and regional reference laboratories for trichinellosis where expert advice and support on research and diagnostics are available.

Promoting Collaborative Classrooms: The Impacts of Interdependent Cooperative Learning on Undergraduate Interactions and Achievement.

PubMed

Premo, Joshua; Cavagnetto, Andy; Davis, William B; Brickman, Peggy

2018-06-01

Collaboration is an important career skill and vital to student understanding of the social aspects of science, but less is known about relationships among collaborative-learning strategies, classroom climate, and student learning. We sought to increase the collaborative character of introductory undergraduate laboratory classrooms by analyzing a 9-week intervention in 10 classrooms ( n = 251) that participated in cooperative-learning modules (promoting interdependence via a modified jigsaw technique). Students in an additional 10 classrooms ( n = 232) completed the same material in an unstructured format representative of common educational practice. Results showed that, when between-class variance was controlled for, intervention students did not score higher on weekly quizzes, but science interest and prior science experience had a reduced relationship to quiz performance in intervention classrooms. Also, intervention classrooms showed increased collaborative engagement at both whole-class and individual levels (24 students at three time points), but the intervention was only one of several factors found to account for late-intervention classroom collaborative engagement (prosocial behavior and discussion practices). Taken together, findings suggest that integrating interdependence-based tasks may foster collaborative engagement at both small-group and whole-classroom levels, but by itself may not be enough to promote increased student achievement.

Innovation in the occupational health physician profession requires the development of a work collective to improve the efficiency of MSD prevention.

PubMed

Caroly, S; Landry, A; Cholez, C; Davezies, P; Bellemare, M; Poussin, N

2012-01-01

Given the ageing population of occupational health physicians and the deteriorating situation of employee health, reforms targeting the multi-disciplinary nature of occupational health are currently being drawn up. These are of great concern to doctors in terms of the future of occupational health, notably with regard to changing medical practices. The objective of this study is to explore the actual practices of occupational health physicians within the framework of MSD prevention in France. By analysing the activity of occupational health physicians, we could gain a better understanding of the coordination between those involved in OHS with the ultimate goal being to improve prevention. Based on an analysis of peer activity, this method made it possible to push beyond pre-constructed discourse. According to activity theories, it is through others that the history and controversies of a profession can be grasped and skills developed. The results produced by these collective discussions on activity analysis contributed to establish a collective point of view about the important aspects of their profession that need defending and the variations in professional genre in relation to the current reforms, notably.

Driving towards an improved research and development culture.

PubMed

McNicholl, Mary P; Coates, Vivien; Dunne, Kathleen

2008-04-01

This study examined the research and development culture and capacity within one NHS Trust in Northern Ireland. Strengths and challenges were identified and opportunities for further research and development expansion were sought. This is a two-stage project incorporating a baseline survey (n = 379) followed by consultation with key stakeholders across the Trust (n = 11). In the survey, over half of the respondents (n = 194) stated they had participated in a research project and a significant number (n = 313) read health care journals. Identification of barriers to research resulted in findings similar to other published work. Staff responded positively about using research in practice (n = 328) and that practice should be influenced by research (n = 312). Nurse Managers indicated support for research and development activity. The study provides a starting point from which to develop a positive research and development culture within this Trust. After establishing a baseline of research and development activity across a large acute Trust, the strengths and weaknesses of such activity were identified with a view to informing a strategy to develop this aspect of professional activity. A change in an organizational culture cannot be made without full support of both the clinicians and their managers.

Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature.

PubMed

de São José, José; Barros, Rosanna; Samitca, Sanda; Teixeira, Ana

2016-01-01

The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research. © 2015 John Wiley & Sons Ltd.

Novel mathematical model to estimate ball impact force in soccer.

PubMed

Iga, Takahito; Nunome, Hiroyuki; Sano, Shinya; Sato, Nahoko; Ikegami, Yasuo

2017-11-22

To assess ball impact force during soccer kicking is important to quantify from both performance and chronic injury prevention perspectives. We aimed to verify the appropriateness of previous models used to estimate ball impact force and to propose an improved model to better capture the time history of ball impact force. A soccer ball was fired directly onto a force platform (10 kHz) at five realistic kicking ball velocities and ball behaviour was captured by a high-speed camera (5,000 Hz). The time history of ball impact force was estimated using three existing models and two new models. A new mathematical model that took into account a rapid change in ball surface area and heterogeneous ball deformation showed a distinctive advantage to estimate the peak forces and its occurrence times and to reproduce time history of ball impact forces more precisely, thereby reinforcing the possible mechanics of 'footballer's ankle'. Ball impact time was also systematically shortened when ball velocity increases in contrast to practical understanding for producing faster ball velocity, however, the aspect of ball contact time must be considered carefully from practical point of view.

Visual communications with side information via distributed printing channels: extended multimedia and security perspectives

NASA Astrophysics Data System (ADS)

Voloshynovskiy, Sviatoslav V.; Koval, Oleksiy; Deguillaume, Frederic; Pun, Thierry

2004-06-01

In this paper we address visual communications via printing channels from an information-theoretic point of view as communications with side information. The solution to this problem addresses important aspects of multimedia data processing, security and management, since printed documents are still the most common form of visual information representation. Two practical approaches to side information communications for printed documents are analyzed in the paper. The first approach represents a layered joint source-channel coding for printed documents. This approach is based on a self-embedding concept where information is first encoded assuming a Wyner-Ziv set-up and then embedded into the original data using a Gel'fand-Pinsker construction and taking into account properties of printing channels. The second approach is based on Wyner-Ziv and Berger-Flynn-Gray set-ups and assumes two separated communications channels where an appropriate distributed coding should be elaborated. The first printing channel is considered to be a direct visual channel for images ("analog" channel with degradations). The second "digital channel" with constrained capacity is considered to be an appropriate auxiliary channel. We demonstrate both theoretically and practically how one can benefit from this sort of "distributed paper communications".

Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices - a focus group study.

PubMed

Fernandez, Ritin; Rolley, John X; Rajaratnam, Rohan; Everett, Bronwyn; Davidson, Patricia M

2015-01-01

Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD). Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians. Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken. Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions. Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation. Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals' point of reference around food and recommendations for an optimal diet.

Current management of acute diverticulitis: a survey of Australasian surgeons.

PubMed

Jaung, Rebekah; Robertson, Jason; Rowbotham, David; Bissett, Ian

2016-03-11

To evaluate the current practice and degree of consensus amongst Australasian surgeons regarding non-surgical management of acute diverticulitis (AD) and to determine whether newer approaches to management are being translated into practice. An online survey was distributed to all Australasian colorectal surgeons and all general surgeons in the Auckland region. Responses were collected over two months and analysed to identify points of consensus and areas of significant difference in opinion between these groups. Responses were received from a total of 99 of 200 (49.5%) colorectal surgeons, and 19 of 36 (52.7%) general surgeons. The Hinchey Classification was the most commonly used measure of disease severity, used by 67 (95.7%) colorectal surgeons and 12 (92.3%) general surgeons. There was lack of consensus around important aspects of AD management, including antibiotic therapy, and use and modality of follow-up imaging. Selective antibiotic therapy and use of anti-inflammatory medication as adjuncts to treatment were practised by a minority of those surveyed. Newer approaches to management were being utilised by some respondents. The lack of consensus regarding management of AD may be a consequence of a paucity of high-level evidence to support specific management approaches, particularly in patients with uncomplicated AD.

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.

[How the information system can contribute to the implementation of a risk management program in a hospital?].

PubMed

Staccini, P; Quaranta, J F; Staccini-Myx, A; Veyres, P; Jambou, P

2003-09-01

Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.

Developing IVHM Requirements for Aerospace Systems

NASA Technical Reports Server (NTRS)

Rajamani, Ravi; Saxena, Abhinav; Kramer, Frank; Augustin, Mike; Schroeder, John B.; Goebel, Kai; Shao, Ginger; Roychoudhury, Indranil; Lin, Wei

2013-01-01

The term Integrated Vehicle Health Management (IVHM) describes a set of capabilities that enable sustainable and safe operation of components and subsystems within aerospace platforms. However, very little guidance exists for the systems engineering aspects of design with IVHM in mind. It is probably because of this that designers have to use knowledge picked up exclusively by experience rather than by established process. This motivated a group of leading IVHM practitioners within the aerospace industry under the aegis of SAE's HM-1 technical committee to author a document that hopes to give working engineers and program managers clear guidance on all the elements of IVHM that they need to consider before designing a system. This proposed recommended practice (ARP6883 [1]) will describe all the steps of requirements generation and management as it applies to IVHM systems, and demonstrate these with a "real-world" example related to designing a landing gear system. The team hopes that this paper and presentation will help start a dialog with the larger aerospace community and that the feedback can be used to improve the ARP and subsequently the practice of IVHM from a systems engineering point-of-view.

Medication non-adherence and uncertainty: Information-seeking and processing in the Danish LIFESTAT survey.

PubMed

Kriegbaum, Margit; Lau, Sofie Rosenlund

2017-09-23

Statins are widely prescribed to lower cardiovascular morbidity and mortality. However, statin non-adherence is very high. The aim of this paper was to investigate reasons for stopping statin treatment in the general population and to study how aspects of information-seeking and processing is associated with statin non-adherence. This study used a population survey on 3050 Danish residents aged 45-65 years. Reasons for statin discontinuation was studied among those who were previous statin users. The association between information seeking and processing and statin discontinuation were analysed using multivariate logistical regression models. Experience of side effects and fear of side effects played an important role in the discontinuation of statin treatment. Feelings of uncertainty and confusion regarding information on statins predicted statin discontinuation. This applied to information from both mass media and from general practitioners. There was no clear pattern of information seeking and statin non-adherence. The article point to the impact of information-seeking on the decision to take cholesterol-lowering medication. This included contributions from information disseminated by media outlets. Side effects and fear of side effects should be addressed in clinical practice. Health care professionals should pay attention to emotional aspects of how information is disseminated and perceived by statin users. Copyright © 2017. Published by Elsevier Inc.

Investigating the quality of mental models deployed by undergraduate engineering students in creating explanations: The case of thermally activated phenomena

NASA Astrophysics Data System (ADS)

Fazio, Claudio; Battaglia, Onofrio Rosario; Di Paola, Benedetto

2013-12-01

This paper describes a method aimed at pointing out the quality of the mental models undergraduate engineering students deploy when asked to create explanations for phenomena or processes and/or use a given model in the same context. Student responses to a specially designed written questionnaire are quantitatively analyzed using researcher-generated categories of reasoning, based on the physics education research literature on student understanding of the relevant physics content. The use of statistical implicative analysis tools allows us to successfully identify clusters of students with respect to the similarity to the reasoning categories, defined as “practical or everyday,” “descriptive,” or “explicative.” Through the use of similarity and implication indexes our method also enables us to study the consistency in students’ deployment of mental models. A qualitative analysis of interviews conducted with students after they had completed the questionnaire is used to clarify some aspects which emerged from the quantitative analysis and validate the results obtained. Some implications of this joint use of quantitative and qualitative analysis for the design of a learning environment focused on the understanding of some aspects of the world at the level of causation and mechanisms of functioning are discussed.

Status of ionization chambers calibration for radiation therapy in Brazil

NASA Astrophysics Data System (ADS)

Gonçalves, M.; Joana, G.; Leal, P.; Vasconcelos, R.; do Couto, N.; Teixeira, F. C.; Soares, A. D.; Santini, E. S.; Salata, C.

2018-03-01

CNEN makes a constant effort to keep updated with international standards and national needs to strengthen the radiological protection status of the country. The guidelines related to radiation treatment facilities have been revised in the last five years in order to take in consideration the most relevant aspects of the growing technology as well as to mitigate the accidents or incidents observed in practice. Hence, clinical dosimeters have gained special importance as significant items in Brazilian regulation. In the present work we discuss the importance of inspections from the point of view of equipment dosimetry and instruments quality control. The dosimeter sets based on thimble and well ionization chambers need periodic calibration, and this calibration becomes a fundamental task in order to guarantee the dose prescribed-delivered to patients. Thus Brazilian guidelines enforce the need of at least two sets of clinical dosimeters with thimble chambers calibrated and one set of electrometer with well ionization chamber for hdr equipment. We call attention to the fact that inspections are a very valuable tool in order to enforce the application of guidelines around the country both by enlightening the weaker aspects of facilities concerning radiological protection and by stating in loco that reasons which lead the regulatory body to enforce such guidelines items.

Sub-arcminute pointing from a balloonborne platform

NASA Astrophysics Data System (ADS)

Craig, William W.; McLean, Ryan; Hailey, Charles J.

1998-07-01

We describe the design and performance of the pointing and aspect reconstruction system on the Gamma-Ray Arcminute Telescope Imaging System. The payload consists of a 4m long gamma-ray telescope, capable of producing images of the gamma-ray sky at an angular resolution of 2 arcminutes. The telescope is operated at an altitude of 40km in azimuth/elevation pointing mode. Using a variety of sensor, including attitude GPS, fiber optic gyroscopes, star and sun trackers, the system is capable of pointing the gamma-ray payload to within an arc-minute from the balloon borne platform. The system is designed for long-term autonomous operation and performed to specification throughout a recent 36 hour flight from Alice Springs, Australia. A star tracker and pattern recognition software developed for the mission permit aspect reconstruction to better than 10 arcseconds. The narrow field star tracker system is capable of acquiring and identifying a star field without external input. We present flight data form all sensors and the resultant gamma-ray source localizations.

Practical Handbook of School Psychology: Effective Practices for the 21st Century

ERIC Educational Resources Information Center

Peacock, Gretchen Gimpel, Ed.; Ervin, Ruth A., Ed.; Daly, Edward J., III, Ed.; Merrell, Kenneth W., Ed.

2009-01-01

This authoritative guide addresses all aspects of school psychology practice in a response-to-intervention (RTI) framework. Thirty-four focused chapters present effective methods for problem-solving-based assessment, instruction, and intervention. Specific guidelines are provided for promoting success in core academic domains--reading, writing,…

The Practice of Foreign Language Teaching.

ERIC Educational Resources Information Center

Cajkler, Wasyl; Addelman, Ron

This book on aspects of modern foreign language teaching is written for trainee, new, and experienced teachers of students aged 11-16 and is intended as a practical source of information. The discussion of specific teaching issues includes implications for classroom practice. While not directly addressing Britain's new National Curriculum, it does…

Autonomy, Perfectionism and the Justification of Education

ERIC Educational Resources Information Center

Drerup, Johannes

2015-01-01

This paper is concerned with the practical importance of different forms of paternalism for educational theory and practice. Contrary to the traditional treatment of paternalism as a sometimes necessary and rather messy aspect of educational practices, I demonstrate that paternalism is to be regarded as an "indigenous concept" (Herbart)…

16 CFR 0.18 - Bureau of Economics.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Bureau of Economics. 0.18 Section 0.18 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.18 Bureau of Economics. The bureau aids and advises the Commission concerning the economic aspects of...

16 CFR 0.18 - Bureau of Economics.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Bureau of Economics. 0.18 Section 0.18 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.18 Bureau of Economics. The bureau aids and advises the Commission concerning the economic aspects of...

16 CFR 0.18 - Bureau of Economics.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Bureau of Economics. 0.18 Section 0.18 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.18 Bureau of Economics. The bureau aids and advises the Commission concerning the economic aspects of...

16 CFR 0.18 - Bureau of Economics.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Bureau of Economics. 0.18 Section 0.18 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.18 Bureau of Economics. The bureau aids and advises the Commission concerning the economic aspects of...

Physicians' Assessments of a Rural Preceptorship and Its Influence on Career Choice and Practice Site.

ERIC Educational Resources Information Center

Chaulk, C. Patrick; And Others

1987-01-01

Graduates of the University of Nebraska's medical school preceptorship program, in which students choose their preceptors from rural sites and are exposed to the social and economic aspects of rural practice, were surveyed after entering private practice about the program's effects on them. (MSE)

Educational Achievement and Effective Schools: Examples of Best Practice

ERIC Educational Resources Information Center

Suarez-Ortega, Magdalena; Ballesteros-Velazquez, Belen; Malik-Lievano, Beatriz

2012-01-01

In this article, we present key aspects of a research project entitled "Students' Cultural Diversity and School Efficacy: A Repertory of Best Practice in Compulsory Learning Centers." First, we present our concept of cultural diversity and a reflection regarding "best school practices" and the notion of "student…

A Geometric Model to Teach Nature of Science, Science Practices, and Metacognition

ERIC Educational Resources Information Center

Nyman, Matthew; St. Clair, Tyler

2016-01-01

Using the science practice model in science classes for preservice teachers addresses three important aspects of science teacher preparation: teaching the nonlinear nature of scientific process, using scientific practices rather than the ambiguous term "inquiry-based," and emphasizing the process of metacognition as an important tool in…

Tracking Instructional Quality across Secondary Mathematics and English Language Arts Classes

ERIC Educational Resources Information Center

Donaldson, Morgaen L.; LeChasseur, Kimberly; Mayer, Anysia

2017-01-01

Teachers have the largest school-based influence on student learning, yet there is little research on how instructional practice is systematically distributed within tracking systems. We examine whether teaching practice varies significantly across track levels and, if so, which aspects of instructional practice differ systematically. Using…

16 CFR 0.18 - Bureau of Economics.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Bureau of Economics. 0.18 Section 0.18 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.18 Bureau of Economics. The bureau aids and advises the Commission concerning the economic aspects of...

A Guide to Faculty Development: Practical Advice, Examples, and Resources.

ERIC Educational Resources Information Center

Gillespie, Kay Herr, Ed.

Chapters in this guide provide practical guidance and useful information and resources relating to important aspects of faculty development, from setting up a faculty development program to assessing teaching practices. The chapters are: (1) "Faculty, Instructional, and Organizational Development: Options and Choices" (Robert M. Diamond); (2) "Ten…

Communities of Practice: Literacy and Deaf Children

ERIC Educational Resources Information Center

Kristoffersen, Ann-Elise; Simonsen, Eva

2016-01-01

This article aims to discuss young deaf children's access to literacy within a sociocultural perspective. We introduce the concept of communities of practice as an aspect in early literacy development for young deaf children. Preschools are learning communities and thus constitute communities of practice. Our discussion on the use of communities…

Curriculum Studies in Brasil: A Study of the Teaching Practice.

ERIC Educational Resources Information Center

Marcondes, Maria Ines; Tura, Maria de Lourdes Rangel; de Macedo, Elizabeth Fernandes

This study analyzes how undergraduate university teachers are thinking in the classroom about the theoretical and practical contents related to the subject called "Curriculum Studies." The study focuses on the aspects of the theory-practice relationship, the idea of curriculum, and the theoretical references used by the undergraduate…

Play and Recreation for Individuals with Disabilities: Practical Pointers.

ERIC Educational Resources Information Center

Grosse, Susan J., Ed.; Thompson, Donna, Ed.

This book contains practical information that reflects new developments in sports participation for individuals with disabilities. The focus is on meeting the challenges of the outdoor environment, learning through appropriate and safe play, and keeping fit through active leisure. Specifics include practical aspects of camping and outdoor…

The Changing Character of Dental Practice and Its Impact on Dental Education.

ERIC Educational Resources Information Center

Kerr, I. Lawrence

1981-01-01

The "practice" aspect of the dental profession is reviewed. It is suggested that there is no way to separate education, practice, research, financing, government, science, business, management, motivation, and the public from one another. Retail dentistry, health maintenance organizations, franchising, advertising, and denturism are…

A Survey of Optometry Graduates to Determine Practice Patterns.

ERIC Educational Resources Information Center

Bleimann, Robert L.; Smith, Lee W.

1984-01-01

A summary of a study of optometry graduates conducted by the Association of Schools and Colleges of Optometry (ASCO) is provided. The data covered aspects of recently graduated O.D.s' experience in obtaining a state license, becoming established in practice, and their practice characteristics. (Author/MLW)

Optical levitation of a non-spherical particle in a loosely focused Gaussian beam.

PubMed

Chang, Cheong Bong; Huang, Wei-Xi; Lee, Kyung Heon; Sung, Hyung Jin

2012-10-08

The optical force on a non-spherical particle subjected to a loosely focused laser beam was calculated using the dynamic ray tracing method. Ellipsoidal particles with different aspect ratios, inclination angles, and positions were modeled, and the effects of these parameters on the optical force were examined. The vertical component of the optical force parallel to the laser beam axis decreased as the aspect ratio decreased, whereas the ellipsoid with a small aspect ratio and a large inclination angle experienced a large vertical optical force. The ellipsoids were pulled toward or repelled away from the laser beam axis, depending on the inclination angle, and they experienced a torque near the focal point. The behavior of the ellipsoids in a viscous fluid was examined by analyzing a dynamic simulation based on the penalty immersed boundary method. As the ellipsoids levitated along the direction of the laser beam propagation, they moved horizontally with rotation. Except for the ellipsoid with a small aspect ratio and a zero inclination angle near the focal point, the ellipsoids rotated until the major axis aligned with the laser beam axis.

Mathematical formalisms based on approximated kinetic representations for modeling genetic and metabolic pathways.

PubMed

Alves, Rui; Vilaprinyo, Ester; Hernádez-Bermejo, Benito; Sorribas, Albert

2008-01-01

There is a renewed interest in obtaining a systemic understanding of metabolism, gene expression and signal transduction processes, driven by the recent research focus on Systems Biology. From a biotechnological point of view, such a systemic understanding of how a biological system is designed to work can facilitate the rational manipulation of specific pathways in different cell types to achieve specific goals. Due to the intrinsic complexity of biological systems, mathematical models are a central tool for understanding and predicting the integrative behavior of those systems. Particularly, models are essential for a rational development of biotechnological applications and in understanding system's design from an evolutionary point of view. Mathematical models can be obtained using many different strategies. In each case, their utility will depend upon the properties of the mathematical representation and on the possibility of obtaining meaningful parameters from available data. In practice, there are several issues at stake when one has to decide which mathematical model is more appropriate for the study of a given problem. First, one needs a model that can represent the aspects of the system one wishes to study. Second, one must choose a mathematical representation that allows an accurate analysis of the system with respect to different aspects of interest (for example, robustness of the system, dynamical behavior, optimization of the system with respect to some production goal, parameter value determination, etc). Third, before choosing between alternative and equally appropriate mathematical representations for the system, one should compare representations with respect to easiness of automation for model set-up, simulation, and analysis of results. Fourth, one should also consider how to facilitate model transference and re-usability by other researchers and for distinct purposes. Finally, one factor that is important for all four aspects is the regularity in the mathematical structure of the equations because it facilitates computational manipulation. This regularity is a mark of kinetic representations based on approximation theory. The use of approximation theory to derive mathematical representations with regular structure for modeling purposes has a long tradition in science. In most applied fields, such as engineering and physics, those approximations are often required to obtain practical solutions to complex problems. In this paper we review some of the more popular mathematical representations that have been derived using approximation theory and are used for modeling in molecular systems biology. We will focus on formalisms that are theoretically supported by the Taylor Theorem. These include the Power-law formalism, the recently proposed (log)linear and Lin-log formalisms as well as some closely related alternatives. We will analyze the similarities and differences between these formalisms, discuss the advantages and limitations of each representation, and provide a tentative "road map" for their potential utilization for different problems.

Comparative analysis of structural concrete quality assurance practices on nine nuclear power plant construction projects. Final report

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

Willenbrock, J.H.; Thomas, H.R. Jr.; Burati, J.L. Jr.

1978-06-01

The basic objective of this research effort was to perform a comparative analysis of the Quality Assurance practices related to the structural concrete phase on nine nuclear power plant projects which are (or have been) under construction in the United States in the past ten years. This analysis identified the response of each Quality Assurance program to the applicable criteria of 10 CFR Part 50, Appendix B as well as to the pertinent regulatory requirements and industry standards. The major emphasis was placed on the construction aspects of the structural concrete phase of each project. The engineering and design aspectsmore » were examined whenever they interfaced with the construction aspects. For those aspects of the Quality Assurance system which can be considered managerial in nature (i.e., organizational relationships, types of Quality Assurance programs, corrective action procedures, etc.) an attempt has been made to present the alternative approaches that were identified. For those aspects of the Quality Assurance system which are technical in nature (i.e., the frequency of testing for slump, compressive strength, etc.) an attempt has been made to present a comparative analysis between projects and in relation to the recommended or mandated practices presented in the appropriate industry codes and standards.« less

Fellows' in intensive care medicine views on professionalism and how they learn it.

PubMed

van Mook, Walther N K A; de Grave, Willem S; Gorter, Simone L; Muijtjens, Arno M M; Zwaveling, Jan Harm; Schuwirth, Lambert W; van der Vleuten, Cees P M

2010-02-01

The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. A nationwide study was performed in 2007-2008. All ICM fellows (n = 90) were sent a questionnaire containing the following questions regarding training in professionalism (7-point Likert scale (1 = very inadequate, 7 = very adequate)): which are the elements perceived to be important in intensivists'' daily practice (38 items, cat. I)? Which methods of learning and teaching are recognised (16 items, cat. II)? Which methods of teaching and learning are considered especially useful (16 items, cat. III)? Finally, the perceived quantity and quality of formal and informal learning methods, as well as the responsible organisational body was studied. Data were analysed using SPSS 15.0. Response was 75.5 % (n = 68), mean age 34 years. Regarding Elements, scores on virtually all items were high. The factor 'striving for excellence' explained half the variance. Two other aspects, 'Teamwork' and 'Dealing with ethical dilemmas', were identified. Regarding Methods, three dimensions, 'formal curriculum'', 'private and academic experiences' and 'role modelling', proved important. The factor 'formal curriculum' explained most of the variance. Regarding Usefulness the same factors, now mainly explained by the factor Private and academic experiences, emerged with variance. In both categories the items 'observations in daily practice' and 'watching television programmes like ER and House' were the highest- and lowest-scoring items (5.99 and 5.81, and 2.69 and 2.49, respectively). Mean scores regarding the quantity of formal and informal teaching were 4.06 and 4.58 (range 1.841 and 1.519). For the quality of teaching, the figures were 4.22 and 4.52 (range 1.659 and 1.560, respectively). 54 suggestions for improvement of teaching were documented. The need for some form of formal teaching of professionalism aspects as well as for feedback was most frequently mentioned (n = 19 and 16). The local training centres are considered and should remain pivotal for teaching professionalism issues (n = 17 and 28). Almost all elements of professionalism were considered relevant to intensivists' daily practice. Although formal teaching methods regarding professionalism aspects are easily recognised in daily practice, learning by personal experiences and informal ways quantitatively plays a more important, and more valued role. Qualitative comments, nevertheless, stress the need for providing and receiving (solicited and unsolicited) feedback, thereby requesting expansion of formal teaching methods. The local training centres (should continue to) play a major role in teaching professionalism, although an additional role for the (inter)national intensive care organisations remains.

Electronic excitations and defects in fluoroperovskite LiBaF3

NASA Astrophysics Data System (ADS)

Springis, Maris; Brikmane, Liga; Tale, Ivar; Kulis, Peteris

2003-08-01

A survey of the present situation with respect to knowledge of lattice defects, electronic excitations, such as excitons and localized excitons, as well as energy storage and transfer phenomena in LiBaF3 crystals is given. Both phenomenological models and experimental interpretations of optical absorption bands, tentatively associated with F-type (electron) centers created by X-ray or electron irradiation, is reviewed. Interpretation of three radiative processes (super-fast core-valence transitions, slow trapped exciton luminescence and luminescence of structure defects) observed in undoped LiBaF3 crystals is analyzed with respect to practical application. Attention is paid to the behavior of ultraviolet emission so far ascribed to self-trapped exciton luminescence and also observed as a result of electron recombination with localized hole at various temperatures (even at room temperature), depending on crystal purity and growth conditions. Finally, some aspects of ionic processes in thermal relaxation of defects are pointed to.

Tutorial: Parallel Computing of Simulation Models for Risk Analysis.

PubMed

Reilly, Allison C; Staid, Andrea; Gao, Michael; Guikema, Seth D

2016-10-01

Simulation models are widely used in risk analysis to study the effects of uncertainties on outcomes of interest in complex problems. Often, these models are computationally complex and time consuming to run. This latter point may be at odds with time-sensitive evaluations or may limit the number of parameters that are considered. In this article, we give an introductory tutorial focused on parallelizing simulation code to better leverage modern computing hardware, enabling risk analysts to better utilize simulation-based methods for quantifying uncertainty in practice. This article is aimed primarily at risk analysts who use simulation methods but do not yet utilize parallelization to decrease the computational burden of these models. The discussion is focused on conceptual aspects of embarrassingly parallel computer code and software considerations. Two complementary examples are shown using the languages MATLAB and R. A brief discussion of hardware considerations is located in the Appendix. © 2016 Society for Risk Analysis.

Object-oriented programming for the biosciences.

PubMed

Wiechert, W; Joksch, B; Wittig, R; Hartbrich, A; Höner, T; Möllney, M

1995-10-01

The development of software systems for the biosciences is always closely connected to experimental practice. Programs must be able to handle the inherent complexity and heterogeneous structure of biological systems in combination with the measuring equipment. Moreover, a high degree of flexibility is required to treat rapidly changing experimental conditions. Object-oriented methodology seems to be well suited for this purpose. It enables an evolutionary approach to software development that still maintains a high degree of modularity. This paper presents experience with object-oriented technology gathered during several years of programming in the fields of bioprocess development and metabolic engineering. It concentrates on the aspects of experimental support, data analysis, interaction and visualization. Several examples are presented and discussed in the general context of the experimental cycle of knowledge acquisition, thus pointing out the benefits and problems of object-oriented technology in the specific application field of the biosciences. Finally, some strategies for future development are described.

Deep and continuous palliative sedation (terminal sedation): clinical-ethical and philosophical aspects.

PubMed

Materstvedt, Lars Johan; Bosshard, Georg

2009-06-01

Terminal sedation continues to fuel debate. When confronted with a patient for whom terminal sedation is considered a possible treatment option, decision making can be difficult. In this paper we focus on the clinical-ethical issues, with an aim to provide clinicians with ways of framing the issue from an ethical point of view. In addition to the clinical-ethical issues, terminal sedation touches upon interesting and complex questions of an essentially philosophical nature. What it means to be a "person" is one such question, and is a topic that is relevant to clinical, daily practice. Accordingly, in the latter part of this paper we draw briefly on selected philosophical positions to elucidate this question. A doctor's belief of what it means to be a "person" might well affect their actions. For example, if a doctor believes terminal sedation involves the destruction of the person, they might not be willing to proceed with it.

Dynamic risk factors: the Kia Marama evaluation.

PubMed

Hudson, Stephen M; Wales, David S; Bakker, Leon; Ward, Tony

2002-04-01

Risk assessment is an essential part of clinical practice. Each of the three aspects of risk (static, stable, and acute dynamic) are important at various points of contact between the man and the systems that are responsible for providing service. Dynamic factors, the typical treatment and supervision targets, have received less research attention than static factors. This paper examined the extent to which pretreatment, posttreatment and change scores were associated with reoffending among men incarcerated for sexually molesting. The results were generally supportive of change in prooffending attitudes as the key to not reoffending and suggested that the perspective-taking component of empathy and the use of fantasy may be important mechanisms. Affect scales generally failed to show any relationship with reoffending, outside decreases in trait and suppressed anger. Moreover, these data suggest that we could improve our assessments and treatment through increased sensitivity to offense pathways.

Insights and limits of translational research in critical care medicine.

PubMed

Pène, Frédéric; Ait-Oufella, Hafid; Taccone, Fabio Silvio; Monneret, Guillaume; Sharshar, Tarek; Tamion, Fabienne; Mira, Jean-Paul

2015-01-01

Experimental research has always been the cornerstone of pathophysiological and therapeutic advances in critical care medicine, where clinical observations and basic research mutually fed each other in a so-called translational approach. The objective of this review is to address the different aspects of translational research in the field of critical care medicine. We herein highlighted some demonstrative examples including the animal-to-human approach to study host-pathogen interactions, the human-to-animal approach for sepsis-induced immunosuppression, the still restrictive human approach to study critical illness-related neuromyopathy, and the technological developments to assess the microcirculatory changes in critically ill patients. These examples not only emphasize how translational research resulted in major improvements in the comprehension of the pathophysiology of severe clinical conditions and offered promising perspectives in critical care medicine but also point out the obstacles to translate such achievements into clinical practice.

[Current Practice of Pre- and Postnatal Screening and Future Developments for Evidence Based Guidelines].

PubMed

Hebebrand, J; Hamelmann, E; Hartmann, A; Holtmann, M; Jöckel, K-H; Kremer, U; Legenbauer, T; Lücke, T; Radkowski, K; Reinehr, T; Wand, K; Mühlig, Y; Föcker, M

2017-01-01

Objectives: In this selective review we provide an overview of the current pre- and postnatal screenings up to 18 years established in Germany to inform physicians of different medical fields (gynecologists, pediatricians, general practitioners, other medical specialists who treat children, adolescents or pregnant females). Current State: Research on screening for different types of cancer has frequently failed to show any benefit. Thus, there is a need to broaden the evidence basis related to medical screenings especially for children and adolescents. Outlook: Potential future developments of pre- and postnatal screenings are illustrated including their social impact. The lack of an early detection of mental health problems is pointed out. An interdisciplinary collaboration and research is required to accumulate evidence with regard to medical screenings and to consider health economic and ethical aspects. © Georg Thieme Verlag KG Stuttgart · New York.

Special series on "The meaning of behavioral medicine in the psychosomatic field" establishment of a core curriculum for behavioral science in Japan: The importance of such a curriculum from the perspective of psychology.

PubMed

Shimazu, Akihito; Nakao, Mutsuhiro

2016-01-01

This article discusses the core curriculum for behavioral science, from the perspective of psychology, recommended by the Japanese Society of Behavioral Medicine and seeks to explain how the curriculum can be effectively implemented in medical and health-related departments. First, the content of the core curriculum is reviewed from the perspective of psychology. We show that the curriculum features both basic and applied components and that the basic components are closely related to various aspects of psychology. Next, we emphasize two points to aid the effective delivery of the curriculum: 1) It is necessary to explain the purpose and significance of basic components of behavioral science to improve student motivation; and 2) it is important to encourage student self-efficacy to facilitate application of the acquired knowledge and skills in clinical practice.

The Effects of Real-Time Interactive Multimedia Teleradiology System

PubMed Central

Al-Safadi, Lilac

2016-01-01

This study describes the design of a real-time interactive multimedia teleradiology system and assesses how the system is used by referring physicians in point-of-care situations and supports or hinders aspects of physician-radiologist interaction. We developed a real-time multimedia teleradiology management system that automates the transfer of images and radiologists' reports and surveyed physicians to triangulate the findings and to verify the realism and results of the experiment. The web-based survey was delivered to 150 physicians from a range of specialties. The survey was completed by 72% of physicians. Data showed a correlation between rich interactivity, satisfaction, and effectiveness. The results of our experiments suggest that real-time multimedia teleradiology systems are valued by referring physicians and may have the potential for enhancing their practice and improving patient care and highlight the critical role of multimedia technologies to provide real-time multimode interactivity in current medical care. PMID:27294118

Characteristics of place identity as part of professional identity development among pre-service teachers

NASA Astrophysics Data System (ADS)

Gross, Michal; Hochberg, Nurit

2016-12-01

How do pre-service teachers perceive place identity, and is there a connection between their formative place identity and the development of their professional teaching identity? These questions are probed among pre-service teachers who participated in a course titled "Integrating Nature into Preschool." The design of the course was based on a multidimensional teaching model that yields a matrix of students' perceptions and the practical aspects derived from them as the students undergo a range of experiences in the course of an academic year. The profile of perceptions uses a mixed-methods analysis that presents statements attesting to four indicators of place identity: familiarity, belonging, involvement, and meaningfulness. These indicators point to a broad spectrum of perceptions arrayed on a continual time axes as well as differences in perception and its complexity. A connection between the development of place identity and that of professional teaching identity is found.

Nonplanar wing load-line and slender wing theory

NASA Technical Reports Server (NTRS)

Deyoung, J.

1977-01-01

Nonplanar load line, slender wing, elliptic wing, and infinite aspect ratio limit loading theories are developed. These are quasi two dimensional theories but satisfy wing boundary conditions at all points along the nonplanar spanwise extent of the wing. These methods are applicable for generalized configurations such as the laterally nonplanar wing, multiple nonplanar wings, or wing with multiple winglets of arbitrary shape. Two dimensional theory infers simplicity which is practical when analyzing complicated configurations. The lateral spanwise distribution of angle of attack can be that due to winglet or control surface deflection, wing twist, or induced angles due to multiwings, multiwinglets, ground, walls, jet or fuselage. In quasi two dimensional theory the induced angles due to these extra conditions are likewise determined for two dimensional flow. Equations are developed for the normal to surface induced velocity due to a nonplanar trailing vorticity distribution. Application examples are made using these methods.

Cell separation: Terminology and practical considerations

PubMed Central

Tomlinson, Sophie; Yang, Xuebin B; Kirkham, Jennifer

2013-01-01

Cell separation is a powerful tool in biological research. Increasing usage, particularly within the tissue engineering and regenerative medicine communities, means that researchers from a diverse range of backgrounds are utilising cell separation technologies. This review aims to offer potential solutions to cell sorting problems and to clarify common ambiguities in terminology and experimental design. The frequently used cell separation terms of ‘purity’, ‘recovery’ and ‘viability’ are discussed, and attempts are made to reach a consensus view of their sometimes ambiguous meanings. The importance of appropriate experimental design is considered, with aspects such as marker expression, tissue isolation and original cell population analysis discussed. Finally, specific technical issues such as cell clustering, dead cell removal and non-specific antibody binding are considered and potential solutions offered. The solutions offered may provide a starting point to improve the quality of cell separations achieved by both the novice and experienced researcher alike. PMID:23440031

Is Sugar the new Tobacco? Insights from Laboratory Studies, Consumer Surveys and Public Health.

PubMed

Le Bodo, Yann; Paquette, Marie-Claude; Vallières, Maggie; Alméras, Natalie

2015-03-01

In the Americas, mean energy intake from added sugar exceeds recent World Health Organization recommendations for free sugars in the diet. As a leading contributor to this excess, sugar-sweetened beverage (SSB) overconsumption represents a risk for the population's health. This article provides an overview of clinical and epidemiological evidence, marketing practices, corporate influence and prevention strategies related to added sugar and SSB. For each aspect of this multidimensional profile, we briefly compare SSB to the case of tobacco pointing to similarities but also major differences. Tobacco control has demonstrated the effectiveness of long term multifaceted prevention strategies in multiple settings supported by strong public policies which may be applied to the consumption of SSB. However, translating these policies to the specific case of SSB is urgently needed, to inform preventive actions, decide which intervention mix will be used, and evaluate the process and impact of the chosen strategy.

Introduction: From "The Popularization of Science through Film" to "The Public Understanding of Science".

PubMed

Vidal, Fernando

2018-03-01

Science in film, and usual equivalents such as science on film or science on screen, refer to the cinematographic representation, staging, and enactment of actors, information, and processes involved in any aspect or dimension of science and its history. Of course, boundaries are blurry, and films shot as research tools or documentation also display science on screen. Nonetheless, they generally count as scientific film, and science in and on film or screen tend to designate productions whose purpose is entertainment and education. Moreover, these two purposes are often combined, and inherently concern empirical, methodological, and conceptual challenges associated with popularization, science communication, and the public understanding of science. It is in these areas that the notion of the deficit model emerged to designate a point of view and a mode of understanding, as well as a set of practical and theoretical problems about the relationship between science and the public.

Atmospheric, Magnetospheric, and Plasmas in Space (AMPS) spacelab payload definition study, technical summary document

NASA Technical Reports Server (NTRS)

Keeley, J. T.

1976-01-01

Some 60 instrument candidates and 80 possible science investigations were evaluated. The early analysis emphasized the science aspect in terms of the functional requirements for each of the potential experiments identified by the AMPS science working group. These requirements were then used for the grouping of instruments into practical payloads which would fit the capabilities of the Shuttle/Spacelab. This analysis resulted in the definition of eleven different AMPS configurations. The data were then used to define a typical set of requirements for a flexible AMPS laboratory. The data gathered to this point showed that a planned sequential buildup of the laboratory would be necessary to meet both physical and funding limitations. This led to the definition of five strawman payloads by the science working group, which were used to establish a conceptual laboratory and to define preliminary design of a configuration which could satisfy AMPS needs during the early program period.

The World Trade Center Attack Disaster preparedness: health care is ready, but is the bureaucracy?

PubMed Central

Mattox, Kenneth

2001-01-01

When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness. PMID:11737919

The World Trade Center attack. Disaster preparedness: health care is ready, but is the bureaucracy?

PubMed

Mattox, K

2001-12-01

When a disaster occurs, it is for governments to provide the leadership, civil defense, security, evacuation, and public welfare. The medical aspects of a disaster account for less than 10% of resource and personnel expenditure. Hospitals and health care provider teams respond to unexpected occurrences such as explosions, earthquakes, floods, fires, war, or the outbreak of an infectious epidemic. In some geographic locations where natural disasters are common, such as earthquakes in Japan, such disaster practice drills are common. In other locations, disaster drills become pro forma and have no similarity to real or even projected and predicted disasters. The World Trade Center disaster on 11 September 2001 provides new information, and points out new threats, new information systems, new communication opportunities, and new detection methodologies. It is time for leaders of medicine to re-examine their approaches to disaster preparedness.

[National Policy of Humanization and education of health care professionals: integrative review].

PubMed

Barbosa, Guilherme Correa; Meneguim, Silmara; Lima, Silvana Andréa Molina; Moreno, Vania

2013-01-01

The National Policy of Humanization aims at innovations in health production, management and care with emphasis on permanent education for workers in the Unified Public Health System and training of university students in the health care field. This study aimed to know, through an integrative review of the literature, the scientific production about the National Policy of Humanization and education of health care professionals, from 2002 to 2010. Ten articles were analyzed in thematic strand through three axes: humanization and users caring, humanization and the work process, humanization and training. The articles point to the need to overcome the biological conception, valuing cultural aspects of users. The work process is marked by the devaluation of workers and by users deprived of their rights. The training of health professionals is grounded in health services where the prevailing standards are practices that hinder innovative attitudes.

On-Line Robust Modal Stability Prediction using Wavelet Processing

NASA Technical Reports Server (NTRS)

Brenner, Martin J.; Lind, Rick

1998-01-01

Wavelet analysis for filtering and system identification has been used to improve the estimation of aeroservoelastic stability margins. The conservatism of the robust stability margins is reduced with parametric and nonparametric time- frequency analysis of flight data in the model validation process. Nonparametric wavelet processing of data is used to reduce the effects of external disturbances and unmodeled dynamics. Parametric estimates of modal stability are also extracted using the wavelet transform. Computation of robust stability margins for stability boundary prediction depends on uncertainty descriptions derived from the data for model validation. The F-18 High Alpha Research Vehicle aeroservoelastic flight test data demonstrates improved robust stability prediction by extension of the stability boundary beyond the flight regime. Guidelines and computation times are presented to show the efficiency and practical aspects of these procedures for on-line implementation. Feasibility of the method is shown for processing flight data from time- varying nonstationary test points.

Modifying autonomy--a concept grounded in nurses' experiences of moral decision-making in psychiatric practice.

PubMed Central

Lützén, K; Nordin, C

1994-01-01

Fourteen experienced psychiatric nurses participated in a pilot study aimed at describing the experiential aspect of making decisions for the patient. In-depth interviews focused on conflicts, were transcribed, coded, and categorized according to the Grounded Theory method. The theoretical construct, 'modifying autonomy' and its dimensions, such as being aware of the patient's vulnerability, caring for and caring about the patient, were identified. The findings in this study make clear the need for further research into the experiential aspect of ethical decision-making in psychiatric practice. PMID:8083870

Application of Strategic Management Principles as Tool to Improve Quality of Construction Technological Process

NASA Astrophysics Data System (ADS)

Kluchnikova, O.; Pobegaylov, O.

2017-11-01

The article focuses on the basic theory and practical aspects of the strategic management improving in terms of enhancing the quality of a technological process: these aspects have been proven experimentally by their introduction in company operations. The authors have worked out some proposals aimed at the selection of an optimal supplier for building companies as well as the algorithm for the analysis and optimization of a construction company basing on scientific and practical research as well as on the experimental data obtained in the experiment.

Gossip, stories and friendship: confidentiality in midwifery practice.

PubMed

James, S

1995-12-01

Women often seek midwifery care as an alternative to the maternity services that are readily available within the insured health care system in Alberta. Some aspects of community-based, primary care midwifery in Alberta that characterize this alternative are the use of story-telling as a form of knowledge, the development of social connections among women seeking midwifery care, and nonauthoritarian relationships between midwives and women. In this paper, the concept of confidentiality, as it relates to these aspects of midwifery practice, is explored, using traditional, caring and feminist models of ethics.

Nine steps towards a better water meter management.

PubMed

Arregui, F J; Soriano, J; Cabrera, E; Cobacho, R

2012-01-01

The paper provides a comprehensive perspective of the critical aspects to be taken into account when planning the long-term management of water meters in a utility. In order to facilitate their quick understanding and practical implementation, they have been structured into nine steps. Ranging from an initial audit up to the final periodic meter replacement planning, these steps cover three aspects of the problem - field work, laboratory work and management tasks; and each one is developed in detail paying attention to the particular data needed and noting the practical outcome it will yield.

The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark

PubMed Central

Assing Hvidt, Elisabeth; Søndergaard, Jens; Ammentorp, Jette; Bjerrum, Lars; Gilså Hansen, Dorte; Olesen, Frede; Pedersen, Susanne S.; Timm, Helle; Timmermann, Connie; Hvidt, Niels Christian

2016-01-01

Objective The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP–patient encounter. Design A qualitative methodology with semi-structured focus group interviews was employed. Setting General practice setting in Denmark. Subjects Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews. Results Although understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains. Conclusion GPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients’ multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. Key pointsAlthough integration of the existential dimension is recommended for patient care in general practice, little is known about GPs’ understanding and integration of this dimension in the GP–patient encounter.The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects.The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient symptoms occur. Integration of the existential dimension happens in unsystematic and intuitive ways.Cultural barriers such as shyness and lack of existential self-awareness seem to hinder GPs in communicating about issues related to the existential dimension. Educational initiatives might be needed in order to lessen barriers and enhance a more natural integration of communication about existential issues. PMID:27804316

Making Space for Innovative Practice Supporting Teaching and Learning through Integrating Online Peer-to-Peer Feedback between Geographically Separated Students

ERIC Educational Resources Information Center

Kim, Cathleen K. H.

2017-01-01

This dissertation is comprised of three linked studies investigating integrating online feedback practices into traditional classrooms. It focuses on one innovative practice, that of online peer-to-peer feedback, and highlights aspects of the process of developing this practice in each article. Each article relies on separate but connected…

Situated Literacy Practices Amongst Artisans in the South West of Nigeria: Developmental and Pedagogical Implications

ERIC Educational Resources Information Center

Ade-Ojo, Gordon O.

2012-01-01

This paper reports an aspect of a larger study on literacy practices, needs and perceptions of artisans in a part of the South West region of Nigeria. Using an ethnographic approach to research, it identified a variety of literacy practices, events and mediums, thus confirming the notion of literacy as social practice. The study employed a…

A study of the mechanism of thigmomorphogenesis in plants, with special reference to the role of ethylene and its significance to research with plants in space

NASA Technical Reports Server (NTRS)

Jaffe, M. J.

1979-01-01

Because of the paucity of data concerning thigmomorphogenesis, all aspects of the phenomenon were under study, although the role of ethylene mediation was central to the approach. Although this report must necessarily point to a specific time in ongoing research, several aspects of the study reached at least temporary stopping points and were therefore written and submitted for publication. These are identified. Other papers which are currently in preparation, but not yet submitted, are also identified. The phenomenon of thigmomorphogenesis is divided into the sensory function, transduction step(s) and the response function.

A Coarse Pointing Assembly for Optical Communication

NASA Technical Reports Server (NTRS)

Szekely, G.; Blum, D.; Humphries, M.; Koller, A.; Mussett, D.; Schuler, S.; Vogt, P.

2010-01-01

In the framework of a contract with the European Space Agency, RUAG Space are developing a Coarse Pointing Assembly for an Optical Communication Terminal with the goal to enable high-bandwidth data exchange between GEO and/or LEO satellites as well as to earth-bound ground stations. This paper describes some development and testing aspects of such a high precision opto-mechanical device, with emphasis on the influence of requirements on the final design, the usage of a Bearing Active Preload System, some of the lessons learned on the BAPS implementation, the selection of a flex print design as rotary harness and some aspects of functional and environmental testing.

Aspects of seasonality.

PubMed

Battey, N H

2000-11-01

The seasons are astronomical, astrological, meteorological, biological, and agricultural. From a perspective outside the biological sciences, the questions of interest about plant seasonality are linked to this wider context. In this review I try to see flowering time, as one important aspect of seasonality, from an outsider's point of view, and describe what is known about it in different types of plants. What is known about it is conditioned by what particular scientists have asked about it, so the variety of approaches to seasonality is another point of emphasis. Detailed consideration is given to flowering seasonality in perennials compared with annuals, and both molecular and whole plant perspectives are presented.

The philosophical aspects of hate crime and hate crime legislation: introducing the special section on the philosophy of hate crime.

PubMed

Brax, David; Munthe, Christian

2015-06-01

In this introduction to the special symposium on the philosophy of hate crime, we provide an overview of the main philosophical aspects of hate crime and hate crime legislation. We point out that there are two overarching philosophical issues that span over the literature: the Conceptual Question--concerning what hate crime is--and the Normative Question--concerning the status of hate crimes and the justification of hate crime legislation. We also provide brief summaries of the articles in the special section and point to their relations to the broader themes. © The Author(s) 2014.

Correlation Function Approach for Estimating Thermal Conductivity in Highly Porous Fibrous Materials

NASA Technical Reports Server (NTRS)

Martinez-Garcia, Jorge; Braginsky, Leonid; Shklover, Valery; Lawson, John W.

2011-01-01

Heat transport in highly porous fiber networks is analyzed via two-point correlation functions. Fibers are assumed to be long and thin to allow a large number of crossing points per fiber. The network is characterized by three parameters: the fiber aspect ratio, the porosity and the anisotropy of the structure. We show that the effective thermal conductivity of the system can be estimated from knowledge of the porosity and the correlation lengths of the correlation functions obtained from a fiber structure image. As an application, the effects of the fiber aspect ratio and the network anisotropy on the thermal conductivity is studied.

Incoherent imaging of radar targets

NASA Astrophysics Data System (ADS)

van Ommen, A.; van der Spek, G. A.

1986-05-01

Theory suggests that, if a target can be modeled as a rigid constellation of point scatterers, the RCS pattern over a certain aspect change can be used to produce a one-dimensional image. The results for actual measured RCS patterns, however, are not promising. This is illustrated by processing on 4 s of echo data obtained from a Boeing 737 in straight flight, during which its aspect change is 2 deg. The conclusion might be that, for the application considered, aircraft cannot be modeled as a rigid constellation of point scatterers; this is partly due to the treatment of a three-dimensional target as a line target.

Graphic and cultural aspects of pictograms: an information ergonomics viewpoint.

PubMed

Spinillo, Carla Galvão

2012-01-01

The use of pictograms is discussed considering their information content, graphic complexity and cultural dimension. The resemblance and the illusion theories are highlighted to define pictogram as a salience-based representation system, which communicational efficacy depends upon historical and cultural aspects in their interpretation. Thus, the competence in interpreting pictograms is considered relative to users' acquaintance with the pictorial system and with the referents. Pictogram as a general/neutral visual statement is questioned, pointing out the cultural and gender attributes added to pictures to represent people, professions and social events. As a result of this discussion, some critical points of the standardization of pictograms are presented.

The (lack of) relation between straylight and visual acuity. Two domains of the point-spread-function.

PubMed

van den Berg, Thomas J T P

2017-05-01

The effect of cataract and other media opacities on functional vision is typically assessed clinically using visual acuity. In both clinical and basic research, straylight (the functional result of light scattering in the eye) is commonly measured. The purpose of the present study was to determine the link between these two measures: is visual acuity in cataract and other media opacities related to straylight? Interdependence between acuity and straylight is addressed from three different points of view: (1) Methodological: can acuity differences affect the measurement value of straylight, and vice versa? (2) Basic optics: does the optical process of light scattering in the human eye affect both straylight and visual acuity? (3) Statistical: how strongly are acuity and straylight correlated in the practice of important clinical conditions? Experimental and theoretical aspects will be considered, with a focus on normal ageing and cataract formation. (1) Methodological: testing potential effects of acuity, artificially manipulated with positive trial lenses, showed no effect on measured straylight values. Since light scattering in the eye involves a low percentage of the light and has large angular spreading, contrast reduction due to straylight is limited, resulting in virtually absent acuity effects. (2) Basic optics: light scattering from the human donor eye lens is found to have virtually no effect in the centre of the point-spread-function, also for cataractous lenses, resulting in virtually absent acuity effects. (3) Statistical: literature data on straylight and visual acuity show a weak correlation for the important groups of normal ageing and cataract populations. The point-spread-function of the normal ageing and cataractous human eye is built upon two rather independent basic parts. Aberrations control the central peak. Light scattering controls the periphery from about 1° onwards. The way acuity and straylight are measured ensures no confounding between them. Statistically within the normal ageing and cataract populations, visual acuity and straylight vary quite independently from each other. Visual acuity losses with cataract and other media opacities are not due to straylight, but caused by aberrations and micro-aberrations. Straylight defines disability glare, and causes symptoms of glare, haloes, hazy vision etc. Overall, visual acuity and straylight are rather independent aspects of quality of vision. © 2017 The Author Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Anatomy of point-contact Andreev reflection spectroscopy from the experimental point of view

NASA Astrophysics Data System (ADS)

Naidyuk, Yu. G.; Gloos, K.

2018-04-01

We review applications of point-contact Andreev-reflection spectroscopy to study elemental superconductors, where theoretical conditions for the smallness of the point-contact size with respect to the characteristic lengths in the superconductor can be satisfied. We discuss existing theoretical models and identify new issues that have to be solved, especially when applying this method to investigate more complex superconductors. We will also demonstrate that some aspects of point-contact Andreev-reflection spectroscopy still need to be addressed even when investigating ordinary metals.

Thin-film module circuit design: Practical and reliability aspects

NASA Technical Reports Server (NTRS)

Daiello, R. V.; Twesme, E. N.

1985-01-01

This paper will address several aspects of the design and construction of submodules based on thin film amorphous silicon (a-Si) p i n solar cells. Starting from presently attainable single cell characteristics, and a realistic set of specifications, practical module designs are discussed from the viewpoints of efficient designs, the fabrication requirements, and reliability concerns. The examples center mostly on series interconnected modules of the superstrate type with detailed discussions of each portion of the structure in relation to its influence on module efficiency. Emphasis is placed on engineering topics such as: area coverage, optimal geometries, and cost and reliability. Practical constraints on achieving optimal designs, along with some examples of potential pitfalls in the manufacture and subsequent performance of a-Si modules are discussed.

The significance of routines in nursing practice.

PubMed

Rytterström, Patrik; Unosson, Mitra; Arman, Maria

2011-12-01

The aim of this study was to illuminate the significance of routines in nursing practice. Clinical nursing is performed under the guidance of routines to varying degrees. In the nursing literature, routine is described as having both negative and positive aspects, but use of the term is inconsistent, and empirical evidence is sparse. In the research on organisational routines, a distinction is made between routine as a rule and routine as action. A qualitative design using a phenomenological-hermeneutic approach. Data collection from three focus groups focused on nurses' experience of routines. Seventeen individual interviews from a previous study focusing on caring culture were also analysed in a secondary qualitative analysis. All participants were employed as 'qualified nursing pool' nurses. Routines are experienced as pragmatic, obstructive and meaningful. The aim of the pragmatic routine was to ensure that daily working life works; this routine is practised more on the basis of rational arguments and obvious intentions. The obstructive routine had negative consequences for nursing practice and was described as nursing losing its humanity and violating the patient's integrity. The meaningful routine involved becoming one with the routine and for the nurses, it felt right and meaningful to adapt to it. Routines become meaningful when the individual action is in harmony with the cultural pattern on which the nursing work is based. Instead of letting contemporary practice passively become routine, routines can be assessed and developed using research and theoretical underpinnings as a starting point for nursing practice. Leaders have a special responsibility to develop and support meaningful routines. One approach could be to let wards examine their routines from a patient perspective on the basis of the themes of pragmatic, meaningful and obstructive routine. © 2010 Blackwell Publishing Ltd.

A service model for delivering care closer to home.

PubMed

Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

2011-04-01

Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

Effectiveness of multimedia-supported education in practical sports courses.

PubMed

Leser, Roland; Baca, Arnold; Uhlig, Johannes

2011-01-01

Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn't affect the learning effects. Key pointsMultimedia-assisted learning showed no positive learning effects on technical skills in soccer.Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer.Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects.

Effectiveness of Multimedia-Supported Education in Practical Sports Courses

PubMed Central

Leser, Roland; Baca, Arnold; Uhlig, Johannes

2011-01-01

Multimedia-assisted teaching and learning have become standard forms of education. In sports, multimedia material has been used to teach practical aspects of courses, such as motor skills. The main goal of this study is to examine if multimedia technology impacts learning in the field of sport motor skill acquisition. This question was investigated during a practical sports education course involving 35 students who participated in a university soccer class. The whole course was split into two groups: Group A was taught traditionally with no assistance of multimedia and Group B was prepared with multimedia-assisted instructional units. To quantify selected skills of soccer technique and tactic, the test subjects performed a specific passing test and a tactical assessment. Furthermore, a ques-tionnaire was used to assess the subjective impressions of the test subjects. All testing instruments were applied before and after a six-week-long teaching period. A comparison of the gathered data between the two groups resulted in no significant differences, neither concerning the results of the technique test nor concerning the tactic test. However, the results of the ques-tionnaire showed a positive agreement among the participants in the usability and assistance of multimedia for the sports practical course. Considering the reviewed conditions, it can be concluded that the use of multimedia content doesn’t affect the learning effects. Key points Multimedia-assisted learning showed no positive learning effects on technical skills in soccer. Multimedia-assisted learning showed no positive learning effects on tactical skills in soccer. Students participating in practical sports courses have very good attitudes towards the use of multi-media learning material. This may be considered for motivational effects. PMID:24149313

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

PubMed

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

2017-05-01

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

Nanoparticle agglomeration in an evaporating levitated droplet for different acoustic amplitudes

NASA Astrophysics Data System (ADS)

Tijerino, Erick; Basu, Saptarshi; Kumar, Ranganathan

2013-01-01

Radiatively heated levitated functional droplets with nanosilica suspensions exhibit three distinct stages namely pure evaporation, agglomeration, and finally structure formation. The temporal history of the droplet surface temperature shows two inflection points. One inflection point corresponds to a local maximum and demarcates the end of transient heating of the droplet and domination of vaporization. The second inflection point is a local minimum and indicates slowing down of the evaporation rate due to surface accumulation of nanoparticles. Morphology and final precipitation structures of levitated droplets are due to competing mechanisms of particle agglomeration, evaporation, and shape deformation. In this work, we provide a detailed analysis for each process and propose two important timescales for evaporation and agglomeration that determine the final diameter of the structure formed. It is seen that both agglomeration and evaporation timescales are similar functions of acoustic amplitude (sound pressure level), droplet size, viscosity, and density. However, we show that while the agglomeration timescale decreases with initial particle concentration, the evaporation timescale shows the opposite trend. The final normalized diameter can be shown to be dependent solely on the ratio of agglomeration to evaporation timescales for all concentrations and acoustic amplitudes. The structures also exhibit various aspect ratios (bowls, rings, spheroids) which depend on the ratio of the deformation timescale (tdef) and the agglomeration timescale (tg). For tdef

Control Points in School Business Management, Presenting General Observations, Specific Control Points, and a Series of Checkpoints for the Practicing School Business Administrator.

ERIC Educational Resources Information Center

Association of School Business Officials, Chicago, IL.

This revised outline of a 1962 address contains general guidelines considered still useful for practicing school business administrators. Introductory "general observations" and a preamble give advice about good personal qualities, policy and planning practices, and relations with school boards, community, staff, and fellow professional…

How to Fail in Private Practice: 13 Easy Steps.

ERIC Educational Resources Information Center

Hines, Max H.

1988-01-01

Uses satire to broach the topic of counseling aspects of how to succeed (at failure) in establishing and maintaining a private practice as a counselor. Thirteen mistakes counselors can make are listed and discussed. (NB)

The Mentoring Experience.

ERIC Educational Resources Information Center

Longhurst, Mark F.

1994-01-01

Dialogue with Canadian family practice faculty and teachers indicates that the mentorship experience is one that cannot be assigned to a learner. Examines aspects of a mentorship that can be ascribed and explored in a family practice residency training program. (LZ)

Knowledge, attitude and practice of aspects of laboratory safety in Pathology Laboratories at the University of Port Harcourt Teaching Hospital, Nigeria.

PubMed

Ejilemele, A A; Ojule, A C

2005-12-01

To assess current knowledge, attitudes and practice of aspects of laboratory safety in pathology laboratories at the University of Port Harcourt Teaching Hospital in view of perceived inadequacies in safety practices in clinical laboratories in developing countries. Sixty (60) self- administered questionnaires were distributed to all cadres of staff in four (4) different laboratories (Chemical Pathology, Haematology, Blood bank and Medical Microbiology) at the Hospital. Gross deficiencies were found in the knowledge, attitudes and practice of laboratory safety by laboratory staff in areas of use of personal protective equipment, specimen collection and processing, centrifuge--related hazards, infective hazards waste disposal and provision and use of First Aid Kits. Issues pertaining to laboratory safety are not yet given adequate attention by both employers and employees in developing countries in this ear of resurgence of diseases such as HIV/AIDS and Hepatitis Band C, is emphasized.